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Dr. Marshall kept a diary while on the journey which is now valued highly. He also has many rare specimens of the handiwork of the Japanese in carved ivory and various woods of the East. Bayard Taylor, a personal friend of the doctor's, was with the expedition, taking notes, but he was not allowed to use them afterward. He, however, wrote his "Visits to India, China, Loo Choo and Japan" from memory, which was well received.
The doctor is seventy-six years old, but is remarkably well preserved. He practiced medicine and surgery for many years after his return from the Japanese trip.
Carl Schurz a Truly Great Man.
NEW YORK, June 5.-The recent meeting of the Maryland Civil Service
Reform Association was made the occasion of a testimonial to Carl Schurz by Dr. Daniel C. Gilman, ex-President of Johns Hopkins University, who said:
"The name of Carl Schurz will always stand in the front rank of those Americans who were not born in America, but who, by choice, identified themselves with American society and were devoted observers of American institutions. It is not too much to associate his name with De Tocqueville, not a resident of this country, but a visitor to it, and a remarkable critic of progressive democracy; with James Bryce, now the illustrious ambassador of Great Britain, whose study of the American Commonwealth is our best manual of the character and workings of American institutions; with Francis Lieber, one of the ablest and most thoughtful advocates of civil liberty and a vigorous defender of the principles which underlie our Government, and with Edwin L. Godkin, founder and editor of the Nation, a persistent advocate of civil service reform, who for nearly fifty years fought with wild. beasts at Ephesus and cleared the way for others to build up and strengthen the foundations of our society.
"These four men, De Tocqueville, Bryce, Lieber and Godkin, are like four evangelists, students of social conditions, discoverers of fundamental principles, advocates of righteousness in public affairs. A sagacious Frenchman, a philosophical German, an enthusiastic Englishmen, and a critical Irishman all contributed to the elucidation of our problems and the improvement of our conditions.
"With these great men Carl Schurz will always be remembered. In some respects he surpassed each one of them. His extraordinary versatility, his ability as an orator, his skill as a writer, his position in the Senate and the Cabinet, his readiness to spend all his force in the promotion of right methods, however unpopular they might be, however slow the public response, and however complex the difficulties which beset him, give him the foremost place among the adopted citizens of this country.
"Fine in his various gifts, as exemplified by the career of an editor, writer, orator, legislator and administrator; generous in his impulses toward friend and foe; fearless in the battlefield, whether combat was in the arena of bloodshed or in the quieter but not less bitter controversies of the platform and the study; always hopeful, and not despondent as he looked toward the future, however dark any moment might be; co-operative, suggestive, undismayed, he is forever to be commended as an example to the citizens of this country, whether they are of native or of foreign birth.
"In the great meeting which was held last November in New York to commemorate this illustrious statesman, Grover Cleveland, twice President of the United States, used these words:
"The man whose memory we honor never knew moral fear, and never felt the sickening weakness of moral cowardice. With him it was only to see what he believed to be injustice or error to hurl himself upon its defenses
with the impetuosity of a zealot and the endurance of a martyr. He did not shun politics; but in his conception, political activity was valuable and honorable only as it led the way to the performance of civic duty and had for its end and purpose the advancement of principles and the enforcement of practices that best promoted the public good. He had no toleration for the over-nice foppery that drives many who claim patriotic impulses away from politics through fear of contaminating defilement. He entered politics because he saw his duty there; and he found immunity from defilement in cleansing and purifying his political surroundings.'
On motion of Dr. Gilman, a resolution was adopted approving the movement started for raising funds to commemorate upon an adequate scale the services and high character of Mr. Schurz.
Malcomb Morris Knighted.
Many will remember Malcolm Morris, now Sir Malcolm Morris, who delivered a most interesting course of lectures on Disease of the Skin under the Lane endowment at Cooper Medical College. His friends will be pleased to know that King Edward on January first last, dubbed him a Knight Commander of the Royal Victorian Order. Malcolm Morris is now, therefore. Sir Malcolm Morris, K. C. V. O.
This event is particularly gratifying to men engaged in the specialty of cutaneous medicine, as it is the first time one of their number has been knighted in England for distinguished medical services. It is true that Erasmus Wilson was also knighted, but his title came, not on account of scientific or medical work, but because of the donation of the Egyptian obelisk which now stands on the Thames embankment. This is obviously a different affair.
In another way this deserved honor points a lesson. Sir Malcolm Morris is not alone an excellent man in his
specialty, but he is a clever physician in a general sense, and for a long time was known as the able editor of The Practitioner. In addition to this, Sir Malcolm is a man of wide general literary culture. All these abilities congrue to a well balanced judgment, as in no specialty is a knowledge of the every day working of the body so necessary as in diseases of the skin, and general culture, while not absolutely essential for the cure of disease, is of importance to the medical man in whatever sphere his activities may lead, in developing the human side of him. The most widely respected and beloved physicians have always been those
who, to their special knowledge have added an intimate acquaintance with the field of general literature, as for instance, the late Professor Kussmanl, and in the present day, Wm. Osler. We feel, therefore, that King Edward in selecting Sir Malcolm for the high honor he has conferred upon him, has done a graceful and wise act.
