MEDICAL INDEX - LANCET. -BY JOHN PUNTON, M. D., EDITOR AND Publisher. JBORETARY AND PROFESSOR OF NERVOUS AND MENTAL DISEASES, UNIVERSITY MEDICAL COLLEGE PUBLICATION OFFICE: 532 ALTMAN BUILDING. O. L. McKILLIP, BUSINESS MANAGER. C. F. WAIN RIGHT, M. D. ASSOCIATE EDITORS. B. C. HYDE, A. M., M. D. J. D. GRIFFITH, M. D. HONORARY CONTRIBUTORS. H.T. PATRICK, M. D., Chicago, Ill. France, 6 Francs; TERMS $1.00 PER YEAR IN ADVANCE. HERMAN E. PEARSE, M. D., C. A. RITTER, M. D., F. W. LANGDON, M. D., Cincinnati, Ohio. SINGLE COPIES 10 CENTS. Germany, 5 Marks; England, 5 Shillings; EDITORIAL. KANSAS CITY MEDICAL COLLEGES, It is with great pleasure that we extend congratulations to the medical colleges of Kansas City upon the success of their past year's work. There has been an appreciable decrease in the number of graduates as compared with former years, but this fact in no wise detracts from the credit of the schools, but is rather a sign of progress. The decrease is attributable to the adoption of full four years' courses by the trustees, and the addition of a year's study is no attraction to those students who view the medical profession superficially. On the other hand, as is evidenced by the personnel of the freshman classes, the extra year is accepted by students averaging better educations and qualifications than in previous years, while the senior classes arecomposed of earnest students who have either studied medicine four years or are possessed of literary degrees. The worth and ability of matriculants. throughout the schools evidence the appreciation of so manifest an improvement in our curricula, and insures to the public a better equipped class of young physicians. The number of graduates for 1902 in the several schools, as compared with former years, is not discouraging to faculties or classes. when viewed in the light of meritorious attainments that are assured. A sign of the times is the tendency towards consolidation of various medical colleges in many of the cities and the adoption of such measures as would bring about a similar condition in Kansas City would be a notable mark of progression. DAMAGE SUITS AND THE MEDICAL PROFESSION. The case of Dr. J. W. Perkins vs. C. R. Rockwell for $189 for medical services, with the counter claim of Rockwell for $25,000 damages for mal-practice, was decided in favor of Dr. Perkins after a hard fought trial, lasting over a week. There never was any doubt as to the outcome of the case from a medical point of view, but the presence of the defendant, who was constantly kept before the jury on a cot, was counted on to enlist the sympathies of the jury and blind their judgment. Fortunately this case was tried before Judge Slover and an unusually intelligent jury. The result is a victory for the whole medical profession. Every physician can be placed in a very unenviable light by any of his patients who chooses to do it. All communications to the physician are confidential, and not only may he be punished for revealing them, but public sentiment does not fail to condemn a physician who discloses his patients' affairs. Also, most of what passes between physician and patient takes place in the presence of the friends of the patient, so that if any disagreement occurs, it is the doctor's word against that of his patient and his friends. The doctor tries to practice a profession and the law and public make it a trade. The testimony in this case shows that unusual care and skill were shown in treating the defendant. Had it not been for the daily record of this unusual case, kept by the doctor and his nurses, together with the evidence of the several consultants in the case, it would have been impossible to have disproven the absurd claims of the patient. Every practicing physician should constantly keep in mind the necessity of making notes of his cases, for his own protection, as well as the wisdom of frequent consultations, even if the condition of the patient does not demand it. A physician should never hesitate to insist upon a consultation whenever the circumstances are such that they could be used by a patient to his disadvantage. What shall we say of those members of the profession through whose advice and encouragement such damage suits are instigated? It would be well if in every case the offenders could be brought before a representative society and properly disciplined. Such conduct violates every principle of ethics and decency, and is suicidal to the profession. Every case of alleged mal-practice ought to be brought before the County Society and probed to the bottom before it goes into the court. If, in the opinion of the members, the accused is worthy of their support every member should be laid under contribution, financially or otherwise, to protect him, and let it be understood that the fight is made against the profession as a whole. We predict that there would soon be an end of needless damage suits. THE MORTALITY AND MORBIDITY OF PHYSICIANS. Alfred Moeglich has collected a series of statistics which give results sufficiently discouraging to the medical practitioner who aspires to reach the scriptural age of three score and ten. Of all the professions, medicine offers its devotees the least promise of a ripe old age; the average time of death varying from fifty-two to fifty-six years, according to different authorities; while for the