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duction of germs, and not to their own injections. | charges' would do harm. On the contrary, Be that as it may, it will do no harm to give we were only fearful of trouble and danger Fritsch's account of the symptoms produced. when there was an arrest of the lochia too early. Both Küstner and Fritsch give cases. In Instead of visiting the patient every day for a Küstner's case, which subsequently proved fatal, couple of weeks, and having her disturbed by there were suddenly developed unconscious- the nurse with her syringe and quart of water ness, contraction of the pupils, rapid respiration twice to four times daily, we let her alone; (forty a minute), and the pulse one hundred and generally, if it was convenient, visited her the forty-three being weak and scarcely perceptible. next day, and again the second day after that, Clonic spasms seized the arms, the head was and there was an end of it. Some of them thrown backward, the jaws were clinched, the would be up and at work in two or three days, small muscles of the face were convulsed, and nearly all up on the ninth day, as the nurses a clammy sweat covered the patient. The so- felt that their skill as nurses would be doubted lution used was one of acid to twenty of water.' should the patient not be able to be up and All this when not needed. Fritsch records dressed' on that day. The times were fifty two cases in which carbolic acid solution was years ago? Yes! but women then were a good used, and in one salicylic acid solution. In deal as women are now-very much like their all the cases sudden collapse, unconsciousness, daughters and granddaughters whom I have atand extremely rapid pulse were observed. tended quite recently-and all of whom have These all recovered.' (Country Practitioner, done well without antiseptics. I have never used June, 1879.) Recently persons have reported one in all my life for a lying-in woman. I am as great success with non-medicated water as pleased with nurses who have a regard for with antiseptics. After all I have written about cleanliness, but I shall be far from allowing the need of such ministrations as are urged by them to inject even hot water into the womb our teachers of midwifery, I am impelled to directly after the placenta has been removed, ask whether the mortality of puerperal women and shall certainly forbid the patient being disin the country, and in private practice in cities, turbed every four hours afterward for several was not less before antiseptics were used than days. Since my last report there has not been now? Whether women's lives are not now put one case of puerperal fever in the six hundred in greater jeopardy, and their condition after de- and forty-nine labors attended by me. livery for a week or two made more uncomfortable now than before the rules referred to were put in practice? That is my belief. You say it makes you laugh to hear me put up my opinion against eminent obstetricians-even against professors. Laughing and sneering are light argu

ments.

What proof have I that these measures, these precautions, to secure the safety of puerperal women, are not absolutely essential? Only this: That in more than three thousand cases which I have attended-hundreds of them having these poor 'nusses' of whom good Sairey Gamp speaks, and who I know followed the old traditions which had come down to them from former times, and which forbade washing the patient for several days after the completion of labor-they nearly all did well; that septicæmia-blood poisoning-did not occur in one in many hundred cases, if ever even in a single one; that I did not force the after-birth from the womb, did not use injections of poisonous fluids as soon as I removed it, that the uterus and vagina were not washed out even with warm water, that no fear was felt that the 'dis

"While I was a student of medicine, in 1827, my preceptor sent me to attend a young woman in her first labor. I was loath to go, but he told me that I need do nothing until the child should be born, then tie the cord, after which, in fifteen or twenty minutes, the patient would have a pain, and I should aid in the removal of the after birth as directed by the gentle Professor James. In a hut on the banks of the Delaware River, four miles away from our office, I found my patient, who had been for a few hours suffering light, 'grinding pains.' After a few hours, in which they gradually grew stronger, the morning dawned; weary hours more passed, and the pains changed their character-became more propulsive, but even less worrying than the former ones, though so fierce in their expulsive efforts that I feared for her life. As the long and, to me, weary day was yielding to the coming night the child was born. The after-birth followed in due time, and I went home a wiser boy than ever before. It had been a weary, anxious day to me; but what a valuable experience was mine! I had

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THE AMERICAN RHINOLOGICAL ASSOCIATION

will hold its fourth annual meeting at St. Louis

on Wednesday, October 6, 1886.

