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EXTRACTION OF A HAIR-PIN FROM THE BLADDER.

BY S. B. BRINKERHOFF, M.D., Santa Barbara, Cal.

I was called at night to a patient eighteen years old, who stated that she had passed an old-fashioned gutta percha hair-pin into the bladder, and that it had been there seven days. A little blood had passed in the urine. I sounded the bladder, but could detect nothing of a foreign nature. Patient feverish; pulse, 110. I called in consultation another physician, and he decided, after careful sounding of the bladder, that there could be no hair-pin there. In the afternoon I injected the bladder with warm flax-seed water. Made another examination, but could detect nothing.

Next morning patient's pulse was 120; passing blood and pus with the urine, and slightly delirious. I had dilated the urethra by sponge tents all that the parts

would bear.

I went to a silversmith and procured a small silver wire, and had a loop made at one end as large as would pass into the bladder, and had a stronger wire brazed between the loop and the ends of the wire, and wound

this with waxed silk thread. With this instrument I determined to fish for the hair-pin. Passing the wire loop into the bladder, I soon found that I had caught something, which, with careful tension on my guide, and delaying from time to time, as spasms of the parts occurred, I soon brought so near the orifice as to be reached with a mouth-tooth forceps, and extracted. The wire loop had caught between the points of the pin.

I claim, in using the wire loop, that if anything was caught and could not be extracted, the loop could be disengaged and removed without injury to the surrounding parts. It is also a very simple instrument, easily made by any silversmith. My patient was about the house in ten days, and is now in perfect health.

HYDROPHOBIA.-A woman showed the plain symp toms of hydrophobia, and the treatment was the bypo. dermic injection of Curare, administered simply with a view of neutralizing the convulsive cramps. The success of the treatment depended upon the fact that the author did not limit himself to minimal doses, but injected absolutely twenty centigrammes in several operations, all within five hours. It was amazing to see the cramp which tortured the patient before the antidote took effect. Very quickly set in the horrible convulsions in the throat, in the muscles of respiration, the hydrophobia, the raving and mania, which all seemed to threaten imminent death by suffocation and exhaustion. It was just in the height of this stage that the injections were made. As by a stroke the cramps ceased suddenly, but to recur after a short interval. After repeated injections the Curare mastered the rabid virus, which now showed its presence in the body only in light twitchings. At last the Curare began to exhibit in an alarming degree its own toxic effects, inducing great danger of paralysis of the circulation and respiration. These dangerous symptoms were only allayed by active efforts at artificial respiration, whereupon the patient fell into a condition of great weakness, from which, however, she slowly rallied to complete recovery.-Allg. Med. Centralzeit, No. 57, 1879.

TO TEST FOR ALBUMEN.-Da Costa says drop the fluid slowly down the side of the test-tube upon the nitric acid. If any albumen be present, an opaque white ring is seen to cover the surface of the acid. This is the most delicate test with which I am acquainted.Courier of Medicine.

THE editorial office of the Cincinnati Medical Ad. vance has been removed to Ann Arbor, Michigan.

THE HOT-WATER VAGINAL DOUCHE.-Dr. E. C. Dudley. The necessary apparatus consists of a bucket suspended on a hook about four feet above a couch, on which rests a bed-pan (the bucket should be large enough to hold two or three gallons of water), a soft rubber syphon, and a rubber tube attached to an opening in the bed-pan and leading to another bucket placed on the floor.

Proper Method of Application.-1. It should invaria bly be given with the patient lying on the back, with the shoulders low, the knees drawn up and the hips elevated on a bed pan, so that the outlet of the vagina may be above every other part of it. Then the vagina will be kept continually over-flowing while the douche is being given. 2. It should be given at least twice every day, morning and evening, and generally the length of each application should not be less than twenty minutes. 3. The temperature should be as high as the patient can endure without distress. It may be increased from day to day, from 100° or 105° to 115° or 120° Fahr. 4. Its use, in the majority of cases, should be continued for months at least, and sometimes for two or three years. Perseverance is of prime importance.

