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I of course used the strictest antiseptic precautions; I removed the dressing on the tenth day. The parts were well united, with no discharge of pus except about two drops in the drainage tube. The patient made a rapid recovery, and was on his crutches in three weeks.
Case 2.-J. C., age 20; amputated five inches below the knee. Well in two weeks, and on crutches.
Case 3.-S. M. (col.), hand cut by saw. Amputated middle of fore arm.
All of these cases were treated with the strictest antiseptic precautions, and all recovered without any discharge of pus.
Aneurism. Mrs. J., age 38, popliteal aneurism. Ligated femoral artery ; prompt recovery.
Perineorrhaphy. I have operated on three cases of lacerated perineum within the last year. Two on the third day after delivery, which I think preferable, as the granulations have well sprung up, and the parts unite by direct union. I have operated on quite a number of cases within the last few years, waiting until the third day after the rent, and have been successful in each case. One case in which the secondary operation was performed, when the sphincter was torn through; all were satisfactory. I will say here that I always use the straight common sewing needle recommended by Emmett, and I prefer it to the crooked one.
Trachelorrhaphy. I have performed the operation for laceration of the cervix uteri sixteen times within the past eighteen months; ten double, the others single. In probably half of them I used silkworm gut; the others, wire. I never operate for laceration until I have treated the cas and find that it is really necessary for a cure. In the majority of these cases I had curetted the uterus some time before closing the laceration. In performing this operation I used Skeen's hawkbill scissors to complete the denudation, as I have before stated in this society. I prefer using the silkworm gut and a corkscrew needle, as it is more convenient to apply the sutures. This operation is condemned by some gynecologists, but there is no operation in surgery that has given as universal satisfaction in my hands, both to myself and patients, as this one, save the operation for hemorrhoids.
Uterine cancer. Case 1. A mulatto woman, age 50, uterine sarcoma. Operated Jan. 23, 1890; removed all the diseased portions, which included cervix, and extending into the cavity of the uterus and excluding a portion of the vagina, using a sharp curette and scissors. I then thoroughly cauterized the parts with Paquelin's thermo-cautery, and packed the cavity with carbolated cotton. The case did well, and is in fairly good health.
Case 2.—A negro woman, age 65, uterine sarcoma. Operated May 29, 1891. This case was very extensive, including the vagina, and extending to the cellular tissue. I removed all cancerous tissue possible, and scraped the cavity of the uterus to a mere shell, and taking away the upper and posterior parts of vagina, an assistant holding the intestines out of the way during the operation. I then thoroughly cauterized the parts with thermo-cautery (the assistant protecting the protruding intestines), sprinkled the parts lightly with iodoform, and packed with carbolized cotton. Removed the dressing the second day, and redressed each day for a week. The patient was up in about three weeks; has gained flesh, and is in comparatively good health.
Ovariotomy. Mrs. F., age 27, has given birth to three children; the last one the first of last February, and was confined to her bed six weeks with peritonitis. Was sent to me for operation May 1, 1891. The patient being in such feeble condition, and as I had made arrangements to start to Washington to attend the A. M. Association, I deferred the operation. I operated May 19, 1891. I made the usual incision, found complete adhesion, evacuated the cyst with a Wells trocar, washed out the cavity thoroughly with a hot sublimate solution to prevent any of the contents of the cyst getting into the peritoneal cavity. I then undertook to dissect away the tumor, and found it not only adherent to the abdominal walls, but to the intestines and mesentery. I will say here that the cyst contained about one gallon of very dark, brownish-looking fluid. Believing that it would be criminal to undertake to remove all of the cyst, I cut off all that I had dissected loose, and closed the wound. She made a good recovery;
gained strength quite fast, and is in better health now than for two years past, with no evidence of the cyst refilling.
Oophorectomy. Miss P. H., age 33, has been in bad health for eight years. She came under my treatment April, 1886; was suffering with most extreme nervous excitement; worse during her menstrual period, which came on every three weeks. Tender ovaries, with severe pains in them at times. She was subject to acute mania, which would last about two weeks at a time. The nervousness continued, and in 1887 I advised removal of ovaries as the only cure, but she would not consent to it until last spring, as she was gradually growing worse. On June 9, 1891, I operated, removing both ovaries with left tube. Cystic degeneration of both ovaries, with a small cyst the size of my thumb hanging to a pedicle from the left tube. She made a rapid recovery from the operation, and was up in three weeks.
