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A NEW hospital car has been added to the medical equipment of the Erie Railroad. The car, which is sixty feet long, comprises two compartments-an operating room fifteen feet ten inches in length, and a ward forty-three feet ten inches in length. In the operating room are operating tables, sterilizers, instruments, and dressing materials. The ward furnishes accommodation for eleven persons.
THE HAGUE was the scene of this year's International Tuberculosis Congress, which convened on September 6 under the presidency of M. Bourgeois, the French Foreign Minister, and in the presence of Prince Henry of the Netherlands. The discussion of September 7 contemplated the establishment of popular sanatoria. Among the American speakers was Doctor Lawrence F. Flick, of Philadelphia.
NINE thousand two hundred twelve persons met violent death in the United States during 1905, an increase of seven hundred thirty over 1904. Three thousand one hundred forty-two of this number were killed in railroad accidents, and the street railways were responsible for four hundred sixty-four. Our homicide rate is nine times greater than that of the Germans, and four times that of the English.
THE American Orthopedic Association held its twentieth annual meeting at Toronto, Ontario, on August 20-23, 1906. The following officers were elected for the ensuing year: President, Doctor Joel E. Goldthwait, Boston; vicepresidents, Doctor Henry Ling Taylor, New York, and Doctor Ansel G. Cook, Hartford, Connecticut; secretary, Doctor Robert B. Osgood, Boston; treasurer, Doctor Elliott G. Brackett, Boston.
WORK on Buffalo's new Children's Hospital, the erection of which was facilitated by a bequest of the late Doctor DeVillo W. Harrington, will shortly be commencd, a site having already been procured. Since the gift of the doctor, which amounts to $75,000, is to be shared with the General Hospital, of Buffalo, it is not yet known what expenditure will be possible, and definite plans for the structure have not yet been adopted.
THE report of the San Francisco Board of Health to the California State Board of Health discloses the fact that four hundred fifty-two lives were lost in the earthquake. Of these, one hundred seventyone perished by fire, seven were shot and two died as the result of ptomain poisoning. Four hundred twenty of the victims were white, eighteen were Chinese, four were Japanese, and ten were unidentified as to nationality.
SOME interesting figures were disclosed by the Japanese minister of war at a recent banquet of representatives of the medical service. At one time during the late campaign the Mikado had one million two hundred thousand troops in the field. Of this number three hundred ten thousand were wounded or sick and seventy thousand died. However, only fifteen thousand died of sickness, and nine thousand eight hundred died of wounds after receiving treatment.
THE corner stone of the Missouri State Sanatorium for the Treatment of Incipient Tuberculosis, located at Mount Vernon, was laid on August 15, under the auspices of the Knights Templar and other Masonic orders. The address of the occasion was delivered by Doctor William Porter, of Saint Louis, who congratulated the state upon its awakening to the necessity of such an institution. Governor Folk also addressed the multitude.
NOTWITHSTANDING the ordinary tribulations of medical journalism occasional exigencies arise to encumber the situation. The latest is a canvasser who has, without authority, been soliciting subscriptions for Surgery, Gynecology and Obstetrics. So clever was this fakir that in many instances doctors were persuaded to issue checks payable in his The profession is warned against yielding collateral to solicitors unable to produce credentials.
DOCTOR MARY PUTNAM JACOBI, wife of Doctor Abraham Jacobi, New York's eminent physician, died on June 10, 1906, aged sixty-three years. Doctor Jacobi inaugurated her scientific career by receiving a pharmacal degree in New York, and later (1861) graduated from the Woman's Medical College of Philadelphia. In 1871 she graduated from the School of Medicine of Paris. For many years she was a prominent physician of New York City.
THE following appointments have been made to Johns Hopkins faculty: Professor of pharmacology and physiological chemistry, Doctor A. S. Lovenhart; associate professor of bacteriology and lecturer on hygiene, Doctor William W. Ford; associate professor of art in its relation to medicine, Doctor Max Broedel; instructor in anatomy, Doctor A. W. Myer; instructor in pathology, Doctor G. H. Whipple; and instructor in physiology, Doctor J. A. English.
THE necessity for a leper hospital in the United States is apparent, and it is reported that Surgeon-General Wyman, of the Public Health and Marine Hospital Service is endeavoring to obtain an appropriation for its establishment. Notwithstanding a bill appropriating $250,000 toward the project passed the last Senate, it failed of passage in the House because of the opposition of a delegate from New Mexico, who feared that the buildings would be erected in his state. It is to be hoped that the renewed efforts will meet with success.
THE apprehension of an imposter who claims to be a pupil of Lorenz, of Orthopedic fame, is desired by the officials of New Jersey. The swindler has been operating among the poorer classes, and succeeded in securing a considerable sum of money before his methods were detected. After gaining charge of a case he would manipulate the deformed member, simulating the movements of the great specialist, and then leave a bottle of liniment, promising to return and administer further treatment. The fee was demanded in advance and the charlatan always failed to appear a second time.
PROVIDENCE seems to have spared many of the medical institutions of stricken San Francisco. Cooper Medical College, and Lane Hospital, which is in affiliation therewith, were but slightly damaged and the operation of both institutions will not be materially hampered. The medical department of the University of California and Children's Hospital suffered no serious damage, and although the College of Physicians and Surgeons was destroyed, its new building will be ready for occupancy at the opening of the fall term.
