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The officers thus elected by the individul camp should hold office through life, or as long as they may be willing to yield their gracious and gratuitous services to the sick, disabled and destitute Confederate Veterans, subject to removal only for due

The surgeons and assistant surgeons elected, chosen or appointed by the individual camps should be duly commissioned by the commanding general, and should constitute the permanent standing medical corps of the United Confederate Vet



Each camp should preserve a hospital register of all the sick and wounded treated, giving full particulars of all wounds or injuries, however, or wherever, or whenever received, and with the detailed statements of the Confederate Veterans of the circumstances of the battles or skirmishes in which said wounds were received.

Each surgeon in charge of a camp or soldier's home, should prepare and forward an annual report relating to the sick and disabled veterans to the surgeon general.

The consolidated report of the labors of the medical corps thus constituted should be submitted by the surgeon general in his annual report to the United Confederate Veterans.

We also urge upon the United Confederate Veterans assembled, the necessity of conferring upon the surgeon general the power to effect a thorough and permanent organization of the medical department by approving and confirming his effort in behalf of the U. C. V. and by conferring upon him the power of appointing one or more medical officers, medical directors, and medical inspectors with the rank of colonel and lieutenant colonel in each of the southern states namely: Alabama, Arkansas, Florida, Georgia, Indian Territory, Kentucky, Louisiana, Maryland, Mississippi, Missouri, North Carolina, South Carolina, Tennessee, Texas and Virginia.

The surgeon general should be clothed with power to fill vacancies on his staff, and to apportion to each staff officer such inspection and medical duties, as he may deem best for the relief of the sufferings and the advancement of the hygienic and sanitary interests of the Confederate Veterans.

Each camp or soldier's home should preserve: 1. Roster of its officers and members giving name, nature and place of service; date of commission in the Confedei ate Army or Navy, nature of wounds and date and circumstance of reception.

2. Hospital register containing names and description of sick and injured, results of all post-mortem examinations, and a record of all deaths and their causes.

The discharge of difficult responsible and benevolent duties appertaining to honorary positions without pay, must rest upon the patriotic interest of the officer whose highest reward must be sought in the approval of his comrades, and the satisfaction in being used for the relief of human suffering. Permanency appears to be the essential to the success of labors relating to wants and sufferings of men, and the gathering and the preser. vation of important statistics, illustrating the extent and nature of the sufferings and losses by battle and disease of the Confederate Soldiers. With Great Respect and High Esteem, I have the honor General to remain,

Your Obedient Servant,

JOSEPH JONES, M.D., L.LD., Surgeon General United Confederate Veterans.


THE USE OF IODOFORM IN LOCAL TUBERCULOUS AFFECTIONS.—Although iodoform has been extensively employed in local tuberculosis, and very favorably reported upon by European writers generally, particularly by Continental surgeons, it has been used here, but to very limited extent. With the exception of the work done by Senn, the subject has received almost no attention in this country. The frequency of tuberculous affections, and the satisfactory results of the iodoform treatment, certainly warrant a fuller trial of the remedy at the hands of American surgeons.

Much has been written upon the manner in which iodoform acts upon tuberculous tissue, but the question still remains sub

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judice. König believes the beneficial effects to be due to the formation and rapid contraction of connective tissue at the seat of injection. Mosetig, von Moorhof, von Bünger and others attribute to iodoform a true antituberculous effect. De Reyter thinks it has a marked antiseptic effect when it comes in contact with the tissue fluids at the temperature of the body. On the other hand, Ch. Heyn and Rokild Krosing deny any such action.

Although the treatment has been somewhat empirical, the practical results are not the less important. Krause reports a cure in 50 per cent. of the cases of cold abscess treated by iodoform injection. In a large experience in Trendelenburg's hands, 68 per cent. of all cases are said to have been favorably influenced by this treatment. De Vos reports that 72 per cent. of the cases of joint tuberculosis treated by this method at the clinic and polyclinic at Leyden were entirely cured. Brodnitz has given his experience in the use of iodoform. Eighty-seven cases are referred to, a large portion of which were cured, while still others were much benefitted. Billroth says the results obtained by this treatment "far exceeded his expectations." Bruns reports one hundred cases of cold abscess, subjected to the iodoform treatment, with eighty cures. It is needless to multiply examples. Those already given indicate the position iodoform has taken in the treatment of this frequent and troublesome class of cases.

