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CARL E. BLACK.

7

turbance; there was entire absence of pain in
the stomach, and there was
Even the blood which the patient brought

be described as having been “choked Issued Tenth and Twenty-Fifth of Every Month. up;" he coined the expression bimself, be

Under the Editorial Direction of cause he objected to the term vomited."

FRANK PARSONS NORBURY, As to Dr. Deutsch's suggestion that the

THOS. A. HOPKINS, tin might have been swallowed in infancy, it

With the following staff of Department Editors should be remembered that the canning in

0. E. LADEMANN, Internal Medicine. dustry is comparatively recent. The point

JOHN MCHALE DEAN, Surgery.

R. B. H. GRADWOHL, Pathology and Bacteriology. which the case impressed was that one should W. H. VOGT, Obstetrics and Gynecology.

WALDEMAR FISCHER, Ophthalmology. continue to study every possible way wher

A. LEVY, Pediatrics. ever the diagnosis is not entirely satisfactory.

W. T. HIRSCHI, Therapeutics.
A. F. KOETTER, Otology.

HERMAN STOLTE, Laryngology and Rhinology.
Dr. Charles H. Shattinger.-Dr. Mardorf's F. P. NORBURY, Nervous and Mental Diseases.

T. A. HOPKINS, Genito-Urinary Diseases. remark that absence of pain in the stomach ROBERT H. DAVIS, Dermatology. spoke against ulcer recalls a case that I had very recently. The man did not vomit blood, he would lean over the side of the bed and

EDITORIAL simply let it run. This lasted for hours. He would drink water or beer to relieve his

THE endeavor by limitation of membership thirst and that liquid ran out also. He had

to insure fellowship with the scientifically no pain in the stomach at all. He simply

elect has characterized had hemorrhage, but I know he bad an ulcer,

a number of American for he died and I made the post-mortem. I do Scientific

medical organizations, agree, however, that in the vast majority of Bodies with

and has been productive cases you would expect pain in stomach in Limited

of adverse criticism, not ulcer. I agree with Dr. Mardorf that we owe Membership.

alone among outsiders, a great deal of gratitude to Dr. Cook for the

but even

within the report of this case and his very frank state

ranks. The editor of the Lancet-Clinic has ments. I hope the doctor will not relinquish admirably presented this matter as it appears this standpoint as he grows older.

to us, and we take pleasure in giving our Dr. Gradwohl.-I would second Dr. Mar readers the editorial. He says: dorf in his remarks relative to Dr. Cook's "It is rather remarkable that in democratic courage. I have followed up many cases at America, wbere all men are born free and autopsy and found the conditions far removed equal, and where there is no nobility and from the diagnosis, but it has been seldom aristocracy, and class distinctions have no my lot to hear a man report bis autopsy find. existence, exclusive medical societies have ings so different from what we might have flourished and reached a degree of developexpected.

ment greater than in any other country on Dr. Cook, in closing:- I must acknowledge surprising as this may appear

, when applied

.

the face of the earth. Paradoxical and that the case looks quite a little different tban it did before the post-mortem. The diagno.

to any sect, profession or class of individsis of caroinoma still seems to me the most

uals, it is still more so in the profession of probable of those considered, however I do

medicine. Medical societies should be or. not care to enter into a justificaticn of my

ganized solely for the advancement of sciconclusion, as it has no pertinent bearing on

ence and the love of truth, and they the points I wished to emphasize. I am sorry

should stand with outstretcbed arms to wel. an esopbagoscope was not at hand; the

come all who are willing to receive and ready laryngoscope was of course unable to reveal

to impart information and knowledge. It

is difficult to conceive how societies of this a body as far down the esophagus as this one.

character have been permitted to continue an

apparently successful course for such a long Over a million circulars of warning have period of time. Societies which are unnecbeen distributed during the past two years by essarily exclusive are necessarily narrow, pre: the German Society for the Prevention of judiced and bigoted, and their work will Venereal Disease. The campaign has been eventually partake of the same character. Advery thorough, physicians, dispensaries, and ditions to the societies are dominated by the the army being the agencies through which same influences, and new members are qual. the distributions were effected. It is the pur ified by personal rather than scientific attain. pose of the society to issue a similar circular ments. These societies, like all organizato women and girls during the coming year. tions in general, are made up of the good, bad

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and indifferent, and the close affiliation and more liberal, broader and correspondingly exclusion impart to mediocrity a false, ficti. greater special societies. tious value and an intolerable air of self-sat. isfaction.

