ON Ponasang Mission Hospital, FOOCHOW, CHINA, BY H. T. WHITNEY, M. D. Physician in Charge. January 2, 1897, Foochow Mission held its jubilee, celebrating the fiftieth anniversary of the beginning of mission work in Foochow. The medical work, of course, received a due share of attention, and a brief resumé of the twenty-seven years of the Ponasang work may be of interest to the readers of the FORTNIGHTLY: The medical work at Ponasang was begun in 1870 by Dr. D. W. Osgood. The first years were naturally difficult owing to the prejudices of the people against both foreigners and foreign medicines; and also the poor accommodations and inadequate facilities for carrying on medical work. But Dr. Osgood was a strong, energetic New Hampshire man and a worthy representative of the old Granite State. By patient perseverance he overcame many difficulties, and developed what was then considered a large medical work. The first eight years of his dispensary work was carried on mostly at Hapuoka, fifteen minutes walk from Ponasang. The hospital work was confined to a small native building-afterward used for several years as an asylum for the cure of the opium habit. In 1878, through the the generous help of the foreign community of Foochow, he was able to erect a new hospital capable of accommodating about sixty patients. With this improved condition his work assumed a new aspect, and soon became only second to any medical work in China at that time. Under Dr. Osgood's wise management the work continued to grow and extend its influence over a large portion of the province. In August, 1880, he was taken sick and died at Sharp Peak. He was buried in the American cemetery at Foochow. After Dr. Osgood's death the writer took charge of the work until nearly the close of 1888, except while home on furlough and one winter spent in Shaowo, during which time Drs. Adam and Rennie_made weekly visits to the hospital while Dr. C. C. Baldwin and Rev. G. H. Hubbard respectively had the general care of the work. Near the end of 1889 Dr. H. N. Kinnear arrived and carried on the work until March, 1896. The good condition in which Dr. Osgood left the work has continued, with few exceptions, and the work has gradually increased both in the hospital and dispensary, reaching as high as 600 inpatients in a year, and over 14,000 outpatients including return visits. The influence for good of such a work it is impossible to estimate, and no attempt will be made. The one great regret the writer feels in all this twenty-seven years of labor is, that the training of Chinese medical students has been so limited. One of the main objects of our work in China is to develope the science of medicine and train young men and women who can carry on and extend the work after we are gone. It is, therefore, earnestly hoped that there will be considerable improvement along this line in the near future. As to the work of the past year: On the departure of Dr. Kinnear and family, in April, 1896, for a furlough to the United States, the writer was asked to take charge of the work during his absence. Living at Pagoda Anchorage, ten miles away, and having charge of other work in the Tiongloh District, it was impracticable to make more than weekly visits to Ponasang. But as there was one competent assistant and two good student assistants, the hospital and dispensary work went on as usual, with the exception of major surgery, and we are able to report a successful year. The old and return cases were somewhat less, but the new cases were more, and the hospital patients between 50 and 60 per cent more than the previous year. There was a slight increase, also, in the amount of surgery, notwithstanding no major work was done. This is gratifying, as showing the confidence the people had in the native assistants. The inpatients averaged from fifteen to thirty per month during most of the year, and the outpatients from fifteen to twenty per day. Dispensing was conducted every day but Sundays. Each morning, when changing the dressings of the inpatients, a good many outpatients would be in waiting and received treatment, as the dispensary is in the same building and comparatively convenient. In this way several thousands were treated, besides those at the regular clinics. A great many women attended the clinics, and 1843 were treated during the year. Among the hospital patients twenty were cured of the opium habit in connection with their other treatment. During the years from its establishment to and including 1896, the hospital has treated a grand total of 227,982 patients. Its prospects and opportunities were never better than at present. With increasing equipment and facilities for handling patients, we may say that Ponasang's past is but a hint of what we expect it to be in the future. THE OFFICIAL ROUTE.- Physicians who contemplate attending the meeting of the Mississippi Valley Medical Society, will consult their best interests by selecting the Henderson Route to Louisville. Double daily service, through sleepers and reduced rates. Ask C. H. Jones about it, at 206 N. Broadway. COLORADO has already fulfilled the pledge for $2,000 contribution to the Rush Monument Fund, made by Dr. Graham at the meeting of the American Medical Association at Philadelphia. At the meeting of the State Medical Society, June 15, the full sum pledged by Dr. Graham was immediately raised by individual subscriptions offered most generously and with great enthusiasm. THE PRINCE OF WALES is now a member of the medical profession. On July 19 he was formally created an honorary fellow of the Royal College of Physicians of London, and after taking the required oath, was presented with a diploma of the college. The Prince of Wales is a great worker for the hospitals of London, and has always been considered an especially good friend of the Medical profession. MEDICAL SCHOOLS IN DENVER.