CAROLINA MEDICAL JOURNAL, August 20, 1898, pp. 120, 121, Editor.) The patient had been a girl seven years of age. The dislocation of the right hip had been upward and forward. The neck had been found to be short and the muscles shortened and somewhat atrophied. During life there had been more than one inch of shortening and the child had walked with difficulty like one with weak muscles. The head had made a deep and extremely well defined acetabulum lined with cartilage, below and near the anterior superior iliac spine. The original acetabulum was almost equally well defined, measuring 1% inches in its vertical and 1-inch in its transverse dian.eter with a depth of 4 in. So well defined a first acetabulum at this age was rare. Lorenz cited one at the age of 18 years and the older anatomists found them at very late periods of life. As a rule, however, the acetabulum not in use failed to keep pace with the development of the other parts and at an age much younger than that of the specimen it was usual to find it rudimentary and frequently presenting a convex contour. The old acetabulum was found to contain some fat but was chiefly occupied by an exceptionally large ligamentum teres, measuring 11⁄2 inches in length, 34 in. in width and in. in thickness, running from a well defined cotyloid notch through the vertical diameter of the acetabulum to an insertion in the femoral head. As a rule the ligamentu.n teres had been found at the age of 3 or 4 years to be a mere ribbon, or to have disappeared. In the usual dislocation on the dorsum iliac, the disappearance of the ligament might be explained by the facts that it had no function and was compressed closely between the margin of the acetabulum and the femur. In the specimen, however, the displacement had been directly upwards and the tremendous size of the ligament was apparently the result of its being called on to sustain the weight of the trunk at every step in walking. Its great size then was physiological rather than pathological. Dr. Whitman said that the old acetabulum appeared to be of fair size and that, as the tissues were doubtless far more yielding in life than in the preserved specimen, an operation by the open method in which the hypertrophied ligament would have been removed, might have been successful. Dr. Sayre said that, as the head was as broad as, if not broader than, the place where the acetabulum should be, it was doubtful whether chiselling away a part of the head would not have been required before reduction. TABETIC TALIPES VALGUS. 377 Dr. Judson presented a photograph of talipes valgus of the left foot in a man about 35 years of age afflicted with locomotor ataxia of several years duration. It was an instance of Charcot's joint affecting the tarsus. The patient's right knee joint had been exsected for this condition but stability had not been restored to the kee by the operation. Pathologically there were pulpy and fiuid degeneration of the bony and other tissues and disintegration of the structures of the joints. Eino varus also occurred in locomotor ataxia and in Frederich's disease but was the result not of bony changes but of adnormal muscular action. The primary disease was so serious and disabling that the question of treating these secondary affec· tions was not often a practical one, Mechanical treatment might, however, be considered with three objects in view: 1. to give firmness to the foot and ankle and direct the sole to the ground; 2, to give lateral support to a Charcot's knee; and 3. to stiffen the knees by the use of automatic joints in order to prolong the period when locomotion is possible with the aid of crutches. THE NEW ARMY HOSPITAL AT SAVANNAH.-The following description of this proposed hospital which will be the largest maintained by the government is found in the Medical News. The ground plan of buildings will be rectangular, with covered ways connecting all of the buildings with each other, and with the administration building in the center of the group. There will be forty-nine buildings in all. The cost of the Savannah establishment is to be $150,000. The material used will proba. bly be Georgia pine. The buildings are to be designed aud constructed with a view to permanency. Each building ill be ceiled inside and under the floors. Each of the four sides of the quadrangle will contain a ward capable of accommodating 250 single beds, with ample space between, making room for 1,000 beds in all. One ward will be set aside for surgical cases, and an enclosed passage-way will connect it with a modern operating-room. Besides the general wards there will be private sick-rooms for the accommodation of invalid officers. The plumbing is to be of a permanent character, and the drain pipes will be connected with the city sewer system. The artesian water supply will be unlimited. The heating will be by means of coal base-burners. It has not been decided whether the lighting will be by electricity or gas, but both are immediately at hand. There is an ice factory within fifty yards of the site, and ice is 15 cents per hundred pounds by retail. The officers' quarters will be of two stories. The domitories for the nurses and hospital corps will occupy two buildings. The chief surgeon will have a private residence. ROBERT D. JEWETT, M.D., EDITOR SURGERY: DEPARTMENT EDITORS