clergy, for example, it is ten years later. The combination of pedagogy with medicine appears to be particularly fatal, for one set of figures in which the normal death-rate is represented by 100 gives 111 as the factor for physicians, and 113.8 for medical instructors. Of the causes of death infectious diseases rank highest and, among these, typhoid fever occupies se prominent a place as almost to entitle it to characterization as an occupation disease. Tuberculosis comes next, the death-rate from this cause among physicians being almost double that of the clergy. Altogether it is rather a melancholy fact to realize that the men whose life work it is to teach others how to keep their health, or to regain it if lost, should themselves be unable to profit by their own knowledge and should be so completely at the mercy of the great bodily and mental stress to which their calling subjects them.Deutsche Aerzte-Zeitung, November 15, 1900. MORTALITY RATE IN THE UNITED STATES. The statistics recently published by the Census Bureau of this country with regard to the death-rates are of exceptional interest, and are of a nature to give rise to hopeful views regarding the checking of the spread of disease, and perhaps even the extinction of some maladies, says the Medical Record. The mortality rates given in the bulletin are those for 1890 and 1900, and the comparison between the death list of these periods shows conclusively that the efforts made by hygienists to lengthen the lives of American citizens have been attended with complete success. The statement is made that the proportion of deaths to population has decreased within the dates mentioned by nearly 10 per cent, and that the average age at death of an American is now 38.2 years, as compared with 31.1 in 1890. This, of course, is a magnificent showing, and the only drawback to the picture is that the bettered conditions of living apply only to the larger cities. The country districts exhibit according to the bulletin no such relative improvement. The most striking feature of the reports is the great reduction in the death rate from tuberculosis, which has fallen from 245.4 per 10,000 persons in 1890 to 190.5 per 10,000 in 1900, a gratifying proof of the efficacy of modern sanitation, and of the means now employed in fighting the disease. Diphtheria, cholera infantum, bronchitis, diarrhoea and typhoid fever, also, for the same reasons, claim far fewer victims at the present time than in 1890, the decrease in mortality from these causes having been substantial and progressively steady. On the other hand, pneumonia, as a factor in the death rate, occupies a more prominent position, there having been 191.9 per 10,000 deaths in 1900, and 186.9 per 10,000 in 1890. The cause of this increase in the occurrence of pneumonia has been on many occasions given in the Record and in other medical journals as undoubtedly due to influenza. This insidious malady has made rapid progress since 1890. In that year, the deaths directly attributed to it were, the census bulletin states, 6.2 per 10,000, while in 1900 the number was 23.9 per 10,000. The fact must also be taken into consideration that influenza peculiarly predisposes its victims to other diseases, notably to pneumonia, by rendering the system susceptible in a high degree to the ingress of disease germs. Pneumonia as a sequel to influenza is also a most fertile cause of death, the vitality of the patient when seized being at a low ebb, and recuperative powers well-nigh used up by the drain put upon them by the former affection. Cancer, again, has been conspicuously on the increase during the past ten years, as have kidney complaints, heart affection and apoplexy. The activity of scientific men in different parts of the world, who are engaged in the investigation of the origin and causes of cancer, give rise to the hope that some of its unknown features may soon be definitely solved, and that, as a consequence, its treatment may be conducted upon more intelligent preventive and curative principles. The bulletin of the United States Census Bureau is a most satisfactory document, and the tale it tells is a feather in the cap of our city boards of health, and of our municipal reformers generally. There is yet, however, room for much improvement in the sanitary conditions of the large cities of America, particularly in the direction of wholesome dwellings for the poor-Scientific American. AN INDISPUTABLE TRAGEDY OF CHRISTIAN SCIENCE. On December 17 last the Rev. Edmund R. Hardy of the city of Buffalo died of chronic Bright's disease. He was the oldest and most widely known Christian Scientist in that city, and perhaps in western New York. He was also the first Christian Science "reader" of Buffalo. The facts of his sickness and death are as follows: On or about October 15 last Mr. Hardy called upon Elisha P. Hussey, M. D., of 493 Porter avenue, Buffalo. He informed Dr. Hussey that he was "having trouble which was not yielding to the usual treatment," evidently meaning Christian Science treatment. He also stated to Dr. Hussey that having some time before had serious trouble with his eyes, which also refused to yield to the usual treatment, he had gone to a prominent oculist of the city, who had told him that he undoubtedly had a serious, and in fact a very alarming, condition of the kidneys to deal with. From