504 The only journals represented at Hot Springs were the Iowa Medical Journal, the MEDICAL HERALD and the Medical Fortnightly. Drs. Stone, Thomas, Hungate, Kime and others, have good voices, and entertained the travelers with their selections of sacred music. The souvenir edition of the MEDICAL HERALD was distributed on board the train, and was the subject of many complimentary comments. Dr. Seybert of Council Bluffs, Ia., the largest man on the excursion, finally succeeded in finding a bath suit large enough to fit him, at the plunge. Drs. Hargens, Adams and Moffit earned the hearty appreciation of the association for the excellent manner in which they arranged the entertainment at Hot Springs. The Hot Springs newspapers are very enterprising, and gave excellent reports of the doings of the Society. The Herald printed many of the papers and toasts in full. Ex-president A. L. Wright, whose biography appeared in our last issue, graduated from Rush Medical College, in 1874. This fact was inadvertently omitted from the sketch. It was a source of universal regret that the President, Dr A. L. Wright, could not accompany the party to Hot Springs, his professional engagements making it impossible. Sunday at Hot Springs was an ideal day, and fully substantiated the assurances of the resident physicians that one dark day at a time was all they ever have in Hot Springs The delay of two hours in getting out of Hot Springs was said to have been occasioned by Dr. Thomas' banquet story of the goat" and the 'red flannel shirt." It flagged the train." Dr. Donald Macrae, of Council Bluffs, the "Grandfather" of the Society, in whose hands the excursion was placed, and through whose efforts the trip was secured, was signally effective in making the journey pleasant. Dr. T. B. Lacey of Council Bluffs, the genial Treasurer of the society, made himself useful to the ladies without husbands. They trusted him with their pocket books, knowing that he was not the kind that skip to Canada. The amount of noise emanating from the "Plattsmouth" caused some one to make the unkind remark, that it must be the "incurable ward," as they had seen Drs. Woodson and Thomas making the "rounds" among the patients. Mr. Kennett F. Harris, of Hot Springs is an old St. Joseph boy, having been on the Evening News staff some ten years ago. Mr. Harris is now editor and publisher of the Hesperian, a literary magazine published at Hot Springs, South Dakota. Chief Clerk Nickerbocker, of the Evans, was one of the pioneers in the hotel business in St. Joseph, having officiated in the old Patee House during the days of the Pony Express; and he is still a young man, judging from the celerity with which he serves a houseful of guests. The famous Londonderry Lithia Water was served free on the special train, much to the gratification of all. Especially was this service enjoyed by the ladies. Dr W S. Agnew, of Chicago, was in charge, and made many new friends for himself and the sparkling Londonderry. Mr. F. A Henry, who has lately succeeded the old firm of Renz & Henry, in the pharmacal line, sent a case of samples of his famous Tri-Iodides for use on the excursion, and it was most liberally prescribed for the prevailing rheumatics" among the members. One lady remarked that the effect of Heury's TriIodides was simply miraculous in relieving a severe rheumatic pain in her wrist. The Catholicon banquet comprised all of the delicacies of the season, and was served in the best of style, but one feature predominated above all-the presence of the ladies. We have always insisted that the pleasure of an early evening dinner would be enhanced by the attendance of the fair sex, and now it has been proven. The ladies lend a charm and grace to any social event and have a decided tendency to elevate the tone of the after-dinner speeches. Dr. R. C. Moore of Omaha, is the picture of complacency, and one would think his temper never ruffled. The doctor, however, says it bad a frill on it at one time. He was called to see a patient in the country, and was told to hurry. As he was driving at a rapid gait he overtook and passed another fellowtraveler. Arriving at the house the doctor had just taken his seat by the bedside of the patient, and was preparing to diagnose the case, when a rap at the door attracted his attention. The lady of the house not being present for the moment, the doctor opened the door and admitted the stranger, who proceeded to make his business known at once. It proved to be the man the doctor had passed on the way, and he was selling tombstones! Dr. Moore told him (as he gritted his teeth) that he could not give him an order