« ForrigeFortsæt »
brought such cases under the Workman's Compensation Act, although formerly they were considered to come under another act. These are the cases of the wet nurses who contract syphilis. The nurse can only obtain damages by furnishing proof that the persons who engaged her to nurse the child were imprudent or negligent, and also that they knew of the possibility of the child being syphilitic. So in two recent cases the parents were not assessed damages for they were able to show that they did not suspect that they were syphilitic, and they called experts to witness that there were no evidences of syphilis about them. In both cases the children were evidently suffering from hereditary syphilis. Such dcisions are possibly correct law, but they are not humane, and some way of solving the problems should be found which would give more justice to the sufferers than does the present law.
Photographing the Dead for Identification.—The London Lancet states that the coroner has on two recent occasions commented on the unsatisfactory character of the photographs of the unidentified dead taken by the police authorities. It adds that Doctor Miniovichi has contributed a valuable report on this subject from his experience as director of a Medicolegal Institute of Bucharest. He describes his method in the Archives d'Anthropologie Criminelle. He substitutes artificial eyes and gives a natural appearance to the lids by means of lead foil or by pinning them to the eyeball with small pins. The jaws are drawn together with threads, and the face drawn to a natural expression by means of pins, evacuating accumulations of gas by means of incisions in the scalp or mouth. He gives photographs of the various steps in photographing the dead and states that he was able in one case to fully establish the identity by means of the photograph, the body having been in the water for six weeks.
Penalty for Selling Cocaine.—A Norfolk, Virginia, druggist was fined $1,000 and costs for selling cocain illegally. This is the maximum penalty in Virginia.
Interstate Prescriptions Affected by New Drug Law.—The question of physicians' prescriptions has been brought before the committee in charge of the new Pure Food and Drug Law and they refused to exempt these prescriptions from coming within the scope of the law. This would mean that any prescription put up and sold in any state, territory, District of Columbia or insular possession and sent out to another state, et cetera, or any foreign country, “must bear a statement on the label of the quantity or proportion of any alcohol, opium, morphin, cocain, heroin, alpha or beta eucaine, chloroform, cannabis indica, chloral hydrate, or acetanilid or any derivative or preparation of any substances contained therein. The solution of this complication by the commission which has charge of the enforcement of these regulations will be watched with interest.
Expert Testimony in Cases of Alleged Insanity.—This subject has become of interest of late owing to the release of a patient from the New York Asylum for Insane Criminals on his confession of murder, and his subsequent commitment to prison on his acknowledging that he had feigned insanity on his examination by the experts at his trial. The experts were two of the leading authorities in the city and the methods of the criminal seem to have deceived them. Interest has been intensified by the occurrence of the recnt Thaw case. Interest is also added to the case by an incident in a recent trial for murder during which one of the most prominent medical experts changed his opinion as to the sanity of the criminal appearing, in fact, first on the one side, then on the other. Various methods have been proposed to remedy the evil. That which receives most favor is the creation of a state board of medical experts under rules and regulations established by the state. It is contended that such a state board would be carefully selected as to its membership, and if the compensation were fixed by public authority and paid out of the public treasury, impartiality would be secured.
Dental Bill in Court.-The $1,000 dental bill of Prince Louis, of Battenberg, while being feted in New York, is outdone. Doctor Robert E. Payne, another New York dentist, has brought suit against Mrs. Jennie Wheeler, an artist of that city, for $1,505 for three weeks' work on her teeth. Mrs. Wheeler, though fortune's wheel has been kind to her, refuses to divide up with the dentist, asserting that the price was to have been $500 and that the work was unskillfully done. She also objects to paying $15.00 per hour for professional services when they were taking lunch together and $52.50 per diem on occasions when she failed to appear at the office for treatment.
Who Owns the Extracted Tooth?—The German courts have had this question up before them recently. The dentist contended that the tooth had been evicted from occupancy with the full consent of the landlord, and had become ownerless and derelict, and as the patient's tooth in question was curiously shaped and valuable to him as a specimen he proposed to keep it. The patient won the controversy, the court deciding that the tooth belonged to the patient after it left the jaw as well as before. This is certainly as it should be, but the patient should be willing to devote a portion of his anatomy to science and be proud of the distinction.
Tooth In Bronchus.-A firm of dentists in Los Angeles extracted seven teeth from a man and allowed one of them to drop into his bronchus. He sued for damages and was awarded two thousand four hundred dollars. An appeal from the verdict was not granted.
Pure Food Bill.—The enactment by congress proscribes interstate commerce in patent medicines unless a full formula as regards alcohol and poisonous drugs is stated upon the label. The law provides against the shipping of proprietary medicines from one state into another. The manufacturing of such medicines, like their sale, is not prohibited within the state, hence the necessity of every state protecting its citizens. It can be depended upon that the dope will be manufactured in the state in which it is sold if there is no state law with this requirement as to labels.
Headache Powders Again.—Mr. Wolf, a prominent merchant of Findlay, Ohio, died after taking "safe, sure, and reliable” headache powders sold by a local druggist. He was found dead with an empty powder paper beside him. He had no means of knowing the condition of his heart and circulation, and neither had the druggist who sold him the poison. The druggists and nostrum vendors cry about interference with personal liberty. What about the poor victims and their families ? Are they to have no consideration at the hands of the state?
Syphilis in Relation to Crime. This subject is very exhaustively treated by Ravogli (Ohio State Medical Journal). He claims that syphilis in the acquired and hereditary forms has increased crime and may therefore be considered as one of the predisposing causes to criminality. The syphilitic toxins carried in the circulation in the secondary period are frequently the causes of neuroses. He traced history and ascribes the butcheries and crimes of the fifteenth century to be due to acquired and hereditary syphilis. It is a good argument to connect so terrific an epidemic of crimes with syphilis, recalling the time in which it was enacted, just after the spreading of syphilis epidemically.