MILK DIET IN ACUTE RHEUMATISM.-M. Biot, in an

important work published in the Revue Mensuelle de Medicine et de Chirurgie, exposes new ideas on the nature of acute rheumatism. The treatment must be started as soon as possible, and pure milk must be used to the exclusion of any other food. The quantity may vary according to taste and habits of the patient; the minimum dose being one quart a day, which can be increased to two, and even three quarts.

It is necessary that the milk be taken in small quantity and at regular intervals.

In a short time-from three to seven days-the patient becomes convalescent. When the pains have ceased and the fever has subsided, the treatment must be continued with mixed food, but alcohol, wine and meat must be dispensed with for some time, otherwise a relapse would surely be the result.

"

CORRECTIONS TO BE MADE IN DR. GOODNO'S ARTICLE IN JANUARY ISSUE.-First line of third paragraph should read felt for "feel;" first line, second column, page 229, should read Pott instead of "Post," and in several other instances the same error is made. Page 229, second column, line 20 from below, "phalangral should read phalangeal; page 230, first column, line 25 from below, instead of “recommendation" read reconsideration; page 230, second column, line 12 from above, should read 200 cases instead of "no case;" line 16 from above read fractures instead of "fracture."

REPORT of the Brooklyn Homœopathic Hospital Dispensary, 109 Cumberland Street, for the month ending December 31, 1879: Prescriptions, 1,443; new patients, 736: average daily attendance, 61; largest attendance, 116. T. D. KOONS, M.D.

A RUPTURED BLADDER was recently exhibited by Dr. Friedlander to the Berliner Medicinische Gesellschaft, Berliner Klin. Wochenschrift. The specimen was removed from the body of a woman who had fallen down a flight of stairs. A large quantity of fluid was detected in the abdominal cavity during life, but the urine could always be drawn off in considerable quantity. Death did not take place for eight days after the receipt of the injury. A rupture was then deteated in the bladder wall, but the omentum almost completely filled the rent. The fluid in the abdomen had an odor resembling carbonate of ammonia; it consisted not only of urine, but also of peritoneal exudation.

to practice as they conscientiously can, homeopath

The Homeopathic Times. ically or otherwise; in other words, they are inde

A MONTHLY JOURNAL

Of Medicine, Surgery, and Collateral Sciences.

Editors:

EGBERT GUERNSEY, MD.

pendent, and bound only by their own consciences.

The question is, whether the homeopathic school can afford to ignore the wishes of this large and intelligent class of our colleagues, or whether it should make its platform sufficiently broad to hold

ALFRED K. HILLS, M.D. them?

J. B. GILBERT, M. D.

Published on the First of each month.

It will be too late when they have gone to reconsider the matter, for they will not return, and with a declining membership our societies will soon feel

Office, 18 West Twenty-third Street, New York. the effects of their withdrawal.

NEW YORK, FEBRUARY, 1880.

=

"A regular medical education furnishes the only presumptive evidence of professional abilities and acquirements, and oUGHT to be the ONLY ACKNOWLEDGED RIGHT of an individual to the exercise

We hope the society in its deliberations will look these facts squarely in the face, and not attempt to pervert, misinterpret, or defraud itself into thinking they do not exist.

It is all very well to say, "Let them go," as some and honors of his profession."-Code of Medical Ethics, Amer. will; but what will be the consequence to the

Med. Ass., Art. iv., Sec. 1.

THE STATE SOCIETY.

The annual meeting of the society will be held at Albany on the second Tuesday of February, and upon its deliberations will depend interests of vital importance to our school at the present time. There ought to be a full attendance of members, and the issues which come under consideration should receive careful, dispassionate discussion, with but one end in view, and that the triumph of truth.

school? From declining numbers will come failure of confidence of the community, and no ex cathedra statement that "Homœopathy is all-sufficient under all circumstances" will save it, because well known to be otherwise.

Again we say: Beware of the counsels of those who would surround us with "articles of faith!" for they have no place in any organization which claims to belong to the family of scientists.

