Cases of Appendicitis." li^ve it would surely prove a failure.
Abstract: j^^ fee-bill, we believe, would be proper and
I. Symptoms-Each case presents some com- ^^,pf^j .^ ^^^^^^^ j^^j^^^^ ^ maximum nor a
bination of the following symptoms: minimum list alone is considered sufficient nor
(1) Pain-At first general over the whole of j^ j^ thought advisable to bind the members of
abdomen or referred to the epigastrium. It soon ^j^j^ ^^.^^^ ^^ j^,,^^ 3^^^ ^ schedule invariably,
localizes itself to the appendicular region. ^,^^^3^ t^^y ^„„^,t a„j ^^^^^ ^^^ j^ ^
(2) Tenderness-This was present in all of the g^^ ^ j.^^ ^.^ ^ ^^^ ^^^^^ ^^ ^^^^^ .^ .^^
*'â– '*" "Lf^f"- , . , ,.. . . , prices, to which to refer at times, would aid
(3) Rigidity of right rectus abdomm.s muscle. ^t^j^Uy j„ g^j^g „p^„ ^ charge, and when
This is often to be found. questions arise concerning the propriety of a
4) Vomiting may or may not be present. ^^^^^^ ^^^^^ ^ ^^^y,, backed by the Society
(5) Constipation usually found. ^^^^j^ ^ ^ ^^,^^y^ ^i^ To those who have
(6) Temperature ranged between 97 to 104J4 ^^j^ ^^^^^^^ ^^^^^ ^^^^ ;^ ^^j^ ^^^^^y j^ ^^.^^j^
* ^ ^ , , , , be especially of use.
(7) Pulse ranged between 65 to 160 beats per ' - ..^ , , , . , ., ^
. ^ ^ Therefore your committee has formulated the
,„.'«, * u ^- «^* following schedule of fees for medical services,
(8) Tympany may or may not be present. * . .
(9) Chill may occur. basing it upon the prevailing prices in this region
(10) Tumor may be palpable in certain cases. and recommend that it be adopted by the Society.
II. Indication for operation:- J. G. R. Man waring.
Whenever we find persistent localized tender- Chairman.
ness over the appendix, this is in itself an abso- general practice.
lute indication for operative procedures, having First visit, prescription, and advice $1 to $?.
in view the removal of the vermiform appendix. Each subsequent visit to same patient 1 to 2.
III. The time to operate: Visit with treatment or dressing 1 to 3.
"I am going to operate upon my cases of ap- Night visit between 10 p. m. and 7 a m $1.50 to 3.
pendicitis as soon as I see them first, last and Additional visit to patient in same family .50 to 1.
always." A. W. Herrick, Sec'y. Visit and consultation 5. to 10.
Joint attendance after consultation 1. to 3.
Mileage in addition to visit, one way .50 per mile.
' Rising at night and prescribing 1. to 3.
GENESEE COUNTY. Examination of insane person and cer-
Dear Doctor :— The following is the report of *^^^^^^ 5. to 25.
the committee appointed at the January meeting ^^V^'^^^^ examination of chest 1. to 5.
to investigate the matter of a uniform fee-bill and ^"^^^^ P^^ ^"^ varioloid 10.00 per visit
to devise a plan whereby the impositions of the ^^^' contagious diseases 1.50 to 3.
"dead beat" may be abated. Please give the re- ^^^^^"^ ^^ "^^^^'^^^ ^^P^^*^ ^5. to 50.
port careful consideration as some action will Attendance at coroner's inquest, (autopsy extra) 5.
be taken at the next meeting which will be office practice.
held at Fenton and Long Lake, July 26. The t> • *• j j • • j- ir/v i. <
* , , 1 Prescription and advice m ordinary case . . .50 to 1.
committee of arrangements has planned some Examination and opinion 1. to 5.
pleasant social features in which the lad.es will Vaccination in office 50 to 1.50.
be invited to participate. ^.^^.^^ j„,33 .^ ^j5^^ 2 t„ 5
Respectfully yours, Gynecological treatments 1. to 3.