D. W. MONTGOMERY, M. D.
The Typhoid Season. The typhoid season is still upon us and a few suggestions on this topic may not be untimely. We do not believe that it has ever been shown that typhoid can be cut short after an infection obtained; but almost every one knows that it is one of the preventable diseases, and that a bit of caution may save many months of care. Food and drink are the well recognized carriers. of typhoid infection, and yet, within the past few years, there have been several well authenticated cases of individuals who were distributors of typhoid poison to the food and drink consumed by others. Every safeguard should be taken, especially with milk and water, during this period of the year when typhoid is prevalent. It may not be amiss to inquire of a new domestic whether she personally has had typhoid or has been associated recently with a typhoid case. In the case of a guest, more particularly one
who has had relapses or a recent infection, it is desirable to sequestrate articles in which his food is served, as well as all linen. Every specific which has been suggested has failed to fulfil the promises made for it; but it may be possible, by thoroughly cleansing the whole digestive tract at the beginning of the least disturbance, to uproot and dislodge a possible typhoid nidus. It is by no means easy to say just what type we can expect in an individual case; indeed, we have seen two cases, which undoubtedly received an infection from the same source, run such different courses that we could almost have believed the diseases were themselves different had not the Widal test been repeatedly positive in both cases. The really important thing to remember is this: that a case that has had typhoid may, for many months, be a distributor of the disease. For this reason it is well worth the trouble to learn whether, in the individual case, any such infection has recently occurred. We cannot presume to dictate the details of treatment, but we can say from an experience of many cases that nursing and liquid diet are essential. We have yet to find any vaunted intestinal antiseptic of any value. The disease is not an intestinal, but a blood infection. In short, drugs, except for particular conditions, are of little or no value; the coal tar products for the reduction of temperature are decidedly disadvantageous and are apt to result in serious cardiac weaknesses. Tepid water with alcohol, for sponge baths, and plain cold water in the lower bowels, by enema, are the two best methods for the reduction of temperature. The Brandt cold tub has not seemed to justify the expectations which it aroused, and certainly for many patients in the higher walks of life, a cold plunge roes not give the results so often claimed, and may do considerable damage. The Post-Graduate.
The Omnipresent Sexual Question. In spite of the formidable array of books and papers and medical sermons on the vital subject of publicity of the sexual question, with a view to the enlightenment of all classes, which have inundated us of late, we must realize
that the sincerity and sobriety in our advocacy of new and important means to stem the tide of sexual gratification so as to lessen the potential eventualities which may ensue, has as yet been to small purpose. And this can be accounted for in many ways, principally because without oneness of thought affixed to any movement, confusional ideation obfuscates its simplicity and. directness.
For how can great good come out of a warring mass of argumentative flotsam and jetsam, no matter how talented the gloss, when the one idea which should be primal, is submerged?
Now to further the idea of the proper dissemination of knowledge on this subject, it is not necessary to cry aloud for transcendent purity, as those who are unacquainted with the behests of Nature would desire, or imagine, as Swift did, that nearly every man "combines in himself all the diseases and vices transmitted by ten generations of rakes and rascals." Fortunately for us there is a middle road which should be frequented by those delvers into the problem who desire some recognition. from the world at large for clarity of vision and a sanity unalloyed by foolish prejudices. There, our moral reformers would see that men are not like Thoreau who "ate no flesh, drank no wine, never knew the use of tobacco; had no temptations to fight against, no appetites, no passions," but the victims of a false education which is not so much the result of separateness of their doctors' knowledge of diseases from their early training, as the foolish and accepted idea which, especially, obtains in this country that boys have the right to choose their companions. from the walk of life which appeals to them. In this respect Otto Ernst, the
well-known German writer, some apposite remarks in an article on "Sexual Enlightenment" in a recent number of the Vienna Neue Freue Presse. "In my opinion," says Ernst, "what is more important than sexual instruction is the duty which should devolve on all parents to see that their children associate only with those persons whose mentality is of a high order-pure, noble and exalted. If my mind was detached from all thought of sexual matters, even after I had passed my callow days, it was because of association with men and women of this calibre, and my earnest attention to scientific and literary subjects." Or, as Emerson said, "If you would make a man tall you must walk him under a high ceiling." Inter-State Medical Journal.
Death of Dr. Edebohls.
