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transmission. It is the same with nervous impulses. If new connections can be formed by the action of any physical or psychical force to take the place of those broken by disease, it matters not so long as they are sufficient to transmit the natural nerve force, upon the free transmission of which depends the perfection of every mental and bodily activity."



ABORTION. RECENTLY a Detroit physician was arrested on the charge of criminal abortion. His story, which is borne out by the antemortem statement of the patient, is that the latter induced the abortion by instrumental means before piacing herself under his care. An operation was performed at the physician's house. The patient grew worse and was sent to a hospital, where a second operation was performed for puncture of the uterus, the patient surviving but a short time. A postmortem examination showed septic poisoning from perforations of the intestines and uterus. The prosecuting attorney was called into the case before the death of the patient. In spite of the latter's testimony, corroborating the physician's story, in the eyes of the law, the circumstances were suspicious enough to warrant the arrest of the physician.


Whatever may be the merits of this particular case, and medical men should be the last to judge a practitioner guilty until so proven by law, it serves a useful purpose in again bringing certain questions to the attention of the profession of the state. What course should a physician pursue when called upon to treat a patient who either has produced the abortion herself, or has accomplished her purpose through outside assistance? Unquestionably no physician should have anything to do with such a case until he has called in the best counsel obtainable. He should insist upon a consultation for two reasons: first, because he does not wish to bear the responsibilities of such a case alone; and second, because he needs a witness in case legal complications arise, Evidently the best possible witness he can summon is a practitioner in good standing in the community. The testimony of such a man would be far more valuable than would be the same testimony from a layman.

The physician owes it to himself, his family and his professionai reputation to employ every means of protection in these cases of criminal abortion. It is too often the case that the abortionist accomplishes his end by instrumental means, collects his fee, and leaves it for someone else to save the life of the patient. The latter must be cared for, and no true physician refuses to do his duty by such cases. However, there is no need of doing this in such a manner as to arouse suspicion in the eyes of the public in case of death of the patient. Recklessness and a lack of foresight do not redound to the practitioner's credit, nor do they enable him to render any better service to his patient. Even the summoning of a consultant does not always free the parties from suspicion in certain cases. Not long ago, such a case occurred in New York, where in spite of all precautions, two reputable practitioners were charged with having produced a criminal abortion. Later it was shown that their statements were true and that they had assumed charge of the case after the crime had been committed.

Prosecutors are at times either too zealous or lack judgment in sizing up the circumstantial evidence in certain cases. Hence, even when the physician has protected himself to the best of his ability, he may be called upon to defend himself. Usually, however, if his testimony be supported by that of an equally reputable physician, the judge will either throw such a case out of court, or a jury will acquit without leaving their seats. The Michigan statutes do not seem adequately to cover the situation under discussion except by implication. The law states that every person who shall wilfully produce a miscarriage resulting in the death of mother or child, unless the same shall have been necessary to preserve the life of the mother, or shall have been advised by two physicians to be necessary for such purpose, shall be deemed guilty of manslaughter. By implication, also, according to the first portion of the statute, wherein occurs the phrase "unless the same shall have been necessary to preserve the life of the mother," the physician in remote country districts, where a consultant is not always to be obtained, is adequately protected. The physician under these circumstances does the best he can for his patient. His defense, in case of legal complications, being his statement of the case to the jury.

Should the physician secure a statement from the patient as to how, when, or by whom the abortion has been committed before he assumes any responsibility of the case? In a general way the answer would be in the affirmative. Whenever possible, he should have the patient state the facts in the case before a witness or witnesses, but he should not go out of his way to secure a written statement. In case of legal complications arising from the subsequent death of the patient, an attorney could seize very easily the opportunity of impressing upon the jury the possibility of the physician's having acted under the spur of a guilty conscience and the probability that he had committed the abortion himself.

After all, the physician's main defense lies in the reputation he has established in his own community. This defense becomes well nigh impregnable when supported by the sworn testimony of another physician of irreproachable reputation. Is it not well for the young practitioner to bear this ever in mind? Day by day he is establishing his reputation for honesty and uprightness in his professional work or vice versa. Woe unto him if, in his hour of need, his community as one man does not rise up and proclaim faith in his innocence. R. P.




(BOSTON MEDICAL AND SURGICAL JOURNAL.] THERE can be no question that money invested in sanitary measures intended for the protection of the public health, and the consequent saving of human life, is well invested, and in the long run will yield profitable returns. Too often does it happen that the truth of the old proverb, “When the steed is stolen shut the stable door,” is recognized only too late to prevent serious illness and loss of human life.

This principle is frequently illustrated in the indifference of many communities to the importance of providing every possible means of protection for public drinking water supplies. In Pennsylvania the people have paid dearly for this wanton neglect, as shown in the longcontinued pollution of the water supply of Philadelphia, and the serious outbreaks of disease which have taken place at Plymouth and at Butler.

In Massachusetts the question of water pollution has been a subject of frequent discussion by legislatures, medical societies and social organizations for a third of a century, the result being the enactment of a general statute in 1886 placing all public water supplies under the supervision of the State Board of Health. Under the provisions of this act the work of introducing new supplies and of improving those already existing has gone rapidly forward until, at the present time, over ninety per cent of the population of the state is supplied with public water, mostly of good and wholesome quality.

