MARYLAND

portant in the prevention of puerperal fever, ophthalmia neonatorum and other septic com

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BALTIMORE, JUNE 8, 1895.

EVEN in these days of antisepsis and germs there still lurk in some parts of the world old

fashions and old customs Unclean Midwives. which nothing seems to affect. Dr. Smith tells us in this number of the unclean midwives that work havoc in confinement among the ignorant and poor. The law on the duties and obligations of midwives needs revision. They are supposed to be compelled to report all cases of sore eyes in babies just born and whether they do it or not no one knows, but how much more important would it be if they were compelled to be properly registered and examined as to their fitness and capability.

Every physician remembers in his early days of hospital and dispensary work among the poorer classes to have met these typical midwives who know more than all the physicians put together and who use their forcing drops and follow their old customs and traditions, against which the poor sick woman is helpless or too ill to protest. It has been shown so often that cleanliness is most im

the dangers of the unclean midwife can hardly be exaggerated. The time has come when the profession should take some stand and demand a reform and the public should be enlightened on the importance of this question. It would be impossible and probably wrong to drive the midwife out of her business, but she certainly can be dispensed with.

Malthus believed that with the rapid increase of population in the world there would not be occupation enough for all and there would follow starvation and misery, but his solution of this question was not to cause the death of helpless mothers and innocent babies; and at this time both mother and infant need the protecting hand of the physician, and the dirty midwife should be driven into other callings or so converted that she may be of use. By far the majority of births take place normally and without complication, and often even a midwife is not needed if some intelligent member of the family is at hand to assist, but in too many cases there are complications which the midwife or unskilled person does not comprehend and which too often cause the death of both mother and child.

Midwives, like some physicians, sacrifice their cases to a pride which prevents them from calling in consultation others who know more than they do. The time has come, as Dr. Smith has plainly shown, when midwives should not only be carefully watched, but when they should be registered and compelled by fears of punishment to give a strict account of each case treated, with the results.

The obstetrician and gynecologist reaps benefit from the mistakes of these women but the profession as a whole and the public too, if it had the necessary knowledge, would gladly drive these unclean murderers out of their unlawful business, if that could be done.

***

ON account of the extreme heat perhaps the meeting of the Association of American Physicians in WashingAssociation of ton last week was not up American Physicians. to the standard. Many of the papers were trite and the discussions were scanty and forced. The President's address on the study of

specialists in clinical medicine and the making of internal medicine a specialty was very timely in these days of extreme specialization.

Even if Dr. Abbott's very elaborate address reached negative conclusions they were extremely valuable and contained much food for reflection.

Dr. Rachford's remarks on the leucomains would be satisfactory in practice if every one could reach the same result that he did. The difficulty of finding the xanthines and paraxanthines in the urine would be positively prohibitive as few physicians carry urinary analysis to such refinement. Renal affections following influenza and the various papers on the heart were all rather ancient history and hardly worthy of the excellence which this Association attempts.

The discussion on antitoxine was rather trying in such weather and could have well been postponed until more definite facts had been obtained. Dr. Cary's models on the position of the bronchi had some signs of originality about it although it is extremely difficult to hit on any anatomical point which the thorough ancients have no already described. Dr. Williams's calm manner of comparing a bottle to a human being in reducing temperatures was not very edifying.

In some cases the discussions were very lively and interesting but in most instances papers were read and passed on without remarks, which probably was the best thing that could have been done, until Dr. Jacobi reported a temperature of 148°, the patient running away from hospital after this temperature. That was entertaining. Dr. Adami reported a very rare and noteworthy disease which had never before been seen on this continent and was well studied even though the author added that unfortunately he was married at that time and could not work up the case better.

The Association, as the President said in his address, is an organization with no code and no desires beyond reading scientific papers and contributing articles to medical literature and the nine volumes show what excellent work has been done, but like other small colonies, there is danger of degeneration. The membership is limited to one hundred and an excellent rule this has been in the past, but the question is, if no new members are allowed to enter would it not be

a good idea to let some of the old ones who have been absent for three successive meetings drop out and make way for new blood? It is to be regretted that the proposition to increase the membership limit to 125 failed to pass. The Association is undoubtedly the best national body in this country and has put forth solid work and its aim should be to keep this up by renewing its youth and taking in new grafts.

