The fourth affidavit is by Dr. Wm. C. McDonough, who says Miami Valley (Ohio) Medical Society.—This society held that on or about June 23, 1902, he went to the office of Dr. its twenty-fifth anniversary meeting at Loveland, October 13 A. H. Peck with Dr. C. C. Rogers, at which time Dr. Rogers and 14. asked Dr. Peek where he had obtained the article in question, Boswell Park Medical Club, Buffalo.—This club has to which Dr. Peek replied that he had written it himself. The elected officers for the ensuing year as follows: President, Dr. affiant further states that thereon Dr. Rogers produced the Julius H. Potter; vice-president, Dr. William C. L. Meisberger, lecture delivered before the Chicago College of Dental Surgery, and secretary and treasurer, Dr. George F. Cott. Oct. 16, 1901, and that at that time Dr. Peck stated that when Mower County (Minn.) Medical Society.—This society he prepared his address as published in The Journal he had was organized at Austin, October 3, with Dr. William L. Hol- never heard or seen the lecture as delivered Dr. The lister, Austin, president; Dr. Willis F. Cobb, Lyle, vice-presi¬ by Rogers. Dr. affiant further states that Dr. Peck at that time stated that he dent; Christian A. Hegge, Austin, secretary, and Dr. George J. treasurer. had had his address for two years, but had not before Schüttler, Dexter, prepared Boulder made it and said then of delivered it in County (Colo.) Medial Society.—This society public nothing having met October 4. April, 1900. In addition to the scientific program steps were taken to secure a permanent home for a library and medical reading room for the society .i.-id visiting physicians. New Members. A committee on legislation was appointed, and also a commit¬ tee on health. The following is a list of new members for the month of public September, 1902: Brown County (Minn.) Medical Society.—After lying dormant for nearly seven years, this society is about to be re¬ ARKANSAS. James, W. B., Eloise. organized in accordance with the of the Helena. Wade, G. B., Laingsburg. suggestions American Ellis, J. B., Medical Association. At a held in MINNESOTA. meeting New Ulm, Sep¬ CALIFORNIA. tember 0, over Dr. W. B. Wiedow, Henry, Round Lake. presided by Jacob Wellcome, Sr., Beede, W. M. F., Stockton. Sleepy Eye, it was decided to call a meeting, reorganize and FLORIDA. MISSISSIPPI. elect officers. J. P., Tampa. Champenois, Cecil, Meridian. Helms, New York State Medical annual meet¬ Pierpont, J. Harris, Pensacola. MISSOURI. Association.—The Perry, P. C., Jacksonville. ing of this association will be held at the New York Academy Duncan, J. H., St. Louis. of GEORGIA. Carthrae, Lewis, Corder. Medicine Building, New York City, October 20 to 23. The is a most Hardin, R. M., Rome. MONTANA. program interesting one, including a symposium on one on ILLINOIS. Sievers, J. R. Butte. colds, typhoid fever, one on pneumonia, and one on E., the Horner, C. P., Tampico. Roentgen rays. Among guests from other states invited E. Winona. NEBRASKA. to Drs. Oliver, W., W. present papers are William J. Mayo, Rochester, Minn. ; Ferguson, H. M., Morris. Bellwood, S., Alliance. Albert J. W. Larchland. Ochsner, Chicago; S. Thayer, Baltimore, and Newell, S. C, NEW JERSEY. Alfred Yoder, H. L., Morton. Devlin, ï'rank, Newark. Stengel, Philadelphia. Shamel, J. Y., Gibson City. 'Guion, Edward, Atlantic City. Conference of State and Provisional Boards of Health Zillak, A. L., Olney. Paterson. . Tattersall, J., of North seventeenth annual conference will Cuthbertson, ., Chicago. Rogers, Geo. ., Newark. America.—The Hess, J. H, Chicago. Parker, G. H., Trenton. be held at New Haven, Conn., October 28 and 29, under the Patton, D. H. R., Chicago. C. of Trapp, . R., Peoría. Craythorn, J., Trenton. presidency Dr. H. M. Bracken of Minnesota. This confer¬ MacKenzie, W. W., Chicago. NEW YORK. ence has for its object the assembling from time to time of a Jacobs, R. H., Samoth. G. of executive officers to Gordon, R. El Paso. Scott, T., Davenport. body sanitary exchange opinions and E., Lusk, W. C, New York City. consider questions relating to the practical administration of INDIANA. NORTH CAROLINA. public hygiene. This assembly differs from the American Dancer, C. R., Ft. Wayne. Health in its Thomas, C. E., Leesburg. Tayloe, D. T., Washington. Public Association devoting attention exclusively Willeford, Geo. W., Washington. OHIO. to subjects which are of direct interest to the executive officer Detamore, J. E., Union City. Weaver, W. B., Cincinnati. of a health department, and in endeavoring to answer the INDIAN TERRITORY. Tunison, I. F., Cincinnati. questions which arise daily to every health officer as to the Schmidter, W. C, Cincinnati. of truths of Hailey, W. P., Wilburton. Schenck, W. E., Cincinnati. practical' application accepted sanitary science. Horine, W. H., Haileyville. . Rossford. Its includes boards of health. Sames, W. W., Gowen. Holst, B., membership thirty-five McClure, Bartony, Wittevllle. OREGON. International Convention for the Unification of Heroic LOUISIANA. White, C. S., Gervais. Remedies.