that cure cannot be intelligently attempted excepting under guidance of similia similibis curantur as law," etc.

A POST-GRADUATE COURSE.

To those practicing physicians who desire to add to their store of knowledge by special study of the diseases of the eye, ear, nose and throat, is offered an especially fine postgraduate course at the Chicago Eye, Ear, Nose and Throat College of Chicago. This institution is pleasantly located in the handsome new Trude building. We cannot speak in terms which too highly commend its worthy faculty and splendid facilities for study and practical operating work. The gentlemen who compose the faculty are men well-known for their scientific understanding and treatment of this delicate class of disease, who represent the more advanced methods. The hours of instruction are from 9 a. m. to 6 p. m.

A PERFECT CO-ADJUVANT.

Physicians should uot forget that no matter what their preference may be as to the form in which milk should be used for their patients and the babies under their care, whether it is modified, sterilized, Pasteurized, peptonized, treated by some other method, or natural, they can always depend on the perfect co-adjuvancy of that unrivalled dietetic preparation, imperial granum. Many years of successful clinical experience having proved this combination of nutriments to be acceptable to the palate and also to the most delicate stomach at all periods of life, being in many cases retained and assimilated when everything else is rejected, though in very extreme cases the imperial granum is often prepared with pure water only.

Don E. Ashley, M.D., Guy's Mills, Pa., says: After the mania produced by improper use of alcoholic beverages has been controlled I know of no better compound than celerina to restore tone to the nervous system and vigor to the whole human economy. I find it an excellent remedy for colliquative sweats, especially in convalescent cases of typhoid fever. I speak not from the experiences of other physicians, not from hearsay, but from knowledge obtained from the careful

observance of happy results brought about by the admistration of this useful medicine.

The number of medical missionaries in the world, says the Maryland Medical Journal, is 460, an increase of 122 in five years. Of these 168 are in China, 165 in India, 44 in Africa, 34 in Syria and Turkey, and a smaller number in each of nearly a score of other countries. More than 340 are men and about one-third of that number women. The United States has 246 in the field; Great Britain, 174; Canada, 21. The American Presbyterians lead with a total of 71; the American Methodists follow with 55. Not to be outdone by Artemus Ward, who was ready at the call of duty to sacrifice all his wife's relations, we doubt not the medical profession in this land alone would bid Godspeed to as many more earnest workers, could they but be induced to offer themselves up for the good cause.

A WOMAN'S MEDICAL COLLEGE OPENED IN RUSSIA.

The opening of a medical college for woman in St. Petersburgh last fall was an event of the greatest importance, not only to those who will be most directly benefited by it, but to all who long for the uplifting of women in all lands. The following details were gathered by the Literary Digest from an article in a St. Petersburgh paper:

"The number of those who have passed the severe examinations and secured admission is one hundred and sixtyfive, of whom more than half have come from the provincial cities. Forty-seven are the graduates of colleges, the remainder being graduates of special educational institutions and gymnasia. The average age of the students is twenty-four years, the youngest being twenty years of age and the oldest thirty-seven. Ninety per cent are orthodox Christians of the Greek Church, three per cent. Catholics of the Roman persuasion, three per cent. Lutherans, and three per cent. Jewish. The extraordinary percentage of the Orthodox Russian woman is significant of the strong hold of liberal ideas upon Russia."

The need of women physicians in Russia is thus set

forth by one of her leading physicians :

"The life of the provincial physician is a life of heroism, of sacrifice; and who are so capable of self-abnegation and pioneering as a woman? In the district where I passed the summer, one physician had daily one hundred and twenty patients in his dispensary. At the rate of five minutes to a patient, ten out of twenty-four hours have to be spent in dispensary service alone. In addition, the physician had under his control a hospital containing twenty-five beds. Twice a week he had to operate on the average in a dozen cases more or less serious. Finally, he had a territory of about twenty miles to cover each day in visiting patients too ill to come to the hospital-altogether, an amount of work exceeding that of those condemned to hard labor in the state prisons, and for which the twenty-four hours are scarcely sufficient. Such is the task of the provincial physician employed by the local assembly, and it requires extraordinary love of one's profession and rare devotion to humanity to enable one to cope with the Herculean labors devolving upon him."

