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The American practitioner online

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Co. 1898.

Coming from so eminent a source as the author, a work of this character
must be most welcome to any one aspiring to be a thorough surgeon. It
is quite exhaustive of the subject, and written and illustrated in the
most pleasing manner. The book begins with a concise history of the
development of renal surgery, after which follows a lucid description of
every form of wound or disease to which the kidneys and ureters are sub-
ject requiring surgical treatment.

A brief abstract of two hundred and sixty-seven operations performed
by the author on the kidney is arranged in tabular form. A number of
cases are also reported in which operations have been done for calculous
anuria, a subject about which the author thinks too little is known.

D. T. s.

A Text-Book of Materia Medica, Therapeutics, and Pharmacology. By George
Prank Butler, Ph. G., M. D., Professor of Materia Medica and Clinical Medicine
in the College of Physicians and Surgeons, Medical Department of the University
of Illinois, etc. Second edition. Revised. 860 pp. Price, cloth, $4.00 net; sheep
or half morocco, $5.00 net.

Unless an author were limited to his own personal experience, there
can not be expected a great difference among works on materia medica.
except in the style of writing and presenting the subject. The major por-
tion of all such works are compilations. In such parts of this work as are
so made up we must simply give the qualification that comes from saying
that it is in line with current work.

It is almost as hard to surrender medical dogma and custom as it is
religious, and leaving one fetich, it is much easier to swing into another
than to take one's stand in the open forum of reason.

Men who had fought homeopathy with the greatest bitterness will
jump at some new fad and outdo the most extreme of them. This is so in



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J 1 2 The American Practitioner and News.

great degree with organotherapy and serum treatment. It is here that in
its claims this book seems to be scarcely ahead of some commercial medical
journals. In its arrangement and style it is excellent, and the letter-press
could not be other than well done, coming from the house of W. B.
Saunders. d. t. s.

Accident and Injury : Their Relations to Diseases of the Nervous System. By

Pierce Bailey, A. M., M. D., Attending Physician to the Department of Correc-
tion and to the Alms House and Incurable Hospitals, etc. 430 pp. New York :
D. Appleton & Co. 1898.

If there is a field where a new book has been needed, it is exactly that
occupied by this work. The medical mind seems wholly unsettled as to the
nature of the nervous diseases that can be brought on by injuries unac-
companied by gross lesion.

Probably one trouble has been the standpoint of the diflFerent classes
of physicians engaged in the discussions. Railroad surgeons, carrying out
the rule of human nature, have hardly been able to see any thing but fancy
or malingering in these cases, and their opponents, driven almost to resent-
ment by this seeming partisanship, have probably veered to the opposite
extreme.

Fortunately in this work it is not opinions that are given but authentic
cases, and that with evidently the most perfect freedom from bias. We
most heartily commend the work to every physician who is likely to meet
with cases of the kind, or likely to be called on to testify in them, and this
leaves out few indeed. d. t. s.

Thirteenth Annual Report of the 5Ute Board of Health and Vital Statistics of
the Commonwealth of Pennsylvania. Two volumes. 11 10 pp. William Stan-
ley Ray, State Printer of Pennsylvania. 1898.

This is a more than usually interesting report from the able board of
health of Pennsylvania, a board that would do honor to any country what-
ever. It gives every thing that could easily be conceived of as relating in
any important way to the public health, with an interesting report on vital
statistics.

Not the least attractive part is that relating to reservoirs and their
dams. Descriptions are given of nearly all the important dams in the
world with illustrations and in many cases their history. d. t. s.

Transactions of the American Orthopedic Association. Twelfth Session. Held at
Boston, Mass., May 17, 18, and 19, 1898. Volume xi. 467 pp. Philadelphia: Pub-
lished by the Association. 1898.

The transactions of the Society at the last meeting will sustain and
even advance the high esteem in which it is held in every civilized country.
Orthopedics is the one branch in surgery in which America is distinctly
in the lead. The authority of American orthopedists is everywhere de-
ferred to, and in the list of the members of this association are the workers
and leaders in this department. d. t. s.



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The American Practitioner and News



NEC TENUI PENNA."



Vol. 27. FEBRUARY 1, 1899. No. 8.



