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ures have been equally as inefficient as those tween 20 and 50 years of age. Eighty per directed toward suppression, that all history cent of this number is 16,000,000. Now and knowledge of human nature bave shown multiply this by the average loss of each pathat prostitution cannot be suppressed, and tient to himself and the state, and the quotient as venereal diseases are the worst results, it will show part of the monetary loss from follows then that efforts must be directed to gonorrhea alone. ward protection from these dangers, in behalf of the wife and the state as well as the sinner, 2. Invalidism and Operations in Women. if he insists upon exposing himself. Explain - It is under this head tbat we see the apto bim that there is always danger and urge palling results of gonorrhea. Humiston and continence, but also advise him as to prophy. Price claim from 90 to 95 per cent of ablactic measures, in case he exposes himself, dominal operations performed in the world which, it is sad to relate, will be of frequent today, are required on account of infections, occurrence. If he will not reform we are jus. adhesions and pus collections due to gonortified in behalf of an innocent wife to protect rhea (7). These are higber tban the perher and their offspring.

centages given by other authorities, but even The use of the condom greatly lessens the the lowest is enough to stir the most indolent danger of gonorrhea but it may rupture during to activity. coitus. Good results also follow injections In addition to the operations, equally freof 10% argyrol after urinating and thoroughly quent are those patients who are made inval. washing the penis. The region of the meatus ids for life. Worse than these, however, are should be smeared with the same solution the cases who become mentally unbalanced to kill any gonococci outside, while if the in. on account of the removal of their sexual or. jection is properly given and retained five gans whioh were so damaged by the inflamminutes the germs in the anterior urethra matory process that the gynecologist found are destroyed. There is, however, always them useless or dangerous. A large number the danger of sypbilis and a chancroid wbich of these cases are due to latent gonococci must be impressed upon the patient.

from apparently cured husbands. Other important sociological problems are to be considered in attempting any metbod 3. Sexual Neurasthenia, so frequently preventing venereal diseases; the regulation caused by gonorrhea, is one of the most of sexes in industrial life; the low wages re- intractable conditions with which they ceived by working women; the more rigorous have to contend, and undoubtedly makes attempts to control abortions; and efforts the patient more unhappy than any other to segregate the prostitutes in certain sections non-fatal disease. From the number of cases of the oities and leave them there undisturbed with which I have come in contact, who have in order to lessen the number of the more explained how depressed they were, and that dangerous clandestines. I regret that it is on a number of occasions they b not within the province of this lecture to enter plated suicide, I feel justified in saying that into the deails of these subjects.

this condition next to financial embarrassment To show further the necessity of devoting and love affairs is the main cause of self-demore time and attention to this widespread struction. I am equally positive that a certain though insidious disease that stalks through per cent of these cases become insane. It is every nation, causing untold suffering, and also without doubt a frequent cause of di. making invalids of strong men and women, vorce. let us consider briefly some of its various pbases:

4. Sterility. Through its effeot on the

epididymes and prostate gland it plays the 1. The Monetary Los8.— So enormous main role in causing sterility and impotence are the figures and so meager and unrelia. in men. Benzler (8) followed the history of ble are the statistics, that I will ask you 474 soldiers with gonorrhea and found sterto make a mental calculation for yourself ility resulted in 10% of the cases of urethand estimate about the average cost of an ral involvement; 23% where there was uni. average patient for necessary expenses inci. lateral epididymitis and 41% where the epi. dent to the disease, and to that add the loss didymitis was double. Impotence is one of time, the loss in business from physical of the disastrous results of damage to the weakness and mental worry, and the loss to prostatic urethra by the inflam the nation from lessened capacity for produc may be complete or partial, as in perfect tion. Eighty per cent is the usual estimate erection, premature ejaculation, or loss of norof the men who have gonorrhea (6). Accord. mal sensation apparently due to the de. ing to the U. S. census 1900, there are about struction of the nerve endings in this part of 20,000,000 men in these United States be. the urethral canal (9).