—This convention was held in Brussels, Belgium, Gaster, L. D. S., New Orleans. PENNSYLVANIA. September 15. The object of the convention was to devise Levy, J., New Orleans. means of to a uni¬ McUehee, E. L., New Orleans. Skinner, J. O., Chambersbui'g. regulating poisonous preparations, secure Ryan, J. J., New Orleans. Meredith, C. C, Pittsburg. form percentage of strength in heroic remedies. There were Dorwoi'th, E. S., Beliefonte. nineteen each and Kiblinger, E., Avayelles Parish, Atlee, J. L., Lancaster. governments represented, sending a physician Plancheville. a chemist. Dr. Frederick B. Powers, of Hanson, T. H., Donaldsonville. SOUTH DAKOTA. formerly professor T. chemistry at the Wisconsin but now a resident of Butler, M., Sunimerville. Hanson, H. Beresford. University, Toler, E. McL., Woodland. P., London, was the United States and Dr. Thibodaux. England, chemist, Stark, Thos., TENNESSEE. Horatio C. Wood, the It was a Landry, . ., Assumption Par¬ Philadelphia, physician. very ish, Paincourtville. Van Meter, L. M., Memphis. harmonious meeting, and an agreement was reached establish¬ MAINE. TEXAS. ' ing a standard of strength for these drugs—all tinctures to be 10 It was decided the Gehring, J. G., Bethel. Loving, R. S., Ft. Worth. per cent. that Belgian government Hix, R. W., Vernon. should ask all the nations to out this MARYLAND. represented carry agree¬ ment. In most countries—the United States and Great Brock, C. E., Baltimore. WASHINGTON. McNerthney, J. B., Tacoma. Britain being the exceptions—the sale of drugs is MASSACHUSETTS. regulated by WEST VIRGINIA. law, and the change can be readily made by such governments. Lithgow, R. A. Douglas, Beverly. Upton, C. L., Shelburne Falls. Deyerle, J. H., Harding. American Academy of Railway Surgeons.—The ninth Cutler, C. N, Chelsea. WISCONSIN. annual meeting of this association was held in Kansas City, MICHIGAN. O'Malley, P. H., Madison. Mo., October 2 and 3. The president, Dr. August F. Jonas, Wilson, S. J., Detroit. Williams, W. E., Cambria. Omaha, chief surgeon of the Union Pacific Railway, delivered Grand F. M., Benton. Whinery, J. B„ Rapids. Bail', the annual address on the subject of "Negligence." The papers presented dealt chiefly with the responsibility of railway com¬ panies, medical experts, surgery and hygiene, and a symposium Societies. on "The Surgical Organization of the Railway Service," which included papers and a general discussion of the surgical and of The local members of the COMING MEETINGS. hospital systems railways. academy entertained the members at a banquet at the Midland, New York State Medical Association, New York City, Oct. 20-23, over which Dr. August F. Jonas, Omaha, presided as toast- 1902. master. The election of officers resulted as follows: President, Conference State and Provincial Boards of Health of North Dr. Luther Sexton, New Orleans, Illinois Central; vice-presi¬ America, New Haven, Conn., Oct. 28-29, 1902. Drs. Arthur L. Guthrie, Nov. 11, 1902. dents, Wright, Carroll, Iowa, Chicago Great Oklahoma Territory Medical Association, and John Kansas Southern Surgical and Gynecological Association, Cincinnati, Western, W. Perkins, City, Mo., Union Pacific Nov. 12-14, 1902. and Santa Fe; secretary and treasurer, Dr. Thomas B. Lacey,

Downloaded From: http://jama.jamanetwork.com/ by a Karolinska Institutet University Library User on 05/30/2015 Council Bluffs, Iowa, Wabash, Illinois Central and Chicago cal Indications for Induction of Labor," Simpson asserted that and Northwestern, and editor, Dr. R. Harvey Reed, Rock the habitual death of the fetus at a certain month is an indi¬ Springs, Wyo., Union Pacific. cation for intervention before this date. He, with others, in¬ International Congress for Care of the Insane.—The cluded tuberculosis, uncontrollable vomiting, certain cases of resolutions voted this congress which met at in hemorrhage and the nephritis of pregnancy among the indica¬ by Antwerp tions September, favored the "family colony" for suitable cases as whenever the prognosis of the pre-existing or intercurrent the most natural, the freest, the best and the most inexpensive disease is rendered more serious by the pregnancy, or the is on manner of caring for the indigent insane, while at the same pregnancy doomed account of them. Schauta stated that time it constitutes an important factor in the treatment. It 95 per cent, of women with heart disease can go through a can be an annex feature of any institution in charge of a pregnancy without much trouble. In case of mitral stenosis, psychiatrist, but the ideal is the foundation of central estab¬ however, he advocates interruption at the first sign of disturb¬ lishments in suitable country localities to serve as nuclei for ance of compensation, and also in rapidly progressive tuber¬ the foundation of the colonies. These colonies do not culosis, especially the laryngeal form. Hofmeier thinks that family chronic encroach on the establishments as they are adapted nephritis entails such disturbances that the fetus is existing when only for a restricted number of insane patients, but they solve lost ordinary treatment fails to relieve, and consequently the problem of the overcrowding of these establishments, and he advises induction of labor at