WASHINGTON. ings, and a steamboat excursion up the Hudson and not as a protection to the lives and property of the down to Coney Island, which is to take place imme- community, but as an agency which is placing these in diately on the final adjournment of the association, peril." and the expense of which will be borne by Mr. William Wood, the publisher. The committee of arrangements consists of Dr. Thomas, chairman, Dr. Walter R. Gillette, secretary, Drs. Stephen Smith, C. I. Pardee, W. M. Polk, R. F. Weir, A. A. Smith, and M. A. Pallen, of New York, Dr. Joseph C. Hutchinson, of Brooklyn, Dr. M. A. Burton, of Troy, and Dr. E. H. Parper, of Poughkeepsie. There is also an associate committee, consisting of Drs. C. A. Leale, Le Grand N. Denslow, L. A. Rodenstein, P. Brynberg Porter, Charles W. Packard, Daniel Lewis, and others. -The dreadful calamity at the Madison Square Garden, where the fair in aid of the homeopathic hospital was being held, is naturally exciting a great deal of public interest, and it is hoped that the inquest concerning it, which is now in progress, and the investigations made in connection with it, will have the effect of rendering the occurrence of such a needless catastrophe henceforth impossible in this city. As far as can be made out at present, there seems to be no doubt that the owners of the property and the Department of Buildings are directly responsible for this wanton destruction of human life: the former being culpable for constructing such a wretchedly insecure edifice, and the latter for allowing its erection. For a considerable time past it has been believed by those who had the best opportunities for information on the subject that there has been not only the most reckless negligence, but even gross corruption, on the part of the principal officers of this department of the city government (an opinion which this disaster would seem to go very far towards confirming); but hitherto political trickery has interfered with an exposure and removal of the existing evils. Efforts have not been wanting from time to time, however, to put an end to such a disgraceful state of affairs, and since the Madison Square calamity some resolutions were introduced into the board of aldermen by one of its most efficient and public-spirited members to the effect that a committee should be appointed for the purpose of hearing testimony and collecting all facts, statements, and other matter bearing on the subject. The preamble of these resolutions is as follows: "Whereas, The late dreadful calamity at Madison Square Garden, by which several persons have lost their lives, and many others have been mutilated and injured, has filled this community with horror and just indignation; and, Whereas, this disaster has again directed public attention to the administration of the Department of Buildings, in regard to the proper conduct of which frequent allegations have been made,— which allegations have as yet received no thorough official investigation or inquiry; and, Whereas, This occurrence, coupled with the facts and statements previously averred, which have never been satisfactorily explained, furnishes strong ground for belief that the administration of the Department of Buildings is such as to shake public confidence in its efficiency and honesty, and to cause it to be regarded, -The following, as a joint resolution, passed the United States senate on April 29th: Resolved, etc., That the president of the United States is hereby authorized to call an international sanitary conference to meet at Washington, District of Columbia, to which the several powers having jurisdiction of ports likely to be infected with yellow fever shall be invited to send delegates, properly authorized, for the purpose of securing an international system of notification as to the actual sanitary condition of ports and places under the jurisdiction of such powers and of vessels sailing therefrom. A resolution in the form of an amendment to this was offered, appropriating $5000 to defray the necessary expenses, but it was voted down. - As an evidence of the sometimes disastrous effect of tardy legislative action on the "save at the spigot, lose at the bung," principle, that part of the discussion on the Indian appropriation bill which refers to the supply of medicines and medical services is very forcible. The Northern Cheyennes, some five thousand in number, were placed upon a government reservation, comprising