The large attendance at the recent meeting "There can be no question that these small,

of tbe American Medical Association is a non-representative societies have their short

matter of satisfaction to comings and exert unfavorable and pernicious

the officers of the asso. influences, and that their existence is neces Missourians sarily short-lived. The bigb pedestal upon

ciation, and to those at the Boston

who were so fortunate wbich they place themselves and the aristo Meeting.

as to be present. In a cratic air which they boldly assume is a slur and insult to the rank and file, to wbiob they 4800, Missouri is credited with 73.

registration of about

Our properly belong. Left to themselves they will probably die their just, natural deatb.

urban delegations were usually large, while Their weakness is readily apparent, and their

country representation was surprisingly small.

The following Missouri physicians attended : undoing is a matter of easy accomplishment "The American Urological Association

From St. Louis Drs. N. Allison, J. H.

Amerland, J. M. Ball, W. Bartlett, M. A. affords a striking example of how a society

Bliss, R. D. Carman, M. B. Clopton, W. S. founded upon general, non-exclusive, liberal lines will Hourish and prosper and completely Deutsch, W. L. Diokerson, C. H. Dixon, W.

B. Dorsett, G. S. Drake, D. Forster, F. R. eclipse a society conducted along the older lines. For a great many years a small exclu- Fry, W. W. Graves, Jno. Green, Jr., T. A. sive body of medical men, composed mostly Hopkins, C. H. Hughes, A. R. Kieffer

, B.

Lewis, A. H. Meisenbach, C. V. Mosby, H. of general surgeons and genito-urinary spe

G. Mudd, J. S. Myer, C. D. Riley, J. C. cialists, formed and conducted a small exclu.

Salter, H. J. Scherok, S. J. Schwab, R. E. sive society called the American Association

Schlueter, B. E. Stockwell, J. H. Tanquary, of Genito-Urinary Surgeons. They met onve a year, read some very good, some very med.

F. J. Taussig, P. Y. Tupper, H. P. Wells,

M. Wiener, F. A. Baldwin, W. H. Luedde. iocre, papers to each other, elected from time

-37. to time a few, some good, some mediocre, but

From Kansas City, Drs. Beattie, Binnie, for the most part personal friends, to membership, and excluded many whose scientific Block, Carbaugh, Cordier, Crowell, Curdy,

Frick, C. L. Hall, F. J. Hall, Jackson, and personal attainments justly entitled them to membership in such society. These ex

Kyger, Murphy, Neff, Pearse, Porter, Pun

ton, Sheldon.-18. cluded members, under the guidance of Val

From St Joseph Drs. Campbell, Elam, entine, Guiteras and a few other, able urologists, effected the American Urological Asso

Fassett and Potter.–4.

From Hannibal, Dr. Baskett; Marshall, ciation and adopted a broad, general, liberal organization. The new society prospered and

Drs. Gore, Giay; Summit, Dr. Rusk; Kirkflourished from its very beginning: its meet

wood, Dr. Wyer; Sedalia, Dr. Dunlap; Cape

Girardeau, Dr. Rosenthal; Springfield, Dr. ings bave been largely attended, the papers

Farnsworth; Marthasburg, Dr. Alexander; presented have been of the highest type of excellence and of the deepest scientific in. Novinger, Dr. Gashwiler; Linneus, Dr. E? terest, and the discussions of the wholesome

D. Standley; Brookfield, Dr. K. V. Stand. and beneficial obaracter. Its rostrum con

ley; Laolede, Dr. Z. T. Standley; Holstein, tains the names of the most active, energetic

Dr. Stewart; Plattsburg, Dr. Desmond.--14. and prominent genito-urinary specialists of the county, and the future of the society is A PARTY of thirty enjoyed the Illinois Cenan assured success from every standpoint. tral Grand Trunk route from St. Louis to The society has established and successfully

Boston; our party operated its official organ, the American Jour

joined with others at

The Trip to pal of Urology, which has gained for itself

Chicago, and a party of

Boston. the enviable position of the leading genito

185

the urinary journal of this country, and one of

quence, and the leading genito-urinary journals of the given a special train. A day was spent at world. Success and long life to the Ameri. Niagara Falls, a few hours at Toronto, the can Urological Association and all others of trip through Thousand Islands and the its type! It is truly American, medical and rapids of the St. Lawrence on steamers of scientifio in character. Let us relegate to the Richelieu & Ontario Navigation Co. to oblivion our exclusire, un-American, un Montreal took twelve hours. At Montreal we scientific societies by thorough reorganiza- found our train waiting for us, and after a tion, or let them be justly eclipsed by the few hours in that interesting city we boarded

was

conse

We

were

and landed in Boston the following morning. REPORTS ON PROGRESS A few separated themselves from the main comprising the Regular Contributions of the Fortnightly Departy at Montreal and made a side trip to

partment Stafr. Quebec, arriving in Boston a day later. Without exception the members of our party rejoiced in their oboice of route, it gave us,

PATHOLOGY AND BACTERIOLOGY. as was announced in the prospectus, a maxi.

