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J. A. (Joel Asaph) Allen.

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twins. She made a good recovery, and is in good health." — Cana-
dian PractitioneTy February, 1894.



REST IN CARDIAC AFFECTIONS.

Db. T. Laudeb Bbunton (The Practitioner) believes that as a
remedial measure, rest frequently requires to be absolute ; as a pre-
ventive one it may be relative. The amount enjoined must be
carefully proportioned to each case, as in advanced mitral disease,
when the power of the heart is failing, absolute rest gives satis-
factory results, in that the circulation recovers its balance, the
arteries become filled and the veins emptied, the dropsical effusion
and venous engorgement of the organs disappear, and the patient



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544 SELECTIONS.

recovers a fair amount of health. In cases of mitral disease incom>
petence may come about from :

1. Enlargement of the auriculo-yentricular orifice.

2. Thickening of the valves, or

3. IncoOrdinated action of the musculi papillares.

In the first case it may be hard to say if this be the sole cause
of the regurgitation, without any obvious disease of the valves, as
some disturbance of the relationship between the musculi papil-
lares may tend to aid the regurgitation. In such hearts in grow-
ing boys and in chlorotic girls, comparative rest may be useful,
and sometimes absolute rest may be almost essential. In some
cases the former may be all that is wanted as a prophylactic
measure. In chlorotic girls gentle exercise is advisable, but it
must be carefully graduated, as exhaustion is likely to do harm.
Massage may be useful, as it gives the patient exercise without
putting any strain upon the heart. With a fatty heart gentle
exercise may be advisable, as it may be more likely to bring about
a healthy condition of the heart than absolute rest. When in
mitral disease cardiac tonics, even pushed t9 their utmost limit,
fail to give relief, then absolute rest becomes of great importance.
Massage is of great usefulness in clearing out the body-waste,
quickening the flow of blood through the muscles, and relieving
the edema, and the patient gets the advantage of the exercise
without overdoing his heart. It also allows the treatment to be
carried out more easily than it would otherwise be, for it removes
the feeling of weariness and irritability, faintness and unrest of
the patient. — Medical BevieWy February 10, 1894.



It is estimated that about 400 candidates will apply for the
diploma of the Board of Regents in the State of New York, dur-
ing the coming year. If the enterprising medical student alluded
to in the last number, succeeds in getting the fee reduced to $5.00,
it will be impossible for the Board to do this work, unless the
State steps in and pays this expense. At the time the law was
passed, the State said it must be a paying board. Now the law-
yers want the medical examiners to work for nothing, /or the honor
of the thing^ as one of the members of the committee who heard
the delegates, from the State Medical Society, suggested. We
would like to know about how much labor lawyers do for the



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COBBBSPONDENCE. 545

boQor of the thing, without any money. No doubt it is true that
the medical profession is bound to do a great deal without any
reward other than comes from the consciousness of doing its duty,
but we think senators and assemblymen are a little hard on them
when they propose that we should select seven examiners to travel
^11 over the State, prepare a series of carefully arranged questions
on seven subjects, examine and decide on four hundred answers,
for the honor of the work. — Post- Graduate^ March, 1894.



(®orreApoa3.eace»



To the Editor of the Buffalo Medical and Surgical Journal :

Sib — In the current number of your journal, you very justly
oommend the action of Mrs. Chace, of Providence, in devising
money to build a Nurses' Home for the local training school for
nurses, but we need not go so far afield to find an even more
-commendable example.

In 1890, the Buffalo General Hospital Training School for
nurses entered an elegant and completely equipped nurses' home,
the donation of a lady, who gave us the benefit of her practical
wisdom in the selection of a plan, and in supervising the details of
construction and furnishing, as well as the money wherewith to
build and furnish. Last summer, learning that the nurses were
considering how they might obtain a piano, she ordered an upright
Steinway, which now adorns the parlor, and is the source of daily
delight and entertainment.

Is it not better to give to a training school while living and
«njoy the satisfaction of seeing the improved health and increased
happiness of these hard-working young women, than to depend on
the uncertainties of a bequest ?

