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not seen a single journal, from North, South, East, or West, that did aught but condemn the action in no uncertain sound. And these utterances are the true index of the feelings of the profession. Fifty-two doctors at Albany, reckless of honor but greedy for gold, undertook to sell out the regular profession, but only succeeded in selling themselves, and very cheap at that. . . . The fees which those men hoped for they will not get, while the honorable name which has been heretofore accorded to them is theirs no longer. - Ohio Medical Journal.

At the regular stated meeting of the Homœopathic Medical Society of Lancaster County, Pa., the following resolution was unanimously adopted:

"Resolved, That it is the sense of this meeting that since the practice of homoeopathy has established for itself an honorable position in the estimation of the community against all opposing forces that the old school could bring to bear against it, that there is no advantage or prestige to be derived by homoeopathic physicians in consulting with allopaths, and therefore the recent action of the Allopathic Medical Society of the State of New York in resolving in future to consult with them was entirely gratuitous." S.

A CASE OF TRUE VACCINIA IN A CHILD, FOLLOWING THE VACCINATION OF THE MOTHER.

BY J. T. HARRIS, M. D., BOSTON.

On the 13th of February, 1882, I called at the house of Mr. G-, intending to vaccinate his two children, one about three years old, the other a seven months' babe at the breast, whose head, face, arms, and legs were covered with eczema, crusta lactea, from which it was suffering severely. Fearing an aggravation of the humor from complication with the vaccination, I declined to operate, giving as my reason that I thought the child. was suffering enough already; that she would be more feverish, irritable, and would require greater care if vaccinated than at present. Although the three-years-old child was troubled with the same form of humor, I vaccinated her, and also the mother. Both vaccinations took, and ran the usual course without much constitutional disturbance. The fifth day after the operation was Mrs. G's sickest day. She then had headache, backache, fever, and chill. The vaccination developed normally, but more rapidly than usual.

On the first day of March the baby was more restless and feverish, requiring constant care. On the second day the mother noticed a number of little red pimples upon the child.

These

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increased rapidly upon the face, arms, and legs. I was called to see the little patient on Saturday, the 4th of March. The little pimples at this time were very numerous, had increased in size; the areola quite red; some swelling; baby feverish; temperature To the question, "What is it, doctor?" I frankly answered, "I don't know, it is not small-pox nor chicken-pox. I shall have to wait until it is more fully developed.'

I02.

On Sunday morning, the fifth day since the fever, the vesicles were forming and more or less filled with lymph, and in the afternoon some were umbilicated. Fresh eruptions were also developing, and upon the face, arms, and legs- those portions of the surface most severely marked with the eczema -the new eruption had become confluent, the whole character of the eruption resembling that of small-pox. There were without doubt between four and five hundred well-defined circular vesicles upon the child during the course of the disease. I invited Dr. Miles to see the case on Sunday afternoon. After a careful examination, we concluded that it was a case of vaccinia, communicated to the child through the mother's milk. That there should be no mistake, however, I called upon Dr. McCullom, the city physician, reported the case, and invited him to see the patient with me, which he did on Monday morning. Dr. Martin of Roxbury, and Dr. Cutler of Chelsea, also saw the case, and were much interested in it.

On Monday, Tuesday, and Wednesday, the sixth, seventh, and eighth days, there was much swelling of the face, arms, and legs, where it had taken on the confluent form. The little patient was quite feverish and restless. On the seventh, eighth, and ninth days was quite hoarse, and had some difficulty in swallowing. All the symptoms gradually diminished after the ninth day, and many of the scabs were rubbed off. On the seventeenth day very few adherent scabs remained. Acon. and Tart. emetic were the remedies used.

At the present time, May 14, the child shows many pits, not deep however. The parts where the eruption was confluent are still quite red. The eczema, however, seems to have left for good, and I am in hopes of seeing a good, clear skin before many weeks. Although the diagnosis the first few days was obscure, all doubt was removed, and it was pronounced a case of vaccinia communicated from the mother. You will note that on the fifth day after the revaccination of the mother, the paroxysm of fever occurred, and ten days after the baby was feverish, and the eruption made its appearance one day later. We can therefore call it fourteen days from the time the babe first took the milk impregnated with vaccinia from its mother. If the system can thus be so thoroughly impregnated with vaccinia, may we not also

fear various and worse evils from the milk of unhealthy and unclean nurses?

