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bilateral dislocation the same movements should be made, first on one
side, reducing it to unilateral displacement, then on the other.

Dr. J. J. Putnam said that cases were more numerous than was
supposed, and cited the instance of a man injured by a fall, who
accidentally died through carelessness in his removal to a hospi-
tal. Dr. Sachs asked if this method would be practical in other
than recent cases. Dr. Walton replied that the operation had
been performed in one case of about ten days' standing. A case in
which bilateral dislocation was produced spontaneously, with per-
fect recovery, would lead him to recommend the attempt at reduc-
tion, even after a number of months, should there be no doubt as
to the diagnosis. — Medical Standard,



THE TREATMENT OF HEMOPTYSIS.

Dr. Fr. Eklund, of Stockholm , (Therapeutic Gazette^ February^
1893,) severely condemns the common practice of giving cold
drinks and small bits of ice to the patient with hemoptysis to
swallow. He believes that the irritation of the ends of the pnen-
mogastric nerve in the mucous membrane, by the cold, must result
in paroxysms of coughing, as is the experience with many phthisi-
cal patients, and that the cold tends to contract the vessels of the
stomach and vicinity, leading to higher pressure in the pulmonary
area. Instead, he advises lukewarm, mucilaginous drinks. He
also advises against the popular practice of giving large amounts
of salt dissolved in water, since the fragility of the vessels is
increased upon absorption of the sodium chloride and fluid. He
suggests that a small ice bag be placed over the bleeding spot, and
that quinine be administered as follows :

R Sulphate of quinine 3J

Extract of ergot , gr. xxx

M. Make into forty pills, and take one or two pills twice or three
times a day.



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ACADBMY OP MEDICINB NOTES. 161

Or the following may be given :

B Fluid extract of hamamelis !^i j

Fluid extract of cinchona 3ij

Extract of liquorice Sijss

Distilled water Oj

Shake thoroughly, and take a dessertspoonful to a tablespoonful
every two or three houi^s.

He advises that in young persons lead acetate be withheld, for
fear of colic ; in older persons this remedy may be of service, but
should be given in combination with morphine. — Texas Medical
Journal,

•KcaSlenr^ of MeSlicine Rofe/^.

The Conncil has decided to meet monthly immediately after the
close of the Section on Medicine.



Dbs. Arthur £. Collins and Burt G. Johnson were elected fellows
at the last meeting of the Academy.



The program for the December meeting of the Academy will
be arranged by the Section on Surgery.



At the next meeting of the Section on Medicine, Dr. Krauss will
read a paper on What Have the Newer Therapeutical Procedures
Done for Nenprology. The discussion will be opened by Dr.
Putnam, followed by Dr. Crego and others.



The officers of the Section on Medicine have sent to each fellow
of the Academy a circular asking for original report of cases and
contributions. The program committee is composed of Drs.
Rochester, Frederick, Pohl, Heath, and Potter.



The library of the Academy has received a handsome donation of a
fall set of the proceedings of the American Association of
Obstetricians and Gynecologists. Dr.W.W. Potter, the secretary
of the Association since its organization, was the donor.



The next meeting of the Section on Surgery will be held Tuesday,
October 3d, with the following program : Affections of the Eye,
associated with and dependent upon the Scrofulous Diathesis, Dr.
Alvin A. Hubbell ; Discussion by Dr. Lucien Howe, Dr. H. Y.
Grant, Dr. Elmer E. Starr, Dr. B. H. Grove.



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162 EDITORIAL.

BUFFALO MEDICAL AND SURGICAL JOURNAL

A MONTHLY REVIEW OF MEDICINE AND SURGERY.

EDITOBS:

THOMAS LOTHROP, M. D. - - WM. WARREN POTTER, M. D.

All oommunlcations, whether of & literary or business character, should be addressed
to the managing editor: 2S4 Fbanklim Street, Buttixo, N. Y.

Vol. XXXIII. OCTOBER, 1893. No. 8.

THE FIRST PAN-AMERICAN MEDICAL CONGRESS,
WASHINGTON, D. C, 1893.

The First Congress of the medical profession of all the Americas,
has met, discussed the questions for which it was convened, and
adjourned. Its record has passed into history, and will furnish
many a theme for reflection during many years to come. There
are some points which it seems within the province of the
journalist to comment upon, even though it is yet too soon to
form a complete judgment as to the far-reaching benefits that will
■accrue from this remarkable meeting.

