catgut sutures are run clear through the clamp-fenestra and the four layers of foreskin. 5. With strong scissors the latter is cut off at one sweep. 6. Tractor and clamp being removed, the double length sutures being divided, and two additional sutures being placed at the dorsal and frenal sites-previously occupied by the tractor. 7. The vessels are secured and sutures tied all around, making a circumcision that is at once symmetrical, precise and admirable, leading to prompt union and a satisfactory result. This operation does away with inaccuracy, appended cutting of the mucous layer, and slowness or replacing of suturing, etc. Patients read the newspaper while it is being done. Drawings illustrating the steps of the procedure and of the instruments (made by the A. S. Aloe Co., of St. Louis,) were also presented by the author. Modern Surgical Technique By Dr. Henry O. Marcy, of Boston. In this paper the author emphasizes first the importance of a most careful bacteriological training on the part of him who would become proficient in surgical practice. In the preparation of the operating room, Dr. Marcy points out the ease and safety with which an ordinary living room, by preference the kitchen, is made comparatively sterile, when from necessity the surgeon is called upon to act promptly and suddenly. In abdominal wounds, where irrigation is not advised, he substitutes for it a slowly flowing stream of oxygen gas from a compressed cylinder. This sterile gas is heavier than atmospheric air which it displaces, and as a consequence renders the wound less likely to infection from the products of respiration and atmospheric contamination. Dr. Marcy reiterates his well known views upon the value of tendon sutures, buried in al aseptic wounds for the approximation and reinforcement of the structures, emphasizing the importance of abandoning the drainage tube in all aseptic wounds and hermetically sealing of the same 'with iodoform collodion. Aseptic wounds made in aseptic structures, aseptically closed, and sealed are always followed by primary union. Dr. W. C. Weber, of Cleveland, Ohio, read a paper on Hydrocele The author first dwelt upon the anatomy of the testis, and then alluded to congenital and acquired hydrocele. 47 The congenital form results from an imperfect enclosure between the cavitise of the tunica vaginalis and the peritoneum. Acquired hydrocele OCcurs in children and most frequently in early adult life. Its cause is not always known, though traumatism is probably the most constant factor in its production. In a hydrocele of small or ordinary size, and the date of its origin is recent, an evacuation by means of a small trocar and canula may be all that is necessary to accomplish a cure. Should this fail in its purpose, it becomes necessary to adopt measures whereby sufficient irritation of the tunica vaginalis may be produced to secure inflammatory adhesion of the opposing surfaces. This end is usually attained by the injection of tincture of iodine, alcohol, carbolic acid, per chloride of iron and other substances into the sac, after the removal of its adventitious contents. Among other methods of treatment may be mentioned excision, incision and the seton. The author reported a case in which he used carbolic acid, which illustrated very nice y in the way of radical treatment in apparently extreme cases. The result was very satisfactory. Treatment of Traumatic Cataract Attended With Rapid Swelling of the Lens By Dr. James M. Ball of St. Louis, Mo. The proposition the author advanced in this contribution was this: In cases of traumatic cataract with rapid increase of intraocular tension, an operation should be performed, and it should not be linear extraction, but an extraction made with the Graefe knife, and with the incision located in the corneo-scleral junction. The knife should cut from one-third to twofifths of the corneal circumference, according to the extent to which the softening of the lens has advanced. If glaucomatous symptoms supervene with softening of only a small part of the lens, the corneal incision should be large. If the softening involve the whole of the lens, the incision should be of less extent. The chief merit of the operation lies in the avoidance of the valve which is produced by the linear method. In other words, the authors method permits of free evacuatoin of all the lenticular substance with the least amount of traumatism. An iridectomy is not made. All debris is removed at once. This cannot be accomplished by the linear method. The author then reported two very instructive and interesting cases. Fourth Day-Morning Session Dr. Robert C. Heflebower, of Cincinnati, contributed a paper, entitled: The Removal of the Auditory Ossicles For the Relief of Chronic Deafness and Other Abnormal Conditions From his experience with this class of ear cases, he draws the following conclusions: 1. No bad results attend the incision of the maleus and the incus, but removal of the stapes is not without most serious danger, both to life and hearing. 