The present editions of the documents on of the State, and as to its probable extent the Restriction and Prevention of Scarlet and cost. Fever and on the Restriction and Preven- ' tion of Diphtheria being practically ex-, hausted, it was decided to have them revised, the Board, it will, if candidates apply, exJuly 14, the day after the next meeting of published in the next annual report, electrotyped, and a large edition of each document printed. As it is to be electrotyped, local Boards of Health may procure any number of either document at a slight cost. DIPHTHERIA. The Secretary stated that, inasmuch as diphtheria has been so prevalent in this State, it has been suggested by an officer of the National Board of Health that this was a favorable field for a systematic investigation of the causes of the disease, particularly as to what are its relations, if any, to filth. The subject was thoroughly discussed at some length, and the great desirability of such an investigation was unanimously conceded, but the resources of the Board are entirely inadequate for such a house-tohouse inspection as seems essential. The Secretary was directed to correspond with the National Board of Health and see SANITARY SCIENCE EXAMINATIONS. amine them in sanitary science, giving a certificate of merit to those who pass a satisfactory examination. An outline of the plan of these examinations will appear in the forthcoming report for 1879. An unusual amount of routine business was transacted, auditing of accounts, etc. The next meeting of the Board will be July 13th. Detroit Academy of Medicine. The DETROIT, Jan. 13, 1880. Dr. McGraw-Several weeks ago I saw a child, in consultation with Dr. Leach, who had been suffering from pleurisy, and at the time I saw the patient he had empyema. The right pleural cavity was full of pus, and the interspaces were bulged away out. child was about 10 years of age. I put in an aspirator needle and drew off a large quantity of pus. About a week afterwards. saw the patient again, and found that the pleural sac was again filled: I decided to evacuate the pus by a free incision, which I The Secretary was authorized to begin did forthwith, making a free incision in the printing the proceedings of the recent sani- eighth interspace instead of the ninth. tary conventions at Detroit and Grand Large quantities of pus came away, and a Rapids as soon as practicable. The report hollow drainage tube was inserted. No antiof the Board for 1879 is now in press and will shortly be issued. what arrangements can be made for such an investigation. SANITARY CONVENTIONS. Dr. Kellogg, as committee on the disposal of decomposing organic matter, presented a paper on DECAYING WOOD A CAUSE OF DISEASE. I The septic dressing was used in this case. cavity was washed carefully with carbolated water. The patient is recovering very nicely. You will notice that I opened into the pleural cavity higher up than has heretofore been recommended in these operations, but He related experiments by Prof. Wm. H. recently it has been advocated by some of Brewer, confirmed by himself, showing that our Eastern surgeons, because it allows of a when green wood was allowed to stand for better drainage and a freer opening. There some time in water the solution decomposes is usually a cheesy degeneration of the pus and gives off very offensive odors. Even in the lower portion of the cavity. when the water was renewed again and again, similar results ensued. The paper was prepared with especial reference to the practice of putting sawdust in streams and ponds, and it tended to confirm the belief that the practice is frequently productive of malarial and diarrheal diseases. SANITARY SURVEY. Dr. Jacokes, chairman of the committee on such survey, made a statement relative to the desirability of having a sanitary survey Dr. Noyes-What prevented the lung from collapsing? Dr. McGraw-The lung was already collapsed from the presence of the pus in the pleural cavity. When I first examined him, there was of course dullness over nearly the whole lung surface, except above and in front, where it gave a tympanitic resonance over the compressed lung tissue, around the larger bronchi. The point that I wish to bring out here is, that the incision was made 506 Dr. Shurly-I have not had any great experience with cases of empyema, but I should think that it is by far the best plan to make a free incision in the eighth intercostal space, as has been lately recommended. in the eighth intercostal space. All below by several physicians in the place, but they the eighth rib was filled with a cheesy mass were unable to make out the proper diagof pus, which would have interfered with nosis, and he was sent to Milwaukee, to a the free flow had the incision been made very prominent surgeon in that city, who He again lower down, as has been the method hereto was unable to diagnose the case. returned to his native town and came into fore. the hands of the physicians who had first seen him. They decided that the tumor was of a cystic variety, and concluded to intro This duce a trocar and draw off the fluid. they did, and drew off 11 pints of a cornIn Dr. McGraw-Another case I would like to colored fluid, which proved to be urine. speak about, that of a girl who was suffering thirty days the tumor began again to apfrom a felon on her thumb. She consulted a pear, and 11 pints were removed by means of physician in Canada, and he advised her to a catheter, and the urine was after that time apply carbolic acid to it. She got some at a drawn daily with that instrument. The most drug