THE ANNALS OF HYGIENE is a new monthly science and the preservation of health. It is journal, devoted to the fostering of preventive edited by Dr. Joseph F. Edwards, one of the most energetic of the sanitary workers and writers of Philadelphia, and is destined to be a potent factor in the dissemination of correct hygienic principles.

THE NEW YORK RECORD believes that when

men that will do honor to American medicine.

seen nature at her work from the beginning to | MEDICAL NEWS AND MISCELLANY. the end of the process—a work for which she seemed to be eminently qualified-a work now taken from her, but which I have seen her perform successfully, unaided, thousands of times. How gently and gradually she begins! A slight pain-so slight that the patient is scarcely certain that it really was one; after a time a more decided one, so on increasing gradually -dozens, scores of them, but with rests between, gradually preparing the way for the final expulsion of the child, the grinding pains' being as necessary as the expulsive ones. Time, too, was needed; the hard, square head had to be shaped by scores of pains, so that it could pass through the bones; the rigid, soft parts to be softened and dilated to allow it exit; and a flow of mucus established to lubricate the head and facilitate its passage. It would be well if every young practitioner could see his first case from the first pain through all the stages to the delivery of the placenta. It is my belief that there are very few graduates of the last twenty years who have ever seen a case of labor in all its stages. If early called, before the dilatation of the os uteri, they fancy it is a rigid os,' and they go to work to force it open; if called later, they rush at the patient with the forceps; if the child is born while they are present, they do not allow the mother a moment to rest and recuperate for the effort to expel the placenta, but pounce upon her and press the womb-not the after-birth-down to the bottom of the pelvis. They never, unless they disobey their teachers, allow the womb, by its contractions, to expel the placenta.

"After what I have said no one need be in doubt about my practice. I allow nature to do the work if she can without imperiling the patient, whose comfort and safety I promote and guard with constant care and vigilance."

AN ADMIRABLE SELECTION. Dr. A. M. Pollock, of Pittsburgh, Pa., has been appointed Secretary of the Section of Anatomy and Surgery of the American Medical Association for the present year.

MARCH (1886) NUMBERS OF THE MEDICAL BULLETIN WANTED.-Any subscriber sending a copy of this number to 1217 Filbert Street, Philadelphia, Pa., will have his subscription advanced two months for each number received by us.

the nine national (special) associations are brought together as a Congress of American Physicians and Surgeons, we will have a body of It adds, "The question of finding a time and place agreeable to all is a serious one. Yet it should not prove insuperable, and some of our associations might concede a little for a common good." Certainly! So far as we are concerned we would prefer to have it meet alternately in New York and Philadelphia, but will not object to Alaska, if the common good should demand it. -Weekly Medical Review.

The New York Medical Record has been so A POOR SPECIMEN OF PERSONAL JOURNALISM. clearly put in the wrong about the International Medical Congress, and feels so sore at being exposed as the organ of the New York clique who want to break down the barriers of legitimate medicine and admit consultations with all sorts of irregulars, that it takes refuge in the last and worst of all defenses-an unfounded personal attack on the senior editor of the Medical and Surgical Reporter.

This is the small-souled way in which Dr. Shrady satisfies his spleen :

"Our learned and scholarly contemporary, the Medical and Surgical Reporter, is a stalwart supporter of the Old Code. This is an excellent thing, and is another reason for admiring the sunset covers of our neighbor. We believe, ourselves, in all that is moral in the Old Code, and especially in the sections which say, 'it is also reprehensible for physicians to give certificates attesting the efficacy of patent or secret medicines, or in any way to promote the use of them.' Yet we observe, with sorrow, that there regularly appears in the daily papers an advertisement of a certain proprietary 'water,' which is the famous specific for the cure of Bright's disease,' and is indorsed by D. G. Brinton, M.D., of Philadelphia. We beg our erring contemporary to set a better example."

