physiological deafness is admitted, it is probably to be explained by an obstruction to the passage of sound waves through the middle ear, and not by an early deficiency in the sound-perceiving apparatus.

*

CASTRATION AS A CURATIVE FACTOR IN OSTEOMALACIA.—In a severe case of endemic osteomalacia, says the International Medical Journal, Kleinwächter has seen a complete cure occur after a Cesarean section, the ovaries not being removed. The patient, a thirty-seven year old Jewess, was the mother of eight children, and showed all of the skeleton to be diseased with the exception of the bones of the head. As she was six months pregnant, the producing of premature labor was advised, but refused. The woman was then lost sight of for several years, when a telegram was received, asking for the performance of an immediate Cesarean section, as she had again become pregnant. She informed the physician that her former labor had been very difficult, and since then her pains had been all the more severe. The bag of water had ruptured the day previously. The body was now still more deformed, her height having diminished five centimeters. At the examination the finger could barely be admitted into the vagina. It was thought, however, that the placenta was adherent, and the head pressing upon it. An immediate Cesarean section was performed. After removing a living child, forty-seven centimeters long, the uterus was washed with a warm creolin solution and sprinkled with iodoform. The uterus contracting well, the opening was closed by stitches not penetrating through the muscle, additional superficial stitches of sublimated silk being next employed. Kleinwächter intended to remove the ovaries for the sake of the supposed curative action on the osteomalacia, but did not do so on account of his being physically exhausted at the time of the operation. Recovery was attended with no fever, but was complicated by vomiting and a severe cough. Five months later the woman was in a much better condition than formerly, and after a year she claimed that she

The

PORNOGRAPHIC LITERATURE. literature, says the Western Reserve Medical Journal, that comes to the office of a medical journal is very suggestive in its range, morally as well as intellectually. The fact that advertising pays subjects the medical editor to temptation as much as, probably, is the case with the newspaper men. The business management of the large eastern journals is entirely separate from the work of the editorial staff, and the ethics of the advertising columns are apt to be somewhat lower than are those of the editorial pages. Leading articles in those journals do not, as a rule, cater to the trade. Publications in smaller towns are usually managed by the editors, and as human nature is weak, and profits in legitimate journalism small, advertisements are apt to creep in disguised as original papers, even into the pages of legitimate journals. Others there are, sown broadcast over the land, which are simply advertising sheets, and from them private formulas and special remedies loom out from every page. No doubt the profits of such advertising are large, and there is no law of the land to prevent it. But there is a limit beyond which this thing should not go, and it is to this that we wish to call attention. Many of these sheets resort to medical quips and jokes of, to say the least, doubtful propriety. This has been carried so far that in a recent sample just received, there appeared a number of half-tones, artistically excellent, but essentially lewd, and evidently there to attract attention for that very quality. Low-class journalism can go no further

than this. The postal laws allow nude pictures in genuine medical publications, and very properly, as they are necessary for illustration. There is nothing indecent in a necessary exposure of the person for medical examination, or in the pictures which illustrate medical subjects. That drug advertisers should avail themselves of this liberty to distribute obscene literature is but a poor compliment to the ethical standards of our profession, and should be dealt with as it would be if carried on without its thin disguise of professionalism.

* *

BLOOD ALTERATIONS IN ETHER ANESTHESIA.—In seeking for the cause of anesthesia in ether inhalations, Dr. J. C. DaCosta gives, in the Medical News, the results of a series of cases carefully studied, in which he is of the opinion that not only the direct action of the ether on the nerve elements, but an alteration in the composition of the blood, causes this unconsciousness. His conclusions are:

1. Etherization produces a marked diminution in the hemoglobin of the blood.

2. The red corpuscles and the hemoglobin are especially affected in blood previously diseased, in such conditions, for instance, as anemia.

3. Irregular reports are due to faulty observation, to the presence of altered hemoglobin in the blood, to the faulty aberration as to color of a Fleischl instrument or to taking the blood before anesthesia is completed.