In the first place, it must be understood that this Congress
was an independent organization, with its own autonomy from
istart to finish. While it is true that the Organization Committee
was made up by appointment of the American Medical Associa-
tion, yet, as soon as the Congress became incorporated, it ceased
to have any relationship to the American Medical Association, or
to owe any fealty to that body. It seems necessary to make this
-clear at the outset, for the reason that it has been asserted that
some prominent physicians remained away from the Congress
because it was supposed to be a creature of the American Medical
Association. If any such there be, let them be pitied ; we fear
they made a serious mistake, besides having shown, by their
-conduct, on what small foundation their mentality is constructed.

The Pan-American Medical Congress possesses the power of
«elf-perpetuation, and has already appointed the second Congress
to convene in the City of Mexico, three years hence.

The opening address, by the President of the United States,
was in singularly good taste, not only with reference to its
material, but also with regard to its length. Brief, concise,



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THS FIBST PAN-AMEBICAK MEDICAL CONGRESS. 168

^nished, it is, taken altogether, one of the best public addresses
that His Excellency has made.

The President of the Congress, Dr. William Pepper, of
Philadelphia, was an ideal presiding officer. His practical knowl-
^ge and tact, together with his wit, wisdom, and acumen,
equipped him with all that was needful for the occasion, and it is
hardly necessary to add that the best possible use was made of
all this varied and diversified #alent. Dr. Pepper's address was
a scholarly paper, that will take rank among the first of such, and
should be read by every thoughtful physician in the Western
hemisphere.

The attendance upon the Congress was very large, even more
so than could reasonably have been anticipated, for the enormous
number of 1,500 was borne upon the register as early as the
second day of <he meeting. The total registration was several
hundred greater. The foreign delegates were there in goodly
numbers, and were representative men in every sense of the word.

The work of the sections was judged by competent observers
to be above the average at such meetings. Several of the sections
were very largely attended, and in them discussions were both
animated and instructive to an extreme degree. It is fair to say
that the congress was subdivided into too many sections to make
its work the most effective, and its experience will serve to benefit
the organization of future congresses. The sections on medicine,
surgery, obstetrics, gynecology, pedagogy, and hygiene, were
especially interesting, and the debates were participated in by
representative men from every portion of the Western hemisphere.

It is to be regretted that it became necessary to fix the date
of the meeting so early in the season, on account of the hot
weather which nearly always prevails in Washington during
September. It was originally thought to name the first Tuesday
of October as the date of meeting, and this would have been much
the better time. But it was ascertained that that date would
conflict with the Eleventh International Medical Congress at
Rome. Since it has been necessary to postpone the latter, we
regret that October was not chosen instead of September for the
congress.

The founder of the congress. Dr. Charles A. L. Reed, of
Cincinnati, can ever look back upon his work, arduous though it
has been for more than two years, with the satisfaction that he
has been supported by the best men in the profession that



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164 EDITORIAL.

America can produce, supported loyally and faithfully from start
to finish, and he will always be able to point with great pride to
the fact that the First Pan-American Medical Congress was the
creature of his own brain, and its great success will ever be a
monument to his skill, erudition, and executive talent. All praise,
then, say we to the father and secretary-general of the First Pan*
American Medical Congress. The Congress was not merely a
success — it was a triumph. •



THE RELATION OF NOISES TO HEALTH AGAIN.

In the issue of the Journal for July, we discoursed briefly upon
the influence that noises in great cities have over the health of
their inhabitants, intimating that we should probably return to
the subject again in the near future. We hav^ also alluded, in
paragraphs at various times, to the nuisances of certain particular
noises. Possibly the subject may be somewhat threadbare to
many of our readers. Nevertheless, it is one of great importance,
and we venture to recur to the subject for the reason that reform
can only be brought about by continual hammering at the evila
which exist.

The Medical N'ewa, of Philadelphia, in its issue of August
26th, has considered the subject in much detail, and with great
completeness, in an editorial entitled Medicine and City Noises^
This article has attracted great attention among the newspapers in
several American cities, many of which have published lengthy
editorials on the subject. The I^ew York Worlds in its issue of
August 27th, was the first to take up the cudgel, adopting the
editorial of the I^ews as its text, and amongst those later ta
discourse thereupon, is the Buffalo Enquirer, in its issue of Septem-^
ber 14th.

