Neither they nor their mothers before them have ever been injured or deformed by clothing, tight or otherwise. I have never discovered any signs of rickets among them, hence contracted pelves are, to say the least, very rare. They live very largely on a vegetable diet, and as a rule bathe every day. The girl is married while still a child, but does not, as a rule, assume the duties of a wife before puberty, at which time she does so. I believe the average girl there does not reach puberty before her 13th year, popular opinion to the contrary, notwithstanding. It is rare for conception to take place during the first two or three years of menstrual life. So far as I know, nothing is ever done to prevent conception or produce abortion. The signs upon which they base a diagnosis of pregnancy are, principally, absence of menstruation, morning sickness and enlargement of the abdomen. Enlargement of the abdomen is more significant there than here, as abdominal tumors are very rare. During the tenth "moon" of her pregnancy the woman goes to her mother's village, if it is not too distant, and does not return until her child is about a month old. *Read before the Southern California Medical Society, December 4, 1901. When labor comes on she goes alone into a hut and closes the door. On the ground in one corner of the hut a sort of basin has been formed of banana leaves, and filled with a decoction of bark and leaves. The woman frequently sits down in and adjacent parts in the decoction, and this basin, bathing the external genitals into this basin the child is sometimes expelled. If after long effort she seems unlikely to succeed, her mother and other women go in. Some scold her, some advise her, No others drench her with cold water. man ever enters the hut. There is no physician, no midwife; no digital examination is ever made, nor any attempt at extracting the child. Nature is allowed to take its course, and is, often, fatally slow. Immediately after the child is born, the cord is crushed off with a piece of split bamboo, the reason given being that, if cut with a sharp instrument, it bleeds too freely. It is not tied. The woman herself takes the placenta into the bush and hides it, as it is their belief that it must do service again if she is ever to have another child. The child is washed by pouring cold water over it, the hand serving for both sponge and towel. A piece of vine the size of wrapping twine, tied around the wrist is considered sufficient clothing until the child is about five years old. They expect the cord to come off on the third or fourth day, after which event the child's head is shaved. Umbilical hernia is very common, especially among girls, and one the size of a lemon is considered quite an ornament and not in any sense a source of danger. The mother considers herself able to sit up immediately after the birth, but she does no work for about a month. Abscesses of the breast are not infrequent. Sexual intercourse is prohibited until the re-establishment of menstruation. This is for the sake of the child at the breast, since as there is no artificial feeding of infants, it is important that the mother's milk-supply be not interfered with by another pregnancy. Children often nurse until three years old. Deformed children are rare, barring supernumerary toes, which are plentiful. Ophthalmia neonatorum is unknown, due, doubtless, to the absence of gonorrhea. Medicines are administered to children through the nose. Babies are encouraged to stand and to walk at the earliest possible day, and, although the people are quite innocent of trousers or skirts, yet I have not seen a pair of bow-legs. Notwithstanding their free outdoor life, good health, fine physique, a strong desire to bear children, and their freedom from the ravages of gonorrhea, many of these women are sterile. Their social customs are such as to exclude in almost all cases the possibility of its being the husband who is sterile. Perhaps the custom of more or less indiscriminate sexual relations may be a factor in accounting for sterility in some cases, yet in others this same custom must favor conception. The majority of these women who die in childbed die because they are unable to expel the child, and this very often with a normal pelvis and a normal presentation. My experience there has led me to believe it very often due to exhaustion from lack of nourishment and rest during a long and trying labor. Then, too, they often become frightened, having no one in whom to place confidence, or to look to for help, and this adds to their exhausted and wretched condition These African women doubtless escape some puerperal fever, because of the absence among them of the ever-ready examining finger, and the hand so quick to 'bring down a leg." Doubtless they escape also many lacerations by not being subjected to hasty or unskillful forceps deliveries; but, on the other hand, many of them are subjected to terrible suffering, and lose their lives and the lives of their children, for lack of a little well-timed nourishment and a sleeping potion. Some lives are lost for lack of a little clean, skillful manipulation at the hands of an obstetrician, and many more for lack of a few well-directed tugs with the Whiteman's forceps. Twentieth-century civilization and twentieth-century obstetricians may have much to answer for, but certainly their balance is on credit side.-South. Calif. Practitioner. Practical Significance of Lactation Atrophy of the Uterus. (W. Thorn in Muenchener Med. Wochenschrift, Nov. 19th.) According to Thorn, the number of women unable to nurse their children is constantly increasing in Germany. It almost seems, he remarks, that Germany is taking its place beside France, at the head of the procession. Progressing civilization entails this inability to nurse, as exemplified in the history of India, Greece and Rome. Mothers unable to nurse their offspring are less resistant and sufferer from various general and local disturbances. The physiologic process-lactation atrophy of the uterus is interfered with. Under normal conditions, the body of the uterus be comes atrophied during lactation, and normally is accompanied by amenorrhea, although ovulation continues. Complete regeneration follows after the weaning of the child, or at least within six weeks. If the cervix or ovaries are involved in the atrophy, or if it extend beyond, the amenorrheic nursing woman should be strengthened by abundant nourishment, and the nursing should be interrupted at intervals, to restore the atrophy to its physiologic limits. If this can not be accomplished, the child must be weaned. No woman, especially if amenorrheic, should nurse for more than a year, and eight months should be the