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Transactions of the Medical Society of the State of North Carolina.
Fortieth annual meeting, held at Raleigh, N. C, May 9, 10 and 11,
1893. Octavo, paper, pp. 164. Wilmington, N. C. : Jackson & Bell.
1893.

A Manual of Minor Surgery and Bandaging, for the Use of House-
Surgeons, Dressers and Junior Practitioners. By Christopher Heath,
F. R. C. S., Surgeon to University College Hospital and Holme Professor
of Clinical Surgery in University College, London ; Member of the
Council of the Royal College of Surgeons of England. Tenth edition.
Illustrated, 16mo, pp. xvL— 389. Price, $2.00. Philadelphia: P. Blak-
iston. Son & Co., 1012 Walnut street. 1894.

A Text-Book of the Diseases of Women. By Henry J. Garrigues.

A. M., M. D.. Professor of Obstetrics in the New York Post-graduate
Medical School and Hospital ; Gynecologist to St. Mark's Hospital in
New York City ; Gynecologist to the German Dispensary in the City of
New York ; Consulting Obstetrician to the New York Infant Ayslum ;
Obstetric Surgeon to the New York Maternity Hospital ; Fellow of the
American Gynecological Society ; Fellow of the New York Academy of
Medicine ; President of the German Medical Society of the City of New
York, etc. Octavo, pp. 690, containing 310 engravings and colored
plates. Price, cloth, $4.00 net; sheep, $6.00 net. Philadelphia: W.

B. Saunders, 926 Walnut street. 1894.

A Primer of Psychology and Mental Disease. By C. B. Burr, M. D.,
Medical Superintendent of the Eastern Michigan Asylum ; Member of
the American Medico-Psychological Association, the American Medical
Association, the State Medical Society, the Pontiac Medical Society ;
Corresponding Member of the Detroit Medical and Library Association.
Duodecimo, pp. vi. — 104. Price, $1.00. Detroit, Mich. : George S.
Davis.

Clinical Lectures on Pediatrics, delivered in the Vanderbilt Clinic
during the Session of 1892-93. By A. Jacobi, M. D., Clinical Professor
of the Diseases of Children in the College of Physicians and Surgeons
of New York, etc., etc. (Stenographic reports.) Reprinted from
Archives of Pediatrics, Volume X., 1893. Octavo, pp. 196. New
York : Baily & Fairchild. 1893.

Manuel de M^decin Practicien, la Pratique Journalifere de la Chirur-
gie, dans Les Hopitaux de Paris, Aide-Mdmoire et Formulaire de Ther-
apeutique Appliqude par le Professeur Paul Lefert. Paris Librairie J.
— B. Baillidre et Fils. 1894.



Examinations U. S. Army Medical Corps. — In view of the
possibility of the reduction of the Medical Corps from 125 to
ninety Assistant Surgeons, by action of Congress at its present



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^74 LITBBAJIT NOTES.

session, and to save possible loss of time and expense to candi-
dates if such action be taken, the examinations appointed for
March and April, 1894, will, by order of the Secretary of War,
not be held until further notice.

It is probable that if the Corps should not be reduced, the
Examining Board will be convened in the fall of 1894. Of this,
notice as early as possible will be given.



Tub whole world has been traversed to find material for the
Easter Number of The Literary Digest, Almost every civilized
language is represented. It is superbly illustrated^ full of
information ; treating all questions of present interest, and all
sides of those questions ; presenting the leading articles in the
foremost magazines and journals of the world. This number of
The Literary Digest probably excels any other attempt to
give the literature of the world in one issue. The Easter number
was ready on Thursday, March 2 2d.



We have received one of Hewson's Anomaly Blanks, designed for
the use of dissectors, demonstrators of anatomy or post-mortem
examiners in which to record any anatomical anomaly that they
may find. The sheet is nine by six inches, has proper spaces for
the dissector's name, the principal normal physical characteristics
of the subject and for anomalies of each of the principal organs or
classes of tissues. These blanks are supplied in blocks by the
publishers, Messrs. P. Blakiston, Son & Co., Philadelphia, free
to any professor or demonstrator of anatomy in any medical college.



Dr. Charles N. Smith, editor of the American Gynecological
Journal, published at Toledo, Ohio, announces the discontinuance
of that magazine. We regret to part with this useful periodical,
but the increasing professional duties of Dr. Smith interfered with
the exacting demands that the journal made upon his time.



