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Street Car Sanitation.

Sudden Death....

Suits for Services..

Surgery, Country.

Syphilis, Ancient Attempts at the Sup-
pression of...

Syphilis, Legal Control of.

Syphilis, Some of the Diagnostic Nervous
Manifestations of.

63

314

191

14

174

283

116

283

27

400

280

479

388

427

355

351

173

425

PAGE

Thrombus of the Vagina in Pregnancy.. 29
Tibia, Treatment of Bone Cavities in the
Shaft of the.
To Work Again...
Treatment, The Necessity of Early Diag-
nosis and Efficient.

Trional Poisoning...

269

185

Tubal Pregnancy of Fourteen Months.... 479
Tuberculosis in Colorado..
406
Tubercle-Infected Houses, Disinfection of 443
Tumor, Frontal, With Psychical Symp-
toms.

333

Tumors, Fibroid, Electical Treatment of 143
Tumors, Thyroid, On.....

244

Turpentine in Incontinence of Urine...

Two Important Meetings.

Typhoid Fever...

299

117

74, 336

Typhoid Fever, Directly Infectious Na-

ture of.....

Typhoid Fever in Country Districts..

Typhus Fever, Spinal Cord Disturbances

After...

74

II

Urinary Analysis as a Means of Diagnosis 291

Urine Filtration...
311

Uterine Appendages, Inflammation of the. 244
Vaccine-Serum in the Treatment of Va-

263
164

riola

Vaginal Injections During Labor.
Vaginal Section and Drainage for Pelvic
Abscess; With Report of Cases..... 454

Vascular Spasm with Cardiac Dilatation. 294

Venesection..

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3831

APR 4 1896

LIBR

MARYLAND

MEDICAL JOURNAL

A Weekly Journal of Medicine and Surgery.

VOL. XXXIII.-No. I. BALTIMORE, APRIL 20, 1895. WHOLE NO. 734

SS⋅N⋅

ORIGINAL ARTICLES.

MODERN SANITARIUMS; THEIR METHODS AND

ADVANTAGES.

By Edward Morton Schaeffer, M. D.,

Baltimore.

A RECENT number of the MARYLAND MEDICAL JOURNAL, in speaking of the imminent decline of the Medical Society in Baltimore, among other good reminders says: "There are many things that help a medical society, and one is intelligent discussions, not so much diffuse book-talk which the speaker has crammed up according to the card before coming to the meeting, but results of actual experience. What is needed at medical societies is not so much quotations from well known and familiar authors as results of unrecorded observations nd experience. A man may see few cases in a year, and yet may have such keen powers of observation and such an ability for classifying facts that his remarks are worth much more than the busiest blind man's.

"Do not drag out the evening with useless historical references and long quotations. It is just as well for the reader to know that most of his hearers have heard of Hippocrates and Galen and let them rest in their graves. A good article is often spoiled by the fact that the writer thinks it necessary to take a survey, unfortunately often too lengthy, of the whole history of medicine from its earliest beginnings."

It will not do then for a brother editor to yield to the temptation which the love of men and letters brings-not so often perhaps as the love of cramming,

in medical papers-though in the case of hygiene and sanitation it is a long distance but a very easy transition from the code of Moses to the best thought and treatment of the present day. (If Moses made any "mistakes" of the Ingersoll type, the chief one, it seems to me, was in not securing a royalty on the whole contagious germ family-certainly so far as the privilege of naming or destroying them was concerned-for he might easily have traded in his foreknowledge of modern bacteriology, as shown by his methods of meeting contagion, and relieved his name and nation of some subsequent odium from flippant and unscrupulous money-getting wit.) "This Hebrew," says a writer, "in the midst of absurd theories and illogical and uncertain practice and general ignorance of hygienic matters, suddenly appears, and changes the entire aspect of medical science. He originates an entirely new system of theory and practice, completely subversive of, and indeed totally opposed to, the prevailing plans. He departs widely from the undeviating usage-that of therapeutical or curative medicine-followed not only by the Egyptians and other nations of antiquity, but by others of a much later day; and substitutes for it the more philosophic and wiser hygienic or preventive method. He gives to the world a health-code without a tinge of the ab

surdities of necromancy, superstition and astrology, then so prevalent a well-defined, condensed and pointed epitome for the prevention, arrest, and ultimate stamping out of that class of ailments which have most afflicted mankind in all ages, namely, contagious diseases. Renouard tells us that even the Hippocratic collection, a thousand years after the supposed date of the Egyptian encyclopedia, or Hermetic Code, does not present so complete and methodical a system; proving that, thus far, hygiene had not progressed."

66

66

There seems to be some natural antipathy between a man of letters and a man of drugs, between broad and general culture and over-devotion to the apothecary's ointment, between the man who is more than a monarch of some little isle of expert knowledge" and the state of pharmacomania. Dr. Rush of Philadelphia was such a man, ' eminent as a physician, but distinguished as a philosopher and a scholar. He paid little regard to the name of a disease, and founded his treatment on its nature and the condition of the system. By this course he reduced his materia medica to a few active medicines, and so prepared the way for the simplification of remedies that has been accomplished since his day."

Dr. James Jackson, one of the founders of the Massachusetts General Hospital, was an another illustration and contemporary with these men was our own Nathan R. Smith, whom the same critic characterizes" as a sound observer, who having enfranchized himself from the bonds of authority, delighted to study nature with his own eyes, and was not afraid to follow where she led." When we erect monuments to the great of our profession, let us see that he whom we are proud to call the Emperor has his place in enduring marble or bronze.

No worthier name has been inscribed on the temple of Hygeia than the one last placed there, that of the ever to remembered Oliver Wendell Holmes, to whom so graceful a tribute from one of our honored members, himself so fit a critic, has recently been paid.

Dr. Weir Mitchell, who stands facile princeps as an exponent of these larger views of the art of healing, has pointed out that the best cure for the evils of civilization is a return to the healthgiving conditions of barbarism, or the ancestral acres of Hygeia, where nature and nature's elements soothe the repentant sinner or self-sacrificing victim and erase the record of dissipation, excess and violated law.

In what follows, I shall aim to condense my experience of about three years in these most hospitable walls, partly as patient, partly as assistant, and point out certain misconceptions which still linger, I find, in some professional minds as to their methods and advantages. For this purpose I select three of which to speak, from these I have familiarized myself. Alighting at one in New York State for the first time six years ago, exausted both physically and mentally, I yielded with reluctance and utter want of faith to a course of baths, invigorating rubs and regulated diet-plain and unstimulating food, very little meat, no condiments, abundance of cereals, etc. The intense irritation and toxic apathy arising from mal-assimilated food reacting on an overstimulated, hence exhausted, nervous system, gradually left and I underwent a hygienic regeneration to which I am indebted for the key to the permanence of my recovery. Without further personal detail, suffice it to say that having seen hundreds of chronic patients similarly recover, who like myself had run the gamut of all that pills, powders and potions given by the most expert hands could promise, added in my own case to a long sea trip, a six weeks' rest cure, and an out-door "roughing it," I shall for ever remain a convert to such sanitarium methods and deprecate the resort to bromides and reputed tonics in lieu. of a more rational and effective system of removing debris and rebuilding waste places by natural agencies of depuration and nutrition.

"The real science of medicine does not consist in the treatment of diseases, but in the cause and prevention thereof. In studying the cause and prevention,

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