pass through his pylorus, and was operated upon at St. John's Hospital. This man recovered from his operation and continued to give these exhibitions. He has had during the last month two distinct gastric attacks, associated with efforts of the stomach to empty itself of something it was not able to extrude, and in a seizure of this sort about a week ago he fell down in an unconscious state and was removed to the German Hospital.

The X-ray picture which was presented showed an accumulation of X-ray-stopping substances in the region of the cardiac end of the stomach. The patient believed, from his record of things which he had swallowed and not been able to pass, that there remained unaccounted for one pen-knife, ten nails and two watch chains. That was his inventory of the unaccounted for materials. With this inventory at hand in the operating room Dr. Warbasse proceeded to open his stomach over the cardiac end and about two inches to the left of the former incision which had been made in the median line. An opening large enough to admit the hand was made, and the foreign materials disentangled and removed.

He found the stomach firmly adherent to the abdominal wall at the site of his former operation. The cardiac end of the stomach had sagged down in a pouch, and the contents of this pouch is what produced the shadow in the picture. The stomach was opened and the following materials were removed: Seven pocket knives, twenty nails, seven door keys, two watch chains, a salt spoon, and a button hook. The chains bound these things together in a compact mass.

The gross

weight of the mass sagged down the cardiac end of the stomach to such a degree that the musculature was not strong enough to hoist things over into the pylorus, and even though the stomach had been able to present it at the pyloric orifice, the pylorus would not have accommodated it. It was interesting to observe that the pearl and bone handles had been digested off of the knives.

This man has made an uninterrupted recovery. A full report of this case will be found in a paper on gastric tetany in the Annals of Surgery for December, 1904.

BROOKLYN MEDICAL SOCIETY.

The Ninety-fourth Regular Meeting of the Brooklyn Medical Society was held on the evening of Friday, June 17, 1904, the President, Dr. W. B. BRADER, being in the Chair. Application for membership:

Dr. V. A. Robertson, 834 Union St.; St. P. & S., 1883.

Admissions to membership:

Drs. G. P. Thomas, F. D. Jennings, O. C. Swift, F. E. Wilson.

CLINICAL SECTION.

Dr. J. P. WARBASSE, Chairman. CHARLES NATHAN, D.D.S., presented a of Mechanical Closure of Congenital Cleft Palate by means of an Obturator or Artificial Palate, exhibiting the patient.

The

The following history was presented. young lady, now 18 years of age, was born with a complete cleft of the hard and soft palates alveolar process and the left side of lip with a projection downward of the pre-maxillary bones. She was operated upon when 6 weeks old for closure of the hare lip, which operation proved unsuccessful; a secondary and successful chilorrhapy was performed at six months after birth. At the age of 6 years two successive operations for uranorrhaphy and staphylorrhaphy were performed, but were attended with partial success, as there is only a union of about half an inch of the alveolar process and hard palate.

When 12 years of age the patient had an obturator constructed which at the time made considerable improvement in her deglutition, mastication and vocalization. But as the patient advanced in years the appliance outlived its usefulness and she was recommended to the doctor to see if an appliance could be constructed which would more completely close the cleft in order that her speech might be rendered more articulate and regurgitation of fluids into the nasal cavity be prevented.

The appliance as constructed consists of two sections joined by a hinge. One section of the appliance consists of a vulcanite rubber plate covering the vault of the buccal cavity to the posterior border of the hard palate and fitting around the lingual surfaces of the upper teeth and having clasps of gold attached which fit around one or more of the molar teeth on either side, serving to hold the obturator in position. The other section consists of a hollow bulb of vulcanite rubber fitting into the cleft of the soft palate and shaped so as to allow for the passage of air into the posterior hares. There is a spring attached to the plate portion of the appliance which rests upon the bulb, thus helping to keep the bulb in apposition to the soft parts by counteracting its depression during the downward play of the muscles in deglutition and vocalization. The appliance is removable and easily ad

justed by the patient. It is intended to be removed upon retiring. The lingual surface of the appliance is of highly polished gum color pink vulcanite, so as to give a smooth surface to the tongue, thus helping to keep the appliance clean and the color is to harmonize with the adjacent mucous membrane.

