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Dr. Ward, chairman of the committee on revision of the constitution and by-laws, reported the work of this committee, and a motion was made and carried to have the report printed in the Railway Surgeon, so that the members could digest it and be prepared to act on it at the next meeting.

Dr. E. R. Lewis of Kansas City read a paper entitled, "One Fallacy Regarding Ununited Fracture, with Report of Cases," which was discussed by Drs. Jay, Crook, Thorn, Hoy, Daugherty, McCrea, Lane, Howard, Nash and Lewis.

Dr. Outten read a letter from Dr. J. B. Murdoch of Pittsburg, in which the doctor regretted his inability to attend the meeting.

A communication was also read from Dr. Thomas H. Manley, regretting his not being able to attend the meeting.

Dr. J. M. Dixon of Springfield, Ill., read a paper entitled, "Tetany From Traumatism."

Dr. C. W. Tangeman of Cincinnati contributed a paper on "The Value of Examinations of Sight, Color Sense and Hearing in Railway Employes." This paper was discussed by Drs. Ball and Wescott, and the discussion closed by the author of the paper.

Dr. A. I. Bouffleur of Chicago followed with a paper entitled, "A Plea for Delay in the Amputation of Tissue of Doubtful Vitality, with Special Reference to the Treatment of Such Tissues," which was discussed by Drs. Daugherty, Hoy, Pierce, Hungate, Peck, Jackson, and Jay, and the discussion closed by the essayist.

On motion, the association adjourned until 2 p. m.

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Dr. Thos. O. Summers of St. Louis read a paper on "Railway Neurasthenia," which was discussed by Drs. Outten, Hoy, Punton, Daugherty, Lanphear and Barclay.

Dr. A. H. Levings of Milwaukee, Wis., contributed a paper entitled, "Restoration of Nerves after Injury, Experimental Research and Clinical Observations," which was discussed by Drs. Outten and Thorn.

On motion of Dr. Thorn, a rising vote of thanks was extended to Dr. Levings for his very valuable and interesting contribution.

Dr. J. J. Buchanan of Pittsburg contributed. a paper entitled, "Capital Operations Without an Anæsthetic and the use of Large Saline Infusions in Acute Anæmia."

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Missouri, S. S. Thorn of Ohio, C. W. P. Brock of Virginia, S. R. Wooster of Michigan, A. O. Williams of Iowa, J. E. Luce of Wisconsin, E. R. Lewis of Missouri, C. D. Wescott of Illinois, W. J. Eddy of New York, W. R. Hamilton of Pennsylvania, W. E. Lincoln of Minnesota, Bruce L. Riordan of Canada, W. R. Priest of Kansas.

On motion of Dr. Hoy, seconded by Dr. Elliott, the association then adjourned until 8 p. m.

SECOND DAY-EVENING SESSION.

The association reassembled at 8 p. m., with President Murphy in the chair.

The president introduced Dr. John B. Deaver of Philadelphia, who delivered an address entitled, "Review of the Symptoms and Diagnosis and the Indications for Treatment of Intra-Abdominal Injuries Without External Evidence of Violence."

Dr. Outten moved that a vote of thanks be extended to Dr. Deaver for his excellent address. President Murphy requested that a rising vote be taken, which was unanimous.

Dr. W. B. Outten of St. Louis read a paper entitled, "A Study of Synthetic Metabolism in the Healing of Granulating Wounds."

The paper was discussed by Drs. Lanphear, Daugherty, Broughton, Hoy, Summers, Mudd, Lewis, Lee, Lane, Trainer, Murphy, and discussion closed by Dr. Outten.

Dr. Wellinton Adams of St. Louis gave a demonstration of the Roentgen or "X" ray, and made some remarks on the value of these rays to the scientific physician and surgeon.

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When the association came to consider the place of next meeting, Dr. Brock moved that this matter be placed in the hands of the executive committee, and that as soon as the committee has decided on the place of meeting, it be made known through The Railway Surgeon. Carried.

The cities of Pittsburg, St. Paul, Chicago, Toledo and New York were suggested for the benefit of the executive committee.

Under the head of "Special Committees," no reports were made.

Dr. Hoy moved that the association continue in session until all the business and the reading of papers had been disposed of, so that when the convention did adjourn it could do so sine die. Carried.

Dr. Ward of the auditing committee, stated that, in view of Dr. Hoy's resolution, this committee would be unable to report to the association, and he therefore asked the privilege that the committee be empowered to prepare its report and place it in the hands of the executive committee.

