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in two doses of 30 grains each during the bodies and independent bodily functions. day, has often been effectual after all other A few days ago the twins, now 36 years of measures have failed to check them. It is age, again came to the clinic, as the former more effectual when given in the form of patient again suffered from colicky pains. camphoric acid internally than when ap- The surgeon made a diagnosis of advanced plied in the form of camphor or cam- pregnancy or rather incipient labor. Alphorated alcohol externally. Camphorated though that possibility was absolutely dealcohol rubbed into the skin may assist the nied by the girls, the patient soon gave effects of camphoric acid given internally, birth to a healthy boy, and later, after rebut of the two it is the internal remedy peated questioning, confessed. The other that affords by far the greatest benefit. sister felt nothing at all of the pain of the

mother so closely united to her, and when

the next day the temperature of the mother Balsam Peru in the Treatment of went up two degrees the temperature of the Wounds. — Sickmann reports his experi- other twin remained normal

, showing the ences with Peru balsam from the surgical absolute separation of the two organisms clinic in Erlangen, in which it has been as regards function and metabolism. employed systematically for a number of years. The balsam proved to be very useful in all cases of accidental wounds. It Lactation in the Blazek United Twins.1 is necessary, however, that all the recesses Considerable scientific interest has been of the wound be filled with an excess of aroused over the phenomena of lactation the balsam, since it only acts efficiently in the united Bohemian twins, the Blazek when any bacteria present are completely sisters, one of whom was delivered recently enveloped in it. No toxic disturbances of a boy at Prague (mentioned in the need be feared. In cases of infected Vienna letter April 28). The father of wounds, discrimination must be observed the child is the manager of the two sisin its use, and this can only be gained by ters, who has exhibited them to the public experience. The balsam appears to have for several years. The Blazek twins form a favorable influence in stimulating gran- a pygopagus; that is, twins joined at the ulations.

buttocks; all the organs of the trunk are duplicated, except that the rectum and the

introitus vaginæ are in common. Formerly GENERAL TOPICS.

the sisters menstruated for a four to five day period. During pregnancy the menses

ceased in the pregnant woman, while the Pregnancy and Labor of one of the

other sister menstruated regularly until the Siamese twins.2— There live in Prague twin

last two months before the birth. It is resisters, known as the “Siamese twins," who

markable that lactation set in not only in are united to each other by a solid bridge her sister. Dr. Basch, who examined the

the woman who was delivered but also in of tissue, with some cartilage and bone en

sisters in the Prague hospital, reports this closed, in the region of the hip-joint and the brim of the iliac bone. Several attempts

fact and its explanation in the last number at separation have been suggested, but re

of the Deutsche medizinische Il'ochenfused by the twins because they desired to schrift. (Trunececk and Baudouin also disexhibit themselves for money. One of the

cuss the teratologic aspect of the case in twins suffered a few years ago from chole

the Semaine Médicale, May 18.) Basch relithiasis, and had to be operated on in the gards the influence of the sympathetic surgical clinic of Prague, where examina

nervous system on the secretion of milk as tion revealed that apart from the malfor

small.

The role of the sympathetic is mation of the connecting iliac bone, the especially shown in the transmission of retwo persons have separate and independent

flexes in sucking or milking which are

necessary to a uniform continuous activity 'J. Sickmann, M. D., Deut. Zeitschr. f. Chir., of the mammary glands. The essential speBd. 104. ?Jour. A. M. A., May 14, 1910.

Jour. A. M. A., July 2, 1910.

cific activity of the mammary glands is in- with Chinese wine make a valued blood dependent of the nervous system. Accord- tonic much used in northern China among ing to Basch, the growth of the breasts is all classes; the receipt is held by a Shangoccasioned by stimulant substances which hai firm, which has become very wealthy are present in the ovary after impregna- upon it.' Old deer horns are boiled down tion, while the initiation of the secretion to make the medicinal glue which binds the of milk is brought about by stimulating fifty ingredients composing the average substances which may be obtained from Chinese pills; in these one may get anythe expelled placenta. According to his thing from a pint of gunpowder to cobra opinion the secretion of milk in the non- tail dust. Of equal medicinal efficiency pregnant twin is to be explained by the are three high-grade tiger remedies—the fact that we have to do with two indi- eyeball, liver and blood. The genuine tiger viduals living in parabiosis in whom the eyeball can be prescribed only for the very necessary stimulus to the production of wealthy Chinese; similarly the liver, dried lactation generated by the pregnant sister and reduced to a powder, is worth its was carried by the common blood stream weight in gold; tiger blood, evaporated to to the other sister with positive effect. a solid at a high temperature is believed by Whether this idea will be sustained by Asiatics to transform a craven into a hero. other investigators remains to be seen. Finally the dentist is looked up; this pro

fessional will be found on any street corner in all large Chinese cities.

