House of Delegates badge; this he expects to hand down to his progeny forever as a mark of one of the epochs in medical history. This narrative is already growing too long; I will therefore append the roster of officers elected for the ensuing year and close : President, Dr. Frank Billings, of Illinois; 1st Vice-President, Dr. J. A. Witherspoon, of Tennessee; 2nd Vice-President, Dr. G. F. Comstock, of Saratoga Springs; 3rd Vice-President, Dr. C. R. Holmes, of Ohio; 4th Vice-President, Dr. James II. Dunn, of Minnesota; Treasurer, Dr. Henry P. Newman, of Illinois; Secretary, Dr. George H. Simmons, of Illinois. Dr. J. M. Anders, of Philadelphia, was invited to give the oration in Medicine; Dr. A. F. Jonas, of Omaha, the oration in Surgery; and Dr. Wm. H. Welch, of Baltimore, the oration in State Medicine. Hot Springs, Arkansas, was recommended as the next place of meeting, but later New Orleans was substituted. This was followed by the formal installation of the newly elected officers, after which, the closing exercises being completed, the association adjourned to meet in New Orleans in 1903. WM. BRITT BURNS, M.D. PROGRESS OF MEDICINE. MEDICINE. UNDER CHARGE OF B. F. TURNER, M.D. Visiting Physician St. Joseph's Hospital, Memphis. The Symptoms of Chronic Non-Alcoholic Gastritis. G. R. Lockwood (Med. Record, vol. 61, no. 22) says: 1. In uncomplicated chronic gastritis not of alcoholic origin, if the muscular power of the stomach be good, the only symptom apt to be referred to the stomach is acidity. This occurs in about half of the hyperacid cases, but may be observed in the cases of complete achylia. Cases with normal acidity, and the vast majority of cases of anacidity, give no gastric symp toms. 2. The hyperacidity cases may give a course resembling that of a neurosis in that the symptoms are intermittent and are easily influenced by nervous conditions. It would seem, however, that a long-continued gastric neurosis was exceedingly rare, and that the great majority of such neuroses were rarely the neurotic outbreak of an organic lesion. 3. In gastritis, contrary to the accepted teachings, the following negative facts are to be noted: (a) The appetite is good. The few exceptions are observed in advanced atony, where the quantity of food is not well borne, and in cases of neurasthenia. In neither case, however, is the gastritis itself the cause of the anorexia. (b) Pain occurs in two ways: (1) From acidity, differing in no way from similar pain in cases of nervous hyperacidity; (2) from gas. This latter pain differs in no way from that observed in cases of simple atony without gastritis, so that pain does not seem to be a symptom of gastritis proper. (c) Nausea does not occur in relation to meals. Patients with atony, are those who are neurasthenic, may complain of nausea, but the nausea is not related to meals, and does not interfere with a normal appetite. It usually occurs when the patient is tired or nervous. (d) Vomiting does not occur in the non-alcoholic cases. (e) Unless there be diarrhea the nutrition is good, and, as a rule, the patients are not anemic. Exceptions may be made in cases of atony, but in these cases the anæmia may well be the primary condition. 4. If the muscular power be poor, gas is present as a prominent symptom. This is more apt to occur in hyperacid cases, and is probably due to swallowed air. As this same symptom is observed in a similar number of cases of simple atony, the symptom is not directly due to the gastritis. 5. Gastritis may give rise to severe and long-continued diarrhea and emaciation, which may be mistaken for colitis, or malignant disease of the colon. The diagnosis, however, should present no difficulty if a careful examination be made. These cases are more common than is usually supposed, and occur both in the hyperacid, and in the anacid cases. Between the two a diagnosis is possible only by gastric analysis. 6. Biliousness and its allied symptom-complexes are rarely, if ever, due to a primary functional disturbance of the liver, but are almost regularly due to an intestinal toxemia, trace able to some derangement of gastric chemistry, whereby improperly prepared chyme enters the intestine. 7. Anemia and constipation are the chief and only symptoms in a great many cases of even well-marked gastritis, and their continuance without apparent cause should justify an analysis of the gastric contents. SURGERY. UNDER CHARGE OF W. B. ROGERS, M.D. Professor of the Principles and Practice of Surgery and Clinical Surgery, Treatment of General Peritonitis. Doyen, of Paris, at a recent meeting of the German Surgical Congress (Med. Press & Cir., vol. 73, no. 3290), said: The results of operation in infectious peritonitis had been very different, for the reason that cases had been included in statistics that could not be compared with each other. Thus many surgeons had thought they had cured a general peritonitis by laparotomy when the case was only one of circumscribed peritonitis (suppuration in the pelvis, the iliac fossa, subhepatic or subphrenic regions). A careful bacteriological examination of the fluid in the abdomen should be made, so that the favorable cases with sterile sero-purulent fluid might be distinguished from those infected with staphylococci, streptococci, and bact. coli. Regarding operative technique and its results he would observe: 1. The earliest possible diagnosis regarding the local condition, the pulse and the general symptoms. 