In an article, nearly one year ago, we called attention to some clauses of the "Code of Ethics," If we desire to promote strife in our ranks, there bearing upon the subject of which a committee was is no better way to do it than to allow the promul-appointed at the last annual meeting, to report at gation of eccentric or peculiar notions-views which this, and we again call attention to the matter as are held by a small minority-and attempt to coerce having an important relation to the subject under, the majority into a belief in them.

consideration.

The time has long since passed-if it ever was- The "Code of Ethics" was adopted as a part of when belief in any theory should constitute a quali- the by-laws of the society, and we must be careful, fication for membership in a scientific body. The in adopting resolutions, not to violate either its homœopathic mode of practice is now so well known letter or spirit. On account of the sentiment of the that a simple preamble indicating an interest in it should be the only requisite for candidacy for membership.

The more we attempt to formulate our theories dogmatically, the slower will be the progress of the school which adopts them: '

There is too much difference of opinion respecting the practice of medicine to expect any great number to agree upon its minutiæ; hence the importance of a broad and catholic platform.

At no time in the history of our school was it so important that wise counsels should guide us as at present. The two extremes are becoming more and more arbitrary and dogmatic, and if we will avoid catastrophe their propositions must be so tempered that the conservative will not be driven to seek affiliation and protection in more genial atmosphere.

Already has the disaffection of the conservatives gone so far that some of them have joined the "old school" societies, asserting that there they are free

«Code "--and we see no reason for reiterating it in the form of resolutions-the resolutions presented by Dr. Fowler might be rescinded.

But whatever is done should not be hastily, for there is plenty of time, and it is better to take our leisure for consideration of the subject than for re pentance after the harm has been done.

ORGANIZED CHARITY.

In large cities, and in smaller towns and villages, nearly every case of absolute want and distress can be met and relieved by a well organized system of charity; and that, too, more efficiently and at a less expense than in the fitful and desultory way in such common practice. The plan of indiscriminate giving without proper inquiry, sometimes from the warm impulse of a generous heart and sometimes to get rid of persistent importunity, is productive of positive harm by fostering vice and relieving a large

Dispensary can be accomplished wherever there is need of such organizations. The cost is comparatively trifling; the good is beyond estimate. The work appeals strongly to the medical profession, whose members not unfrequently forget the wants of the poor in the selfish desire for personal aggrandizement.

PHILANTHROPY RUN MAD.

class, who are perfectly able to work, of the respon- plished in a quiet, unostentatious way, is beyond sibility of taking care of themselves. As a proof of estimate. What has been accomplished by the New the efficient work which a well organized charity York Diet Kitchen and the Western Homœopathic can accomplish at a comparatively trifling expense, we have only to point to the labors of the New York Diet Association and the Western Homeopathic Dispensary. The New York Diet Association was incorporated in 1873, having for its object the supplying of nourishing and well cooked food for the sick poor. It has at present three kitchens-the Centennial Kitchen, at 137 Centre Street; the West Side Kitchen, corner of Ninth Avenue and Thirtysixth Street, and the East Side Kitchen, corner of Twenty-third Street and Third Avenue. The physi. cians of the dispensaries within whose district the kitchen is located have the right to give the requisition for the food. Each requisition may call for three articles, viz: one pint of beef tea, one pint of milk, and one egg, or two pints of milk and rice, according to the discretion of the physician. One requisition cannot run longer than seven days, when, if the patient needs it, a new one may be furnished. The patient sends for the food each day to the kitchen. While the rule of the Association is that only the sick ones of a family shall be cared for by this charity, much is done by the ladies having the kitchen under their particular care to alleviate the sufferings and needs of all with whom they come in contact. Even though a physician may visit the family, the matron of each kitchen is required to visit all who apply for relief, not only to guard against imposition, but that all proper means may be taken to restore the sick to health and comfort those who are incurable.

In the Centennial Kitchen during 1879 there were given out to 6,458 patients 10,485 pints of milk; 2,315 pints of beef tea; 2,702 eggs; 1,653 portions of rice and 7 portions of oat-meal, at a cost of 16 cents a day to each patient. We are indebted for the above statement of the New York Diet Association and the Centennial Kitchen to Mrs. Harriet B. Barrow, directress. It will be impossible to measure the amount of real, positive good which has been quietly accomplished by this thoroughly organized and well directed system of charity. It goes with its blessings to those who are really needy, many of whom, in their desire to avoid public notice, would die of starvation were it not for the helping hand of this true, practical, Christian philanthropy.