According to Neisser, 50% of all involun- and vaginitis are exceedingly frequent in intary childless marriages are due to gonor. stitutions for children, highly contagious and rbea. Cervical catarrh prevents the en difficult to control. He says where this in. trance of the spermatozoa, thereby render- fection is known it is justly regarded as the ing the woman sterile. After the inflam. bete noire of institutions for children, the matory process has reached the endometrium importance of which has only just begun to and tubes, still further obstruction prevents be appreciated. Twenty-six cases of gono. the fertilization of the ovum even when the coccal arthritis are reported, and it is claimed disease has not progressed to pus formation, that a pyemio arthritis in a young infant is

Bland.Sutton says gonorrhea is the chief much more frequently due to the gonococcus cause of sterility of the prostitute class (7). than to the streptococcus or any other pyo. Morrow has shown that women having it genio organism. frequently can only give birth to one child, 7. The Need for Reporting These Dis. and subsequent trouble is likely to date from

eases.-All efforts to study venereal diseases this event which furnishes ideal conditions

are hampered by the absolute lack of any refor the growth and spread of the gonocuoci.

liable statistics in this country, and the atSome of the worst results of gonorrhea are

tempt to have them reported purely for not due so much to gonococci, which as a

statistical purposes, without the names of rule limit themselves to the mucous mem.

the individuals, is most heartily approved. branes, but to the secondary infections that

“While venereal diseases cause more deaths are afforded extremely favorable conditions

and deplete the population by causing aborfor their growth.

tion and preventing conception more than DeWarker (10) gives the first place to gon.

any other known disease or condition, this orrhea in the three diseases (gonorrhea, tu

subject is laregly ignored by sanitary bureaus berculosis and syphilis) that press urgently

in their registration of contagious diseases” for solution. He gives it the first place, not

(7). It is only in this way that the laity, because it is more destructive to life than tu.

physicians, and especially philanthropists, berculosis, but on account of its greater dan.

are to be shown the necessity of taking steps gers to society, in its power to impair fertil.

to check the ravages of these diseases which, ity and to permanently infringe upon use.

although sapping the vitality and life blood fulness.

of the nation, continue to be ignored. No 5. General Gonococcal Infections have city in this country has adequate hospital ac. also been reported very frequently in recent commodations for the venereal patients. years, and Wion (11) states that the lesions There is no more crying need today than for and symptoms depend upon three factors: efficient treatment and medicine for all poor

(1) Direot infection with the gonocoocus patients before the disease has tightened its itself; (2) absorption of a toxin (gonotoxin), relentless hold, and they are doomed, for and (3) mixed infection with other germs. life, to be sterile, imputent, or invalids. Krause (12) demonstrated gonococoi in the In conclusion, gentlemen, I hope the facts blood during life, and Ullmann bas reported I bave reviewed will enable you to appre. five cases of fatal gonorrheal pyemia, in four ciate more fully the importance of gonor. of which a necropsy showed the point of ori. rbea, its widespread and far reaching effect, gin to be a prostatic abscess. Gonorrheal in- and trust none of you will admit it a dis. fection has no special clinical features wbioh ease to be feared no "worse than a cold can differentiate it from other pyemias, and in the head," and will combat any such a positive diagnosis can only be made by a criminal ideas on all occasions. bacteriological examination of the blood or

BIBLIOGRAPHY. from an accessible lesion. Krause calls at. tention to the ease with which gonococci may

1. Holton: Journal American Medical Association, March be overlooked, which only grow to small col.

2. Peterkin: North West Med., Vol. II, No. 9, 1905. onies in blood, and in cultivating them the agar must not be heated above 41 deg. C.

8. Benzler; Archiv f. Dermatol. and Syph., Band XLV, 6. Blindness.- Formerly about 50% of all blindness was due to gonorrhea, but since 10. De Warker: New York and Philadelphia Med, Journal. the adoption of Crede's prophylactio meas.

14. Krause : Berlin klin. Woch., May 9th, 1924. ures this has been reduced to about 20%. Even with this reduction it may still be given as evidence against gonococoi, and to furtber strengthen the case against their at. If an incised wound in the soft parts does tack on the innocent helpless obildren Holt not heal as readily as it should, examine the has recently shown that gonococcal infections urine for sugar.

11th, 1905.

3. Kelly : Jour. A. M. A. March 4th, 1905.
4. Heidingsfeld: Jour. A. M. A. January 30th, 19
5. Weiss: Jour. A, M. A., January 24th, 1903.
7. Johnson: Jour A. M. A., March 11th, 1905.

Heft 1.

