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are devoted exclusively to its study, and in the great congress of nations to meet in this country in 1887 there has been provided a section for gynecology as well as for obstet

rics.

In closing this brief and very imperfect review of the magnificent advance of our science we cannot fail to be impressed with the weakness and the imperfection of our own intellect. Is it not strange that the little we know has only just now been acquired? Why have these important facts which I have attempted to place before you been hidden from our knowledge so long, and why have we groped along the length of the centuries in such utter darkness? "The eye sees only that which it has been taught to see," says the proverb. When reflecting upon this and similar lessons drawn from the pursuit of science in other departments, we may derive profit from the study of the fable of the Sphinx, as it has been expounded by Lord Bacon. This monster had the face and voice of a virgin, the wings of a bird, and the talons of a griffin. She resided on the top of a mountain and also beset the highways. She would lie in ambush for travelers, propound to them her riddles, and when they failed to solve them she would fall upon and tear them to pieces. There was no way to subdue her except to interpret her riddles, and to the man who would do this, the Thebans offered their kingdom. Lame Edipus, a penetrating and prudent man, accepted this condition, and solved the riddle which she propounded. He thereupon slew her, and laying her carcass upon an ass led her away in triumph. This elegant and instructive fable, says the philosopher, seems invented to represent science especially as joined with practice. For science may, without absurdity, be called a monster, being strangely gazed at and admired by the ignorant and unskillful. Her figure and form is various by reason of the vast variety of subjects that science considers; her voice and countenance are represented female by reason of her gay appearance and volubility of speech, wings are added because the sciences and their inventions run and fly about in a moment, for knowledge, like light communicated from one torch to another, is presently caught and copiously diffused.

Sharp and hooked talons are elegantly attributed to her because the axioms and arguments of science enter the mind, lay.hold of it, fix it down and keep it from moving or slipping away. Science is said to beset the highways because through all the journey and peregrination of human life there is matter and occasion offered for contemplation. Sphinx is said to propose various difficult questions which she received from the Muses; and these questions, so long as they remain with the Muses may very well be unaccompanied with severity. But when the Muses have given over their riddles to the Sphinx, that is to practice, which urges and impels to action, choice and determination, then it is that they become torturing, severe and trying, and unless interpreted, strangely perplex and harass the human mind, rend it every way, and perfectly tear it to pieces. It will be observed that when the Sphinx was conquered her carcass was laid upon an ass; “for there is nothing so subtle and abstruse, but after being once made plain, intelligible and common, it may be received by the slowest capacity." Lastly, you will notice, says Bacon, that the Sphinx was conquered by a lame man, and impotent in his feet; for men usually make too much haste to the solution of Sphinx's riddles. Whence it happens, that she prevailing, their minds are rather racked and torn by disputes, than invested with command by works and effects.

I now thank you for the kind attention you have given me, and at the same time venture to express the hope that the present course of lectures will not only be a profitable, but a very pleasant one to you.

A CASE OF SPONTANEOUS MOIST GANGRENE OF THE PENIS AND SCROTUM: SYPHILITIC.

S. T. ARMSTRONG, M.D., PH.D.,

Passed Assistant Surgeon U. S. Marine-Hospital Service.

Geo. Washington, negro, aged twenty-three, a native of Tennessee, married, was admitted to the U. S. Marine-Hospital in this city on February 19, 1886, for gangrene of the penis. There was no prepuce, it having been destroyed in the summer of 1885 by a phagedenic sore, the first venereal sore he ever had. He stated that this sore was treated by a

physician; but after the appearance of the local lesion, a papular eruption developed on the body, the papules pustulating, crusts forming, and on healing, circular depressed cicatrices remaining to attest the severity of the constitutional process. He stated that on February 15, without any appreciable cause, a pimple appeared on the skin of the penis near frænum præputii: subsequently the penis commenced to swell, and on February 18 the skin was black on the inferior surface of the organ.

When admitted to the hospital his temperature was 39.3° C., (102.6° F.), pulse 90, respiration normal. From the region of the frænum, extending backward for two inches, was a moist, irregular, brown slough, the color changing to yellow at the demarcation between the gangrenous and the healthy tissue. Linseed meal poultices were applied to the penis every four hours, and five grains of quinine sulphate, and five drops of the tincture of the chloride of iron given every two hours.