H. A. COTTELL, M. D., Editor.



A Journal of Medicine and Surgery, published on the first and fifteenth of each
month. Price, $a per year, postage paid.

This journal is devoted solely to the advancement of medical science and the promotion of the
interests of the whole profession. Essays, reports of cases, and correspondence upon subjects of pro-
fessional interest are solicited. The editor is not responsible for the views of contributors.

Books for review, and all communications relating to the columns of the journal, should be
addressed to the Editor of Thb American PRAcrmoNER and News, Louisville, Ky.

Subscriptions and advertisements received, specimen copies and bound volumes for sale by the
undersisrned, to whom remittances may be sent by postal money order, bank check, or registered
letter. Address jOHN P. MORTON & COMPANY, Lonisville, Ky.

CHRISTIAN SCIENCE.



The death in Omaha on the 27th of December, 1898, of a woman
who was a Christian scientist, and who, though the subject of an exten-
sive burn caused by an explosion of boiling turpentine, was allowed to
suffer for three days without medical ministration, gives the case of
faith versus science a new hearing at bar of public opinion.

The absurdity of such metaphysics as denies the existence of matter
and the laws which condition it, holding that all diseases and injuries
** are figments of the imagination which will disappear under the power
of the mind,'' has proved insufficient to dissipate the charm wherewith
a considerable portion of the public mind is enthralled, and Christian
Science has not only been steadily growing in force and influence
during the last decade as a healing fad, but has actually become a new
religion with societies, church edifices, pulpits, and order of worship
which rival the ancient cults of the world.

To demonstrate the utter absurdity of its major premise (which a
child might do) and to show that the honest advocates of such a doc-
trine are insane (which it does not take an alienist to prove) is all
foreign to the purpose. The leaven is quick, and is rapidly leavening
a large lump in modern society, and nothing short of such fanat-
ical cruelty as the Omaha case exhibits and its suppression by the
strong arm of the law can bring these deluded psychopaths to their

senses, if even such measures will avail.

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114 1 he American Practitioner and News.

The answer of science to these dreamers is full and conclusive — it
is: **Show your faith by your works."

Dr. Charles A. L. Reed, of Cincinnati, adopts this method in dealing
with Mary Baker G. Eddy, who, in an article published in the New York
Sun, " with characteristic bravado ** asserts the tenets of Christian
Science, claims miraculous results in healing, and "challenges the
world to prove a negative."

Dr. Reed says :

She should remember that even people who are not the victims of vaga-
ries such as hers, and whose everyday utterances do not toy so confusingly
with the eternal verities as do hers — even such people are expected to bear
the burden of proof when they seek to tax credulity. I therefore demand
the proof of this high priestess, and that the issue may be clearly drawn I
shall take up a few of her declarations seriatim :

Mrs. Eddy says: "I healed consumption in its last stages . . . the
lungs being mostly consumed."

I denounce this declaration as false, and challenge its substantiation
by competent and disinterested testimony.

Mrs. Eddy says : *' I healed carious bones that could be dented with
the finger."

I denounce this declaration as false, and challenge its substantiation by
competent and disinterested testimony.

Mrs. Eddy says : " I have healed at one visit a cancer that had so eaten
the flesh of the neck as to expose the jugular vein so that it stood out like
a cord."

I denounce this declaration as false, and challenge its substantiation
by competent and disinterested testimony.

When Mrs. Eddy speaks of "malignant tubercular diphtheria'* as
among her cures, she, by her own phraseology, proclaims her utter ignor-
ance of one of the most dangerous of diseases, now nearly bereft of its
horrors through the beneficence of modern medical science — a disease
chiefly of defenseless childhood that she and her fanatical followers would
sacrifice upon the altar of their tragic egoism.