9. Progres. Med., December, 1899.

11. Winn: The Lancet, February 11th, 1905.

THE St. Louis MEDICAL SOCIETY held its

THE MEDICAL FORTNIGHTLY annual meeting on the evening of December

THOS. A. HOPKINS.

W. H. VOGT. Obstetrics and Gynecology.

T. A. HOPKINS. Genito-Urinary Diseases.

30th, the interest in the Issued Tenth and Twenty-Fifth of Every Month.

election brought out

The Annual
Under the Editorial Direction of

the largest attendance

Meeting of the
FRANK PARSONS NORBURY,

in the history of the so

St. Louis
CARL E. BLACK.

Medical

ciety, 235 members be. With the following staff of Department Editors

Society.

ing present. 0. E. LADEMANN, Internal Medicine.

The reports of the JOHN MCHALE DEAN, Surgery. R. B. H. GRADWOHL, Pathology and Bacteriology.

officers and committees

for the year showed that 1905 has been in WALDEMAR FISCHER, Ophthalmology. A. LEVY, Pediatrics.

several respeots the best year of the society's W. T. HIRSCHI, Therapeutics. A. F. KOETTER, Otology.

history. Thirty-nine meetings were held HERMAN STOLTE, Laryngology and Rhinology. with an average attendance of 49.7. Fifty. F. P. NORBURY, Nervous and Mental Diseases.

one essays and addresses were delivered and ROBERT H. DAVIS, Dermatology.

a large number of anatomic and pathologio

specimens were demonstrated, and various EDITORIAL

other matters were considered within the scope of the soientific work of the society, all

of which marks the work for the year as of In entering a new year the FORTNIGHTLY exceptional excellence. Sixty-four physicians follows what has become a custom, in wish. were elected to associate membership during

ing all our friends “A the year, and a number of lapsed member

Happy New Year;" ships were revived, bringing the total active A Happy

oustom though it be it membership to 461 at the close of the year. New Year.

is no less heart-felt and The society lost seven members by death dur.

sincere. We would have ing the year, Drs. Wm. Johnston, W. M. Mc. each of you in the new year experience an ex. Pheeters, R. M. King, C. V. F. Ludwig, J. cess of prosperity and true happiness beyond J. Curl, A. Schlosstein and Will Rinninger. that of any of the years past.

The new building under way, the foundaTHE FORTNIGHTLY looks to 1906 to be one tion having already been laid. The work of advances in its worth and usefulness. We will be pushed from this on, and it is ex. look back on our work during the past year pected that the society will be meeting in its with a pardonable degree of pride, and at the own hall before the summer recess. same time with a thorough appreciation of The election of officers for 1906 resulted as the fact that our large audience has at all follows: times encouraged us and proven an incentive President-Dr. Geo. Homan. to endeavor. The managing editors also feel Vice-President-Dr. Robert Barclay. that they will be expressing the sentiments Recording Secretary-Dr. Hart Goodloe. of our readers in expressing their apprecia. Corresponding Secretary-Dr. E. A. Babtion of the work done by the Fortnightly De ler. partment Staff, the increasing excellence of Treasurer-Dr. C. J. Orr. our departments is bringing us flattering commendation, and for this our thanks are due the men who are so ably doing this work. ADVANCE reports from the St. Louis Health

The outlook for 1906 is indeed lattering, Department indicate that 1905 has been a there promises to be a very material increase

prosperous year in in the amount of department work presented,

Local Birth

health matters as well and our original department will be materi.

as in growth and finan.

and Mortality ally inoreased by the papers presented before

cial affairs; to have bet.

Statistics the Medical Society of City Hospital Alumni,

ter than 1000 less deaths

for 1905. the FORTNIGHTLY having been selected by

than in 1904, and that this prosperous society to publish its pro

with a greatly increased ceedings. It is our belief that our readers population is indeed prosperity.There will see improvement in all departments and were 10,325 deaths during 1905. These fig. a gratifying increase in the amount of matter ures are not official, as the number for the furnished, for it is our purpose to make the ast two days of the year was estimated by the FORTNIGHTLY for 1906 the best yet.

mortuary clerk. During the year 1901 there were 11,506 deaths recorded. The number

of births reported up to the time for closing If possible. always tie each component of the office, December 30th, was 12, 168, by a kidney pedicle separately, not en masse. months as follows: January, 907; February

