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1886, and the close of 1892, in 115 cases in Europe and America,
with a mortality of nine mothers and twenty-four children lost,
tip to the close of 1892, it had been attempted but once, each, in
England and Ireland. These figures are taken from Playfair,
sixth American edition, edited by Harris, and may be regarded as
subEtantially correct, for Dr. Harris seldom errs in his statistics.

During the year 1893, almost every obstetrical surgeon in the
larger cities of America has performed symphyseotomy one or
more times, and the record of successful work in this field is of a
most encouraging nature. This operation, however, can never
take the place of the Cesarean section in extreme cases of pelvic
deformity, but it may be properly offered as a substitute for crani-
otomy, in those slighter cases that are just too small to admit the



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SYMPHYSEOTOMY. 431

passage of a living child. Prof. J. Edwin Michael, of Baltimore,
has performed the operation successf ally where there was impaction
in consequence of mal- presentation — a case in which craniotomy
would formerly have been considered necessary. The two opera-
tions, symphyseotomy and Cesarean section (Sanger and Porro),
ought to drive craniotomy from the field, and make it no longer
considered as an alternative.

Symphyseotomy is less difficult than Cesarean section or Porro's
operation, or even than a difficult craniotomy, though Chroback,
of Vienna, thinks that it is not less dangerous than Cesarean
section, and demands a more complicated apparatus.

The method of performing the operation is as follows : the
symphysary cartilage is incised with a blunt-curved knife, or sawed
with a straight or chain saw, from above downward. After the
incision, there is generally much hemorrhage, which is stopped
with a plug of iodoform gauze, supplemented by counter pressure
from the vagina. After the passage of the child, sutures should
be introduced, uniting the pubic bones. Some surgeons have con-
tended that sutures were unnecessary, but we think it safer to
apply them. After this, the legs are extended and brought back,
and the pelvis is surrounded by a large band of plaster, and shored
up with pillows or bran bags.

With the expectant method, women may be delivered without
operation who have eight centimeters of useful diameter ; version
permits the extraction of children through a diameter of seven
and five-tenths centimeters, while the lowest limit for a symphys-
eotomy would be from six to sir and three-tenths centimeters.
The operation is to be avoided among primiparaB, and it should be
practised only when the introitus is completely dilated, else it may
cause grave lesions to the vagina. It is not an operation to be
practised by the inexperienced, but should be left in the hands of
the most competent obstetric surgeons. All the details of aseptic
surgery should carefully be followed, and every safeguard known
to modem surgery employed.



The Medical Mirror, St. Louis, for December, 1893, publishes an orig-
inal lecture on Intestinal Indigestion, by Thomas Hunt Stucky, M. D.,
Professor of the Theory and Practice of Medicine in the Hospital Col-
lege of Medicine, Louisville, Ky., delivered by invitation of the faculty
of Marion-Sims College of Medicine to the class and Invited mem-
bers of the medical profession, Tuesday evening, November 21, 1893.
This is an able and exhaustive exposition of the subject, and all inter-
ested should procure the December number of the Mirror.



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432 EDITORIAL.



TOPICS OF THE MONTH.



The Hospital College of Medicine, of Louisville, which is the
Medical Department of Central University of Kentucky, has
moved into a splendid new huilding, located at Preston and Chest-
nut streets. The dedicatory exercises were held on Tuesday
evening, January 9, 1894, at which a large audience was assembled,
including nearly 200 matriculates of the college. Prof. John A.
Larrabee, M. D., President of the college, conducted the exercises,
and around him were seated the members of the faculty, namely :
Drs. Dudley S. Reynolds, Frank C. Wilson, Samuel G. Dabney,
Thomas Hunt Stucky, James Lewis Howe, John Edwin Hays, H.
Horace Grant, Lewis S. McMurtry, and P. Richard Taylor.
Besides these were the Rev. T. M. Hawes, and Drs. William Bailey,
J. M. Matthews, Sam Cochran, Ap. Morgan Vance, A. Wilkes
Smith, of Richmond ; H. E. Pelle and B. Allen. Dr. Paul Y.
Tupper, Professor of Surgery at the St. Louis Medical College,
the guest and orator of the evening, and a former graduate of the
Hospital College, was also present.

Dr. Larrabee^s address was an interesting and eloquent setting
forth of the progress made by the college, and especially did it
discourse upon the advantages of higher medical education. We
extract from this interesting address the following :

Today clinical teachlDg has surpassed all other modes of instruc-
tion» and the young practitioner is sent to the bed-side with an experi-
ence in the management of disease which heretofore required years of
practice to obtain.

