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muslin to protect the clothing. It is also effectual in psoriasis-like patches.

In the Finsen Light and X-Ray we have much effectual agents for these old, obstinate, infiltrated cases. If the patch is not a large one, and easily accessible I prefer the Finsen Light. If, however, the patch involves more than twelve or fifteen square inches or involves the fingers, I prefer the X-Ray or a combination of X-Ray and Finsen Light. The High Frequency current is a valuable adjuvant, both as a constitutional and local remedy in promoting metabolism, improving nutrition, circulation, etc., but was not often curative in my experi-ence.

The Finsen Light destroys all infection and speedily causes absorption of the abnormally proliferating and ædematous cells, at the same time contracting the blood vessels in the cutis.

[To be Continued in February issue.]


Twelfth Annnal Meeting Held at Toledo, December 13th, 1905. In the presence of a room full of physicians the president of the Society, Wm. A. Humphrey, M. D., declared the twelfth annual session open. The first paper, read by Emma Butman, M. D., of Toledo, was entitled; “Mental Therapeutics,'' and may be found in this number of the REPORTER. It was very freely discussed, some of the statements made by the essayist being combated freely.

Following this came a paper by Dr. Howland M. Flower on “Seven Radicals,” which also is printed in this number of the REPORTER. Dr. Flower had patients present at the meeting ready to demonstrate the results of the operations noted, showing that good results had followed. The discussion was led by Dr. Strong and Dr. Emma L. Boice-Hays, of Toledo.

Dr. Kinyon's paper on “Posture in Labor” was a very interesting one. He combated very vigorously the idea so prevalent among physicians that a woman could be confined in almost any position. He argued that much could be gained by careful attention and scientific consideration of posture. He advocated the prone position on the bed, with the sacrum at the edge, the legs and feet hanging down, noting that from this position an actual gain in diameter of the pelvis was obtained. He spoke also of the knee-chest position (emphasizing the fact that it is not the knee-elbow position) and also a position which he called the lateral-prone position. The paper was extremely

interesting, giving the members points which they could use in their daily work. The paper was discussed in a commendatory way by Dr. H. F. Biggar.

Dr. W. A. Dewey, under the head of “Neglected Uses of a Few Common Remedies," read a paper which, though it was short, was one of the most practical we have ever heard him present. He called attention to the action of Graphites in constipation, noting that it does for women what Sulphur does for men. There is much mucus in the stools, which are composed of hard, round balls, passed without urging. The presence of anal fissures strengthens the indication.

Nux vomica is useful in dysmenorrhea, where the patient almost faints when the menses come on and has to go to bed. The presence of the usual Nux symptoms would strengthen the case. Cocculus is · indicated in indigestion, where the patient is morose and depressed. He has an aversion to sour things. Sepia is the remedy in rheumatism, where the patient has red sand in the urine, and in sciatica with lancinating stitches which force the patient to get up and walk about. It is what might be termed a “venous” remedy. Lycopodium is indicated in rheumatism, particularly of the right shoulder and hip joint, the pain being violent and localized. The Anacardium patient is hungry all the time and his desire for stool is due to the presence of something in the rectum. There is also intense sexual excitement. Dr. Dewey elaborated on these remedies, giving other indications of a very practical nature.

Dr. L. T. Gill, of Gibsonburg, opened the discussion, calling particular attention to the use of Elaterium lx in renal dropsy, claiming it to be very effective and without a tendency to disturb the stomach.

The time having arrived, the president at the conclusion of this paper adjourned the meeting to the Toledo Hospital, where Drs. DeWitt G. Wilcox, of Buffalo, and L. K. Maxwell, of Toledo, gave a gynecological clinic.

Dr. Wilcox presented the following case:

Mrs. B., married, aet. 38. No children. Has been in poor health fourteen years. Was operated at that time for diseased ovaries, and both removed. Has had constant pain on right side between appendix and right ovarian stump. Bowels have been very constipated and been getting worse, amounting almost to a stoppoge. Is now bedridden, very hypochondrical and exceedingly nervous. Complains of dragging down in abdomen.

Diagnosis: Adhesion of the intestines to ovarian stumps. Advised operation.

Patient given ether and placed in Trendelenburg position. Incision made parallel to old scar and same removed. No adhesions to the uterus, which was small; but on the right side the appendix was found imbedded in a mass of exudates formed around the stump of the right ovary. Cæcum and bowel were firmly fixed to said stump. These were released, appendix removed and all raw surfaces at the site of old stump were covered over with peritoneum. The uterus was then removed, as it showed a tendency to retro-displacement, and as it was of no use it was amputated just above internal os and all surfaces covered over with peritoneum. The abdomen was not flushed but dried. Peritoneum at line of incision was sewed with continuous catgut. Aponeurosis was treated the same. Three through and through silk worm gut inserted. Patient showed no shock.

Dr. Maxwell's operations consisted of a hysterectomy, an appendectomy and a myomectomy, these operations being followed by an operation for floating spleen. The usual technique was followed, with the success which characterizes operations done by the Doctor.

Upon the conclusion of the clinic the members of the Society adjourned to the St. Charles Hotel, where luncheon was provided. The clinic was extremely enjoyable, giving the visiting members an opportunity to examine the fine hospital which, under the active and splendid management of Miss Kent, its superintendent, has made a reputation for itself which extends far beyond the limits of that city. A special car was provided to take the members to the Hospital and return, thus avoiding a loss of time.

