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Hospital. He expressed a doubt as to their occurrence apart from some tuberculous affection. A remarkable fact was that all three cases were under two years
age. Cancer of the mediastinum is thought by Steven,t despite the statistics advanced by Hare, to be nothing like as frequent as sarcoma of that region, or especially lympho-sarcoma.
An operation for opening the posterior mediastinum has been lately described and devised by Quenn and Hartmann :I A vertical skin incision is made midway between the spinal border of the scapula and the vertebral column. After division of the exposed portions of the trapezius and rhomboid muscles and displacement inward of the outer border of the sacrolumbalis, a portion of the entire thickness of each bone and about į inch in length is taken from the third, and each of the following ribs. An opening is thus formed nearly five inches in length, extending from the first rib to the upper border of the sixth. Quenn states that by separating the sides of this wound, one can very clearly see all of the posterior mediastinum and all the organs it contains. It is pointed out that this operation is attended with more difficulty and danger on the right side than the left. Braun has shown that the pleura insinuates itself on the right side, between the esophagus and the vertebral column in order to reach the aorta. On the left side it passes directly from behind forward. It is thought that operative procedure into the posterior mediastinum might be indicated in disease of any organ contained in this part of the thoracic cavity. It is most probably necessary in cases of impacted foreign body in the lower part of the esophagus. The anatomical conditions are not favorable to removal of malignant disease of the gutlet, unless the growth is of very limited extent.
The attention of our readers is called to the advertisement of Robinson-Pettet Company, which appears in this issue. This house is one of long standing, and enjoys a reputation of the highest character. The preparations referred to we commend specially to the notice of practitioners.
† Glasgow Medical Journal, June and August, 1891.
MEDICAL LEGISLATION. Readers of the Monthly, who are the best posted on the subjects of medicine at the present time, who are they that win the honors at the final test, when we are all arraigned before the “ tribunal bar” of the “green room?” Is it the boy who has been raised in the lap of luxury, amidst never-failing ease and comfort, or is it he who has had to make his bread by the sweat of his brow? I have been in the quiz room with the poor and the rich, and have heard the questions of medicine put to them, and, nine times out of ten, the boy who had on his fine clothes, diamond stud buttons, etc., with a father to “ back him," able to send him ten sessions if necessary, would stick his head down in shame, and some poor boy who was working himself through college, with a bright, intelligent face, would “get there” every time. If the medical laws abridge the privilege of any citizen of the United States to earn an honest living for his family or him. self by prescribing conditions and qualifications that are burdensome and inconsistent, they are without a doubt unconstitutional, and cannot be enforced. The courts have always held that a man's professional education, no matter how acquired, is as much his property as are his books, instruments, horses, etc. The“ trust” that makes it criminal for a citizen to use property for his own good and the advantage of others, or proposes unnecessary and burdensome restrictions, practically deprives him of that property without due process of law. If any man or woman is ordinarily successful in treating diseases, it is the duty of the State to protect such individuals in the exercise of this God-given privilege. I say let the faculty of every medical college consist of men who are competent to judge when a man knows enough to practice medicine, and when they give a man a sheepskin, let all other men keep their mouths shut. If they can't stand competition, it shows there is a screw loose somewhere, and therefore let them stand back and let the man who has gained the day do the work. Long live the dear old Monthly.
J. T. NORMAX.
A SEXUAL FREAK.*
In Havana, Cuba, there is a boy 3 years and 10 months of age, whose father is 59, twice married. By first marriage he had six sons. By the second, thirteen sons and two daughters. The mother is 42 years of age. Both parents of excellent constitution.
The child referred to occupies the thirteenth place among his brothers, all of which are of perfect development. Until the eighth month this child presented nothing unusual in his growth. At this time, attention was called to the extraordinary rapid growth of the external genital organs, which had reached a size vastly disproportionate to his age. The pubis was soon covered with hair, while at 12 months the first dentition was complete.
During the second year he had a fever in which temperature fluctuated between 38 and 40 C., proving rebellious to all medication ; possibly, caused by rapid growth. Following the fever, were two attacks of pulmonary congestion, with corresponding hemoptysis, in which at one time he vomited about two ounces of blood. Such are his physico-pathological antecedents.
Let us call attention to the slight development of the fore part of the head, as compared with the back part and the body. The measurements cause us to think we have a microcephalus, but this is not so, because at three years the head should not be larger. The back part has a much larger development, and is in direct relation with the growth of the genital apparatus.