The doctor then demonstrated the sound of the patient's voice with the appliance in position and without the same, and explained that patients of this class contract certain habits in their endeavors to vocalize, which when a more normal condition was restored, interfered materially with proper enunciation.

The patient was advised to practice speaking as slowly and distinctly as possible in order that she may overcome those habits.

There was, however, a great improvement in the speech of the young lady with the appliance in position, and with time and practice the doctor hopes for a restoration of speech very near the normal, and as regards deglutition there was no longer any regurgitation of fluids into the nasal cavity, great comfort thus resulting to the patient.

Discussion by Drs. J. S. King and J. C. Kennedy.

(2) Hysterectomy for Recurrent Carcinoma of the Uterus, by Dr. W. B. Chase. Discussed by Dr. J. C. Kennedy.

Paper: The Work of the Milk Commission, by Dr. Peter Scott; Dr. Harris Moak. Discussion by Drs. H. C. Ager, Alfred Bell and J. R. Blatters.

ALFRED BELL, M.D., Secretary, pro tem.

PROGRESS IN GYNECOLOGY AND OBSTETRICS.

BY CHARLES JEWETT, M.D.

OLD PRIMIPARA WITH MYOMATOUS UTERUS.

Lepage (Comp. d'Obstet. de Gyn. et de Ped. de Paris, October, 1903) refers to two cases of labor in his practice complicated with myoma, in which no surgical intervention was required.

CASE I. was that of a woman pregnant for the first time at 57 years of age. Examination shortly before term revealed a small pedunculated fibroid at the fundus, two sessile tumors on the anterior wall, one of which was near the cervix. Another about two and a half inches in diameter lay in Douglas' cul-de-sac. Still another was found low in the pelvis at the right of the uterus.

The child, weighing six and a half pounds, was born dead, the labor ending spontaneously.

CASE II. occurred in a woman 38 years of age and a primipara. There were several myomata in the uterus, one as large as a foetal head, deep down in the pelvis behind the uterus. The woman had been kept under observation during the last four months of gestation in the Clinique de Baudelocque. At labor at term the lower tumor slipped up above the pelvic brim, and the child, which presented by the breech, was extracted without difficulty. The pelvic floor, which was torn into the rectum, was repaired several days. later.

Both these cases were carefully watched during the later months of pregnancy, and were kept on special diet. They serve to emphasize the fact that even extensive fibroid disease of the uterus does not necessarily seriously complicate labor.

CARCINOMA OF THE CLITORIS.

Weber (Monats. f. Geb. u. Gyn., February, 1904), reporting a case of carcinoma of the clitoris, upon which he operated, discusses the disadvantages of thermocautery as compared with the knife. Redlich has advocated the former. Weber believes that the presumed advantage of cautery may be had as well by enveloping the growth in gauze and pushing it aside during the dissection, thus protecting the healthy raw surfaces from implantation of the cancer cells. An objection to cautery is the slow healing of the wound. Again, he thinks immunity from recurrence is practically out of the question in cancer of the clitoris. In all his cases the growth has returned.

CONVULSIONS IN CHILDBED FROM CEREBRAL

TUMOR.

Zweifel (Zentralbl. f. Gyn., No. 17, 1904) reports a case in which more than eighty convulsions occurred during labor. To all appearance the case was one of true puerperal eclampsia. The woman died and the autopsy revealed a cerebral tumor. [Cerebral tumor is not the only condition that may simulate puerperal eclampsia. Doubtless the abrupt onset of convulsions during labor, without antecedent evidence of toxemia, is more frequently a pseudoeclampsia than is usually suspected.]

PYOCOLPOS.