Cincinnati, Grand and Nassau.
CLINICAL SOCIETY OF THE UNIVERSITY OF MICHIGAN.
STATED MEETING, NOVEMBER 7, 1906.
REPORTED BY DAVID M. KANE, M. D., SECRETARY.
REPORTS OF CASES.
TUMOR OF ORBIT. DOCTOR WALTER R. PARKER: I wish to exhibit a patient on whom I performed a Krönlein operation for the removal of a tumor from the orbit without injury to the eyeball. A male, aged thirty-four, gave a history of exophthalmos, gradually increasing during the past twelve years, with attacks of acute mania during the past six years. There was no pain nor discomfort except from double vision; no fundus changes; vision about normal. The patient being illiterate and mentally substandard, accurate results could not be obtained. The eyeball was displaced outward about three-quarters of an inch, and downward about one-half of an inch. A distinct tumor could be felt deep in the orbit which appeared to communicate with a nodule about the size of a marble situated upon the brow just above the supraorbital notch.
After consulting with Doctor Canfield to exclude the accessory sinuses as a possible origin of the tumor, it was decided to remove the nodule from the brow and determine the nature of the growth. While the patient was under the anesthetic, deep palpation revealed the fact that the orbital tumor was movable.
The report from the Pathologic Laboratory on the nodule removed from the brow was fibroma, possible neurofibroma.
The diagnostic points were as follows:
(1) A nonmalignant growth, as revealed by the history and pathologic report.
(2) The displacement of the globe outward and downward indicating that the tumor was situated outside and above the muscle cone.
(3) It was movable.
An osteoplastic flap was made after the method of Krönlein. A curved incision was made beginning over the temple extending along the outer margin of the orbit, dividing the periosteum, then backward along the upper edge of the zygomatic arch.
The periosteum lining the inner side of the outer wall of the orbit was retracted together with the orbital contents. The lateral wall of the orbit was cut through with a chisel in two places. Above in the suture between the great wing of the sphenoid and the malar bone and below in a horizontal plane passing outward in a line directly above the insertion of the zygomatic arch. This piece of bone with its muscle and cutaneous attachments was forced backward giving free access to the orbit. The periosteum was divided in a horizontal direction and the tumor dissected out. After removal of the tumor the periosteum was sutured with catgut, the bone and soft parts replaced and the latter sutured with silk, and dressings applied.
Union was perfect and recovery uninterrupted. The excursion of the eyeball is perfect and the vision the same as before the operation.
The tumor measures thirty-five by twenty-five by nine millimeters and apparently has its origin in the frontal branch of the fifth nerve. It will be sent to the Pathologic Laboratory for examination and a detailed report will be given later.
DISCUSSION. DOCTOR R. BISHOP CANFIELD: There is great difficulty in the diagnosis in such a condition. The first Krönlein I saw was by Krönlein himself. He found nothing but congestion.
The case turned out to be polyp of the sphenoid, causing the congestion and so the ptosis. Another point to be observed, is that in almost all cases where the condition is caused by disease in the accessory sinuses. there is an inflammatory reaction. There was no evidence of inflammation in this case and the accessory sinuses showed no evidence of disease.
DOCTOR REUBEN PETERSON: I would like to ask why there is no pain from so distinct an involvement of the supraorbital nerve.
DOCTOR SOLIS: We usually find excessive pain associated with such a growth. This is probably due to the pressure of the growth on the surrounding tissues.
DocToR PARKER: There is rarely or never pain in multiple fibromata. They are in fact fibromata arising from the fibrous sheath of the nerve, and not true neuromata.
NEPHRECTOMY FOR HYDRONEPHROSIS DUE TO RENAL CALCULI.
DOCTOR REUBEN PETERSON: I have an interesting specimen to present, a case of stone in the kidney, giving rise to hydronephrosis of marked size. The kidney tissue has almost disappeared, the pockets or loculi being of immense size when filled. An interesting point is that this long, peculiarly-shaped calculus blocked up the ureter completely so that there was absolutely no communication between the pelvis of the kidney and the ureter. I also call your attention to a stone lying in another pouch. This specimen was removed from a woman of forty-seven, whose previous history had been in every way normal, except that for the last ten years she had noticed in the right side, especially in the flank, occasional pains, but never to a marked degree. She had complained that when in bed there was a sense of discomfort at this point.
Two months ago she noticed a tumor just under the right ribs, which has grown rapidly since that time. I saw the patient a week ago. At that time there was a tumor which did not distend the flank to any great degree. It went beyond the median line and downward to the anterior superior spine. The circumstances were such that I could not make an examination of the ureters. The patient was extremely fleshy so that I could not determine with any degree of certainty whether the growth was cystic or solid. The intestines covered the growth, so we were dealing evidently with a retroperitoneal growth in the neighborhood of the kidney or with a cystic kidney. My diagnosis was probable cystic kidney, possibly a retroperitoneal growth in connection with the kidney. Then came the question of the operative route. It reached so far
. over in the median line that it seemed to me better to get at it by the transperitoneal route. An incision was made from the edge of the ribs downward at the outer edge of the rectus. The incision through the peritoneum was made well outside. There was great difficulty in enucleating on account of the adhesions, which shows the advisability, in these large growths with adhesions, of adopting this route in preference to the extraperitoneal route. I think it would have been more difficult by the other operation. I drained posteriorly and also anteriorly, and sutured up the peritoneum.