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length of the usual program. The effort is ing the debatable points in the subject properly apparently made to cover the entire field of under consideration. medicin, surgery, or whatever specialty is the Who has not felt humiliated at the bungling, occasion of the meeting. Paper after paper hesitating, monotonous and expressionless
readis fired at ihe listeners, with no reasonable in- ing, and the stammering, illogical and inconsetervals for deliberate discussion. It is not un- quential speaking in doctors' meetings? It usual to find half a dozen papers on important might be profitable for a goodly number to subjects crowded into a single session of two or take a few lessons in elocution. Excellent three hours. Those who devise the programs
ideas are often murdered in the rendering, and ignore the fact that there may be subsequent Spalding's glue can hardly restrain people from medical meetings, and that it will be wise, if vacating their seats, rather than listen to prosy, not generous, to leave some topics for their hum-drum, uninteresting readers who address consideration.
themselves, and gesticulate to their manuscript The next cause of complaint is the inordinate rather than to their auditors. It is a relief to length of the majority of the papers presented. have some man rise in his place and deliver himEven in meetings, where it is well known that self of ideas in language that is unmistakable, only a stated and definit time limit is allowed that strikes home and makes itself felt. to each paper, not seldom does the reader There is a great difference between what is flounder in the prolog and introduction until barely tolerated and words that are irresistible his time has expired by limitation, and then he and convincing. is either untimely cut off by the chairman's If these suggestions serve in any way to gavel, or perchance, the good nature of the repress the interminable bores, and rouse to hearers, with more or less forbearance, extends forceful expression readers and speakers, they his time, often infringing on the rights of sub- will have served their purpose and will make sequent numbers on the program.
medical meetings more interesting and profithere are very few medical papers presented able.
BENJ. EDSON, M.D. in the course of a year that could not be prost- Brooklyn, N. Y. ably compassed in the space of fifteen minutes. [It seems that some men are so constituted Many of them are not worth ten minutes of the that they cannot aim directly at the point, time of an audience of intelligent professional whether speaking or writing. What should be men. And yet men of standing and reputa
done with them? We freely “blue pencil "the tion continue to inflict their tiresome com- useless preliminary verbiage on contributions pilations upon suffering hearers in secula that come here.-Ed.] seculorum. If those who prepare “ literary” papers
Consultation among the Various Schools. would at the outset grant that their hearers Editor MEDICAL WORLD:-) am interested possess at least an elementary knowledge of the in your open discussion concerning consultarudiments of medical science — would give tion among the various schools. The question Hippocrates, Galen, Arataeus, and the defunct is a broad one and has two sides. However, it ancients generally a rest and burial—would seems to me that preponderant arguments are realize that an assemblage of learned doctors is deducible in favor of intra-sectarian consultapresumably beyond the kindergarten stage of tion. These arguments will naturally fall into medical lore-would in short give us some- two divisions : The doctor's reasons, and the thing new and up to date, personal experiences patient's. . and observations, deductions and conclusions The first readily offers itself for division into from their own field of investigation, it might three sub-heads : Social, scientific, and sectawarrant traveling long distances to listen to rian. something interesting and profitable.
Socially, common human interests, favor As it is, the social functions of many a liberality rather than bigotry, for after all, the medical meeting are all that rescue the gather- doctor is merely a man, and whenever he ing from being “flat, stale, and unprofitable.”' permits sect prejudice to interfere with his
Those whose province it is to discuss the relationship to the humanities, his value as a papers are often sinners likewise. Some so healer diminishes. The tradition of all ages like to hear the sound of their own voices that points to the doctor as an altruistic and optithey are oblivious to the passage of time and to mistic adviser. Aside from this are the fellowthe fact that possibly some one else may have a ship and sympathy desired and neeeed, from coword to say.
workers, by every man. An even more selfish We have all seen the man who comes pre- reason for consultation is the mental and social pared with a pocketful of specimens, and who, broadening always possible. Whether the coninstead of fairly discussing the subject in hand, sultant is our superior or inferior mentally, proceeds to exalt himself
and his doings, ignor- socially, or scientifically does not affect the
truth of the preceding statement. The man
medical unity is chimerical, and should be such, who is as thoughtful as the medical man should methods as herein suggested will remove rebe, will deduce beneficial comparisons, either movable friction. thru approbation or reprobation.
