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J. A. (Joel Asaph) Allen.

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employ a competent medical shorthand writer in order to keep
pace with the demands of the publishers for copy.

Miss Mary L. Danforth, of Buffalo, is a competent medical
stenographer, who offers her services to physicians in this city.
Her card appears on page xxiii. in our advertising columns, to
which we invite attention.



The smart medical student is again on hand with his little bill
before the Legislature relating to the Medical Examiners' law.



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TOPICS OP THE MONTH. 48V

This time he simply asks that the fees be redaced from $25 to $5.
This looks very innocent at first sight, bat when it is understood
that daring the first two academic years of the operations of the
law governing the State Medical Examining and Licensing Boards,
the expenses were sach as to leave a balance to each examiner of
only $123 a year, it can be easily seen that sach an amendment as
is proposed by the stadents wo aid render the law inoperative, for
it woald redace the receipts far below the expenses.

It woald seem to as more logical for the stadents to petition
the faculties of the medical colleges to abrogate the diploma fees
that are universally charged. The diploma is merely a certificate
of study, and might be readily furnished by the colleges for a fee
of five dollars that would more than cover its cost, not to say its
value ; whereas, the State license once obtained is a diploma that
has legal recognition in all the states as well as in many foreign
countries. The students evidently do not comprehend the value
of the license that they are struggling to nullify, else they would
change front and direct their united forces towards the reduction
of the college diploma fees to which we have referred.



Thb coMMiTTKB ou legislation of the Medical Society of the State
of New Torky consisting of Drs. D. B. St. John Roosa, Daniel
Lewis and D. V. O'Leary, has entered protest before the Senate
Committee on Public Health against the passage of a bill in which
the medical students are asking for a reduction of the State fees
for examination. Now that so many States are requiring separate
examinations, the latest of all beiog Pennsylvania, it is amazing to
us that an intelligent legislature should listen one moment to
appeals, or waste an instant of valuable time in the consideration
of bills, that look to a nullification of the excellent medical prac-
tice act now in force.

Shall New York drop behind her sister commonwealths in the
reform movements that are taking possession of all states of the
Union with reference to medical education ? It seems to us that
these annual attempts of the students to resist, in one form or
another, the application of this law, is a confession on their part of
ignorance, timidity or cowardice. If they are well equipped, why
should they hesitate to take the examination ? If not well
equipped, why have they been allowed to obtain the faculty
diploma ?



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488 EDITORIAL.

If the State should be persuaded into the necessity of relieving
the medical student of a portion of his fees, let it either render it
unlawful for the college faculties to charge a diploma fee in
excess of $5 or else pay to the Regents of the University the State
fees for examinations.



The subject of male nurses has recently been commented upon
by Dr. Charles H. Stowell in Food. We have for a long time
been of the opinion that the male nurse had very small place in
the care of the sick. This is certainly true outside of the insane
hospitals or prisons, or in a few exceptional cases where mere
muscular power is needed. In private homes, certainly, the male
nurse is rarely required. In these days of trained nurses there is
no comparison between the male and the female nurse as regards
usefulness in the sick room.

There are many diseases, for example, typhoid fever, where
nursing has a larger place than medicine, and today no reputable
physician would conduct such a case without obtaining the services
of a trustworthy trained nurse to carry out his instructions and
to do the thousand and one things so needful to establish con-
valescence, that only her thoughtful brain and delicate hand are
capable of accomplishing. We believe there has been no stronger
evidence of progress in medical science in the last fifteen or twenty
years than in the training of nurses and in their extensive employ-
ment in the sick-room.



The annual report of the resident physician of Brigham Hall, a
hospital for the insane that was established in 1855 at Canan-
daigua, has come to our table. It is a neat brochure with numer-
ous illustrations from photographs, and bespeaks the progress that
is making in private institutions of this character. Dr. D. R.
Burrell, the physician in charge, has had a large experience in the
treatment of the insane, and the hospital over which he presides is
justly one of the most celebrated private institutions for the care of
this class of patients in this country. Its location, too, is such as
to commend it from a general sanitary point of view.