Laroyenne (Ann, de Gyn. et d'Obstet., April, 1904) reports a case of imperforate hymen in a girl of 17 years, in which the vagina was distended with pus instead of menstrual blood. The

Brooklyn Medical Journal.

All communications, books for review, articles for publication, and exchanges should be addressed BROOKLYN MEDICAL JOURNAL, Library of the Medical Society of the County of Kings, 1313 Bedford Avenue, Borough of Brooklyn, New York.

Authors desiring Reprints of their papers should state on the galley proof the number of Reprints desired.

than the frail but temporary hut or shelter in which they lived but for a few days or weeks before wandering to a new locality.

On contact of the aborigines with the Caucasian traders, the garment of skin is replaced by the less comfortable one of cotton. The long

of the JOURNAL containing his article, on application at the Library of the Society, 1313 Bedford Avenue.

A limited number of black and white drawings to illustrate papers will be reproduced by the JOURNAL free of charge. Electrotypes will be furnished at cost.

Alterations of the proof will be charged to authors at the rate of sixty cents an hour, this being the printers' charge to the JOURNAL.

Entered at Brooklyn, N. Y., post office as second-class matter.

BROOKLYN-NEW YORK, SEPTEMBER, 1904.

THE CAUSES OF RAPID MORTALITY OF UNCIVILIZED RACES, ON CONTACT WITH CIVILIZATION.

The paper by Dr. Frederick A. Cook, presented in this issue of THE BROOKLYN MEDICAL JOURNAL, is unusual in several respects. In the first place it is a paper written by the only medical man living who has had the opportunity of studying the aboriginal races of both the far northern and the extreme southern limits at which human beings exist-the Eskimos, Patagonians and the Fuegians.

It is also remarkable in that the paper presents some hygienic facts of extreme importance to students of medicine and anthropology. No fact has excited greater wonder in the minds of students than the sweeping away of the really great aboriginal population which once inhabited this country, so that now the very names of many once populous tribes have passed completely from human knowledge.

It has been common to regard the extinction of such a great number of races to the combined effect of alcohol and small-pox, and, to a less degree, to syphilis and the acute,, contagious dis

eases.

Dr. Cook, basing his judgment on his observations both north and south, attributes the extinction to several hygienic factors, of which the changed modes of life of primitive man, after contact with the Caucasian, are regarded as important. Thus, the tendency to congregate in settlements or villages, coupled with an ignorance of the laws of cleanliness, is a cause of this degeneracy. The rapid change to substantial habitations works them harm. Their new houses, though they may be better built, are poorly cared for and consequently much more prone to harbor disease germs, especially those of tuberculosis,

the diet of meat becomes changed to one composed largely of starch.

Dr. Cook likewise attributes an important proportion of their rapid mortality to the introducion of the acute contagious diseases. These he finds. not only severe in the children of primitive man, but even more so in the adult population. Thus, in 1893, he observed an epidemic of chicken-pox among the Eskimos which was so severe as to lead him for a time to suspect the disease to be small-pox. Alcohol and the venereal diseases are recognized as factors of mortality; while tuberculosis, to which the changed conditions of life and the debility engendered by diseases render them most prone, plays an important part in the subjugation, moral and physical, of the primitive peoples.

TYPHOID EPIDEMICS.

A typhoid epidemic in the City of New York, even though of a local character, is a matter likely to arouse considerable anxiety and foreboding. The epidemic in the Bedford Park section of the Bronx to which the one referred to is at present confined, seems to have been due to the use of water other than the public supply. The sufferers had apparently been consuming water from a spring into which surface water has ready ac

The situation, therefore, is one which may be hardly sufficient to cause justifiable alarm. The matter is already the subject of thorough investigation in the hands of the health authorities, who are using every precaution to prevent a further spread of the disease. The Italian colony, among which the epidemic is at present located, has formed an extremely favorable quarter for the successful propagation of typhoid. The area in which the spring is located was to have shortly formed part of a new storage reservoir; but this fact need likewise have no special significance as favoring the spread of the disease throughout the city, in view of the preventive measures which are being employed in stamping it out.