From the patient's view-point, the matter is As a scientist, any opportunity for patholog- one of his paramount right to the best obtainical review should command a willingness to able treatment. What is a certain school to consult. Scientific experience and research is him if he die? The correlativs of the arguof value, whoever its medium. Every scientist ments used in discussing the physician's phase must have learnt something of value. The real of the question, apply with full force here. All student rises above school limitations in mat- the arguments of selfishness and also of altruters of original research. The man in the ism are his in favor of consultation. Not all scientist prevents his classification as a mere consultants will be ideal ; nor will all patients sectarian. The sciences of anatomy, pathology, recover if a consultant of differing school is etc., recognize no sect, and it is as often diag- called, but I believe nothing but good can nosis, as treatment, that brings us to our knees. come from a discriminate choice of consultants I once consulted with an elderly allopath. He from different sects. did not wholly understand the rationale of my
WALTER S. BOGART, M.D. treatment, but admitted the point after expla- Cleves, Ohio. nation. There was a stubborn feature in the case under consideration which seemed unac- Prevention of Mould in Aqueous Solutions. countable, owing to absence of objectiv symp.
-Long Continued Typhoid. toms. My consultant, after a long résumé of Editor MEDICAL WORLD:-Some time ago, the mutually perplexing case, said, "Have you in THE WORLD or some other journal, I saw a suspected syphilis?” I had not, but his sug- prescription given for the preservation of solugestion offered a solution of the whole prob- tions of epsom salts and other solutions from lem. Could he have done more for me if a moulds, which we know so soon form on and member of my
own school? His leading spoil such aqueous solutions. The simplest and question was the result of experience and re- cheapest way I ever saw or tried is to keep a search. Might not this be true of any con- little pure chloroform at the bottom of the stock sultant of any school in any particular case ? bottle; the vapor is continually present at the
As sectarians, there are numerous reasons top, and as it is death to all kinds of moulds, it for professional communion. As one of your very effectually prevents their growth in any contributors says, pathology, symptomatology, solution, and it gives a sweet, pleasant flavor and therapeutics are best represented in differ- that helps to mask nauseous mixtures. I have ing schools. Is not that a fact, if we will let never seen it in print, but have used it for ourselves admit it? And should it not be taken many years, and no doubt others have done so advantage of? If the difference between your also. knowledge of one of these three fundamentals, I have treated my share of typhoid fever and that of your neighbor, should justify your cases in the past forty years. I have tried calling him, and you do not, for school reasons, most of the abortivs for the same and the difand a life is lost, aren't you a long way toward ferent modes of treatment that worthy men in being a murderer ? Or if, as an individual, he the profession have found so successful in their has buttrest himself firmly in some department practise. I have been blest with good success of science, can you lose by conferring with him? under the intestinal antiseptic plan of treatIs dogmatism compatible with an increasing ment, and have a good deal of faith in it, even civilization or with your own best business or tho some of our professional brethren try to moral interests? Then, there is the individu- show us that the proportion of the antiality in treatment. Do you know of many septic to the body avoirdupois can never be physicians in any given school who treat ex- sufficient to affect the disease working bacillae ; actly alike? Are doctors machines, any more even Nothnagel in his late work on the subject than patients? The results of such individual gives little credence to the good they do in experience cannot fail to benefit somewhere. that direction, but notwithstanding the adverse Above all else, in choosing your confrere, should opinions of so many, I feel confidence, to a you look to his ego? Lastly, I believe free great extent, in their beneficial action, and I consultation would redound to the benefit of use them in every case. Some years ago I had all sects. It must be true that each can learn, a typhoid case that hung on for sixty-two days in some things, from every other, and learning in spite of all the antiseptics I gave, with a means elimination of errors. Thus can each fever line of about 100°. I never had one of school be taught its own errors and bettered, these cases again until the past fall, when I got and the entire medical body be leavened with four of them, three in one family and one in the disseminated knowledge. While absolute another many miles away, all boys from 5 to