Subgeon-Genebal George M . Sternberg, United States Army,
announces the convening of an Examining Board in Washinfi^ton,
April 15, 1894, for the purpose of passing upon the qualifications



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TOPICS OP THE MONTH. 489*

of candidates seeking appointment in the medical corps of the
United States army. The examination is very rigid, and, as a
rule, not more than one out of five to ten succeeds at the examina-
tion. The pay, too, is entirely inadequate to command the skill
that a well-educated practitioner should possess. It is probable,
however, that the improved standards of medical education
adopted by the colleges, consequent upon and resultant from the
establishment of separate State medical examining and licens-
ing boards, will serve to equip candidates better, so that rejectiona
will now be fewer by the army and navy examining boards. We
would not discourage young men from attempting these examina-
tions, but rather would encourage them to adequately prepare for
them.



The State of Pennsylvania has finally fallen into line with many
other States in the Union, regarding separate State medical exami-
nation for license. Under the Act of May 18, 1893, the Governor
has appointed the following boards of State Medical Examiners :

Mepreaenting the Begtdar Profession — H. G. McCormick, Wil-
liamsport, three years; Henry Beates, Jr., Philadelphia, three
years ; W. J. R. Kline, Greensburg, three years ; A. H. Hulshizer,
Philadelphia, two years ; N. S. Foster, Pittsburg, two years ; J*
E. Silliman, Erie, one year ; Samuel W. Latta, Philadelphia, one
year.

Homeopathic — C. S. Middleton, Philadelphia, three years ;
Hugh Piteairn, Harrisburg, three years ; Isaac G. Smedley, Phila-
delphia, three years ; Edward Cranch, Erie, two years ; C. F.
Bingamen, Pittsburg, two years; Augustus Korndoerfer, Phila-
delphia, one year ; J. F. Cooper, Allegheny, one year.

JSklecHc — H. Yeagley, Lancaster, three years ; Augustus Niles,.
Wellsboro, three years ; L. B. O'Neale, Mechanicsburg, three
years; H. B. Piper, Tyrone, two years ; J. R. Borland, Franklin,
two years ; W. H. Blake, Philadelphia, one year ; A. B. Wood-
ward, Tunkhannock, one year.

The Act also established a Medical Council, consisting of the
Lieutenant-Governor, Attorney-Genera], Secretary of Interna)
Affairs, Superintendent of Public Instruction, President of the
State Board of Health, and presidents of the three Boards of
examiners appointed. The members of this council receive no
salary, except the secretary and treasurer, who will receive not
over $500. This council will meet twice a year, and supervise the



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490 EDITORIAL.

examinations of the State boards and issue licenses to practice
medicine and surgery. The expenses of the boards of examiners,
it is provided, shall be paid from fees, and, if any surplus above
expenses shall remain at the end of any year, it shall be appor-
tioned among the examiners pro rcUa^ according to the number of
candidates examined by each. The first meeting of the examining
boards will be held on the first Tuesday of April.



Medical politics in medical societies seems to disturb the Ameri'
can Lancet in the extreme. Especially is this the case with refer-
ence to the Medical Society of the State of New York, but it is not
at all disturbed by the fact that the American Medical Association
is a hotbed of medical politics, not to mention some politics that
are not medical. Those who are most familiar with the workings
of the Medical Society of the State of New York are aware that it
was never freer from politics than during the last ten years.
Again, these same persons are aware that the society never did any
better scientific work, whether judged by quality or quantity, than
during this same period. It would seem to us that it is ill-timed for
a person outside the State, who does not even attend the meetings
of the New York Society, to speak in disparagement of the good
work that it accomplishes. Notwithstanding this criticism of the
Lancety we asseverate here and now, that the Medical Society of
the State of New York is flourishing to a degree hitherto un-
known, financially, scientifically and numerically, and it is willing
to have its work compared with that of any other state medical
organization, not doubting that the verdict will be favorable to its
own record.



The action of the State Lunacy Commission has been a subject
of criticism for some time past, not only in medical, but in lay
journals. The resolutions introduced by Dr. Eugene Beach, of
Oloversville, at the late session of the Medical Society of the State
of New York, condemnatory of the centralized management of the
State hospitals for the insane, was a just expression of an indig-
nant profession regarding the conduct of the lunacy commission
in general, and of the exercise of its political powers in particular.
We trust the legislative committee of the society will be able to
«olve the problem through amendments to the existing law that
will be satisfactory to all interests concerned.