Now, as Dr. Shrady well knows, nothing is more common than for the names of persons of some prominence in the profession to be thus

used without their consent. At this writing, we have before us the advertisement of an unblushing gynecological "professor," who refers to Drs. Thomas and Lusk, of New York City, as his guarantors. To come out in a medical journal and accuse these gentlemen of connivance and approval of such reference would be disreputable and indecent in the person who did so. And we apply these adjectives to Dr. Shrady's action in the case quoted. We defy him to bring any evidence to show that the sellers of the proprietary water in question had any authority to use the name of the senior editor of this journal. They acknowledge in letters before us that they can produce none, and if Dr. Shrady had made the slightest inquiry before publishing his contemptible charge, he could have convinced himself of

this. It shows to what poor straits a defeated man of a certain character may be reduced in order to seek revenge when he can no longer expect success.-Medical and Surgical Reporter. THE PHILADELPHIA CORRESPONDENT OF THE BRITISH MEDICAL JOURNAL.-One of our most valuable foreign exchanges is the British Medical Journal, and we regret greatly to see the painfully labored effort made by its Philadelphia correspondent to influence English sentiment against the coming Congress.

We learn that the writer has recently located in the city of brotherly love (?), and, consequently, has some excuse for his ignorance, though he shows a surprising amount of information in some particulars. As the most of his letter is what we have heard again and again from certain quarters, the suspicion grows upon us that he has been "coached." It is a disgrace for any man to serve up second hand material in so pretentious a manner, at such a "feast of reason" as we generally find in the British Medical Journal. Such a caterer is better designed for a bottle washer.

We quote a few samples:

"It was from this class that the original Congress Committee made the appointments to office. They ignored locality altogether, and the cities of the East, being older medical centres, came in for a very large share of these appointments."

(Ignoring locality is good; ignoring truth isn't.) Once more:

"Austin Flint, Jr., Lewis Sayre, and Lewis Smith, of New York, are the only men of first rank to represent the East in the present Congress."

(Present! very. Only a year from next autumn, when the "present" Congress arrives, the B. M. J. correspondent will probably be late.)

We would mildly suggest that if the time comes that this Philadelphia recorder of exaggerated grievances shall be taught to exhibit a certain amount of appreciation of his new

countrymen and of truth, he will admit that even in his own adopted city there are "representative" men alive to the interests of the coming Congress, and working for its success-men whose names are household words where his name is unknown. Well may the question be asked, who is this who omits from the list of "men of first rank" such names, even in his own city, as Pancoast, Shoemaker, Brinton, Woodbury, and Atkinson?

Our only excuse for noticing this foreign adaptation of the "representative men" comedy is the fear that, appearing in such good company, the comedian's remarks might be taken for original observation, rather than for a poor imitation of unsuccessful actors.- Weekly Medical Review.

THE "TRUE INWARDNESS" OF THE THING.—

The question has often been repeated by seekers after truth, "What is the 'true inwardness' of the thing?" referring to the International Medical Congress difficulties. Various answers have been given, all possibly containing more or less of truth, but possibly lacking completeness. A Philadelphia correspondent of the British Medical Journal, June 12th, gives us an answer from the standpoint of the first organizers of the Congress. We quote his exact language:—

It has been a struggle of the West and South against the North and East, and the West and South have won." The writer admits the probability that the Congress will be more distinctively American than if conducted by the Original Committee. The first committee, he admits was "strongly tinctured with European methods." Thus it appears from this writer, that the first committee sought to hold the Congress according to European ideas, and so to centre the wisdom of the country in New York, Philadelphia, Boston, and Baltimore, with their attachés. It was perfectly plain that the leaders of these cities, not the North and East, were determined to import the despotic methods of the old despotisms of Europe into the management of the International Congress. It has really been a conflict of ideas. The men and other elements are and have been but the means by which these ideas have been wrought out. It was the old war cry of the Revolution, "There shall be no taxation without representation." The despotic spirits tinctured with European methods," simply forgot the lesson of American history. Had they re-read and learned the lessons of the establishment of the American Republic, they would never have entered into the scheme to place under despotic rule the American medical profession. There still remains enough of the spirit of "Bunker Hill" to thwart the well-laid plans of those tinctured with 'European methods." True it is that many able men are alienated because "democratic methods" have won in the conflicts for individual and pop

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ular liberty.