A valuable index of the purity of the water supplied to a community is the amount of typhoid fever prevalent among the people thus supplied, as shown either by the mean annual number of cases, or of deaths from this disease as compared with the existing population.

In Massachusetts during the years preceding the general introduction of public water supplies, for example, the ten years 1856-65, the death rate from typhoid fever throughout the state was high, at nine or ten out of each ten thousand inhabitants, but since such introduction it has rapidly fallen until in the last year (1902) the death rate from this cause was not over two per ten thousand, or less than one-fourth of its former rate.

In the report of the State Board of Health for 1896 a diagram is published in which the death rate from typhoid fever and the percentage of persons not supplied with public water are shown in two parallel and descending lines, which are nearly coincident throughout the period of forty years. It is among this class of persons not supplied with public water that typhoid fever is most prevalent. What may be properly termed epidemics of such illness appear to be a thing of the past in Massachusetts. When, therefore, a limited outbreak occurs like that which was reported in Lowell in September last, or the occurrence of a dozen or more cases at Williamstown, public suspicion is unduly aroused, since even these limited outbreaks are of rare occurrence.

In Pennsylvania, however, the outbreak at Butler has assumed a seriously epidemic form, since here there were one thousand two hundred cases in a population of eighteen thousand, or more than seven per cent, a ratio exceeding any that have occurred in Massachusetts in recent years at least thirty-fold, and this is only a repetition of the severe epidemic which proved so disastrous at Plymouth in Pennsylvania a few years earlier. Recent advices from Butler show that the probable cause of the epidemic in that town was due to the existence of cases of typhoid fever upon the watershed of the public supply at a time when repairs were being made in the filtering plant, which allowed unfiltered water to be supplied to the inhabitants.

In the state of Vermont, with less than three hundred fifty thousand inhabitants, the Legislature appropriates ten thousand dollars a year for the use of its State Board of Health, while the Legislature of Pennsylvania, a state having a population of six million, makes a niggardly appropriation of six thousand dollars for all sanitary purposes.

In Massachusetts liberal provision is made for special work in the protection of the purity of public water supplies, and the State Board of Health is given general supervision of this work. By this means the Board is enabled to assume a careful oversight of all the water supplies in the state, both those of municipalities and those of private corporations. It makes regular and systematic examinations of the waters, provides rules and regulations for the sanitary protection of such supplies, gives advice to the authorities of cities and towns, gives warning of impending danger from pollution and from lead poisoning, and by these means affords a protection the value of which is far beyond the amount expended in carrying out the provisions of the law.


PASSINGS DUE TO PNEUMONIA. DOCTOR GEORGE J. ENGELMANN, formerly of Saint Louis, the city of his birth, but a resident of Boston since 1895, died at Nashua, New Hampshire, November 16, 1903, pneumonia being the fatal illness. The doctor was born July 2, 1847, and graduated at Washington University in 1867, later receiving the degree of A. M. from the same institution. His medical education was acquired in European universities, and his professional career was inaugurated in the FrancoPrussian war of 1870 and 1871, where he rendered service in the German army. He returned to his native city in 1873 and pursued the practice of medicine until his removal to Boston, gynecology being the department of medicine which enlisted his special attention. He was professor of this branch in the Missouri Medical College for a number of years, resigning in 1894: trustee of the Missouri Botanical Gardens at Saint Louis from 1880 to 1894; founder of the Saint Louis Obstetrical Society; president of the Southern Surgical and Gynecological Society in 1890; charter member and later (1900) president of the American Gynecological Society; honorary president of the gynecological section of the International Medical Congress in 1884; honorary president of the International Congress of Obstetrics and Gynecology at Brussels in 1892, Amsterdam in 1899, Rome in 1902; and president of the Boston Obstetrical Society. He was not only a student of medicine but of ethnology and archeology as well, and the Peabody Archeological Museum at Cambridge and the Smithsonian Institute at Washington are recipients of various and valuable collections made by him. Doctor Englemann was an extensive traveler, a fluent talker, and a ready writer, one of his latest contributions to medical science being on the subject of “Sterility.”

DOCTOR CYRUS EDSON, of New York City, died of pneumonia at Roosevelt Hospital in that city on December 3, his illness being of brief duration. He was born at Albany, New York, on the 8th of December, 1857, and was a son of Franklin Edson, an ex-mayor of Gotham. His academic education was received at Columbia University, and in 1881 he graduated in medicine at the College of Physicians and Surgeons of New York. The following year he was appointed assistant sanitary inspector in the New York Health Department, and eventually, by process of gradual promotion, became chief inspector of the Second Division. He was appointed president of the Board of Health in 1891. He occupied various other positions at different times, notably president of the Board of Pharmacy; vicepresident of the American Society of Public Analysts; visiting physician to Charity Hospital; and assistant surgeon of the twelfth regiment of the New York State National Guard. The distinction of being one of the famous Columbia crew which won the Henley cup in 1878 was likewise his lot.

MINOR INTELLIGENCE. The Index to Volume XXV will be mailed in an early number.

THIRTY children were poisoned recently by impure milk at the County Orphanage located at Fresno, California.

PATTI, the world-renowned singer, has bequeathed her larynx (after her demise, so report says) to the museum of the Royal College of Surgeons.

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