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President Elliot was called upon to respond to a toast to Harvard University. He said it gave the representatives of the university great pleasure to extend its greeting to this the strongest professional body in the country, and then entered upon a very humorous delineation of a disease peculiar to Harvard students. For symptoms of the same we must refer our readers to the reports published in the daily papers.
Dr. D. Humphrey Storer was called upon to speak in memory of the dead. His sententious and eloquent eulogies framed such striking portraits that only the few failed to recognize Jacob Bigelow, J. B. S. Jackson, and W. W. Comstock.
The chairman alluded to the absence of Dr. Bowditch, regretting the cause of his detention. Dr. Amory then read an earnest and characteristic letter of greeting from Dr. Bowditch, after which Dr. Wainwright responded happily for the Connecticut State Medical Society.
Surgeon Head responded for the United States army in interesting reminiscence.
Assistant Surgeon Stevenson briefly replied to a toast to the United States navy.
Dr. Alfred Hosmer, president of the Medico-Legal Society, made a fine response to a toast touching upon the marriage of law and medicine.
Dr. Millet, of Bridgewater, briefly responded to a sentiment to the medical profession.
We regret that space does not allow us to include the very pertinent and happy toasts of Dr. Holmes, who, though a veteran toast-master, never excelled his record of this occasion.
About six hundred and fifty gentlemen were at the tables, of whom, with but five exceptions, all were physicians.
The exercises were interspersed with excellent music by the Germania orchestra ; everything passed off satisfactorily, and this successful annual meeting will only increase anticipations of the pleasure of future meetings of the Massachusetts Medical Society.
PROCEEDINGS OF THE CONNECTICUT RIVER VALLEY MED
ICAL ASSOCIATION. A. P. RICHARDSON M. D., CORRESPONDING SECRETARY, WALPOLE, N. H. May 7, 1879. The annual meeting was held at Towne's hotel, Bellows Falls, Vt. Thirty members were present, Dr. Brooks, of Charlestown, N. H., in the chair. Epidemic Diseases. — This was the subject of the president's address, hav
- , ing particular reference to the comparative frequency and violence in the Connecticut River Valley and the region extending on either side. It was shown by Gallup's history and by the testimony of old practitioners, as well as by observation, that epidemic diseases have been much more prevalent and severe on the hills than in the valleys. The speaker was inclined to the belief that the cause was largely due to meteorological changes, there being two or more degrees' difference in the isothermal lines included in these regions. As this difference causes marked changes in the flora, it must produce a like effect
upon health and disease. As epidemic diseases are more severe on the hills than in the valley, the conclusion was reached that the former are near or at the centre of the disease realm, while the latter is on its border.
Discovery of Anæsthetics. Dr. Loveland read a paper on the history of the discovery of anæsthetics, awarding the discovery to Horace Wells, who was born in Windsor, Vt., in 1815. He studied dentistry, and was located in Hartford, Conn., at the time he discovered the anæsthetic property of nitrous oxide gas, December 11, 1844. Dr. Riggs administered the gas to Dr. Wells at this time and extracted a molar tooth. Dr. Wells devoted all his faculties to the details of his discovery, and published the results. His desire to benefit mankind overcame all pecuniary considerations. In January, 1845, Dr. Wells, in connection with his friend, Dr. Marcy, discovered the anæsthetic property of the agent generally used, namely, sulphuric ether. Dr. W. G. T. Morton, a former student of Dr. Wells, who is named in works of high authority as the discoverer, did not use any anæstbetic agent till September 30, 1846. Some of the statements contained in the paper were novel to many present, but the reader claimed that they rested on a solid foundation, he being acquainted with the mother and sister of Dr. Wells, from whom he had obtained some of the above facts.' — Dr. Allen, of White River Junction, Vt., remarked that Horace Wells deserved the honor of discovering the use of anæsthetics.
Dr. Frost said Boston was ready to take the honor, but it belonged to Wells. - Dr. Phelps remarked that while attending medical lectures at Burlington, Vt., in 1822, the idea prevailed in the class that by inhaling sulphuric ether from a saucer through a tunnel one could have a tooth extracted without pain. He did not know that any teeth were extracted under its influence.