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TOPICS OP THE MONTH. 491

The finances of the free kindergartens in Buffalo have become
so strained in the carrying on of the present work, that in order to
extend it proportionately to the increase in the population of the
city, an appeal is made to public-spirited citizens, professional men
and all who are interested in the progress of this important method
of educating the young. A proposition has been made by Mr.
John 6. Milburn to secure the cooperation of the lawyers of Buf-
falo to raise a sum sufficient to maintain one kindergarten, pro-
vided the physicians will unite to sustain another. This means
the pledging of from $1,000 to $1,200 a year, and it is much desired
on the part of the kindergarten managers that this pledge be made
for three years. If it should prove inexpedient for physicians to
pledge $1,000, they possibly may be able to raise $600, which will
support a kindergarten exclusive of the salaries which would be paid
by the city. To aid this charity, the Journal will receive any
subscriptions, or they may be sent to Dr. James Wright Putnam>
388 Franklin street.



Db. Gbobgb H. RoHi, Superintendent of the Maryland Hospital
for the Insane, publishes in his annual report for 1893, a continua-
tion of his observations on the relation of pelvic disease and
psychical disturbances in women and the results of such observa-
tions. From advance sheets, kindly furnished the Joubnal, we
observe a table of twenty-two operations made by Dr. Roh^ on the
pelvic organs of insane women, and a review of the table shows that
even in apparently the most hopeless case a beneficial effect upon
the mental functions is obtained by the removal of a persistent
source of local irritation. In one case of hystero-epilepsy with
violent maniacal attacks lasting during a period of eight years,
complete recovery was obtained. In this case both ovaries were
cystic, and to the removal of the uterine appendages may be cred-
ited the cure. Dr. Rob^ has been subjected to criticism for his
work in the direction indicated, but his critics generally know lit-
tle of the great advances made by modem gynecology, and are
even more ignorant of the results of recent studies of mental
pathology. The facts presented in this report will be regarded by
all unprejudiced minds as a justification of the course pursued by
Dr. Roh6 in the conduct of these trying cases.



The annual report of the Rhode Island Hospital for 1893 pos-
sesses a point of great interest, to which we desire to call atten-



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492 PEBSONAL.

tion, in the hope that it may stimolate some puhlio-spirited
citizen of Buffalo to imitate the example of Mr. George I. Chace,
deceased, who was for many years president of the institution.
Upon his death, Mr. Chace made certain charitable bequests to be
paid upon the decease of his wife, including one of $12,000 for the
establishment of free beds in the Rhode Island Hospital. He also
directed that one-half of the remainder of his estate should go to
such objects of charity as his wife might name by will, expressing
the hope that the hospital would share in her remembrance. Mrs.
Chace died December 25, 1892, and directed that, after the pay-
ment of certain sums, one-half of the remainder should go to the
hospital for the erection of a building for the accommodation of the
training school for nurses. The whole of this generous bequest
has been devoted to the construction of a new building bearing the
name of George Ide Chace, and psed as a nurses' home. It is a
handsome three-story structure with balconies in front, and is every
way adapted to the purpose named. In these days of training
schools and trained nurses, it is essential that these useful, not to
say indispensable, young women should be provided with suitable
homes adjacent to, but separate from, the hospital training schools.
Let somebody in Buffalo, reading of the example set by Mr. George
Ide Chace, go and do likewise.



Per/*onaf.



Dr. William Thomas Coggin, of Athens, Ga., performed the first
American symphyseotomy in Freedman, Ala., March 12, 1892.
Dr. Coggin, in Heidelberg in 1890, heard of Morrisani^s success
and then decided to prefer symphyseotomy to craniotomy when-
ever a case should come under his care in which one or the other
alternative should be presented. Dr. Coggin operated upon the
wife of a miner, who had been fifteen and a half hours in labor
and who had a contracted pelvis of the justo-minor type, computed
to be one-third smaller than the average. After opening the
symphysis, he applied the forceps and delivered a male fetus,
weighing eleven and three-quarter pounds. It was noted that the
pubic bones became separated two and three-quarter inches. There
was no injury produced by the extraction of the child either to
the sacro-iliac synchondrosis or to the soft parts. Under a proper



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PERSONAL. 498

restraining apparatus the pubes readily united, there was no lame-
ness, and the mother and infant both did well. This information
is obtained from Dr. Harris's paper in the AnncUs of Gynecology
and Pediatry for February, 1894, and we regret that we did not
poiBsess these faots to incorporate in our editorial on symphyseo-
tomy in the February issue of the Journal.