We herewith reproduce, from the Medical News, its editorial
entire, and ask from our readers its careful consideration. The
matter is ably presented, and is withal so scientific, that we hope
the constituted authorities may heed the suggestions given and
take some action to correct the evils complained of.

MEDICINE AND CITY NOISES.

Not long since a foolish gentleman, who preferred to live in New York
or not live at all, committed suicide rather than to longer endure the
ear-splitting noise of the bells of a neighboring church. In thousands
of cases people are being made ill, are committing slow suicide, or are



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THB RELATION OF NOISES TO HEALTH AGAIN. 165

being painfully and slowly killed by useless city noises. Noise, then,
becomes a question of health and of medical importance concerning
which physicians should have a word to say and a duty to perform.

Scientifically, our rebellion against the noise-makers is founded
upon the physiologic truth that rest is necessary to health, and that
OTer-stimulation or persistent stimulation of any organ or of all organs
in essentially pathogenic. Herbert Spencer secured for himself a
sad sort of freedom from noise by a mechanical contrivance that held
some kind of soft plugs or stoppers in the external auditory meatuses.
If there were only some method whereby one could, at will, shut out
unwelcome sound, as one can shut out the light from the eyes ; if some
aurist could devise an artificial method h la Spencer, one that would
not injure the ear, he would be a great benefactor to humanity. The
evil done the few people that would thereby possibly be burned to
death or otherwise injured would be small, as compared with that of
the many deaths and much sickness due to noise.

Sociologically, the whole commimity has an unrecognized duty as
regards noise that rests upon a physiologic and aesthetic basis. Deli«
cacy and accuracy of response to a physiologic stimulus are the charac-
teristic marks of perfeciion in an organism. Whatever prevents this
is against the welfare of society and progress. In this brutal noise-
making era, one of two things must follow the ceaseless bruising of the
mind by noise. Either the auditory mechanism, and the nervous
mechanism with which it is related — that is, the whole mind — must
become blunted in sensitiveness, crushed and stupefied ; or it must
react pathologically. People are, therefore, divisible into two classes :
those whose nervous systems and minds are becoming mechanicalized,
anesthetic, and brutalized, and those who, thus failing to kill sense and
mentality, develop disease-reactions. The distinct agency of noise is
to make us either savage or sickly. Civilization, of which noise-mak-
ing is a decided component, is thus bearing in its bosom ^ a self-poison,
to its own undoing. We are losing all refinement and delicacy of the
senses, and are reverting to the condition of the barbarian whose senses
had to be pounded and whipped into reaction, or we are becoming neu-
rotic hysteric, and neurasthenic. Grenerally and progressively,
** Society " is either a crowd of the mentally stupid or of the hyperes-
thetically morbid, and social amusement is becoming a game of batter-
ing and spurring jaded and blunted senses, or of ministering to sense-
diseases.

In the narrowest sense, we are medically bound to reduce the amount
of Doise-making, not only because noise engenders disease, but also
because it prevents the cure of disease, or aggravates disease — very
often, indeed, is the immediate cause of death. In an American city
like Philadelphia, there are something like 3,000 needless deaths and
the equivalent of 6,000 years of needless illness each year. What pro-



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166 EDITORIAL.

portion of this waste of life is due to noise, it is, of course, impossible
to say, but certainly a considerable proportion is charg-eable to it. The
sick are in private houses scattered all through the city, or in hospitala
that are often located in the most densely crowded portions. Every
physician knows how necessary quietness is to the sick, and how often
noise has been the last baneful influence that the weakened organism
could not resist, and thus the controlling and distinctive cause of fail*
ure to cure.