In adopting the three years' graded course of instruction, the stu-
dent escapes the intolerable bore of listening to the same set of lectures
year after year. I can never forget when, as a beginner in medicine,
the nomenclature of disease was rolled in upon me from the chair of
practice, and that nearly the whole year was passed in the attempt to
follow, intelligently, lectures, the value of which was wholly unappre-
ciated. The gastro-epiploica-dextra and the gastro-epiploicarsinister
were mixed with duodinal dyspepsia, and the whole treated by a sub-
nitrate of bismuth.

To the medical students here assembled I mean to say a few words.
What a change has passed over the spirit of our dreams ! The medical
student of today is no longer the Dervish plowing through the town with
his slouchy gait like a Bedouin of the desert, but he is a gentleman
possessed of refinement, whose ambition is to become a learned scien-
tist. Permit me to give you a little advice in regard to study. Many
students fail because they try to grasp too much.



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TOPICS OF THB HOKTH. 438

The Loaisville Hospital College of Medicine is the first in the
Boath to advance the standard of medical edacation, and we con*
gratulate the facalty, as well as the friends of this excellent insti-
tution, upon such a sabstantial marking of her progressive career
as this splendid new edifice indicates.



In oub issue for January we commented upon the illustrated
calendar, for 1894, issued by the Maltine Manufacturing Company.
At that time we were ignorant of the fact that the New York Medx-
tcU Joumaly in its issue of December 23, 1893, under the head of
'^Quousque Tandem?" had criticised the Maltine Company on
this subject. The company now asks the publication of its letter
to the New York Medical Journal in these columns, a privilege
that we gladly grant. The letter is as follows :

To the Editor of the New York Medical Journal :

Sir— Your reference to our calendar for 1894 demands our atten-
tion. While you did not mention us by name, the reference is so direct
that the physicians who received the calendar can not but know to
whom you referred.

It has been our custom for several years to send to the medical pro-
fession, throughout the United States, portraits of eminent physicians
and surgeons and, inasmuch as their distribution has been scrupulously
confined to medical men of good repute, no objection has been offered
by those gentlemen whose likenesses we reproduced. Not a copy of
this calendar, nor of any of our other numerous publications, has ever
been sent to the laity.

Maltine is distinctly not a "patent medicine, ^^ nor has it ever been
advertised to the public, and. therefore, we have considered it within
our province to distribute portraits just as we have promulgated testi-
monials from the most eminent physicians and chemists in this country
and Europe. /

We have statistics to prove that ninety per cent, of the physicians
of the United States prescribe maltine. This fact, in addition to the
fact that we reach the patient only through the physician, would seem
to amply vindicate our use of the likeness of a physician whose pictures
are on public sale and have continually appeared in the public press,
and who is well known as a public man.

The portraits referred to were not used to push the sale of our
preparations, as was the portrait of Dr. D. Hayes Agnew, recently
published by us. It will be remembered that we printed under Dr.
Agnew's portrait a facsimile of his indorsement of maltine. Our only
reason for publishing the portrait of Dr. — ^ was because we thought



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434 EDITORIAL.

it would iQterest his medical brethren, who have shown so high ai\
appreciation of the series of likenesses we have already published.

We should like further to say. that as soon as objection was made
by him we suspended the distribution of the calendars, as we would
not knowingly offend even one of the honorable profession, to whon^
we are so greatly indebted.

THE MALTINE MANUFACTURING COMPANY.

Nbw York, December 26, 1893.



The Jennie Casseday Infirmary for Women, at Louisville, Ky.^
was enlarged daring the past Summer by the addition of a wing,
in which there are eight additional rooms for patients and an
operating room, thus greatly increasing and improving its facili*
ties. Dr. L. S. McMurtry, the surgeon in-charge, has lately been
doing a long series of abdominal operations in this hospital, where
be has accepted every case that presented, including in the group
many of the most unpromising sort. Among the number may be
mentioned perforative appendicitis, multiple abscesses, pyosal-
pinx, pelvis-bound myomata treated by hysterectomy, and other
similar desperate conditions. Only one death has occurred in
this group ; that was a case of hysterectomy for myofibroma
which had undergone malignant degeneration, and the patient hacl
become a morphine habitue.