any period, although there is of This on in a practical, active and inexpensive manner. The delegates very little danger eclampsia. danger is great, the other in case of the of were unanimously in favor of organizing an asylum-school for hand, nephritis pregnancy, and this also idiot and imbecile children in the family colonies, and of in¬ indicates termination of the pregnancy, while acute nephritis creasing the number of physicians in asylums and relieving the is not an indication for it, and is not influenced by it. Rein overworked attendants. They also favored the organization of advocates intervention in case of nephritis and in heart disease, a surgical service in such institutions. The congress ad¬ and reports 11 women thus treated and all cured, while 7 of journed to meet in 1904 at Edinburgh. the children were saved. He has induced labor 41 times in 2090 obstetric while list is 20 times Second International of cases, Pinard's in 22,708 Congress Electrology.—Among cases in the last ten with 15 recoveries. other the communications at this which closed years, Among presented congress, subjects discussed were in the Treatment of its sessions at Berne, 6, some the ad¬ "Hysterectomy September proclaimed Puerperal Infection" ; "Tuberculosis of the Female Genitalia" vantages of electric treatment of eczema and certain other and Treatment of of skin affections, of "Surgical Cancer the Uterus." Cullen of constipation, gastralgia, exophthalmic goiter Baltimore was invited to deliver an address on latter and tuberculosis. Fort of Paris advocated electro¬ the sub¬ pulmonary The was out as announced mitral ject. program carried in The lysis for strictures of the esophagus and valve, and Journal of 13, 639. the of Moscow lauded the continuous current for acute September p. Among Americans Chatzky present were Drs. Mann, inflammations. The addresses were on Engelmann, Kelly, Jewett, Cullen, "Electro-Diagnosis"; Wakefield, Barton, and the late Dr. John Byrne, with Brennan "Surgical Electrolysis"; "Radiology and Radiography of In¬ of Montreal. On invitation of the Russian ternal "Accidents from Oudin of government, St. Organs" ; the Z-Rays" by was selected as the of and of Industrial Electric An Petersburg meeting place the next con¬ Paris, "Dangers Currents." gress. exhibition of electric appliances was an important feature of the congress, as were also Kronecker's electric experiments at Narcosis was induced in a his Institute of Physiology. dog MEDICAL SOCIETY OF VIRGINIA. with the current, the cathode on the skull interrupted placing Annual and the anode over the kidneys. In another animal the heart Thirty-third Meeting, held in Newport Neivs, Sept. was arrested with a current of 240 volts, and then started to 28, 2Jf and 25, 1902. with the after the beating again same current opening thoracic The President, Dr. Richard S. Martin, Stuart, in the Chair. The next will be held at Amsterdam in 1905. cavity. congress Welcome. Vermont for the and of Tuber¬ Society Study Prevention Dr. John W. welcomed culosis.—This was at Ayler, Norfolk, the society on behalf society organized Burlington, Septem¬ of the profession of and referred to ber 28, a number of physicians and laymen from the differ¬ Newport News, the courage by and of the the ent parts of the state. A constitution was adopted, and spirit Virginia physicians, welcoming older ones as the of Medical various phases of tuberculosis were discussed. Officers were fathers the Society of Virginia and bidding elected as follows: President, Hon. E. C. Smith, St. Albans; the younger men welcome and Godspeed in their efforts to re¬ vice-presidents, Drs. Don D. Grout, Waterbury, and Charles W. lieve suffering humanity. Peck, Brandon; secretary, Dr. H. Edwin Lewis, Burlington, Dr. Robert Lee Payne, Norfolk, in his address to the public,, and treasurer, H. L. Stilson, Bennington. The following reso¬ informed the assembly of the aims and objects of the society. lutions were adopted: Whereas, The widespread occurrence of tuberculosis in any com¬ President's Address. which in the interests of human¬ munity presents problems highest The President characterized his address as "A talk ity, charity and the public welfare should engage the attention of plain onr some of the all thinking people ; and benefits to be derived by thorough organization of Whereas, Tuberculosis, a disease that scientific study has shown the medical society, both to the laity and the profession, with, to be preventable and curable to a marked extent, is responsible for mention most more suffering and deaths in Vermont than all other transmissible of the prevalent causes of sickness, race decay diseases combined, and and their prevention." He asked whether the medical It has been demonstrated that the arrest and profes¬ Whereas, amply sion had attained that and to it cure of tuberculosis can be best accomplished in properly arranged high noble position which was and' controlled sanitaria, entitled, discussed this matter at length and referred to the Therefore. Be It Resolved, That we, the Vermont Society for the vast made in medicine in the last Study and Prevention of Tuberculosis, do hereby earnestly