just then, but he might sit down and wait. During the session in Hot Springs, Dr. B. F. Crummer, of Omaha, introduced the following resolution, which was unanimously adopted: Resolved, That the members of the Missouri Valley Medical Association here assembled desire to record their grateful appreciation of the many courtesies shown them on this occasion, and to extend their sincere thanks to the medical representatives of Hot Springs, the citizens and the F. E. & M. V. and B. & M. Railroads for their many kind acts and generous hospitality. We regard it as a matter for congratulation that we possess in this section of the Union a health resort whose climate and water possesses qualities second to none in a large class of chronic affections, and we take great pleasure in bringing Hot Springs, South Dakota, to the attention of the medical profession and the public. 505 MISSISSIPPI VALLEY MEDICAL ASSOCIATION Proceedings of Annual Meeting at Detroit, September 3-6, 1895. Officially Reported for THE MEDICAL HERALD. Merganthaler Typesetting Machine. The Association convened in the Strassburg Academy, and was called to order by Dr. H. O. Walker, of Detroit, chairman of the comittee of arrangements. Prayer was offered by Rev. Marcus A. Brownson, of Detroit. Dr. Walker then introduced Mayor Pingree, who paid an eloquent tribute to the medical profession, and extended a cordial greeting to the Association. THE ADDRESS OF WELCOME. The address of welcome on behalf of Detroit physicians was made by Dr. J. Henry Carstens, of Detroit. Dr. Walker presented the President of the Association, Dr. Wm. N. Wishard, of Indianapolis, who delivered the PRESIDENTIAL ADDRESS. He said the importance and advancement of Detroit were represented by the standing and intelligence of the local physicians. He referred to the beginning of the four years course in medical colleges, and said that the fear that the new rule would operate to the disadvantage of the smaller schools was unfounded. The President urged the advisability of publishing the records, papers and discussions in some manner to make them accessible to all members. He recommended a permanent executive committee, and regretted that the large number of papers necessitated the holding of two meetings at the same time. He commended the preparations for the convention, and pledged his earnest efforts to the promotion of the profit and pleasure of the convention. The reports of the Secretary and Treasurer were read and accepted. The reading of papers was proceeded with, the first one being read by DR. THOMAS HUNT STUCKY, of Louisville, entitled THE GOLD COMBINATIONS AS AL- At a meeting of the Medico-Chirurgical Society of Louisville, April 5th, 1894, the author had the pleasure of exhibiting a series of cases who had been taking the preparations of gold and arsenic, known to the profession as arsenauro and mercauro. He was under the impression at that time that the good effect claimed was produced in three ways: (1) by stimulation of the secreting glands of the stomach; (2) by the probable alterative effect upon these secretions, and (3) that probably there was a local antiseptic influence exerted. The class of patients in which he had used the preparations were people afflicted mostly with consumption, Bright's disease in its various stages, chronic hepatic troubles, and convalescents. He made it a rule with all these cases to withdraw all medicines except the combinations of gold and arsenic. He had selected CASE 1. Patient, a male, 60 years of age, with tuberculosis. History good. Eight drops of the mercuric bromide of gold and arsenic given hypodermically every four from a series of cases four or five, which he detailed. were hours, this treatment being continued for two months. No deleterious results were noticed. On the contrary, he is decidedly better; physical condition, color, appetite and bodily strength improved. we He reported a few cases out of a large number to demonstrate in his judgment conclusively that by the combination of arsenic gold and have an agent acting as neither of the minerals do when administered separately, or in other words, we have an entirely new agent in so far as therapeutical action is concerned. The author then dwelt at considerable length upon the chemical differences between the chloride of gold and sodium, and the bromide of gold and arsenic (arsenauro) with reference to their therapeutical action and subsequent elimination. He believes that in the action of the combination of bromide of gold and arsenic, it is entirely different from any therapeutic agent known. As compared with mercauro, iodine or the