4. The white corpuscles show irregular changes which are not characteristic, and exhibit variations not more pronounced than would be found in the same number of samples of normal blood on different examinations.

5. Age does not apparently influence the results.

6. Ether-pneumonia may possibly be due, in some instances at least, to the action of intense cold upon the lungs, produced by the action of ether-vapor.

7. Edema of the lungs may arise from contraction of the pulmonary capillaries, thus producing a loss of vis a tergo and damming up of blood in the veins.

Furthermore, the same condition may produce sudden paralysis of the heart. 8. The often-quoted observation as to the effect upon the hemoglobin of shock and hemorrhage requires enlarged repetition upon human beings before the statements can be unreservedly accepted that hemorrhage causes a great fall in the amount of hemoglobin, but that shock does not affect it.

9. The chilling of the blood-stream may be responsible for the nephritis. that occasionally follows etherization.

10. Prolonged anesthesia profoundly deteriorates the blood and strongly militates against recovery; hence rapidity of operation is most desirable.

* *

BATHS IN THE TREATMENT OF STERILITY.-Kisch (British Medical Journal) ascribes sterility in the female either to the result of some form of pelvic peritonitis, to constitutional affections, to chonic local inflammations or catarrhs, or dyspareunia. He then describes the measures and treatments likely to alleviate the condition. Ordinary baths, partial or complete, douches, compresses, etc., are able to act on inflammatory deposits together with mineral waters, which increase the secretion of the intestinal tract. The baths of Elster, Franzensbad and Marienbad endowed with ferruginous properties, or the saline baths of Kreuznach, etc., are specially indicated. Sterility dependent on anemia should be treated at places like Pyrmont, Schwalbach, Spa, etc. For catarrhal conditions, alkaline springs such as those of Ems, Vichy, etc., should be resorted to; or should the secretion be excessive, more benefit might be derived from the astringent waters containing sulphate of iron, namely, Alexisbad, Levico, etc. Excessive corpulence as a cause of sterility should be treated at Marienbad, Tarasp, Friedrichshall, or Püllna. The results of vaginismus may be alleviated by the warm springs of Schlangenbad, Wildbad, etc. Finally dyspareunia, an important cause in the author's estimation, may be improved by baths or douches of water containing carbonic acid, as also by residence at an altitude, or by the sea.

MARYLAND

city and State. Physicians will come here in large numbers from every quarter of this vast

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BALTIMORE, MARCH 16, 1895.

THE coming meeting of the American Medical Association promises to be a very large af

fair. Already the commitAmerican tees of arrangements have Medical Association. done much work and are meeting weekly in their efforts to make this event a most successful

one.

Baltimore has for a long time had the reputation of being a very hospitable city and combining the easy and cordial manners of the south with the plenty of the north, and the beautiful women who are called in other States "terrapin women" are supposed to get their beautiful complexions and rich coloring from a long line of ancestors whose chief diet was canvas-back duck and diamond-back terrapin. This charming hospitality has not been lacking at other times and in other associations, as the recent convention of bankers will attest. To make, then, this meeting of the American Medical Association the success which it should be calls for a certain amount of patriotism on the part of each physician in the

first visit. Cordiality and hospitality can be shown without unnecessary effusiveness and a genuine welcome will not only be a proper greeting for the visitor, but will help all the physicians here in their pleasant duty of entertaining the profession, will make their guests feel at home and in an indirect way will assist the city of Baltimore.

Too long has it been the custom in many places to belittle any project or plan because it was begun and fostered at home and many a good thing has been near failure only to be saved by removal to a metropolis whence with the mark of success it returns to its former home to be supported by those who disdained it before.

If the meeting next May is to be a success, every man is to use his influence as far as he can and then when the members leave here pleased with their reception, each one can take to himself some credit for the results and feel a thrill of pleasure as a reward for hard work and an expenditure of time and money.