Upon a brass tablet in the main hall is the following inscription :

'< As a grateful recognition of the generosity of Sarah H. Gates,
in building and furnishing the Nurses' Home, this tablet is placed
by the nurses of the Buffalo General Hospital, in the year of Our
Lord, 1892."

And thou shalt be blessed, for they cannot recompense thee, for
thou shalt be recompensed at the resurrection of the just. — St. Luke
xlv., 14.

FRANK W. ABBOTT, M. D.,
Chairman Training School Committee^ B. O. H,

BuPPALO, March 9, 1894.



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546 EDITORIAL.

BUFFALO MEDICAL AND SURGICAL JOURNAL

A MONTHLY REVIEW OF MEDICINE AND SURGERY.

EDITORS:
THOMAS LOTHROP, M. D. - - WM. WARKEN POTTER. M. D.

All communications, whether of a literary or business character, should be addressed
to the managing editor: 284 Fbakklin Stbsbt, Butfalo, N. Y

Vol. XXXIII. APRIL, 1894. No. 9.

AN OBJECT LESSON IN HYGIENE.

Our servants and pratectors in two of the more important depart-
ments of oar municipal government have given the medical pro-
fession of the city a rare opportunity to study a sanitory problem
of singular interest and importance, and upon a scale of singular
magnitude. In order to fully realize the significance of the sani-
tory situation of our city during the first week of March, we must
glance for a moment at the habitual experience of the people of
our State during the last ten years with the malady, typhoid fever.
In brief, this disease prevails throughout the State and dur-
ing the entire year, having each year a distinct period of increase
from May to November, and a definite and regular period of de-
cline from November to May ; the months August, September
and October habitually furnishing four times as many deaths as
the months March, April and May.

The testimony of our colleagues, whether in private or hospital
service, seems to set forth most conclusively that our experience
of this disease was the usual observation during the months of
December, January and February, and the same testimony as
clearly establishes that our experience with typhoid fever during
the month of March, 1894, is alarming^ is a complete reversal of
the legitimate expectation of the month, and is utterly unprece-
dented in the history of this city.

Typhoid fever is epidemic in Buffalo, and has been since March
Ist. Up to this writing over 450 cases have been reported, and of
these undoubtedly over 200 fell ill in one week, — the first week
of March. From inquiry we learn that the disease knows no
locality within our city limits, save one to be named later, and is
absolutely independent of hygienic or unhygienic environment,.



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AN OBJECT LESSON IN HYGIENE. 547

claiming its victims at will from the hovel of the tramp, the cot-
tage of the laborer and the palace of the politician.

Over against this unseasonable and furious outbreak of infec-
tious disease stands the following fact of terrible significance :
At various times during the month of February of this year the
supply of water in the city reservoir was not more than one-half
or one-quarter of the usual quantity. In order to increase this
deficient supply, water was pumped from a shallow portion
of the river near its margin, where its slow moving currents are
habitually befouled by the sluggish and sewage-laden waters of the
Buffalo harbor, the two being at this place only nominally divided,
and that by a slender wall of loose masonry, — the Bird island pier.
Our only real protectors, the city press, seem unable to fix accurately
the dates on which the poison-laden, death-dealing waters of the
harbor were substituted for the pure Niagara, of which we are so
justly proud ; various dates have been mentioned, and, so far as
we know, not contradicted by those whose business it is to know, and
who may yet be made to tell. February Ist, 5th, 12th, 16th, 2l8t
and each of the remaining days of the month are thus mentioned.

The precise facts regarding the occasions when our water sup-
ply was polluted, or the exact proportions of poisoned and pure
water which our servants of the Water Department furnished for
our drinking, may never be known, but no physician at all familiar
with literature as to the causation of typhoid fever, can for a
moment doubt the causative relation of our befouled water of
Febrftary with the outburst of disease of the first days of March.
Cause was never more plain, and effect never more unmistakable.
And yet we have not heard of any shootings, hangings or burn-
ings. Were we quite sure that this apparent composure, forbear-
ance and self-control, exhibited by the masters of the house (whose
well-paid servants have just shown their utter want of either capa-
bility, efficiency or loyalty by a wholesale poisoning), was not in
good part merely the result of ignorance and scepticism, we should
say that Christian forgiveness and charity has never shown more
benignly than in the dibease-stricken families of Buffalo this
March, 1894.