urge and progress twenty years. He- that men recommend the establishment of a state sanitarium in Vermont for urged young seeking to enter the profession should the proper care of consumptives ; and possess a better preliminary education; that there should be Furthermore, Be It Resolved, That the committee on legislation of this society should present the matter for the consideration of an entrance examination on educational qualifications entirely the assembly of 1902, and use every legitimate means to insure the distinct from the medical and that the passage of a bill for the establishment of a Vermont examination; laws providing should be so amended to sanitarium for state consumptives. Also these resolutions : as drive from the state cancer doctors, Whereas, It is the consensus of scientific opinion that bovine osteopaths, Eddyites, and all other forms of He held tuberculosis is a real menace to health and quacks. public ; that there should be a and Whereas, The efforts of the Vermont board of agriculture and complete thorough reorganization cattle commission to eradicate tuberculosis from Vermont cattle of the society, as in Virginia only one in ten have been attacked and criticised physicians belong severely ; to the American Medical and about one in Therefore, Be It Resolved, That we, the Vermont for the Association, only Society three or Study and Prevention of Tuberculosis do express our appreciation four are affiliated with the state and county societies. of the honest and work the commis¬ painstaking of Vermont cattle Every county in the state should have a medical society organ¬ sion ; under the Resolved, That whatever modifications may be made in the pres¬ ized plan suggested by the American Medical Asso¬ ent laws relative to bovine tuberculosis we earnestly protest against ciation. By organization medical laws could be enforced and the removal or relaxation of any measures which tend to lessen or eradicate bovine tuberculosis. the state can be freed from irregular practitioners and quacks only when each county has a committee whose it shall be International Congress of Gynecology.—The fourth con¬ duty to see that the medical laws in its own gress convened at Rome, September 15, with more than 450 district are enforced. members registered, including 20 from the United States, 57 He then spoke of the harm done in the profession by reason of from France and 7 from England. The membership of the petty jealousies and of the necessity of obtaining better med¬ largest previous congress was 316. In the addresses on "Medi- ical laws and of the repeal of obnoxious and dangerous legisla-

Downloaded From: http://jama.jamanetwork.com/ by a Karolinska Institutet University Library User on 05/30/2015 tion. He next discussed at length the prevalent causes of sick¬ The Etiology of Typhoid Fever. ness, and race degeneration, including expectoration, bad ven¬ Dr. Wm. K. Jaques read this paper. A constant stream of tilation, the cigarette, drug and alcohol habits and also decried pathogenic germs is passing through the intestinal tract. To patent medicines, commended pure food laws and mentioned the prevent the invasion of these into the tissues there must be treatment of smallpox, vaccination, the evils of unhygienic present the destructive fluids and resisting powers of the in¬ dress and the follies of mothers. testinal cells. The greater the virulence of the germ the Colored Physicians Not Admitted. greater must be the resistance to prevent invasion. The trans¬ Two organizations of colored physicians, the Old Dominion mission of the typhoid bacillus from the intestinal or urinal Medical Association and the Tidewater Medical Association, tract of the diseased into the alimentary tract of a susceptible presented petitions asking recognition and admission to the individual is necessary to produce typhoid fever. The key to sanitation is of the contamination Medical Society of Virginia, and a committee was appointed typhoid the prevention of consisting of Drs. W. L. Robinson, George Ben Johnston and food and water by human dejecta. J. L. Shackleford, to report on this petition. After consider¬ The Occurrence of Typhoid Bacilli in the Urine During able discussion, the petitions were rejected by a vote of 52 Typhoid Fever. to 23. Dr. Adolph Gehrmann followed with a paper on the results An excellent series of scientific papers was given and dis¬ of investigations covering 71 specimens of urine from 68 ty¬ cussed. phoid patients in the Cook County Hospital. None of these Reorganization Proposed. were specially selected, except in so far as it was positively Dr. Charles Grandy presented a paper on "Organization of recognized that typhoid was present. No attempt was made to the American Medical Association," and proposed a plan for show at what stage during the sickness the bacillus may ap¬ reorganization of the state and county societies, which was re¬ pear in the urine or to study the conditions that may be inci¬ ferred to a committee of five to report on at the next meeting. dent thereto. The report is preliminary in that there has not Election of Officers. been opportunity to study the histories of