R. B. H. GRADWOHL, M, D. mum of comfort and sight-seeing-it gave so much of sight-seeing that for this alone the

ST. LOUIS. trip was well worth taking. Not one of us

The Bacteriological Examination of the returned without a determination to do lower

Blood of Cadavers.- M. Otten (Virchow's Canada again and thorougbly.

Archiv f. path. Anat., Band 184, Heft 2,

May, 1906) adds another chapter to tbe con. THE AMERICAN UROLOGICAL SOCIETY at its tention of Simmonds of Hamburg that the recent meeting in Boston elected Dr. Brans bacteriological examination of the blood of ford Lewis, of St. Louis, to its presidency cadaver is a useful procedure in making the for the ensuing year. Official recognition pathological anatomical diagnosis in autopsy has not been coming this way with any great work. He reports about two hundred cases liberality from the national bodies, and it is in which there was a careful bacteriolog. a pleasure to note this exception. The other ical examination of the heart's blood of officers elected were: Secretary, Dr. Hugh cadavers, in 42% of which the blood was Cabot, Boston; treasurer, Dr. F. R. Hayner, sterile and in 58% it contained bacteria of Washington. The society will hold its 1907 various varieties. This blood was taken out meeting at Atlantic City.

at intervals after death varying for the most THE BRITISH MEDICAL ASSOCIATION AT

part from 16 to 24 hours after death, the body TORONTO.-The 1906 meeting of the British

being kept in a "cool room" during this time Medical Association will be held in Toronto,

before autopsy and blood examination. The Ontario, next August.

sum of his results coinicides with that of Sim.

A cordial invitation is being extended to the American profession

inonds who reported that there is practically to attend.

no invasion of the heart's blood post-mor. This is an exceptional occasion, and an opportunity we seldom

tem, and that blood obtained from this place

bave, it is to be hoped that a large number of physicians

is just as useful for bacteriological analysis from the States" will avail themselves of it.

as that obtained from peripheral veins, all of St. Louis should send a strong delegation.

which the reviewer of this article respectfully Rates have not yet been announced, but they

denies. In the December number of 1904 of will be made.

the Annales de l'Institut Pasteur, the re

viewer published an account of work done THE AMERICAN ROENTGEN RAY SOCIETY.

along this line with the blood obtained from -The seventh annual meeting of the Ameri- dead bodies upon wbich autopsy had been can Roentgen Ray Society will be held Au.

performed for medico-legal reasons. Otten in gust 29, 30, 31, 1906, at the Cataract and In- bis article neglected to acquaint himself with ternational hotels, Niagara Falls, N. Y. A

the full literature on this subject by overlarge and interesting program containing the looking this artiole. the results of which conames of the best known X-ray workers in

incided with that obtained by Cannon whose tbis oountry as well as a number from abroad,

work is mentioned. This work of tbe rehas been prepared. An interesting feature

viewer's showed that in 50 selected cases the of the meeting will be the exhibit of prints

streptocoocus was present in about 65% of and negatives. The railroads have granted a

the cases indiscriminately, even though the rate of a fare and a third on the certificate

cause of death was of such a nature as gun. plan. The officers of the society are: Presi.

shot wound of the brain or abdomen, etc. dent, Dr. Henry Hülst, Grand Rapids, Miob.; The blood from the heart showed streptosecretary, Dr. Geo. C. Johnston, Pittsburg,

cucci, but that from the peripheral veins was

nocci hot that from Pa.; treasurer, Dr. Leavitt E. Custer, Day.

: Custer, Day- sterile in all cases excepting those in which ton, O.; vice-presidents, Dr. Russell ..

# there was intra vitam a general pus infection. Boggs, Pittsburg, Pa.; Dr. Clarence E. Skinner, New Haven, Conn.; Dr. G. Wil. The Histology of Callus.—Theodore Guem. liams, Richmond, Va. ; Dr. Eugene W. Cald. bel (Virchow Archiv, Band 183, Heft 3, 1906) well, New York City. Full information re- says that the subject of histologioal investi. garding the meeting and application blanks gation of the structure of callus has often for membership may be obtained by address. been gone over, but with the newer methods ing the secretary, Dr. Geo. C. Johnston, 611 the subject needs revision. Normal and Fulton Building, Pittsburg, Pa.

pathological ossification was studied by

Kolliker and Manasse, as well as by Kasso

OTOLOGY. witz, v. Recklinghausen and Ziegler. Strict examination in a quantitative way of the met.