We remarked that the present epidemic knew no locality
within our city limits save one, — namely, the area supplied by
water from the Jubilee Water Works, which water comes from
pure springs. From this territory of about 260 dwellings comes
but a single case of the disease.



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548 EDITOBIAL.

Our people maintain at great expense a water bureau and a
health department, to the end that we may enjoy the advantage
of a free supply of pure water, — the article of food second in import-
ance only to pure air, — and to the further end that all possible care,
diligence and knowledge may be exercised with ceaseless activity
for the protection of the public health. In the name of the medi-
cal profession and in the interest of the public, we would like to
ask our servants in these two offices certain questions :

1. How far apart in space or time are the headquarters of the
Board of Public Works and the Health Departments ?

2. How frequently and when during the months of December,
January and February were consultations held between these
departments upon the question of abandoning the reservoir on
Niagara street, of opening the reservoir on Best street and of open-
ing the inlet at Bird island pier ?

3. What records are on file in the respective offices of any
such consultations and the resulting advices and recommenda-
tions ?

4. What care and pains were taken to clean the reservoir on
Best street before filling the same with water ?

6. How far above low water mark, — the bottom of the river, —
are the inlets to the new tunnel ?

6. How far above low water mark, as above indicated, are
the bottoms of the suction pipes in the wells at the pumping
station ?

I. On what days in February, 1894, was water pumped*from
the inlet of Bird island pier ?

8. While water was being pumped from the Bird island pier
inlet, was Niagara water also being pumped, and what were the
relative quantities of each ?

9. Does the Bird island pier inlet lead to the pumping station
through the old or the new tunnel ?

10. In case the Bird island inlet leads to the pumps through
the old tunnel, what means were used to clean the same before
pumping from it for city use ?

II. When and how did the Health Department first learn
that water was being furnished the city for domestic use from Bird
island inlet ?

12. What steps, if any, did the Health Department take to
ascertain the reason why foul water was furnished the city at
various times during the month of February, 1894 ?



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TOPICS OP THE MONTH. 549

13. To whom do the incumbents of these departments owe
allegiance, — to the politicians who gave them place or to the
people who pay the taxes ?



TOPICS OF THE MONTH.

The Board of Medical Examiners of the State of North Carolina
is doing a most excellent work, as appears by a record thereof,
prepared by Dr. Francis M. Duffy, of Newburg, embracing a period
from 1885 to 1890, and published in the February number of the
North Carolina Medical Journal, The following editorial com-
ment thereon in the same issue of the journal possesses sufficient
interest to warrant republication :

Those states which have not done so must, in the near future,
defend their citizens from the quackery, charlatanry and ignorance that
have gotten to be so rife in the land. As water flows to, and settles
in, the lowest places, forming bogs unpleasant to the eye and danger-
ous to health, so will these fellows, who cannot find an abode in those
states which require a demonstration of their fitness to deal with the
lives of men, drift into those other states which have left their doors
wide open to them, and will ply their nefarious practices to the
discredit and detriment of those spates.

With strict laws in North Carolina, Tennessee, Alabama and
Florida, these fellows, like pus, make towards the point of least resis-
tance, and escape into South Carolina and Georgia. All honor to the
Old North state, which was the first to move in this salutary reform
which forced the medical schools to require a higher standard for their
graduates ; and all praise to her boards of medical examiners, wbo
have so faithfully performed their duties and protected the lives of her
people from the danger of ignorant men, who were ever ready to take
advantage of their necessity and credulity.



