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itive in declaring the swelling an abscess, and demanding an operation. The patient was disposed this time to agree with them. I asked for a consultation with Dr. Eaton, an Eclectic ten miles away. He only knew my history of the case and agreed with the others. I was confounded, but persisted in my judgment. Dr. Eaton then declared to the friends that I had been successful in the matter thus far, and probably understood it better than any one else. He accordingly advised them to leave it entirely in my hands. I assumed the responsibility; promising, however, to recall him if unfavorable symptoms appeared.
This case was a forcible illustration of the inherent power in existing structures to repair their own lesions, if left at rest and permitted full operation. I put the man to bed, bandaging the limb from the toes to the knee, and applied a stimulating liniment every morning with vigorous friction; all the time requiring absolute rest. In two weeks the knee had returned to its natural dimensions and it become as strong and healthy as the other.
Since that time I have been an urgent advocate of physiological rest during the presence of pain and the processes of repair.
I submit another example: The case was one of accidental shooting. An entire charge of buck-shot had passed through the left foot, entering about the articulation of the scaphoid with the internal cuneiform line, passing along the foot posteriorly through the external malleolus and severing the internal plantar artery. The wound had been dressed by an old physician, but bled so profusely afterward that the family became alarmed and sent messengers in every direction for surgical aid. Four came at the summons. All but one declared amputation necessary. The fourth maintained that with rest and good care the foot could be saved, and convinced the others that it was worth the endeavor. They belonged to the Old School, and were very gentlemanly in their deportment during our consultation.
The patient, a young man, was placed on his back, the foot elevated and secured in position, and a solution of persul
phate of iron, full strength, was injected to stop the hemorrhage. The wound was so large that I passed two fingers into it when removing the loose pieces of bone and other foreign substances. We went away to return in an hour. The hemorrhage had sensibly diminished and we decided to continue the same treatment. We assembled again the next morning and found the symptoms favorable and the bleeding stopped.
The question how to prevent gangrene was discussed. I proposed to wait till it had appeared. The dependence was on good treatment, good nursing, proper food and perfect rest. The pain which the patient suffered for a long time was very severe, as well as the swelling. At the end of nine months the foot and ankle had taken shape and were in excellent condition. He now walks without a halt. The moral is, that nature points to physiological rest for injuries and overtaxed energy. It is true in the animal and vegetable, as well as the human kingdom, and the result of the privation is death.
(B) MEDICINE, GENERAL AND SPECIAL.
MILBREY GREEN, M. D., Chairman;* J. A. MUNK, M. D., Secretary.
Address by MILBREY GREEN, M. D., Boston.
Every year Boards of Health and Health Officers throughout the country report a large number of cases of typhoid fever, diphtheria and other zymotic diseases traced directly to bad house-drainage. Many instances have been reported where, owing to faulty plumbing-neglect of proper trapping, or the use of imperfectly constructed or porous traps-the deadly miasma from sewers, and waste and soil pipes, has impregnated the air, food and drink of households, and infected the clothes, furniture, carpets, and even the walls, and swept away nearly entire families. We have seen that houses impregnated with the miasma from sewers and soil-pipes are more dangerous than those infected by small-pox, and more difficult to render safe.
Bad house-drainage is frequently the result of ignorance, cupidity and a mistaken sense of economy. There are many plumbers who have little or no knowledge of hydrostatics and mechanics, but are employed by builders equally ignorant, because they work cheap. Of the plumbers who thoroughly understand their business, some fail to do their work well because they take their contracts so low they can make no profit if they use first-class materials and employ skillful workmen. A large proportion of men who build houses to lease or sell care very little how the plumbing is done, provided their walls and ceilings are not stained by leakage from pipes and tanks, or their houses rendered uninhabitable by strong odors from water-closets and sewers. They give the plumbing work to the lowest bidders, and as they pay only
*In the absence of the Chairman, the Section was organised by the appointment of Dr. Albert Merrell, of Missouri, as Chairman, and Dr. J. A. Munk as Secretary
for cheap work they are quite sure to get it. Plumbers do not claim to be more honest than other mechanics, and cannot be expected to give better material and better work than they are paid to furnish. In order to meet competitive bidding they cipher close and economize in every possible way, and use as cheap material as the often loosely-drawn contract allows, and employ the cheapest workmen they can find. Under such circumstances competent plumbers neglect many precautions in properly trapping, and other details, which they know are essential to health, when they would have done differently had they been paid for first-class work. The same thing sometimes occurs in houses built by men for their own residence, where a mistaken sense of economy leads them to contract for cheap plumbing while they spend money freely for external and internal ornamentation.
Much of the evil resulting from the cupidity, dishonesty and ignorance of plumbers and builders might be abated by a proper regulation of house-drainage by law. In almost every city there are ordinances regulating the construction of buildings, prescribing the size of timber, thickness of walls, and other details, so that no unsafe buildings shall be constructed ; and carpenters are obliged to conform to these regulations, or lay themselves liable to a fine. We hear no complaint of this being an unjust law, and no one can deny that a city has as much right to prescribe how the plumbing of a building shall be done as the carpenter-work. House-drainage, as well as the work of connecting houses with sewers and water-supplies, ought to be regulated by law. The danger from shabby buildings is often apparent to ordinary observers, but the evil results of poor plumbing and defective drainage are often unsuspected until sickness, and sometimes death, makes them. manifest.
Massachusetts, in 1877, enacted a law authorizing Boards of Health "to prepare and enforce, in their respective cities, such regulations as they may deem necessary for the safety and health of the people with reference to house-drainage and its connection with public sewers, where such connection is made." This enactment was subject to acceptance by a
majority of the legal voters of the several cities of Massachusetts, present at a meeting called for the purpose of acting thereon. In 1881 this act was amended in regard to sewerconnection.
Under this Act the Board of Health of Cambridge, in 1881, adopted certain regulations in relation to the construction of house-drainage, embracing directions for materials to be used, grades, traps, ventilation, workmanship, etc.; and the city ordinances were amended in accordance with these regulations, and there has been no difficulty in enforcing them. Boston and two other cities in Massachusetts have followed the example of Cambridge. The Municipal Assembly of St. Louis, in January, 1880, passed an ordinance to regulate the construction of house-drains, and I have been informed by the Chairman of the Board of Health, and several prominent physicians there, that the ordinance has worked well. New York and a few other cities in various parts of the United States have lately enacted ordinances regulating plumbing, the construction of house-drainage, etc.
The last Annual Report of the Massachusetts State Board of Health, Lunacy and Charity contains some excellent suggestions in regard to house-drainage. They are the result of much study and research, and until something better is proposed much good will result if they are followed by builders throughout the country:
"(a) All drain-pipes inside the house should be of metal, and all joints of well-calked lead or solder. Metal is recommended in preference to stoneware, owing to the difficulty in keeping tight the joints of the latter. All connections between lead and iron should be by a calked brass nipple and solder. It is best to keep drain-pipes in sight, or at least of easy access. They should never be hidden under the ground. If needed below the basement or cellar floor, they should be placed in a trench lined with brick walls, with movable covers on the trench. It is a good plan to paint the pipes white, so that any slight leakage of gas may be seen readily; for such gas generally discolors the paint.
(b) Changes of direction in iron pipes should be made mostly by Y-branches, leaving an open hub, to be closed by a brass nipple calked in with a movable brass clearing-screw as