combinations of iodides, the action of gold in the combinations named is greater and intensified; that these combinations enter into the circulation as gold and arsenic, and spend their forces and exert their influence in an alterative way upon the glandular system; that a marked alterative effect is exerted upon all scleroses (nonmalignant); that it is not only a blood-maker, but a bloodbuilder; that it not only increases the quantity, but the quality of the corpuscles; that under its use haemaglobin is markedly increased; that it is eliminated by the kidneys; that they produce no irritation either when given per orum or hypodermically. Cases corroborating the beneficial and curative effects of the preparations mentioned by the essayist were reported by Drs. A. P. Buchman, I. N. Love and Wm. F. Barclay. LEGIMATE PHARMACY. This paper was read by DR. WM. F. BARCLAY, of Pittsburg. He defined legitimate pharmacy as that which meets the necessities and demands of the regular medical profession and the people. The medical profession is entirely separate and distinct from pharmacy. Medicines are divided into four classes-patented, proprietary, non-proprietary and secret. There are a large number of cures, mixtures and tonics bearing the name of their originators and deserying of consideration as proprietary preparations. Pharmacists and physicians are interdependent and should work together. Legitimate pharmacy has called into service educated and able men, but the imcompetent and dishonest have got in, too, and cannot be too severely condemned. Pharmacists make errors, but physicians are careless, too, in writing prescriptions. Physicians should not favor any particular pharmacist, and should not receive pay from them. On the other hand, it is unworthy the profession ! He considered the powerful stimu dant action of cod liver oil on nutrition, also demonstrating with specimens the difference in the color of oil digested from fresh livers and that prepared from putrid livers, the former being pale, golden or light brown, according to the number of hours digested, and the latter dark brown. The darker oils contain more extractive matter. Dr. Stewart said the text books contained many errors regarding the preparation of cod liver pil. DR. I. N. LOVE in the discussion. conceded the merits of the paper, but expressed himself as rather skeptical as to the value of cod liver oil. He declared that there was danger of our getting too professional, and said that which brings relief to the patient is to be commended. He favored proprietary remedies which have come to the profession through pharmaceutical channels. 1 DR. TOD D. GILLIAM, of Colum bus, O., read a paper entitled UTERINE FIBROIDS--WHEN OPERATE. TO The medical and eletrical treatment of uterine fibroids is today in a very unsettled state. While it cannot be denied that amelioration or even recovery has followed such lines of treatment, there has not been that degree of uniformity in results cal,culated to inspire confidence. To the author's mind, there is no better field for a competent observer, than the study of natural history of uterine fibroids. It will enable us to determine the true value of so-called curative agencies. It will insure a more certain prognosis. It will give the proper cue to surgical interference. If. out of 100 cases, 90 suffering women can be restored to lives of usefulness and happiness, would it not be better to give them a chance? No surgeon is justified in doing hysterectomy or the more serious operations for uterine fibroids when the patient has not experienced sufficient trouble to make it a menace to her life. DR. WM. HUMISTON read a paper entitled A METHOD OF PREVENTING THIRST FOLLOWING CELIOTOMY. He said, "No one who has had any experience in the after-care of abdominal cases,will deny the important place that thirst occupies. It is the one prominent, annoying and distressing symptom, and I know it can be overcome. "This is my method of procedure: The patient should have the usual preparation for celiotomy; i. e., diet, daily baths, cathartics, etc. For three days prior to operation order the patient to drink one pint of hot water an hour before each meal and on retiring, thus drinking two quarts of water each twenty-four hours, the last pint to be taken three hours before the time set for operation. Do not omit to give the water the day previous to the operation, while the patient is restricted to a limited amount of liquid nourishment and the bowels are being unloaded. We thus restore to the system the large loss of fluid occasioned by the free use of catharsis, and we have the great satisfaction