The Angier Chemical Co., of Boston, is sending to the medical
profession a card of excellent pens made by the Tad el la Pen Co.,
76 Fifth avenue. New York, which the company will take pleasure
in forwarding on application to any physician who has not already
received one.



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LITBBABY NOTES. 575

Thb International Medical Magazine has been transferred by J. B.
Lippincott Co. to the International Medical Magazine Co., pub-
lishers, 716 Filbert street, Philadelphia. It is edited under the
supervision of Drs. John Ashurst, Jr., and James T. Whittaker by
Henry W. Cattell, M. D. Manuscripts, exchanges and books for
review should be addressed to the editorial office, 3455 Woodland
avenue, Philadelphia.



We ikvitb attention to the advertisement of the Labordine Chemi-
cal Co., that appears for the first time in this journal and will be
found on our third cover page. We hope this new vegetable
preparation will receive thorough investigation as to its merits at
the hands of our physicians. If a satisfactory and safe substitute
can be found for the numerous coal-tar preparations it will prove
most desirable.



The Woman's Medical College of Baltimore publishes its announce-
ment on pagexvi. of our advertising columns. There is a constant
increase in medical colleges for women which indicates a demand
for them. We hope that the standard provided by these colleges
both for admission and graduation will not be made lower than in
colleges for men.

The Xfouisville Medical Monthly is the title of a new medical
journal, published in Louisville, Ky., that appeared in March, 1894.
Its editors are Drs. James B. Steedman and George M. Warner.
In its list of active collaborators are included the names of some of
the most prominent physicians of Louisville.



A WORK that is really new, and unlike any other, is TAe Nutshell
Cyclopedia. It is not intended to take the place of any other
general cyclopedia, but to supplement every other ^ and whatever
other you have you will probably want the Nutshelly and if you
have no other you will surely want it. It treats only live subjects,
the facts concerning which are constantly changing, and the latest
information concerning which is important. Probably three-fourths
of its contents will be found in no other cyclopedia, because the
occurrences and the facts described are of later date than the pub-
lication of any other cyclopedia. Though the entire work will
comprise probably 2,500 pages, it is sold at a price so low that
anyone can afford it, ranging from $1.75 for the complete work in



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576 LITEBABY NOTES.

Monthly Parts, to $3.20 for the same in four Tolumes, half morocco
binding. The issue before as covers such important subjects as
coinage, Colorado, Columbia celebrations and expositions, com-
merce and crops, bringing statistics down to 1894 (mostly a year
later than to be found in any of the annuals), Congress, with list of
the members, Connecticut, and so on. For sample Monthly Part
send 4 cents postage to John B. Alden, publisher, 57 Rose street.
New York.



The Shadow-Test. — A course of lectures, demonstrations and
clinical work on skiascopy, or the shadow-test, will be given at
the Philadelphia Polyclinic during the week commencing April
9th. This method of determining the refraction of the eye has for
years been practised as a part of the regular routine examination
in that institution ; and is there found to be of greater practical
value than the methods by the use of the ophthalmoscope or the
ophthalmometer.



Vick's Floral Guide, 1894. — It contains descriptions that de-
scribe, not mislead ; illustrations that instruct, not exaggerate.
This year it comes to us in a suit of gold. Printed in eight dif-
ferent colors besides black. Colored plates of chrysanthemums,
poppies and vegetables. On the front cover is a very exquisite
bunch of Vick's new white branching astor, and on the back is the
new double anemone ; 112 pages filled with many new novelties of
value as well as all the old leading varieties of flowers and vegeta-
bles.

We advise our friend who intends doing anything in the garden
this year to consult Vick's before starting operations. Send 10
cents to James Vick's Sons, Rochester, N. Y., for Vick's Guide ; it
costs you nothing, as you can deduct the 10 cents from first order.
It certainly will pay you.



Edward Bok's successful article in the January Cosmopolitan
on The Young Man in Business has been reprinted in a taste-
ful and handy booklet form at ten cents by The Curtis Publish-
ing Company, of Philadelphia. To this reprint Mr. Bok has added
some fourteen pages of editorial matter answering Three Uncer-
tain Young Men.



