M. D., Philadelphia, Pa.: "Differential Diagnosis Between Labyrinthine and The regular meeting of the Cleveland Homeopathic Medical Society was held in the College Building on Wednesday, April 14th, at 8 p. m. The program was as follows: Wm. M. Gregory, M. D., Treatment of LaGrippe; B. B. Kimmel, M. D., Fractures of Carpal Scaphoid; H. F. Staples, M. D., Cremation. A called meeting of the Homeopathic Medical Institute of our state was held at the Threadgill Hotel, Oklahoma City, April 15th and 16th. The feature of the meeting was the presence of Dr. W. D. Foster, of Kansas City, president of the A. I. H. Dr. Foster read a paper dealing with the propagandism of Homeopathy, there were also read papers from Drs. Hensley, Gue and others, which will appear in the different journals. At the banquet held in the evening of April 15th at the Threadgill Hotel, Dr. J. Hensley, honorary president, of Oklahoma City, acted as toastmaster. There were responses from Dr. Miller, Dr. Foster and others. We had present with us Dr. A. M. Butts, of Holdenville, and L. E. Emanuel, of Chickasha, members of the State Board, who also responded. We consider our meeting second to none that has been held in any state; the members and all present were greatly benefited by the high order of the papers read. Our fourth annual meeting will be held at Oklahoma City, October next; we will be represented at the A. I. H. meeting in June by Drs. Hensley, Oklahoma City,. D. M. Miller, of Blackwell, our president, M. E. Ray, and others. MARY E. RAY, M. D., State Secretary. The 37th annual meeting of the Homeopathic Medical Society of Eastern Ohio was held in Akron, Ohio, Wednesday, April 21st, 1909. The following program was presented: R. De W. Robinson, M. D., Akron, O.: "Electricity in General Practice."' W. A. Mansfield, M. D., Barberton, O.: "What Shall We Do to Be Saved?'' A. S. Green, M. D., Youngstown, O.: "Abnormal Surgery." N. T. B. Nobles, M. D., Cleveland, O.: "Surgical Kidney Clinical Reports. C. S. Cutter, M. D., Cleveland, O.: "Tubercular Peritonitis." E. O. Adams, M. D., Cleveland, O.: "Physic Indigestion." G. W. Spencer, M. D., Cleveland, O.: Therapeutic Philosophy. H. Primm, M. D., Ravenna, O.: "Lacerations of Cervix Uteri." J. W. Rockwell, M. D., Akron, O.: "Materia Medica." 66 Dr. H. F. Biggar, Sr., was elected president of the society. There were over forty physicians in attendance. Obituary. CHARLES B. JARED, M. D. Hahnemann Medical College, Chicago, 1905; a lecturer in his alma mater; died at his home in Chicago, April 5, aged 52. ELBERT GILBERT BENSON, M. D. Washington (D. C.) Homeopathic Medical College, 1896; president of the Eclectic Board of Medical Examiners of the District of Columbia, and a member of the Board of Medical Supervisors of the District; died at his home in Washington, March 27, from pneumonia, aged 50. WILLARD SOUTHARD WHITNEY, M. D. Homeopathic College, Cleveland, 1868; a pioneer practitioner of Big Rapids, Mich.; died at the home of his daughter in Pontiac, April 2, from senile debility, aged 90. JOSEPH CLIFFORD MOORE, M. D. New York Homeopathic Medical College, 1866; a member of the New Hampshire Senate in 1880; died at his home in Laconia, N. H., March 19, from cerebral hemorrhage, aged 64. OSCAR M. BARBER, M. D. New York Homeopathic Medical College, New York City, 1871; for several years health officer of Stonington, Conn.; died at his home in Mystic, Conn., April 3, from gastritis, aged 71. FRANK FOSTER CRANDELL, M. D. Cleveland Homeopathic Medical College, 1903; died at his home in Turtle Creek, Pa., April 10, from pleurisy, aged 40. ISAAC H. LEWIS, M. D. Western Homeopathic College, Cleveland, 1857; one of the earliest settlers of David City, Neb.; died at his home, April 3, aged 81. DR. CHARLES L. KINGSBURY died at San Diego, Cal., where he had gone for his health, on March 14, aged 59 years. Dr. Kingsbury, who was a native of New Hampshire, was graduated from the New York Medical School in 1874, and had practised in Spencer and in Boston, Mass., until his health failed two years ago. DR. GEORGE E. TYTLER, of New York, died on April 15, after a short illness aged 60 years. Dr. Tytler was graduated from the New York Homeopathic Medical College in 1873, and was a member of the American Institute of Homeopathy, the State Homeopathic Society, and the Academy of Pathological Science. DR. SIMON O. PILLING, of Hartford, Conn., died at his home on March 17, aged 44 years. Dr. Pilling was a graduate of the medical department of Boston University and served as surgical interne in the Massachusetts Homeopathic Hospital. He had practised in Newburyport, Mass., until his retirement, because of failing health, a short time ago. DR. LAVINA THORPE, class of '83, C. H. M. C., died Friday, April 23rd. Deceased was wife of Dr. S. L. Thorpe, 8604 Cedar Ave., Cleveland, O. CORA LEE OUTCAULT, M. D. Hahnemann Medical College, Chicago, 1902; formerly of Ottawa, Ill.; died at her home in Chicago, April 20, from carcinoma, aged 47. BENJAMIN F. GAMBFR, M. D. Homeopathic Hospital College, Cleveland, Ohio, 1877; formerly professor of anatomy, physiology and hygiene in his alma mater; of Oakland, Cal.; a fellow of the Royal Microscopical Society; died in Lancaster, Pa., April 14, from nephritis, aged 65. There is a popular misconception surounding these states of mental alienation, which I wish to remove from your minds before proceeding to discuss the subject in general. There is no puerperal mania; there is no insanity of pregnancy; there are only certain mental disorders incident to these states. Pregnancy, the puerprium. and lactation, may act as etiological factors in the production of any form of mental derangement; but psychiatrists are less and less classifying mental disorders according to etiology. We are on firmer ground when we deal with these conditions upon a pathological basis. We congratulate ourselves when we can find a physical basis of pathology, such as in dementia-paralytica (commonly called paresis), or in the psychoses of senility; but when we are unable to find any physical changes sufficient to account for our mental symptoms, we try as best we can, by a process of psychanalysis to place such disorders upon a basis of psychopathology. Few physicians who have not paid special attention to psychopathology know how much has been accomplished in this field during recent years through the labor of such men as Janet, Jung, Freund, Meyer, Boris Sidis, and Morton Prince. Other conditions being equal, there are three periods in every one's life that favor the development of mental disorders. They are:-(1) Puberty, the period of most rapid evolution, when the boy or girl is blooming into man or woman; (2) the period of pre-senility, when all the bodily functions (particularly the sexual) are beginning to slow down; (this is sometimes spoken of as the involutional period.