A MANUAL AND ATLAS OF DISSECTION.*
THIS work is an illustrated augmentation of "Yutzy's Dissection Guide." It is such a vast improvement on the former publication, however, and withal so comprehensive in character, that the features of the initial book are barely recognizable. It embraces sixteen demonstrations and three hundred fourteen illustrations of the various organs and structures of the body. For the elemental student, whose knowledge of anatomy is meagre, this illustrated manual is destined to prove a boon, and it will undoubtedly gain the circulation it merits.
*By Simon M. Yutzy, M. D., Instructor in Osteology and Demonstrator of Anatomy in the University of Michigan. P. Blakiston's Son & Company, Philadelphia.
MESSRS. W. B. SAUNDERS COMPANY announce for publication in the early fall the following excellent and practical works: "Keen's Surgery-Its Principles and Practice (Volume I);" "Sobotta & McMurrich's Human Anatomy (Volume III);" "Webster's Text-Book of Gynecology;" "Hill's Histology and Organography;" "McConnell's Pathology;" "Morrow's Immediate Care of the Injured;" "Stevenson's Photoscopy (Retinoscopy and Skiascopy);" "Preiswerk & Warren's Atlas of Dentistry;" "Goepp's State Board Questions and Answers;" and "Lusk's Elements of Nutrition." The most notable announcement is the new work on "Surgery," edited by Doctor W. W. Keen, complete in five octavo volumes, and containing over one thousand five hundred original illustrations. The entire work is written by the leaders of modern surgery-men whose names are inseparably associated with the subjects upon which they have written. Without question, "Keen's Surgery" will represent the best surgical practice of today.
PREOPERATIVE TREATMENT FOR ABDOMINAL SECTION.
BYRON ROBINSON, B. S., M. D.
professor of GYNECOLOGY AND ABDOMINAL SURGERY OF WOMEN IN the illinois medical college.
WE do well what we do automatically. Truth should be constantly advocated because the majority constantly advocate error.
The object of preoperative treatment for abdominal section is to place the patient in a condition, mentally and physically, to resist the operation-the anesthesia, trauma, infection.
ADVICE AS REGARDS OPERATIONS.
The demonstration of the functional capacity of the visceral tracts during the preoperative treatment, in addition to the presenting pathologic condition requiring operation, indicates what kind of advice is to be given the patient or his responsible friends. First and foremost, during the preoperative treatment the surgeon has no legal or moral right to announce that there is no danger accompanying the operation. Second, it is not the surgeon's duty to persuade a patient to accept an operation. The surgeon may announce that he thinks or it is his opinion that the operation will benefit the patient, or that the operation is advisable, or that the patient is better off with the operation. It is deplorable and an immoral blotch on a surgeon's escutcheon to tell a patient that there is no danger in the operation and that he will die without it. There is a mental and physical preoperative treatment. A proper knowledge of the subject and the statistics may allow an explanation of the probability of success or failure. The surgeon knows, in general, that operations do not kill-it is disease that kills. However, the lay mind views the operation as a large factor in cause of death. With the doubtful statement "there is no danger in the operation" some unforseen fatal accident may circumscribe the surgeon's position to
that of a fool, or more particularly that of a deceiver, a liar, employing his vocation to the advantage of securing patient's money by false pretense. Explanation of a patient's death subsequent to an operation will not extricate the surgeon from a dilemma. The surgeon assured the people there was no danger connected with the operation and that is all the people wish to know.
Abdominal section is at present a science-not as formerly a haphazard of fortune and misfortune-and demands scientific (physiologic) preoperative and postoperative treatment. The real battles in abdominal surgery are fought before and after the operation. Successful abdominal surgery demands systematic preoperative treatment because the preoperative treatment demonstrates: (a), the power of the individual patient to resist the operation (anesthesia, trauma, infection); (b), the individual patient unable to resist the operation where defects were discovered by preoperative treatment, can be placed on prolonged preparatory treatment to decide the fate; (c), ample preoperative treatment may aid in discovering the anatomic and physiologic defect that would result in immediate death from operation-a black eye to surgery. The emergency peritonotomy patient-the unfortunate, experiencing no preoperative treatment-presents an appalling mortality which stands in such marked contrast to the successful recovery of patients experiencing preoperative treatment that the laity vividly comprehend.
The diagnosis of disease is the rock and base of all treatmentmedical and surgical. Rational therapeutics rests on rational diagnosis. The surgeon is first a physician with merely acquired technique. The surgeon must possess knowledge of every visceral tract—its anatomy and especially its physiology. He must be able to estimate the functional capacity-power of resistance-if systematic success attends his surgery. Surgical technique is merely mechanical skill executed on the base of a diagnosis. The localizing of a uterine myoma is a fragment of the diagnosis only. The preoperative treatment will demonstrate the diagnosis of the tractus vascularis (classification of arterial and cardiac lesions), of the tractus urinarius (classification of nephritis), of the tractus pulmonalis (classification of lung lesions). The diagnosis not only includes the local pathologic anatomy but also the physiologic capacity of the patient to resist the operation and recover. The abdominal surgeon should be a master in pathologic physiology and pathologic anatomy.
The diagnosis having been established the preoperative treatment reveals the basis of prognosis. The acutal state of the functional capacity of each visceral tract gradually becomes demonstrated by disclosing its functional capacity, forecasting the probable results of the operative procedure-the prognosis. Systematic preoperative treatment predicts the probabilities of success and the danger elements, the