these cases and add the clinical to the data. The urine collected At the afternoon session, September 25, the following officers bactériologie was in large sterile test tubes, without any special antiseptic pre¬ were elected for the year: President, Dr. John N. Upshur, cautions. The tubes were filled in and the Richmond; Drs. William F. early the morning vice-presidents, Cooper, Newport cultures from them were started before an time Richard W. Max Meadows, and Junius F. noon, average News, Sanders, of four to six hours The method Norfolk; secretary, Dr. Landon B. Edwards, intervening. employed was Lynch, recording to of the over inclined and Dr. John F. Rich¬ spread loopfuls specimen agar incu¬ Richmond; corresponding secretary, Winn, bate the cultures for Colonies mond, and treasurer, Dr. Richard T. Styll, Newport News. twenty-four hours. were thus at once obtained, and tnese were examined for the of Dr. Clifton M. Miller, Richmond, was elected to fill Dr. Up- presence motile bacilli. Transplantations from the suspected colonies shur's place on the executive committee and Dr. William S. were then made and the pure culture was carried Christian, Urbanna, was elected to deliver the annual address. resulting on agar, milk and bouil¬ Roanoke was selected as the of for 1903. Drs. through gelatin glucose agar, litmus, place meeting lon for differentiation. A test- Stuart McGuire, Richmond, and Richard S. Martin, Stuart, with positive reacting typhoid blood was then made to verify the results. In a few instances were elected delegates to the American Medical Association. the specimens were immediately eentrifuged, and the sediment Banquet. examined by direct microscopic preparation. When large num¬ The meeting of the society closed with an elaborate banquet bers of motile bacilli are found in specimens so treated, one at the Hotel Chamberlain, Old Point Comfort. Covers were may almost rest assured that typhoid bacillus is present. laid for 300. Dr. William F< Cooper, president of the Newport From the 71 specimens the typhoid bacillus was isolated 15 News Medical Society, officiated as toastmaster, and Drs. John times, giving a percentage of 21 per cent, positive results. In N. Upshur, Richmond, Edwin Ricketts, Cincinnati, Hugh T. 12 specimens Bacillus coli communis was found; in 6, pus Nelson, Charlottesville, Elliott T. Brady, Abingdon, J. Wilton cocci; in 31, saprophytes, more or less numerous, and 20 speci¬ Hope, Hampton, and J. Allison Hodges, Richmond, and Messrs. mens were sterile. The typhoid and colon bacillus were found W. F. Johnson and A. A. Moss, responded to toasts. mixed in 3 of the cases. As regards cloudiness of the urine and the presence of typhoid bacilli, he found the bacillus in 9 cases of urine the 15 CHICAGO MEDICAL SOCIETY. cloudy among positive specimens. Bacilli in the Blood. Regular Meetings, held October 1 and 8, 1902. Typhoid Drs. E. K. Kerb and F. G. Harris read a joint paper on the The Dr. William A. Evans, in the Chair. President, subject. The situation was reviewed from the time of the dis¬ October 1. covery of the bacillus down. The technic of examination by The Typhoid Fever Situation in Chicago. culture and agglutination was given in detail. In the author's list of 50 31 were and 25 Dr. Arthur R. Reynolds read a paper with this title. He cases, positive In a series of 102 cases with 118 examinations com¬ said that the one supreme measure necessary to prevent recur¬ negative. from recent the bacilli were found in the first rences of of this disease is the protection of the piled writers, epidemics week in 87.5 70 50 water from sewage per cent.; second, per cent.; third, per supply pollution. and later In the 6 examined While the investigations have been unable to cent.; 25 per cent. relapses they laboratory were found in The is 70 cent. demonstrate typhoid-infected milk during the epidemic, every case. general average per present Cultures were before the Widal test was obtained in the presence of the typho-colon group has been repeatedly de¬ positive 37 cent, of 81 cases when this relation was It tected. search has been made for per reported. Although special frequently was shown that the bacilli few. The the bacillus in the milk the last are comparatively prac¬ typhoid city during eight tical in the method of the it has been found in three and those in application lies easy isolating bacil¬ years, only instances, lus, and in the aid thus offered, which is local epidemics, where the relation of eases of the disease and diagnostic sure, early in and fairly easy, at least in hospital cases. a common milk supply was clearly established. appearance, The practical point with reference to the sanitary quality of October 8. the city water supply is that low lake levels cause increased Ninety Cases of Typhoid Fever in Infants and Children. pollution; high lake levels improve the sanitary quality, and Dr. Isaac A. Abt stated that a large proportion of the cases neither the one nor the other will be perceptibly affected by ran the entire course of the disease without receiving any "the abstraction of from 300,000 to 600,000 cubic feet per min¬ drugs. Patients were kept in bed and, as near as possible, ute;" through the drainage canal. The abstraction of double absolutely quiet. They were encouraged to change their posi¬ the maximum quantity would not be seriously felt, and it is tion in bed frequently. This enforced rest in bed could not be to be hoped in the sanitary interest, not only of Chicago, but strictly adhered to in young children. It was necessary to of all points between Chicago and New Orleans, that this flow pick them up on account of restlessness, or to change their will some day be secured. napkins, and for their baths. The mouths were kept