On motion, this request was granted.

The president-elect, Dr. Lutz, in accepting the office of president, said: "Members of the National Association of Railway Surgeons:When Dr. Thorn informed me, on my arrival here, that the undeserved and distinguished honor of being elected president of this asso

ciation had been conferred upon me, I thought it was an after-thought of night before last on his part, and that he was guying me. I yet do not believe it. I really feel, gentlemen, that I do not deserve this position. On the other hand, I feel to be elected president of this association is worth the ambition of any man's lifework. I want to say for myself, that I do not think it is intended as a personal compliment to me at all, but is rather an expression of good will on part of the association for the surgeons of the great city of St. Louis, and of this great state, and as such I take it, and I thank you all heartily for this expression of your confidence, which I hope will not be illy-founded. I assure you that I shall endeavor to the very best of my feeble ability to continue in the footsteps of the illustrious gentlemen who have occupied this position in the association, and I would ask each and every member to contribute his mite toward making the future meetings as successful as those of the past have been. Again, gentlemen, I thank you, one and all, most cordially." (Applause).

Dr. Emory Lanphear of St. Louis, Mo., read a paper entitled, "Why Railroad Surgeons Should Not Try to Practice Aseptic Surgery,” which was discussed by Drs. Crile, Elliott, Fulton, Thorn, Daugherty, McCrae and Jelks, and the discussion closed by Dr. Lanphear.

Dr. W. J. Eddy offered the following resolution:

Resolved, That a vote of thanks be extended to Dr. W. B. Outten, editor of The Railway Surgeon, and Dr. C. D. Wescott, assistant editor, for their untiring devotion to the success of the journal and for the efficient manner in which they have edited the same.

Seconded by Dr. Elliott, and unanimously carried.

Dr. Barr offered the following resolution: Resolved, That inasmuch as the place of the next meeting of this association has been placed in the hands of the executive committee, we ask that the committee, as soon as it decides on the next place of meeting, announce the same in The Railway Surgeon, so that the members may be able to make their arrangements accordingly.

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Seconded and unanimously carried.

The retiring president, Dr. Murphy, said: "I take this opportunity to thank you for your very kind and courteous treatment of me during the sessions. I am very grateful to each and every one of you. I also thank you for the excellent papers which you have presented and for the forcible and, at times, spirited discussions that you have entered into on the papers presented.

"From your conduct at this meeting, I think the motto placed at the heading of the programme on the seventh page should be adopted as a motto for this association: 'Let us be resolute in our pursuits, but gentle in the manner of pursuing them.' I think that exemplifies your conduct through this entire meeting. Again, I thank you for your kindness to me. (Loud applause.)

"I think Dr. Outten, the chairman of the committee of arrangements, deserves our sincere thanks, also the local profession, who have given us so much attention while we have been here in a quiet way, and I will ask the members to rise and extend a vote of thanks to both Dr. Outten and the local medical profession of St. Louis."

The vote was unanimous.

There being no further business before the association, either scientific or otherwise, President Murphy, on motion, declared the meeting adjourned sine die.

The New Hampshire Medical Society.

The one hundred and fifth annual meeting of the New Hampshire State Medical Society is being held as we go to press, June 1 and 2, at Concord, N. H.

The following is the scientific programme: Dissertation.-"Medicine of To-day." By D. E. Sullivan, M. D., Concord. Discussion opened by E. A. Clark, M. D., Concord.

Report on Surgery.-"The Treatment of Several Tendons." By W. A. Megrath, M. D., Loudon. Discussion opened by W. H. Mitchell, M. D., Loudon.

Essay. "Before and After Treatment of Laparotomy." By A. F. Wheat, M. D., Manchester. Discussion opened by D. S. Adams, M. D., Manchester.

Dissertation.-"Modified Milk as a Food for Infants." By A. K. Day, M. D., Concord. Discussion opened by Geo. Cook, M. D., Concord.

Report.-"Gastro-Intestinal Diseases of Children." By I. G. Anthoine, M. D., Nashua. Discussion opened by M. H. Felt, M. D., Hillsborough.

Report.-"On Physical Exercise and Athletics." By J. W. Staples, M. D., Franklin Falls. Discussion opened by F. A. Stillings, M. D., Concord.

Dissertation.-"Myxeodema." By G. W.

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Report. "On Variola." By Geo. Cook, M. D., Concord. Discussion opened by I. A. Watson, M. D., Concord.