H. R. NiLES, Sec'y. Fitting pessaries • .-Drgitlzscf byCjOOQlC" "•
358 COUNTY SOCIETIES. Jour. M. S. M. S.
Gonorrheal cases, each attendance 1. to 10. bers of this Society that their bills be presented
Syphilis cases 1. to 10. at the close of each year.
OBSTETOiCAL WORK. . ^^ ^^^^^ ^ Considered proper to make reduc-
^ ,. , ,. tions to all persons in moderate circumstances.
Ordmary deliveries 10. i„ ^n ^^^^^ -^ ^^all be the duty of the physi-
Detention after six hours 1. per hour. ^-^^ ^^ ^^^^^^^ ^^^^ j^^j^^. ^^„^^, ^^ ^^^^ ^^.
Instrumental deliveries and other difficult ,^,,^^^^ i^ ^^ operation, to notify the patient or
^ ,f^^f ^. ; • • • ; ^' ^° ^^' ^^^^^ his friends, at or before the consultation or opera-
All visits made subsequently, after the first ^. .u ^ .u r .• • .u
^, ,, r 1 tion» that the fee — mentioning the sum — is ex-
three, the same as for other cases 1. to 3. ^ , • , ...
Abortions and miscarriages 10. ^^^""^ ^' ^^^ ^'"^^ ^^^ '^'^*^^ ^' «^^^^" ' '" ^"^ '^
Repairing lacerations at once, extra 5. to 15. '^^" "^^ ^ ^^ P^^^ *^^ attending physician shall,
unless otherwise requested by the one called in,
SURGICAL PRACTICE. include the charge or charges in his own bill or
Capital operations 100. to 500. send in both accounts together, and he shall ac-
Secondary operations 25. to 100. count to the consultant for his proportion of the
Amputations of a finger or toe nioney paid on said account.
Tapping abdomen H. R. Niles, Sec'y.
Operation for fistula m ano 5. to 50.
Operation for cure of hydrocele
Removal of tonsil
Circumcision SAGINAW COUNTY.
Opening deep seated abscesses ^^.^,,^*t^ ^^ ^^,,-r.^r,^Tx^ ^^*,
n™;«t ^J^. ,K..«cc . * K TREATMENT OF COMPOUND COM-
Openmg minor abscesses 1. to 5. xyrTXTTTTu-T^ t-d A/^-rTmirc
Tapping hydrocele 1. to 5. MINUTED FRACTURES.
Extraction of foreign bodies from pharynx 5 to 50 o. p. barber s agin aw.
Removal of polypi from nose or ear. . . 5. to 50. Abstract:
Plaster dressings and other fixed dressings 2. to 15. 1. The object of this paper is to lay before the
Reduction of hernia by taxis 3. to 10. medical profession a practical method of hold-
Extraction of foreign bodies from the eye, • ing these broken bones and sloughing tissues in
ear, nose, urethra, wounds 1. to 25. such a manner that they can he kept clean with-
Introduction of a catheter or bougie 1. to 3. out the daily changing of the splints and d^ess-
Post-mortem examination 25. to 50. ings, made necessary by the constant discharge
Dislocations of large joints 25. to 50. of pus.
Of other joints 5. to 20. 2. The method employed is as follows : Allow
Reduction and first dressing of fractures of the for illustration that you have a compound corn-
femur and important open fractures of this minuted fracture of the leg midway between the
and other bones 25. to 50. knee and ankle joints. Cut out from a sheet of
Reduction and dressing of fractured bone of leg, heavy wrapping paper a pattern of the exact
armor forearm 10. to 50. size of the uninjured leg, one that will wrap
Anaesthetics for the extraction of teeth. .2. to 5. and enfold that limb from the upper third of the
Anaesthetics for other surgical purposes. 5. to 10. thigh down to and including the foot. Lay this
Attendance upon surgical cases, per visit. 1. to 3. pattern on and cut its duplicate from a roll of
Medicines in all cases are extra. coarse-meshed sieving, made from galvanized
iron- wire. Get the meshes a half inch or larger
all fees are payable at the time the services .- ^ . , ., . . t ,. . ,
11 you can. Soak or boil it m your carbolic acid
are given. , . , . . . - .,•/,.