On February 20 the patient seemed quite as prostrated as when admitted; temperature 40.4° C., (104.8° F). February 21, poultices had encouraged suppuration, and to-day, with a few incisions of gangrenous fibrous tissue bands, the slough, composed of the skin and cellular tissue, was removed; the granulation surface was dressed with iodoform; the evening temperature was 38.5° C., (101.2° F). There was a rise of temperature on February 22d and 23d, but subsequently the fever was reduced, the temperature becoming normal on the 26th, and remaining so until March 2, when the patient was transferred across an open porch to another ward. A few hours later he had a chill, and his evening temperature was 40.2° C., (104.4° F).

On March 3 he felt well, and there was no subsequent pyrexia until the evening of March 15; in the interim the penis being dressed daily-either with iodoform or boracic acidand cicatrization having progressed rapidly. On March 14 a nodule developed on the right side of the penis a few lines below the cicatrizing surface. The patient stated that it resembled the "pimple" which preceded the gangrene. March 15 the nodule was lanced, a little pus escaping; during the

day he had a chill, and at 6:30 P. M. his temperature was 40.2° C., (104.4° F.), pulse 114. March 16 his temperature was normal. Pyrexia on the 17th, and induration was detected in the anterior portion of the scrotum at the raphe. The fever continued on March 18 and 19, and on the 20th a black spot appeared in the center of the fundus of the scrotum. Poultices were applied. On the 21st a large, brown-yellow gangrenous spot had appeared on the scrotum, presenting appearances exactly similar to those which had developed on the penis. March 26 the slough was sufficiently detached to permit partial removal; it involved the septum, and exposed the testicles, a large granulation surface being laid bare. Iodoform or boracic acid were alternately applied; the tonics continued, no effort being made to administer anti-syphilitic medication. Cicatrization of the scrotum progressed slowly, the patient remaining in the hospital until April, when he was discharged recovered, a new scrotum having formed from the adjacent skin.

Before the gangrene of the scrotum commenced, it seemed as if the gangrene of the penis was due to a local venereal sore, notwithstanding the asseverations of the patient's wife regarding her personal immunity from specific disease, and the positive denial of the patient regarding any recent entrance into "foreign relations." But when, in the course of treatment, the same conditions as in the penis were manifested elsewhere, his statement was accepted as accurate.

Agnew (Surgery, vol. ii, p. 435,) considers that gangrene of the penis has either an inflammatory (from sloughing chancre, after circumcision in children of irritable constitution, etc.), or obstructive origin. He had seen one case of the latter, from embolism of the dorsal artery, in an old man.

Bernays of St. Louis, in a personal letter, refers to a case of spontaneous gangrene of the penis in an old man, where successful amputation of the organ was performed.

F. A. Coward (Brit. Med. Jour., September 4, 1886,) reports a case of spontaneous gangrene of the penis in a married man, aged thirty-five; no venereal history; where successful amputation by the thermo-cautery was performed. Also a case of a married man. aged forty, suffering from acute orchitis of

the left testicle, and subsequent extravasation of urine, gangrene of the penis and death.

The number of recorded cases of spontaneous gangrene of the penis or scrotum are quite few, and the four cases above noted are the only ones I have been able to refer to. As far as I can find the case herewith reported is quite rare.

The severity of the secondary eruption in this case justifies the presumption of a profound susceptibility to syphilis, for which disease he had not been properly treated. Consequently the rare manifestation occurred of a tubercular development and adjacent gangrene. This latter process was due to a syphilitic endarteritis, as shown by Alfred Hardy, (Lecons sur les maladies de la pean, etc.), probably local in extent.

THE ZYMOTIC THEORY OF CAUSES.

H. S. ROBERTSON, M.D., TUPELO, MISS.

There is in nature a formative and disintegrative action. The plant, the vegetable and the mineral are being decomposed, reduced and displaced by a disintegrative force or forces. In this action the elements are not lost, but take other forms according to the law of indestructibility. When the plant is cut down decay and displacement follow; when the animal dies decomposition results. This is nature's way of reducing everything, "dust to dust, earth to earth, ashes to ashes." If the plant or the animal is injured or mutilated beyond the reparative force of nature, then the formative act is displayed in the interest of that of disintegration, and thus an expeditious work is effected. In other cases diseases are removed, injuries repaired, and lost parts restored. There is a conservatism in this, represented as clearly in disintegration as in formation. Without this work of reduction there could be no life; animals, plants and minerals could not exist. This reciprocity of formation and decomposition is the essence of the conservatism, and as long as these normal forces act in equilibrio there is uniform health. Interrupt or destroy the equilibrium and there is disease. Animals, plants and minerals are produced by a formative force (molecular power). This action is effected by heat and mois

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