Carcinoma of Rectum; Lumbo-Colotomy. - Dr. G. W. Hunt, of Cornish Flat, N. II., by request reported the following case: A farmer, forty-seven years old, was having five or six discharges from the bowels daily, sometimes accompanied with blood and mucus, with very little pain. Patient said that eighteen months before he had a slight attack of dysentery ; but did not have medical treatment. Since then his bowels had been slightly irregular, but he bad no trouble sufficient to hinder him from active work. Had general appearance of health, digestion good, was working as usual, but supposed he was suffering from piles. Rectal examination revealed a hard mass, three inches from sphincter muscle, filling the rectum so that it would not admit a gum catheter. Carcinoma was diagnosticated. A week later all movements from the bowels had stopped. On consultation with Drs. Phelps and Frost an operation was recommended. Dr. C. K. Briddon, of New York, was summoned by telegraph, and performed the operation as follows: The patient was etherized, and placed with face downwards, and a pillow under the abdomen. An incision five or six inches in length was made upon the left side, between the crest of the ileum and the lower rib, and midway between the crest of the ileum and the posterior processes of the third and fourth lumbar vertebræ, down by the outer side of the quadratus lumborum muscle, by a careful dissection, till the colon was revealed. The bowel was inflated through a tube in the rectum, so as to bulge somewhat into the wound, and was then transfixed by two strong liga
1 The italics are ours, as we have not space to inflict again upon our readers a statement of the facts. — ED.
tures, one and one half inches apart, carried deep through the lips of the wound, when a transverse incision was made one and one half inches long, not quite half severing the intestine. The ligatures were hooked up through the cut in the bowel and divided, thus making four sutures. A few small sutures were added between the large ones, and the artificial anus established by fine sutures around the cut of the bowel. The colon immediately discharged fæces freely, the patient rallied well, the wound healed rapidly, and the man, five months after the operation, is in comfortable health, looking after his business. He has two or three evacuations daily, with a few minutes' warning of the same. The tumor has not made rapid progress since the operation, and the patient's lease of life seems much extended.
Dr. Frost presented a model of the brain now in possession of Dartmouth College, and gave a review of the anatomy of the head; exhibited also a diagramatic representation of the function of the brain, and gave an interesting and scholarly explanation of the same.
Epithelial Cancer ; Specimen. - Dr. Rugg, of Hartland, Vt., presented specimen of cancerous uterus. The disease had run the usual course.
SUMMERS ON YELLOW FEVER.: This little work, which is dedicated to three of the author's mer students and colaborers who lost their lives in the great epidemic last summer, gives in a lucid, logical, and practical manner the writer's views, drawn from experience on the various points at issue regarding yellow fever. Ætiologically, he considers it a zymotic disease, not necessarily dependent upon a specific germ; always ushered in in any locality by a train of intensified malarial influences, which gradually glide into the specific fever; depending for its development upon atmospheric relations of heat and moisture which are favorable to sporulation of the infectious germs ; not contagious but infectious, and liable to spring up at any time in Southern latitudes indigenously, whenever the atmospheric conditions favor. This is in opposition to the more popular opinion which has been usually promulgated in our Southern States. The author bases his opinion on the preëxisting aggravation in the type of the malarial fever, which he states always ushers in the specific yellow fever, and upon the fact of its occurrence during the last epidemic in many small, isolated places, “ where there was no possible chance for the importation of the disease without knowledge on the part of the inhabitants. . ... The issues have been so fearful,” he says, “ that it is no longer expedient, nor possible, indeed, to waive the investigation of their origin. We have already too long hugged the delusive phantom of quarantine, which is as inhuman as it is un. scientific and impracticable.”
In these matters he is in accord with an increasing number of experienced physicians in the South, who believe that yellow fever is now indigenous; that for its development both“ seed and soil" are requisite; that in many places, for instance, Huntsville, Ala., Atlanta, Ga., and Nashville, Tenn., the soil
1 Yellow Fever. By Thomas O. SUMMERS, M. D., Professor of Anatomy and Histology in the University of Nashville and Vanderbilt University. Wheeler Bros. Nashville, Tenn. 1879.
does not exist, as has been shown by exposure to frequent epidemics; and that when both these factors are present quarantine is of no avail. On the other hand, last summer, in Galveston, Texas, where strict quarantine, carried to the extent of non-intercourse with infected distr prevailed, there was not a case of yellow fever, although in all former epidemics for thirty years whenever yellow fever has broken out at New Orleans it has soon after attacked Galveston, transferred presumably by vessels.
Although Dr. Summers presents his convictions on these points in strong terms, there are still many doubtful questions regarding the origin, cause, and mode of propagation of yellow fever, in answer to which it may be said that we derive little assistance from the hasty and ex parte report of the United States Yellow Fever Commission presented last autumn. The necessity for the greatest vigilance in sanitary measures is the one thing upon which all agree.
