SOCIETY REPORTS.

AMERICAN GYNECOLOGICAL SOCIETY.

Dr. James R. Chadwick, of Boston, conceived and Dr. Fordyce Barker, of New York, generated the American Gynecological Society.

Dr. H. P. C. Wilson, of Baltimore, in his presidential address before the meeting of the American Gynecological Society, held at Boston in September, 1889, was not very friendly toward the new complications into which the society is becoming entangled, i. e., with the American Congress of Physicians and Surgeons. He said: "I would restrain this society from all entangling alliances with other societies. The distractions of such large assemblies are not promotive of the best work in any specialty. If we would make it the great authority on gynecological subjects, if we would make it the first in wisdom as the first in age, we must abstain from too much allegiance to other societies and let our full strength be concentrated here. Whatever time and labor we spend with them will be subtracted from this, and by so much will its vigor and strength be diminished."

Laparotomy during Menstruation was the subject of the scientific portion of the address. Shall laparotomy be performed immediately preceding or during menstruation was a subject which had frequently embarrassed him during his earlier professional career. His experience had taught him that for laparotomies involving the pelvic organs, it was better to select the uterine flood than the uterine ebb. During the uterine flood the circulation and innervation are in a state of tonic excitement. During the uterine ebb they are in a state of relaxation and depression. On this account patients are more liable to passive hemorrhages, the absorption of septic poison, the deadly influence of shock, than when the system is under the stimulus of the uterine flood. It might be said that inflammatory troubles are more apt to be set up during the uterine flood, yet he could not recall that he had lost a case of laparotomy by inflammation other than septic. The doctor related two cases in detail in which he had performed laparotomy for ovariotomy during menstruation which came on owing to the excitement of the patient in anticipation of the operation. He said he could

relate many cases in which he had performed laparotomy very near or during menstruation, but would not detain the society. Within the past year he had done a number of such operations and every one recovered. He has not lost a case where laparot

omy was done immediately before or during a menstruation, and he is forced to make the uterine flood the time of selection for such operations, rather than the uterine ebb.

THE MEDICAL TREATMENT OF DYSMENORRHEA.

E. W. MITCHELL. M.D., PROFESSOR OF INTERNAL MEDICINE, CINCINNATI POLYCLINIC.

Abstract of paper read before the Cincinnati Obstetrical Society, October 10th, 1889.

Dysmenorrhoea is a symptom associated with many pathological conditions. The frequent existence of these, without dysmenorrhoea, is proof that no one of them is the efficient cause of the suffering.

The explanation which seems most in accord with clinical facts is that which attributes it to a "hyperæsthetic condition of the endometinum, especially at or near the os intenum, combined with more or less stenosis or induration at this point." (Wylie, Am. Syst. Gyn. VI). Whatever theories we may acccept as to the immediate cause it is quite certain the dysmenorrhoea is not cured without the cure of the pathological attendants. Since many of these are only cured by surgical means, the number of cases amenable to medical treatment alone becomes a limited one, yet it is by no means an unimportant one, because it will include a large part of the numerous cases of girls and young ladies in whom it is desirable to avoid local treatment, and, if possible, local examination.

When in such, constitutional measures do not relieve, examination and dilatation, or other surgical measures indicated, should be made. The general practitioner is perhaps as prone to persist in medical treatment alone, when surgery is needed, as are some specialists to undue haste to examine and operate.

Remedial measures are divided into those of relief and those of cure. Of the former, opiates are the most powerful for relief and for evil. They should be avoided. Chloral should also be avoided, or used cautiously, because of the danger of forming the chloral habit. The prolonged use of the bromides should be

avoided, especially in anæmic subjects, on account of their depressing effect upon the general health. For the relief of the paroxysm they are often valuable, and may sometimes, as in spasmodic cases, be advantageously combined with belladonna or hyoscy amus. Cannabis Indica the writer has found often to give prompt relief, especially in cases in which the flow is free. Antipyrin is a valuable addition to our means of relieving pain. Tincture of cimicifuga and pulsatilla have both been found to give relief in some cases. Oxalat of cerium, in six grain doses every two hours, has been lately recommended in fleshy, robust women with scanty flow. (M. L. Chambers, Med. Record, July 7, 1889).

Foremost among curative agents stands general hygienic treatment. Nutrition, exercise, healthful mental and moral surroundings are of the utmost importance. Young girls must have especial attention to these matters, and all undue drains upon their vital forces, as too close confinement in school, at musie or art lessons, late hours, and the dissipations of society, must be stopped. Local treatment is seldom needed. The trouble in these

cases is a lack of development of the utero-ovarian system. The demands of our modern education and the excitements of "society," keep the demands of the brain and nervous systems for nutriment so active, that there has not been sufficient to complete the growth of the sexual system. She now comes to perform an adult function with an infantile organ. The effort is imperfect and painful. The reproductive organ must be given a chance to catch up with the rest of the system in its development.

Cases which are neurasthenic, or in which the nutrition is very poor, are often best treated, at the start, by a course of " rest cure "-seclusion, milk diet, massage and electricity. Iron is usually indicated by the existence of anæmia, Arsenic is often valuable as a tonic. Electricity, both general and local, has rendered me good service.