Il years old except one girl 5 years old. Some started in with high fever from time I first saw them; others moderate fever; but after pushing intestinal antiseptics, all fell in a short time to about 100°, sometimes little over or under, and they all kept this up for over eight weeks and two for ten weeks. I gave these four children during treatment about 2 of sodium sulfocarbolate; there being no diarrhea, I did not use the zinc salt, but did use bismuth salicylate, salol and beta napthol, and should have tried the new treatment with Merck's sodium bisulfate, of which I got in 2 oz. to give it a trial in the bombardment of the bacillae, but they weakened, health returned and the fever gradually left them, so I have not given it a trial yet. They had arsenite of copper continuously. These cases never felt very ill after the fever got down to the 100° line, seemed in fact so well that a stranger would think very little ailed them. But the fever stuck there steadily right along, in spite of all my antiseptics. Of course I cannot say what it would have been if they had not had this treatment, but I feel confident the antiseptics held the temperature down, because each time I slackt up on the dose the fever rose a little. I began to doubt my thermometer and tried three or four others, but they all told the same tale. Can you or any of the brethren give a reason why in these cases the fever should keep up for such an abnormally long time? I treated them in regard to nursing, feeding and medicin on about the general plan that I treat all my · typhoid cases.
Thos. D. HULME, M.D. Commerce, Iowa. [Was there not some local irritation somewhere that kept up the fever? Was there delay in the healing of the bowel ulcerations ? Was there a lack of vitality to overcome the disease? Was there double poisoning, in some way. that would induce a double course ? Brotherhood please discuss. —ED.]
formed that the child was dead, I proceeded to investigate, and found a deformity and complication which I do not remember of having read about. It was not a spina bifida, and was not hydrocephalic; but there was a lack of osseous development extending from the frontal bone back over the superior and occipital parts of the head, down to the lumbar vertebrae. This structure was about two inches in width, and was rather cartilaginous in character, but presented a reddish, beefy appearance. There
no signs of protrusion of meninges of either brain or cord, and no tumor of any kind existed. There was absence of all bones of the skull except portions of the frontal and parietal. Now, the queerest thing of all was the fact that the placenta was closely adherent to the child's back and occiput. The child and placenta were envelopt in a tenacious membrane on which I used scissors to effect an entrance. The placenta must have had very little uterin attachment. Had I expected to find the placenta thus inclosed, a closer examination before puncturing might have enabled me to have ascertained just the extent of attachment. There was entire absence of the child's neck, but aside from these malformations, the child was normal, and the full period of gestation seemed complete, or nearly so.
I read in The MEDICAL WORLD once some doctor's experience in removing a piece of beefsteak from an old fellow's throat, a hypodermic of apomorphin being the remedy. Recently an old man, while intoxicated, became choked on a piece of meat two inches square and about a half inch thick, which I caused him to expel in just five minutes via the apomorphin route.
W. F. MARRS. Jewett, ill.
Incomplete Bony Development and Queer Placental Attachment.- Removal of
Beef from Throat. Editor MEDICAL WORLD:-On December 10, at i a.m., I was called to see Mrs. X., primipara. The uterus was well descended and pains were moderately severe, but as they continued to wane I left, after having been with the woman about twelve hours. I gave a prognostic guess that labor would come on in about twelve hours—midnight. It over-ran a little, labor setting in about 3 a.m., and the woman was delivered about 4.30, which was a few minutes previous to my arrival. Being in
Eighteen Children in Eight Years.
Twins, Mother 32 years old at last birth. All lived to be over 20 years old, then died.
Langdon, D.C. John S. DORSEY.
[We suppose that the doctor intends this as a sort of challenge for comparison in fecundity. We doubt if the above record can be equaled -certainly not exceeded. -Ed.]
Hydrogen peroxid, diluted with an equal bulk of water, makes an admirable dressing for chilblains. It is all the more serviceable if the skin has formed in blebs or ulcers, and being non-poisonous, may be applied continuously in the form of a wet dressing."