The South Dakota Medical Assembly.

The "Medical Assembly" was organized at Sioux Falls, South Dakota, May 26, 1896.

The following is the scientific programme: "Address in Medicine," Dr. Robert E. Conniff, Sioux City, Iowa.

"Address in Surgery," Dr. J. N. Warren, Sioux City, Iowa.

"Address in Gynecology," Dr. Edward Hornibrook, Cherokee, Iowa.

"Address in Obstetrics," Dr. S. A. Brown, Sious Falls, South Dakota.

“Address in Anatomy," Dr. L. Phelan, Sioux City, Iowa.

"Address in Ophthalmology," Dr. R. E. Woodworth, Sioux Falls, South Dakota.

"Sparteine in Surgical Anæsthesia, Dr. G. G. Cottom, Rock Rapids, Iowa.

"Antitoxin in Diphtheria," Dr. W. H. Meyers, Sheldon, Iowa; Dr. Jos. Schwartz, Hartford, S. D.

"Injuries to the Eyeball," Dr. J. C. Dunlavy, Sioux City, Iowa.

"Bacteriology in Diagnosis, Dr. S. Olney, Sioux Falls, S. D.

"Pyonephrosis," Dr. William Jepson, Sioux City, Iowa.

"Lessons from 800 Confinements, Dr. F. J. Smith, Alton, Iowa.

"Hysterectomy: Its Uses and Abuses," Dr. V. B. Knott, Sioux City, Iowa.

"Afterbirths," Dr. T. S. Roberts, Sioux Falls, S. D.

"Extra-uterine Pregnancy," Dr. A. C. Bergen, Sioux City, Iowa.

"Proprietary Remedies," Dr. Geo. W. Bliss, Valley Springs, S. D.

"Obstetric Anæsthesia," Dr. W. M. Richey, Le Mars, Iowa.

"Ulcers of the Cornea," Dr. George Park, Sioux City, Iowa.

The purse of the patient frequently protracts his cure.-Zimmermann.

Miscellany.

(154) Pathogenesis of Uræmia.

Ajello and Paraveandalo (Lo Sperim, an. 49, fasc 4), as the result of numerous experiments on animals, believe that uræmia is closely related to the presence or absence of an internal renal secretion. Just as other glands have internal secretions, so has the kidney. The authors found that animals, after unilateral nephrectomy and without any treatment, died in from eight days to eleven months with albuminuria and cachexia. On the other hand, animals, after unilateral nephrectomy, when inoculated with renal juice prepared after the method of Brown-Sequard and D'Arsonval (20 c.cm. injected daily in dogs, 10 c.cm. in rabbits), did not present any albuminuria or cachexia, and lived in good health until killed for other experiments. After double nephrectomy without treatment the animals died in four to fortyeight hours; if treated with renal juice they lived from forty-eight hours to four days and more. The implantation of kidneys, whether subcutaneously or in the peritoneal cavity, gave negative results.-British Medical Journal.

The four humors in man, according to the old physicians, were blood, choler, phlegm and melancholy.-R. C. Trench.

FOR SALE.

PRACTICE FOR SALE:-I offer for sale my practice in the county seat of one of the best counties in Iowa. Have been here for twelve years; am surgeon of the leading road entering the town; am medical examiner for six life insurance companies, etc. I simply require that my successor buy my office fixtures, mostly new-worth $700. Purchaser must be reliable physician with few years' practice. Address "Z. V.," care RAILWAY SURGEON, Chicago.

Desiring to remove to the Pacific Coast, I offer my well-established practice of over 20 years to any physician who will purchase my real estate, situated in one of the most beautiful and thriving towns in Southern Michigan, and surrounded by a very rich farming country. The town is intersected by two important railroads, for one of which the subscriber is surgeon. The real estate consists of a fine brick house of eight rooms and two fine offices besides, attached to, and a part of, the residence. A fine well of the purest water, two cisterns, waterworks, etc. Fine garden filled with choice fruit in bearing, peaches, pears and apricots and small fruits, raspberries, currants, etc. Fine barn and other outbuildings, comparatively new and in the very best condition, all offered with the practice and goodwill at a very low figure for cash. Address MACK, Surgeon," care RAILWAY SURGEON, Monadnock Block Chicago, Ill.

By reason of failing health, physician wishes to dispose of real estate and practice. Practice amounts to nearly $4,000 per year. No charges except for real estate. Address WM. D. B. AINEY, Montrose, Pa.