It was so in the American Revolution. It will ever be so. All the brains and culture cannot be gathered on one side. It can be fairly said that the great mass of the medical profession in every portion of the United States rejoice that "American" rather than "European" methods will govern the American management of the International Medical Congress. When we go to the Old World to attend Congresses organized according to the imperial plans, we will have the politeness to let our hosts follow their own imperial methods, and not seek to have them adopt our methods. But, on our own soil, when acting as host, we will be and act the part of American citizens, of independent men, courteous and hospitable in thought, word, and deed.

It has, however, laid bare the fact that imperial ideas control some members of the American medical profession; that many who have received in whole or in part their education in the Old World, have come back to try and play king over the medical profession in this country. But it has also made evident that this element is in the minority, and we may still point to the American medical profession with pride in its loyalty to its country and its country's institutions, its country's methods of government-in a word, to its country's liberty. All medical men who love their country more than their own personal schemes, will be found to work for the success of the coming Congress.-American Lancet.

But by what right can a hundred medical men or any other special number associate themselves together and call themselves " The Association of American Physicians?" If they had called it "An Association of American Physicians," associated for a specific purpose, and limited to that object, it would not look so badly and no especial criticism or objection could be made against it, though exclusiveism is against the spirit of science and its pursuit. Any one has a right to be heard in prosecuting any of its branches, and no one can dictate to, or obstruct him in its development and promulgation. Knowledge is too widespread and its votaries are too numerous and universal to be hindered on their way in this period of the nineteenth century. But as this new association places itself before the public I do not hesitate to say that its projection is an insult to the rest of the medical profession in the United States, whose standing in every respect equals its members; and besides this, the character and intentions of this new association show a tendency to form a class relation which is altogether foreign to the intent and meaning of the government under which we live.

But there is another aspect of the matter which comes home to the heart of every physician who regards the reputation of his country, in at least a practical point of view, as of paramount importance, and that is the strong contrast that will be attempted to be made between this new organization and the American Medical Association in the eyes of the medical world, especially in the eyes of our foreign medical brethren who may favor us with a visit at the International Medical Congress, and those also who decline to do so, because of the assumed exclusiveness which it proposes to set up. Is the American Medical Association and the medical profession to be degraded by a set of men in its own ranks, in a profession which teaches and has always taught fraternity of feeling, and goodwill towards its fellows? Or do they intend to degrade themselves and their co-workers necessarily by breaking up the profession into little fragments, thereby producing such discord that the way may be opened to let in our enemies to

THE ASSOCIATION OF AMERICAN PHYSICIANS. -The readers of The Journal will doubtless observe many familiar names in reading the proceedings of the first meeting of "The Association of American Physicians," some who took an active part with the Original Committee of Seven of the American Medical Association in regard to the International Medical Congress to meet in this country in 1887, and some who took an active part against the committee when it was enlarged. It may be asked, what means this multiplication of medical associations, and what is the necessity for them? In this case the answer is obvious. In reply I would answer the last question first-that there is apparently no necessity for them; and the reply to the first is, it means a bold and aggressive attack. The animus of this new association is open and ap-destroy the traditions of medicine handed down parent, for it is evidently organized ulteriorly in opposition to the American Medical Association, and is intended eventually, with kindred associations the Surgical, the Gynecological, Laryngological, Ophthalmological, etc., to absorb that association or destroy it, or its influence for usefulness, framing their organization in such a way as to keep out all who may be obnoxious to it in any way, and constituting itself the representative body of the medical profession in the United States. This seems to be the end in view.

to us through so many centuries? Can they be satisfied to sever the chain that has joined the far past with the present, and destroy the line and pathway by which medicine has reached its present eminence? And yet such seems to be the very object in view, and the animus of such organizations.

The day will come when such as seek to destroy the great temple of medicine in such ways-by caprice and whims and spitefulnesswill wofully repent it, will abhor themselves

human race.