It is announced that physicians in New York City attached to
any hospital, under a recent ruling of the courts, can give their
testimony in any case of a patient who is an inmate of the institu-
tion in which they serve, before a referee, thus avoiding annoy-
ance and loss of time in attending court. This is a wise step
towards reforming a great evil, but we think it would be well to
extend the privileges by statutory enactment to cover the court
attendance of all physicians. It is very annoying for medical men in
active practice to dance attendance upon " the law's delay," to the
detriment of their patients and to the annihilation of good temper.
Lawyers are too indifferent as to the value of physicians' time,
and courts are sometimes very unaccommodating in relation to
their emergency necessities. A statute compelling counsel to
stipulate to take a physician's testimony before a Commissioner
would solve a very difficult problem.

Another point of importance that now comes to our mind in
this connection, relates to the fees of physicians as experts. Not



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PERSONAL. 435

seldom counsel manage to extract an opinion from a physician
who is placed on the witness stand as to fact, thus escaping the
payment of compensation, a practice that is reprehensible, if not
illegal. Dr. H. N. Moyer, of Chicago, the distingaished nearo-
logist, has done the profession great service in Illinois by demon-
strating, as he did in the Prendergast trial, that an expert cannot
be compelled to testify in that State without compensation.

Db. Seneca D. Powell, in his inaugural address as President of
the Medical Society of the County of New York, made some
admirable suggestions, that it is hoped will be adopted, look-
ing to the correction of some existing evils. The first has rela-
tion to the practice of many dispensary and hospital associations
with reference to the free treatment of patients who are able to
pay, at least, a moderate sum for professional services. The ser-
vice of rich corporations for nominal fees was also condemned.
He further suggested the appointment of a commission of com-
petent physicians to pronounce upon the expert testimony given
before the courts. The enactment of a statutory law to correct
the medical expert evil, and certain other legislation relating to
the society, was advocated. These, together with matters of local
interest, were ably dealt with by the new president, showing his
familiarity with the medical affairs of the society and of the coun-
try, and demonstrating the wisdom of his election.



Peri^onaf.



Db. Joseph Pbice, of Philadelphia, has resigned as physician-in-
charge of the Preston Retreat, and Dr. Richard C. Norris, associ-
ate editor of the Annals of Gynecology and Pediatry ^ has been
elected his successor. It has been apparent to the friends of Dr.
Price for some time that his resignation would soon become
necessary, on account of the enormous demands upon his time
made by ))is work in abdominal surgery. If he has no rival in
this country in the latter field, it is also to his everlasting credit
that he has made the Preston Retreat, during his six years of
service, the most famous maternity in the world.



Db. W. H. Myebs and Dr. Miles F. Porter, of Fort Wayne, Ind.,
having been recommended for Pension Examiners by Hon. W. F.



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436 OBITUABY.

McNagny, have been duly constituted a Pension Board. The
Fort Wayne Medical Magazine comments approvingly on Mr.
McNagny's judgment, as follows: "He has not only risen above
mere party dictation, but has recognized honorable and progressive
men in an honorable profession. Physicians everywhere should
take this as an indication that they may exercise the rights of
citizenship in a manner becoming the profession, and yet be
selected for their worth rather than for their lack of it."



Dr. EuGEifE Smith^ of Detroit, according to rumor, has disposed
of his Athoi Springs hotel and the Spring House, located near
Buffalo, to the Fresh Air Mission, of this city. It is anticipated
that the Mission will convert the hotel into an Infants' Hospital
for Summer use.



Dr. Lucien Howe, of Buffalo, was elected a member of the
Ophthalmological Society of the United Kingdom (Great Britain
and Ireland), on December 14, 1893. This exceptional honor, we
believe, has been conferred in but one other instance on a resident
of the United States.



®6ituar^.



Dr. Willard 0. Marselius died at his residence, in Albany, on
Sunday, December 24, 1898. He was taken ill the Wednesday
previous with appendicitis, and an operation was performed
Friday morning by Dr. Albert Vander Veer, assisted by Drs. Mao-
donald and Ward. The appendix was found to be gangrenous,
and there was intestinal perforation with general peritonitis. Th«
operation consisted in removing the appendix and closing the per-
forations, and it was borne without serious shock. The inflamma-
tion, however, extended, and within forty-eight hours death
ensued.

Dr. Marselius was born in Schenectady county, and was
descended from otie of the oldest Dutch families in the State. He
was a graduate of Union University, class of '81, and in 1884 he
was graduated from Albany Medical College. In 1886, he became
associated in the practice of medicine with his uncle. Dr. Yander
Veer, which relation continued until his death. He was one of



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COLLEGE NOTES. 437

the representative phvsioians of Albany, and was esteemed by
both profession and laity. He was married, September 12, 1893,
to Miss Gertrade E. Wheeler, of Massaohasetts, whose bereave-
ment appeals to the sympathy of a wide circle of friends.



