Pa.; Hendricks, Augustus William, Pa.; Hess, J. Bruce (M. D.), Pa.; Hirst, Jesse Watson (A.B.), Mass.; Hoopes, Charles Wilson (D. D. S.), Pa.; Hubbard, John Parkinson, Jr. (M. A.), Pa.; Huebner, George William, Pa.; Huff, Scott M. (M. E.), Pa.; Hug, Edward Victor, Ohio; Humphrey, Walter Newton (A. B.), Pa.; Hunsberger, William Henry, Pa.; Hunter, Herbert Kingsley, England; Hunter, Joseph William, Pa.; Hutchins, Adrian Albertus, Ohio; Isenberg, Joseph Lloyd, Pa.; Jacob, James Francis, Pa.; Kain, William Wilkins (Ph. G.), N. J.; Kalbach, Isaac Irwin, Pa.; Kasten, William Henry, Pa.; Kiley, Frank Love, Pa.; King, Hiram Orville, Pa.; Kiteley, William Ellis, Canada; Kleinstuber, William George, Del.; Klemmer, William Nikolous, Germany; Klotz, Robert Bertram, Pa.; Knapp, Warren A. Bickel, Pa.; Krusen, Wilmer, Pa.; Kyle, Elmer Bryan (Ph. G.), Pa.; Lacey, James Henry (M. D.), Col.; Lewis, William H. (Ph. G.), Pa.; Luster, George Edgar (M. D.), Ill.; McDaniel, Edward Bruce (M. D.), Oregon; McGee, James McMeekin, Pa.; McGregor, Andrew, Canada; McKelway, George Irvin (M. D.), Pa.; McKenzie, William White, N. C.; Maddock, Louis, Oregon; Means, Robert Markle, Pa.; Meixell, Edwin Wesley, Pa.; Metz, John Pancoast, Pa.; Miller, William Haman (Ph. G.), Del.; Mitchell, William Cottonham, Pa.; Moore, Lynford Lardner, N. C.; Moukaddim, Hammoud, Syria; Mullen, Joseph Aloysius, Pa.; Müller, Rodolph Emile, Switzerland; Murdoch, James Hutton, Pa.; Murdoch, John Floyd, Pa.; Murray, John Arthur (M. D.), Pa.; O'Donnell, Hugh Boyle, Ireland; Oyer, Harry Willrich, Pa.; Patty, Louis Greenlee (D. V. M.), Iowa; Payne, Marshall John, Va.; Pearson, Edward James, Del.; Pease, Frank David (M.D.), N. D.; Peralta, José Maria (D.V.S.), C. Am.; Persing, Amos Vastine, Pa.; Piper, Charles Eugene (M. D.), Mo.; Pope, Mardelle Yates, Ark.; Powell, George Perry, Neb.; Ramirez, Leopolde M., C. Am.; Ramsey, William George, Pa.; Reckefus, Charles Halwadt, Jr., Pa.; Redelin, Albert Augustus, Pa.; Reed, John Orlando, Pa.; Rentschler, Harry Fleisher, Pa.; Reum, Charles George (M. D.), Wis.; Rhoads, Thomas Leidy, Pa.; Rich, Edward Israel, Idaho; Ritz, Reinhart Joseph, Pa.; Rogers, Asa Holt, Texas; Rush, Warren Blachley (Ph. G.), Fla.; Sallade, Frank Reed, Pa.; Sargent, Albert Alonzo, Maine; Savitsky, Joseph Adam, Russia; Scholl, Harvey Frederick, Pa.; Sedgwick, Walter Nelson, Pa.; Segal, Bernhard, Pa.; Sheeder, Benjamin Franklin (A.B.), Ohio; Shrader, Edwin Elmer, Minn.; Sittler, Warren Clement, Pa.; Smith, George Hartford (M. D.), Iowa; Smith, Patrick Albert, Canada;