average for moderately strong, amenorrheic women, unless in special circumstances. local treatment of the atrophy is necessary, not even for the frequently accompanying retro-displacement. An acute No intercurrent disease does not interfere with regeneration. It the atrophy persists for more than six weeks after weaning, local treatment should be instituted as a supplement to general tonic measures. During the period of atrophy the walls of the uterus are very soft and thin, and consequently no instruments should be inserted, or should be employed only with extreme caution. men who menstruate more or less regularly during lactation do not present this atrophy of the uterus. The cavity of the uterus in the typical amenorrheic cases becomes reduced to 4.5 cm. and the walls to a few millimeters thick, but the cervix and the ovaries retain their normal size. Wo Frommel has reported that regeneration did not occur in any of the 28 cases he observed, but his material was all gynecologic. All of Thorn's 25 patients returned to normal conditions at the normal time. They were healthy obstretric cases.-Jour. Am. Med. Assn. Book Reviews. MODERN OBSTETRICS; GENERAL AND OPERATIVE. By W. A. Newman Dorlan, A. M., M. D., Assistant Demonstrator of Obstetrics, University of Pennsylvania, etc. Second edition, rewritten and greatly enlarged; 797 pages, 201 illustrations. Price, $4.00. W. B. Saunders & Co. Publishers, Philadelphia and London, 1901. While the author claims the work as only rewritten, the change of name from "Manual of Obstetrics" to "Modern Obstetrics," with the many rewritten sections, make it practically a new work. The division of physiologic and pathologic Obstetrics is still retained by the author, an easy classification for the reader, and one that places the article sought for easily found. The revision shows careful and thorough study, the elaboration of the mechanism of labor is full and accurate, and accompanied by a number of wellexecuted drawings. It would be difficult to point out each subject separately, as all are of the same high order of merit. Puerperal sepsis has been entirely rewritten, brought up to date both in its medical and surgical treatment and is well worthy of careful study. In the causes of puerperal convulsions, while the kidney and its diseases are carefully noted, the author seems inclined to the opinion that the role of the liver is of paramount importance, and that in the majority of cases is the cause of the convulsions; the author can justly claim the priority of inserting in his work the "Liver Role in Puerperal Convulsions." Dystocia, with its complications and management, both manual and instrumental, is thoroughly and carefully described; nothing is left wanting. The pathology and management of the newborn is enlarged and covers a great deal more ground than in the manual. The book is well worthy of study both by the physician and the student, and should be on their shelves for constant reference. We have read with interest two well-written pamphlets, "The Pancreas in its Relation to Emaciation and Decline," and "Creating Hunger When the Appetite Fails," put out by the Charles N. Crittenton Co., 115 Fulton St., New York. COUNCIL readers should send for them. William R. Warner & Co., Philadelphia, have issued a very valuable Dose Table in chart form, suitable for hanging in the office for instant refer ence. A very desirable Chart of Diseases of the Lungs, Pleuræ, Bronchi, Trachea and Larynx, containing valuable information in condensed form, also a calendar, has recently been distributed among physicians by the McArthur Hypophosphite Co. of Ansonia, Conn. If you have not received one it is worth your time to make application. SOME EXTRACTS FROM OUR DAILY MAIL In order that our readers may see what others think of the earnest work we are doing, we quote below a very few of the thousands of letters of appreciation we have received this season. It is a great satisfaction to know that we are doing a work that meets with the approval of the better class of the medical profession. I am perfectly delighted with your book, "The Physician as a Business Man." It is a muchneeded work among the profession in this locality, and I suppose everywhere else. This makes about four years I have been a subscriber to THE MEDICAL COUNCIL, and I must say it is without doubt the best journal I ever took. This also makes three years that I have used your Physician's Pocket Account Book, and I wouldn't have anything else as long as I can get one. Yours respectfully, Laurens, S. C. B. F. GODFREY, M. D. Doctor, send us two new subscribers to The Medical Council, at $1.00 each, and we will pay you by sending you either the Account Book, "The Physician as a Business Man" or "Practical First Principles." How shall be told the tale? For innocents slain. Helpless in death camps thrown, For harvests of Cain. Ashes of desolate hearth, Heap on us the curse- Can'st build with vengeance and hate O England? Spurn from thy gate What boots it, thine Empire's pride, -WALTER CRANE, in London News. Martin H. Smith Company, 68 Murray Street, New York. Being constantly in the treatment of a considerable number of phthisical hospital patients, it is in order for me to state, that in the persistent cough so harassing to the patient, and preceding or accompanying "Pulmonary Hæmoptysis or Hæmorrhage" I have found " Glyco-Heroin' (Smith) an invaluable remedy, applicable in the vast majority of cases of phthisis pulmonalis, and far preferable to combinations of morphia or codeia. I also find this happy combination exceedingly valuable in the troublesome, dry, so-called stomach cough following la grippe, and supposed to be dependent on irritation of the pneumo-gastric nerve. Chs. Brewer, M. D., Resident Physician, N. J. State Prison. The accuracy of our present medical diagnosis is but the expression of careful clinical study fol lowed by patient post-mortem investigation." "To say that insanity, or in fact any of the neuroses or psychoses, are inherited would be a verbal fiction. It is an unstable nervous organization that is inherited." "There is an irritable, and restless, unhealthy mental action engendered by excess of work or pleasure or superinduced by intemperate indulgence in alcoholic drinks, and in which wellchosen music has a decidedly beneficial influence." -Peoria Med. Jour. Two farmers, at Dyea, Alaska, raised 25,000 bushels of potatoes this year, and will receive for them $2.00 a bushel. The potatoes are described as large, solid, mealy and palatable, and contain more sugar than potatoes grown in lower latitudes. At this season, when there is so much grip present, and when people are exhausted by the business (Continued over next leaf.) |