***

WARM weather does not seem to dampen the ardor of the average medical society member and for the past month

Investigating conventions and associations Water. have been and still are raging in the east and west. The last one to be noted is a convention of bacteriologists to be held at the Academy of Medicine, New York. It is called by the American Public Health Association to determine the possibility of establishing co-operative investigation into the bacteriology of American waters, and from the responses it will probably be a very important meeting and such work should be encouraged. Drinking water is a potent cause in several dangerous diseases and anything that is done to simplify and facilitate its examination is a step forward in the right direction.

Among those who will take part by reading papers or discussing, are Drs. William H. Welch, A. C. Abbott, George M. Sternberg, Victor C. Vaughan, H. C. Ernst and others.

One of the objects of this meeting is to agree on some uniform and easily interchangeable method of work and nomenclature so that, as in a language, the work of one man may be interpreted and used by another without confusion, and there will be an attempt made to establish some common ground-plan for systematic work in bacteriology in general and in the bacteriology of American waters in particular.

Many workers in laboratories have methods which would be of great use in this investigation if made public, and it is believed that in these laboratories there are many valuable but unpublished data upon these points.

In view of the importance of this meeting and the great practical advantage of this subject it is hoped that all laboratories will send representatives and all those taking an interest in this subject will attend this meeting.

The plague has reappeared at Hong-Kong. The female oculists of the United States number 130.

The Texas health bill met defeat at the hands of the Legislature of that State.

The Trustees of the Johns Hopkins Hospital have begun an addition to the dispensary.

A statue of the illustrious Billroth was unveiled in the Hospital Rudolfinerhaus on April 25.

The seventeenth annual Congress of the American Laryngological Association will be held at Rochester next week.

Dr. J. S. Billings is said to have received ten thousand dollars for his Index Catalogue of the Surgeon-General's Office.

At the meeting of the American MedicoPsychological Association, to be held at Denver next week, Drs. Berkley, Rohé, Brush and Hurd will read papers.

A physician has been presented by the Grand Jury of Baltimore for illegally practicing his profession. The result of this prosecution will be awaited with interest.

Cholera is officially declared epidemic at Mecca, and in the villages along the Red Sea frequented by pilgrims. The pilgrimage is fortunately not as large this year as it was in 1891.

At the Johns Hopkins University, Dr. Simon Flexner has been promoted from Associate, to Associate Professor of Pathology and Dr. William S. Thayer was appointed Associate in Medicine.

In the Inter-State quarantine regulations recently issued by the Treasury Department, the quarantinable diseases are declared to be cholera, yellow fever, smallpox, typhus fever, leprosy, the plague.

The S. D. Gross Prize of $1000 has been awarded to Oscar H. Allis, M. D., of Philadelphia, for his essay entitled "An Inquiry into the Difficulties Encountered in the Reduction of Dislocation of the Hip."

The National Association of Railway Surgeons at its recent annual meeting at Chicago elected the following officers: President, Dr. J. B. Murphy of Chicago; Secretary, Dr. D. E. Welsch, Grand Rapids, Michigan; Treasurer, E. R. Louis, Kansas City.

The Supreme Court of Connecticut has recently decided in a suit brought against the Waterbury Hospital, for alleged maltreatment, that the Hospital was not liable, as no fees were paid to the attending physicians and no charge was made for treatment.

The American Gynecological Society elected the following officers for next year: President, Dr. Wm. M. Polk of New York; First Vice-President, Dr. James H. Etheridge of Chicago; Second Vice-President, Dr. Fernand Henrotin of Chicago; Secretary, Dr. Henry C. Coe of New York; Treasurer, Dr. J. Montgomery Baldy of Philadelphia.

As a memorial of the late Dr. Alfred L. Loomis, a site of 190 acres has been purchased in Liberty, Sullivan County, New York, on a plateau 2200 feet above the sea, and on this will be erected a building to be called the Alfred L. Loomis Memorial. Around the building will be grouped a number of cottages and the whole will be used as a sanitarium for tuberculous patients.