Downloaded From: http://jama.jamanetwork.com/ by a Karolinska Institutet University Library User on 05/30/2015 clean with acid solution. The scrupulously by washing boric The physician should watch the abdomen for gaseous distention usual the of bed-sores of precautions concerning prevention by the bowel, and the stools for evidence of indigestion or food rubbing the back with alcohol was practiced. During the putrefaction. If present, correct the diet rather than ad¬ febrile period the patients were kept on a liquid diet, consist¬ minister antiseptic or anti-fermentative remedies. Alcohol ing almost exclusively of milk, except in those rare cases where may be used according to the particular indications in the milk could not be borne. After the temperature had fallen to specific case. normal, strained gruels, broths and fruit juices were permitted. of The patients were all encouraged to drink large quantities of Hydrotherapeutic Treatment Typhoid Fever. water. No solid food was allowed until the tenth day of Dr. Henry B. Favill spoke on this subject. The statistics normal temperature. in favor of the bath treatment are favorable as compared with other The treatment of the temperature was hydrotherapeutic. A forms of treatment. He referred to the typical, original Brand which he as temperature above 102 degrees was treated by tepid sponging; bath, defined the vigorous rubbing and of well if the temperature rose still higher and was not reduced by manipulation the typhoid patient, immersed in water of the sponging, the patient was placed in a cold pack. In those a temperature varying from 60 degrees to 80 degrees. The of the is an cases where the fever was not controlled by either of the fore¬ manipulation bath essential part of the process; the is to the going, the patient was given a cold bath. He was placed in a temperature subject variation. Although anti¬ value of the bath is considers a comfortable, warm bath of about 90 F. This was gradually pyretic important, he it mis¬ to centralize attention reduced to 80 F. He found it rarely necessary to reduce the take on its antipyretic effects. Its temperature of the bath much below this point. At times, how¬ effect on the patient is sedative and tonic. A patient who is to an a cold ever, where the fever did not yield, the bath temperature was subjected intelligent administration of bath in and reduced to 70 or 75 F. No antipyretic drugs were employed typhoid, typically regularly, shows marked sedative effects, as manifested, first, a of as a to reduce the temperature in any case. In those cases show¬ by feeling comfort, against pre¬ vious of malaise; as a ing nervousness or restlessness, an ice-bag applied to the head feeling second, manifested by tendency to as contrasted with restlessness and sometimes gave relief. At times a small dose of Dover's sleep, previous inability to The second of the was tonic as powder or sodium bromid was given for restlessness and sleep¬ sleep. phase bath its effect, manifested an in the a lessness. Constipation was treated by enemata, and cases of by improvement cerebral condition, condition of clearness of mind as alert¬ severe diarrhea were given small doses of deodorized tincture against hebetude; of ness as of and of opium. In the prolonged cases, which showed the exhaust¬ against indifference; comfort, physical psychical, as distress. This was a fair index ing effects of the disease, where the pulse was rapid and weak, against of improved tone. As to the tract, there was a better whiskey or brandy was employed, and moderate doses of digestive typically digestion, as evidenced the less of the strychnia were given. A child ten years of age was given by decidedly typhoid character and a less to meteorism. 1/100 of a grain of strychnia three or four times a day. A tongue, by tendency child three years of age was given 1/200 of a grain three or Surgical Treatment of Hemorrhagic Pachymeningitis. four times a Intestinal were day. antiseptics rarely employed. Dr. John C. Munro of Boston read this paper (by invi¬ were on rational Complications treated, as they arose, a plan. tation). His conclusions were that: 1, alcohol, syphilis, acute At the close of the febrile were period, patients frequently and wasting diseases and trauma apparently bear some causa¬ a tonic in a routine the favorite the elixir of given way, being tive relation. 