2. That the removal of the malleus and incus alone is far preferable to the removal of the stapes. 3. The operatoin is of extreme service in chronic suppuration in suitable cases frequently avoiding mastoid and other serious disturbances of an equally serious nature. cases 4. It should be performed in where there is a high perforation, or where the membrana flaccida is perforated, and where the ossicles are necrotic. 5. Tinnitus, headaches, of ear origin and vertigo are relieved. 6. In suitable cases it is invaluable for relieving deafness, whether from chronic suppuration or from chronic catarrh and sclerosis. The Treatment and Management of Corporeal Endometritis and a Word as to Prophylaxis in Tubal and Ovarian Diseases Was the title of the paper read by Dr. William H. Humiston, of Cleveland, Ohio, in which the author said that nine-tenths of all cases that he treats suffer from some form of endometritis, and its baleful influence on the sympathetic nervous system is marked and manifested by numerous and varied symptoms. 48 The first and important principle in treatment is to relieve the passive congestion of the uterus, and this is accomplished by medicated tampons. The first tampon should be medicated with boro-glyceride, ido-glycerine, or icthyolglycerine and supported by sterilized, non-absorbent cotton tampons. The septic cases must be treated on modern surgical principles-rest, asepsis, drainage and curetting. When the cases are diagnosed early and the proper treatment instituted, the author says the abdominal surgeon will not have his belt hanging full of suppurating tubes and ovaries. A Few Remarks on the Early History of Rectal Diseases This was the title of an interesting, historical paper read by Dr. S. G. Gant, of Kansas City, Mo. Dr. Hanau W. Loeb, of St. Louis, reported a very interesting case of double nasal atresia due to small-pox, relieved by operative interference. Dr. G. Frank Lydston, of Chicago, contributed a paper entitled Remarks on the Relation of Residual Urine to Vesical Irritation, Especially in Prostatiques The author said it is generally accepted that most of the symptomatic disturbances incidental to certain chronic bladder diseases, especially in cases of prostatic enlargement, are dependent upon the accumulation of residual urine. The author has long been impressed with the idea that residual urine per se is not as important a factor in genito-urinary irrigation as is ordinarily believed. He is satisfied that in a large proportion of adult males there is always a greater or less residum of urine remaining in the bladder after micturition. If prostatic enlargement or other obstruction attacking the mouth of the bladder develop, we have the typical accumulation of residual urine characteristic of such cases. It will then be seen that there may be at varying periods of life extreme differences in the degree of accumulation of residual urine is simply an incident upon which, if taken alone, the symptoms of vesical irritation in no wise depend. Ideally perfect drainage of the basford can only be accomplished by through drainage from above the tube through the trigone and out of the rectum. There were certain objections to this method which the author said it was not necessary to dilate upon. He simply stated as his opinion that only by some such procedure can the bas fond be thoroughly drained. Dr. Charles B. Parker, of Cleveland, Ohio, contributed a paper on The Surgical Treatment of Injuries of the Head. After the introduction and adoption of resolutions of thanks, the Association adjourned. For Infants and Invalids. A Soluble Dry Extract of Barley Malt and Wheat, prepared after the formula of the eminent chemist, Baron Justus von Liebig, for the MODIFICATION OF FRESH COW'S MILK. MELLIN'S FOOD is entirely free from Starch; the Carbohydrates contained therein are Dextrins and Maltose. "The sugar formed by the action of the Ptyalin of the Saliva and the Amylopsin of the Pancreas upon starch is MALTOSE. In the digestive tract MALTOSE is absorbed UNCHANGED." Textbook of Human Physiology, Landois