a radius of fifteen to thirty miles, which was infested with malaria, a condition of things hitherto unknown to these Indians, who had come from a region entirely free from it. To meet their wants they were supplied with one attending physician (recently he has been furnished with an assistant). Hundreds of these Indians fell sick; a requisition for medical supplies was made upon the department in May. June 19th the contract was awarded; August 27th the contract was approved; November 28th the medicines were delivered; January 17th these supplies were received at the post for which they were intended. What an encouragement for medical men who seek such places! — a family of five thousand under the exclusive care of one man, with miles of territory between him and his patients, the probabilities that all will suffer more or less from a disease which they have never before encountered, and no medicine. But then they have a fair appropriation for industrial schools; moral pocket handkerchiefs are not set down as such in the bill. Miscellany. CRUDE PETROLEUM IN ASTHMA. MR. EDITOR, — It is a well-known fact that many of our most valuable medicines have been borrowed or developed from general impressions or the prevailing prejudice of the common people in some district or country. Jenner deduced an important scientific truth from the vague notions and common prejudice of the dairymen of Gloucestershire. In like manner has it been with many of the important remedies of the now extensive materia medica, which have often been in use by the common people before being investigated by the profession. Pursuing this line of observation, we find the veterinary surgeons, farmers, and horse-jockeys now pre a vis a tergo. He painted the face (small portions at a time) with cantharidal collodion, producing vesication, and then applied poultices. The discoloration in the epidermis of course disappeared so soon as the epidermis was removed by the blistering, and the discol oration located in the rete mucosum and corium was washed out by the serum in its exudation into the blisters. The result was very gratifying; the face regain scribing the ordinary crude petroleum as a remedy for broken wind and heaves in horses, and with astonishing success, improving the general condition of the animal, giving him a fine appearance, and removing the difficulty of breathing as if by magic; a cure which they are willing to swear is permanent, which assertion I accept with several grains of allowance. Heaves and broken wind I have always looked upon as due to emphysema, and consequently treatment must nec-ing its normal color except in the angle between the essarily be only palliative. Crude petroleum is a stimulating anti-spasmodic expectorant and diaphoretic of no mean power. It seems to act by stimulating the secretions generally, especially those of the skin, and improving the digestive functions. The dose for the horse is one teaspoonful in meal, placed well back upon the tongue, two or three times per day, continued until relief is afforded. nose and the cheek, where the vesication was not done as carefully as in the other situations. Dr. E. H. Gregory invited the members to examine a case of doubtful gender, which had presented itself to him to know if marriage were possible. The face, figure, and general appearance of the patient were those of a man. It wore a beard, and was rather above the average size. Upon examining the genitals there was found an organ resembling a penis, from two and a half to three inches in length, in a flaccid condition, and a little larger than a man's thumb in circumference, bent upon itself as if in a chronic condition of chordee. The glans was disproportionately small, being about the size of the last phalanx of a man's little finger. The cov Upon raising this organ perfect labia majora and minora and a vagina about three inches in depth and rather small in circumference were revealed. The urethra did not extend to the end of the organ resembling a penis, but opened into the vagina, the meatus being farther back than it is in women, the urethra being continued on the under surface of the penis as a deep groove. The labia minora on the under surface of the glans seemed to replace the frænum preputii; farther back they extended up over the corpora cavernosa, and as we have already said in this position they had all the appearance of true skin. These attachments of the labia gave