The recklessness of production and the unnecessariness of modem
city noises are disgustingly astonishing. The worst of it is that they
are even kept up throughout the night. If the night, at least, were kept
quiet, and the organism were thus given periods of repose, it would cot
be so impossible to preserve normality of sense-reaction and sanity of
mental reaction. In Philadelphia one or a dozen drunken brawlers may
make the nighl hideous with howl, and curse, and obscenity. Remon-
strance with the policeman elicits a smile, with ill-concealed contempt for
the remonstrant as a crank, and the avowal that he has no authority to
interfere. In Philadelphia it is illegal for locomotive-engineers to blow
whistles, and yet all night long, sleep, at least in Summer, is to healthy
ears and minds impossible by reason of this ear-splitting curse. Street-
oar bells rung all the time (by horses or by wheels) are no protection to
the public, and yet the public submits to the horrible nuisance. The
laying of rail way- tracks and the paving of streets at night are only
necessary for the advantage and profit of mercenary corporations, and
yet the authorities have no power, or do not assert it, to repress the
evil. If our freedom-loving American submits to the dictation of his
tyrant and master as to trolley-cars, his master puts down the new tracks
at night, with fiendish noises, and will by-and-by run the cars with the
still more fiendish and ceaseless noises.

From whatever aspect the subject be considered, it seems strange that
people will submit to the indignities of the noise-makers. A thousand
are outraged in order that one or a few may possibly be benefited. The
shrieking of whistles and the ringing of bells to notify workmen to stop
or to start work is an instance in point. Everybody has a watch or a clock
at hand. Why, then, blow the whistles P Why, also, thunder or jangle
bells to tell people that should be asleep what o'clock it is during the
night ? The ten per cent, of people who go to church must be
warned by bells ; but have the ninety per cent, no rights who do not
need or heed; and what about the sick ? The milkman arouses a whole
neighborhood in delivering a quart of milk. The cartmen, the peddlers,
the hawkers, the ragmen, etc., bawl and howl to be heard half a mile
away if some other greater noise near by did not drown their voices.
There are persons that think it strange that barking dogs and crowing
roosters in a city should be objected to.

All noises may be divided into the necessary, the partially neces-



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THB BBLATION OF NOISB8 TO HBALTH AGAIN. 167

Bary, and the wholly superfluous. The makers of the last class of
Boises should be proceeded ag^ainst in the interests of the public health
by all the forces and with all the vigor at the command of physicians.
And this by all odds is the largest and most injurious class of
noises. Here is a work ready for the Associations for the Public Good.
There is something particularly exasperating and baneful in the unnec-
essary noise in the very fact of ita unnecessariness. Let all the loafing
rowdies, howlers, hawkers, whistle-blowers, bell-ringers, and the rest
be incontinently hushed, and especially if they carry on their diabolism
at night.

Concerning the class of partly preventable noises of cities, the
greater amoimt of them is connected with street traffic, and here arises
the shameful need of good smooth pavements. As with the strawberry
BO it is with the asphalt pavement — doubtless a better one could have
been or may be invented, but doubtless it never has been invented. It
Is incomprehensible that people should consent to endure the torment
arising from the stone and boulder pavements, and seemingly designed,,
like African music, for creating the most intolerable clatter possible.
In addition to this aspect of the question, there is another reason why,,
as physicians, we should do away with block and cobble-stone pave-
ment ; they are excellent culture-grounds for lodging filth and disease-
germs. The asphalt pavement offers no such a nidus, and can be easily
flushed and kept clean.

The degree and character of the civilization of a country are indi-
cated by the amount of unnecessary noise it endures, and this is accur-
ately gauged by the condition of the pavements of its cities.

In the city of Buffalo, the noise incident to pleasure and traffic
is greater, we venture to assert, than that required for the same
conduct of affairs in the city of London, and it is assuredly greater
than in the city of Paris. We mean that the aggregate noise in
Buffalo is greater than the aggregate in either of the cities mentioned^
both of which are several times larger than Buffalo. . So long as
the question of noise is considered only as a mere discomfort, no
one would feel disturbed enough over it to call the attention of
the municipal authorities thereto, but when the noise nuisance
becomes so serious as to menace health, it is high time that
measures were adopted to at least reduce it to a minimum. Every
superfluous noise, from the shouting, tooting, and whistling boy,
up to the ringing of church bells and screeching of locomotives
and other steam whistles, should be prohibited under severe
penalty.