Of drugs which have been supposed to have a specific influence, but few have maintained a place in general usage. I shall speak of but two, apiol and manganese, both of which, I believe, do have some specific influence upon the utero-ovarian system. The binoxide of manganese is probably quite as efficacious as the permanganate, and being much easier to give, is to be preferred.

Of eight cases reported, apiol had seemed to give entire relie in two. Binoxide of manganese had apparently cured one case of extreme suffering, accompanied by epileptiform seizures at each

period, in an unmarried woman, aged 31 years. Two other cases of young ladies had been cured by the binoxide, and a third one, of chlorosis, by that remedy associated with iron, and with general regimen. One case had been very greatly relieved by the galvanic current. These were all cases uncomplicated by appreciable pelvic disease.

THE seventh annual meeting of the Ohio State Sanitary Association will be held in the hall of the Young Men's Christian Association, Dayton, Ohio, November 21st and 22d, 1889. The following papers will be presented :

The Relations of Theologians to Sanitarians, Dr. D. J. Snyder, Scio; Sanitation vs. Medication, Dr. S. P. Bishop, Delta ; Recent Advances in Etiological Science, Dr. E. R. Eggleston, Mt. Vernon; Sanitation in Small Villages, Dr. Austin Hutt, Waverly; Bodily Comfort as a Sanitary Object, Dr. G. C. Ashmun, Cleveland; Influence of Climate Upon So-Called Malarial Fevers. Dr. Wm. Owens, Cincinnati; The Cadaveric and Vital Alkaloids, Prof. C. C. Howard, Columbus; Will General Sanitation Ever Become Popular? Dr. John McCurdy, Youngstown; Address of Welcome, Hon. A. D. Witt; Response to the Address of Welcome, Dr. R. Harvey Reed, Mansfield; Poem-Bacteria, or the Flies We Feed On, and the Bugs that Kill Us, Dr. W. S. Battles, Shreve; President's Address; The Use of Pork, and Description of TrichniaSpiralis, Dr. D. H. Beckwith, Cleveland; Food as a Therapeutic Agent, Dr. H. J. Herrick, Cleveland; The Best Food for Man, Dr. J. D. Buck, Cincinnati; The Relation of Water Supply to Disease, Dr. H. J. Sharp, London; The Necessity of Uniform Rules, Regulations, Reports and Records of Local Boards of Health, Dr. F. Gunsaullis, Columbus; The Sanitary Teachings of the Bible, Prof. E. T. Nelson, Delaware; The Hygiene of the Chronic Insane, Dr. J. W. Scott, Cleveland; Garbage and Night Soil Crematories from a Financial and Practical Standpoint, Dr. George I. Garrison, Wheeling, W. Va.

Through the courtesy of the Central Traffic Association, persons attending the seventh annual meeting of the Ohio State Sanitary Association will be granted a reduction in their return railroad fare under the following conditions:

Ist Each person must purchase a first-class ticket to the place of meeting, for which he will pay the regular tariff fare, and upon request, the ticket agent will issue to him a certificate of such purchase, properly filled up and signed by said ticket agent.

2d. Tickets for the return journey will be sold by the ticket agents at the place of meeting, at one-third the highest limited fare, only to those holding certificates, signed by the ticket agent at point where through ticket to the place of meeting was purchased, and countersigned by the secretary or clerk of the convention, certifying that the holder has been in attendance upon the convention.

R. HARVEY REED, M.D., Secretary.

VACCINATION STATISTICS.-Dr. Hopkirk (Medical Press Polyclinic) says that of 2,800,000 vaccinations performed in Germany in 1883, not a single case of transmitted syphilis, or other illness, has been observed. Since 1875, when compulsory vaccination was enforced, not one single German soldier had died of smallpox, but the mortality from that disease has remained very high both in the French and Austrian armies. In 1886, the smallpox death rate per 100,000 was, in Berlin, 0.07; in Hamburg, 3,58; in Munich, 0.75; in Dresden, o.o; in Breslau, 0.0; in London, 0.6; in Vienna, 26.15; in St. Petersburg, 15.30; in Prague, 55.49; in Buda Pesth, 368.7; in Marseilles, 543.3; in the German army, 0.0; in the Austrian and French armies, 7.9 each; total smallpox mortality in Germany, 155; in Marseilles, 2051!!!! It being thus an incontrovertible fact that in Germany, the only thoroughly vaccinated country in the world, smallpox has ceased to be a scourge, need one be surprised that the opposition to compulsory vaccination in that highly-educated land is as minimal as the mortality from smallpox.

MALTA FEVER.-Dr. Bruce concludes his studies upon this disease with the following:

1. Malta fever is a specific disease quite distinct from enteric and remittent fever.

2. It is caused by the entrance into the system of a minute parasite.

3. No drug at present known has any power of modifying the action of the bacteria in the system.

4. Treatment is to be principally directed to keeping the patients strength up by fluid, easily digested food, and, when required, by stimulants, and by attention to ordinary hygienic principles. Removal of the patient from the infective area does not cut short the course of the fever.