Dr. W. C. Cutler, of Chelsea, being much interested in this unique case, had a photograph taken on the eighth day, from which he had the accompanying cut made, and, through his kindness, we are able to reproduce it for the benefit of our readers. It represents the right thigh and part of abdomen of the child. - ED.

PHYSICAL

EXAMINATION

OF THE

ABDOMEN AS A MEANS OF DETERMINING THE POSITION OF THE CHILD IN UTERO.

BY G. R. SOUTHWICK, M. D., DRESDEN, GERMANY.

In this short article neither the differential diagnosis of pregnancy from the various forms of abdominal tumors will be considered, nor the operations of external manipulation. Its aim is to call attention to a method scarcely mentioned in most of the text-books on midwifery used in the United States. The reason of this may be that these are usually English works, and external examination is not common in the English school. In Germany, all patients admitted to lying-in hospitals are examined in this manner. Valuable information as to the position, condition, and size of the child can be obtained some time before labor, and, according to recent writers, mal-positions rectified. It is also very useful during epidemics of zymotic diseases, or in cases of danger of infection through other causes. Vaginal examination gives more information regarding the mother, abdominal regarding the child; and the two combined will often enable the accoucheur to form an opinion at a much earlier period in labor than if used separately. Mal-positions, as in transverse presentation, may be detected, and, if version be decided upon, the time of operating can be selected, instead of being compelled to turn with a shoulder driven down in the brim, the membranes ruptured, and the uterus contracted, - conditions which make it a dangerous operation, especially in unskilful hands.

There is an objection raised that it requires an expert to practise external examination successfully. Where the uterus is tightly contracted, the woman long in labor, or an excessive amount of fat present, the method is often difficult. In the majority of cases, however, when the uterus is relaxed and the physician knows what to look for, where and how to find it, the task is an easy one. Especially, if it be compared to that of distinguishing, per vaginam, the anterior or posterior position of the occiput.

It may be objected, moreover, that women will not submit to it. The examination need not be painful, nor should enough force be used to make it so. There is little exposure, and it seems hardly probable that a sensible woman would refuse that which might be the means of relieving her from much suffering. The best literature recently published on this subject will be found in Schroeder's "Text-Book of Midwifery," 1882, — I believe the last edition is not yet translated, - Playfair's "Science and Art of Midwifery," 1881, “Monographs," by Dr. Paul F. Mundé, of New York,reprinted from the American Fournal of Obstetrics, and by Pinard of Paris. The last is probably the

most complete.

The patient must lie on her back, the thighs partially flexed, and the bladder emptied. All clothing must be loosened, particularly corsets, or anything forming a tight band about the body. The abdomen should be bare, as anything between it and the hands greatly increases the difficulty of distinguishing clearly the parts. If the patient gives trouble by holding her breath and contracting the recti muscles, she may be instructed to keep her mouth open and breathe naturally, or kept in conversation during the examination.

The child may be felt at the sixth month, but the most favorable time for determining its position is during the last month of pregnancy, before strong labor pains have commenced. The means at our command for diagnosis are, inspection, mensuration, percussion, palpation, and auscultation. By inspection, we notice the size and contour. A large uterus may contain, Ist, a large amount of amniotic fluid (Hydramnios), so distending the organ that it cannot contract to advantage, thus giving rise to a common cause of tedious labor; 2d, plural pregnancy; 3d, a very large child. A large uterus may be simulated by one of ordinary size with thick, fat abdominal walls, or by pregnancy complicated with extra or intra uterine tumors. The normal contour is oval and a little prominent. A very prominent uterus may be the result of relaxed abdominal walls and a thinning or separation of the recti muscles. It may even overhang the pubes. The uterine axis is thus thrown out of relation to that of the vagina, forming an acute angle with it. The force from above, chiefly from the diaphragm, is directed against the back of the fundus uteri instead of the upper surface. The acuteness of the angle is thereby increased, the presenting part driven. against the sacrum instead of in the axis of the parturient canal, and a very tedious labor results. A prominent uterus often indicates a contracted brim, which the head cannot easily enter. There is usually seen associated with it a transverse furrow in the abdomen, midway between the pubes and umbilicus. This

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