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HARVARD UNIVERSITY

MEDICAL DEPARTMENT. BOSTON, MASS.

ONE HUNDRED AND TENTH ANNUAL ANNOUNCEMENT (1892-1893).

CHARLES W. ELIOT, LL.D., President.

HENRY P. BOWDITCH, M.D., Dean, and Professor of Physiology.
OLIVER W. HOLMES, M.D., LL.D, Professor of Anatomy, Emeritus.

DAVID W. CHEEVER, M.D., Professor of Surgery.
JAMES C. WHITE, M.D.. Professor of Dermatology.

OLIVER F. WADSWORTH. M.D., Professor of Ophthalmology.

CLARENCE J. BLAKE, M.D., Professor of Otology.

FRANK W. DRAPER, M.D., Professor of Legal Medicine.

CHARLES B. PORTER, M.D., Professor of Clinical Surgery.

J. ORNE GREEN, M.D., Clinical Professor of Otology.

AMOS L. MASON, M.D., Assistant Professor of Clinical Medicine.

J. COLLINS WARREN, M.D., Associate Professor of Surgery.

FACULTY.

REGINALD H. FITZ, M.D., Hersey Professor of the Theory and Practice of
Physic.

WILLIAM L. RICHARDSON, M.D., Professor of Obstetrics.

OTHER

THEODORE W. FISHER, M.D., Lecturer on Mental Diseases.
SAMUEL H. DURGIN, M.D., Lecturer on Hygiene.
HENRY P. QUINCY, M.D., Instructor in Histology.

THOMAS DWIGHT, M.D., LL.D., Parkman Professor of Anatomy.
EDWARD S. WOOD, M.D., Professor of Chemistry.
WILLIAM H. BAKER, M.D., Professor of Gynecology.
FREDERICK C. SHATTUCK, M.D., Professor of Clinical Medicine.
EDWARD H. BRADFORD, M.D., Instructor in Surgery and Orthopedics.
T. M. ROTCH, M.D., Assistant Professor of Diseases of Children.
WILLIAM B. HILLS, M.D., Associate Professor of Chemistry.
WILLIAM F. WHITNEY, M.D., Curator of the Anatomical Museum,
WM. T. COUNCILMAN, M.D., Shattuck Professor of Pathological Anatomy
CHARLES S. MINOT, S.D., Professor of Histology and Embryology.
MAURICE H. RICHARDSON, M.D., Assistant Professor of Anatomy
SAMUEL J. MIXTER, M.D., Demonstrator of Anatomy.
HAROLD C. ERNST, M.D., Assistant Professor of Bacteriology.
CHARLES HARRINGTON, M.D., Instructor in Materia Medica and Expe
WILLIAM H. HOWELL, M.D., Associate Professor of Physiology.

INSTRUCTORS.

JAMES J. PUTNAM, M.D., Instructor in Diseases of the Nervous System.
ELBRIDGE G. CUTLER, M.D., Instructor in the Theory and Practice of Physic,
EDWARD M. BUCKINGHAM, M.D., Instructor in Diseases of Children.
FRANCIS H. DAVENPORT. M.D.. Instructor in Gynecology.
JOHN W. ELLIOT, M.D., Assistant in Clinical Surgery.
WILLIAM W. GANNETT, M.D., Instructor in Clinical Medicine.
CHARLES M. GREEN, M.D., Instructor in Obstetrics.

VINCENT Y. BOWDITCH, M.D., Assistant in Clinical Medicine.
HERBERT L. BURKELI, M.D., Instructor in Clinical Surgery.

GEORGE H. MONKS, M.D., Assistant in Clinical and Operative Surgery.
FRANCIS S. WATSON, M.D., Assistant in Clinical Surgery.
CHARLES P. STRONG, M.D., Assistant in Gynecology.
FRANCIS B. HARRINGTON, M.D., Assistant in Clinical Surgery.
THOMAS F. SHERMAN, M.D., Assistant in Diseases of Children.
HERMAN F. VICKERY, M.D., Instructor in Clinical Medicine.
MYLES STANDISH, M.D., Assistant in Ophthalmology.

The following gentlemen will

JOHN HOMANS, M.D., in the Diagnosis and Treatment of Ovarian Tumors.
EDWARD COWLES, M.D., in Mental Diseases.