Men whose minds revolve around a single idea are very apt to allow that idea to lead them into the wildest vagaries and most absurd positions. We in New York have had a feeling of pride in Mr. Bergh, the able and energetic President of the Society for the Prevention of Cruelty to Animals. That society is Mr. Bergh, for without him it would never have had an existence. It has done a most Christian work, and is one of the most useful organiza tions in the city. Mr. Bergh and his society, nevertheless, require careful watching. Confined to their legitimate business they deserve all praise, and should receive the support of every good citizen. But when Mr. Bergh attempts to shut down the gate on the progress of physiological science, it is quite time, in the interests of science, the public, and especially the medical profession, should say, "hands off; we do not intend to permit you to obstruct the wheels of progress by any of your fanatical ideas. So long as you confine yourselves to a rational interpretation of your legitimate business we will help you, but when you go beyond that we will stop you.”

Mr. Bergh has introduced a bill into the legislature which virtually puts an end to all vivisection, and as the greatest progress in physiology has been made by investigations on the living subjects, this science will come to a stand, and all further progress be debarred. If these investigations were made at the expense of great physical suffering, Mr. Bergh would have a strong argument in favor of his position. But there is no suffering. The animal is put under the influence of a potent anæsthetic which effectually puts an end to all suffering. We have no doubt there is a great deal of entirely useless vivisection done by physiologists, but so long as not one particle of suffering is produced, this work had better be left to the judgment of scientists themselves.

EXAMINERS IN LUNACY.

The Western Homœopathic Dispensary during the past seven years has treated over one hundred thousand patients, many of them at their own houses, The examination of persons suspected of insanity and given out more than two hundred thousand has been considered of sufficient importance for the prescriptions, at a cost not exceeding three cents to Commonwealth to order that "no person shall be each prescription. Working hand in hand with the committed to or confined ** * * except upon the diet kitchens, giving not only medicines and medi-certificate of two physicians, under oath." It also cal advice, but often what was far more necessary, provides that said certificate "be approved by a judge food, the amount of good which has been accom- of a court of record," etc.

Notwithstanding the care with which the law has been framed, there is still the greatest opportunity for injustice in regard to these unfortunates, one of the most important of which is the looseness and carelessness with which some of these examinations are

conducted.

The subject of our complaint would not in the least be affected by a more rigid selection of the examiners; for the trouble does not lie in this direction, but rather in the lack of appreciation of the gravity of the undertaking, error in judgmert respecting what constitutes insanity, or from interested motives, either personal or secondary.

Every examiner in lunacy ought to have a keen perception of the crime of perjury, and conduct each examination of this kind as if it would be the basis for an action of this character.

There is great danger in placing too much confidence in the history of the case, which is liable to be colored by influences too subtle for analysis in the short space usually accorded to such examinations. The reasons for declaring a person insane should be not only beyond doubt in the mind of the examiner, but so clear that they can be demonstrated to the satisfaction of any intelligent disinterested individual who may have the right to inquire.

A proper understanding of this matter would have done much to disarm those enthusiastic alarmists who instigated the late movement which resulted in the recent legislative inquiry.

The general professsion owes to itself and to theCommonwealth at large a full knowledge of this important subject, to the end that they may not only quiet the anxieties of interested clients and friends, but also that they may impart information to legislators in their respective localities--who are not expected to be so familiar with the subject as medical men ought to be in order that they may act intelligently, should questions in this regard arise in those legislative bodies to which they may have the honor to belong.

The committee of the State Senate did excellent service when they investigated last winter the gross and insinuating charges respecting the institutions for the insane, and its report should be in the hands of every physician in the State. It is more than likely that these grumblers, who know very little of the inside workings of these institutions, will continue their work and, if possible, cause more alarm to those who may be grieving over the necessary incarceration of some loved one.

It devolves upon the members of the medical profession to restore peace by means of enlightened confidence in those who have official connection with our institutions, and who are thoroughly competent for their work and surrounded by sufficient guards for the public safety.