He is very A Chinese Triumvirate.- According to

impressive by reason of his seriousness; althe Medical Record the doctor, dentist, and

ways reading and thinking of his collection barber are powerful factors in Chinese

of some 2,000 teeth on a table, and a few civilization. Once a week the Chinaman

bottles of some secret drugs said to convisits the barber for a general overhauling.

tain the moisture of the inner side of an old First the head and face are shaved; then

coffin collected after a ten years' burial. The the ears are scraped and cleansed with a

dentist in China is called a boxer; for he small brush made of duck's hair ; third, the

is suppposed to have great strength in his upper and lower eyelids are scraped with a

arms and hands. dull edged knife, all granulations being smoothed away, after which a salt solution

A Novel Cure for Obesity.1 - It is is applied with a duck's hair brush. It is

obvious that there can be no real cure of for this latter reason that so much blind

obesity unless the habits of life, dietetic and ness is found in China.

No antiseptic precautions whatever are taken; all instru

otherwise, undergo a radical change. Now

this is what obese persons, generally large ments are held in the operator's hand when not used. Finally the patient's back is

eaters, specially resent and in the majority

of instances they are unable, or at any rate massaged; and after paying a fee of three

unwilling, to suffer the pangs of unrecents (and no tip) he leaves the shop feeling clean outside. He next consults the quited hunger entailed by the necessary re

strictions. Dr. Dubois-Havenith of Brusphysician. After undergoing the usual ex

sels relates the curious case of a young amination (a form of military inspection)

lady afflicted with polysarcia who “enthe case is diagnosed and treated, unless a devil happens to jump down the patient's joyed her food” to such an extent that be

fore she reached 25 years of age she throat. For this the only remedy that will

weighed close upon 190 pounds. She serve is the setting off of one hundred fire

found herself quite unable to forego the crackers, and a daily visit to the joss house.

pleasures of the table, and as her digesThis done he receives the usual pills for those vacated by the devil; these may con

tion was slack she suffered a good deal

of discomfort after dinner. On one ocsist of spotted rhinoceros horn-a wonder

casion she experienced such physical disful cure for intestinal troubles; these horns

tress that she provoked vomiting by putcome from southern China and in the Singapore market a single specimen will ting her finger down her throat with imbring $25. Tiger bones, ground and mixed *London Lancet, Aug. 6, 1910.

mense relief. She was delighted to find pitals. In accomplishing her great work that it was possible to conjure the evil which has resulted in revolutionizing field effects of over-indulgence in so simple a sanitation, Miss Nightingale had not only manner, and so it degenerated into a habit. to contend with disease in the Crimean To her surprise she found that under this campaign, but her greatest fight was regimen she rapidly lost flesh, so much so against the

the prejudice which existed that in three months her weight had fallen against a woman engaging in work of that to 120 pounds. She then called attention character. At the beginning of the Crito the

fact that whereas a moderate mean War not a woman nurse was emquantity of food used to leave her with ployed in the military hospitals. It was an unsatisfied craving, after deliberate not untii the war was over and the generals emesis she was free from hunger between and medical men at the front enthusiastimeals. Physiologists may explain this on cally praised her work that public sentithe assumption that the mere act of eating ment was turned in her favor and she be"decongests" the digestive apparatus came a heroine whose fame has endured and so confers functional peace. In any from 1855 down to the present time. A event, the Romans, who were past-masters brief summary such as this cannot adein gastronomy, knew all about voluntary quately present the work which she acvomiting, as is shown by the institution of complished, but it has had the greatest posthe vomitorium, which was resorted to sible influence on field hospitals and the presumably very much for the purpose treatment of the wounded in all wars that described in Dr. Dubois-Havenith's case. have occurred since that time. When she Of course, it is irrational to take more returned to England the British public food than one requires, but having done so raised a fund of $250,000 and presented the provocation of vomiting cannot be it to her as a token of the esteem in which described as unphysiological. Nature pro- they held her. This she accepted, but not vides that remedy automatically in suckling for herself. She used it to establish a infants whose overloaded stomachs are re- school for nurses at St. Thomas's Hospital, lieved by a timely puke, and even in grown- London. She superintended this school for up persons the reflex is not unfrequently many years, finally retiring from active called into play to avert the consequences

work for a much needed rest. In 1907 of over-indulgence in food drink. she received from King Edward the Order Whethei, however, voluntary vomiting can of Merit, the statutes being modified to adsafely be allowed in any individual to de- mit of her appointment, and she is supgenerate into a habit is a matter calling for posed to be the only woman who has been careful consideration. Æsthetically objec- so honored. In 1908 she was given the tionable and morally questionable, the freedom of the city of London. Although method is also physiologically incorrect, her health was never robust after the Criand it is not likely to supplant more ortho- mean War, yet she wrote much that was dox treatment which affords a disciplinary of value. training of value.

SURGICAL HINTS. The Death of Florence Nightingale.

In young children caries of the mastoid

process with abscess formation may ocFlorence Nightingale, the heroine of the

cur without involvement of the inner ear, Crimean War, died at her home in Lon

and without fever, pain or other constitudon on Saturday, August 13th, aged ninety

tional symptoms. years. Her long life was devoted to the cause of saving life and relieving suffer

Rectal feeding can usually be dispensed ing in times of war and pestilence and to

with after

after esophagotomy for foreign the general improvement of hospital serv

bodies, the patient being given small ice at all times and everywhere. To her we

amounts of sterilized water for the first owe the modern system of army field hos

twenty-four hours, after which liquid food New York Med. Jour., Aug. 20, 1910.

may be administered.

or

American Medicine

H. EDWIN LEWIS, M. D., Managing Bditor.
PUBLISHED MONTELY BY THE AMERICAN-MEDICAL PUBLISHING COMPANY.

Copyrighted by the American Medical Publishing Co., 1910.