But if Mrs. Eddy has done all of these wonders, she can do them again.
If she is devoted to humanity in the altruistic fashion that she proclaims,
she will not hesitate to demonstrate her alleged "science" under circum-
stances that will give it the widest possible influence. To this end, if she
will come to Cincinnati I will place at her disposal cases of *' consump-
tion," cases of ** cancer," and cases of ** carious bones." She shall have
them under observation for such time as she shall determine, and she shall
dictate all details of their management. They shall, however, be under
the daily observation of a competent and disinterested person of my choice,
but who shall have no voice in their management and who shall visit them



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The American Practitioner and News, 115

only in her presence. If she, by her Christian Science, shall cure any one
of them I shall proclaim her omnipotence from the housetops, and if she
shall cure all or even half of them I shall cheerfully crawl on my hands and
knees that I may but touch the hem of her — walking dress. If it will be
more to the convenience of Mrs. Eddy and she is not disposed to honor us
with a visit, I shall take pleasure in endeavoring, through my friends, to
make a similar arrangement for her at Bellevue or some other New York
hospital. If Mrs. Eddy will accept this challenge and cure one or more of
these cases she will thereby demonstrate that she may be something more
than either a conscienceless speculator on human credulity or an unfortu-
nate victim of egoistic alienation.



Hotes anb £iueries.



Dropfoot Following Alcoholic Paralysis. — Fernand Gaucher
draws attention (Thise de Paris, 1898) to the great importance of prevent-
ing permanent deformity in cases of alcoholic paralysis. The writer points
out that in the large majority of cases permanent dropfoot and other
deformities are due to the want of suflScient care on the part of the medical
attendant. In all cases of alcoholic paralysis the antero-external group of
muscles of the leg are early affected, allowing of dropfoot with internal rota-
tion ; consequently, if the patient is lying in bed, pressure of the bed cover-
ings tends to aggravate this pernicious position. It is important, therefore,
to correct this deformity by means of suitable apparatus. This, on the other
hand, requires considerable caution, as the low trophic condition of the tis-
sues is liable to result in pressure lesions, should any of the different forms
of rigid apparatus be employed. The writer therefore suggests using a sim-
ple wooden stand, thickly padded so as to maintain the foot at right angles
to the leg. The next point is to obviate the pressure on the limbs by using
a cradle. During the earlier part of the disease this' should suffice, but so
soon as the patient is able to bear it, passive movements and massage should
be regularly employed, with a view to keeping the mobility of the joints in
a healthy condition, and as quickly as possible to promote the nutrition of
the wasted muscles. From an early period in the case the exhibition of
galvanic currents is necessary. To this may be added the faradic so soon
as the patient can stand it. In those cases where dropfoot becomes per-
manent, there is generally chronic myositis, and it is to prevent this condi-
tion that our best efforts should be employed. Sulphur baths, hot-air baths,
and other methods have often been of extremely beneficial influence in
these cases. — British Medical Journal,

'I^E Lancet's Critical and Analytical Inquiry Into Quacks
AND Abortion: The Methods of Quacks.— The London Lancet has
done good work in exposing the character of certain adveitisements too



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1 16 The American Practitioner and News.

common in the newspapers and from which the religious papers are not al-
ways free, in which cures are guaranteed, on receipt of payment, for
"obstructions," "irregularities," and "suppressions," these advertisements
being designed to attract women in trouble. It is clearly brought out that
the amenorrhea for which remedies are sought generally means preg-
nancy. Of 183 patients who had amenorrhea, and who presented them-
selves at the out-patient departments of the large London hospitals, 156
were pregnant, and twelve were young girls at puberty in whom the condi-
tion of pregnancy was out of the question, so that of the 171 who might
have been pregnant, 156, or 96.5 per cent, were so. Of the remaining fifteen
cases, one patient, age twenty-seven years, single, had primary amenorrhea ;
seven patients ( four married and three single ) had definite anemia ; one
patient, single, had had pelvic peritonitis two years before and had seen
nothing since; one patient, married, had approaching menopause; one
patient, married, had fits, and had seen nothing for seven years,. and one
patient, married, had seen nothing since before marriage, some years ago.
This leaves three patients, two who were married and one who was single,
in whom there was no definite cause for the amenorrhea. The Lancet
writer, after stating that in none of these cases would the administration of
emmenagogues have done any good, concludes: (i) Amenorrhea or irregu-
larity of the periods is common about puberty and at approaching men-
opause ; (2) in otherwise healthy married or single women amenorrhea
in the great majority of cases is undoubtedly due to pregnancy ; (3) where
this is not the case, with very few exceptions (three out of the 183 cases),
the condition of the patient or the circumstances under which the periods
fail to appear are such as to render unlikely the possibility of pregnancy
being the cause. He further reasons that " seeing that the majority of
instances in which healthy married women miss a period are cases of com-
mencing pregnancy, it is obvious that such a condition can not be and is not,
as a rule, productive of the ills ascribed to it by the venders of quack nos-
trums ; while equally, as a rule, to attempt to bring on menstruation in such
cases is to attempt a criminal abortion."