the peculiar curvature to the organ. Having seen the beneficial effects of this remedy frequently applied to the horse, I was led to experiment on that difficult disease to cure, asthma. I used the ordinary oil in various combinations, as in syrups, emulsions, etc.; but however it might be combined, I found that it always produced a disagreeable eructation, and that it was hard to induce patients to perse-ering of the corpora cavernosa was perfect integument. vere in its continuance. But the semi-solid oil that accumulates on the tubing and casings of the wells, and hardens to the consistency of putty, made into pills of five grains by incorporating with some inert vegetable powder, and taken every three or four hours, has afforded almost instant relief. The paroxysms will not return under its usage. It is not curative, but the patient does not suffer while taking the pills, and after a few days the spasmodic symptoms seem to pass off. Many asthmatics care affected only in the spring or fall, and after these attacks pass off they are comparatively comfortable. Nothing has afforded me as much relief in the treatment as these pills in hay fever, autumnal catarrh, or asthmatic bronchitis. The cough and dyspnoea are promptly alleviated. I have already called the attention of the profession to the value of this remedy in pulmonary tuberculosis. M. M. GRIFFITH, M. D. IRVING, N. Y. With a catheter in the bladder and a finger in the rectum no uterus could be discovered. There were no testicles in the labia majora. The patient is nineteen years old; has orgasm accompanied by some sort of ejaculation; has never attempted connection with a woman, but the passion is directed toward women. The patient came to have the urethra extended to the end of the penis or clitoris, which ever it may be, as the statement had been made that if this were accomplished he or she would be able to beget children. There is no menstruation, and no ovaries have been found. Dr. Gregory will probably discourage any idea of marriage. The Sanitary Council of the Mississippi Valley has just held its meeting in St. Louis. Dr. J. D. Plunket, president of the State Board of Health of Tennessee, presided, and Dr. John H. Rauch, of the Illinois State Board of Health, acted as secretary. Among those present were Dr. H. A. Johnson, of Chicago, member of the National Board of Health; Dr. Thompson, delegate of the Kentucky State Board of Health; Dr. Lindsley, representing the Tennessee Board of Health; Dr. Lyman, of the New Orleans Auxiliary Sanitary Association; and Dr. Geo. Homan, from the St. Louis Board of Health. Reports from several committees were received, showing that the members of the council have been attending to their duties since the council's organization, not quite a year ago. They also adopted the following resolutions: Resolved, That the passage of the bill now before Congress, to increase the efficiency of the National Board of Health and to provide the funds necessary to enable it to aid financially state and local boards of health, is in all its essential features wise and judi cious. Resolved, That the senators and representatives in Congress, from the States represented by this council, are respectfully requested to support in all important particulars this measure. The usual tours of inspection were made, and on one of them the following resolution, very gratifying to St. Louis, referring to our quarantine station, was adopted, it being introduced by Dr. Lindsley, of Tennessee: Resolved, That the council have viewed with special interest the provision made at the quarantine station for the care of those having infectious or contagious diseases. From a strictly sanitary stand-point, and for the general purposes for which it is intended, it is superior to anything in the valley of the Mississippi. The officers for the ensuing year are Dr. R. C. Kedzie, president, president of the Michigan State Board of Health, and Dr. Pinckney Thompson, vice-president, president of the Kentucky State Board of Health. Dr. John H. Rauch tendered his resignation as secretary, but the council declined to accept it. Dr. Plunket, who was famous for his Order No. 6, Cities. last summer, and was hanged and burned in effigy in Memphis, when asked if there was likely to be an epidemic of yellow fever this year, replied that there might be a few scattering cases through the Mississippi Valley; but he did not anticipate another