2. The incision should go direct to the collection of pus. In subumbilical peritonitis the incision should be parallel to the right Poupart's ligament so that the appendix might be at once sought for. 3. For the protection of the peritoneum compresses should be at once introduced above and to the mid line. The appendix if necessary was to be removed, and the pelvis mopped out with compresses. Then toilette of the whole inflamed neighborhood with dry sterile compresses without any flushing. 4. The toilette finished, the incision wound was to be closed partially and drained with gauze and a glass drainage tube. 5. In case of extensive peritoneal effusion opening in the middle line; in case of collection near the spleen, on the left side. 6. He had never seen recovery in a case of acute general peritonitis when the exudation was septic and when it reached from the pelvis to the subphrenic region. Extensive washing out of the abdominal cavity was dangerous, its only effect could be to make matters worse by dissemination of the infection. 7. In intestinal paralysis an anus preternaturalis was made in the first section of the jejunum. This was closed in from ten to twelve days by a lateral enteroanastomosis. NOSE, THROAT AND EAR. UNDER CHARGE OF RICHMOND MCKINNEY, M.D., MEMPHIS. Laryngologist to East End Dispensary; Laryngologist to Presbyterian Hospital. Surgery of the Larynx. Gluck, of Berlin, at the recent meeting of the German Surgical Congress (Med. Press & Cir., vol. 73, no. 3290) discussed the surgery of the larynx with demonstration of one hundred operations on the larynx performed by himself. One case was operated on four and a half years ago by B. Fraenkel for cancer of the glottis, and the plica aryepiglottica resected per vias naturales. Three years later a carcinoma of the glands of the neck was removed by the speaker. The man was healthy and articulation intact. Several cases of diffuse papillomata of the larynx were treated radically after fissure of the larynx with permanent recovery and good speech. One case of exenteration of the larynx for tuberculosis. Total laryngoplastia by the speaker's method, with formation of artificial laryngoschism after excision of the epiglottis along with the plice aryepiglottica. The patient did not wear a canula. Still sound after four and a half years, and speech perfect. Two children who had complete aphonia in consequence of development of cicatricial stenosis of the trachea. After tracheotomy low down transverse resection of the trachea in a healthy part was performed, and the two ends united. Speech was now clear. One patient, on account of laryngo-pharyngeal carcinoma, had an operation performed which embraced removal of the larynx, pharynx, the jugular vein and carotid artery of the left side, along with the glands affected. Recovery had lasted three and a half years, and he had a clear pharyngeal voice. In extirpation of malignant secondary tumors of the neck he proceeded as follows: Central freeing of the large tissues of the neck, severance after double ligature. From the mastoid region he proceeds to the jugular foramen and the canal of the carotid; ligature and tamponade of the vessels; and then extirpation of the tumors with vessels and nerves, making the section through healthy tissues. Memphis Medical Monthly Memphis Medical Monthly, established as the Mississippi Valley Medical Monthly, 1880 Memphis Lancet, established 1898. LYCEUM BUILDING, MEMPHIS, TENN. Subscription Per Annum, One Dollar in Advance. Official Organ of the Tri-State Medical Association of Mississippi, Arkansas and Tennessee, Memphis Medical Society, and Yazoo Delta Medical Association. C. H. BRIGHT, BUSINESS MANAGER. RICHMOND MCKINNEY, M.D., EDITOR W. B. ROGERS, M.D. DEPARTMENT EDITORS. A. G. SINCLAIR, M.D. T. J. CROFFORD, M.D. W. D. HAGGARD, M.D., Nashville. B. F. TURNER, M.D. THE RECENT MEETING OF THE AMERICAN MEDICAL ASSOCIATION. THE Saratoga meeting of the American Medical Association which was held last month, while not as well attended as the two meetings immediately preceding this, was productive of some very excellent contributions to medical literature, and was further notable on account of being the first meeting under the new plan of organization of the Association, which provided for a House of Delegates to conduct the official business of the organization. This body got together promptly and transacted a great deal of routine business in a most expeditious manner. The program on the occasion of this meeting was without doubt one of the best that has ever been rendered by the Association, and the various section secretaries are deserving of considerable commendation for the discriminating taste with which they each secured contributions to the work of his section. This matter of filling the program with deserving papers, and excluding the merely library and padded product, is one that presents itself to every large medical association, and we believe that the American Medical Association is as successful in this undertaking as any organization of which we have cognizance. A British contemporary, the Medical Press and Circular, in a VOL. XXII-28 |