The occurrence of amenorrhea in cases of anemia or other debili-
tating diseases, such as phthisis, is beneficial to the patient by avoiding any
loss of blood, and is a provision of nature to assist in arresting the progress
of the diseases causing the condition.

The Lancet's exposure of the knavery of the advertisements is timely.
There is a legion of shameless shysters — of whom we have some on this
side of the water — who subsidize the newspapers and parade with
unblushing impudence their " never-failing " specifics, and who have doubt-
less too long been let severely alone by the medical profession and by the
police. The analysis made by the Lancet's chemist of many of these nos-
trums shows them to be composed of such simple and well-known ingredi-
ents as sulphate of iron, aloes, colocynth, and Glauber salt ; in some, traces
of rue, apiol, and savin were detected. One of the most popular of these



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The American Practitioner and News. 117

nostrums contained aloes, iron, and borax. It has been asked whether any
real harm has ever been received by taking these " female pills," and we are
referred to the evidence given at a certain coroner's inquest lately, to the
effect that a woman had been poisoned by large doses of aloes in some
emmenagogue pills swallowed to produce abortion. Ordinarily, however,
the patent-medicine vender takes care that his medicine shall be innocuous
in any dose. He well knows that his nostrums will sell in the ratio of the
way they are advertised and the lies that are flaunted about them before the
public, not in the ratio of their merit. Quacks often evince in the wording
of their advertisements a genius worthy of a better cause, as one can read-
ily see who reads the numerous nostrum advertisements which the Lancet
has published, giving the proprietors a notoriety free of charge. The cred-
ulous are duped with a statement that the testimonials are sworn to on oath
as genuine !

We can not forbear in this connection to make a diversion from the sub-
ject of the Lancet's special mission, in order to notice one of the Rev. Dr.
Talmage's proteges, whose advertisement occupies a whole half-page of the
Christian Herald ; we allude to " Dr. Blosser, the well-known minister of
the gospel and medical specialist," who is the ** originator" of **the only
catarrh cure in the world," and whose testimonials from " eminent phy-
sicians," " ministers of the gospel," etc., are read by the " hundred thousand
readers" of that religious journal every week. He deserves and shall
receive from us a free advertisement. — Boston Medical and Surgical Journal.

American Medical Association. — At the June meeting of the
American Medical Association, in addition to their regular programmes,
the Section on Ophthalmology and that of Laryngology and Otology will
devote the morning of the second day, June 7th, to a joint meeting, under
the Chairmanship of Dr. Casey A. Wood, of Chicago, and of Dr. Emil
Mayer, of New York. The subject for discussion will be : ** The Relation
of Ocular Diseases to Affections of the Nose and Neighboring Cavities."
Four papers are to be read on this subject, by invitation, as follows : Dr.
Charles Stedman Bull, of New York, on "Some Points in the Symptoma-
tology, Pathology, and Treatment of the Sinuses Adjacent and Accessory to
the Orbit " ; Dr. D. Bryson Delavan, of New York, on '* Nasal Stenoses in
their Relation to Ocular Disturbances " ; Dr. Joseph A. White, of Rich-
mond, Va., on " Eye Troubles Attributable to Naso-pharyngeal and Aural
Disturbances" ; Dr. J. H. Bryan, of Washington, D. C, on ** Diseases of the
Accessory Sinuses in their Relation to the Eye." General discussion on
the main question.

Gunshot Injuries of the Spine. — Prewitt (Annals of Surgery,
August) has tabulated 49 cases of gunshot injuries of the spine treated
since the beginning of the aseptic era. Of this number, 24, including a case
treated by the author, were subjected to operation, with 11 recoveries and



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1 18 The American Practitioner and News.