FRANCIS B. GREENOUGH, M.D., and ABNER POST, M.D., in Syphilis.
JOHN B. SWIFT, M.D., in Diseases of Women.

GEORGE W. GAY, M.D., in Surgery.

WILLIAM M. CONANT, M.D., Assistant Demonstrator of Anatomy.

HENRY JACKSON, M.D., Assistant in Clinical Medicine and Demonstrar of
Bacteriology.

JOHN C. MUÑRO, M.D., Assistant in Anatomy.

EDWARD REYNOLDS, M.D., Assistant in Obstetrics.

CHARLES W. TOWNSEND, M.D., Assistant in Obstetrics.

ARTHUR K. STONE, M.D., Assistant in Bacteriology.

CHARLES P. WORCESTER, M.D., Assistant in Chemistry, and Secretary
the Faculty.

CHARLES L. SCUDDER, M.D., Assistant in Clinical Surgery.
WILLIAM S. BRYANT, M.D., Assistant in Anatomy.

JOHN C. CARDWELL, M.D., Instructor in Physiology.

AUGUSTUS S. KNIGHT, M.D., Assistant in Clinical Medicine.
FRANK BURR MALLORY, M.D., Assistant in Pathology.

FRANKLIN DEXTER, M.D., Demonstrator of Histology and Embryology.
EDWARD M. GREENE, M.D., Assistant in Histology.
ALEXANDER BURR, M.D.V., Assistant in Bacteriology.
ARTHUR H. WENTWORTH, M.D., Assistant in Chemistry.

give Special Clinical Instruction.

GEORGE L. WALTON, M.D., and PHILIP COOMBS KNAPP, M.D., « Su
ease of the Nervous System.

ARTHUR T. CABOT, M.D., and FRANCIS S. WATSON, M.D., in Greb
Urinary Surgery.
FREDERIC E. CHENEY, M.D.. in Ophthalmoscopy.

Every candidate for admission, not holding a degree of arts or science, must pass a written examination on entrance to this School, in English,' Physics and any one of the following subjects: French, German, Elements of Algebra, or Plane Geometry, Botany. General Chemistry will be a requires for admission on and after June, 1893. The admission examination for the coming year will be held June 30, at Boston, Exeter, Andover, New York, Ph Chicago, Cincinnati, St. Louis, and San Francisco; on September 26th at Boston, only.

Instruction is given by lectures, recitations, clinical teaching and practical exercises, distributed throughout the academic year. In the subjects of Antr Histology, Chemistry and Patholo, ical Anatomy, laboratory work is largely substituted for, or added to, the usual methods of instruction. The year beg September 29, 1892, and ends on the last Wednesd y in June, 1893, and is divided into two equal terms.

Students are divided into four classes, according to their time of study and proficiency, and during their last year will receive largely increased oper for instruction in the special branches mentioned. Students who began their professional studies el-ewhere may be admitted to advanced standing; but persa who apply for admission to the advanced classes must pass an examination in the branches already pursued by the class to which they seek admission.

Beginning with the academic year 1892-93, the required course of study in this school will be a graded coursc covering four year The degree of Doctor of Medicine cum laude will be given to candidates who have pursued a complete four years' course, and obtained an average of 75 per upon all the examinations of this course. In addition to the o'd nary degree of Doctor of Medicine, as hitherto cbtained, a certificate of attendance on the s of the fourth year will be given to such students desiring it as shall have attended the course, and have passed a satisfactory examination in the studies of the ORDER OF STUDIES.

For the First Year.- Anatomy, Physiology, Histology and Embryology, General Chemistry, Hygiene, Bacteriology and Medical Chemistry dura second half-year. For the Second Year.- Anatomy, Pathology and Pathological Anatomy, Clinical Chemistry, Materia Medica and Therapeutics, Theory and Practice a Medicine, Surgery and Clinical urgery. For the Third Year.-Theory and Practice, Clinical Medicine, Surgery, Clinical Surgery, Obstetrics, Pediatrics, Dermatology, Neurology, Gynae For the Fourth Year-Required Studies: Clinical Medicine, Clinical Surgery, Clinical Microscopy, Genito-Urinary Surgery, Ovarian Tumors, Mental Ophthalmology, Otology, Laryngology, Orthopedics, Legal Medicine and Syphilis. Elective Studies: Ophthalmology, Otology, Orthopedics, Gynecology tology, Neurology, Bacteriology, Physiology, Chemistry, Hygiene, Operative Surgery, Operative Obstetrics.