In ak editorial the Medical News recently discussed the cost of
sanitary negligence. In a table furnished by the secretary of the
Maryland Board of Health, it is shown that the death-rate of
London is 19.11 per 1,000, while that of New York is 26.47. Fol-
lowing out this computation, it is shown that New York is
criminally chargeable with 4,171 additional and unnecessary deaths
each year as compared with Brooklyn ; 4,071 more deaths to her
debt than Philadelphia and 6,774 more than Chicago. It is
further affirmed that if London cared as little for the lives of her



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550 EDITORIAL.

citizens as apparently does New York, there would die in the
former city every year 21,524 more people than at present die.
These are striking figures and rank among that class of statistics
that do not misrepresent the facts. They furnish a sad commen-
tary on the so-called economy of municipal authorities in relation
to the money supply to health boards. Municipal legislatures,
almost without exception, treat the estimates of health officers
either with contempt or with a niggardliness that borders on
criminality.



The death of a Polish woman, through the ignorance and neglect
of a midwife, as reported in the newspapers on March 16, 1894, is a
sad commentary on the intelligence of the people in this city.
It is amazing that a woman should be allowed to go thirty hours
after child-birth without delivery of the placenta, and finally die
from this inhuman neglect in the midst of a populous and intelli-
gent city. If it be true that the so-called midwife, who attended
Mrs. Waligorska, had been pursuing her calling for two years
without license, it is high time that the whole abomination relat-
ing to the present system of licensing midwives should be investi-
gated. We recommend the committee of hygiene of the Medical
Society of the County of Erie to probe this matter thoroughly.
It is quite time for the state to assume the responsibility for the
licensing of midwives, and thus relieve the local authorities of an
unpleasant duty. We hope the bill proposed on this subject by
the Medical Society of the County of New York will become a
law.



It is one of the healthy signs of the times to see an activity spring-
ing up in all directions looking toward the prevention of the spread
of consumption. It is announced among other things, that all
passenger trains between Buda-Pesth and Gleichenberg, during the
season at the latter place, will have special cars attached for
phthisical patients. These are to be carefully renovated and disin-
fected after each trip. In this connection we note that Mr.
Benjamin A. Parker, of Bedford, Mass., a consumptive, en route
home from Yuma, Arizona, whither he had been for his health, died
in a sleeping car in this city on Sunday, March 18, 1894. The car
was detached from the train at Buffalo, and we hope that it was
thoroughly disinfected under the direction of the health depart-
ment.



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TOPICS OP THE MONTH. 551

The first annual report of the Children's Hospital of Buffalo^
•ending October, 1893, is jast at hand. It is a neat little duodecimo
brochure, and tells the story of the work done for the year in a
simple and entertaining fashion. The hospital was established in
September, 1892, through the generosity of Mrs. Gibson T.
Williams and Miss Martha Williams, who purchased the property,
^19 Bryant street, and after refitting it for the purposes of a
hospital, offered it, rent free, to the board of managers. During the
year fifty-five patients were admitted to the hospital, forty-four of
which were surgical cases, and eleven were medical in character ;
thirty-seven patients have been discharged and two have died in
the hospital during the year, while thirty-one surgical operations
have been performed during this period. The receipts for the
year have been $11,183.78; the expenditures, $8,928.74; leaving
ncash balance October 2, 1893, of $2,255.04. This is a credita-
ble exhibition of the energy and executive capacity of a group of
philanthropic Buffalo women.



The lessons to be learned from epidemics are always many and
interesting. The present waterborne fever epidemic in Buffalo
accentuates the necessity in a most striking manner of subordinat-
ing the Water Department to the Health Department. No changes
in the method of the water service, after it has once been estab-
lished by the health department, should ever be made without the
full knowledge and consent of the latter bureau. It is idle to talk
about the causation of the present epidemic, call the disease by
what name you will, as being other than due to polluted water.



The following able exposition of the relationship of the medical
profession to journalistic literature is worthy of preservation, and
we commend it to the thoughtful perusal of every physician. It
is taken from the editorial columns of the Kansas MedicalJbumaly
issue of March 3, 1894, and we make no apology for reproducing
entire such an able setting forth of so important a subject:

MEDICAL JOURNALS AND THEIR RELATION TO THE PROFESSION.