2. The symptoms are those of diffuse subdural iron, quinin and strychnia. hemorrhage coming on slowly, producing mental irritation, The Dietetic Management of Typhoid Fever. spasm and rigidity of the extremities, convulsions, and later on the more or less The Dr. Frank X. Walls followed with a paper on this subject. paralysis, sequence being irregular. He paid particular attention to "milk alone," saying that it treatment is surgical, and should be instituted as early in the disease as Without in cases where was as a typhoid diet: 1. Because it is intol¬ possible. operative relief, objectionable the erable as a sole food for the adult in health or disease. 2. It pressure symptoms manifest themselves, prognosis is prac¬ the best chance re¬ contains a large amount of poisonous filth. 3. In digestive tically hopeless. Early operation gives for tract infections it feeds the parasitic intestinal flora rather covery. than the host. 4. The systematic intoxication from milk discussion. is serious and often fatal. 5. We have abundant Dr. A. J. Ochsner said a difficulty which surgeons encoun¬ poisoning in with other substances that are without these objectionable features, tered connection hemorrhagic pachymeningitis was the lack of came as and more palatable, equally abundant, very nutritious, easily history. They hopeless cases, frequently in a digested and readily assimilated. comatose condition, and it was often difficult to say whether were under the of a or Successful treatment in a measure on the at¬ they intoxicated, influence drug, whether depends large in the last tention that is to the diet. The of the dietetic they were stages of uremia. He had operated on a given keynote of such with management is individualization. Water should be given freely, number cases, and, two exceptions, all with fatal results. In one case, aside from a plain or charged. Gruels, well cooked and seasoned, strained hemorrhagic pachymenin¬ and malted, if preferred, made from oatmeal, rice, barley, gitis, the patient suffered from a cerebral hemorrhage. After the subdural clot was of arrowroot or other cereals, have a moderate nutritive value. removed, symptoms pressure persisted. showed a clot, the result of a cerebral hemor¬ Meat broths or soups, of beef, mutton or chicken have a slight Autopsy large nutritive but more stimulant value. Meat juice, made by tne rhage. E. that cold method, contains from 7 to 9 per cent, of proteid, and is a Dr. Wyllys Andrews thought spinal puncture would be a valuable aid in some of these cases. He had not tried good food, and from 5 to 15 ounces may be given a day. White it, but he believed it would furnish some information. of egg added to water, gruels or soup enriches them. The yolk Dr. Archibald Church said that a differentiation of the egg is very rich in fat, and beaten in with cereals, it sharp should be made between which makes a very palatable, nutritious food. Jellies, calf's foot hemorrhagic pachymeningitis, is found in and in some of the late or fruit, are a delicate addition. Fruit juices, of orange, grape, commonly general paresis, of dementia, and the or the cerebral berries, lemon or pineapple are tonic beverages that break the stages pachymeningitis which had been described the had monotony of the sameness of a typhoid diet. Cream and milk, hemorrhage by essayist. He had considerable with of disease but the best only, may be given very cautiously with other experience the variety the found the and everi there the was ex¬ foods; given plain, or flavored with malt, coffee, chocolate, among insane, diagnosis In his the etc., acidulated, peptonized, pancreatinized. Koumyss, butter¬ ceedingly difficult. experience salient point which stood out was that in these cases was milk, and junket are nutritious milk foods. This list is prominently there almost a of and habitual merely suggestive, and may be as varied as the needs of the invariably history protracted alcoholism, in of the the on individual require. The concentrated foods are rarely required, although some cases pathologic condition came of two though somatóse, tropon, plasmon, plasmon coca or condensed irrespective alcoholism. He detailed very interesting cases. milk are at times of service. Patients should not be overfed.

Downloaded From: http://jama.jamanetwork.com/ by a Karolinska Institutet University Library User on 05/30/2015 Dr. Jacob Frank spoke of having reported two cases before Another recommended by Rummo, in Jour, des Pract : the society years ago. He emphasized the importance of dis¬ R. Morph. hydrochlor . tinguishing between alcoholic and traumatic pachymeningitis. Cocaina? hydrochlor, ää.gr. ii 12 0006 In the traumatic cases the diagnosis was not very difficult, be¬ Atropina? sulph.gr. 1/100 laurocerasi 10 cause if there was hemorrhage there was generally paralysis. Aq. .3iiss M. : Three to ten be taken in the 24 In 1890 he stated and believed that, if a patient was brought Sig. drops may hours, either in a little or on a of sugar. into a hospital and no lesion was found, yet who manifested syrup piece signs of meningeal hemorrhage or concussion of the brain, Heroin may be prescribed as follows: tapping of the ventricles would be good practice. He had seen R. Heroin .gr. %-ss 1015-03 Sacch. patients on the operating table with contracted pupils, ster¬ albi .3i 4| torous breathing, very slow pulse, who were relieved