-The supreme court of the State of Colorado has forbidden the University of Colorado from carrying on any medical department in Denver, because the constiution locates the universtiy itself at Boulder. In consequence of this the members of the faculty resident in Denver have resigned, and most of them have united with the medical department of the University of Denver. WHY THEY GROW RICH-Physicians are said to average only $1,500 per year in New York, and the reason may be found in these statistics: There are 114 dispensaries and 26 hospitals in New York County. In the 26 hospitals, in the year 1895, 75, 368 patients were treated free, and in the dispensaries 661,803, making a total of 737,171. This is a goodly proportion out of a 1,851,000 populaton-nearly 40 per cent. There have been 92,529 free visits of patients to hospitals, and 1,387,170 free visits of patients to dispensaries. In attendance upon the 114 dispensaries in 1895 were 949 medical men, which is 27 per cent. of all the physicans in the city, who number 3,430. Here we have more than 1,500,000 free visits and more than 1,000,000 free prescriptions, and more than one-quarter of all the physicians in the city of New York engaged in treating the population free of charge.-The Engineer. I The Antitoxin Treatment of Diphtheria A Symposium. A Report on the Use of Antitoxine. BY E. H. TROY, M. D. DETROIT, MICH. SAW a case of laryngeal diphtheria in a child four years old, who was convalescing from a severe attack of erysipelas, of seven weeks' duration. When I discovered the laryngeal membrane I gave her 1000 units of Parke, Davis & Co's antitoxine, and called Dr. Miner, one of the leading laryngologists of Detroit. This was at 3 o'clock P. M.; at 1o A. M., following day, I gave her 750 units, and again at 3 A. M. following I gave her 1500 units, and in an hour afterwards she was intubated. She made a complete but very protracted recovery. The results in one case prove nothing, and this was the only desperate case I have seen. Was my treatment right? I had diphtheria myself, and used doses from 500 to 1500 units to note effects. After injecting small doses I felt a mild, stimulating and somewhat pleasant sensation. The feeling of soreness in the throat was relieved. Larger doses gave increased relief, and for longer time. Previously I treated a rapidly fatal case of pulmonary tuberculosis. Temperature was high, rigors marked and sweating copious. I believed other toxins than tubercular caused these symptoms. After dicussing the case with Dr. Ingliss, we concluded to try antitoxine on general principles. The symptoms were modified, and the patient felt better. Something like tonic in effect, although the disease progressed as before. For these reasons I believe I would get the same benefit from antitoxine in case cited, although exhaustion was caused by erysipelas. The therapeutics of antitoxine will in all probability have to be worked out clinically, hence full notes of cases with results of microscopical examination, and repeated analyses of urine, would be of value. The method adopted by Parke, Davis & Co., of using guinea pigs to test strength of antitoxine, gives a very reliable antitoxine, and with good clinical reports, two quantities in the equation will be available. The larger amount of antitoxine is obtained from the cellular tissue of the blood (probably the colorless corpuscles), as is shown by preparing the antitoxin from the freshly drawn blood, or from blood allowed to stand in "cooling chamber" for some hours, allowing corpuscle to break down. So if the physiologist can determine the function of the parts of the blood, we may soon know "what antitoxine does." The preceding papers of this series appeared as follows: Dr. Solis-Cohen, April 1; Dr. Floyd Crandall, April 15; Dr. Edwin Rosenthal, May 15; Dr. Dillon Brown, June 1; Dr. Jacob R. Johns, June 15; Dr. Given Campbell, July 1; Dr. R. Brent Murphy, July 15; Dr. Jos. H. Lopez, August 2; Dr. Wm. Flitcroft, Sept. 15. COMPRISING THE REGULAR CONTRIBUTIONS OF THE FORTNIGHTLY DEPARTMENT STAFF. DISEASES OF THE RECTUM-Daniel OBSTETRICS-R. B. Murphy, M. D. LONDON CORRESPONDENT — R. CHICAGO CORRESPONDENT-Geo. T. GYNECOLOGY BY JOSEPHINE MILLIGAN, M. D., JACKSONVILLE, ILL. Treatment of Puerperal Sepsis with Antistreptococcic Serum.-(From the American Journal of Obstetrics, Vol. xxxv, No. 5.) Dr. Barton Cooke Hirst reports three cases of puerperal sepsis in which Marmorek's antistreptococcic serum was used, The first case did not improve. The second case grew worse, and died after having received 30 cubic centimetres on three successive days. In the third case directly after the administration of 5 cubic centimetres on two successive days, the temperature rose a degree or two, there was profuse sweating, and the pulse was 160, irregular and weak, but within twenty-four hours after the second injection the temperature dropped to normal and stayed there, at the same time pus was discharged par vaginam, and probably was the cause of the improvement. Dr. Richard C. Norris reports one case of sepsis with pseudo-diphtheritic exudate on lacerated cervix and perineum, and after ordinary methods failed to improve the condition, ten cubic centimetres of Marmorek's serum were injected; improvement followed within twelve hours; in temperature, and pulse, and the exudate disappeared. Within six days, 40 cubic centimetres were given, and the patient was doing well, when facial erysipelas developed. The patient had had nine attacks of erysipelas, during eleven years, but the last attack occurred two years before the present confinement. On the hypothesis that the immunity given by the serum had worn out, the doses were repeated (five cubic centimetres), twice daily, were given, with a resulting cure by lysis, instead of the usual crisis in such cases. Dr. George Erety Shoemaker reports a case of septicemia from selfinduced abortion that was treated with Marmorek's serum. Two doses were given, the first ten, the second five cubic centimetres. One and onehalf hours after the first dose, the patient suffered from a papular eruption with intense itching. No other apparent effects from the serum. Patient died suddenly with uremic symptoms. |