epidemic. X. COLOR BLINDNESS. MESSRS. EDITORS, - In the journal of the British Medical Association it has been proposed, as a test question, to examine for color-blindness all the members present at the annual meeting at Cambridge, August 3d to 5th. It would be a valuable contribution to science to be able to do the same in reference to the Massachusetts Medical Society at our coming meeting. This I hope to undertake it the members are willing to spend the time, not over one minute, for the test. The value of the investigation would, of course, largely depend on having all the members recorded. Names would neither be used or published, thus it would not be known who proved to be defective in the chromatic sense. May I ask for the coöperation of the JOURNAL in this investigation? Respectfully yours. B. JOY JEFFRIES, M. D. 15 Chestnut Street, Beacon Hill, May 3d. Two thousand four hundred and thirty-three deaths were reported; 933 under five years of age: principal "zymotic " diseases (small-pox, measles, diphtheria and croup, diarrhoeal diseases, whooping-cough, erysipelas, and fevers) 342, lung diseases 404, consumption 372, diphtheria and croup 102, scarlet fever 50, measles 48, typhoid fever 38, diarrhoeal diseases 31, whooping-cough 20, malarial fevers 19, erysipelas 16, cerebrospinal meningitis 15, small-pox three. From measles, New York 15, Brooklyn 10, Philadelphia eight, Chicago, St. Louis, and Pittsburgh four, Holyoke two, Cincinnati one. From whooping-cough, Pittsburgh four, Brooklyn and Cincinnati three, New York, Philadelphia, Baltimore, and Nashville two, St. Louis and Worcester one. From malarial fevers, Brooklyn eight, New York six, St. Louis four, Baltimore one. From erysipelas, New York six, Chicago three, Philadelphia and Brooklyn two, Baltimore, Cincinnati, and Milwaukee one. From cerebro-spinal meningitis, New York four, Philadelphia, Milwaukee, and Fitchburg two, District of Columbia, Pittsburgh, New Haven, Worcester, and Taunton one. From small-pox, Philadelphia, Chicago, and Worcester one. One hundred and nine cases of measles, 41 of diphtheria, 28 of scarlet fever, three of whooping-cough, and one of typhoid fever were reported in Brooklyn; diphtheria 24, scarlet fever six, in Boston; diphtheria 23, scarlet fever five, in Milwaukee; scarlet fever 24, diphtheria seven, cerebro-spinal meningitis four, erysipelas two, typhoid fever two, measles one, in Providence; diphtheria four, scarlet fever one, typhoid fever one, in Cambridge; scarlet fever five, diphtheria four, in New Bedford. The total number of deaths reported was considerably diminished from that for the previous week, and the deaths under five diminished in about the same proportion. Lung diseases and pulmonary consumption diminished. Principal “zymotic" dis eases diminished twenty-five per cent. Typhoid fever diminish ing in Pittsburgh. One death from small-pox in Philadelphia, in Chicago, and in Worcester. In 36 cities and towns of Massachusetts, with an estimated population of 1,023,560 (population of the State about 1,690,000), the total death-rate was 19.82 against 22.66 and 22.89 of the previous two weeks. For the week ending April 3d, in 150 German cities and towns, with an estimated population of 7,713,077, the death-rate was 28.6 against 28.9 and 27.6 for the two previous weeks. Five thousand_six_hundred and ninety-nine deaths were reported; 1976 under five: pulmonary consumption 677, acute diseases of the respiratory organs 597, diphtheria and croup 162, whooping-cough 63, typhoid fever 60, scarlet fever 59, measles and rötheln 50, puerperal fever 24, typhus fever (Braunschweig, Königsberg, Thorn, Beuthen) five, small-pox (Königsberg, Beuthen) four. The death-rates ranged from 18 in Potsdam to 38.6 in Aachen; Königsberg 37.8; Breslau 33.7; München 36.9; Dresden 26.5; Berlin 25.7;Leipzig 28.6; Hamburg 28.6; Hanover 21.4; Bremen 24.8; Cologne 28.3; Frankfort 26.4; Strassburg 27.7. For the same week, Vienna 35.3,-small-pox greatly diminished, scarlet fever one death; Paris 29.8,- smallpox, diphtheria, and typhoid fever prevalent. The meteorological record for the week in Boston was as fol lows: Mean. Maximum. Minimum. April 18 30.233 38 19 30.215 45 66 20 21 30.082 51 62 30.232 51 22 29.973 56 73 23 66 24 39 30.081 42 51 41 30.138 45 100 40 33 33 71 66 63 67 N 37 73 41 69 61 S 70 70 57 50 45 NW SE S 20 77 S S S 4880846 7 8 10 1 O., cloudy; C., clear; F., fair; G., fog; H., hazy; S., sleet; R., rain; T., threatening. DR. HENRY