Apparently a Double Placenta.
many, especially young men, give it little heed, Editor MEDICAL WORLD :-Recent issues of and attribute cures to medication when in your valuable journal have recorded several many cases the cure has been effected in spite remarkable cases of labor, which recall to my of medicins. All doctors of much experience mind a case in my practise which was at least know this to be true. remarkable to me, having never seen por read As doctors grow old in experience, they of a similar case. Mrs. J., primipara, gave place less faith in medicin and more in the birth to a well developt eight-pound boy, efforts of Nature to restore the lost balance in labor normal. With little trouble I delivered disease. Their own shortcoming in efforts to the placenta, which was double, or rather two relieve disease, assisted by investigations to placentas with about an inch of membrane find the truth, has taught them this valuable intervening between the two. What caused it lesson. thus? Was it originally a twin conception Of course it is understood that the editorial with death and absorption of one fetus? does not favor over-medication, nor heroic There was only one cord.
treatment, only under certain conditions, and Krum, Texas. J. C. Gose, M.D. to produce certain effects thought to be desir
able. Now, to meet these indications with Conservatism in Medicin.
powerful medicins often puts too great a risk Editor MEDICAL WORLD:-In the December on the life of a patient, especially when used number of THE MEDICAL WORLD appears an by the inexperienced and thoughtless. Many a editorial on “ Therapeutic Cowardice," which time the practician cannot see his way clearly, may perhaps be misleading to some extent. and in that case it were better to trust to The writer has high appreciation of the editor- nature, and render her whatever aid may be ials in The Medical WORLD generally, and plainly indicated. Better to be on the safe side even this one may be adapted to the needs of than to take extra risks, and in nine cases out those of long service in the profession, espe- of ten it will redound to the good of the cially if they be level headed; but for tyros in patient. the service it seems to bear a little too strong Some effects thought to be desirable in the on the bit; in other words, may cause rash- treatment of disease are very questionable ; ness on the part of young men, and older ones such as the reduction of the pulse in certain too, who have not given therapeutics a thoro diseases, and the reduction of heat in others. study. It is unfortunately true that too much Forty-five years ago Norwood's tincture of medicin has been given in the past, and even veratrum viride was considered the sine qua non today the same is true to less extent. Men in the treatment of pneumonia. The medical who have been in the profession for fifty years journals were filled with its wonderfully curativ and more, know something of heroic medica- effects in this disease. To the writer the idea tion, when venesection was used almost invar- seemed to be based on a false theory. It was iably to the detriment of the patient, mer- believed by him that the pulse should come curials used to the loss of teeth and to shattered down because the disease was being subdued, constitutions, tartrate of antimony to the point and not from the effect of a powerful heart of turning inside out, to say nothing of endless depressant, the pneumonic pathological condipurgation with drastic medicins.
It is not tion still existing. Such treatment did not forgotten that the deathrate of typhoid fever seem to be consistent with science nor common in those days was about 33 percent, and now it is only 1 or 2 percent under proper treat- About that time two healthy negro men in ment, which includes scarcely any medicin. In the prime of life were taken down with the those days Cook's theories and mercurial med- disease and occupied the same room. One of ication held sway, and doubtless did great them was treated in a mild way by the writer, damage.
assisting nature, and the other was treated Owing to this over-treatment, the way was heroically by another doctor with veratrum. made plain and easy for the introduction of He said in two or three days that his patient eclecticism, homeopathy, and, in later times, for was doing well, the pulse down from 120 to Christian science, and healers of various kinds. 70. The writer remarkt to him that when the The tendency of the profession is continually pulse of his patient came down to that point toward less medication, and the people demand he would turn him over to the cook. "The and will have less physicking. It is a notorious result was, in a few days the patient with the fact that the vis medicatrix naturae is sufficient deprest pulse went to his grave, while the other in the vast majority of cases to effect cures if recovered in due time. Repeated observations only a fair showing shall be given it. This of a like kind seem to prove that such treatwonderful restorer of lost balance should never ment is not only of no good, but is full of harm. be overlookt or ignored. It is too true that After a few years' trial, the profession gen
erally came to the same conclusion, and the follow necessarily that this is true, especially in remedy went into disuse, or nearly so, along medicin, since older men have the benefit of with venesection, mercurialization, large doses extensiv information thru medical journals, of tartar emetic, etc.