961; March, 997; April, 976; May, 948; 4. More suitable provision for the care of June, 933; July, 973; August, 1145; Sep poor consumptives by the city, such as: tember, 1031; October, 1092, November, Special hospital accommodations in present 1032; December, to date, 1137.

institutions for bedridden cases. A “rest The following diseases claimed the greatest cure" hospital for the non-bedridden cases number of victims during 1905: smallpox, 59; during prostrating attacks of the disease. diphtheria, 110; typhoid fever, 127; pneu. An "open-air” hospital for treatment of monia, 969; phthisis, 1250; heart disease, all cases where a oure is possible. 907; suicide, 179; homicide, 77; accidents, Adequate publio dispensary facilities, with 431. During 1901 there were 227 suicides, 105 définite hours for treatment and advice. homicides and 525 accidental fatalities.

5. The freedom of the public health service The report prepared by the mortuary olerk from partisan political influences in order for the week ending at noon on December 30th that the best men may render the best service. shows a total of 317 births, the largest num. In accomplishing this it is working with ber for one week during the year.

the Civic Improvement League. Every pby. sician in our city should unite himself with

one or both of these organizations. The So. THE St. Louis Society for the Prevention of ciety for the Prevention of Tuberculosis Tuberculosis in its recently issued annual elected to office the following gentlemen for

report shows that the 1906: .

interest in this very im. Francis G. Eaton, chairman; Dr. William Report of the

portant work is growing Porter, vice-chairman; Jordan W. Lambert, Society for the

in a satisfactory man. treasurer; G. R. Blickhahn, secretary; AshPrevention of

ner, though the people ley Cabell, Dr. J. R. Lemen and Dr. Albert Tuberculosis.

of St. Louis have as yet Merrell

to reach that degree of appreciation of the worth of preventive meas. ures wbich has resulted in the large decrease DR. J. F. JENKINS, Tecumseb, Mich , (Jour. in the death rate from tuberculosis in New A.M.A., December 23) insists on the resum. York, Philadelphia and Cleveland. The fol.

bent position from the lowing is a brief summary of the work done Tinte

beginning in typhoid by the society during the past year:

*. fever. He states that The preparation and successful adoption

milk preferably given by the city of an ordinance giving St. Louis with pepsin and hydrochloric acid and two its first legislation for the control of the dis- soft-boiled eggs every twenty-four hours, ocease. Nothing in this law can offend physi. casionally alternating with barley or rice cian, patient or family. Properly enforced, water for a change, makes a very efficient its operation will be beneficial in the highest diet during the whole course of the fever. In degree.

the later stages a little old whiskey, as a stimThere were prepared, printed and distribu- ulant to a flagging pulse may be added to the ted, under many forms and in many ways, milk. In the early stages, fractional doses about 250,000 leaflets, brochures, cards, eto, of calomel, followed by a small dose of Rochinstructing the public about the disease, its elle salts or sodium phosphate are indicated; treatment and prerention. Special attention in some cases they may be repeated from was given to warnings about careless spit. time to time during the first and second ting. The posting of special cards in most of weeks. Intestinal antispetios are of value, he the street cars was found the best way to call states, in checking putrefaction and relieving the public mind to this tremendous evil. diarrhea and tympanitis, and, therefore, should

Lectures in various parts of the city were be prescribed. When the temperature rises given during the year under the auspices of to 102.5, cold sponging or tubbing should be the society and the league. At the solicita. resorted to, and it is advisable to follow up tion of the society and the league, the publio the bath by vigorous frictions. Frequently press assisted the work by much publication a small amount of stimulant is indicated of relevant matter.

after the bath. When there is delirium or Its purposes for the future are:

coma the ice bag to the head will relieve and 1. The rational and actual enforcement of often induce a natural sleep. During con. the antispitting ordinance.

valescence a tepid sponge bath of alcohol and 2. The proper and effective compliance water, equal parts, he thinks, has a beneficial with the recent law for controlling the dis effect. One should insist on the patient takease.

a ing from a quart to a quart and a half of 3. More intelligent methods for cleaping boiled water every twenty-four hours as the streets and sidewalks.