JOHNSON. Ar a meeting of the New Bedford Society for Medical Improvement, held on April 21st, the following preamble and resolutions were passed: Whereas, Death has removed from our midst our much-esteemed friend and colleague, Dr. Henry Johnson, of this city, and, whereas, it is fitting that this society, of which he was one of the founders, and at the time of his decease its vice-president, should express their feeling of sorrow at this great loss, therefore Resolved, That we gladly testify to our appreciation of his great professional skill, his readiness to advise whenever called upon by any of us, his honesty of principle toward his medical brethren and toward his patients, his affability at our social gatherings, all of which we shall always hold in grateful remem OFFICIAL LIST OF CHANGES OF STATIONS AND DUTIES OF OFFICERS OF THE MEDICAL DEPARTMENT U. S. ARMY, FROM APRIL 24, 1880, TO APRIL 30, 1880. MOORE, JOHN, major and surgeon. Granted an extension of two months of his present leave of absence. S. O. 90, A. G. O., April 23, 1880. AINSWORTH, F. C., captain and assistant surgeon. The oper ation of so much of paragraph 1, S. O. 74, C. S., A. G. O., as relates to him is suspended until September 1, 1880. S. 0. 83, A. G. O., April 22, 1880. SUFFOLK DISTRICT MEDICAL SOCIETY. - A regular meeting will be held at the hall, No. 19 Boylston Place, on Saturday evening, May 8th, at seven and a half o'clock. The following papers will be read: Dr. Douglas Graham, Massage in the Treatment of Uterine Affections, with a Report of SeventyTwo Cases; a reply in part to the paper of Dr. Wing on the Modern Abuse of Gynecology. Disputants, Dr. James R. Chadwick, Dr. William H. Baker. Dr. J. B. Swift, A Case of Empyema illustrating the Value of the Antiseptic Operation. All members of the Massachusetts Medical Society are cordially invited to be present, and to take part in the discussion. H. C. HAVEN, M. D., Secretary. We have received the first four volumes of Wood's Library of Standard Medical Authors for 1880, which indicates success on the part of the publishers in their "endeavor to supply standard professional literature at a price lower than ever before attempted in any country." VOL. CII., No. 20.] DCLIFFE RIVERS LIBRAND BOSTON MEDICAL AND SURGICAL JOURNAL. Lectures, MAY 80 1 ON THE DIAGNOSIS OF OVARIAN TUMOR.1 FOR A LECTURE DELIVERED AT RUSH MEDICAL COLLEGE, CHICAGO, FEBRUARY 9, 1880. BY PROFESSOR W. H. BYFORD, M. D. GENTLEMEN,We will consider to-day the subject of the diagnosis of ovarian tumors. An ovarian tumor, when small, may be mistaken for extra-uterine pregnancy, tumor of the Fallopian tubes, fibroid tumor of the uterus, and pregnancy. These are, perhaps, the most common disorders of the pelvic viscera which are liable to be confounded with ovarian dropsy, but further along enlargement of the spleen, peritoneal dropsy, enlargement of the liver, kidneys, and bladder, may also be mistaken for ovarian tumor. Let us now look at some of the symptoms, both objective and subjective, which these disorders present, and compare them with those found in dropsy of the ovary, and see if we shall be able to make a correct differential diagnosis in most cases. In pregnancy the symptoms and signs pertaining to that condition will be present, including more obtained by auscultation and palpation, and the tumor is found in the centre of the pelvis, and is symmetrical in shape. Where we have an ovarian tumor the symptoms of pregnancy are absent, and we will find the uterus crowded forward nearer the abdominal wall, and the tumor will be found in the cul-de-sac of Douglas. How may we know when we have a tumor of the Fallopian tubes? We shall find this variety of tumor located at or near the side of the uterus, and oblong in shape, while an ovarian tumor is globular, and situated behind the uterus. We may be pretty sure that we have a fibrous uterine tumor when we find that the mouth of the uterus is hard and misplaced; that there is menorrhagia or metrorrhagia; that the tumor itself is hard; that when the uterus is moved the tumor moves also, and the cavity of the uterus is enlarged. We shall probably experience great difficulty in diagnosticating an extra-uterine pregnancy, or rather in differentiating it from ovarian dropsy. In extrauterine pregnancy the tumor is generally in the posterior cul-de-sac, is globular, pushes the uterus forward, and extends up into the abdominal cavity like an ovaSo far, you see how these two growths may simulate each other and deceive the physician unless he is extremely careful. But there are some other symptoms and characteristics about extra-uterine pregnancy which will enable us to tell the difference between it and ovarian tumor. rian tumor. 