Desiring to remove to a warmer climate, owing to poor health. I offer my well-established practice of 11 years to any physician who will purchase my real estate; situated in one of the most thriving towns in the Platte Valley, in Central Nebraska, on main line of Union Pacific R. R., on which road I am the assistant surgeon.

The real estate consists of 2 lots "on corner," on which there is a fine artistic "modern" frame house, 8 rooms; stable 20x30, wind mill, tower and 30-barrel tank: nice blue grass lawn, trees and fine garden (all new); and all offered with my $5,000 practice and good will, at a very low figure. A part cash, balance on time. A very thickly populated country. Address BOVINE," care RAILWAY SURGEON, Monadnock Block, Chicago, Ill

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VOL. III.

CONTENTS OF THIS NUMBER.

ORIGINAL ARTICLES:

Rupture of the Bladder Without External Evidence of Injury-by S. R. WOOSTER, M. D........

The Use of the Ophthalmoscope by the General Practitioner-by CASSIUS D. WESCOTT, M. D...

Tumors of the Lachrymal Gland-by ADOLF ALT, M. D.....

EDITORIAL:

CHICAGO, JUNE 16, 1896.

Hæmostatics in Hæmophilics..

PAGE

EXTRACTS AND ABSTRACTS:

The Question of Position in the Treatment of Fractures of the Lower End of the Humerus.....

Color Vision.....

NOTICES AND REVIEWS......

NOTES, NEWS AND PERSONALS...

36

That Microbe of Old Age.....

The Extremes of Shock as Manifested in Railway Injury......

25

MISCELLANY:

The Association of Military Surgeons..... A Case of Traumatic Ventral Hernia and one of Hæmophilia..

28

3333

37

41

43

44

45

46

47

47

Officers of the N. A. R. S., 1896-7.

President.....
.F. J. LUTZ, St. Louis, Mo.
First Vice-President.. W. R. HAMILTON, Pittsburgh, Pa.
Second Vice President....J. H. LETCHER, Henderson, Ky.
Third Vice-President......JOHN L. EDDY, Olean, N. Y.
Fourth Vice-President. .J. A. HUTCHINSON, Montreal, Canada
Fifth Vice-President...... A. C. WEDGE, Albert Lea, Minn.
Sixth Vice-President...... RHETT GOODE, Mobile, Ala.
Seventh Vice-President... E. W. LEE, Omaha, Neb.
Secretary..
.C. D. WESCOTT, Chicago, Ill.
Treasurer...
..E. R. LEWIS, Kansas City, Mo.
Executive Committee:-A. I. BOUFFLEUR, Chicago, Ill., Chair-

man:

J. N. JACKSON, Kansas City, Mo.; JAS. A. DUNCAN, Toledo, O.; J. B. MURPHY, Chicago, Ill.; S. S. THORNE, Toledo, O.; W. D. MIDDLETON, Davenport, Ia.; A. J. BARR, McKees Rocks, Pa.

No. 2.

RUPTURE OF THE BLADDER WITHOUT EXTERNAL EVIDENCE OF

INJURY.*

By S. R. WOOSTER, M. D., GRAND RAPIDS, MICH.

In reporting this case I am conscious of the fact that I shall not present anything new or instructive, or of special interest to the members of this association; neither will the experience gained in this case be of practical benefit in the treatment of cases of this character in the future; my only object in presenting it to you is to show the extent and severity of the injury, with no abrasion or discoloration, or any other external evidence of injury.

April 6, 1894, at 3:30 a. m., I was called to see Edward Adams, freight brakeman, aged 21, I saw a strong, robust, healthy young man.

him about thirty minutes after being injured, and found him suffering severely from shock. His abdomen was distended, but he complained little of pain; his pulse was small and thready, and the skin was cool and moist. He said he was in the act of coupling an engine to a freight car when he was caught between the "bumpers." A careful examination failed to reveal any evidence of external injury. I had the patient removed to the hospital and introduced a soft rubber catheter, which readily passed into the abdominal cavity. With the aid of stimulants and rest, after a few hours waiting, the patient rallied considerably, his pulse became stronger and the surface warm. Under the influence of ether an incision was made in the median line of the abdomen which revealed a rupture of the abdominal muscles and fasciæ, and the bladder. The abdominal muscles were crushed, so to speak, and the bladder was ruptured throughout its long diameter. The peri

*Read at the ninth annual meeting of the National Association of Railway Surgeons at St. Louis, Mo., April 30, 1896.

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