THE LUNACY QUESTION.

In order that our readers may feel assured that there is not the occasion for alarm which some would make them think, we submit the following able report concerning the subject, made by the "Committee on Public Health" in the State Senate, May 22, 1879, based on a most thorough investigation :

The general assertions of the petition are not substantiated by any facts. They are merely allegations of mismanagement and defects, and incompetency of far as the committee are aware, has even been inside officers. Not one of the petitioners, medical or lay, so of the State institutions for several years past, and only some half-dozen have ever been in any of the wards of any of the asylums. Dr. Chapin, of the Willard Asylum, recognized the name of but one person on the petition who had ever visited that institution. Dr. Gray, of Utica, said that but two out of the whole number had ever visited the wards of that asylum, and neither of these for several years past. Dr. Cleveland, of Poughkeepsie, said that but four or five had ever visited that institution since its opening, and these not for several years. Dr. Hammond had never visited the Willard Asylum, had been at Utica but twice, twelve and eight years ago, at Poughkeepsie but a few times, and at Blackwell's Island before the incumdale under a former superintendent. Dr. Morton had bency of the present superintendent, and at Blooming. never visited any asylum except Ward's Island a few times. Dr. Spitzka had never been in any of the State institutions, and had no personal acquaintance of any of the officers; had never visited but one of the city asylums, and the same could be said of Dr. Kiernan.

The value of a petition gotten up by persons so with no knowledge on the subject, it requires Lut wholly ignorant of the institutions, signed by persons

little to estimate.

In conclusion, the committee would say:

First. The petition is not substantiated in its allegations by any existing state of facts. The Governor in his last message to the Legislature has spoken of the satisfactory condition of the State asylums from per

'sonal visitation.

Second. The Board of State Charities, an official visiting body, has never suggested any such defects or mal-administration of any kind in their annual reports to the Legislature. A special committee of that board (President M. B. Anderson, of the Rochester University, and Mr. E. W. Foster), after examining the State asylums with reference to similar insinuations and allegations, reported on December 15, 1877, that "the community is justified in having entire confidence in the administration of these institutions." Third. It appears from the archives of the State Commissioner in Lunacy, as well as from his personal statement before the committee, that since the creation of this office, no formal complaints have at any time been made or filed with him against the management or internal administration of any State asylum, and his reports and personal statements before the committee show that no occasions calling for special criticism upon such management or administration have up to this time presented themselves.

Fourth. The insinuation of the petition that the superintendents of these State asylums are not thoroughly trained and thoroughly competent medical men, is too notoriously untrue to require denial.

Fifth. It is not true, as alleged in the petition, that assistant physicians in State asylums. The charge is s undergraduates in medicine have been appointed a reckless misrepresentation of these officers, and, und a examination, the four persons appearing admitted th From the statements of the superintendents of asylu it appeared that in almost every instance assista

have received training in civil or military hospitals, and in other cases an equivalent in medical practice after graduation. Outside of the State asylums it appears that but one undergraduate is employed, and that he obtained his place by examination as to quali fications by the authorized medical examining com. mittee of the institution in which he is employed.

Sixth. In the judgment of the committee, there is no necessity for investigation or examination into the management of any of the State lunatic asylums. This petition sets forth nothing new or valuable, and all the persons signing it, as far as the committee have been able to ascertain, have no personal knowledge of these institutions, or of the allegations made in the petition, and many of them are so obviously and grossly untrue that they would seem to be the offspring either of ignorance or malice. In either case they are unworthy of notice.

This attack by medical men on the scientific work of a State institution evinces an ignorance and a spirit of recklessness unworthy of a great liberal profession, and should be condemned by all who have the interests of science and humanity at heart.

The assailment of public officers and the great charities of the State in such a reckless manner, the committee believe, should be exposed, not simply because it is a wicked use of the sacred right of petition to the injury of individuals, but it also creates public distrust in the administration of State charities, and fills with unnecessary pain the hearts of those who are obliged to commit their loved ones to the care of these institutions, and further, because it tends to degrade the dignity of the State.

