ப The Medical Herald Incorporating The Kansas City Medical Index-Lancet An Independent Monthly Magazine Under the editorial direction of CHARLES WOOD FASSETT and S. GROVER BURNETT ASSOCIATE EDITORS P. I. LEONARD, St. Joseph CONTRIBUTING EDITORS ST. CLOUD COOPER, Fort Smith, Ark. S. S. GLASSCOCK, Kansas City, Kan. D. A. MYERS, Lawton, Okla. JOHN PUNTON, Kansas City PAUL V. WOOLEY, Kansas City W. T. WOOTTON, Hot Springs, Ark. HUGH H. YOUNG, Baltimore DEPARTMENT EDITORS P. T. BOHAN, Therapeutics DON CARLOS GUFFEY, Obstetrics J. E. HUNT, Pediatrics JOS. LICHTENBERG, Ophthalmology J. ELLIOTT ROYER, Neurology R. T. SLOAN, Internal Medicine J. M. BELL, Stomach C. A. GOOD, Medicine A. L. GRAY, Obstetrics J. W. MCGILL, Rectal Diseases L. A. TODD, Surgery OMAHA H. M. McCLANAHAN, Pediatrics H. S. MUNRO, Psychotherapy DES MOINES WALTER L. BIERRING, Medicine Address all communications to Chas. Wood Fassett, Managing Editor, St. Joseph, Missouri. THE AWAKENING AT ST. JOSEPH. The tendency of the St. Joseph-BuchananAndrew Co. Medical Society at its meeting on February 19 shows signs on every side that its members are becoming alive to the necessity of dealing aggressively with the many abuses which operate to cripple its members financially. The explosion of strenuous oratory was precipitated when a special committee to revise the constitution, reported that "contract and lodge" physicians were ineligible to membership. After a little wrangling a resolution was adopted to request the committee to define the meaning of contract" physician for the next meeting. The well known subject of dichotomy was "just" mentioned, a hint being sufficient to produce general paralysis of the audience. We look forward to a decided amelioration of the abuses under which we suffer and which are so notorious No. 3 that there is no necessity of recapitulating them. Proper attention to economic matters need not be indicative of a depreciation in professional tone. As intelligent men we must consider and act upon the facts and conditions that encompass us. A wholesome economic environment means a wholesome grappling with the problems of the sick. St. Joseph has a new "economic" medical society. It goes without saying that a county society is to judge of the character and actions of its members, and at present there is no advantage to be gained inside the county society, as far, as for instance, life insurance examinations are concerned, that are not enjoyed by those on the outside. Non-members have no difficulty in getting consultations. The present awakening may bear fruit, if not, a little ventilation of our grievances may improve the atmosphere. We are not pessimistic. The darkness preThe darkness precedes the dawn as well as the beginning of the night. It is proposed to weed out the "undesirables" from the membership list, and the county society should not be used as a refuge. We do move, and our "economic" society friends are seeing things, rays of light ushering into local medical life, rays of hope, and we sincerely trust that the future physician may bask in the sunshine of a happier and more equitable existence. LEGISLATION AGAINST FEE-SPLITTING. An amendment to the Medical Practice Act has been introduced at Jefferson City by Mr. Woodward, which has for its purpose a legislative solution of the feesplitting evil. It reads as follows: "Sec. 8319a. It shall be unlawful for any physician or surgeon to divide or offer to divide his fee or charge for performing any surgical operation with any other physician or physicians, surgeon or surgeons; and any physician or surgeon so offending, on conviction thereof, shall be fined in a sum of not to exceed five hundred dollars, and such conviction shall operate as a revocation of his license to practice medicine and surgery." We would offer as a suggestion to Mr. Woodward, that the party who accepts the fee be considered equally guilty of crime. SPONDYLOTHERAPY, A REPLY TO DR. ABRAMS' ARGUMENT. As Lord Bacon said, the most difficult philosophy to disprove or overcome is that in which there is an element of truth, one not wholly fallacious. The tenets of Dr. Abrams spondylotherapy have virtue, but are much limited in application. It is just this element of plausibility that has enabled osteopathy, the chiropractic theory and other isms to assume the proportions of as school of medicine and receive public recognition, and therein lies the danger. In regard to spinal therapy it must be admitted there are individuals of such sensitive nervous tendencies, in whom reflexes are exalted that it is possible to cause relaxation of a spasmodically contracted pylorus through spinal manipulation or to alter the heart rhythm, yet the use of such treatment will not apply categorically. I find it possible in some cases, and use frequently the application of heat from a leucodescent lamp on the spine to lower blood pressure or remove high nerve tension. In selected cases it acts admirably; in others there is no response. There are conditions in which it is possible to secure physiologic results either of stimulation or relaxation through spinal medication, yet the field is limited in that it is possible only in selected cases. I therefore reiterate my previous opinion that to establish an ism upon such grounds