Incidentally the epidemic furnishes a graphic illustration of one of the shortcomings of a water supply which is composed in part of surface

drainage. A supply so situated that it is open to the reception of surface drainage, is always insecurely guarded from the accidental reception of typhoid fever germs.

APPOINTMENT OF CONSULTANTS TO STATE

INSTITUTIONS.

It is, in a manner, a tradition that the medical consultants appointed to State Hospitals shall be chosen with as nice a sense of fitness as possible. Thus it has been the case that the men assigned to fill the positions at the State Hospital for the Insane in our Borough have invariably been Brooklyn men. The patients treated here are Brooklyn people and the consultants who may be called upon know, or are supposed to know, the local conditions of life surrounding them better than do outside men. There are other reasons

which appeal to every citizen of the Borough, physician or layman, which confirm the course in the past as the correct one. It would, therefore, surprise us, if the report that this precedent has been departed from, should be confirmed. We are certain that the physicians of Brooklyn look favorably upon the present arrangement and would feel it an infringement if appointees, however worthy, were chosen from other parts of the State for an institution in which citizens of Brooklyn alone are treated.

MEDICAL NEWS.

EDITED BY CLARENCE REGINALD HYDE, M.D.

It is earnestly hoped that all members of the profession possessing news concerning themselves or their friends, which would interest others, will communicate the same to the News Editor before the 9th of each month. Items for this department should be sent promptly to Clarence Reginald Hyde, M.D., 126 Joralemon Street.

Dr. Edward M. De Castro, of 482 Henry Street, is receiving the congratulations of his friends in the event of the birth of a son, August 15th.

Dr. William F. Campbell, who has been seriously ill with typhoid fever at his home, is now convalescing rapidly. His many friends have been much disturbed at the disquieting reports

regarding his illness, and will be pleased to learn of his safe return to health.

Dr. Wilbur L. Rickard, who was operated upon for appendicitis by Dr. Ferguson, of Troy, the last of July, has fully recovered. He was visiting his father at Canajoharie, New York, when attacked and an operation was necessary on the fifth day. We tender hearty congratulations on his recovery.

Dr. John A. McCorkle, in company with Dr. Gordon Hall, travelled abroad during August.

During the summer many improvements have been made in the Long Island College Hospital. The operating amphitheatre has been enlarged, electric lights installed and more space allotted the attending surgeons in the matter of dressing rooms and modern wash basins. Telephonic communication has been established throughout the hospital. The hospital now runs its own ambulance service.

The Mount Sinai Hospital has been left one thousand dollars by the late Marcus Goldman.

The Jungfrau boring, which is rapidly approaching completion, is the highest in Europe. Contrary to medical anticipation, the men engaged in the work enjoy splendid health while working at the present great elevation.

Dr. Earl H. Mayne, of Remsen Street, has returned from a three months' study of rectal diseases in the hospitals of London, Amsterdam and Paris. The doctor is making a specialty of rectal diseases.

Dr. Sidney D. Wilgus, of New York City, has been appointed by the State Commission in

Lunacy as chief examiner, with a salary of five thousand dollars. Dr. George D. Campbell, of New York City, and Dr. W. E. Sylvester, of College Point, have been appointed assistant ex

aminers at a salary of three thousand dollars each.

Dr. Herman T. Peck, of Halsey Street, who recently lost his father, mother and sister, has suffered a further bereavement in the loss by drowning of Arthur Z. Peck. Much sympathy is expressed for Dr. and Mrs. Peck in their new affliction.

Edward Ashbee, a medical student, and Miss Ada Outend, a trained nurse, both connected with Dr. Muncie's sanitorium, at Oak Island Beach, Babylon, L. I., were drowned in the surf, August 2d.