of seeing our patient pass through the trying ordeal of the first thirty-six hours after the operation in comparative comfort, with no thirst, a moist tongue, and an active renal function, represented by an excretion of from twenty-eight to fifty fluid ounces of urine during the first twenty-four hours, catheterization being seldom necessary. This is in keeping with (the full character of the pulse noted. "The above detail I have recently carried out in twelve cases. To eleven chloroform was administered, to one ether. The time required to complete the operation varied from ten to fiftyfive minutes. Whether the case was one of sclertoic ovaries or a pus case with universal adhesions of all the pelvic structures, the result has been uniform and highly satisfactory, thirst being allayed and excretion stimulat ed. TUBERCULAR PERITONITIS. This paper was read by DR. L. H. DUNNING, of Indianapolis, Ind. In the domain of surgery there is no more attractive study than tubercular peritonitis. The mode of invasion, forms of the disease, diagnosis and treatment were considered in the paper, and finally a brief history of five cases was given. Tubercular peritonitis, with effusion, is now universally considered a surgical disease. Even in the acute suppurative cases adominal section yields a sufficient number of successes to render its employment imperative. Senn excludes all forms of the disease from surgical treatment except the exudative form. Manclaire gives as the chief contraindications to surgical treatment, the generalization of the lesion, and the existence of profound systemic inflection. Linder analyzes the results in 205 operations, with a mortality of 7.5 per cent. The deaths resulting in the most of these cases was from prolapse. In cases of involvements of the tubes and ovaries they should be extirpated. His ex perience in two cases leads him to believe that we should, if possible, avoid using silk ligatures in tying the pedicle when it is necessary to remove the uterine appendages. H. W. LOEB, M. D. , CASE 1. Mrs. A. B., aged 56 years, consulted the author concerning the extirpation of a fibroid tumor of the uterus. She had passed the menopause five years previously, but the tumor had gradually increased in size. At the time of examination it had reached the umbilicus. There was a small amount of fluid in the abdomen, and on opening it probably a quart of clear, straw-colored fluid ran out. The peritoneum and intestines were studded with innumerable small grayish deposits of the size of millet seed. Similar deposits thickly studded the serous covering of the tumor. The in testines were agglutinated, but were not adherent to the tumor. After removal of the tumor by supravaginal hysterectomy, and ventro-fixation of the stump, the abdominal cavity was irrigated, and then leaving the drainage tube just behind the stump, the 508 abdominal incision was closed. Recovery. In CASE 2, a diagnosis of ovarian tumor had been made and examination revealed an accumulation of fluid in the abdomen which was encysted. The uterus fixed and immovable and was outlined in the pelvis upon the right side, which the author believed to be a small ovarian tumor surrounded by inflammatory exudates. An exploratory incision was made, and three gallons of dark fluid evacuated from the abdominal cavity. A small tumor was felt in the pelvic cavity. The incision was enlarged, the tumor enucleated, and the pedicle tied off, together with the Fallopian tube. The left tube and ovary were likewise extirpated. On exposing the abdominal and pelvic cavities to view, it was seen that the viscera were thickly studded with small grayish deposits. Microscopical examination demonstrated the presence of tubercle bacilli. Patient now, eleven months after operation, in good health. Two of the five cases reported by the author terminated fatally. DR. GILLIAM, of Ohio, believes that where we have tuberculosis of the ovaries and tubes, it is better to remove the uterus, too. DR. J. FRANK, of Chicago, asked whether any of the members, who had operated for tuberculosis of the peritoneum, had noticed a recurrence, or how long the patient was immuned from further attack. DR. HUMISTON, of Cleveland, O., reported two cases upon which he had operated successfully. TO BE CONTINUED The Nominating Committee reported as follows, which was adopted: PRESIDENT-Dr. H. O. Walker, Detroit. FIRST VICE-PRESIDENT-Dr. B. M. Ricketts, Cincinnati. SECOND VICE-PRESIDENT-Dr. F. C. Woodburn, Indianapolis. SECRETARY-Dr. H. W. Loeb, St. Louis. TREASURER-Dr. H. N. Moyer, Chicago. JUDICIAL COUNCIL-Drs. W. N. Wishard, T. E. Holland and A. P. Buchman. |