There is a set of men here, very few of whom are ex. perienced neurologists, who constitute an organization styled the Neurological Society. It is well known in this community that Dr. Hammond is its controlling spirit, and when he wants " chestnuts," he uses this organization as a means of getting them. There are apparently many unseen inside wheels here, and any thing this Society may do should be accepted with

caution!

At a recent meeting, the investigation, of which the above is the conclusion as adopted by the Senate, was severely condemned, and measures instigated for further agitation in the present Legislature.

We trust the profession at large will take means to protect the community against such marauders, and expose their real animus.

cially interesting the municipality, is one upon which it is to be hoped that other States will act, and espe cially those which are as yet unprovided with boards of health.

It is certainly full time that the great State of New York should have some health organization. Upon the existence of properly constituted State boards like the one proposed, boards which shall be charged with the duty of collecting vital statistics; of making scientific investigations and sanitary surveys; of doing away with nuisances beyond the reach of municipality, such, for instance, as the pollution of its sources of water supply at a point beyond its jurisdiction, depends to a great extent the future of sanitary science in this country; and every sanitarian, every educated medical man, and every one who can look far enough beyond the present hour to see that public health organizations are destined soon to become an essential feature of all governments, will do what he can to secure the enactment of such a bill as this.

It is not meant that the bill is perfect!'in all its details; that cannot be asserted of any public health organization in existence; but the general principles of the bill are correct, and it is sincerely hoped that it may soon become a law and be put into practical operation.

AN ACT TO ESTABLISH A STATE BOARD OF HEALTH.

The people of the State of New York, represented in Senate and Assembly, do enact as follows: Within twenty days after the passage of this act the governor shall appoint, by and with the advice and consent of the senate, three State commissioners of health, two of whom shall be graduates of legally constituted medical colleges in the State, and of not less than seven sioners, together with the attorney-general, the State years' practice of their profession. The said commisengineer, and the health officer of the port of New York, who shall be ex-officio members of the State board of health, and three other persons, to be designated and commissioner of health of the board of health of the appointed by the governor, one of whom shall be a city of New York, and the others shall be commissioners of health of regularly constituted and organized boards of health of cities of the State, shall constitute Nothing in chapter 335 of laws of the State of New York, in the laws amending the same, or in the laws constituting boards of health in the various cities of the State shall be read or construed to prevent the health of cities, also members of the board of health of appointment of the said commissioners of boards of the State of New York, and no appointment to an office or acceptance thereof under this law shall be held to vacate the office previously held in any board

"The Board of Health of the State of New York."

THE PROPOSED STATE BOARD OF HEALTH of health of any city in this State.
FOR NEW YORK.

Special attention is invited to the following plan for a Board of Health for the State of New York, which will be at once proposed to the Legislature in the form of a bill, and which it is hoped may soon become a law. This plan has been prepared after extensive consultation with those most interested in the subject, and it embodies several points which are new in such legislation in this country. It has been largely because of the supposed difficulty of harmonizing the powers and interests of the Boards of Health of great cities with those of a State Board of Health that the States of New York, Ohio, and Pennsylvania are yet without State health organizations.

SEC. 2. The said three commissioners so appointed shall take the oath of office prescribed by the constitution for State officers and receive from the secretary of state certificates of their appointment. They shall hold office for three years, and whenever a vacancy occurs the place shall be filled as in other cases provided by law, and the other commissioners shall from time to time be designated by the governor as occasion may require or as their places may be vacated in the board by the expiration of their several terms of office.

SEC. 3. The State board of health shall Leet at least once in every three months, and as much oftener as they shall deem necessary, their first meeting being held within two weeks after the appointment duly made of the members of the first board and after they shall The manner in which this has been adjusted in the have qualified as aforesaid, and cach annual meeting present plan seems to be eminently satisfactory, and to be held within two weeks after the first of May the general principle upon which it is based. i. e., each year after the first, as herein provided. No mem giving the municipal health organization two forms of ber of the board except the secretary shall receive any representation in the State Board, one by permanent compensation, but the actual traveling and other exappointment, the other temporary,1, in matters spe-penses of the members and officers of said board while

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