solution. Line it with sterilized plain gauze after
It shall be considered dishonorable for any bending and fitting and trimming it to fit the in-
member of this Society to attend families or in- jured limb. Before applying the wire gauze over
dividuals by the year, or to make any other bar- the seat of fracture, place a thin layer of gauze,
gain, or arrangement the tendency of which will but at other points such as ankle, foot and knee,
be to avoid the full purport and effect of the fore- use more of the gauze, or in its place use cotton,
going list of charges. Over this long stocking of coarse iron wire roll
All bills will be considered due when the serv- your plaster of Paris bandages everywhere except
ices are rendered and statements are to be pre- over the seat of the fracture. After putting on two
sented and settlement requested at least twice a or three layers of plaster bandage, lay on strips
year. It is particularly recommended to mem- of half wound hoop l^iyi^E^nding them outward
August, 1904.
COUNTY SOCIETIES.
359
over the fracture and letting them extend up
over the instep and leg to within two or three
inches of the fracture. When they reach this
point they should be bent out so as to curve
out a reasonable distance and pass on up the leg
to the end of the splint Have three of these
strips and incorporate them solidly in the plaster.
3. What does this method accomplish?
(a) This splint will hold the bone exactly
-where it is placed.
(b) You can get at every portion of the
mangled tissue without disturbing bone, torn
muscles, or cell-growth in the slightest degree.
(c) Perfect drainage is obtained through the
meshes of the wire and the nozzle of an irrigator
can be thrust through whenever needed and all
the pus and debris can be washed away.
VAN BUREN COUNTY.
The Van Buren County Medical Society held
its regular meeting at South Haven June 16th.
S. C. Graves, of Grand Rapids, read a paper en-
titled, "The Bougie-Catheter in Retro-Catheter-
azation."
Abstract:
Among the most distressing and incapacitat-
ing as well as perilous of surgical maladies, those
due to infection of the urinary tract and, at the
same time, associated with obstruction to the
normal evacuation of urine, must of necessity
take high rank. Prominent in this category are
urethral rupture and stricture with all their at-
tendant woes.
Etiology of stricture: This condition of af-
fairs is quite generally brought about by trauma
(rupture) cr by inflammation (urethritis speci-
fica).
When should retrocatheterization be per-
formed?
1. In cases of urethral rupture, when there is a
doubt as to the ability on the part of the operator-
to secure the proximal portion of the urethra, a
high section should be made.
2. In cases of stricture where to gain entrance
into the stricture reaches a magnitude greater
than the danger to the patient of a high section
in the hands of the operator, the section should
be made.
3. It must be remembered that under the cir-
cumstances which obtain in cases suitable for this
method of treatment, entrance per vias iiaturales
for drainage and antiseptic flushings is out of the
question.
4. It should never be attempted in the absence
of ample justiflcaition as it is always a perilous
proposition by reason of the danger to the pa-
tient of the probable absorption of toxines by
the lymph vessels in the exposed areas of an
incised cavum retzil.
5. It should be done without delay in the pres-
ence of factors calling for it.
Method:
1. Entrance must be made above pubes.
2. Edges of wound should be treated prior to
opening of the bladder with zinc stearate.
3. Bladder is exposed. The urine is with-
drawn by aspiraitor. Bladder (through needle)
is washed repeatedly with warm, weak boracic
acid or some other mild antiseptic solutions.
4. Bladder is incised and the internal urethral
orifice is localized by passing the finger into the
bladder.
5. A gum elastic catheter is entered and is
easily pushed down to perineal wound.
6. End of bougie is cut down upon and the
writer's "Coupler" drainage apparatus is inserted
and sutured in position.
7. Bladder wound is closed with fine, plain
cat gut for the mucosa and larger chromicized
cat gut for the musculo-fibrous layer.
8. The abdominal wound, down to the vesical
wall, should be provided with provisional sutures
of worm-gut, tied loosely and packed. The same
can be closed definitely in a few days or a week
if the vesical sutures hold.
The bougie-catheter, I think, meets all the in-
dications, lit drains and at the same time main-
tains urethral patency, both of which features
are quite necessary for the successful outcome of
the case.