H. T. BAHNSON, M.D., Salem, N.C. R. L. GIBBON, M. D., Charlotte, N. C. NERVOUS DISEASES:-J ALLISON HODGES, M.D., Richmond, Va OBSTETRICS: GYNECOLOGY: B. L. PAYNE, M.D., Norfolk, Va GEORGE G. THOMAS, M.D., Wilmington, N. C. H. S. LOTT, M.D., Winston, N. C. J. W. LONG, M.D., Salisbury, N. C. H. A. ROYSTER, M.D., Raleigh, N. C. PATHOLOGY:-ALBERT ANDERSON, M.D., Wilson, N. C. All communications, either of a literary or business nature, should be addressed to, and any remittances by P. O. Order, Draft or Registered Letser, made payable to ROBERT D. JEWETT, M.D., Winston, N. C. Editorial. HEALTH CONFERENCE. The annual health conference of the State Board of Health will be held in Winston Salem on the 7th of December. We are pleased that the Board has selected this city for its meeting and feel sure that the Conference will receive a hearty welcome from all who desire to see the two towns keep abreast of the times in the matter of sanitation. These conferences always do good to the town in which they are held. They awaken interest in sanitary matters in the mind of the people and are a source of useful education. Especially is it well for the city authorities to be brought into direct contact with the Board, so that the matters which must necessarily come before them in the discharge of their duties as custodians of the health of the people over whom they rule may be freely discussed from the standpoint of the modern sanitarian; thus may they be better qualified to enact wise laws for the preservation of the public health. We trust that every member of the city council may be present at all the meetings of the Conference, and that some representative from the neighboring towns may be delegated to attend the meeting. In this way the usefulness of the Board will be felt over sections of the State where it is entirely impracticable for a Conference to be held. DR. ROBERT H. WINBORNE. It becomes our said duty to chronicle the death of Dr. Robert H. Winborne, which occurred at his home in Chowan county on the 7th of November, 1898. Dr. Winborne was in his 73rd year and was one of the oldest and most honored members of the Medical Society of the State of North Carolina. For forty four years he was an active practitioner of Chowan county and during that time had greatly endeared himself to the people among whom he worked. The immediate cause of his death was heart disease. Since the last meeting of the Society death has claimed two of our oldest members, Dr. Gibbon and Dr. Winborne. It is with much sadness and a sense of the rapid flight of time and the unchangeableness of the great laws of nature that we see our ante bellum members dropping, one by one, from the ranks of our profession; but though their active life-work must cease we know that the good they have done will live after them, and that even in death, the seeds they have sown will continue to yield fruit. We trust that the Obituary Committee of the Society will take such steps that the memory of their good deeds and noble lives may be perserved in the archives of the Society and serve as ensamples for the help and guidance of those who follow them. TROUBLE AT THE WILMINGTON HOSPITAL. We see from the local papers that there has arisen a very unpleasant state of affairs among the medical staff of the Wilming ton City Hospital. Nearly two years ago there was a reorganization of the management of the hospital, the Board of Managers appointing a Board of Regents from among the local physicians who should have charge of the medical affairs of the hospital, and one of whom should make a daily visit to the hospital to see that the patients had proper treatment-in fact the patients were placed under the medical care of the Board of Regents. The Board was to select as Resident Physician one of those six applicants before the Board of Medical Examiners, who made the highest general average. To fill this position, the Board selected from the class of 1897, Dr. R. E. Zachary. He was to serve one year as Assistant and the second year as House Physician. The conduct of the hospital still proved unsatisfactory and the Boards of Managers and Regents requested Dr. Wertenbaker, of the Marine Hospital Service, to assume temporary charge of the hospital and place it on a good working basis, after the plans of conduct of the marine hospitals. With Dr. Wertenbaker's experience and executive ability the condition of the hospital seems to have greatly improved, with the exception that there have been frequent clashes of authority between Dr. Wertenbaker and Dr. Zachary. The tension became greater when a young physician was imported from Virginia and made Assistant Superintendent to Dr. Wertenbaker, thus being pl: ced over Dr. Zachary. Things reached such a condition that at last Dr. Zachary's resignation was asked for. He refused to resign, claiming that his election, which was upon competitive examination, was for two years which would not expire until July, 1899. The Board of Managers then adopted resolutions dismissing Dr. Zachary, and on his failure to leave the institution by 12 o'clock of November 30th, that officers be sent to eject him by force. This was done and Dr. Zachary has instituted suit for his salary to the expiration of his term of office and $10,000 damages. These are the conditions which are visible from the outside; |