store and made the application as di- curious points in the case are that during the rected. The next day it was found that the whole time he had been passing his urine in thumb was white and without the slightest about the natural quantities; and again, that sense of feeling; in fact, it was dead. The the man should have been examined by a carbolic acid had soon relieved the pain by surgeon and the nature of the disorder not killing the part. Several such cases have discovered. come under my notice, and I speak of it be- Dr. Noyes-Such deceptions quite often cause it shows the carelessness of physicians happen after confinement cases, where the and druggists in prescribing this acid. A nurse is ass ed if the patient has passed her strong solution of carbolic acid, with oil, urine and the answer is in the affirmative. will sometimes have the same disastrous effect when applied to a finger or toe. k But the patient ers made, the bladder is omplaining of pain and an examination being ve drawn with a catheDr. Shurly-Some time ago a girl came to found full and has to beo-y any eminent sur me who had had her fingers crushed. The middle and ring finger being badly lacerated, I dressed them and gave a prescription for carbolated oil, that they might dress the fingers at home. The prescription was lost, and the father of the girl said he remembered what was ordered, so he went to a drug store and got some carbolic acid, with which the fingers were dressed. The next day it was found that the fingers were dead and had to be amputated. The second case that I saw was the foreman of Hodges' foundry. The thumb, first and middle fingers were badly crushed. He went to a druggist, who gave him some carbolic acid to dress them with. The result was that the fingers and thumb had to be taken off, and he lost the use of his hand from the inflammation caused by the acid. eistake, as in the objective sympmting tumor in ter, but I do not see how I a stroy vision? Dr. Connor-Does tobacco deoi at I may reput the question in this way theint, which late a case bearing upon this pwd. About has from time to time been dispute who bea year ago, a man, 22 years of ageti uddenly fore that time had been healthy, equation I lost most of his vision. On examist unable found that with the left eye he wase right to distinguish fingers at all; with th Mayers at eye he was unable to distinguish fingffo.f the twelve inches, except directly in front eye. He gave about the following hist ouanHe had been accustomed to use large arming tities of tobacco, both smoking and chewr ory: Dr. Clark-When I was at Beaver Dam, otherwise his habits were good. Ophtha Wis., last summer, I saw a case which inter- moscopic examination: Anterior structure ested me considerably. A banker in the of left eye clear, lens clear, but in the posplace had a tumor in the lower part of the terior part, hiding the optic disc, was a large abdomen. His general health was very black patch; vessels somewhat injected. good, but he suffered considerable pain in Right eye, the vessels were over full, but and around the tumor. He was examined otherwise the eye was normal in appearance. S If tobacco was not the exciting cause in this case, what was? As soon as he stopped using tobacco his vision began to improve and his urine to diminish in quantity until it was reduced to the normal amount. Urine was examined-passed about two tinctly seen through it. The pupil was conquarts in the twenty-four hours. No sugar. tracted. The left eye presented also wellI told the patient not to use any more to- marked objective symptoms of sympathetic bacco and to take only milk as food and irido-cyclitis. No mydriatics or local depledrink. Several days afterwards he could see tion had been used, as should have been done fingers plainly with both eyes, and the field in the treatment he had received. He was of vision had greatly improved. Now he at once put upon the following 'course of has about the nor:nal vision in the right eye, treatment: A brisk cathartic for abstraction and in the left eye he can see to distinguish of blood from each temple, and atropine, two people in the room. grains to the ounce, instilled into each eye, to be repeated many times a day, and exclusion of light from the eye. This was followed by an alterative course of treatment (proto-iodide of mercury). January 3, leeches were again applied to temples, also the week About six months since Mr. F. S. came to following. Under this course of treatment me, complaining that he was blind in his left the inflammation soon began to subside, and and almost blind in the right one, so that in the course of three weeks he could read he could not read the largest letters of Snel- No. 10 Jaeger's test type with the right len's type at five feet distance. The first eye eye. The 27th of January he was obliged had been lost from purulent conjunctivitis to return to his home. He was advised to in childhood, but the latter had been troub- continue the iodide of potassium instead of ling him only for a year. He was about 40 the iodide of mercury, which had been disyears old, full habit; tolerably correct in his continued, and to re-apply leeches should ochabits, with no history of family taint or pre- casion require it. At present date, March vious general or local disease. The most 12th, vision in right eye is perfectly restored careful inquiry failed to reveal any other and with left eye he can read No. 12 cause for his failing vision than the excessive Jaeger's test type. It may be that vision use of tobacco. The most careful examina- will be