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portunities for public service. Money had no attraction for him save to promote scientific investigation and to discharge his obligagations. Gross spoke of him as one equally eminent as a patriot, a philanthropist and a medical author, and as the most forcible and eloquent medical teacher he had ever listened to. The Free Library in Cincinnati, the Cincinnati College and the Museum of Science and Art were largely his creations. He labored hard for them, secured grants for them and personally solicited funds for their endowment and support.

We have to pass over his other writings and we can only briefly refer to the "colossal work" in two large volumes ("Diseases of the Interior Valley of North America"), to which he devoted the greater part of his life. From his earliest years the future importance of the great Mississippi Valley impressed itself upon him. He mastered its botany, meteorology, geology and archeology. He personally explored the entire region, traveling 30,000 miles in doing so. He instituted the first collective investigation known. It was over thirty years after its announcement before the first volume appeared and the second was not published until two years after his death. Dr. Pepper analyzes thoroughly this work, and shows in how many respects Drake was ahead of his times. As early as 1832 he had arrived at the belief in the microbic nature of malaria, yellow fever and typhoid fever. He anticipated Woodward in his attempt to establish a distinct" typho-malarial" fever. He denounced the excessive use of the lancet and calomel, then almost universal. He urged the external use of cold water to reduce temperature in fevers, and advocated an expectant plan with scrupulous attention to hygienic details. He entertained natural and judicious views on the subject of phthisis and the relation between its frequency and ill-drained soil and damp and poorly ventilated buildings was clear to him, also its fectiousness and its amenability to climatic treatment. He insisted that medical education should be placed under the supervision of the law. He recognzied the supreme importance of hygiene, both in preventive and remedial medicine, more clearly than anyone of his time. He held aloft the standard of scientific truth and professional dignity under the most difficult conditions. Everywhere is manifest the accurate observer, the clear

headed thinker, the practical man who cannot be led by mere authority and who will not lapse into routine. "The accumulation of facts is simply prodigious, the style is clear and admirably adapted, while the obvious sincerity of purpose and the philosophical breadth of view impress you with a sense of the permanent value of the work." We trust we have said enough to show that Drake was one of the great men of our country and that his name should be honored, not only in the valley where he labored, but throughout the land.

***

AN interesting discussion was held in the Section of Medicine of the British Medical Association at the recent meeting on this subject. The question is how far the undoubted controlling influence of antitoxin upon the lower animals can be realized in the human being in the treatment of the actually existing disease, diphtheria. Not all the evidence was favorable. Goodall, dealing only with cases in which a bacteriological examination had been made, found it valuable especially in cases which were subjected to tracheotomy; but it did not diminish the frequency of albuminuria, anuria and paralysis. Von Ranke's German experience was to the same purport, laryngeal obstruction being much less serious under it. Baginsky of Berlin had reduced his hospital mortality from 41 per cent. to 15 per cent. Biggs of New York brought forward statistics to show its prophylactic effects in children who have already been exposed or who cannot be removed beyond the influence of the infection. On the other hand, Lennox Browne has witnessed little if any improvement. It was suggested in explanation of this discrepancy of results that it might be due to a difference in the mode of preparation or the dose used, the greater experience of the continental physicians giving them confidence to use the remedy more freely.

Experience teaches us to be very cautious in accepting the first reports of new therapeutic agents and we cannot yet be said to have reached the point when we can feel secure regarding the value of antitoxin. The prudent physician will be content still to "labor and to wait," carefully watching results and endeavoring to obtain the true estimate of its value.

The Diphtheria Antitoxin.

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PUBLIC SERVICE.

UNITED STATES ARMY.

Week ending September 23, 1895.

Major Clarence Ewen, Surgeon, now on sick leave of absence, is relieved from further duty at Fort Walla Walla, Washington, and ordered to Fort Bliss, Texas, for duty, relieving Major Blair D. Taylor, Surgeon.

Major Taylor, on being thus relieved, is ordered to Fort McPherson, Georgia, for duty at that post.

The following named officers are detailed to represent the Medical Department of the Army as delegates at the annual meeting of the American Public Health Association to be held at Denver, Colorado, October 1 to 4, 1895 Lieutenant Colonel Alfred A. Woodhull, Deputy Surgeon General; Major Calvin De Witt, Surgeon; Major Henry S. Turrill, Surgeon.

Leave of absence for one month, to take effect on or about October 6, 1895, is granted First Lieutenant Paul F. Straub, Assistant Surgeon, San Carlos, Arizona.

BOOK REVIEWS.