Dr. p. O. Hooper, for many years Superintendent of the Arkansas
State Lunatic Asylum, resigned to take effect December 1, 1893.
The Atk(Kn9<u OozeUe regards Dr. Hooper's retirement as due to
political influences. Whatever cause may have led to this result
is a matter of deep regret to Dr. Hooper's professional friends
throughout the country, as well as to those persons more immedi-
ately concerned in the conduct of the asylum, that this step was
thought necessary. It will be difficult to find a successor who
is as well fitted for the charge as the distinguished Superintend-
ent who has retired.



Dr. J. Henry Carstens, of Detroit, has removed his office and
residence from 21 Macomb street to 620 Woodward avenue. His
practice is entirely restricted to gynecology, abdominal surgery
and consultations. His hours are 8 to 9 a. m. and 1 to 3 p. m.



Dr. R. Harvey Reed has removed from Mansfield to Columbus, O.
His address is 150 Broad street.



Drs. Edwin Walker and A. M. Owen, of Evansville, Ind., have
established a sanitarium in that city, the object of which is to pro-
vide a suitable place for the care of medical and surgical cases.
Those who are acquainted with these distinguished physicians will
readily understand that success in their enterprise is already
assured. Patients can make no mistake in placing themselves
under the roof of the Evansville Sanitarium for treatment.



Dr. Montgomery A. Crockett, of 452 Franklin street, Buffalo,
announces that his practice will hereafter be confined to gyne-
cology and obstetrics. His hours are 1 to 3 p. m. Dr. Crockett
published an interesting article in the February issue of this
magazine, entitled. Observations on the Results of Removal of
Diseased Uterine Appendages, which will well repay careful
study.



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494 OBITUABY REVIEWS.

(96iiluaf^.



Dr. Theodor Billroth, of Vienna, died February 5, 1894, of
heart disease. He was one of the most celebrated surgeons of his
day and was an author of great renown. He continued his surgical
and literary work almost to his end. He published a work on
Pathological Histology in 1858 ; and another on Classification,.
Diagnosis and Prognosis of Tumors, translated in 1861, through
which he became known to the profession in this country. His
lectures on Surgical Pathology, published in 1872 by the Apple-
tons, became a text-book in most medical colleges in America. It
is justly claimed that his most striking surgical achievement was
the performance of the first successful resection of the pylorus for
malignant disease, Pean had previously done the operation with-
out success.



S^ooiC S^e>9iecoA.



A System of Genito-Urinary Diseases, Syphilology and Derma-
tology. By various authors. Edited by Prince A. Morrow,
A. M., M. D., Clinical Professor of Genito-Urinary Diseases ; form-
erly Lecturer on Dermatology in the University of the City of New
York ; Surgeon to the Charity Hospital, etc. With illustrations.
In three large. dvo volumes. Volume II., Syphilology. Pp. xviii. —
917. New York : D. Appleton & Co. 1893. Sold only by sub-
scription.

The first volume of this system was noticed somewhat in
extenso in the June number of the Journal. We now proceed to
give our readers the benefit of an examination of the second volume.
The editor states that in its preparation it has been the aim to pro-
duce a complete and systematic treatise on syphilis and chancroid,
which should reach up to the present and embody the most recent
advances made in our knowledge of these diseases. We think he
has accomplished his object, while at the same time he has given
to the profession a work that is essentially practical. In order to
reach this end it has been necessary to eliminate many theoretical
questions and unimportant details, that only the essential facts of
present knowledge might be presented, and that only questions of
live, practical issue might be discussed.

