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MEDICAL JOURNAL

Established 1845 by AUSTIN FLINT, M. D.

EDITOR:
WILLIAM WARREN POTTER, M. D.

ASSISTANT EDITORS:
WILLIAM C. KRAUSS, M. D.

NELSON W. WILSON, M. D.

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ASSOCIATE EDITORS:
JAMES WRIGHT PUTNAM, M. D. ERNEST WENDE, M. D.
JOHN PARMENTER, M. D.

JOHN A. MILLER, PH. D
HARVEY R. GAYLORD, M. D. MAUD J. FRYE, M. D.

VOL. LX.-XLIV. (New Series.)

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CONTRIBUTORS TO NEW SERIES VOLUME XLIV.

(Whole Number Volume LX.)

AUGUST, 1904-JULY, 1905.

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BAIN BRIDGE, WILLIAM S.........
BARROWS, FRANKLIN W..
BAYLISS, A. W..........
BENEDICT, A. L....
Bentz, CHARLES A.
BISHOP, Mrs. J. F....
BRUSH, EDWARD N..
BURROWS, LORENZO, JR.
Busch, FREDERICK
CHAPIN, HENRY Dwight.
CLARK, EDWARD...
CLINTON, MARSHALL..
COTT, GEORGE F.........
CROTHERS, T. D..
CUMSTON, CHARLES GREE
DEWITT, C..........
EDSALL, D. L.
FISHER, EDWARD D.
FOWLER, GEORGE B....
FRAZEE, A. B.........
Frye, Maud J..
GIBSON, JAMES A....
GRAM, FRANKLIN C......
GRANT, John H.
GREENE, WALTER D....
CREVELING, J. P.........
GROSVENOR, J. W...
HANLEY, L. G...
HOPKINS, HENRY REED..
HOUSE, WILLIAM.
HOUSTON, San.....
HUBBELL, A. A..........
JACOBSON, NATHAN.......
JOHNSON, RAY H.....
JOHNSTON, GEORGE BEN.
JOSLIN, ELLIOTT P..........
KING, JAMES E.........

New York

.Buffalo
. Buffalo
.Buffalo
Buffalo

.. China
Towson, Md.

Buffalo .. Buffalo New York

.Buffalo ... ... Buffalo

.Buffalo

.Hartford
........... Boston

Washington
Philadelphia

.New York ......... New York

Rochester

.Buffalo .........Buffalo

Buffalo

.Buffalo
...... Buffalo

.Auburn
. Buffalo
.Buffalo

.Buffalo
Portland, Ore
..... Washington

.Buffalo ....... Syracuse

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KRAUSS, William C.........
LAPP, HENRY....
LE SEUR, JOHN W..
LEWIS, F. PARK.....
LONG, ELI H.....
Love, FRANK W..
LYTLE, ALBERT T.......
MacDONALD, CARLOS A...
MACLEOD, J. A..
McGuire, Edgar R.....
McGUIRE, FRANCIS W..
MCKEE, Thomas H....
MASSEY, MYRTLE L..
MEWBORN, A. D.......
MILLENER, F. H.
MORRIS, ROBERT T.....
NORTON, CHARLES P..
PANZER, B.......
Park, RosWELL.........
PHILLIPS, WILLIAM LINTON.
Potter, William WARREN.
Putnam, James Wright...
REED, CHARLES A. L....
RENNER, W. Scott...
RICKETTS, B. MERRILL.
ROCHESTER, DELANCEY...
ROWELL, E. E..........
RUGGLES, E. WooD...
SAWERS, F. H........
SCHUGENS, M. ELIZABETH
SHERMAN, DEWITT H..
SIMMONS, GEORGE H....
SIMPSON, BURTON T..........
SNELL, ALBERT C..
STEPHENSON, FRANK H.....
VAN DER BEEK, CHARLES A.......
VAN DUZEE, EDWARD P..
VAN FLEET, FRANK......
WENDE, Grover W.....
WEY, HAMILTON D....
WILLIAMS, HERBERT U....
Wilson, NELSON W......

. Buffalo ...... Clarence

.Batavia

. Buffalo ... Buffalo .... Buffalo

. Buffalo Tew York

.Buffalo ..... Buffalo

. Buffalo ... Buffalo

. Buffalo

New York .........Buífalo

.New York .... Buffalo .... Vienna

.Buffalo ... Buffalo

.Buffalo .... Buffalo Cincinnati

...Buffalo ... Cincinnati

.. Buffalo . Stamford Rochester

Rochester .... Buffalo ....Buffalo .Chicago

Buffalo ... Rochester ........ Syracuse

.Rochester

.... Buffalo ... New York ....... Buffalo

.... Elmira .... Buffalo .... Buffalo

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ALUMNI AssociATION, UNIVERSITY OF BUFFALO.
BUFFALO ACADEMY OF MEDICINE.
MEDICAL ASSOCIATION OF CENTRAL NEW YORK,
MEDICAL SOCIETY OF THE COUNTY OF ERIE.
ROSWELL PARK MEDICAL CLUB.

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THE treatment referred to in the foregoing title is undoubt

edly as important as the technic of the actual operation itself and it is best discussed under headings.

THE TREATMENT BEFORE THE OPERATION. This is principally one of prophylaxis, and its aim is to prepare the patient in such a manner that she will enter the operating theater in the best mental and physical condition possible. The question of shock here is one which needs very careful consideration.

Though not attempting to discuss the pathology of shock, one may say that the condition is due to a state of exhaustion of the medulla and the spinal cord, leading to a great reduction of vita] activity and resulting from severe irritation of the peripheral ends of the sensory and sympathetic nerves. In this condition the face is pale and drawn; the pulse is frequent, weak and dicrotic. The pupils are dilated; the reflexes are diminished; the respirations are feeble, irregular and sighing; the temperature is subnormal.

The condition may be much lessened by prophylactic treatment. It is well for the patient to be in the hospital for at least three or four days, even for a week if possible, before the operation, so that she may become accustomed to her surroundings and undergo a careful and systematic preparation.

1. Read before the Erie County Medical Association, June 19, 1904.

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