Sommer, Henry, Jr., Pa.; Sorenson, Soren, Wis.; Speer, Henry Newton, Pa.; Stover, Isaac Francis, Pa.; Targett, Archibald Frederick, N. J.; Thomas, Harry Leedon, Pa.; Tinker, Martin Buel, Mass.; Toner, Mark Ferdinand, Pa.; Tryon, Lewis Royer, N. J.; Turner, Oliver William (A.B.), Me.; Walker, James William Holmes, Pa.; Wallace, William Smiley, Kan.; Walton, Joseph Henry, Iowa; Wamsley, James Winter (Ph. G.), N. J.; Ward, Nathan Gideon, N. C.; Ward, Percy Hall (Ph.G.), N. Y.; Wheeling, William Stuart (B. A.), Pa.; White, Jonas Samuel, Pa.; Whitney, Walter Everett, Me.; Whitten, Jarvis Adams, Pa.; Wilde, John R., N. Y.; Williams, John Henry (Ph. G.), Pa.; Williams, Robert Johnston, N. C.; Winder, Laurence Johnson, Pa.; Wingender, Wendell Phillips (Ph. G.), Pa.; Wintermute, George Preston, Wash.; Wurtele, August Herman, Pa.; Wyeth, Charles (M. D.), Ind.; Yacoubi, Hazarabed Boghos (M. D.), Asia Minor; Yenser, William Albert, Pa.

Of the above there were from Pennsylvania, 105; Ohio, 7; Delaware, 7; Oregon, 6; New Jersey, 4; Maine, 4; North Carolina, 4; Iowa, 4; New York, 4; Wisconsin, 3; Minnesota, 3; Canada, 3; Kansas, 2; Indiana, 2; Massachusetts, 2; Texas, 2; Virginia, 2; Central America, 2; Syria, 2; California, 1; Nebraska, 1; Rhode Island, 1; Kentucky, 1; Colorado, 1; Illinois, I; North Dakota, I; Missouri, I; Arkansas, I; Idaho, 1; Florida, I; Washington, I; District of Columbia, 1; Germany, 1; England, 1; Ireland, 1; Russia, 1; Switzerland, I; India, 1; Asia Minor, 1. Total, 188.

The following prizes were awarded: 1. A Gold Medal, for the best Essay on a subject pertaining to Surgery, to Henry J. Sommer, Jr., of Pennsylvania, with a Certificate of Honorable Mention for the Essay of Soren Sorenson, of Wisconsin. 2. A Gold Medal, for the best Essay on a subject pertaining to Obstetrics, to Warren A. B. Knapp, of Pennsylvania, with a Certificate of Honorable Mention for the Essay of William George Ramsey, of Pennsylvania. 3. A Gold Medal, for the best Anatomical Preparation, to William White McKenzie, of North Carolina, with a Certificate of Honorable Mention for the preparation of Benjamin Matthias Bartilson, of Pennsylvania. 4. A Gold Medal for the best Examination in Therapeutics, to Andrew Clymer Biehn, of Pennsylvania, with Certificates of Honorable Mention to William George Kleinstuber, of Pennsylvania, and Wilmer Krusen, of Pennsylvania. 5. A Gold Medal, for the best Essay on a subject pertaining to the Practice of Medicine, to Rodolph Emile Müller, of

Switzerland, with a Certificate of Honorable Mention for the Essay of Peter Charles Green, of Pennsylvania.

WHY GRADUATES OF "OLD JEFF" DO NOT RECEIVE MORE HOSPITAL APPOINTMENTS?—This question has been a puzzle to both the students and the faculty and graduates of the Jefferson Medical College. Every year has seen the other medical schools of Philadelphia, especially the University of Pennsylvania, carry off most of the hospital appointments. But the question will no doubt be answered by the mode of making appointments, revealed in the St. Agnes Hospital of Philadelphia. Thirty-five students of different colleges applied to this hospital for appointment, and underwent a competitive examination, with the result that out of the four positions for resident physicianship, Jefferson graduates, according to average, captured three of them. The grading was based on a possible fifty, and the result, as given by the board of examiners, is as follows:

The appointments made, however, by Dr. W. V. Keating, who is medical director of the St. Agnes', and also of the St. Mary's and St. Joseph's Hospitals, included Dr. Parkinson Hubbard, a Jefferson man, on account of his endorsement by Professor DaCosta, and the other three appointed were Drs. William S. Newcomet, Stephen E. Rice, and J. O'Malley, all from the University of Pennsylvania. All of the Jefferson men who should have been appointed were endorsed by eminent physicians, and one was endorsed by Prof. H. A. Hare. In consideration of these facts, the faculty of the Jefferson Medical College addressed the following open letter to the Medical Director :

PHILADELPHIA, May 3, 1893. WILLIAM V. KEATING, M. D., Medical Director St. Agnes' Hospital.

Dear Sir:-We, the undersigned members of the faculty of the Jefferson Medical College, beg to call your attention to what we feel is a well grounded grievance. In the rules governing the appointment of the medical staff of St. Agnes'

Hospital, signed by you as medical director, it is provided as follows:

"I. There shall be four resident physicians elected annually by competitive examination.

"II. These shall be graduates of a creditable medical college in good standing and shall present a certificate of good moral standing from a regular practicing physician.

"The position of resident physician in St. Agnes' Hospital has been so highly esteemed that our students, at a cost in time, labor, and mental anxiety, have carefully prepared themselves for the competitive examination. It has come to our knowlege that these are openly violated. Drs. Rhoads, Birriolo and Bowman, graduates of Jefferson Medical College, presented their applications and certificates of moral standing. Dr. Rhoads was indorsed by Dr. H. A. Hare, a member of the medical staff of St. Agnes' Hospital; Dr. Birriolo was indorsed by Dr. Crandall, of Tioga County, Pa., and Dr. Bowman by Dr. A. F. Kempton, of Philadelphia.

Out of thirty-five applicants from various schools the results obtained by your own Examining Board, Dr. Rhoads, of the Jefferson, was first on the list; Dr. Newcomet, of the University of Pennsylvania, was second; Dr. Birriolo, of Jefferson, was third, and Dr. Bowman, of Jefferson was fourth. These three graduates of Jefferson having complied with all your requirements, were entitled to the first, third, and fourth places out of the four appointments made. But as medical director you have set them aside and given the appointments to others. If the rules for competitive examination of St. Agnes' are rules, we say they should be fairly and justly carried out, which we claim has not been done in this instance, and we urge that you do justice to the men that stand at the head of the list by revoking the appointment of those elected who stood twelve, sixteen, nineteen, out of a list of thirty-five.

Very respectfully yours, H. C. Chapman, John H. Brinton, Theophilus Parvin, James W. Holland, William S. Forbes, William W. Keen, Morris Longstreth, H. A. Hare, James C. Wilson, E. E. Montgomery.

-The annual reunion and dinner of the ALUMNI ASSOCIATION OF THE JEFFERSON MEDICAL COLLEGE was held on Tuesday evening, May 2d, 1893, at the Bullitt Building, in Philadelphia. One hundred and fifty members of the Association and invited guests were present, representing members from every class since 1838, which class was represented by Dr. George Hill, of Pennsylvania. The committee having charge of the arrangement were Prof. W. L. Coplin (J. M. C., 1886), Dr. A. H. Hulshizer (J. M. C., 1878), Dr. John Strobel (J. M. C., 1880), Dr. D. B. Kyle (J. M. C., 1891), Dr. A. Hewson (J. M. C., 1879), Treasurer, and Prof. W. W. Keen, who presided at the reunion. The event was one of the most successful ever given by the Association, which was due considerably to the energetic and untiring efforts of the committee.

of the Present," by George L. Porter, M.D., of Bridgeport, Conn.; "The Doctor of the Future," by the Rev. H. L. Wayland, D.D., of Philadelphia; "The Future of the Doctor," by W. B. Scott, M. A., PH. D., Professor of Geology at the Princeton University, Princeton, N. J.; "The College and the Professional School, Twin Pillars of the State," by Ethelbert D. Warfield, President of Lafayette College, Easton, Pa.; "The Trustees of the Jefferson Medical College," by the Honorable Furman Sheppard; "The Alumni of the Jefferson Medical College," by J. K. Weaver, M. D., of Norristown, Pa.; The Graduating Class of the Jefferson Medical College," by Thomas L. Rhoads, M. D., Class Orator of the Graduating Class.