Dr. George Michael Edebohls, the well-known New York surgeon and gynecologist, died at his home in that city on August 8. He had been ill for some time, and his death stated to have been due to Hodgkin's disease. He was born in New York City in 1853, and was a graduate aof St. John's College, Fordham. He received the degree of M. D. from the College of Physicians and Surgeons, New York, in 1875. Dr Edebohls was specially identified with renal decapsulation for chronic Bright's disease, a procedure which he originated. The first operation of this kind which he undertook with the deliberate purpose of bringing about a cure in chronic Bright's disease was performed in January, 1898. The patient, a girl of twenty at the time, was afterward married, and five years later he reported her as five. months pregnant and permanently cured of her kidney disease. The report of this operation, together with that of five preceding operations which led up to it, was published in the Medical News of April 22, 1889. In 1901 and 1902 several articles by him on the subject appeared in the Medical Rec
ord, and in February, 1903, he read before the Medical Association of the Greater City of New York an elaborate paper embodying his experience and that of other surgeons with the Edebohls operation up to that time. This paper was published in the Medical Record of March 28, 1903. Although he by no means claimed that renal decapsulation was universally applicable, and was careful to define its limitations as far as possible, there has always been much dispute as to the real value of the procedure. Dr. Edebohls was for many years Professor of Diseases of Women at the New York PostGraduate Medical School, and among the other positions he held were those of gynecologist to the New York PostGraduate Hospital; consulting gynecologist to St. John's Riverside Hospital, Yonkers, and consulting surgeon. to St. Francis' Hospital and to the Nyack Hospital.-Boston Medical and Surgical Journal.
Three Diagnostic Signs of Erysipelas
Milian (Progres Medical, 1908, No. 30). The diagnosis of erysipelas, especially of the face, is not always easy. In the Parisian Hospital, devoted exclusively to this disease, cases of acute eczema, of artificial dermatitis, of opthalmic zona, of dental abscess, of dacryocystitis, even of mumps, are admitted daily with the mistaken diagnosis of erysipelas. Many of these cases resemble erysipelas somewhat closely and the writer's experience has convinced him that the classical signs, described in text-books, often do not suffice for a diagnosis. The classical sign most frequently absent is the edematous plateau raising the affected area above the level of the normal skin.
In the diagnosis of erysipelas, Milian lays especial stress upon three signs:
1. The sign of maximum involvement at the periphery (du maximum centrifuge); 2, the sign of the ear; 3, the sign of pain upon pressure.
The sign of maximum involvement
at the periphery. Erysipelas spreads centrifugally or at least from point to point, so that fresh areas are continually becoming involved, while those originally infected are recovering. It is for this reason that the areas of greatest swelling and redness are located at a distance from the site of infection and at the periphery of the whole region involved. This sign is especially useful when it is necessary to differentiate between erysipelas and an ordinary inflammation, such as suppurating dacryocystitis, a dental abscess, or parotiditis. These affections may superficially resemble erysipelas, but in them the pain, redness and swelling are at the center of the area involved, not at its periphery. This sign sometimes fails at the very beginning of an erysipelas when only the site of
involved. Twenty-four hours later, however, it is usually well in evidence. A possible source of error in interpreting this sign is involved in the behavior of the eye-lids. These structures, as is well known, become extremely edematous throughout their extent as soon as involved and remain so even when the zone of acute inflammation has passed beyond them. In making use of the sign discussed above, the condition of the eye-lids. must therefore not be taken into account.
The sign of the ear. The skin covering the external ear is so closely adherent to the cartilage that subcutaneous tissue may here almost be said to be wanting. It is for this reason that all ordinary inflammatory processes, since they involve chiefly the subcutaneous tissue, are arrested in their spread when they reach the ear. Erysipelas, however, being a dermatitis, spreads readily over the external ear and may by this means be distinguished from dental abscess and the like.
The sign of pain upon pressure. Tenderness to pressure is probably the most constant feature of erysipelas and this tenderness is most marked at the periphery of the area involved. Acute
eczema, zona, parotiditis, are not nearly so tender; dacryocystitis, dental abscess and the like have their point of maximum tenderness at the center, not at the periphery of the reddened and swollen area. (This most valuable note is from the Inter-State Medical Journal of September, 1908.-Editor.)
Fungus Coccidioides --The California
Since 1892 some eighteen cases of this disease have been reported and as all but one of them have lived at some time of their lives in the San Joaquin Valley, this has been very appropriately called the California Disease. Kellogg, of Bakersfield, Kern county, California, has seen more of these interesting cases than any other one doctor and at a meeting of the San Joaquin Valley Medical Society held in Tulare recently, he brought one of the victims of this disease before the meet
ing, giving the history of this case,
with such treatment as had been tried, and reviewed such instances of the malady as he knew of. At his request Dr. Ryfkogel presented the findings with the microscope and read a paper on the disease.
Those who have met with cases of this disease feel sure that many suffering therefrom fail to have their sickness properly diagnosed (it is probably called tuberculosis) and on this account desire to call the attention of the profession to its symptomatology. Dr. Ryfkogel's paper was printed in the California State Journal, June, 1908.
Indianapolis Medical Society.
At the meeting of the medical society at the Eleanor Hospital on Aug. 17th, the temporary committee appointed to investigate the feasibility of establishing a certified milk commission in Indianapolis, reported favorably. The report was adopted by the society. Several of the members spoke in favor of the good move that was being made to obtain a purer milk