-in woman it is initiated by a secession of the menses, but the menopause is only an incident of the involutional period, merely marking its beginning.) Next, there follows a state of greater or less physical and mental stability, succeeded by the third and last period of stress, senility with its well-known physical and mental changes. To these three periods of stress (through which every one must pass if fortunate enough to live to a ripe old age) we may add others to which woman is only liable, the child-bering period, or more properly speaking, periods. Theoretically, the birth of a child is a natural physiological process, just as normal as in digestion or respiration, and it should result in no mental or physical pathological states. In the lower forms of life this is the case, since in them it never gives rise to the psychoses, and but seldom to physical complications. However, the long impact of artificial influences incident to civilization, brings upon the human female many physical strains and stresses, and as a consequence frequently lowers tissue reserve and vitality below the normal necessary for the bearing of children; hence, when many women are forced into unwelcome pregnancies and unprepared for motherhood, the physical results are frequently distressing, or even at times fatal; and as a consequence, the science of obstetrics is evolved. Now if there is one thing which modern psychiatry has proved, it is the immense influence somatopathological conditions have in the production of psychopathological states. As physicians we know that it is impossible to deal with any organ of the body as an entity. Its relations to all the other organs must be taken into consideration; that there is no such a thing as an absolutely distinct disease, there are only symptom-complexes. I am thankful that the Germans have popularized that expression. An aptly-coined term often in itself signals an advance. We thus see that mental derangements incident to child-bearing frequently must be placed in the same class with its other complications. They are dependent upon the physical strain to which artificial conditions of life subject the woman. But another, the psychic factor should be taken into consideration. While in the female of the lower animals, reproduction is altogether an unconscious and automatic phenomenon, in the human female it rises to consciousness. The wolf-mother does not anticipate the birth of the young cubs she may be carrying. The pains of parturition or the responsibility for their future care and attention, however much or little she may give them, engender no anxiety in her mind. She looks forward to their arrival with no feelings of either joy or regret; but with the human mother an entirely different state of affairs is present. She anticipates the birth of her child, often with the deepest regret; and always there is present a greater or less degree of anxiety for her own welfare, or the welfare of the child. She realizes she is about to assume a great responsibility and undergo a painful physical strain. Such a physiological event necessitates a considerable psychological change. All this has nothing to do directly with her physical state If she is timid in character, she fears the pains and dangers of parturition; if she is pleasure-seeking, inclined to a butterfly existence, she contemplates with bitterness the increased responsibility and social restrictions which will be imposed upon her. If she is harassed by poverty, she thinks of the expense involved; or finally, if finding herself enceinte she does not happen to wear a wedding ring, she contemplates with horror the cruel and unjust verdict society will pronounce upon her case. With this feeling is often mixed the deepest contrition and anguish of conscience, for while physically she has defied the social conventions, mentally she may be very deeply subject to them; and she therefore feels that her condition is. but the proper and God-sent punishment for a naughty deed. Mentally a part of her social circle, she must necessarily, and usually does unhesitatingly accept its verdict. Psychopathological states incident to pregnancy and the puerprium, thus natrually fall into two classes, part having an etiological basis in the physical complications incident to childbirth, and part being dependent upon its mental entanglements and stresses. The former may be identical with one of the phases of maniacal-depressive insanity-that is a true mania, a true melancholia or a state characterized by a mixture of the two; or we may observe a confusional condition identical with Meynert's dementia, sometimes called acute confusional insanity, hallucinatory insanity, or as Ziehen has named it, paranoia dissociation. Again, we sometimes find a true dementia praecox originating at the puerprium. All these are often due simply to the lowered resistance of the patient, the puerperal state thus acting in the same way as any other physical stress might act in the production of insanity. Again the puerprium, especially if there has been some infection, may give rise to the fever and post-febrile psychoses; then there may be a very grave and acute mania incident to this state, usually accompanied by a high fever, yet not dependent upon any as yet recognized specific infection called acute delirious mania, or collapse delirium, using proing rapidly fatal. Those mental derangements incident to the psychic stress of pregnancy resolve themselves into psychasthenia, hysteria, and neurasthenia. Some may be surprised at my calling neurasthenia a mental disorder. While like psychestenia and the various obsessional psychoses, as well as hysteria, it does not of course constitute insanity; in any sense that the word is ordinarily used; yet I believe |