THE AMERICAN MEDICAL ASSOCIATION will meet at Milwaukee, Wisconsin, June 7th, 8th, 9th, Icth. A large and interesting meeting is expected, as the subjects which will be discussed in general session are such as will strengthen the Association and add to its importance as a representative national gathering.

The following programme has been arranged for the Eleventh Annual Meeting of THE AMERICAN MEDICAL EDITORS' ASSOCIATION, at Milwaukee, Wis., June 5, 1893. The general business meeting will be held at 4 P. M. The President, Dr. Culbertson, will deliver an address. Dr. Gould will read a paper on Medical Orthography." This will be followed by a paper on "Some New Phases of Journalism" and a discussion. Reports of committees and election of officers and other business will conclude the session. The banquet will be given at 6.30 P. M., and be followed at 8.30 by the annual address, by Dr. Ernest Hart, Editor of the British Medical Journal. This will be followed by an address on "Editorial Responsibility and Question of Libel," by the Hon. Clark Bell, Editor of the MedicoLegal Journal and President of the International Medico-Legal Congress. Dr. J. Stanly Hall, Editor of the Psychological Journal and President of Clark University, will address the Association on "Psychological Phases of Medical Study and Journalism." Discussion and remarks will follow.

-A fair in aid of the Jefferson Maternity Hospital was held at 2022 St. James's Place, Philadelphia, on Friday, May 5th. The managers of the fair were Mrs. E. D. Gillespie, Mrs. Edward H. Weil, Mrs. Luther S. Bent, Mrs. J. W. Holland, Mrs. E. E. Montgomery, Mrs. Hobart A. Hare,

Mrs. H. Augustus Wilson, Mrs. J. Lewis Parks, Mrs. A. J. D. Dixon, Mrs. Charles J. Cohen, Mrs. N. S. Grant, Jr., Mrs. Robert N. Lesley, and Mrs. E. P. Davis.

-The Faculty of the Jefferson Medical College tendered a graduation party to the graduates of the class of 1892 and 1893, or Columbian Class, at the Natatorium Hall, on Monday evening, May Ist, 1893. The Faculty and most of the Demonstrators of the College were present. Toasts were responded to by Dr. John H. Brinton, Professor of Practice of Surgery and Clinical Surgery, and by Dr. J. Chalmers DaCosta, Instructor in Surgery.

-Dr. William H. Ford (J. M. C., 1863) and Dr. Joseph R. Clausen (J. M. C., 1882) have been appointed, with Dr. E. O. Shakespeare, Dr. William M. Welsh, and John T. Windrim, by Mayor Stuart, of Philadelphia, as a commission to select a site for the new Municipal Hospital.

-In the future students of the second year of the Jefferson Medical College will be obliged to pass final examinations at the end of their second year in Pathology and Morbid Anatomy, in addition to their other examinations.

-The annual spring course of lectures and practical demonstrations at the Jefferson Medical College began on Monday, May 8th, and will continue until June 3d. .

-The new catalogues for the session of 1893 and 1894 of the Jefferson Medical College have appeared.