SUMMARY REPORT of the Organization of the Annual Reunion of the Texas Graduates
of the Memphis Hospital Medical College. The 31st day of March was the date of a very enthusiastic scene on board a special car containing the Texas Graduates of the Memphis Hospital Medical College en route from Memphis to Texarkana.
Had an artist portrayed the different manifestations, physical and psychical, developed by those who only a few hours previous had seen the majestic orb of day make his glittering debut upon their professional career, there would have been pictured the many demonstrations of joy peculiarly associated with those standing on the shore of accountability ready to plunge into its rolling waves and struggle to gain a foothold on the gorgeous land of fame.
Through the energetic endeavors of Dr. G. W. Hill, a list of all the previous graduates from Texas had been secured, and those of '91 and ’92 proceeded to organize themselves into an association, the object of which is pleasure, scientific instruction and a general development of the good qualities embraced in the maxim, “In union there is strength.”
Short speeches complimentary to our able faculty, with special reference to the dean, and the advantage which would accrue from an organization similar to the one proposed, were delivered by Drs. Fitzsimon, Painter and Hill.
The necessity for such a society to meet annually, by which happy combination of events its members could enjoy a social reunion to review the incidents of interest connected with their professional work, was dwelt upon.
On motion, Dr. Jno. T. Fitzsimon was called to the chair
The election of officers was proceeded with, the result being the election of Dr. G. W. Hill, President; Dr. F. W. Painter, Vice-President; Dr. M. Junius Taylor, Secretary and Treasurer. The following executive committee to confer with the President and Secretary, was elected: Drs. J. T. Fitzsimon, J. C. Rice, W. D. McGowan, R. J. Boze, J. R. Warnick, J. A. Campbell, J. V. Cochrum.
The following five gentlemen were appointed by the President to select a title for the organization : Drs. Jones, Tucker, Warnick, Campbell, McGowan.
“The Annual Reunion of the Texas Graduates of the Memphis Hospital Medical College,” was adopted.
On motion, the Secretary was requested to solicit in this summary report the membership and co-operation of all of the graduates of the above named College now residing in Texas. So let us all flock around one common center, and by earnest endeavors make our Reunion an organization to afford a few pleasant days in the busy season, and last, but not least, an ornament and firm plank in the platform of the medical profession of the grand Lone Star State. Correspondence solicited.
G. W. Hill, Pres., Phelps, Tex. M. JUNIUS TAYLOR, Secoy, Moscow, Tex.
Bacteriology of Endometritis.
In order to investigate the bacteriology of endometritis, Dr. Brandt of St. Petersburg recently examined twenty-five cases, including hemorrhagic, catarrhal, gonorrheal, and septic forms. After carefully cleansing the external genitals, the vagina and the cervical canal with a solution of corrosive sub
limate of the strength of 1 in 1000, with alcohol and with ether-preliminary bacteriological observations on scrapings from the cervical canal invariably giving negative resultsthe internal surface of the uterus was scraped with a curette, and dry preparations as well as cultures in agar and gelatin were made. The plate method was likewise employed, as were inoculations in animals. The portions of mucous membrane brought away were also carefully examined with the microscope. In almost all cases microbes were found, both pathogenic and non-pathogenic, the former, however, preponderating. Of these, both cluster and chain cocci were met with; among the non-pathogenic bacteria there were occasionally bacilli, but most commonly cocci. It was remarked that cases where pyogenic microbes were found were not clinically distinguishable from others where none could be detected; these pyogenic microbes, however, when injected into animals invariably produced both local and general symptoms, such as abscesses and a rise of temperature. Sometimes, but by no means always, microbes were seen in the substance of the mucous membrane.-London Lancet.
Chloralamid-Its Action Based on a Study of 280 Cases.*
In giving an opinion of the value of a drug, and in this case of a hypnotic, it is necessary to be particularly careful, as there are so many known and unknown factors which combine to produce the somniferous state that it is often difficult to determine which adverse element to its enjoyment is antagonized by the medication used. Again, the organism may be abnormally susceptible to or against certain physical agents, so that we have in different conditions different procedures in accomplishing a state of physical and mental relaxations at our command. These may be drugs, different temperatures, electricity, or even suggestion.
The compound which is the subject of this paper acts by virtue of its power to quiet the irritability, normal or otherwise, of certain nervous centers, and to induce a condition which we term sleep.
By James Wood, M.D., Brooklyn, Assistant in Pathology and Clinical Medicine, New York Post-Graduate Medical School and Hospital, etc.