improved yet still more in the left tion of the eye failed to detect any gross eye. lesion of any of its structures. He was advised to stop using tobacco and to take full doses of strychnia. In a week vision had improved to, in two weeks to; at present it is about 28. eye 20 VERBAL COMMUNICATIONS. Dr. Noyes-The following case seems to me to have some points of practical interest, and I therefore report it here: The above case is of practical interest, since it furnishes a striking instance of what sometimes occurs, viz., a well-marked and severe case of sympathetic ophthalmia (irido-cyclitis) in the fellow eye, following and caused by a very slight blow upon the eye without transmitting injury to any part of the organ, and also that the eye which has received the hurt may, as has happened before, come out, as to vision, the better of the two. In such a case as this, it need PATHOLOGICAL SPECIMENS. Henry A., a robust and healthy-looking youth, æt. 16, of Atwood, Ind., while at play with a comrade was hit with a knuckle hardly be said that enucleation of the inof the hand in the right eye. The eye apjured organ would not be of any avail, or, peared, immediately after the accident, to indeed, justifiable. have received no hurt or injury; but in a day or two it began to be painful and to look red and inflamed. He immediately consulted a physician, who had charge of the case till his father came with him to me, December 22, six weeks thereafter. At this date the case was found to be in a very unpromising condition. The conjunctiva was inflamed and swollen, accompanied with profuse lachrymation. The cornea also was so vascular that the iris could only be indis Dr. Hawes I have here a specimen of a portion of the stomach, liver, colon, spleen, and you will notice that they are firmly adherent to each other. They cannot be separated without destroying the tissues. Here, at the pyloric end of the stomach, is a tumor which involves all the coats of this organ. The liver and spleen are full of small nodules, about the size of hickory nuts. There were many other such small tumors in the mesen tery and intestinal glands. From the appear-eral State associations. On the other hand ance, I should call this a carcinoma of the the workers in these scientific bodies are, as stomach and the smaller ones secondary a rule, friends of and workers in the larger growths. I do not know much about the and more general societies. history of the patient before death. The Detroit Lancet. LEARTUS CONNOR, A. M., M. D., EDITOR. THE Annual Medical Convocations. HE fifteenth annual meeting of the Michigan State Medical Society will be held at Grand Rapids May 12th and 13th. A reduction of fare on most of the railroads has been obtained by the Recording Secretary. Those desiring to avail themselves of this reduction can, on application, obtain the required certificates from Dr. Geo. E. Ranney, Lansing, Mich. However we may define or explain it, the personal contact of its members at stated intervals is one essential for the best development of any body of men engaged in the same pursuit. Hence we find that men engaged in politics, in religion, in banking, in various kinds of manufactures, etc., etc., as they increase in numbers find it to their interest to confer with each other personally. The pen, press and telegraph have thus far been unable to furnish any adequate substitute for personal contact. To see each other, to hear each other speak, to note the inflections of voice, the peculiar gestures, and facial expressions, is to better understand the writer of books, magazine articles, originator of new operations, the inventor of new The American Medical Association holds instruments, etc. The shake of the hand its annual gathering at New York City, June and the interchange of friendly courtesies 1st, 2d, 3d and 4th. We have no doubt that has united more members of the profession a moderate attendance will be found at both in the bonds of a common aspiration and a State and National meetings. But the at- common labor than all the constitutions and tendance should be more than moderate. Let by-laws ever written. The commingling of each reader of the Detroit LANCET deliberate- the veteran of three score and ten with the ly ask himself why he will not be found there. novice in the profession, binds the past Some will reply that since their object is through the present to the future by living, mainly to make money they must be excused. vital bonds. Rivals in the same field here Others have certain society pleasures which for the time drop the bitterness of their are to them of more importance than any conflicts, and learn to respect the man and medical society meetings. They must needs often the rival. A moment's reflection will be excused. Others say that few if any make it apparent that personal contact stimuoriginal papers of value are read at these lates the sluggish and encourages the active meetings, therefore they must be excused investigator, and so indirectly promotes the from such a profitless journey. Others are interests of medical science. Inducing a so busy with professional work that they greater unity of feeling, such personal conplead to be excused. Many are waiting for tact brings about that unity of action so business, and offer this as in lieu of attend- necessary to protect our common professional ing. Some say that the associations are run | interests in matters of legislation-suits for by medical politicians for their own glory, malpractice, the regulation of medical pracirrespective of any professional advance- tice, the