**I have no time to read medical journals, ^^ or, **I take more
journals than I can read,^^ are expressions altogether too common
among physicians all over the country. It is not by any means con-
fined to those most busily occupied by professional duties ; on the other
hand, we find those physicians who have established reputations by



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552 EDITORIAL.

their faithful, oonBcientious attention to busineBS, and by their perais^
tent, unrelenting labor of investigation, are the readers of medical
journals. They never complain of having too much literature, but their
journals are carefully laid away where at a moment's leisure they may
be easily found. It is certainly no credit to any man's ability, and no
guarantee of a successful or lucrative practice, to see a pile of medical
journals upon his table with the wrappers still on them. It is almost
an unfailing evidence of decline when a physician complains that he is-
too busy to keep posted. He won't be busy very long if such be the case.

There are times in every physician's history when his leisure-
moments from active practice are few and far between, but we are
sufficiently familiar with the profession to know that this is not a^
perpetual condition even with the busiest of our brethren. The mem-
bers of the medical profession, who are renowned for their successful
work, who do not limit their practice either by county or state lines,
are many of them authors of voluminous works, contributors to numer-
ous journals and systematic readers of scores of the same. What are
we to say, then, of the man who has no time to read four or five jour-
nals P Simply this : He is either not in touch with the progressive
spirit of the age ; he completed his knowledge of medicine in the lecture^
room, and sees no necessity for further investigation ; or he is too
ignorant of the principles of the science which he pretends to practise
to understand or appreciate the thoughts of labors of his more intelli-
gent brothers.

It is not a waste of time to read even the poorest of the medical
journals.

We receive each month more than 160 journals which it is our busi-
ness to examine. Some of these are placed high in the rank of medical
Journalism, others are suffering for lack of appreciation and support,
but we often find as many practical suggestions and as many items of
real value to the general practitioner among the latter class as in
the former.

A man who reads to learn will find something he did not know
before in almost any magazine or paper he takes up. We often get new
ideas from rereading a book we supposed we were perfectly familiar
with. The human mind is incapable of storing up every item of
interest it lights upon. It needs to be continually fed, and often by
reading something apparently stale a forgotten idea is called to mind
which may be of incalculable value, but journal items are generally
new. It Is there that the latest discoveries, the most recent investiga-
tions, are reported to the medical world.

Medical editors are especially shy of communications having an
ancient odor, and It is much for this reason that readers of numeroua
medical journals are better posted on recent facts in medicine than their-
brothers who confine themselves to text-books.



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TOPICS OF THE MONTH. 65^

These new thins^s in medicine do not all come from Germany,
£nc:land, France, nor even Kew York. The physicians of the west are
as much alive to the demands of the time and to the possibilities of
advancement as are our more favored metropolitan brothers. Western
medical journals are, therefore, the mediums of communication from the
east to the west, and also from the west to the east.



Thbbb is another despicable bill befote the legislature that ought
t« receive the condemnation of every respectable man and woman
in the State of New York. We refer to the attempt to legalize
the so-called Christian science cure by statutory enactment. We
cannot believe that an intelligent body of men, such as composes
the legislature of the State of New York can seriously contemplate
favorable action on the proposed measure. The State has already
committed to the Regents of the University sole supervision of
the right to practise medicine within its borders, and it^ould not
be consistent to make an exception in faiM)r of a group of persons
who practise on the weaknesses of unprotected humanity by
pretending to invoke the aid of the supernatural in the cure of
their physical infirmities. If it should do so, then we may expect
all the other quacks and fakirs in medicine to ask for similar
privileges, which, if it would be consistent, the legislature must
grant. There are two serious objections to that form of chicanery,
misnamed Christian science, — it is neither Christian-like nor
scientific.



The medical officers who served under contract during the late
war, under the title of acting assistant surgeons, are petitioning
congress to have commissions issued to them for their respective
terms of service. This would give them the same legal standing^
and afford them the same privileges as are enjoyed by regular
army medical officers or those of the volunteer service. We doubt
the propriety of this measure, though we recognize the valuable
services that these contract surgeons performed. As a rule,



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 55 of 78)