It is very easy to be a passenger in the winning boat in a race and it is quite human to shout with the victorious and to take to one's self praise for success as soon as success is in sight. Rats do well to leave a sinking ship, for self-preservation is instinctive; in the same degree in another direction this solemn homily is intended to show that in every effort that requires time and money all should assist and not sit idly by until success comes while the modest promoters of the scheme get no credit at all.

Then let each committee, every member of each committee, take a personal responsibility in his individual task and when the work is over there will be mutual congratulations and many words of praise.

***

If the coming woman is to be a man, or if woman is to don male garb and become masculine, then it is highly Hysteria in the Male. proper that what were once considered the rights and privileges of the female sex should be shared by the male.

Hysteria has for a long time been considered a disease peculiar to woman and indeed its derivation from the word signifying uterus

would show that that organ was blamed for all that complex arrangement of symptoms which were blindly called hysteria. Hysterical patients receive little sympathy, as the hard-hearted physician usually has the idea that the peculiar convulsions of laughing, weeping, unconsciousness or what-not, are "done for fun" or out of "pure cussedness."

This is partly because at that time the disease was supposed to be confined to woman while the practice of medicine was confined to man. Now, however, there seems to be a gradual transposition taking place, an osmosis, as it were. The woman studies medicine and scorns the idea that any one disease should be monopolized, while the man is allowed to go scot free. It seems strange that so many imperfectly understood symptoms should all be massed under the general term hysteria.

Dr. Benjamin Edson, in the American Journal of Obstetrics, has cited a large number of authorities giving various definitions of hysteria. Many writers admit that the disease may occur in the male when it is more than a neurosis and may be due to injury, as the writer of this paper shows. He cites a number of cases in his own and others' practice to show that:

1. Hysteria is not wholly a functional trouble, but it often depends upon organic disturbances.

2. It is a disease of men as well as of women. In the two sexes it is one and the same disease in cause, direct or remote, and in development and manifestation.

3. It occurs in males at all ages, but more especially in boys and young men.

Cosmetics.

THE specialties in medicine are unequally divided. Some are crowded, while others are rather neglected. The department of dermatology is one which requires especial skill and knowledge, and one which when followed with tact and judgment brings great rewards.

The dermatologist who has studied the art of cosmetics and can apply it to cases in hand may be sure of success. A woman will do almost anything to improve her looks and enhance her beauty and anything that can be rightly done to further this end is not only laudable but very desirable. Women should be encouraged in their desire to look as attractive as possible, and whatever tends

to improve their appearance, provided it is not injurious, should be allowed. Too often does a bad case of acne, eczema, or some similar trouble go on untreated until the eruption causes loss of tissue and scars.

Cosmetics should not be looked on as the application of rouge and powder, as is so often the belief. Any article that keeps the skin from performing its functions, as the too frequent application of powders, or the daubing on of an ugly and very apparent rouge, should on no account be allowed and the endeavor should be so to treat the skin that its natural healthy condition and bloom will be restored.

Such defects as hairs and moles should also receive attention, for removal of superfluous hairs can be accomplished with some patience and a little pain and there is no reason why any woman whose face is marred by hirsute appendage should not apply to the proper specialist to have these defects removed. If physicians, particularly the family physician, would take greater pains to attend to these apparent trifles, they would save many a woman from the hands of the quack and charlatan.

***

IT is gratifying to note that some of the physicians of Baltimore are taking an active and

Educational and Sanitary Reforms.

public-spirited interest in certain educational and sanitary reforms. This was first shown by a call for the establishment of free baths, which has at last assumed an encouraging shape. There is an ordinance before the city council to appropriate $8000 for the erection of such facilities, centrally located.

The introduction of physical training into the common schools has also brought several advocates to the front. The idea of military instruction for this purpose is not to be entertained for a moment. The United States Government has long since found it necessary to supplement the manual of arms by more general and systematic exercises of a gymnastic character.