The use of the ethereal solution of iodoform, first recommended by Verneuil and extensively employed for a time, has been largely abandoned on account of its irritating nature and the liability to iodoform intoxication. The combinations of iodoform with glycerine and with olive oil are both largely used at the present time, and both seem satisfactory to those employing them. If there is any choice, it perhaps lies with the glycerine mixture. The manner of their preparation and use is identical. As usually prepared, the mixture contains 10 per cent. of iodoform, and this strength seems to meet all requirements.

The proper sterilization of the mixture is a most important matter, as the iodoform does not insure against the presence of microorganisms. To secure this end, the iodoform, in very fine powder—that obtained by electrolysis is best-should be repeat

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edly washed in bichloride of mercury solution, 1:1000, before use, and the vehicle, whether glycerine or olive oil, should be boiled, care being taken subsequently to prevent contamination of the finished product. These precautions are necessary in order to avoid a “mixed infection," which will surely lead to suppuration, if it has not already occurred.

This treatment has a wide range of application-tuberculous glands, abscesses and sinuses, tuberculosis of bones, joints, etc. In the treatment of tuberculous glands, if softening has not occurred, a few minims of one of the preparations described may be injected with a Pravaz syringe into and around the affected glands. Abscesses may be evacuated by a trocar and the mix. ture injected, or, as advised by Billroth, incised, emptied, curetted, and the mixture introduced, followed by primary suture. Bone and joint tuberculosis are to be treated by bringing the remedy directly in contact with the diseased tissues.

We do not expect this method will do away to any great extent with the necessity for operating in this class of troubles, but it does seem to promise a most valuable adjunct to such operative measures as may seem indicated.

Brodnitz asserts that the results following the operative treatment of tuberculous bones and joints have considerably improved since the introduction of the use of iodoform.

Such lesions as can be totally extirpated may be much more quickly and radically dealt with by the knife, but where such removal is wholly, or in part, impossible, the iodoform treatment should be employed, either alone or in conjunction with such surgical measures as are indicated.--Editorial in Univ. Med. Mag.

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1. Remember that the membrane of diphtheria does not remain confined to the tonsils, but that it spreads to the uvula, soft palate, and perhaps to the post-pharyngeal wall; in other words, it may leave the tonsil. The pseudo-membrane of folli. cular tonsillitis never does this.

2. The membrane of diphtheria is so closely adherent to the underlying parts that you cannot lift it up from the mucous membrane without rupturing the capillary vessels, causing a slight bleeding. The pseudo-membrane of follicular tonsillitis is easily raised from the underlying mucous membrane with a probe; it leaves no abraded surface beneath it, and very often you can draw out with the pseudo-membrane the contents of the follicle, the mouth of which it covers.

3. The diphtheritic membrane is always thick. In follicular tonsillitis the membrane is thin and delicate.

4. The membrane of diphtheria is always of a dirty, yellowish color; the pseudo-membrane of follicular tonsillitis is pure white or of a pearl-gray, and is clean and bright. The membrane of diphtheria after twenty-four or forty-eight hours becomes necrotic and takes on a dirty, blackish-gray color-in

short, it looks what it is, a necrotic, dead, or dying membrane. The pseudo-membrane of follicular tonsillitis, on the other hand, always remains whitish, pearl-white or gray, and never becomes blackish or necrotic.

5. The tonsillar portion underlying the diphtheritic membrane is of a deep red or bluish-red color. The underlying tissue in a case of follicular tonsillitis is bright red, never of a very dark, angry color.

These points, I am sure, will assist you, as they have often assisted me, in making the differential diagnosis between diphtheria and the pseudo-membrane of acute follicular tonsillitis. Of course, we can go further, and with the microscope determine the presence or absence of the Leffler bacillus, but I have given you the practical bedside tests which will usually enable you to answer definitely and quickly regarding the true nature of the membrane.

Now let me say a word about the contagiousness of follicular tonsillitis. Here I must deal largely with the individual belief. I believe to-day, as a result of my own experience, that follicular tonsillitis is mildly contagious; that it is not safe to put others in the way of direct contagion; and my advice to you is that it is best to isolate the patient, and particularly to keep children from being around those suffering from this disease. You should also banish from the sick-room adults having hyperthrophied tonsils or suffering from any condition which predisposes to such a contagion.-American Lancet.

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