The writer reports two cases treated success-
fully in this manner.
N. A. Williams, Sec'y.
WAYNE COUNTY.
The Wajme County Medical Society held its
last regular meeting ere the summer recess, May
30, 1904. The Society entertained at a banquet
the American Pedriatic Society. After the re-
past was finished a symposium on Infant Feeding
was given by several of the visiting doctora,
C. G. Jennings, of Detroit, acted as toastmaster.
"The Influence of Breast Feeding on the In-
fant's Development, by Henry D. Chapin, of
New York City. (See The Journal, August,
1904, page 334). / nn^n\(>
Digitized by VjOOvIC
36o
MISCELLANEOUS.
Jour. M.S. M.S.
** Cow's Milk for Infant Feeding" by Augustus
Caille, of New York City. (See The Journal,
August, 1904, page 338).
"The Milk Laboratory," by John L. Morse, of
Boston. (See The Journal, August, 1904, page
341).
"Substitute Feeding During the First Year,"
by T. M. Rotch, of Boston. (See The Journal,
August, 1904, page 344).
"Feeding in Difficult Cases During the First
Year," by L. Emmett Holt, of New York City.
(See The Journal, August, 1904, page 349).
Drs. Jacobi, of New York City; Douglas, of
Detroit, and Northrup, of New York City, made
a few remarks.
Guy L. Connor, Sec'y.
nDi0ceIIaneou0«
NEWS ITEMS.
Dr. Stanley Hall says, "Excessive individual-
ism insidiously instils the same aversion to *brute
maternity* as does luxury, overindulgence, or ex-
cessive devotion to society. Just as the man must
fight the battles of competition, and be ready to
lay down his life for his country, so woman needs
a heroism of her ow^n to face the pain, danger,
and work of bearing and rearing children, and
whatever lowers the tone of her body, nerves or.
morals so that she seeks to escape this function,
merits the same kind of opprobrium which society
meets out to exempts who cannot or will not
fight to save their country in time of need."
The Des Moines (Iowa) post office posts the
following: "Hereafter preference will be given
clerks married and having large families."
Diphtheria mortality during the past twenty
years in New York city has decreased sixty-five
per cent by the use of antitoxic serum, but cancer
has increased fifteen per cent. Acute respiratory
diseases have increased a like amount, while dis-
ease of the kidneys and circulatory organs have
increased forty per cent.
The Wayne County Medical Society, at Rich-
mond, Ind., lately voted in favor of reporting
every case of tuberculosis to the proper health
officer.
Hereafter no consumptive may teach in the In-
diana public schools. At present two hundred
and fifty are so engaged.
Dr. Jay F. Schamberg says that from 1901 to
1903 inclusive, six hundred and fifty have died
from small pox in Philadelphia, Pa. All might
have been saved by vaccination.
The Neenah (Wis.) Board of Health affirms
that kissing is dangerous, that it spreads con-
tagious diseases, and asks the public to discon-
tinue the custom for the public good.
It is said that one Detroit physician disinfects
all his money ere he spends it. He practices pre-
ventative medicine.
The United States government has employed
experts to determine the nature of claims that the
Hot Springs, Ark., contam some radio-active
substance.
It is estimated that over three hundred and fifty
ounces of cocaine is sold to the dissolute class in
Cincinnati each month.
Judge Davis, of Philadelphia, says that "any
person who offers his services as a physician to
treat diseases, deformities, and injuries by any
means whatsoever, including electricity, clairvoy-
ance, faith healing, etc., is practicing medicine and
the doing this without a license is illegal." Sound
judge is he.
All the great American medical weeklies pub-
lished simultaneously the general addresses de-
livered at the late meeting of the American
Medical Association. This is all right for those
who suscribe to but one, but wearisome to such
as subscribe for several or all.
Sir Henry Thompson, Bart., M. B., died at his
London home April 18th, aged eighty-four. As
a geni to-urinary surgeon he was well and widely
known, counting among his clientele, kings and
emperors. He took great interest in topics of the
day, and by articles and speeches did much to
create public sentiment, on such subjects as mod-
erate drinking, cremation, diet in relation to
health and longevity. His novels had more than
local interest. As a painter he was even more
successful. As a host i^g^^^^@o|<e his
August, 1904.