Mental Diseases.

COURSES FOR GRADUATES AND SUMMER COURSES.

The Faculty has arranged a greatly enlarged and improved Plan of Instruction for Graduates, embracing all the branches of Practical and Serv Medicine, in which graduates of medical schools may feel the need of advanced or special training. It is designed to supply those opportunities for dos laboratory study which have hitherto been sought in Europe, and by means of repeated short courses to limited numbers, to give the practitioner the 2015 to be derived from personal instruction in the following subjects: Anatomy, Physiology, Histology, Pathological Anatomy, Clinical Medicine, Surgery, Chr Gynecology, Dermatology, Syphilis, Ophthalmology, Otology, Laryngology and Rhinology, Neurology, Mental Diseases, Diseases of Children, Legal Me... Hygiene and Bacteriology. For full announcement of these courses, address Dr. C. P. WORCESTER, Secretary, Harvard Medical School, Boston, Mass. REQUIREMENTS FOR A DEGREE.-Every candidate must be twenty-one years of age, must have studied medicine four full years, have spent at least continuous year at this school, have passed a written examination upon all the prescribed studies of the course taken.

FEES.-Matriculation, $5; for the first three years, $200; for the fourth year, $100; for one term alone, $120; for Graduation, $30. For Graduates the fee for one year is $200; for one term, $120; and for single courses, such fees as are specified in the Catalogue. Payment in advance, or, if a bond f the end of the term. Students in regular standing in any one department of Harvard University are admitted free to the lectures, recitations and examzan of other departments. For further information, or Catalogue, address Dr. H. P. BOWDITCH, Dean, Harvard Medical School, BOSTON, Xan

Press of S. J. Parkhill & Co., 226 Franklin St., Boston, Mass.

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THE BOSTON DEC 9 1892

Medical and Surgical

CXXVII.

23.

JOURNAL.

Published Weekly by DAMRELL & UPHAM, corner School and Washington Streets.

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ORIGINAL ARTICLES.
RATIVE TREATMENT OF RESISTANT CLUB-
OT. By E. H. Bradford, M.D.......

.......

541

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Personal Recollections of the late Dr. Ben-
jamin W. Dudley, of Lexington, Ky., and his
Surgical work.- Experiences in Pelvic Sur-
gery. Craniotomy upon the Living Foetus is
not Justifiable.- A Case of Extensive Hæma-
tocele Resulting from Tubal Pregnancy Rup.
turing into the Broad Ligament. Fibroid
Tumor of the Uterus; Pregnancy; Rupture
about the Fourth Month; Operation; Speci-

men.

.... 552

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Five Dollars per Annum.
Single Copies, 15 Cents.

PAGE

Boston and New England.
The River Charles.-The Harvard Dental
School. Typhoid Fever from Milk. - The
Elliott City Hospital, of Keene, N. H.
New York.

Medical Pavilion at the Roosevelt Hospital. —
New Hospital for St. Luke's Hospital.- Hy-
drophobia.- Typhus Fever.- The New York
College of Pharmacy.

MISCELLANY.

THE NEW YORK POST-GRADUATE MEDICAL

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NOTIFICATION OF INFECTIOUS DISEASES...... 553 IS ALCOHOLISM INCREASING AMONG AMERICAN WOMEN?.........

A PAPER HOSPITAL...

563

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MEDICAL NOTES.......

...... 560
561

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Serviceable Specialties.

PICHI, (Fabiana Imbricata), is an emollient, sedative and diuretic in diseases of the nary Organs. It has been found efficient in gonorrhoea, cystitis, dysuria, urinary calculus I all irritable and inflammatory conditions of the bladder and urinary tract.

The pharmaceutical preparations of Pichi are Fluid Extract and Solid Extract Pichi and uble Elastic Capsules Pichi, 5 grs.

CACTUS GRANDIFLORUS is a heart tonic par excellence. In these days when so my persons die of heart failure, the selection of a heart tonic is important.