Dr. Herbert Judd, of Galesbarg, 111., died suddenly, from apo-
plexy, at his residence, January 11, 1894, aged 50 years. He
graduated at the Albany Medical College in 18^7, and has prac-
tised his profession in Galesburg since that time. Dr. Judd had
been surgeon of the Chicago, Burlington & Quincy Railway and
at the time of his death, as well as for some years previous thereto,
was surgeon of the Chicago, Santa F6 & California Railway. He
was a surgeon of eminence and a physician who practised his pro-
fession with a full measure of success. In the city of his residence
he was regarded as a foremost man of affairs, and had a large
acquaintanceship throughout the United States that will be pained
to learn of his sudden and early death.



(Soffege RoCei*.



A FOUR YEARS' COURSE AT JEFFERSON MEDICAL

COLLEGE.

At Jl meeting of the faculty of Jefferson Medical College, held on
January 8, 1894, it was unanimously resolved to institute a com-
pulsory four years' course with the session of 1896-96. This step
was taken in order that the large clinical service of the Jefferson
College Hospital (350 cases a day) might be utilized to the fullest
extent in carrying out the desire of the faculty to provide advanced
medical education of a practical character.



HIGHER MEDICAL EDUCATION AT RUSH.

Ix PURSXTANCB of the policy recently announced in the resolution
to be presented to the American Medical College Association, the
trustees and faculty of Rush Medical College have decided to
require four years' attendance at college from students who begin
the study of medicine this year, with a view to graduation in
1898. However, those who have already studied medicine one
year or more with a preceptor, so that the four years of study



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438 SOCIETY MEETINGS.

already required will be completed before July, 1897, may gradu-
ate after three courses of lectures as heretofore. To encourage
proper preliminary study, graduates in arts and sciences from
high grade colleges, and graduates in pharmacy and dentistry
from colleges requiring a proper amount of study and two
full courses of lectures, will, until further notice, be allowed to
graduate after an attendance on only three courses of lectures.



^ocietj^ Meefingi*.



Eleventh International Medical Congress. — Dr. A. Jacobi,
Chairman of the American National Committee, has received a
letter, dated December 19, 1893, containing the following com-
munications :

American members will pay on the English, French and Italian
railways single fares for double journeys, and will obtain a reduction
of twenty per cent, on fares for Italian round- trip tickets.

The documents required for their identification will be sent to you
in January, and Americans intending to visit the Congress will have to
apply to you for them.

Full particulars concerning the journeys will accompany the
documents.

Messrs. Thos. Cook & Son, London, Paris, Rome and Naples,
should be applied to for accommodation and for tickets for the excur-
sion at Rome, Naples and to Sicily. Such excursions will be arranged
at Rome under the guidance of Mr. Forbes, member of several scientific
societies and correspondent of the Times — for Naples, three days,
including Vesuvius, Fompey, Capri, Sorrento, Castellamare, Bajae,
etc. — for Sicily, ten days from Naples, including Messina, Taormina.
Catania. Girgenti, Siracusa, Palermo, and return to Naples.

The fares for members of the Congress will be considerably reduced
and comprise hotel accommodations, carriages, guides, boats, etc. —
about 70 francs each for the three days and 285 francs for the ten
days.

Full particulars concerning these excursions will be contained in a
leaflet to be added to the instructions and documents for the journey.

From former communications the following are herewith
quoted : The members' fee is l?5.00 ; that of their wives or adult
relations, |52.00 each. Checks or money orders may be sent to
Prof. L. Pagliani, Rome, Italy. Credentials have been promised in
the near future. When they arrive (none were received last year).



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80CIBTT MSBTIK6S. 439

they may be too late for many who have started or are about to
start. The nndersigned, who is not informed of the canse of the
delay, proposes to supply, in as official a form as he thinks he is
justified in doing, credentials which are expected to be of some
practical value. The North German Lloyd has promised to recog-
nize them. It is suggested, besides, that a passport may increase
the traveler's facilities.

Only the North German Lloyd (22 Bowling Green) and the
Gompagnie G^n^rale Transatlantique (3 Bowling Green) have
thought fit to grant any reductions to congressists.

The reductions on Italian railways are available from March
1st to April 30th.