new books, and the post graduate course; beThe antipyretic treatment of disease thru the sides, they have experience, which is so valudepressing effect of the coal tar preparations able as to more than offset any disadvantages. was originated by the Germans, and was par It would seem really that younger men of excellence the treatment demanded in this today need a little restraint than otherwise. country some fifteen or twenty years ago. The Only a few years ago one of twenty-six years Germans saw the error of their ways and called arose in a state medical society and declared a halt on that line, followed finally by the that he had entered the abdominal cavity in medical fraternity in this country ; but not be- search of diseased ovaries and fallopian tubes fore many a poor fellow suffered the conse- in fifty-three cases in the previous eighteen quences. I well remember that in 1888 in one months, with only one death, and that was a locality as many as twenty cases of grip, dis
crazy woman. As he lived in a small town in posed to go into pneumonia, succumbed to this an out-of-the-way place in a new country, this treatment, one after another; while a different was thought to be first-class work, perhaps treatment by others had no such fatality- about as well as any of the big gynecologists indeed, scarcely any.
The idea is false in did in the same length of time in Chicago or theory and most harmful in practise, as is now New York City. Much might be said opposed generally admitted.
to the new “rage for cutting” in appendicitis To reduce the pulse rate and the temper- and other like troubles which would indicate ature, if possible to do so with safety, it is only the necessity for conservatism in all branches necessary to avail ourselves of the help given of medicin.
B. F. HART, M.D. by nature's therapeutics, which are ever at our Seattle, Washington. command. In bringing them into full play, [The above remarks are very sensible. The no risk need be taken on the life of the patient. trouble is that we reach so many different kinds “Therapeutic cowardice,” says the editorial, of physicians that it is impossible for us to "is not overcome by knowledge of drugs, meet the needs of all in a single editorial. many of the most learned being the most Many need the editorial referred to, and many, timid.” This is perhaps true; but why so ? like the above writer, do not.-Ed.] It seems they have been made more cautious because of having learned the great potency of
Bee Sting in the Larynx. many drugs and fully realized their danger in Editor MEDICAL WORLD:-A boy sixteen over-dosage. It further says, “Experience
Experience years old was brought to my office from a alone does not do it, for that also begets much neighboring village about twelve o'clock in the caution." But why? Simply because experi- night, about a week ago. He was suffering ence has taught them many valuable lessons intensely from dyspnea and pain in the throat. that the young still have to learn, one of which His brother had obtained some honey from a is to stay the hand in case of doubt and uncer- hollow tree in the woods, and the whole family tainty. It is not so much "a spirit of kindli- ate heartily of it. Shortly after supper the ness '' that actuates men of experience as it is boy experienced a sensation of fulness in his a conscientious discharge of duty to the patient throat, and later pain with dyspnea. These from the best lights shed on the case. It is symptoms grew rapidly worse until, in a few quite plain why “the young and inexperienced hours, he could scarcely breathe. He first practician shows more therapeutic bravery." supposed there was a piece of wax in the throat, Undoubtedly, because he lacks the “knowl- from the honeycomb. Accordingly vomiting edge of drugs” and “clinical experience" at was induced with a view of expelling or disthe bedside. A half century ago this “tyro lodging the same, but of no avail. · He was bravery" found no place in medical doings. then hurried to a doctor. For the past two or three decades it has, how- The patient spoke in a whisper. Examinaever, come prominently to the front, not only tion of throat revealed great swelling (edemain medicin, but in all other professions. From tous) of the epiglottis. Because of the large the obstacles in the way and the nature of the epiglottis it was impossible to see the vocal calling, it is more difficult to sustain in medicin cords. Besides, the patient always had a and do no harm than in any other pursuit. desire to swallow and was easily gagged. Because of so many inventions and practical Undoubtedly the cords were similarly swollen. improvements in the onward march of progress, Careful examination with the laryngoscope the people seem to have concluded that the finally located the foreign body. It was a younger members of various professions have small dark speck on the laryngeal surface of all the new “wrinkles.” But it does not the epiglottis, and was best brought into view