According to J. Fletcher Horne, M.D., in London Lancet, it is especially valuable in nervous and functional disorders of the heart, where digitalis and strophanthus are unsatisfactory, such as palpitation, irregularity, fluttering, intermission, slow or rapid action arising from debility, worry, dyspepsia, or the excessive use of tea and tobacco, comprehensively classed as cardiac erethism.

CREASOTE is of all the methods of treating consumption the most satisfactory.

We supply Creasote in Soluble Elastic Capsules (Cod Liver Oil, 10 minims, Creasote, inim), and Enteric Pills of Creasote coated with a material that resists the action of the tric juice but dissolves in the duodenum.

Samples will be sent, on receipt of request, to physicians who indicate their willingness to pay express charges.

PARKE, DAVIS & CO.,

Detroit, New York and Kansas City.

Entered at the Post-Office at Boston as second-class matter.

NEW SUBSCRIBERS sending us $5 before end of '92 will receive the Numbers for November and December of this year, gratis, i.e. 14 months for $5.

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PRESCRIPTION OPTICIAN,

JOHNSTOWN, N. Y.

TRAINED NURSES

SUPPLIED AT THE

bound in half-leather book form.

Any System of Account Books supplied. Stationery and Printing of all descriptions. Send copy for estimate.

MEDICAL STATIONERY COMPANY,

Room 40.

1 Beacon Street, BOSTON, MASS.

CENSORS' EXAMINATION.

The Censors of the Suffolk District Medical Society, officiating for the Society at large, will meet for examination of candidates for admission to the Massachusetts Medical So

323 and 325 Washington St., opp. Old South Church. Nurses' Registry, ciety, at 19 Boylston Place, on THURSDAY,

Branch, 454 Boylston St., Boston,

Maker of Spectacle and Eye-glass Frames; Trial Frames, Trial Cases, etc., and Lenses of every description prescribed by ophthalmic surgeons. All kinds of test types. Price list and blanks on application.

ARTIFICIAL EYES.

Selection Packages furnished.

FISK & ARNOLD,

Manufacturers of

ARTIFICIAL LIMBS,

and Appliances for Shortened
Limbs, Resections De-
formities, etc., etc.,

AS A SPECIALTY.

Room 4, TREMONT TEMPLE.

December 15, 1892, at 2 P. M.

Candidates should make personal application to the Secretary, and present their medical di fore the examination.

SANDER & SONS is the only firm which keeps ploma, or its equivalent, at least three days be

extensive works at Sandhurst, Australia, for the manufacturing of their preparation, the pure Volatile Eucalypti Extract (Eucalyptol). According to Professor Dr. Hugo Schultz, Bonn (See Das Eucalyptusoel), mature, three years old leaves have to be worked in their green state to secure a genuine product. To accomplish this the works of the named firm have been erected. Sander & Sons consequently afford reliable guarantee to the profession to obtain Eucalyptol proper. Samples gratis, through Dr. Sander, Dillon, Ia. Meyer Bros. Drug Co., St. Louis, Mo., Sole Agents.

ANIMAL VACCINE VIRUS

Beaugency Stock.

"THIS VIRUS PRODUCED THE BEST RESULTS AND COSTS THE LEAST MONEY."-Report of Boston Board

False Calves, Silk, Elastic, Wool, of Health to City Council, March, 1882.

and Cotton Socks, to wear

with Artificial Limbs.

All cases will receive our personal attention, and from our long experience we feel competent to give advice and satisfaction to ali under our care.

3 Boylston Place, Boston.

Officers and soldiers furnished on government account.

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For further particulars, apply from 2 to 3 P. M., to

JAMES J. MINOT, M.D.,

Secretary,

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PAPOID" Advertisement,

Page 26.

The Secret of its Success (we refer to MERCK'S BULLETIN) is its distinctive character. Some journals are devoted to the expansion of a single man's ideas or the advancement of a special theory. MERCK'S BULLETIN

By DR. JAMES C. WHITE, The Microscope and Its Revelations is a comprehensive, well-rounded,

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Original Articles.

OPERATIVE TREATMENT OF RESISTANT

CLUB-FOOT.1

BY E. H. BRADFORD, M.D.

is between such methods as involve the least mutilation and give the best results in the speediest time.

foot.