PERSONAL.-Dr. J. Phillips has been appointed chief clinical assistant of the ophthalmological department of Jefferson Medical College.-The new appointees at the Jefferson Medical College Hospital, as assistants, are: I. Edward Moore (J. M. C., 1890), chief clinical assistant in the medical department.—Dr. H. R. Loux and N. J. Gillespie (J. M. C., 1890), assistants in the surgical department.-Dr. Clarence A. Veasey (J. M. C., 1890) and Dr. John H. Frick Love, assistants in the ophthalmological department.-Dr. A. T. Targette (J. M. C., 1893), assistant in the orthopedical department.-Dr. R. E. Mullen (J. M. C., 1893), Dr. C. D. Spivak (J. M. C., 1890), and Dr. Jacob L. Heller (J. M. C., 1892), assistants in the department of diseases of children.-Dr. Noble B. Parvin (J. M. C., 1891), and Dr. Dillon Drake (J. M. C., 1890), assistants in the dermatological department.

Vol. XIV. No. 6. June, 1893.

Original Articles.

REPORT OF INTERESTING CASES

IN ABDOMINAL SURGERY.* BY HENRY LEAMAN, M. D. (J. M. C., 1864), Of Philadelphia.

Reported by M. PRICE, M. D.

Dr. Henry Leaman has kindly consented to allow me to report this case of mechanical obstruction of the bowel, as it is one of great importance, and it is his report I give and not mine. You will remember a similar case reported for the same trouble nearly two years ago, and as that case was one that many thought strongly reported, I thought best to call your attention to this one, reported by Dr. R. Leaman and operated by Dr. Henry Leaman, and I had the pleasure of assisting in the work.

Dr. R. Leaman's Report.-I was called to see Thomas P. on November 1, 1892, who presented the following conditions, viz.: retention of urine, relieved by the catheter; no passage from the bowels for three weeks previous, when he had done heavy lifting and active work. My idea was that there must be invagination or twisting of bowel, and treated him after the usual methods, both by mouth and rectum; still, nothing in way of relief was accomplished; the enlarged abdomen grew until the tympanitic condition gave place to a slightly dull note everywhere over the abdomen on percussion, from excessive disten

tion.

The vomiting, which was always present, now became somewhat stercoraceous. Respiration became shallow, rapid, and feeble, from the encroachment of the diaphragm. Pulse feeble, mind wandering. But with all this the temperature never rose above 100°. On November 10, 1892, I called in my brother, Dr. Henry Leaman, in consultation. It was at once decided that nothing but an operation would give the patient any chance. Dr. M. Price was asked to see the patient and assist in the operation. All abdominal, pain had ceased about three days.

* Read before the Philadelphia County Medical Society, May 24, 1893.

131

The operation was done in a little room in Carleton street, and, as usual to the location the environments were not of the best. The patient was taken from the bed and placed on a table and a median incision made as in abdominal operations; the bowel enormously distended with liquid. A search was made for the point of obstruction, but I could not find any. Dr. Price also made an effort to find the obstruction. Failing to find one, we decided to open the bowel and empty out its contents and then make a thorough search for the obstruction. This also failed. bowel was carefully stitched and the patient put to bed. In the next forty-eight hours he had about thirty evacuations. The bladder had to be relieved with a catheter. He made an uninterrupted recovery.

The

2. Mr. K., patient of Dr. Romaine, of Lambertville, N. J., aged thirty-two years, had had a number of recurring attacks of severe pain in the region of the appendix, all of which, save the last, have yielded in two or three days to purgation by salines. Last attack occurred May 2, 1893, and he was at once freely purged. This gave considerable relief; but the pain would return in twelve or fourteen hours in as much severity as ever. It was then decided to have an operation, and I was asked to operate.

May 7. I carefully examined the patient, and from the history and the existence of peritonitis, and the fact that all his pain and suffering came from the region of the appendix, also that he had had a number of attacks with the same symptoms, I did a section and found from three to four feet of ileum adherent in mass over the head of the colon, greatly adherent and covered with inflammatory lymph. There was some pus in the mass, but very little. The bowels were completely separated, washed, and replaced, and then the appendix looked for and found in a hard mass curled up and adherent to the head of the colon on one side and to the pelvic bone on the other. The adhesion to the pelvis was loosened, and the appendix and bowel brought out, but the bowel could not be removed without great injury. So, with