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be then to know that she was under the kind treatment of one of her own sex; one who, in the language of an eminent female physician, "understands better than men can ever do the conditions of life which underlie a vast amount of feminine ill-health, and who can sound the depths of dulness in the kind of life too frequently led by unoccupied women, and understand how destructive it is to nervous health." To such patients the kind, consoling, sympathizing voice of woman is a blessed balm to the disturbed imaginings, a herald of hope to the despairing mind, an assurance that friends have not all forsaken her. And how readily will she give her confidence to a friend so loving, so unwearied in her ministrations.

I could give instances of women who, from disordered bodily functions, have been the victims of mental or moral delusions, have suffered for months in insane hospitals without having been once spoken to in relation to their physical health, and others who have resolutely refused to communicate their condition to the male physician; but who would have been happy to unburthen themselves— to reveal the sufferings of body and the cause of their mental or moral condition to one of their own sex. We are happy to be able to say that viewing this subject in the light here presented the most eminent alienist in the State of Pennsylvania-one long connected with a hospital for the insane-a man richly endowed with humanity and kindness, has on several occasions requested eminent female physicians to take charge for a brief time of patients in his institution, to gain their confidence, to ascertain the condition of their systems, so that a proper treatment could be instituted. This was noble conduct, the act of a nobleman. How loudly does it proclaim the necessity for the change which we urge.

Whenever we have spoken of this subject to members of the profession, even those favorable to our views, the inquiry has met us: 66 How can this be carried into effect? Can there be two heads to one hospital?" Separate houses for the sexes should hereafter be the rule. We shall demand that hereafter no more hospitals shall be built to accommodate both males and females. But we do not see the least difficulty in having both a male and female superintendent in any of our present institutions. They are entirely separate, under the charge of different assistant physicians, nurses, and helpers, have separate yards, and never mingle with each other. The one great error in the organization was in having a common superintendent for both departments, and burthening him with, not only the medical treatment, but also the entire management of all the complicated and onerous duties of carrying on the immense establishment. Is it necessary that he shall be thus burdened?

Cannot a hospital be managed on some other plan? The Pennsylvania Hospital, in the city of Philadelphia, which receives and treats thousands of patients annually, has no medical superintendent. For more than a century it has moved on without a jar. Not a moment of the time of its skilful surgeons and physicians has been diverted from the care and treatment of the patients by the onerous duties incident to the purely business matters of the large establishment. One non-medical business man-call him steward, warden, superintendent, or whatever else may please-purchases all supplies, receives and discharges patients, keeps the house in the most perfect order, has everything ready to the hands of the surgeons and physicians, and accounts to the managers, who, in that house are, what the managers should be in every hospital, real superintendents. Sadly have the insane suffered by the inabilitywe will not say neglect of the physician to have proper supervision over them, when encumbered by the manifold and arduous duties necessarily devolving on one who has charge of a farm of 200 acres, forty or fifty cattle, an immense garden, laundries, and bakeries to supply six hundred or more inmates-who purchases the coal, flour, and meats, makes improvements and changes in buildings, hires and discharges the numerous subordinates, listens to complaints, and settles differences among the numerous workmen; duties which would occupy every hour of the best business man. Is there one among you who believes that the physician of a hospital for the insane should be thus loaded with all those duties, to the neglect of his patients, who may be doomed to lives of chronic mania because not properly cared for when first received? Shall the treatment of five or six hundred insane be given over to inexperienced assistants, because the chief is busy with duties which need for their proper performance the whole time and atten. tion of a good business man-one, too, who would perform them for one-third the salary given to a superintendent? Our present system is one fatal to good management of the insane, and also to an economical disbursement of the public funds.

We would therefore, even in our present hospitals, dispense with one general superintendent, have one side under the exclusive care of a woman physician, assistants, and helpers, the other under the exclusive management of men, the non-medical steward to furnish all supplies under the direction of the managers, to whom, or to the steward, the physicians shall make their wants known, as in the Pennsylvania Hospital.

At Olney Hatch Hospital, in England, the female physician is an independent officer-there is no conflict of authority. There are

two asylums under one general management-each superintendent being responsible for his or her separate charge.

We desire to append the following resolution, and ask for its adoption :

Resolved, That a committee of seven be appointed by the President of the Society to memorialize the legislature to enact laws, if any be needed, to authorize the employment of managers of hospi tals under control of the State, of women medical superintendents for the female departments of said hospitals, and for hospitals to be erected for the accommodation of females. All of which is respectfully submitted.