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Buffalo Medical ? Surgical Journal

Vol. XXXIII. MAY, 1894. No. 10.

©riginaf (^ommunieationA.



THE PHYSICIAN'S PERSONALITY AND ITS INFLUENCE.^

Bt J. C. THOMPSON, M. D., Buffalo, N. Y.

Physiological psychology is comparatively a new science. The
scientific study of the soul, and especially the use of physical
instruments of precision in the inyestigation of psychical attributes,
has only just begun. Consequently, the influence exerted by this
important part of our nature is, as yet, by many but faintly appre-
ciated and by many more even less understood.

It is not meant to include in this essay a consideration of the
physician's personality in relation to all psychical attributes, but
rather the influence of personality on certain elements of the soul,
represented by those subtle attributes and imponderable psychic
qualities commonly termed the emotions.

The emotions influence the mind and modify organic function
much oftener and more profoundly than superficial observation
would cause us to suspect. It is their action which will quicken the
heart-beats or arrest that vital organ in its function, influence the
Yaso-motors with the rapidity of thought so that the cheek will be
suffused in shame or blanched in fear, make a man bold to the
Yerge of rashness or a coward for conscience sake, cause the mother
to defend her young with her life and, from love, endure any pri-
vation and affliction for the object of her affection.

The emotional faculty of the soul influences the mind, and thus
becomes the basis or motive of physical activity to a greater extent
than most individuals may be willing to acknowledge. For
instance, in the case of children, it cannot be that their likes and
dislikes are the result of reasoning or carefully drawn conclusions,
because their intellectual faculties are as yet but in the dawn of



1. Read before the Roswell Park Medical Club, January 20, 1894.



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578 THOMPSON: THE PHYSICIAN's PKK80NAL1TY.

their development. Their standard, if standard it may be called^
is simply that of the instinctive action of their emotional nature,
the prodact of their psychical feeling, which, in a measure, like
instinct in the lower animals, is congenitally mature.

It has been said, and truly, << that adults " (and I add, with all
due reverence for the sex, including women,) " are but children
older grown." We have in this truism an easy explanation of
certain facts observed by you all, viz., the common existence among
adults of the most unreasonable likes and dislikes, incongruous
marriages, erratic love affairs, and the strange actions of people
usually denominated cranks, but who really are ordinary individu-
als misgoverned by their emotions instead of being governed by
reason.

Probably no class of men see more of this mal-attempt at sub-
jection of the human body than physicians. So true is this, that
it becomes a part of their duty to study and administer to a dis-
eased mind and its erratic emotions as often, perhaps, as they are
called upon to treat a disordered body. Indeed, so important a
rdle does the emotional faculty play in all physical affections that
often actual lesions, distinct objective and subjective symptoms,,
may be caused by this subtle agency. In these cases, where there
is apparently something substantially the matter, physicians are
most liable to err. In their hard-headed search after a tangible
cause for disordered function and actual suffering, they will pounce
upon some slight deviation from the physical norm, and treat it
externally, internally and eternally, without the slightest benefit to
the poor patient, unless some suggestion or operation can, through
a mental impression, rouse the nervous system to a more healthy
action.

A case which admirably illustrates this point was, in a late
journal, related by Goodell as follows :

Some years ago, a healthy lady, aged twenty- three, was engaged
to a gentleman whom she tenderly loved. The wedding day was
named, the clergyman was notified, and the invitations were sent out
Three days before the one fixed for the marriage there came a letter
from the man, breaking off the engagement. The blow to her love
and pride was, of course, great. She secluded herself in her room and
in a few days took to her bed with many symptoms of nerve-prostration,
of which dysuria and an irritable bladder were the most prominent.
For these vesical symptoms she was treated by the family physician
with external and internal electricity and with repeated flushings out of