The inspectors of food for Baltimore inspected 13,016 gallons of milk during May and spilled 678 gallons. Two thousand six hundred and forty-five pounds of meat, 3025 pounds of fish, 160 pounds of poultry, cocoanuts and other food products were condemned. Thirty-four sweat shops were inspected and a number of orders to comply with the law as to cubic feet of air space were issued.

WASHINGTON NOTES.

The regular weekly meeting of the Medical Society of the District of Columbia was beld on Wednesday evening, May 29. Dr. D. Olin Leech read an essay on Cystitis. Dr. Walter Reed of the Army Medical Museum read a paper entitled "What Credence should be given to the Statement of those who claim to Furnish Vaccine Lymph free of Bacteria?" Dr. Reed showed by means of photographs the bacteria in the vaccine virus. There were some companies who claimed to have no bacteria at all in their virus, which was proven not to be the case. Dr. C. R. Dufour presented a specimen of Gumma of the Brain. He had the whole brain and showed the gumma at its base. It had been examined by Drs. Lamb and Reed, who pronounced it a true gumma. This specimen produced a lengthy discussion as to the size of doses of potassium iodide. Dr. Dufour stated that he had given thirty grains three times a day to his patient. Dr. Reed stated that he had known iodide of potash to be given in two hundred grain doses three times a day and larger. We would like to state that we ourselves have given it as high as three hundred and fifty drops of a saturated solution three times a day.

The patient in this particular case did not show any marked improvement until he had gotten up to nearly two hundred drops three times a day.

The Clinico-Pathological Society has held its last meeting for the summer months and will not meet again until October 15.

At the next meeting of the Washington Obstetrical and Gynecological Society, Dr. J. Foster Scott will read an essay on "Criminal Abortion." There will be a discussion on this same sujbect by Drs. E. L. Tompkins and W. P. Carr.

There have been as many as five cases of sun-stroke taken to the Emergency Hospital alone in one day, during the last few days.

There will be a competitive examination for the position of Junior Assistant at the Emergency Hospital to be held at the hospital on Juue 17, to fill a vacancy that will occur July 1. Applications should be sent to Dr. Wm. H. Hawkes, Secretary of Attending Staff.

PUBLIC SERVICE.

OFFICIAL LIST OF CHANGES IN THE STATIONS AND DUTIES OF MEDICAL OFFICERS.

UNITED STATES ARMY.

Week ending June 3, 1895.

Leave of absence for one month and fifteen days, to take effect on his arrival in New York City, en route to his station in the Department of the East, is granted Major Timothy E. Wilcox, Surgeon U. S. Army.

UNITED STATES NAVY.

Week ending June 1, 1895.

Medical Inspector T. C. Walton ordered to examination preliminary to promotion as Medical Director.

Medical Directors G. S. Beardsley, B. H. Kidder and W. K. Van Reypen ordered as a Board to examine medical officers for promotion.

Medical Director N. L. Bates, Medical Inspector J. M. Flint and Passed Assistant Surgeon J. D. Gatewood ordered as a Board to revise the Book of Instructions for Medical Officers.

UNITED STATES MARINE SERVICE.

Thirty days ending May 31, 1895.

W. A. Wheeler, Surgeon, detailed as chairman Board for physical examination of applicant for appointment in Revenue Cutter Service, May 13, 1895.

J. H. White, Passed Assistant Surgeon, detailed as Recorder Board for physical examination of applicant for appointment in Revenue Cutter Service, May 13, 1895.

P. M. Carrington, Passed Assistant Surgeon, granted leave of absence for fourteen days, May 4, 1895.

J. B. Hamilton, Surgeon, granted leave of absence for five days, May 16, 1895.

G. W. Stoner, Surgeon, granted leave of absence for one day, May 22, 1895.

F. W. Mead, Surgeon, to proceed to Portland, Maine, and assume command of Service, May 18, 1895.

BOOK REVIEWS.