ALBERT F. KOETTER, M. D. aplastic formation has not, however, been

A Case of Late Hereditary Syphilis of Both gone over. Guembel determined to investi. Labyrinths of the Ear.-iv. Belim. Arobiv gate this problem; for bis material be thanks fuer Obrenheilkunde. A patient twenty Recklinghausen who furnished him material

years of age, whose father had been treated in the shape of fractured ribs and bones of

fibộ and bones of for syphilis, was seized a year ago with sudthe extremities of children; also Bethe who den deafness of the left ear, for a half year furnished him experimentally induced frac. increasing deafness of the right ear wbiob up tures in the bones of rabbits and dogs from to tbis time had been very sensitive to noises. the physiological department of the Univer.

Perforation of the nasal septum, cicatrized

Perforation of the nasal sity of Strassburg. He also used an ossify- scars of soft palate as well as the surprising ing myxoohondroma of the soapula in a

results of a schmier cuse, on the bearing verimale patient of 56 years of age. The first

fied the diagnosis of bilateral syphilis of the material used was the callus on the right labyrinth. The excruciating pains in the left ulna of a two years' old child which died

ear whiob appeared after six weeks were due in the hospital. Tbe patient had a perineal

to a cicatrized retraction of the bandle of the abscess; was affected with hereditary syphilis

malleus in the healing of the synchronously and rachitic condition was simply a slight

existing leutic affection of the tympanic "rickety rosary," separation of the epiphy.

cavity, and was. relieved by the extraction seal cartilages: a form of rachitis called by of the malleus and breaking up of the adhe. Recklinghausen "chondromalacia.” The

sions. After a year these pains recurred, fracture of the ulna occurred on June 9, 1902,

and were said by the author to be due to a and the patient died on July 8, 1902-age of

specifio perichondritis of the left tubal emi. the fracture being five weeks. Autopsy

pence. On account of the rapid return of the showed in addition to these clinical observa.

hearing, this case serves as a warning, in tions cavities and broncho-pneumonio areas

spite of the doubtful prognosis given by in the lungs. The callus bad a thickness of

nearly all authors in hereditary syphilis, 21 to 3 mm. A cartilaginous area was seen

doubtful especially, if as in this case, the at the point of the fracture; osteoblasts were

late treatment and the simultaneous existence seen, but no osteoclasts. The bone and myx of adhesive processes in the middle ear. to ochondrom, from a male patient was well as

inaugurate in all cases an energetic inunction the bones of rabbits and dogs were sectioned

treatment and try all other anti-leutic remeand stained according to the thionin-phos. Dies phorus method of Schmorl. The sum of all these observations was, that in pathological Two Cases of Deafmutism Due to Ptomaine conditions of bone formation, metaplasia pie. Poisoning.-(W. Sobier Bryant, New York dominates. While in normal ossification, this Medical Record.)-Case I. Girl of two years plays an insignificant role, in the ossification and seven months, always healthy, was taken of a callus, the formation of young bone sub- sick after eating fruit ice, with fever and stance follows in the wake of a metaplasia. symtoms of a gastro enteritis. Urine norThe onset of metaplasia depends upon the mal. After four days staggering gait, diffi vascular supply; where there is poor vascu. culty in drinking, spasms of the face. One larization there is metaplastic growth of bone week after poisoning total deafness and as well in the periosteal as in the narrow dumbness. Ears show no changes. Same callus, with this difference, however, that condition after a year. Case II. Boy of two there is byaline cartilage only in the perios. and a half years. Seven weeks ago attack of teal callus, while in the narrow callus there fever, four weeks later child could not walk is hyaline cartilage and fibrous marrow and was deaf. Both cases are no doubt due formed. With the formation of blood vessels, to a toxio neuritis of the acoustic and toxio the metaplasia is arrested and there follcws degeneration of the speech centers. Author final ossification, according to the endochon goes thoroughly into the differential diagno. dromal type The influence of division of sis as opposed to encephalitio processes, nerves upon the transformation of periosteal atropine poisoning, embolic infarcts of the oallus has not yet been determined.

brain, meningitis and bulbar paralysis.

Ear Affections in Scarlet Fever.-(Sprague,

Providence, American Journal of Medical In cases of pain in the hip of doubtful ori. Sciences. ) –Of sixty children who entered gin, examination of the kidney regions may the Rhode Island Hospital from January to discover the cause.