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THOMPSON: THE PHYSICIAN's PEBSONALITY. -679

the bladder. Getting no better, but steadily worse, the next year she
fell into the hands of a specialist, who diagnosticated anteflexion of the
womb, cervical erosion, and fissure at the neck of the bladder. He
dilated the urethra, washed out the bladder and treated the womb
secundem artem. Still remaining an invalid, she consulted a third
physician six months later. He also dilated the urethra, examined the
bladder with an endoscope, washed it out repeatedly, applied electricity
to it by an internal electrode and gave cold douches. No improvement
following this treatment, she called in a fourth physician. He kept her
for several weeks under his care, dilated the urethra, and treated her
mainly with electricity, if I remember correctly, but of this fact I am
not absolutely sure. At any rate, she was not made a whit better, and
a fifth physician was summoned . He. without success, treated her for
anteversion of the womb and rectal ulcer. She now saw her sixth
physician. By this time her urethra had been dilated so frequently
that, in the examination, his finger entered the meatus urinarius, and,
not at first recognizing his mistake, he remarked upon the narrowness
of the vagina. He recommended the formation of a button-hole fistula
in the vrethra, but his advice was rejected. Four years after the
beginning of her disorder, she returned to the second physician whom
she had previously consulted. After treating her heroically for some
time, without the slightest benefit, he proposed the excision of the
bladder. This operation was refused, and she, one year later, drifted
back to her sixth physician. He first made a button-hole fistula in the
urethra. This failing to do any good, an artificial vesico-vaginal fis-
tula was next tried. No benefit accruing from this operation, her
ovaries, as a last resort, were removed, but peritonitis set in and she
died. Now, what is the true interpretation of this sad case? The
terrible shock to her pride and to her affections shattered her nervous
system, and she suffered more from a sore brain than from a sore blad-
der or from sore ovaries.

To go a step further, we are appalled to contemplate the extent
to which faith, hope and religion are dependent upon the exercise
and activity of the psychical faculty of emotion. It was the
erratic emotion of one mind, Peter the Hermit, which started the
crusades to rescue the Holy Sepulcber; in one of which, over
200,000 men, women and children participated, and all perished.
Today the same emotional impulse sends hordes of weary pilgrims,
by divers paths, to the sacred city of Mecca, where they imagine
atoning grace can alone be found. In our lands and time have we
not our Christian scientists and faith cares? And, alas! how many
pseado-holy creeds and opposite isms do the unthinking faithful
follow and worship; impelled by the same emotional impulse



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580 THOMPSON: THE PUYSICIAN's PEBSONALITT.

which sent the hordes of central Europe to miserably perish on the
burning sands of the desert.

Much more might be adduced to prove and illustrate the extent
of psychic influence over human action, but a time limit compels
haste to a consideration of the second phase of this subject: The
influence of the physician^s personality on this very important cause
of disease. In this field of our warfare with affliction we are left
without a tangible weapon. Our great standby (and I say it with
shame), drugs, are here entirely useless. The most potent, or the
most innocuous of them are equally unavailing in a full-fledged
case of nervous disease from emotional origin. We can, with knife
and pill, fight the demon month in and year out, till some poor
fool of a faith doctor comes along, and presto ! with one prayer,
the patient is well. Now, why did not the regular physician offer
up that prayer ? And that is just what he should have done ; not
in so many words, but by so impressing the patient with his
personality that there would have been no occasion for verbal
prayer.

Perhaps you ask, about this time, what is meant by the physi-
cian's personality ? Perhaps that is best answered by saying what it
is not. A famous connoisseur in stringed instruments and antiques
was asked wherein the renowned violins of Cremona, Stradivarius
and Stainer possessed their super-excellence. He replied :

It is not altogether in the well-selected and evenly-f^rained wood
of which they are constructed, although that has something to do with
it. It is not all in their incomparable shape and graceful swell,
although that has something to do with it. Not all in the size and
position of the openings or sound-holes, which also have their share
in creating excellency. Not all in the quality and evenness of the
varnish, but that, too, has its influence. It is all these and many other
points combined that make the matchless and unrivaled qualities of
the master violins.

So too, gentlemen, and I wish you to note this well, it is not
the physician's personal appearance which makes his personality.
It is not the charm of a well-modulated and resonant voice ; not
all in a graceful, hopeful walk and general carriage, although these
all have to do with it. It does not all consist in personal cleanli-
ness, good grooming and neatness of dress, but these are strong
factors in it. Not all in undue familiarity, nor unwarranted cold-
ness and austerity ; not in overslopping sympathy nor frigid indif-
ference, yet these qualities properly modified help much to create



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THOMPSON: THE PHYSICIAN's PEESONALITY. 681

that positive, but incomprehensible and imponderable something,
which for convenience and the lack of a better name we call
animal magnetism^ personal attraction, and the like.