Note the measurements: Horizontal circumference, 52 centimeters (203 in.); antero-posterior circumference, 32 centimeters (12} in.); transverse circumference, 30 centimeters (113 in.); antero-posterior diameter, 180 millimeters (7 in.); transverse diameter, 140 millimeters (516 in.)
The face had the appearance of adolescence, eyes large and somewhat expressionless, brows and lashes thick; nose quite * Translated from the Spanish, Gaceta Medica, City of Mexico, by Geo Mott, M.D.,
Spurger, Tex., for the Memphis Medical Monthly.
large, wide at base, 40 millimeters (1) in.) long; external ear 60 millimeters (26 in.); jaws completely developed ; had cut third molars. Neck, 29 centimeters (113 in.) in circumference; trunk well developed, no hairs in axillæ nor around mammæ. Circumference of chest, 65 centimeters (251 in.); circumference of waist, 66 centimeters (253 in.); circumference of arm, 141 centimeters (511 in.) ; length of arm, 19 centimeters (7} in.) ; length of hand, 13} centimeters (51 in.); length of forearm, 16 centimeters (6ļ in.); length of thigh, 27 centimeters (1096 in.) ; length of leg, 24 centimeters (9g in.); length of foot, 5 centimeters (116 in.); circumference of thigh, 29 centimeters (113 in.) Has slight genu-valgus, but was not born so.
Genital organs: Penis, in semi-erection, 9 centimeters (37 in.) from pubis to extremity; from extremity to scrotum, 8 centimeters (31 in.); circumference, 10 centimeters (37 in.); glans, uncovered; right testicle not yet descended ; left, 7 centimers (211 in.) in length, 13 centimeters (516 in.) in circumference. Erections frequent, when color, consistency and volume of the organ all change, giving length 13 centimeters (51 in.), circunference 11 centimeters (44 in.)
As yet there is no emission, but he is already in love with a girl neighbor, lying awake at night thinking of her, and will cry when she is carried from his sight.
Voice is developed in same ratio as genital organs. All other organs are as usual with a child of his age. All functions normal. Temperature, 37–38° C.; pulse, 108. Is something of a glutton, but has splendid digestion. Sleep tranquil, except when troubled with erections. Intelligence, very infantile; weight, 60 pounds.
Only two similar cases are reported in the International Annual of American Sciences : One by Dr. Bedwell, a child of 5, and one by Gauthier of 7 years. Comparing our case with that of Bedwell's' we have advantage in stature and all other dimensions, his surpassing ours only in weight, twenty-two pounds, which is not a great difference considering his case was two years older. I propose to watch the growth of this child, and report from time to time.-Dr. Pla, in Gazetta Med.
SOUTHERN SURGICAL AND GYNECOLOGICAL ASSOCIATION
Fifth Annual Meeting held in Louisville, Ky., November 15, 16 and 17, 1892. J. McFadden Gaston, M.D., President; W. E. B. Davis, M.D., Secretary.
MORNING SESSION. The Association met in the Council Chamber of the City Hall, and was called to order at 9:30 A.m. by the President, Dr. J. McFadden Gaston, of Atlanta, Ga.
An address of welcome was delivered by Dr. L. S. McMurtry of Louisville, Chairman of the Committee of Arrangements, the response to which was made by the President.
The first paper read was by Dr. Bedford Brown of Alexan. dria, Va., entitled
Personal Recollections of the Late Dr. Benjamin W. Dudley of Lexington, Ky., and his Surgical Work.
The speaker paid an eloquent tribute to Dr. Dudley, and characterized him as the greatest living lithotomist that this country had ever produced, and the most successful in the history of the world. The speaker's close relationship to Dr. Dudley as private pupil and assistant for two years enabled him to present a clear and faithful sketch of his character and surgical work.
Experiences in Pelvic Surgery.
This was the title of a paper read by Dr. A. V. L. Brokaw of St. Louis, Mo. Of all the surgical problems difficult to solve, it may be truthfully said that those met with in the pelvis are the most trying. The speaker knew of no surgical work which will compare with the experiences found in the pelvis; a diversity of conditions, complications and unexpected happenings are ever presenting? In a series of many operations, but few will be alike in every particular. As his experience became larger, he was free to confess his inability to correctly diagnose the character of abdominal and pelvic troubles. He had diagnosed pus tubes and found extrauterine pregnancy; diagnosed extrauterine pregnancy and found pus; diagnosed ovarian lesions and found the trouble located