Memphis Medical Monthly

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THE YELLOW BANQUO AGAIN.

To those inhabitants of the littoral of the Gulf of Mexico it must indeed be discouraging to contemplate the fact that they are likely to continue for some time to receive annual visitations from epidemic yellow fever. And the fact that this icteroid plague seems to have no great difficulty in gaining access to various towns along the Gulf coast is a constant menace to the centers of population further inland. But such truly appears to be the prospect.

For the last several years yellow fever has developed in various Gulf coast towns, and has even invaded the interior of the South. Last summer it came so high up in Mississippi as to the villages of Orwood and Taylor's, and to this day it can not positively be said how and by what means the infection. was brought to the first of these isolated small towns in which. it developed. This year, in keeping with the yellow marau

der's stealthy habits, an isolated case developed in Jackson, Miss., and how it came about appears just as near a solution as the question of the discovery of the steam engine. Some claim that the victim contracted the disease from his brother, who was said to have had yellow fever, while the physician. who attended the latter in his illness, in a letter to the public, states positively that the disease in question was not yellow fever. So there it is.

Now we can assert without fear of contradiction that yellow fever is not indigenous to the United States, therefore these sporadic cases must have been imported from infected foci. Prevention, then, is the keynote to eradication.

The ways and means to prevent the importation of yellow fever is a subject that has been agitated time and again, and continues to be discussed, but we can see no nearer solution of this problem than to enforce a strict maritime quarantine. Yet, even this has failed. Since Joseph Holt first advanced his ideas and working plans for the exploitation of a system of maritime quarantine, State boards of health and the U. S. Marine Hospital Service have been equipped with elaborate and expensive apparatus as required by the Holt system, and have been given plenary authority, but the disease has succeeded and continues to succeed in creeping in and gaining foothold. Therefore, while we cannot see what means are to be employed, we must continue to look for other measures of prevention.

With the discovery of Sanarelli's bacillus of yellow fever dawned fresh hope; a vista of serum therapy opened before us, and we have looked, but looked in vain, for an antimaryllic serum of potent properties. A serum we have had, but cures, Ah! Sanarelli has had them.

Till time brings us other means we shall be compelled to continue to rely upon active quarantine along our seaboard in the prevention of the introduction of yellow fever into the United States, but let this quarantine begin early, be active, exacting, and in the hands of the general government.

MEDICAL LEGISLATION.

In another portion of the MONTHLY we publish a letter from Dr. T. J. Crofford, of Memphis, written while he was attending the recent meeting of the Canadian Medical Association, at Toronto. The chief text of our correspondent's communication is that of medical legislation in Canada, from which we learn that our British American neighbors have troubles of this kind in common with us. But even as it is, the standard of requirements for the practice of medicine in the various provinces of Canada is far in advance of that maintained. by most of the States in the American Union. Not content with what they have, however, the Canadian medical men are struggling to secure parliamentary legislation which will demand that applicants for license to practice medicine in any province of British North America shall have taken at least five graded courses of medical lectures. This is but in keeping with the spirit of medical progress current in Europe and Great Britain, which teaches us that the medical profession should be the most highly cultured of all the professions, and whose members should individually and collectively struggle to maintain an ethical and scientific standard far above the grasp of the sordid.

This spirit is echoed in a few States and medical centers of the United States where the laws of practice are rigid, and where college curricula are properly exacting, but it is distressing to note that in most of the States the medical men are handicapped in their efforts to secure restrictive and protective legislation by the opposition or passive indifference of narrowminded or ignorant legislators, or are discouraged in their attempts by such puerile and degenerate acts as characterized the last General Assembly of the State of Tennessee, which stigmatized the State and placed the graduates of its medical schools in a most cowardly attitude by exempting these latter from the chief requirements of a fairly efficient medical law.

It is not a mere coincidence that in the countries where quackery and charlatanism receive the greatest growth (Spain) and the United States) the medical practice laws should be the most lax.

PROCEEDINGS OF SOCIETIES.

MEMPHIS MEDICAL SOCIETY.

The President, Dr. B. F. Turner, in the Chair.

There were present Drs. Barton, Ellett, Turner, Krauss, Buford, Porter, Alfred Moore, F. A. Jones, Black, Williams, McKinney; visitor, Dr. W. P. Ball.

Dr. B. F. Turner read a paper on Neurasthenia (see p. 445). Dr. Wm. Krauss said Dr. Turner's paper was one of the best he had ever listened to; he regretted there were not more members present. One point had always given him more trouble than anything else—the differential diagnosis between simple neurasthenia and degenerating disease like progressive paralysis, before there is any positive sign of degeneration that we can recognize. Patients and their friends are wont to press us for a diagnosis at a time when we can only make out a neurasthenia. We do not wish to unduly alarm the patient, and yet subsequent developments show that a graver disease existed. Does Dr. Turner know of any mode of differentiation?

Dr. G. G. Buford said he had listened with much pleasure to Dr. Turner's classical paper, and was well pleased, but he cannot see how and why he speaks of neurasthenia as a functional disease. In fact, he cannot, with the utmost stretch of his imagination, conceive of a functional disease any more than he can of the so-called idiopathic diseases. A cell in a normal or physiologic condition cannot give us an abnormal or pathologic phenomenon. A normal cell does not act abnormally. Neurasthenia is an abnormal condition, consequently must result from cells in the nervous system that are in an unhealthy state: Our inability to detect this does not disprove the fact. Dr. Turner made reference to Hodge's discovery. This is next to the fact that the cell is the origin of all matter, the discovery that has done more to aid in giving an exact knowledge of diseases of the nervous system than all others combined. Hodge demonstrated that the nerve cell while generating force underwent both a chemic and a morphologic

change. The nerve cell acts both as a primary and a secondary battery; is both a generator and a storer of force. In neurasthenia the cell either does not generate sufficient force or is unable to store it for use, or it is in the same condition as a chemical battery when its poles are united and the forces are equalized as soon as generated.

Dr. E. C. Ellett spoke of the neurasthenic conditions in which eye symptoms were given prominence, and in which eye treatment, as a rule, affords so little benefit. He also called attention to the relation between some of these cases and eye strain. The neurotic origin of various throat and nose manifestations was also dwelt upon.

Dr. Turner, in reply to Dr. Krauss, admitted the possibility of difficulty in exact diagnosis, especially where, in addition to the neurasthenia, a positive lesion of some form or other obtains in the nervous system. The battery is the great accessory in diagnosis. In reply to Dr. Buford he had only to suggest that perhaps the expression "functional disorder" would sound better than "functional disease." It were as hard to conceive that every functional disturbance is based upon a pathologic condition as to conceive of an absolutely perfect cell. Dr. E. C. Ellett read a report of Two Months Eye Service at the City Hospital.

EDITOR'S NOTES.

The Tri-State Medical Association of Mississippi, Arkansas and Tennessee will meet in Memphis, November 14, 15 and 16, 1899. The sessions of the Association will be held in the Woman's Building, north-east corner of Jefferson and Third streets. It is expected that this meeting will be without a peer, from the standpoint of the number of physicians in attendance and the full program of interesting papers to be presented. Physicians from the territory tributary to Memphis are urged to attend the sessions of the Association.

Titles of papers should be sent to the Secretary, Dr. Richmond McKinney, who will also be glad to furnish any desired information that he may be in a position to supply.

Dr. R. A. Simpson, of Bay, Ark., class of '99 Memphis Hospital Medical College, was married to Miss Clyde Briggs, of Jonesboro, Ark., at the home of the bride, on the evening of August 21, 1899. The MONTHLY extends congratulations.