typhoid patient dues not usually demand

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water, even when the temperature is bigh. ing the past seventy-eight years according to Diarrhea, when excessive is often checked by the records of the Massachusetts General Hosreduction or change of diet and full doses of pital, and the author attributes the bad results bismuth subnitrate will usually be effective. largely to the over-feeding practised. For restlessness in the late stages Jenkins has found Hoffman's anodyne a very useful remedy. In the later stage stimulants are re

In performing subcutaneous infusion do quired for supporting the feeble heart action

not allow too much fluid to accumulate at and during convalescence be advises hexame.

one area, otherwise necrosis may occur. Sbift thylenamin in 5 gr. doses, three times a day,

the needle to various parts not by swinging to destroy the bacilli in the urine.

it from side to side, but by partly withdrawing it and reinserting it to another area.

THE NICHOLAS SENN CLUB.—The profesDR. CHARLES E. PAGE enters a strong pro. sional friends of Dr. Nicholas Senn have or. test against what he terms the non-curative,

ganized a Nicholas Senn Club of which Dr. not to say killing, treat. Fe

Fernand Henrotin has been elected president ment of pneumonia, The Curative

and Dr. Arthur MacNeal secretary. Some which is the prevailing Treatment of

time ago Dr. Byron Robinson suggested that one and includes drugs Pneumonia, with

gs

the

the most appropriate testimonial to Dr. Senn and forced feeding in Points on

in commemoration of his services to the died. Hydrotherapy plus the mischievous ica

ical profession would be a “Festschrift" effects of hot poultices and Therapeutic on hot lungs. The es

after the custom of the German profession in Fasting in

· honoring their great men. The club is the sential features of bis Fevers.

result of tbis suggestion. The publication of own plan (Med.Record,

the “Festschrift" will be the first work unDeo 23) consist in the dertaken by the organization. Dr. Robin. use of cool applications to the chest and ab.

son's idea is to collect in this testimonial stinence from practically all nourishment ex.

volume one article from each country where cept water. In this way the disease when taken

scientific medicine is taught, and to publish early is frequently aborted, and the normal

them each in the native tongue of the writer. death rate becomes five per cent for private and

The general object of the club is to surround hospital cases combined, wbile in private prac

Dr Senn with a small coterie of personal tice alone it is about two per cent. For pneu.

friends, whose duty and pleasure it shall be monia the procedure recommended is as fol.

to assist him in carrying out any work which lows: large towel, coarse linen or cotton, is

in or cotton, 1$

hem

he may from time to time initiate.-Med. folded lengthwise in the middle then folded

Standard. crosswise in the middle, and one-half the length of this four-ply towel is wrung tightly TONSILLITIS.-R. M. Niles, in discussing fronı ice-water, or the coldest water obtaina. the treatment of this affection, says tbat the ble, and again folded crosswise, so as to give patient sbould be isolated, should receive four thicknesses of damp towel next the skin, broken doses of calomel, followed by a saline and the same, dry, outside. The damp folds laxative or croton oil, quinine in tonio doses. should be freshened as often as they become Strychnine, aconitine, sodium salicylate, at all hot, whether this be in ten, twenty, or guaiac and anodynes may also be required. thirty minutes. At first, in severe cases, the Hot alkaline gargles and a spray of hydrogen ohanges will be as often as every eight or ten peroxide are useful. Chlorate of potassium minutes, the intervals lengthening more and has little value. Often the application of more as the inflammation subsides, and the tincture or vinegar of capsicum produces breathing consequently becomes deeper and the most brilliant results. Congestion and easier. When the patient is able to breathe edema are reduced, the separation of sloughs naturally, and the compress no longer be is facilitated, granulations are stimulated, comes hot, and before it is felt to be an un vasomotor inertia is overcome, and normal comfortable treatment, this local cooling tissue metabolism is re-established. Tincture should cease. In some cases hot applications of capsicum, full strength or diluted with are also made to the legs. The author em cod-liver oil should be applied to the Schnej. phasizes the uptoward results attending the derian mucous membranes in the treatment employment of forced feeding, and points of the rhinitis, whioh is a frequent concom. out the great advantages of keeping the pa. itant of the tonsillar involvement. The nasal tient on a diet of warm water until convales. mucosa is first cocainized, and the capsicum cence is established. The mortality from ty. is then applied with a cotton-covered appli. phoid fever has shown no improvement dur. cator.-Med. Record, December 23, 1905.

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