PRACTICAL DIETETICS; with Special Reference to Diet in Disease. By W. Gilman Thompson, M. D., Professor of Materia Medica, Therapeutics and Clinical Medicine in the University of the City of New York; Visiting Physician to the Presbyterian and Bellevue Hospitals, New York. Large Octavo, Eight Hundred Pages, Illustrated. Price, Cloth, $5.00; Sheep, $6.00. Sold by Subscription only. New York: D. Appleton & Co.

The subject is one which does not receive proper attention either in medical colleges or in the standard works upon the Theory and Practice of Medicine; the directions given in the latter being of a very general and vague character, and in the former it is dismissed in one or two lectures. In hospitals and in the training of nurses too little attention is paid to the subject, while in works on food and dietetics the practical application of dietetics to disease receives but slight notice. This work is intended to remedy these shortcomings and to furnish to the practitioner a text-book containing instructions as to the appropriate diet in diseases which are influenced by right feeding.

Beginning with the elementary composition of foods, the author next classifies them, and takes up in succession force production and energy; the force-producing value of the different classes; stimulating foods; their eco

etc.

nomic value; a comparison of the nutritive properties of animal and vegetable foods, and vegetarianism. The classes of foods are next considered, including water, salts, animal and vegetable foods, fats and oils. The author considers the general relations of food to special diseases; those that are caused by dietetic errors and the administration of food for the sick, giving the necessary rules as to method, time, etc. The work abounds in analytical tables giving the percentages of ingredients in the various animal and vegetable foods; standards for daily dietaries as influenced by age and occupation; the energy developed by a given quantity of certain foods, The feeding of pregnant women, nursing mothers, infants and young children constitute a very important part of the work, and an appendix contains receipts for invalid food and beverages suitable for fevers and convalescence from acute illness. It is a book which will be found to be of great assistance to the practitioner in the dietetic treatment of diseases that are influenced by proper feeding, invaluable to the trained nurse in hospital and private nursing, and of inestimable service as a guide in the administration of proper food to infants and invalids in the home. THE HISTORY OF PROSTITUTION: Its Extent, Causes and Effects Throughout the World, By William W. Sanger, M. D., Resident Physician Blackwell's Island, New York City; Member of the American Association for the Advancement of Science, etc. New York: The American Medical Press. 1895. Pp. 709. Cloth $4.00; full leather $5.00. This volume is the result of a seven years' study on the part of its author, whose observations and researches were made both in this country and abroad. The numerous editorial notes and Appendix being the investigations down to the present date. No one can judge of the vast amount of instructive matter thus collected without a careful examination of the contents. The noble purpose which inspired the preparation of this volume should elicit for it a deep interest on the part of the law-maker, the physician and the humanitarian. Truly, "A vice which has been co-existent with the human race, which has preyed upon the morals as well the health of all peoples in all ages, which in the past has defied the edicts of despotism no less than at present it defies the mandate of repressive legislation - such a vice should not in any spirit of prudery be put aside as unfit for public consideration."

CURRENT EDITORIAL COMMENT.

CHOLERA PREVENTION.

Journal American Medical Association. WE must repeat our lesson of a few weeks since; we may not be able to shut out cholera from our shores by quarantine; but we can and should make our environment so wholesome and cleanly as that it shall be fatal to the cholera germ as well as to the germs of all other filth diseases. And in this connection it is well to remind sanitary and civic authorities that wherever typhoid fever exists and flourishes, there also may Asiatic cholera exist and flourish.

ERRORS OF AMBULANCE SURGEONS. The Atlantic Medical Weekly.

It is unfortunately true that there have been reported numerous instances where ambulance surgeons have erred in their diagnosis of alcoholic coma and patients have been refused admittance to hospitals, or have been sent to the police cell as a case of drunkenness, who were suffering from a much more serious disorder. . . While in most instances the error is one of ignorance and the ambulance surgeon thinks he is doing right, there is fault to be found with any institution which delegates to a young and inexperienced interne the power of rejecting a case of coma as unsuitable for admission to the hospital without consultation with men of more experience.

PATENT MEDICINES.

Bulletin of Pharmacy.

THE truth is that no druggist is any longer prompted by either principle or policy to encourage the demand for patent medicines. On principle the drug trade despise and condemn the great majority of nostrums because of the exaggerations, downright falsehoods and sensationalism, by dint of which they are exploited among the ignorant and credulous, as also on account of their injury to public health. As a matter of selfish policy the retail drug trade are opposed to patent medicines, since their sale has been stripped of all profit by the "cutter." The nostrums now sold by the druggist are sold under supposed compulsion; there is no profit in the traffic, but the public look to the druggist for supplies and he thinks he must perforce fill the demand.