HIRAM CORSON, M.D.,
A. NEBINGER, M.D.,
R. L. SIBBET, M.D.

HISTORY AND TREATMENT OF TWO OVARIOTOMIES.

BY JOHN S. DICKSON, M.D.,

OF PITTSBURG.

SEPT. 7th, 1877, I performed the operation of ovariotomy on Mrs. Bessie Miller, of Enon Valley, Pa., a patient of Dr. Nye of the same place. Dr. John Dickson administered the chloroform. Dr. Nye and Nicholas Schenkle, a student of mine, skilfully assisted me. There were also present by invitation of Dr. Nye, Drs. Mygott and Justice, of Polland, Ohio, Dr. Pettit, of Petersburgh, Ohio, Drs. McGehan and Brittain, of New Galilee, Pa., and Dr. Balph, Enon Valley, Pa. The tumor had been correctly diagnosed by Dr. Nye, on the 29th of July previous, as a cystic form of the disease, and on August 2d he performed the operation of tapping, removing twelve pints of albuminous fluid, not entirely reducing the size of the tumor, as it afterwards proved to be a multilocular form of the disease, and some of the cysts quite thick and gelatinoid in consistence. Dr. Nye then prescribed tonics and narcotics, with good nourishing food, and recommended an early operation for removal. The patient was in her 29th year, married six years, and had a child over four years of age; never conceived since birth of child, and when first noticed the tumor, thought conception had taken place. Had ceased to menstruate in April prior to the operation. Was not in a good condition to operate upon, as her tumor had filled up rapidly. Was quite feeble; some œdema in her lower extremities, respiration labored, from the distension. Our prognosis was not favorable to recovery. But an operation was advised as the only means of saving her life. The incision was made about one inch and a half below the umbilicus, and extending four inches and a half in length. After emptying the large cysts by the ordinary method of a trocar, it was found to be adherent around the umbilicus, which was carefully separated with the left hand, the right hand making traction on the tumor with a pair of dog-toothed forceps one side of the incision, and one of the assistants with another pair of forceps making traction on the other side of the incision to prevent

the spilling of any of the contents into the abdomen. I enlarged the incision in the cyst with a knife, all the time having assistants making traction with the forceps. Using my right hand to break up the septums between the cyst walls, the tumor towed out of the abdominal incision very nicely, but was found to be adherent to the omentum, which was carefully separated, and the pedicle ligatured with a strong silk ligature. Clamp, as recommended by Spencer Wells, was put on around the ligature. Carefully examining and sponging the portion of the omentum that had adhered, I put on four fine silk ligatures, cut short, which completely arrested the hemorrhage there, then, investigating the place where the adhesions had been around the umbilicus, it was deemed best to put on three more ligatures, which were allowed to remain in the abdomen-making seven in all. Finally two small vessels in the incision had to be ligated; the ends were brought outside. Five sutures were needed to close the incision-three deep and two superficial. The pedicle was clamped and fixed at the lower extremity of wound. Time of operation, one hour and twenty minutes, of which time the patient was under the influence of the anesthetic about half an hour. The cause of the great length of time consumed in the operation was the hemorrhage from the omentum and umbilicus. The weight of the tumor was over twenty-three pounds. The usual rules about flexing the lower extremities, putting pillows under them, and keeping her head low, were carried out. One-half grain of sulph. morphia was given hypodermically, and whiskey ordered every half hour, a tablespoonful until sufficiently rallied, with occasionally beeftea or milk. After the operation her pulse was very feeble and thready, at one hundred and thirty a minute. In an hour she had rallied some, but was still in pain I then gave her one-third grain sulph. morphia as before. Two hours and a half after the operation the patient had rallied sufficiently to leave her in charge of Dr. Nye, who skilfully treated her until her final recovery. According to Dr. Nye's statement to me, her pulse kept up to 120 a minute for the first six days, simply on account of debility and anæmia. After that her pulse gradually improved. The catheter had to be used twice or three times daily for fifteen days, then she was able to make water without the use of the instrument. She was kept on her back for sixteen days, but moved from one side of the bed to the other every other day after the third. But with all this care a small bedsore made its appearance over the sacrum, which rapidly repaired when she was able to take the pressure off the part by changing her position. Sutures were removed from the sixth to the ninth day. The clamp came away on the twelfth day;

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