and Sterling. "MALTOSE constitutes the end product of the action of diastase, and amylolytic ferments generally, on starch and its congeners." Physiology of the Carbohydrates, F. W. Pavy, M.D., LL.D., F.R.S. MELLIN'S FOOD, prepared with FRESH COW'S MILK according to the directions, is a true LIEBIG'S FOOD, and the BEST SUBSTITUTE for Mother's Milk yet produced. THE DOLIBER-GOODALE CO., BOSTON, MASS. DETACH HERE AND USE ENTIRE FORM. PHYSICIAN'S DISCOUNT ORDER BLANK. TO THE MEDICAL PROFESSION Dear Dr:-You have been reading of Codliver Glycerine in Medical Journals for years. Have you ever tested it in practice? It mixes with water and all medicines and is the strongest tissue builder known. Test it thoroughly. Fill out this card, and you will get a bottle free through your Druggist, or if you carry your own stock of drugs, fill out both blanks and use in ordering from Wholesale Druggists. We accept this card from Wholesale Druggists at 66% cents where it has been used on dozen orders. CODLIVER GLYCERINE Co., ST. LOUIS, MO, G THE MEDICAL HERALD, St. Joseph, Mo. 49 Personalities Dr. Milton Townsend and bride have returned from their Eastern tour. Dr. J. F. Cunningham, president of The National Bank, Brunswick, Mo., died on January 18th, of pneumonia. Dr. W. P. Book, president of the suspended Aberdeen Bank, Washington, has been arrested on the charge of perjury. Dr. E. S. Garner, of St. Joseph, has been appointed a member of the Missouri State Board of Health, vice Dr. J. D. Griffith, of Kansas City. Dr. A. H. Ohmann-Dumesnil has obtained full control of the St. Louis Medical and Surgical Journal, Dr. Frank M. Rumbold having gone to California, perhaps for permanent residence. Mr. Thomas P. Haley, Jr. President of the well-known Peacock Chemical Co., of St. Louis, was formerly a resident of St. Joseph, and therefore we feel very proud of the success he has made in the legitimate pharmaceutical field. Dr. E. L. Reigel, of Bloomsburg, N. J., and William Ebbler of Philadelphia, fought a duel at the former place early Sunday morning December 30th, because of jealousy of the doctor's wife. The doctor was wounded twice in the head; the other escaped injury. Dr. R. P. C. Johnston one of the oldest practitioners in this state, died at his home in Dearborn, Missouri, on January 20. Dr. Johnston was born at the homestead of his father, Stephen Johnston, three miles east of Platte City, Jan. 21st, 1849. He attended the schools of the neighorhood and at Platte City for the needed preparation to enter Louisville Medical College, from which he graduated with honors in 1870, attested by his subsequent long and successful professional career. He was married to Miss Mary E., daughter of Col. W. P. Chiles of Platte City, in 1872, who survives him with three interesting children, Miss Nellie, William and little Sydney. Dr. George W. Kanfield, of Denver, Colo., proprietor of the physicians' supply honse of that city, died very suddenly while sitting in a chair in his room at the Inter-State hotel in Fort Scott, Kas., on the afternoon of Dec. 19th. He was traveling for his health and in the interest of his house. About noon he went to his room and was not seen until his moanings of pain attracted the attention of the occupants of the room next to him. A physician was summoned, who revived the sick man, and left him apparently well. Dr. Kanfield did not go down to dinner, and at 2 o'clock a Mr. Cunnery stepped into his room and found him dead in a rocking chair. In his hand was a letter he had just received from his wife at Denver, in which she asked him to come home for Christmas. His late residence is 1547 StoutStreet, Denver. The body was taken to Denver for interment. Dr. Parkhurst's New Word.-Dr. Parkhurst has coined a new word, and its aptness and clever construction are quite likely to make it famous. The eminent reformer's word is " Andromania," and of it he says: "There is an element in the feminine world that is suffering from what I shall venture to call Andromania.' The word is not an English one, for the reason, i suppose, that the English language makers never supposed that we should need such a term. It is constructed on the same principle as the word Anglomania,' which means a passionate aping of everything that is English. Andromania' means similarly, a passionate aping of everything that is manish." Dr. Parkhurst makes his new word serve as a title for his first article in the next issue of The Ladies Home Journal, and uses it for a vigorous treatment of the type of women for whom he invented it. |