PUBLISHERS' DEPARTMENT.

All letters containing business communications, or referring to the publication, subscription, or advertising department of this Journal, should be addressed as undersigned.

The safest mode of remittance is by bank check or postal money order, drawn to the order of the Maryland Medical Journal; or by Registered letter. The receipt of all money is immediately acknowledged.

Advertisements from reputable firms are respectfully solicited. Advertisements also received from all the leading advertising agents. Copy, to ensure insertion the same week, should be received at this office not later than Monday.

Physicians when communicating with advertisers concerning their articles will confer a favor by mentioning this Journal.

Address:

MARYLAND MEDICAL JOURNAL, 209 Park Avenue, Baltimore, Md.

NOTES.

DR. CASSATT finds that a couple of ounces of yeast at meal times are very useful in diabetes.

IN cases of shock, Professor Hare says that twenty drops of the tincture of digitalis should be given hypodermically, and repeated in an hour if the pulse does not show its influence.

IN Dr. Cantrell's experience, ichthyol applied early to a carbuncle in process of formation will often greatly modify the process and sometimes prevent the further extension of the lesion.

PROFESSOR HARE says the best treatment for vomiting occurring in remittent fever is the administering of small doses of morphine or three to five drops of spirits of chloroform in half a drachm of cherry laurel water.

*

GEORGE COHEN, M. B., in the Lancet, thinks he has discovered a way of preventing the catarrh consequent on the use of iodide of potassium. It is by the addition of 5 minims of tincture belladonna to each dose, the object being to reduce salivary secretion, which sets free the iodine.

DR. POLAKOFF recommends bromide of lithium in Bright's disease, acute and chronic. Employing it in 22 cases he found it a certain and powerful diuretic. He used it thus: two parts bromide of lithium and four parts of bicarbonate of soda in 240 parts of distilled water flavored with peppermint ; 3 or 4 tablespoonfuls of this a day.

MARYLAND

MEDICAL JOURNAL

A Weekly Journal of Medicine and Surgery.

VOL. XXXIII.-No. 25. BALTIMORE, OCTOBER 5, 1895.

ORIGINAL ARTICLES.

WHOLE NO. 758

REMARKS ON THE SURGICAL TREATMENT OF

CHOLELITHIASIS.

Delivered before RichmonD ACADEMY OF Medicine and Surgery, AuGUST 29, 1895. By Hugh M. Taylor, M. D., .

Professor of Practice of Surgery in University College of Medicine, Surgeon to Virginia Hospital, etc., Richmond, Va.

THE surgery of the gall-tract is perhaps claiming a professional interest second only to that accorded to appendicitis. The one morbid condition is as essentially surgical as the other, and both are equally responsible for ill-health and death. The evolution of the subject of appendicitis received an impetus earlier. It followed close upon the concentration of thought on the pelvic phlegmons, but in view of its importance galltract surgery is receiving its merited share of attention. Few of us can review our professional work and not be conscious of having treated operable cases of cholelithiasis and its consequences unrecognized as such. The credit of increasing our diagnostic acumen in this field belongs, in a great measure, to the surgical clinic. In the medical clinic, percussion, palpation, etc., revealed but little tangible information. In the surgical clinic, on the other hand, the exploratory incision revealed the correct anatomico-pathological condition, associated the symptoms manifested with the morbid conditions found and it is now defining on logical lines the limitations and technique of operative interference for the relief of the various products of cholelithiasis. The evolution of the subject has been rapid. Within

the past ten or twelve years all the marked advance in its study has been made and while already yet in its infancy, the field of operative procedure has been immensely widened and many of its morbid conditions have been brought within the scope of legitimate conservative surgery, with untold benefit to mankind. Viewed in the light of recent knowledge, we appreciate the fact that few of us have failed to treat as gastralgia, indigestion, diaphragmatic pleurisy, enlargement of the liver, malarial fever, bilious fever, etc., cases which should have been diagnosed and treated as cholelithiasis and its consequences. In my own early professional work I can recall at least a half dozen clearly operable cases which were allowed to go from bad to worse and die without operative aid. Enough has been ascertained to prove that the socalled medical treatment offers but a small chance of benefiting the condition of impacted gall-stone or stones and certainly no possible chance of curing a cholangitis or empyema or cystitis of the gall-bladder. gall-bladder. Experience shows that the solution of gall-stones by medication is a myth, and that whenever they have attained to any size, or are present in considerable numbers and are producing

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