Complete Series, Vol. XVI., No. 9.

New Series, Vol. V., No. 9.

SEPTEMBER, 1910. .

$1.00

Yearly
In Advance.

The Carnegie Foundation Report on It is quite apparent, therefore, that the the status of American medical schools general movement in medical education, inhas led to an endless amount of discus- cluding essentially all teaching facilities and sion pro and con, and in certain circles at methods, has been forward, while the subleast has stirred up an antagonism that is stantial improvements that have been made anything but passive. On the whole the in not one but many directions are such that Report presents few facts that were not gen- graduates of even ten years' standing cannot erally known, and many of its criticisms fail to appreciate them. and animadversions on the teaching facili- If we were to assume to criticize the ties and methods of our average American Carnegie Report from any standpoint whatmedical college have been foreshadowed by soever, it would be on the grounds that the numerous articles that have appeared from very evident progress of the past ten to time to time in the medical press during fifteen years is entirely disregarded, and the past decade. For a number of years the comparatively little or no credit is accorded Association of American Medical Colleges the medical schools for the efforts they are has been earnestly striving to elevate the obviously making to increase their effistandards of medical education, and a rec- ciency. Unfortunately nothing handicaps a ord of its meetings would show very con- report or a work of reform as surely as a clusively that those charged with the direc- suspicion of unfairness and we fear the tion and management of the medical col- laudable motives and the really excellent, leges of the country have been thoroughly painstaking work embodied in Professor alive to their shortcomings. It would be Flexner's report will fail to accomplish the most unfair to state, or even to convey the good it should—for a while at least. This impression that honest, faithful efforts have situation, the result primarily of the connot been put forth to better existing condi- troversies it will surely stimulate, together tions, or to deny that very real and substan- with the suspicion of an animus against the tial progress has been made in the equip- smaller institutions, bound to result from ment, methods—and aspirations—of prac- the apparent failure to give proper credit tically every recognized medical school. for the advancement practically every colThe state boards of registration have lege has made, will pass away, it is to be worked consistently to these same ends, and hoped, when the Report is more carefully have been particularly successful in raising studied and understood. entrance requirements, a fact well shown by Aside, however, from the foregoing, it the improved type of medical students. will be seen that the Report is epoch mak

ing, that it is fearless and specific in its standards of medical education to the highrecommendations, and should give very est degrees of efficiency. But what we do material aid in placing medical education desire to emphasize is that the day of the on a nigher plane.

small, comparatively inconsequential, mediA real service has been done for the cal college is by no means passed. Equipdeserving medical colleges of the United ment and methods as long as the personal States, a service that will take on new sig- equation plays so vital a part, are necesnificance as the forces at work for the sarily of relative importance, and questions advancement of medicine are better or- of locality, expense (cost of living), and ganized.

expediency will continue for many a day to

give the small medical college a legitimate Medical education, like all other branches

place in the scheme of "things as they are." of learning, is largely dependent on the

The most important phase of medical edupersonal equation. In other words, if a

cation is that which pertains to entrance person is intent on securing medical knowl

requirements. No one who will give the edge, the question of the institution is

matter sufficient thought will deny that purely of secondary consideration. The

rigid entrance requirements mean a higher truth of this is shown by the experiences of countless of America's foremost physicians type of students

. Better qualified students

will exert a powerful influence on each and surgeons. How little important is

institution, with inevitable tendencies todeemed information as to the medical col

ward greater efficiency. A college must lege from which a man graduated! It is

respond to its students' needs, or it will the man himself and his individual ability

very soon find its classrooms vacant. There that commands principal interest, and no

can be no question, therefore, that establishone is ever handicapped—in the public estimation at any rate—by the fact that he ing high entrance requirements promptly

elevates every standard of a medical colgraduated from one of the smaller or mediocre colleges. To show how little import- problems, and achieving true progress in a ocre colleges. To show how little import- lege, solving at once not one but many ance is attached by even the medical pro

most practical and far-reaching manner. fession to the institution from which the

The poorly equipped candidate for a medidiploma is obtained, one has only to inquire cal degree is eliminated automatically, and as to the college data of any of the country's likewise the handicap he would assuredly great medical men, past or present. Unless

place on the work of any institution he the person receiving the inquiry has specially

could enter. posted himself, it is the exception to obtain

The crux of the medical college situation a single fact concerning a man's college

is obviously the elevation of entrance retraining, however prominent he is or may

quirements to the highest possible point have been.

compatible with common sense and sound This should not be understood as mini

judgment. mizing the desirability of first class institutions, or the necessity for every college to seek to obtain the best possible equipment. Experimental typhoid has been proIn no way do we wish to intimate that we duced in animals by Prof. Metchinkoff and are not in sympathy with the elevation of the reported to the Paris Academy of Sciences,

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