is fallacious. Dr. Abrams has been able to accomplish wonderful results through spon dylotherapy, particularly in the cure of large aneurisms, yet the question remains, whether it be not the peculiar dexterity of the individual rather than the philosophy of the procedure; in other words, can the average practitioner get such results from the same tools? J.M.B. OTITIC INFECTIONS. We live in an age of conservation. If the life of the patient and the function of hearing are to be conserved we must accurately and early diagnose and intelligently treat suppurative otitis media. Lives can be saved in preventing severe complications by a free incision of the drum membrane, the establishment and maintainence of free drainage, particularly in recognizing these indications sufficiently early in the disease. Politzer proved by a large number of postmortem examinations in those who had suffered from suppurative otitis media, but who died from some other cause, that an infective inflammation of the middle ear always involve the mastoid antrum. In demonstrating the temporal bone this noted aurist, gracefully lifted it by the styloid process and turning it so that it could be seen by all his hearers, he would slowly and forcibly utter the following words: "The temporal bone has four sides, the outside is bounded by life, from which there comes through the opening of the external auditory canal one form of our appreciation of what life means; on the other three sides this bone is bounded by death." Suppurative ear disease is more prevalent than the general practitioner is apt to believe from actual experience. It is well to remember that dangerously infected mastoids may be present without presenting the usual symptoms as formerly taught. As in all other branches of medicine, it becomes constantly more important to consider the modification and adaptation of certain stereotyped operations according to the needs of the individual case. Wherever possible in complicated cases we should perform the modified radical mastoid operation which conserves the ossicles and drum membrane. The general practitioner should make a more thorough study of these distressing cases which are apparently becoming more frequent and more disastrous. There are great dangers incurred as the result of the non-recognition of acute aural infections. Perhaps many aural cases which terminate fatally are diagnosed as a simple meningitis or cerebrospinal meningitis, while they may have been due primarily to septic middle ear trouble and mastoid disease. Inflammation of the middle ear occurs during the exanthemata, in scarlet fever, measles, diphtheria and typhoid fever and may be clinically divided into two main classes. Serous or catarrhal and purulent inflammations. We condemn the routine and indiscriminate use of the nasal douche or irrigation in the treatment of the nose and throat symptoms of these diseases. In both children and adults, aural symptoms differ somewhat from those of other causes, prominent and striking difference being the absence of pain. Perhaps 80 per cent the children seldom complain of the symptom, and the majority of cases show the first evidence of middle ear complication by a spontaneous rupture of the drum membrane together with a discharge more or less profuse in amount. To prevent or arrest intracranial complications is conservative surgery. With meningitis, not always diagnosed as otitic, with extradural or cerebral abscess already present the chances for life are small indeed. Those who are acquainted with the usual characteristic clinical picture of meningitis realize a desire to arrive at a diagnosis when none of these symptoms are present: the beginning restlessness and irritability; accompanying headache of severe type; ancrexia and vomiting; the gradual clouding of the eye ground picture; the posture of the head of the body, and that of the body as whole; the Kernig's sign; the Tache cerebri and Brudzinski sign; the Babinski sign; and the Cheyne-Stokes breathing" The winning fight is made in the beginning of the disease. P.I.L. AESCULAPINS DINE. One hundred members of the University Medical College student body and faculty were entertained at the Hotel Edward, Kansas City, February 21st, by the Aesculapian Society. An eight course dinner with trimmings, orchestra and vocal utterances made the evening the banner diversion of the season. L. H. Winemiller of class 1913, presided as toastmaster. The following responses were made: The future of the U.M.C., Dr. S. Grover Burnett, dean; The Doctor, Dr. David E. Broderick, vice-dean; Musings, Dr. Calvin J. Morrow; The Surgeon in History. Dr. John G. Sheldon; Femininity, Dr. Geo. Norberg; Medical Ability, Dr. B. A. Poorman; The Disciples of Blackstone, Judge Denny Simrall; Farewell to Seniors, G. I. Nugent, class 1914. The future of the U.M.C. was pictured in the affilial negotiations now nearing completion wherein the University Medical College is to become the Medical Department of the Kansas City University, which means the resumption of the full four-year course September, 1913. THE MEDICAL SOCIETY OF THE The arrangements are now complete for the spring meeting in Kansas City, March 20,21,22, and a glance at the program in another part of this issue will convince