the time that Mr. Hardy visited the oculist until about October 15, when he came to Dr. Hussey, in spite of everything that he and his Christian Science friends could do for him, he gradually grew worse. From that date, continuously, until his death, December 17, he was in charge of Dr. Hussey, like any other patient, with the simple exception that his family protested. They are all Christian Scientists. Mr. Hardy himself would not believe that he was going to die. So far as we can ascertain no one has questioned Mr. Hardy's sincerity. He was but forty-six years old. In February and March of 1900 the Rev. E. E. Helms, pastor of the Central Park Methodist Episcopal church, in the city of Buffalo, preached a series of sermons on "Why I am not a Christian Scientist." These sermons were fully reported in the three morning papers, and called forth a great deal of correspondence from the local Christian Scientists, and also from Carol Norton, of New York city. On March 8, 1900, Mr. Hardy wrote a letter of great length to the Rev. E. E. Helms, in reply to certain things in his sermon. In that letter he said, "Christian Science is the one remedy for sin, sickness and death," and, referring to the possibility of his dying sometime, said he would not "pass on" by the way of sickness or disease, giving the impression that when he disappeared it would be as an apple falls when ripe. Here then we have a tragedy in Christian Science high life. A sincere and intelligent man, a firm believer; in him an insidious disease was at work and he knew it not. The usual treatment was tried in vain; he did not go so far in fanaticism as to die without making an effort. He went first to an oculist, who discerned at once the difficulty of the kidneys by perceiving the otherwise unaccountable condition of the eyes. And then he went to a phy sician. Will the Christian Scientists deny that he went to the oculist? Will they deny that he took treatment from the physician, whose name and address we have given? While chronic Bright's disease is usually sooner or later fatal, it is quite within the bounds of possibility that if this young man had had himself examined the moment he ascertained that anything was wrong with him (instead of declaring that it was a mere delusion) he might have been restored, or at least by hygienic methods and care might have prolonged his life for many years. To meet such a case the Christian Scientists will say: "Death has not been conquered in this case or in that, it makes no difference whatever to the external verities of being. The science of mathematics is not affected by the errors of those who are learning it. Neither is the science of being affected by the errors of those who are learning to demonstrate its truth." This is simply hedging. The entire concourse of Christian Scientists will have to die, and they will die of some disease; and when they do there is nothing left those who live upon the faith except to say that they failed to "attain a demonstration; but that is a mistake; the demonstration they make when sick or dying is that they have followed a will-o'-the-wisp when they thought they had ideas which would prevent sickness or death.-New York Advocate. OBITUARY. CHRISTIAN FENGER, M. D. Dr. Christian Fenger, one of the most noted surgeons in Chicago, died March 7. He had been ilì for ten days. Dr. Fenger was known throughout the world as a surgeon. He was born in Copenhagen, Denmark, sixty-two years ago. In 1864, while still a medical student, he served as a surgeon in the war between Denmark and Germany. In 1867 he received his diploma in medicine and was for two years assistant in the Wilhelm Mayers ear clinic, Copenhagen. During 1868 and 1869 he was an interne in the Royal Frederich's hospital, Copenhagen. At the outbreak of the Franco-German war he became surgeon in the Red Cross ambulance corps and served through the war. From 1871 to 1874 he was prosecutor and private docent at the Copenhagen city hospital. He went to Egypt as a member of the sanitary council and was appointed surgeon of the Khalifa district of Cairo. In 1877 he removed to Chicago, where he has lived ever since, holding at the time of his death the chair of clinical surgery in Rush Medical college, University of Chicago. Dr. Fenger was a frequent contributor to medical literature. More than eighty articles of great value have been accredited to him during the last thirty years. In 1899 the King of Denmark made him a knight by conferring the degree of Rider of Dannebrog. Dr. W. W. Johnston of Washington, D. C., died on March 20. Dr. Johnston was one of the best known physicians in Washington, being one of the physicians called in consultation during the last illness of President McKinley. HOW VIRCHOW WORKS. Few men have worked harder than Virchow. It is not very long since that, after a full day's work, he went in the evening into his study and sat down at his writing table. Here the next morning the housemaid, coming to clean the room, found him absorbed in his work. This incident did not stand alone, and on such occasions the professor was quite astonished when he learned that it was morning. He would pull out his watch, saying, "Now I must go to bed for a couple of hours before leaving for the university." Professor Virchow's average daily allowance of sleep is between four and five hours.-Ex. |