of all M. Ft. capsula? No. x. Sig: One capsule to be taken three these symptoms by tapping the lateral ventricles. One of his or four times daily. patients recovered. In cases where there is marked cardiac debility associated Dr. Munro, in closing the discussion, expressed doubt as to with the cough the following should be administered: whether spinal puncture would have any effect in such in¬ R. Morph. hydrochlor.gr. ii 12 vii 45 stances. In these eases the clots were firmly adherent, and it Sparteina? sulph.gr. destil.3iii 12 was necessary to clean them out with the finger or some blunt Aqua? M. Ten or fifteen at one dose. instrument, thereby relieving intraventricular pressure. He Sig.: drops hypodermically had tapped the ventricles in several cases, and he hardly opened In other instances the following pill may be ordered: any brain, especially where there was indication of pressure, R. Ext. opii (denarcotized) .gr. i 06 that he did not tap the ventricles. This procedure relieved Ext. cannabis indica? .gr. ii 1:2 pressure on the brain; it was easily done, and was harmless. Ext. stiamomi .gr. i 06 It cured a case once in a while that could not be cured in any M. Ft. pilula? No. iv. Sig. : One to be taken two or three other way. times daily, if the cough is persistent. Locally, the following combination may be applied: R. Cocaina? hydrochlor .gr. ii 12 Therapeutics. Chloralis hydratis .gr. xiv 3 Pot. bromidi .gr. xiv 3 Glycerini .Jiss 45 [It is the aim of this department to aid the general practi¬ Aq. destil .Sx 300 methods tioner by giving practical prescriptions and, in brief, M. Sig.: Put into an atomizer and spray the throat two of treatment for the diseases seen especially in every-day prac¬ or three times daily to relieve laryngeal cough. tice. Proper inquiries concerning general formulae and out¬ lines of treatment are answered ¡n these columns without Treatment of Cystitis. allusion to inquirer.] G. Bjorkman, in Merck's Archives, recommends, in the treat¬ Earache. ment of acute and subacute cystitis, absolute rest ¿n bed; all The following is recommended by Hecht in Med. Ree. to re¬ active, local interference in the acute stage is contraindicated. lieve earache: The first care should be to relieve the distress and support R. Acidi carbol, liq.gr. 130 the bladder in its attempts at free and complete evacuation. Cocaina? hydrochlor . This, according to the author, is best done by opiates in the Menthol, ää.gr. xv 1 form of suppositories and chloral and the bromids per os. Alcoholis .m. lxxv 5 j The diet should consist of milk, soup and gruels. The bowels M. Sig. : To be dropped into the ear. should be evacuated by means of saline cathartics. For vesical Atrophie Rhinitis. spasm and tenesmus, the following may be given in the form While there is but little hope of doing more than relieve the of suppositories: exceeding nauseating odor in this affection, yet if that can R. Ext. opii .gr. i 06 Ext. be lessened will have been as there is hyoscyami .gr. i 06 something accomplished, Ext. cannabis iss 09 no other disease of the nose which will cause such a disagree¬ ind.gr. Lupulini .gr. xv able and fetid discharge. The following combinations are rec¬ Butyr. cacao, q. s. ommended as antiseptics and to so cleanse the membranes M. Ft. No. i. Insert one in the rectum as as to temporarily de? away with the odor : suppos. Sig.: needed two or three times a day. R. Acidi carbol.gr. iii 20 Sodii boratis .3ss 2 Internally, the following will be of service: Sodii bicarb.3i 4 R. Chloralis hydratis .- !. Glycerini .3iss 3 Pot. bromidi, ää.3isa- 6 Aquae, q. s. ad.giii 90 Syr. aurantii .¡i 30 M. Sig. : To be used as a spray three or four times a Aq. destil, q. s. ad.Jiii 90 day; or, according to Merck, the following is of service: M. One tablespoonful every three or four hours. R. Iodof .3i 4 ormogen As an the Bismuthi subnit.3i 4 urinary antiseptic following: Sacch. lactis .3i 4 R. Formin or urotropin.gr. viii j 50 M. Ft. i. : Take one in a M. Cleanse the nose and use as chart. No. Sig. powder glass Sig.: thoroughly freely of water before each meal. a snuff several times a day. Coakley recommends the following in the treatment of If the urine should be hyperacid a little potassium citrate • atrophie rhinitis: or acetate should be added to the water ; if too alkaline a few R. Menthol .gr. xx 1 30 drops of mineral acid may be added. In eases of subacute Aristol .3ss 2 cystitis irrigation may be carried out, using the following Benzoinol .3i 30 solutions : M. Sig. : To be used locally in an atomizer once or twice R. Argenti nitratis .gr. iss-iiss |09-15 daily. Aq. desti!., q. s. ad.3üi Treatment of 90| Cough. M. Sig.: One-half the amount to be used lukewarm, as The following methods of treating cough are quoted in an irrigation; or: Ther. Gazette: R. Argentamini .gr. xv II R. Morph. hydrochloratis .gr. ii 112 Aq. destil.Oii 1000| Aq. laurocerasi .3iiss 10] M. Sig. : One or two ounces to be used in the form of an M. Sig.: Take from three to ten drops four to six times irrigation once or twice a day after the acute symptoms have a day if necessary. ceased.

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