June, admitted to the soarlet fever division,

seven

acquired acute suppurative otitis tion of the membrane. The etiology and media, three were already affected when they pathogeny of true cholesteatoma are still very entered the hospital therefore about 17 per much in doubt, at all events the formation cent, seven bilateral and three unilateral. takes place at the expense of the endotheOf the seven cases developed after admission, lium of the tympanio cavity, attic and antrum. four had earache, increased temperature and Then follows the clinical picture of choles. acceleration of pulse; three had no pain, and teatoma and its complications. The diag. showed only high temperature. Of the sev. nosis is usually very easily made. Luoase enteen cases only two showed involvement of has found an odor peculiar to cholesteatoma mastoid and came to operation. Sprague di. in 98% of the cases, the author would not vides the scarlatinous middle ear inflamma consider it as specific of cholesteatoma, but tion with the following forms: (1) Acute the result of the process of decomposition, serous; (2) acute suppurative; (3) acute Treatment: If the removal of the cholesteat. necrotic form. The acute serous inflamma oma does not occur in the natural way, a rad. tion usually occurs during stage of erup ical removal of the petrous portion of tem. tion, or at least during the first ten days. poral bone and mastoid process by means of The symptoms are those of an ordinary ca a radical operation. tarrhal otitis media. If the child is old

Etiology of Disturbances of the Auditory enough it complains of fullness, tinnitis,

Nerve Apparatus Appearing Suddenly.deafness and pain; in very small children

Stein (Monatsschrift fuer Ohrenheilkunde) restlessness and rise of temperature are noticed. During desquamation the external

quotes a number of observations wbere pa

tients blame mental disturbances as the cause canal is full of scales and the activity of

In the the ceruminal glands is increased.

of subjective sensations of hearing or altera

tion of the hearing as well as cases of funcacute suppurative inflammation, which usu

tional disturbance which are caused by traually occurs in the latter stages of the dis

matio influence, even though the trauma be ease the temperature reaches 103 deg. F., and more. Patient complains of lancinat.

not such as to assume severe changes of texting pains radiating to head and neck, swell

ure in the labyrinth, or in the cranial cavity,

and gives us several points of support for the ing of the glands of tbe neck and stiffness of the muscles are often noted. Occasion.

explanation of the phenomena of a disease

heretofore called vasomotor disturbances of ally we find cerebral irritation, convulsion and von iting. The necrotic or diphtheritic by the internal examination of the objective

the hearing Common to all cases as found form leads to rapid softening of the tissues, the membrane and the ossicles and to inva.

symptoms of the disease a more or less ad. sion of the labyrinth. The secretion is col.

vanced arteriosclerosis, and by examination

of the hearing apparatus the symptoms of an ored and very fetid.

affection of the auditory nerve. Author, Author believes that in mild cases the in

therefore, believes he may accept the alterafection takes place through the tube, in

tion of hearing, as well as the subjective imcases by means of the blood lymph route. He considers the ear

severe

or

pressions of hearing as the local phenomena

of a latent arteriosclerosis cerebri, made tion very contagious, in three cases where

manifest by the psychio disturbance, or the the child was dismissed after the disease bad run its course and the usual quarantine rules injury, and the assumption of a vascular were observed, but the ears still suppurating,

spasm as most plausible, which on account another child of the same family took sick

of the impaired elasticity of the vascular with scarlet fever, when all other ways of

walls continued longer and its deleterious

results on the brain nutrition were brought 'transmission but that of the ear secretion

to bear on the auditory nerve apparatus. could be excluded.

Differential Diagnosis Between Abscess of Cholesteatoma of the Ear.-(De Stella, the Cerebellum and Suppuration of the Laby. Belgique Medical.)-There are two kinds of rinth.--(Neumann, Arcbiv fuer Ohren beilcholesteatoma: (1) The secondary or false. kunde.) —Opposed to the symptoms common (2) The primary or true chclesteatoma called to both diseases vertigo, vomiting, character endothelioma. Autbor speaks of the several of the nystagmus, etc., Neumann has obdifferent sizes or kind and the seat of the served differential diagnostic points in several cholesteatoma. Whereas the secondary chol cases. Whereas, in the labyrinth disease es. esteatoma is very frequent, the true or endo isting nystagmus with the progressive dethelioma is met with very seldom. For its struction of the labyrinth becomes weaker, it inception the following adds to its formation: increases in intensity with the extension and (1) Epidermization of the drum membrane; continued existence of the cerebellar abscess. (2) closure of the tube, and (3) large perfora If there exists in the beginning of the laby.

secre.

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