It is that assemblage of qualities which creates in the minds of
patients and others, respect, and even reverence, hope, ambition,
faith, trustfulness ; that which leaves a remembrance of the doc-
tor's visit as a glorious, vivifying burst of sunshine, in the gloom
and darkness of suffering and distress. Time permitting, endless
well-authenticated cases might be cited, and countless authors
referred to, to prove the correctness of this statement that the
physician's personality acting on and through the patient's mind,
always does much and often more to restore health than anything
else. All possess this attribute, but in a varying degree — varying
within a wide range. It may be cultivated by a painstaking
practice of the many factors which serve to give it expression.
For instance, if a man is habitually careless in his attire and per-
sonal appearance, hasty, excitable, erratic, untidy, he may im-
prove all these. But he who by Nature is endowed with but a
modicum of this physical attribute, is at a great disadvantage in
the work of our guild.

In the cultivation of this power, remember that no counterfeit
of interest, no false note of sympathy will avail, or pass for the
genuine coin. Nowhere will more certainly be taken a correct
inventory of genuine worth than by the exercise of this extraordi-
nary sense in others ; arriving at conclusions not by reason or
logic, but by an intuition, true to fact as the needle to the pole.
The great field for the exercise of the physician's personality, is
with women, for in them the emotional nature is, in many in-
stances, developed to the dignity of a special sense. In men this
phase of the psychical is not so prominent, yet even here it plays
no insignificant part in the estimation of character. In conclusion^
the question arises, can we, as rational physicians, holding fast to
that which is good, and constantly casting about for new weapons
with which to combat disease, suffering and death, can we, I say,
ignore an agent so potent for good, without which the most
concentrated alkaloids may manifest their physiological action, but
fail to produce the desired therapeutical effect ?

Goodell, in the same article already quoted from, in trying
to impress the lesson learned from meddlesome gynecology, says :

So misleading, indeed, are the symptoms of a jaded brain or other
nerve strain, under the uterine guise in which they often masquerade,



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582 KRAUSS: THE LIFE AND WORK OF CHARCOT.

that when a jilted girl, a bereaved mother or a grieving wife consults
a physician, he, unless on his guard, will be more likely to minister to
a womb diseased than to a mind diseased. Such cases, even when
associated with actual uterine disease, are not bettered by a merely
local treatment, nor are medicines by themselves of much avail. What
they need are the incantations of the rest-cure — namely, Massage, elec-
tricity and strict seclusion.

Hope should be infused into every case, and above all, mark
you from Goodell, there should be imported into it the personality
of the physician.

For myself, the longer and closer I study and observe the
effect of the psychical over the physical, of the emotions over the
body, the greater is my respect for this vronderful power, and the
less am I inclined to doubt the remarkable tales of the utter sub-
jection of the body to the soul, even to the suspension of anima-
tion for an indefinite period.

Cultivate a personality that will rob the faith-cures of their
victims, and give to the healing art the true meed of praise for
which she ought to strive —namely, that of being in the van of all
true progress.

243 Dearborn Street.



THE LIFE AND WORK OF CHARCOT.

By WILLIAM C. KRAUSS, M. D., Buffalo, N. Y.

Os THE 16th of August, 1893, there flashed over the wires from
the Lac des Settons the report of the sudden death of Jean Martin
Charcot. Seldom has the death of any scientific man caused such
universal grief, not alone in France, but throughout the civilized
world wherever the medical sciences are taught and recognized.
The public as well as the medical press, in reporting the facts of
his life and work, spoke in but one tone of the magnitude of his
labors and of the irreparable loss to the profession.

Jean Martin Charcot was born in the City of Paris, of humble
but honest parents, November 29, 1825. His father, too poor to
give his three sons a collegiate education, summoned them to his
side one day and announced that the one who would stand highest
in his year's work could continue his education, while the second
could be a soldier and the third would have to become a coach>
maker, like himself. The contest over, ** Charcot" was sent to
Lycee St. Louis, then to the University of Paris, and in 1848 was



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KBAUSS: THE LIFE AND WOEK OF CHAECOT. 583

received as interne to the hospitals. Five years later he passed
his doctor examinations and wrote his thesis on nodosities of the



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 58 of 78)