MISCELLANEOUS.
361
eight courses, for eight people, at eight o'clock.
Both company and food were carefully selected,
so that during a quarter of a century the most fa-
mous figures of art, letters, science, politics, di-
plomacy and fashion were his guests. Sir Henry
Thompson was a live part of his generation.
Roberts Bartholow died in Philadelphia May
10th, aged seventy-two. He was widely known
for his skill as a practitioner, teacher, investi-
gator and author.
Dr. James Henry Dunn was found dead in bed
at the Southern Hotel, St. Louis, after reading a
paper before the American Surgical Association
Uit same day. In connection with the Minne-
apolis Hospitals and the chair of surgery at the
University of Minnesota, he was celebrated for
his excellent work.
The American Neurological Association will
hold its next annual meeting at St. Louis, Mo.,
September 15, 16, 17, 1904.
The American Association of Obstetricians and
Gynecologists will hold its annual meeting at St.
Louis, Mo., September 13, 14, 15, 1904.
The American Electro-Therapeutic Association
will hold its annual meeting at St. Louis, Mo.,
September 13, 14, 15, 1904.
The Association of Military Surgeons of the
United States will hold its next annual meeting
at St. Louis, Mo., October 10-15„ 1904.
The Hawaiian Territorial Medical Society will
hold its annual meeting at Honolulu, December
3, 1904.
The fourth Pan-American Medical G>ngress
will meet in Panama, December, 1904.
The Wyoming State Medical Society will hold
its annual meeting at Rawlins, September 13, 1904.
The Medical Society of the State of Pennsyl-
vania will hold its annual meeting at Pittsburg,
September 27, 28, 29, 1904.
The Colorado State Medical Society will hold
its annual meeting at Denver, October 4, 5, 6,
1904.
The Idaho State Medical Association will hold
its annual meeting at Lewiston, Oct. 6, 7, 1904.
The Vermont State Medical Society will hold
its annual meeting at Rutland, October 13, 14,
1904.
The New York State Medical Association will
hold its annual meeting in New York City, Oc-
tober 17, 18, 19, 20, 1904.
The Medical Society of Virginia will hold its
annual meeting at Richmond, October 18, 19, 20,
21, 1904.
CHANGE IN MEMBERSHIP.
(May 15th to July 15th.)
NEW MEMBERS.
C. W. Ash, St. Clair, Mich.
O. S. Bailey, Lansing, Mich.
G. M. Cliffin, Adrian, Mich.
J. Foster, Lansing, Mich.
D. G. Lawton, Cheboygan, Mich.
L. J. Marshall, Adrian, Mich
C. S. Maynard, Paw Paw, Mich.
E. Newcomb, Blissfield, Mich.
F. C. Penoyar, South Haven, Mich.
F. T. Roach, Mattawan, Mich.
F. R. Robson, Reading, Mich.
F. M. Steams, Frontier, Mich.
A. E. Thompson, St. Clair, Mich.
L. W. Toles, Lansing, Mich.
R. C. Traver, Somerset Center, Mich.
P. J. Woolsey, South Haven, Mich.
CHANGE OF ApDRESS.
F. A. Baldwin, St. Louis, Mo.
J. H. Burley, Almont, Mich.
J. H. Egbert, Dunnville, Ont.
W. Harper, Henderson, Mich.
T. P. Lyman, Superior, Wis.
R. M. Olin, St. Louis, Mo.
E. A. Romig, Newberg, Oregon.
DIED.
James Hosking, Kearsarge Mine, Mich.
R. Johnston, Milford, Mich.
BOOKS RECEIVED.
System of Practical Surgery. By Prof. E. von
Bergman n, M. D., Prof. P. von Bruns, M. D.,
and Prof. J. von Mikulicz, M. D., Vol. IIL
Translated and edited by William T. Bull, M.
D. Lea Brothers & Co. Philadelphia and New
York, 1904.
Digitized by VjOOQIC
362
CORRESPONDENCE.
Jour. M. S. M. S.