13 deaths; 25 were not operated upon, with 8 recoveries and 17 deaths.
The mortality after operation was about 55 per cent in the cervical and 66
per cent in the dorsal region. Of three operations for injury to the lumbar
portion, each was successful. The author has arrived at the following con-
clusions: (i) It is the duty of the surgeon to advise immediate operation in
all cases of gunshot wounds of the spine, provided the wound has involved
the posterior or lateral parts of the spine at an accessible region, unless the
condition of the patient is such as to indicate clarly that he is hopelessly
stricken ; (2) to wait to see whether nature is competent to restore the dam-
age is to wait until irreparable damage has been done in many cases, as, for
instance, rapid degenerative changes, meningitis, and myelitis. The delay
permits of the continuance of conditions, the removal of which is the pur-
pose of the operation ; (3) the presence of complications due to penetration
of the great cavities and injury of their viscera will influence the question of
operation, but not necessarily forbid it. — British Medical JournaL

The Hospital Patient's Right to Secrecy.— Dr. Edmund Andrews
(Journal of the American Medical Association, January 7th) points out a
much-neglected fact that the purposes of clinical instruction and hospital
administration apart, and these are by implication waived by the patient on
becoming an inmate of a hospital, the hospital patient has as much right to
secrecy in regard to his affairs as the private patient. For instance, says
Dr. Andrews, a patient in a hospital may have a claim, or perhaps a suit
against a railway company for injuries received on its line. The hospital
or its oflScers may not furnish to the railway company, or to any outside
parties, any information about the injuries without the patient's consent.
A patient may have syphilis, and the disease may be shown and fully
explained to the clinical class, but it must not be divulged to his inquiring
neighbors and friends, unless he desires it, which he probably does not.
An agent of an accident insurance company often inquires about the con-
dition of an injured patron, but it is not proper to inform him, unless
the patient wishes it, and so of all other cases. The personal honor and
the legal obligation of the surgeon are pledged to preserve the patient's
secrets, except where necessarily waived for hospital purposes. The grow-
ing tendency to make sensational paragraphs for newspaper purposes out
of the ailments of hospital patients renders this warning specially apposite,
for it may be reasonably assumed that the information could not, in many
instances at least, have been obtained without a grave dereliction of duty
on the part of some of the hospital staff— doctors, nurses, students, or
attendants — all of whom are in honor equally bound.— iVea; York Medical
Journal.

The Other Kidney in Contemplated Nephrectomy.— Edebohls
(Annals of Surgery, April, 1898,) insists, on the strength of long experience,
that before extirpation of the kidney a knowledge of the presence and con-



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The American Practitioner and News. 119

dition of its fellow becomes of paramount importance. The aids to such
knowledge are examination of the urine, palpation of the kidney, cystoscopy,
catheterization of the ureters, skiagraphy, the fluoroscope, and lastly — not
first — exploratory incision. The presence of a second kidney is determin-
able by most of these aids, but Edebohls admits that none except incision
can in all cases give completely satisfying information regarding the exact
condition of the other kidney. He further warns us that in cases of pyrexia
and tuberculosis of vesical or of unilateral renal origin, catheterization of
the ureters involves the risks of infection of a previously healthy ureter and
kidney, and should be avoided. Though averse to haste in making an
exploratory incision, Edebohls does not scruple when in doubt to make a
lumbar incision, to deliver through it and then examine the fellow of the
kidney, previous to completing an otherwise indicated nephrectomy. For
modem surgery, he declares, with improved methods and technique, has
rendered lumbar exploratory incision a safe and expeditious procedure, the
most and generally the only reliable one for determining the exact condi-
tion of the other kidney. — British Medical JoumaL

Public Baths and Gymnasia. — Mayor Quincy, of Boston, delivered
an illustrated lecture on Public Baths and Gymnasia before the People's
Institute at Cooper Union, New York City, on January 23d. He argued
that it was better to construct baths and gymnasia with money from the
public treasury than to depend for them on private philanthropy, and that
the providing of baths was just as essential a function of a municipality as
the providing of schools. In the education of children physical training
should be as carefully looked after as mental culture, and public schools, he
thought, should be equipped with both baths and gymnasia. After stating
that both Germany and England were still ahead of this country in the mat-
ter of public baths, he gave an interesting account of the development and



Online LibraryUniversidad de Buenos Aires. Facultad de Derecho yThe American practitioner → online text (page 14 of 109)