THE TREATMENT OF Wounds, Ulcers and ABSCESSES. By W. Watson Cheyne, M. B., F. R. S., F. R. C. S., Professor of Surgery in King's College, London. In one 12mo. volume. Philadelphia : Lea Brothers & Co. 1895. Pages 207. Price $1.25.

This is a very complete little book by a well known author. He has described the methods which he uses himself and he is very thorough and clear in every particular. He believes that suppuration occurring in a wound made through unbroken skin indicates

these errors that he has written this work.

The make-up of the book is very attractive. A MANUAL OF THE MODERN THEORY AND TECHNIQUE OF SURGICAL ASEPSIS. By Carl Beck, M. D., Visiting Surgeon to St. Mark's Hospital, etc. Small 8vo. With 65 illustrations and 12 plates. Philadelphia: W. B. Saunders. Pages 300. Price $1.25. The author presents a combination of the practical and theoretical and while in no way original it is a very happy compilation. The most minute directions as to antisepsis in hospital and private practice are given and plates and figures are most lavishly distributed throughout the book. If everyone should follow his directions strictly the germs would lose their occupation.

A GUIDE TO THE ASEPTIC TREATMENT OF WOUNDS. By Dr. C. Schimmelbusch, Assistant in the Royal Surgical Clinic of the University of Berlin. Preface by Professor E. von Bergmann. Translated from the Second Revised German Edition with express permission of the Author, by Frank J. Thornbury, M. D., Lecturer on Bacteriology, University of Buffalo, N. Y., etc. 43 illustrations. New York. G. P. Putnam's Sons, 1895. Pages 233. Price $2. This is a thorough exposition of the aseptic treatment of wounds and gives full and exact directions how to do an operation from beginning to end. It reflects the methods followed in the Bergmann clinic and receives the sanction of that surgeon. The translator has done his work well in most parts. He is not always uniform in his spelling of chemical terms. The publishers have executed a beautiful piece of work and worthy of their excellent facilities. An objection might be made to the highly glazed paper, which reflects artificial light rather too much.

REPRINTS, ETC., RECEIVED.

Clinical Lecture. By L. Webster Fox, M. D. Reprint from the Charlotte Medical Journal.

The Significance of the Presence of Lactic Acid in the Stomach. By Julius Friedenwald, M. D. Reprint from the New York Medical Journal.

The Prevention and Treatment of Ophthalmia Neonatorum, and the Necessity for more efficient Legislation to Prevent Blindness from this Cause. By Charles H. May, M. D. Reprint from the Medical Record.

UREMIA.

Philadelphia Polyclinic.

WITHIN recent years the knowledge of uremia has been increased by accurate clinical and experimental studies. It is not our purpose to refer to these in detail, but merely to refer to some of the larger results. Modern pathology for a time gave an undue importance to micro-organisms and entirely misapprehended their action in exciting disease, but progress corrected this error and the tendency is now to give due attention to materies morbi that act chemically as pois

ons.

THE PHYSICIAN'S SOCIAL POSITION. The Journal.

EVERY now and then some medical journal gives us a dismal editorial about the social position of the medical profession; about the lack of influence of the doctor in public affairs; about the inferior rewards of a medical career; or about the over-production of doctors; and then each writer falls to wondering why young men will still insist upon studying medicine. The most plaintive and doleful of these lays appear in certain of our contemporaries on the Eastern fringe; and they are pitched in so dismal a strain that one unconsciously feels that the writer must have chronic dyspepsia or a twinge of colic.

KEELEYISM.

Boston Medical and Surgical Journal. THE theory upon which Keeleyism is founded, namely, that these elements of the nervous system can be suddenly forced back into normal action by the influence or shock of a violent stimulant or poison of another character, introduced into the system for a few days or weeks, is at variance with medical experience in this and all other forms of disease of long duration. The claim of Dr. Keeley and the syndicate representing him that 90 or 95 per cent. of cases of inebriety can be cured in a space of four weeks has not been substantiated by facts and efforts to se'cure legislation making the employment of this treatment compulsory in State institutions, especially when we consider the fact that the nature of their remedies is kept secret, are as absurd as if the proprietors of any secret remedy should endeavor to compel the use of their nostrum in public hospitals.