The history, geographical distribution, evolution and general
pathological anatomy of syphilis, by James Nevins Hyde, forms-



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MOBBOW : A 8Y8TBM OF GENITO-UBINABY DISEASES. 495

the opening section of the book, and the thirty-eight pages devoted
to it are of exceeding interest. The next section treats of the
etiology of syphilis, and is written by John A. Fordyce. The micro*
Organisms in syphilis here have received carefal consideration, which
is the prodactof elaborate research and studies in laboratory cultures.
This author very properly classes, among predisposing causes, im-
proper, or imperfectly carried out, treatment during the early stage
of the disease as the most frequent causes of the recurrence of ter-
tiary symptoms. This statement ought to receive great emphasis,
for we believe that in the present state of our knowledge syphilis
ought never to pass beyond the primary stage, and an enlighten-
ment of the community on this subject should be made the aim and
duty of every physician.

The modes of infection in syphilis are briefly considered by L.
Duncan Bulkley. He asserts that there are four methods by which
syphilis can be acquired : 1. Direct contact. 2. Mediate infec-
tion. 3. Hereditary transmission. 4. Maternal infection. Bulk-
ley does not believe that the normal secretions — milk, saliva, etc. —
can communicate the disease except when they act as carriers of a
pathological secretion from a syphilitic lesion.

Primary syphilis is the subject of the next section, to the con-
sideration of which Edward Bennet Bronson devotes thirty-five
pages. Here the various lesions are described and rules for diag-
nosis are carefully laid down. A table differentiating primary
syphilis from simple chancre is especially deserving of study.
Constitutional syphilis is described by Joseph Zeisler, and then we
come to syphilis of the skin, which is exhaustively treated of and
illustrated by the editor-in-chief. Prince A. Morrow. Probably no
department of medicine has improved more of late than the study
of syphilides, and the eighty-two pages here devoted to their con-
sideration invites most careful examination and criticism. Noth-
ing but praise can be given to Dr. Morrow's exposition of the sub-
ject. Syphilis of the appendages of the skin is dealt with by
Samuel Alexander, and next comes syphilis of the mucous mem-
branes of the mouth and tongue, by Charles W. Allen, in the course
of which seven colored illustrations afford elucidation of the
text.

In the next few pages, Frank Hartley treats of syphilis of the
joints, burs» tendons and aponeuroses, and then comes syphilitic
affections of the bones, which are ably handled by W. R. Townsend,
who devotes fifty pages to their consideration, in the course of



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496 BBVIEWS.

which occar nnmerous illustrations. One of the technical points
here is the differentiation of syphilitic and tubercular osteitis. Dr.
Townscnd gives a valuable table in parallel columns that serves to
aid in this differentiation. Next comes the consideration of
syphilis of the upper air-passages, to which John Noland Mackenzie
•devotes forty-eight pages, which affords most interesting reading.
Yisceral syphilis is ably handled by W. T. Councilman, and much
light is thrown upon this important part of the subject in the fifty-
two pages here devoted to it. The next section considers syphi-
iitic affections of the rectum and anus, and James P. Tuttle has
here written most clearly and comprehensively on a difficult part
^f the subject.

One of the most important sections — syphilis of the genito-
urinary system, male and female, written by Eugene Fuller — con-
sists of thirty-eight pages of highly interesting material. The
situation of the initial lesion is usually the penis in the male and
the vagina in the female, and the exact site of the infection in
either case depends upon the location of the abrasion, so that it is
to be asserted with confidence if a man on exposure does not have,
or fails lo produce, an abrasion, he escapes syphilitic infection.
There is much to be unlearned with reference to the preconceived
notions regarding the method of infection as well as new views to
become familiar with.

Syphilis of the nervous system, by B. Jachs, and hereditary
ayphilis of the nervous system, by William N. BuUard, are two
interesting sections that throw much light on a department of
neurology that is beginning to receive deserved attention. Syphilis
•of the eye, by Charles Steadman Bull, who also writes upon dis-
eases of the eye due to inherited syphilis, is an interesting field of
research and is instructively handled by the author. Hereditary
syphilis, by F. R. Sturgis, finds an able exponent of the subject
than whom there is no one more competent to write. Dr. Sturgis
is a student, an author and a clinician who enters fully into the
spirit of his work whatever it may be, and in the present instance
has written a most instructive monograph.

The section on diagnosis and prognosis of syphilis,by Herman
G. Klotz, and the treatment of syphilis, by J. William White,
deserve to be carefully studied by every physician. We have not



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 49 of 78)