The author had good opportunities for post-mortem examinations at the city hospital in Memphis. The pathological appearances noticed were briefly as follows: Extraordinary fluidity of the blood ; great hypertrophy and softness of the spleen, which in four instances was found to be eight inches long and five inches broad; signs of entire cessation of function in the liver ; albuminous and bilirubine infarctions in the tubules and pelves of the kidneys, causing mechanical obstruction; not the slightest pathological change in the gastric walls, although twenty-eight cases presenting the greatest clinical divergence were selected. In some cases of violent black vonit the stomach was examined five minutes after death. A greenish, stringy substance, consisting of degenerated liver substance, blood corpuscles, and mucus, was found in many cases extending from the dilated gall-bladder through the bile duct and duodenum to the stomach, which was in some instances filled with a material of similar appearance, and giving the reaction for biliary coloring matter. This the author believed to be the black vomit, the excrementitious matters of bile which exude when the liver is not secreting, mixed with the fluids of the stomach and altered blood in certain cases. The yellowness of the skin was often absent, but usually a dusky violet-bluish color was observed, which later became yellow in many instances. The yellow color of the internal organs was attributed to biliverdine. The author is of the opinion that the cerebro-spinal system is primarily involved in yellow fever, and that the chief pathological fact is the entire suspension of secretion.
Clinically there is little that is new. Out of four hundred and eighty-two cases the author records two hundred and thirty-seven deaths preceded by black vomit, and thirty-nine recoveries after the occurrence of black vomit, which in some cases was copious. Most of the fatal cases were characterized by suppression of urine.
During the initial rigor a hot bath, the application of mustard to the spine and a dose of castor-oil are recominended. When the fever develops (1040-110° F.) the free use of ice externally and internally, cold spongings, etc., are necessary. The wet pack was useful. The author says, “ Water is the remedy in yellow fever," but regrets the prejudices and want of courage which interfere with the application of so rational a method for lowering the temperature.
TYPHOID FEVER IN MELBOURNE. The author finds that typhoid fever first appeared in Victoria in 1842, when it was imported by passengers from an immigrant ship, on board which the disease had prevailed, and that it has since been repeatedly introduced in the same way. He states that genuine typhoid fever is the ordinary fatal fever of Victoria, where it tends to increase in severity, and is more fatal in proportion to population than in England. The author is also quite satisfied that typhoid fever is strictly and highly contagious, and that no proper effort has been made to destroy the contagion. The tendency on the part of many writers at present is to attribute to contagion a greater share of the prevalence of typhoid fever than has previously been accepted, and we believe with good reason. Unquestionably much greater care should be exercised in the disposal and disinfection of excreta, an object not likely to be gained as long as the disease is regarded as one of slight communicability.
ROCKWELL ON ELECTRICITY.?
This little book, as its name does not imply, cannot be said to give an unbiased discussion of the place of electricity in therapeutics. As a special plea it is, however, useful, as calling attention to this important subject, and especially to the value of the so-called “general faradization ” and “central galvanization,” with which the name of the author has long been associated.
Perhaps this is all that was intended, but then it would have been far better to have omitted the “compendious text-book” chapters, at once tedious and too brief, and to have remodeled the original parts into a printed essay.
WOOD'S LIBRARY OF STANDARD AUTHORS.8
The last three volumes of this series, that of diseases of the liver, by Frerichs, the celebrated professor of clinical medicine in the University of Berlin. The work was translated into English by no less a person than the late Dr. Charles Murchison. Two such names are rarely to be found together as guarantee of the excellence of a book. Former editions of this work have already been reviewed in these pages; we will merely say here that the “library” form in no way impairs the value of it. In each volume there is a
1 Typhoid Fever in Melbourne : Its Cause and Extent. Based on the Report of an Inquiry made by Special Request of the Central Board of Health, etc. By William Thomson, F. R. C. S. Third edition revised, with Remarks on a Review of the Report. George Robertson, Melbourne, Sydney, and Adelaide. 1879.
? Lectures on Electricity in its Relations to Medicine and Surgery. By A. D. Rockwell, M. D. New York: Wm. Wood & Co. Pp. 99.
8 A Clinical Treatise on Diseases of the Liver. By DR. FRIED. THEOD. FRERICHS. In three volumes. Vol. III. Translated by CHARLES MURCHISON, M. D., F. R. C. P. New York : William Wood & Co. 1879.