Transactions of the American Roentgen Ray
Society. 1904.
Transactions of the Rhode Island Medical
Society. 1903.
Corrc0pon&cncc*
Secretary. — I am in receipt of your official
notice that the State Medical Society has con-
ferred upon me the position of an honorary mem-
ber of its body. Permit me, through you, to
thank them for this expression of confidence in
me and endorsement of my course as a profes-
sional man. All through my professional life I
have striven to do my duty at all times, in all
places, to all men.
This expression of the feelings of the Society
of which I have long been a member, comes
to me, when tired and worn with professional
services, with the fragrance of roses, and will be
long treasured as one of the happiest episodes
of my life. Please be the bearer of my thanks
to the Society.
Very respectfully and fraternally,
Samuel P. Duffield, M. D.
Dearborn, Mich., July 9, 1904.
Secretary. — You kindly informed me, under date
of the 7th inst., that the Michigan State Medical
Society has elected me to honorary membership.
I value the compliment, and shall hold it as an
honor.
Thanking you for your courtesy in the matter,
I am, Very truly yours,
G. K. Johnson.
Grand Rapids, July 12, 1904.
Secretary: — Yours of the 7th inst. received in-
forming me of my election to honorary member-
ship in the State Medical Society. This honor I
highly appreciate as coming from the goodwill of
those with whom I have been in association since
1873 (when I became a member) in our life work.
Hugh McColl, M. D.
Lapeer, July 8, 1904.
Secretary: — I have the honor to receive your
notification of election as honorary member at last
annual meeting, and am indeed very grateful for
the kindness of this election. I esteem the honor
very highly, as one conferred by the Michigan
State Medical Society. Sincerely,
Albert Benjamin Prescott.
Ann Arbor, July 11, 1904.
Editor. — In pursuance of the power and au-
thority vested in this Board, it is hereby ordered :
That t3rphoid fever shall be a disease danger-
ous to the public health within the meaning of
Section 12 of Act No. 10 of the Public Acts of
1895, as follows:
"Said boarcl may by its rules or ordinances,
cause any householder who knows that a person
within his family is sick of smallpox, diphtheria,
scarlet fever or ANY OTHER DISEASE
DANGEROUS TO THE PUBLIC HEALTH,
and every keeper of a hotel or lodging house
who knows that a person within said hotel or
lodging house is sick with any such disease, to
immediately give notice to the Board of Health
of said city, and upon the death or recovery and
removal of such person, to cause the rooms oc-
cupied and the articles used by him to be disin-
fected in a manner approved by said Board, and
they may by like rules and ordinances cause any
physician who knows that a person whom he has
called to visit is infected with smallpox, diph-
theria, scarlet fever or ANY OTHER DISEASE
DANGEROUS TO PUBLIC HEALTH, to im-
mediately give notice thereof to the Board of
Health."
Detroit Board of Health.
Editor : — The Journal of the Michigan State
Medical Society treated in its last issue a subject
of great interest, namely, "A Clearing House for
Medical Supplies of Unknown Composition."
This question is very similar to a matter which
has for many weeks, prior to the meeting of the
State Medical Society, engaged the continued and
earnest attention of the medical profession all
over the country and especially the zeal of the
National Auxiliary Congressional and Legislative
Committee of the American Medical Association.
A very important measure, indeed, is pending be-
fore the Senate of the United States. Senator
Hepburn's speech (April 6th, 1904) contains
among other excellent remarks the following:
"The term 'drug* as used in this act shall in-
clude all medicines and preparations recognized
in the United States Pharmacopoeia for internal
and external use. ^
Digitized by VjOOQIC
August, 1904.
CORRESPONDENCE.
363
"The definition eiids there. We have added to
that this provision:"
"Also any substance intended to be used in the
cure, mitigation, or prevention of disease."
"Mr. President, the people who are nearest to
the sick, who know most about this question, are
the physicians of the country."
"I have here [exhibiting] petitions from prac-
tically all of the medical organizations of the
United States and from practically every State in
the Union; and if any Senator desires to know
the sentiments of the physicians in his own State,
I wnll take great pleasure in furnishing him with
their sentiments as voiced in these petitions. They