After the luncheon Dr. Rollin H. Stevens, of Detroit, read his paper on “Eczema-Its Pathology and Treatment." This paper will be found in the present number of the REPORTER.

His paper was discussed by Dr. C. E. Sawyer, of Marion, Ohio.

Dr. Wm. T. Miller, of Cleveland, presented a verbal report of an extremely interesting case of carcinoma of the sigmoid and rectum with formation of artificial anus, the operation required being illustrated by five large colored drawings which he had posted upon the walls of the room. Dr. Miller has promised to furnish the REPORTER in the early future with an illustrated paper on this case.

Under the caption, “Differential Diagnosis of Pelvic Affections,” Dr. DeWitt G. Wilcox, of Buffalo, read a paper which we think should be in the hands of every physician. The first sentence gives the key-note of the paper, namely, “The early recognition of many pelvic affections is the key to their cure.”

He gave it as his experience that complaints of pelvic discomfort demand thorough bi-manual examination, demonstrating with a few

well chosen coses not only the importance but the absolute necessity for such care. This examination should be done with the clothing perfectly loose at the waist, as well as over the abdomen, with the legs well flexed upon the abdomen, with the bladder and rectum empty, and where possible, with the use of two fingers instead of one inserted in the vagina. One valuable point was that the best evidence of normal tubes and ovaries is an inability to find them under favorable conditions, as it is scarcely possible to overlook an inflamed, adherent and enlarged tube or ovary.

Especial attention was called in the paper to the importance of an early diagnosis of a salpingitis due to specific infection as being sure to prevent untold suffering, with no little danger to life. Another condition which has been frequently overlooked by the physician is tubal pregnancy in the early months. He instanced the possibility of the appearance of a patient telling simply of absent menstrual periods, with some slight pelvic distress. The neglect of appreciation of these symptoms, which the Doctor very rightly called "danger symptoms” has in more than one case resulted in the death of the woman from rupture. He cautioned his hearers against attempts to forcibly replace a retroverted fundus or procidentia, which has become so because of an old-time salpingitis, resulting in contracted ligaments and thickened tubes. If operation is not wise or possible in these cases, supports or tamponade may be used as a temporary measure of relief.

He deprecated the removal of the uterus for procidentia, because the pelvic floor remains prolapsed and leads on to a prolapse both of the bladder and rectum. He instanced a case in which the physician upon examination may find upon the cervix a soft, boggy spot, sensitive to pressure and scooped out as though gouged by some sharp instrument. This he claimed could be produced by one of two conditions-syphilis and cancer. The indication for treatment or operation respectively is definite and imperative.

During the menopause there are two points upon which the author insisted women should be instructed:

1st.— A look upon a post-climacteric flow or even a slight show of blood as a danger signal and seek early counsel.

2nd. — To disabuse their minds of the belief that a woman in passing through the change of life is likely to flow more profusely and more frequently than she has heretofore, and when she does so flow to seek medical advice.

With regard to the distinction of pregnancy from certain uterine growths, he gave the following points :

1st.–Never to take it for granted that pregnancy exists, unless you can demonstrate by examination.

. 2nd.— Note the progress or development, which is different in the one condition from the other.

3rd.—In examination use the bi-manual method.

4th. — The fact that a pregnant uterus is in a large measure of instances much softer and more pliable than a fibroid tumor, and this growth or an ovarian cyst will generally push the uterus well down into the pelvis and will not discolor the cervix.

Take it altogether, the paper is a valuable one and if its admonitions were closely followed in all instances much suffering and possibly death, might be prevented in many cases.

It was discussed by Dr. Parmelee, who endorsed very emphatically the conclusions at which the author had arrived, but claimed that office examinations are quite liable to be perfunctory and productive of mistakes. He urged the necessity for the use of an anæsthetic, in which the most thorough work could be done. Dr. Kinyon also endorsed Dr. Wilcox's paper, giving a caution about haste in diagnosis, urging that it is much better to wait until you are absolutely sure before making positive statements as to the existence of diseased conditions. Dr. Horner noted the use in Dr. Wilcox's paper of the expression—"danger signals.” This expression, he thought, applied quite as much to other diseases, noting the fact that many times the lightning pains of incipient locomotor ataxia were treated as neuralgia or rheumatism until the diseases had reached such a point as to be practically incurable, when if the condition had been recognized at the beginning in all probability a cure might have been made.

Upon the conclusion of this discussion Dr. G. J. Jones, of Cleveland, read a paper entitled, “Carthartics,” which will be found in this number of the REPORTER. Drs. W. B. Hinsdale and H. F. Biggar discussed the paper.

Dr. Hudson D. Bishop, under the title of “The Obstetric FeeHow May It be Increased ?” read a paper which elicited a very considerable discussion upon all sides. We present the paper in this number of the REPORTER, and only wish it were possible to reproduce the discussion. Some rather remarkable statements were made and quite a considerable amount of good-natured criticism was had upon these statements.

The title of Dr. Hinsdale's paper was “Dietetic Miscellany." He placed himself on record as being in the main opposed to many of the “health foods” which, prepared by some special process, are supposed

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