anyone of its strength and attractiveness. All physicians in attendance will be entertained at an informal dinner on Thursday evening, at the Coates House, 6:30 sharp, when they will be the guests of the Jackson Co. and Wyandotte Co. Medical societies, and the Kansas City Academy of Medicine. This will be the only diversion of the meeting, the remainder of the time being devoted strictly to the scientific work, for which this organization is noted. After the dinner two excellent addresses will be given. A cordial invitation is extended to physi cians in nearby counties and states. Saturday, third day, will be devoted entirely to clinics in the various hospitals, for which special programs are being prepared. Make arrangements to spend March 20, 21, 22, in Kansas City, and reserve a room promptly at the Coates House, where all sessions will be held. Dr. Clarence L. Zugg, of Kansas City, has removed his office to 713 Gloyd Building. Dr. Hugh Wilkinson, of Kansas City, has removed his office to suite 208 Grossman Building, 640 Minnesota avenue. Dr. Wm. McDougal has opened a clinical laboratory in the same building. The Doctors' Library "Next to acquiring good friends, the best acquisition is that of good books."-C. C. Colton. Psychanalysis, ItsTheories and Practical Applications. By A. A. Brill, Ph. B., M. D., Clinical Assistant in Psychiatry and Neurology at Columbia University Medical School, etc. 337 pages. Philadelphia, Pa.: W. B. Saunders Co., Publishers. (Price, $3.00, net.) The author's extensive clinical study, both at home and abroad, has amply fitted him for the task of giving us this new book with the practical adaptations of Freud's theories. It is Dr. Brill's desire to give valuable aid to both practitioner and the neurologically inclined who see these "border liners" first. His idea is to accept the neuroses as entities and not as mere symptoms as is the case in applying hypnotism and its suggestive and persuasive auxiliaries in psychotherapy. Therefore, psychanalysis deals with the individual as a personality, giving a "real insight into the neuroses and the psychoses," so essential in instituting mental prophylaxes. Altogether it is a commendable work in the newer field of mental medicine. S.G.B. Medical Men and the Law. A Modern Treatise on the Legal Right, Duties and Liabilities of Physicians and Surgeons. By Hugh Emmett Culbertson, Esq., member of the Ohio and New York Bars, etc. Octavo, 325 pages. Philadelphia and New York: Lea & Febiger, Publishers, 1913. (Cloth, $3.00, net.) This unique work touches the personal interests of every physician and surgeon. It deals with the duties, rights and liabilities of the professional man toward the public as settled by law, and the legal relations of many schools of healing. The work is comprehensive and perusal will save many times its cost if only in the item of collecting bills as well as many an anxious hour. Both young and old physicians profit by the knowledge so conveniently placed at hand. It is an unusually serviceable book. Pathfinders in Medicine. By Victor Robinson. With lished. Why Pasteur was not included we do not surmise. Dr. Robinson has some imagination and these biographies or essays read like poetry. We have been amused by the remarks of Dr. Walsh in the Medical Review of Reviews, whose biased conceptions of history deceive no one. Pathfinders in Medicine deserve great praise, and we hope to read more of the fine literary and eminently rational biographies by Victor Robinson. This book is a valu able addition to anybody's library, and reading the history of our art gives us perspective. It tells part of the story of the organic life of humanity. Galen's father, Nicon, said to his son: "Do not give yourself up rashly and blindly to any sect. Sects are implacable despots; to accept their thraldom is to take away from one's action and thought all liberty; seek the truth before all else." A Treatise on Tumors. For the use of Physicians and Surgeons. By Arthur E. Hertzler, M. D., of Kansas City, Mo., Assistant Professor of Surgery in the University of Kansas. Octavo, 728 pages, with 538 illustrations and 8 plates. Philadelphia and New York, Lea & Febiger, Pub lishers, 1912. (Cloth, $7.00, net; half Persian morocco, gilt top, de luxe, $9.00, net.) Only a short time ago tumors were studied only from a scientific, biologic or pathologic standpoint, but this treatise embodies the experience of the author gained in the operating-room, the labora tory and from recent literature. Its aim is to give practitioners a clinical guide, and chief emphasis has been placed upon the practical aspects of the subject. The book begins with a masterly chapter on the General Biology of Tumors. Part II considers the Special Pathology of Tumors, and Part III treats of the Regional Considerations of Tumors. In the diagnosis of the tumor problem the author attempts to solve the triple question, "Is it a tumor?" if so, "What kind of a tumor?" and "Is it a primary or secondary tumor?" In looking over the clinical diagnosis, physical inspection and history we are reminded of what Dr. Kelly, of Cleveland, said recently: "The main object of the Clinical Congress is, I take it, to improve the science and practice of surgery. If so, why does operative surgery