In a nation whose nerves are so highly strung as ours, there is
sufficient unavoidable wear and tear in the every-day conduct of



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168 EDITORIAL.

affairs to shorten human life without the addition of a large
catalogue of unnecessary noise nuisances. We respectfully invite
the attention of the health authorities of Buffalo to this important
subject. Preventive medicine has an important function to per-
form in the field of noise nuisance.



NOTES OF THE CONGRESS.

Mr. Ernest Hart, the learned and distinguished editor of the
British MedicaXJournaX^ delivered an address at the Pan-American
Medical Congress, at Washington, the subject of which was The
Ethics of the Medical Profession. In the course of this remark-
able address, Mr. Hart animadverted upon consultations with
homeopaths, and, if he is correctly reported in the daily news-
papers, characterized these practitioners as quacks, supporting his
assertion by a reference to Dr. Johnson's definition of " quack."
It is true that the published abstract does not read quite that way,
but even the revise makes Mr. Hart come dangerously near the
line.

It seems a pity that the otherwise harmonious proceedings of
the Congress should have been disturbed by such an address.
However much we may be willing to tolerate a discussion on
ethics in our local societies, we have always held that a national
or international congress was not the place to deal with this ques-
tion. It applies entirely and totally to the local societies, and Mr.
Hart makes a mistake when he comes to America and drags in
such questions gratuitously, as he did both in Milwaukee and in
Washington. We hope our homeopathic friends will not be dis-
turbed by Mr. Hart's dogmatic assertions, or conceive any dislike to
the Congress on that account, for we beg to assure them that it
was entirely foreign to the purposes of the Congress to have any
such matter interjected into its proceedings. We hope it will be
excluded from the Transactions.



The foreign delegates, after the adjournment of the Congress,
made a special tour, as the guests of the United States, under
charge of Dr. S. S. Adams, of Washington, chairman of the com-
mittee of arrangements. This tour included Philadelphia, New
York, Boston, Niagara Falls, Detroit, Cincinnati, St Louis, and
Chicago. They were specially entertained in these several cities



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NOTBS OF THB CONGRESS. 169

by the medical profession, and their visit to the several points of
interest will ever be a memorable one. At Chicago, after visiting
the World's Fair, the members separated for their several homes,
apparently much delighted with the visit they had made to this
countrv.



Whilb the Pan-American foreign delegates were in Philadelphia,
and during their visit to the grounds and buildings of the Univer-
sity, Dr. Charles A. L. Reed, Secretary-General, was pleasantly
surprised by the presentation of a silver salver, on which was
inscribed the following : " Presented to Dr. Charles A. L. Reed,
of Cincinnati, Ohio, Secretary-General, by the members of the First
Pan-American Medical Congress, Washington, D. C, September
4-8, 1893, to commemorate the brilliant success — largely due to
his faithful and devoted efforts in its organization — of that import-
ant occasion, when for the first time representatives of the medical
profession of the Western Hemisphere met in council for the
advancement of science and the promotion of the public health.''
Dr. Pepper, President of the Congress, made a happy speech
as he uncovered the salver, and Dr. Reed, in accepting it, replied
in a most felicitous manner. Dr. A. M. Owen, Treasurer of the
<songress, then took Dr. Pepper by surprise, by presenting him
with an ivory gavel, appropriately inscribed, commemorative
of the congress. Dr. Owen's speech was in his usual happy vein,
and served to loosen the tongues of several delegates, who made
speeches in a multiplicity of languages.



"Ernest Hart, F. R. C. S., D. C. L., Editor of the British Medi-
cal JourncUy Dean of St. Mary's Hospital." This is the way, says
Dr. Hammond in the New York Medical Journal of September
16th, that it appeared on the register at the Arlington hotel. Then
Mr. Hart proceeded to read a lecture to the American medical pro-
fession on ethical morals, in which he deprecated so-called
advertising in the newspapers, through the publication of inter-
views and photographs, and especially did he consider it wicked to
consult with homeopaths. A very Daniel come to judgment !



" The American Medical Editors' Association " held a banquet at
the Arlington hotel on Monday evening, September 4, 1893, which
was the inaugural feast at the congress. The President, Dr. C.



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110 EDITORIAL.

H. Hughes, of St. Loais, occupied the post of honor and made t^
brief bat spirited address of welcome. Then he turned the meet-
ing over to Dr. I. N. Love, the talented editor of the Medical Mir-



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 17 of 78)