Of these methods three deserve careful consideration: (1) Forcible correction, preceded by thorough division of the ligaments and tendons; (2) Removal of the astragalus, an operation frequently performed on IN presenting this paper written on the subject of the European continent, and advocated lately by Dr. the treatment of resistant club-foot by means of radi- Morton, of Philadelphia; (3) Osteotomy of the neck cal operation, the statement should be made at the out-of the os calcis and of the astragalus, preceded by careset that it is not intended to advocate operative inter- ful division of the soft parts of the inner side of the ference, even tenotomy, in all cases of club-foot, even of the congenital form. One of the most successful cases of congenital club-foot I am able to report was treated without any operative measures, even tenotomy. The result may be shown by the accompanying footprint (Fig. 1). The drawings from photographs have already been shown; but the foot-imprint is even more convincing than the photograph, and warrants the assertion that the feet are now perfectly normal in a child fifteen years of age treated without tenotomy when a year old. This can be seen by a comparison with the imprint of a normal foot (Fig. 2).

It is not proposed to consider the claims of wedgeshaped resection of the tarsus, although this method has given good results. But any one who has had experience with it will know that an unnecessary amount of bone is sacrificed where this method is relied upon.

Forcible correction, combined with division of the shortened soft tissues accessible to the knife, will be

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FIG. 1. Imprint of foot of a child sixteen years old, treated when one year old for congenital club-foot.

FIG. 2. Imprint of normal foot.

In this article investigation will be limited to those cases which, either through previous neglect or bad treatment or the obstinate nature of the deformity, have developed into the most persistent type of the distortion, resisting the simpler measures of treatment. In the 160 cases I have treated there has been no hesitation to perform more radical operations, such as wedge-shaped exsection of the tarsus, though this method, as will be seen later, is at present not advocated. While it is readily admitted that the successes of Drs. Taylor, Judson, and Shaffer have shown conclusively that club-foot can be in many instances satisfactorily corrected by means of mechanical treatment alone, in advocating operative measures for the persistent cases, the claim, however, is made that in the severest and most | found to be a method which in a large majority even resistant cases cure can be effected more speedily, of the most resistant cases will prove entirely satisfaccertainly and safely by proper radical operative mea- tory. It has the advantage of avoiding any unnecessures than by simpler means. As Dr. Morton has sary sacrifice of bony tissue, and has given excellent well said, some cases of congential club-foot are cor- results. rected without great difficulty and permanently cured, while in others the deformity is resistant, and there is a tendency to relapse; and in treating of club-foot, in some instances time is of importance, and also the inefficiency or poverty of the parents has to be considered. Many resistant cases could be treated by mechanical means alone, provided the parents had sufficient persistency to continue the treatment for six months or a year or longer with daily or frequent visits; but where persistency and attention cannot be commanded, mechanical treatment becomes impossible, and these cases remain doomed to deformity unless some means can be devised which will enable the surgeon to cure in a short time. It is for this reason that operations on the bone, radical in character, are sometimes demanded which otherwise might have been avoided. The choice

1 Read before the American Orthopedic Association.
2 Transactions American Orthopedic Association, vol. i.

The accompanying illustrations will serve to show the fact that in cases of the severest type, the method is capable of giving satisfactory results without any sacrifice of bony tissue (Figs. 3, 4, 5, 6).

This case has already been reported in the Revue d' Orthopedie, March 1, 1892.

The foot-imprint represents the ultimate result three years after operation, and shows a sole of a foot entirely flat in walking, which three years before had been of the severest type of deformity in a woman thirty-five years of age. A lever wrench was used in correction previous to tenotomy having been done. Two sittings were required as the skin tore on the inner side of the foot at the first, and it was thought advisable to delay complete rectification until a fortnight had passed after the first sitting. The patient was en

3 Transactions of American Surgical Association, vol. viii, 1890, p. 71.

abled to walk about with crutches two weeks after the subcutaneous division of the soft parts preceding forcisecond operation, and a splint was applied one month ble correction, in a majority of cases I have emlater. The patient began to walk with the splint and ployed the subcutaneous method, using a section of a cane about this time, and she is now able to walk the insertion of the anterior and posterior tibialis

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