The Medical Society of the State of New York will hold its eighty-
eighth annual meeting, Tuesday, Wednesday and Thursday, Feb-
ruary 6th, 7th and 8th, in the City Hall, at Albany, commencing at
9.15 A. M., Tuesday, and ending at 1 p. m. on Thursday, under the
presidency of Dr. Herman Bendell, of Albany. The following is
the provisional program :

Papers, — Hemorrhagic Serous Effusion of the Pleura, with
tleport of a Unique Case, William S. Cheesman, M. D., Auburn ;
Researches on the Eliminating Power of Diseases, and the Rela-
tion between Vaccinia and Enteric Fever, William Finder, M. D.,
Troy ; Pneumonia of the Aged, John H. Pryor, M. D., Buffalo ;
Diagnosis and ITomenclature of Fevers (second paper). Nelson G.
Richmond, M. D., Fredonia; The Therapeutics of Oxygen, Arnold
W. Catlin, M. D., Brooklyn ; Simple Methods in the Diagnosis of
iTervous Diseases, E. C. Spitzka, M. D., New York.

Discussion on Diphtheria, — (Arranged by A. Walter Suiter,
M. D.) Pathology — Status Praesens, Thomas E. Satterthwaite,
M. D., New York ; Observations on Diagnosis, and Some Sanitary
Aspects, A. Walter Suiter, M. D., Herkimer ; Croup and Diphthe-
ria — Unity or Duality, William H. Daly, M. D., Pittsburg, Pa. ;
The Comparative Status of Intubation of the Larynx, Joseph
O'Dwyer, M. D., New York ; Complicated Intubation of the
Larynx, William Hailes, M. D., Albany ; The Local Treatment,
Abraham Jacobi, M. D., New York ; The General Treatment,
fidward F. Brush, M. D., Mount Vernon; The Use of Tartar
Emetic in Diphtheria, H. DeV. Pratt, M. D., Elmira.

Papers, — Treatment of Depressions in Skull of the New-bom,
t)avid D. Jennings, M. D., New York ; Immediate Trachelorrhaphy,



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440 SOCLBTY MBSTIN68.

Henry 0. Coe, M. D., New York ; Lympho-adenoma of the Uterus,
H. J. Boldt, M. D., New York ; Senile Endometritis, A. J. C,
Skene, M. D., New York ; Treatment of Endometritis, Herman E,
Hayd, M. D., Buffalo ; Nine Years' Experience with Alexander's
Operation for Shortening the Round Ligaments of the Uterus,
Paul F. Mund6, New York ; Pelvic Abscess, Walter B. Chase,
M. D., Brooklyn ; A Case of Hysterectomy for Retention of the
Menses, William Gardner, M. D., Montreal.

Discussion, — (Arranged by Andrew F. Currier, M. D.) Topic,
Menstruation and its Abnormalities. Introduction and Normal
Function, Andrew F. Currier, M. D., New York ; Dysmenorrhea,
Its Causes and its Treatment, Howard Kelly, M. D., Baltimore, Md.;
Profuse Menstruation, Charles P. Noble, M. D., Philadelphia, Pa.;
Scanty Menstruation, Franklin Townsend, Jr., M. D., Albany ;
Irregular Menstruation, Charles A. L. Reed, M. D., Cincinnati, O.,
and E. W. Cushing, M. D., Boston, Mass.; Menopause, Natural and
Artificial, Arthur W. Johnstone, M. D., Cincinnati, O.

Papers, — Urethral Caruncles, Edward M. Liell, M. D., New
York ; The Physical Causes of Sexual Debility in the Male, as
Distinguished from the Psychical Causes, F. R. Sturgis, M. D.,
New York ; The Surgical Treatment ef the Prostate Gland, Seneci^
D. Powell, M. D., New York ; The Fable of the Egg, William S.
Ely, M. D., Rochester ; Artificial Immunity, Henry R. Hopkins,
M. D., Buffalo ; Clinical Notes on Psoriasis, with Especial Refen
ence to its Prognosis and Treatment, L. Duncan Bulkley, M. D.,
New York ; Spinal Supports and Braces, the Indications for Their
Use, History and Modern Perfection (to be illustrated with forty
lantern slides), A. M. Phelps, M. D., New York ; History and
Pathology of the Spinal Cord (illustrated with lantern slides),
William C. Krauss, M., D., Buffalo.

Discussion on Abdominal Surgery, — (Arranged by A. Vander
Veer, M. D.) Disputed Points in the Treatment of Pelvic Surgery,
Joseph Price, M. D., Philadelphia, Pa. ; Influences Affecting the
Results of Abdominal Operations, J. F. W. Ross, M. D., Toronto,
Canada ; Hemorrhage After Abdominal Section, Its Place in
Statistics, A. H. Buckmaster, M. D., New York ; Cysts of the Epi^
gastrium, Dudley P. Allen, M. D., Cleveland, O.; The Technique



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 44 of 78)