receive nine tenths of the time and attention at the clinics? More often in the practice of a real surgeon the history, the examination, the diagnosis, the pathology, the prognosis, the indications for the operation, the choice of operation and other subjects are nine-tenths of his real work, and the operation itself sometimes the least important in the whole series of efforts. Yet, in the great majority of clinics, what is done. One of the house doctors, while fumbling his papers, gives a few items as to age, sex, time of admission, and some laboratory findings, then the surgeon picks up his knife and makes his incision. How seldom do we see the groundwork of the case cleared, the condition stated and classified, the proposed operation described and the reasons 'why' given, all in clear, clean cut sentences. Dr. Hertzler's book will rank with Howard Kelly's "Myomata of the Uterus," and Scudder's "Tumors of the Jaw," and it will prove to be of great help in diagnosis and treatment of tumors. Golden Rules of Surgery. By Augustus C. Bernays. Revised by W. T. Coughlin. St. Louis, Mo.; C. V. Mosby Co., Publishers. (Price, $2.25.) The author of these splendid rules of surgery was a spectacular and original surgical genius. The junior author has brought this edition up-to-date so as to cover the entire field of surgery in a thorough and systematic manner. One is struck with the force of each statement, and surprised to find cardinal principles enunciated in a sentence-not pages. A perusal of this little book will acquaint you with the fundamental truths of surgery. New Aspects of Diabetes. Pathology and Treatment. By Prof. Carl von Noorden, Professor of the First Medical Clinic, Vienna. Lectures delivered at the New York Post-Graduate Medical School, New York. Cloth, 160 pages. New York: E. B. Treat & Co., 1912. (Price, $1.50.) Perhaps no living author can speak with greater authority on the diseases of metabolism than von Noorden. In this volume he takes up the latest developments in the study of diabetes mellitus. His treatment of thousands of cases, his physiologic chemic experiments present the subject of diabetes in its recent aspects. It is a monograph of singular importance, and no one can intelligently treat diabetes without reference to this volume. The Blood of the Fathers. A Play in Four Acts. By G. Frank Lydston. Cloth, pp. 241. Chicago: Riverton Press, 1912. (Price, $1.25.) The versatile Lydston is liable to enter any field of literature or art. This work is an effective plea for eugenic marriages. The action of the play hinges upon the marriage of a social reformer and likewise a doctor with a woman the offspring of degenerated parents, the girl's father being a burglar and the mother an opium habitue, who subsequently commits suicide. There is another young woman; a woman of class, wealth and clean parentage who is doing social settlement work in the same district as that in which the doctor practices. The blood of the father manifests itself when the doctor's wife commits a theft. When accused of the crime, she chooses expiation by the cyanide route and after which we presume the other woman re-enters the doctor's life. The story is presented in a dramatic form, it is clever and sane and is worthy of considerable contemplation by the sociologist. The book displays a true literary quality, it points the moral and is withal most enjoyable. Andrew the Glad. A Novel. By Maria Thompson Daviess. Indianapolis, Ind.; The Bobbs-Merrill Co. (Price, $1.50.) The talented author of the "Melting of Mollie," has in her new book given us another charming picture of that picturesque valley of Harpeth, Tenn. The characters. belong to the South's new order of wealth, culture and society. The love affairs of two sets of young people are involved. It might be said, and correctly, too, that there are two heroes and two heroines, so closely is the texture of the two love-plots woven and interwoven and so well poised are the four chief characters. But at the same time neither phase of the story loses any of its individuality, the double purpose serving only to enhance a new antithesis that Miss Daviess has cleverly created in the characters of the two "heroines." For the author has lent a truly novel touch to her story by trading, as it were, the traits which one might expect to find predominant in the two women, who represent the two forever differentiated sections of the country-the North and the South. To add zest to the book an amusing political situation has been introduced that is done with a light touch and affords an opportunity for some interesting comment. There is a 'possum hunt that is good and serves a subtle and original purpose. There are many good sayings, some exceedingly natural talk and phrases galore that will remain in 'the memory of the reader. The February Craftsman is so full of inspiration and art that no home lover, or art lover should be without it. We are particularly indebted to Jacob Riis for a most interesting article, entitled "Rescuing Our National Festivals." The plans of houses in this number have a wide range in design, from the elegant eleven-room homes-one of which is most wonderfully pictured and furnished-to the bachelor's bungalow, which is of most attractive appearance. |