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sooner or later and be ashamed of their asso- the last so-called national organization just comciates who, with themselves, lifted a hand or pleted. . . A few months since a dozen or voice to aid in such nefarious work.-PRACTI- possibly twenty prominent physicians in PhilaTIONER, Journal of American Med. Association. | delphia and New York held a conference, and EXCLUSIVEISM AND SPECIALISM IN MEDICAL decided to form what was to be called an AssoORGANIZATIONS. That principle or feeling which ciation of American Physicians and Pathologists, prompts one man or class of men to assume suwhich it was supposed would complete the circle periority in some directions over his fellows, and of special organizations known to the profession. therefore to assert exclusiveness in association, They selected a sufficient number, chiefly from rank, or privilege, is probably as old as the the cities of Philadelphia, New York, and Boston, In matters of State or politics, it to make seventy-four in all, effected a temporary underlies all forms of aristocracy; it prompts the organization and agreed to hold their first regular religionist to say to his neighbor "stand thou meeting in Washington, D. C., June 17, 1886. there, I am holier than thou;" and it does not That meeting was held with the results to be seen. fail in prompting men of science even to think they . . Fifty-six of the seventy-four selected have attained an eminence that lifts them so far were in attendance. A constitution for permaabove all others cultivating the same fields of nent organization was adopted, limiting the numhuman knowledge, that they must needs have ber of members of the association to one hunexclusive social organizations for themselves. dred, and the honorary members to twenty-five; The strong influence of this psychological making it necessary that proposed new members principle has been well illustrated in the progress must be nominated by two regular members, reof medical organizations in this country. Al- ferred to the Board of Censors, and elected at a though every State Medical Society in this country subsequent meeting, and, as a part of the qualifihas shown a remarkable disposition to give the cations, it is required that the proposed members fullest opportunity to those cultivating special must have accomplished some scientific or prodepartments of medical science or practice to fessional work of importance. Another provision present reports or papers regarding their own fixes the permanent place of meeting in Washspecial departments at any regular meeting; and ington, D. C., the time, the month of June each although the American Medical Association, as year, and the name of the organization "The Asfast as new specialties were developed, added sociation of American Physicians."

Here are nominally seventy-four, but actually fifty-six presumably eminent members of the profession, forty-two of whom are from the cities of Philadelphia, New York, and Boston, forming an association avowedly of so high an order that of the forty thousand American physicians (not counting surgeons and other specialists) only one hundred can expect to be members at one time, and carefully guarding the door of entrance for the future, and yet so modest, that they adopt a name directly calculated to create the impression everywhere that this new society is simply an association of American physicians and nothing more. Surely this is a serious mistake. There should be something in the name to indicate the distinctively eminent character of the membership. Perhaps the most appropriate title would be" The Association of Eminent American Physicians." But if the extraordinarily frequent use of the word "eminent" in two or three leading medical journals in New York and Philadelphia and their echoes in Canada and elsewhere, during the past year, has rendered that word too monotonous, then follow the News, and call it "The Association of American Clinicians and Pathologists," or even "The Association of Medical Ex

new sections for the accommodation of their votaries, the same spirit of exclusiveism soon prompted each to seek an organization for itself; not for the purpose, as might be supposed, of accommodating all practising a certain specialty with more time and freedom of discussion, but directly for the purpose of including in its membership only those who had already gained reputation, that they might, on the one hand, avoid the necessity of entering into discussions on a level with the common doctor; and, on the other, to more effectually bar the progress of each new competitor in the same field. Hence, each new special organization is formed by a few of kindred spirit meeting and selecting those they desire for comrades, inviting them to a subsequent meeting, when a constitution and by-laws are adopted, with such provisions that all subsequent additions must be made by the nomination and election of those already members, or even by a small council or committee of censors. Consequently, these so-called American Ophthalmological, Otological, Gynecological Societies, etc., instead of being composed of all the American ophthalmologists, otologists, etc., who might choose to join them, or a ratio of delegates chosen to represent all, are close corporations to be in-perts;" something, at least, that will surely precreased or perpetuated only by the gracious favor of the individual corporators.

vent so distinguished a body from being confounded with the great body of American pracThe whole process is admirably illustrated by titioners. We trust, when the members come

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