prevention of the enacting of laws This list of reasons might be indefi- interfering with scientific investigation. nitely extended. Yet, in face of all, we are Never was there a more warning call for of the number who firmly believe that the the profession to combine all its forces for value of State and National associations is purpose of offense and defense. Laws reincalculable. There are such associations specting material for dissection are in most that do excellent scientific work, viz., the States very harmful to our interests. Nothing Ophthalmological, Otological, Gynecologi- but united effort on the part of all will so cal, Laryngological, Dermatological, etc. It revolutionize popular prejudice as to peris interesting to note that we find enrolled mit the profession to utilize the bodies of in these societies few of the names of the paupers and criminals for the purposes. objectors to the American medical and gen- Until this is done the trade of body-snatch ment. ing must exist, and the bodies of the rich as well as of the poor are liable to find their way into the dissecting room. The determined effort made last winter in the New York Legislature to prohibit vivisection, is a hint of what we may expect in other States unless we combine to set in operation such influences as will properly educate the people in the nature and necessity of this method of scientific research. Then in all sanitary matters the medical profession should be prepared to move as one man toward such changes as will promote the best interests of cities and country alike. While we must, to attain these and similar ends, work with politicians, we should be able to exert such an influence as to get the best medical men in political positions calling for medical or scientific knowledge. The name of the above-mentioned Health Officer of the Port of New York is Dr. William M. Smith, of Angelica, Allegany Co. He is a member of his county society; has represented his county in the Assembly twice and was a volunteer surgeon during the war. Besides this, in the Legislature of New York there was an effort to prohibit vivisection in that State, and an effort to prohibit medical societies from disciplining their members for consulting with irregular practitioners. All this indicates that unless the medical profession looks after its interests in legislatures and congresses, it is likely to be seriously crippled in its usefulness. The Health Officer of New York has it in his power to seriously modify the commercial interest of the entire country. Thus the appointment of an incompetent is a general Plans for a re-arranging of the machinery calamity. We may cry peace, but there eviof these large associations were proposed dently is no peace. If we neglect united last year by Prof. Chaillé, of New Orleans. effort and evade general political and social At our June meeting a committee will re- duties, we must be prepared for the anoyport upon these. The nature of these ances, hindrances and persecution of our ene plans, the character of the committee, and mies. We cannot shut our eyes to the fact the evident demands of the hour, render it that we have hosts of enemies, both within almost inevitable that the result will make and without. Only by increasing vigilance the medical profession more and more of a can we hold our own or make any creditable unit, and more of a power, scientifically, po- progress. With a substantial unity and an litically and socially. With enemies on indefatigable effort we can and we should conevery hand, our only safety lies in collecting stitute one of the most important elements all our forces, and marshalling them under of legislation and government. Advancing captains and generals ready for any service civilization calls for doctors who have the of defense or offense. Away with every knowledge and power, not only to relieve inpaltry excuse; away with the allurements dividual pains, etc., but to unravel the probof ease; away with every purely selfish consideration, and let us as one man be found at these great annual meetings. Those who can bring good papers will be welcome, and so are those who bring only a hearty love for the profession and good will to each of its members. Politics and Doctors. lems of life as related to law, government and all the infinitely diversified commercial and social relations. The advancement of the profession and the elevation of the standard of medical education call for a more correct apprehension of the profession by the people. This apprehension can only be brought about by the agency of the profession as an instructor of the people. The Governor Cornell, of New York, has ap- maintenance of our rights and the improvepointed as health officer of the Port of New ment of our privileges in the aforementioned York a man who, in so far as we have been aspects will necessarily make us better known. able to learn, has no qualifications for the by the people, and so end in our mutual benplace other than that he has done much hard efit. Plenty of evidence could be adduced work for the political party to which he be- from every part of the United States to show longs. The pay for this work seems to be that unless we look after our general politicthe above appointment. The Governor seems al relations these relations will look after us to have disregarded the desires of the best in a manner mutually unpleasant and disassanitarians and treated the appointment as trous. As one of the ways of becoming havin reference merely to his own wishes. qualified to intelligently exercise our individ |