THE ABORTIVE TREATMENT OF INFLUENZA BY CALOMEL.

enza.

In the Therapeutische Monatshefte for October, 1897, Frudenthal expresses the belies that calomel is an exceedingly useful drug in the early stages of an attack of influThe dose which he gives amounts to two grains twice a day to adults, or one grain three or four times a day. In infants smaller doses are given according to age. He asserts that the effects of this treatment are remarkable. In a few hours he obtains a great fall of temperature and the disappearance of the neuralgic pains and loss of appetite. The advantage of this treatment he thinks is that it is inoffensive, and admits of general employment. He believes that a cure can usually be produced by the third day.

The Woman's Medical Journal.

VOL. VII.

MARCH, 1898.

NO. 3.

STUDIES IN GYNECOLOGY FROM THE SERVICE OF THE WOMAN'S HOSPITAL OF PHILADELPHIA.*

By Anna M, Fullerton, M. D., Philadelphia, Pa.

Y PAPER does not pretend to be a contribution to the most interesting and valuable subject of surgical gynecology, but rather a plea for what may be termed preventive gynecology, to which per

haps we have given too little heed in the past.

Not that I would in any way decry the brilliant and skilful results attained by surgical gynecology in this day, for it is too true that diseased conditions affecting the pelvic visviscera very frequently result in the production of organic lesions which induce chronic invalidism and render the functional activity of the generative organs a menace to the health and even the life of the patient. Too often, however, the operator himself realizes that in the removal of diseased pelvic organs he is but cutting away, as it were, dead twigs and branches from a plant which has a worm at the root. It is not a matter of surprise, therefore, that when the same social conditions must continue which have originally caused disease, a speedy recurrence is found of the manifestations of ill-health. It has not been uncommon in my experience, after having removed pus tubes for a patient, to have her return suffering from an acute attack of gonorrheal cystitis, endometritis or vaginitis. To insure against the recurrence of an endometritis, at least, it is always best I believe in such cases to amputate the uterus at the same time that the appendages are removed.

Practically, the performance of these very radical operations upon the pelvic organs unfit a patient for the marital life, and since two thirds of all patients operated on for

*Presented to the Section on Obstetrics and Diseases of Women, at the Forty-eighth Annual Meeting of the American Medical Association, at Philadelphia, Pa., June 1-4, 1897

pelvic diseases are women who are or have been married, the decision as to the absolute necessity for any operative procedure is one requiring a very careful judgement.

So largely is the health of a woman affected by her emotions that any cause for unhappiness induced by the changed conditions of her life may seem to make her last state worse than the first. For these reasons it is my ardent hope that we may look in the future to the fuller developement of the constructive processes of our art, the making of healthy women.

How rarely do we find in the special hospitals for the treatment of the diseases of woman, any tolerance of the socalled palliative measures for the relief of the pelvic disease! Yet there is a time in the developement of many of these when they are not beyond the pale of hope. There is no better vantage ground for a study of a woman's needs than that afforded by such a hospital as that with. which I have been connected with for many years, the Woman's Hospital of Philadelphia, with its large obstetric and gynecologic service. Here opportunities for careful study may be obtained, the constitutions and habits of life of patients observed and such investigations made as to cause and effect in the pro duction of disease as can not fail to bring much enlighten: ment.

In reviewing the records of the Woman's Hospital of Philadelphia, during the time of my incumbency as its physician in charge, from September, 1886 to September, 1896, I found that among nearly forty thousand cases treated in its wards and dispensary over 41 per cent. were inflama tory disorders of the pelvic organs, mainly septic in origin, puerperal or gonorrheal; 27 per cent. were displacements with their attendant complications; 14 per cent. were functional disturbances, mainly due to constitutional causes and arrest of developement; 7 per cent. were neoplasms and over 10 per cent. lacerations resulting from childbirth.

In making a study of the conditions which might be regarded as causative factors in the production of the graver forms of pelvic diseases I analyzed 236 cases of major operations occuring in my own service. Forty-two being hysterectomies, twenty-one ovariotomies, twelve cases of extrauterine gestation and the remainder chiefly cases of diseased