457 patient may go almost to the last stages of the disease without any oedema, and then if any be present it may be caused by anæmia. For examination, first place the patient on her back, and in ovarian dropsy there will be seen to be some irregularity of contour, while in peritoneal dropsy there is no irregularity. Percussion in ovarian tumor reveals dullness all over, except at the sides near the spine and high in the epigastrium, where you get in testinal resonance. In peritoneal dropsy there is sometimes very marked resonance over the middle of the abdomen. In dropsy there is fluctuation everywhere, while in ovarian tumor the fluctuation ceases when we get beyond the border of the tumor. Now have your patient sit up, and, if peritoneal dropsy is present, the belly will sag and the tumor will decrease in size above, with increased resonance above, while the abdomen will enlarge below, with dullness in front. In ovarian tumor there will be no change in the shape of the abdomen or the location of the intestinal resonance. Sometimes abdominal dropsy and ovarian tumor coexist in the same patient. In a complication like this we need to use unusual care and tact in making a diagnosis. There will not be resonance in front, because the intestines do not rise up to the abdominal wall. Place the patient on her back, and push the ends of the fingers into the abdominal wall, and press them together from either side. If you can engage a tumor between your hands you probably have something besides abdominal dropsy. The aspirator or trocar will aid us in the diagnosis, as we shall find after a while. An important point in the diagnosis of these ovarian growths is to determine whether they are monocystic or polycystic. The monocyst is generally globular, and fills the abdomen symmetrically, and does not present any very marked prominences or depressions. There is no difference in the wave of fluctuation, no matter at what point you percuss. But in a polycyst the fluctuation is not the same in different localities of the abdomen. You can map out pretty definitely the different cysts which compose the growth. If you Sometimes a deposit of fat in the abdominal walls will mislead us, and we may suppose we have an extra-peritoneal growth. Fat is found in the walls of the abdomen from half an inch to ten inches thick. This layer of adipose tissue is outside of the abdominal muscles, between them and the skin. place the patient on her back and make percussion, you will get a wave of fluctuation which is similar to that of serum; you will be deceived by it unless you are careful. Now place one hand one side of the abdomen and tap upon the other side and you will feel the whole mass tremble; and although the sensation is sim In extra-uterine pregnancy we shall have the usual symptoms of pregnancy: gastric disturbance, nausea, enlarged breasts, and the nervous phenomena accom-ilar to that of the fluctuation you get from a sac filled panying a case of pregnant uterus, attended with irregular hæmorrhages and the discharge of organized material or membrane. When the abdomen is large, ovarian tumor may be mistaken for abdominal dropsy, and vice versâ. In ovarian tumor the patient is often in comparatively good health, while in abdominal dropsy there is generally some serious constitutional trouble. The liver, heart, or kidneys are usually affected. In peritoneal dropsy there is generally oedema of the feet or genital organs, or both, while in cases of ovarian tumor the 1 Reported for the JOURNAL by B. W. Griffin, M. D. with serum you can detect the difference if in percussing you place the fingers far down on either side opposite each other. If the enlargement is due to fat you can grasp the mass and lift it up in rolls from the abdominal muscles. I have known two instances where patients have been tapped and no fluid was drawn, because the trocar or aspirator was plunged into a mass of fat, which fortunately the instrument did not pass through. I have said that an enlargement of the bladder may simulate ovarian tumor. I have seen the bladder so distended as to reach within three inches of the ensiform cartilage. |