Were our local municipal atmosphere more congenial to the broad-minded and disinterested physician, it would not be difficult to secure a specially trained medical director, such as Boston now has, who would be competent and willing to take charge of this as well as other sanitary interests connected with public school life.

Among the recent deaths in the medical profession in Philadelphia are to be recorded the names of Dr. Samuel K. Ashton and Dr. George A. Rex.

Dr. H. C. Parsons has been appointed an assistant resident physician at the Johns Hopkins Hospital and Dr. Theobald Coleman as assistant resident surgeon.

Dr. Theodore J. Micheau died last Monday at his residence in this city, after a lengthy illness from Bright's disease. He was a native of Baltimore and in early life learned the drug business. Among the surviving sons is Dr. Ellis Micheau, a Baltimore practitioner.

At the annual meeting of the Anne Arundel County Medical Society, Maryland, the following officers were elected: President, Dr. H. B. Gantt Vice-President, Dr. C. R. Winterson; Recording Secretary, Dr. Benjamin B. Davidson; Corresponding Secretary, Dr. C. B. Henkel; Treasurer, Dr. Frank H. Thompson; Finance Committee, Drs. H. M. Revell, C.B. Henkel and Thomas H. Brayshaw; Executive Committee, Drs. George Wells, J. W. Dubois and S. H. Anderson.

The following are the titles of the papers that have been promised for the Baltimore meeting of the American Academy of Medicine, May 4 and 6, 1895. I. The Address of the retiring president, J. McFadden Gaston, Atlanta, Ga. 2. "Expert Testimony," Henry Leffmann, Philadelphia. 3. "Hospital Man

agement," W. L. Estes, South Bethlehem, Pa. 4. "The Proper Teaching of Physiology in the Public Schools as a Means of Preventing Intemperance and Venereal Disease," De Lancey Rochester, Buffalo, N. Y. 5. "The Problem of Dependency as Influenced by the Chinese in America," W. F. Southard, San Francisco. 6. "What Agencies Conspire to Check Development in the Minds of Children," J. Madison Taylor, Philadelphia. 7. "How to Avoid the Dispensary Abuse?" Emma B. Culbertson, Boston. 8. "Contract Medical Work and Fees," Charles P. Knapp, Wyonting, Pa. 9. "What Shall We Do With Our Alcoholic Inebriate ?" J. W. Grosvenor, Buffalo, N. Y. 10. "Life Insurance in Its Relation to One of the Dependent Classes," E. O. Bardwell, Emporium, Pa. II. Some Results of Competitive Medical Charity," George M. Gould, Philadelphia, Pa. 12. "Criminal Anthropology," E. V. Stoddard, Rochester, N. Y. 13. Title to be announced, Leartus Connor, Detroit, Mich. 14. "The Increase of Insanity," Gershom H. Hill, Independence, Ia. 15. "A Perfect Consultation," L. Duncan Bulkley, New York.

The Chairman of the Committee of Arrangements of the Baltimore Meeting of the American Medical Association authorizes the following announcements: The railroad fares will be one and one-third on all roads. There will be excursions at popular prices to Gettysburg Battlefield, Annapolis, Washington, and probably Philadelphia and New York. A large attendance is expected. There will be a reception at the Johns Hopkins Hospital and a general reception by the profession of Baltimore to the Association delegates and their families at Music Hall. An auxiliary committee of ladies will be appointed to look after the entertainment of the visiting ladies. The Cyclorama Building has been obtained for the pharmaceutical exhibition and intending exhibitors are requested to make early application for space to Dr. B. T. Winchester, manager of the exhibition, 716 Fremont Avenue, corner of Lanvale Street, Baltimore, Maryland. Diagrams and rates will be furnished on application. The hotels have all made a reasonable reduction and exact rates will be announced later. The Hotel Stafford will be the headquarters of the Association. The sessions will be held on Tuesday, Wednesday, Thursday and Friday, May 7, 8, 9 and 10, 1895.