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REPORTS OF SOCIETIES.

Reports of Societies.

DECEMBER MEETING OF THE WAYNE COUNTY MEDICAL SOCIETY.

The President in the Chair.

The meeting having been called to order, the regular paper for the evening, viz: "Criminal Abortion as a Cause of Insanity," not being prepared, volunteer papers were called for.

Dr. Noyes read a report of an interesting case of amaurosis affecting both eyes, occurring in a sewing girl. The approach of the disease had been very gradual, and had progressed to a degree that precluded work in the evening. The opthalmoscope showed no abnormal change except a slight paleness over the papilla of one optic nerve. A peculiarity in the case was, that vision was perfect over a circumscribed area of four or six inches, while all without this circle was darkness.

Dr. Stebbins made some remarks bearing upon the duty of the medical profession in relation to the subject of criminal abortion. We give a few extracts.

"It appears to me what we need most for the success of the profession at the present time is an esprit du corps which will lead to uniformity of sentiment and action for its moral and scientific interests. We are often accused of direliction in duty to ourselves, by lending our influence and aid to immoralities, towards gratifying others in sensual indulgences which the law of Nature, to say nothing of that of the land and of God, forbids. In this nineteenth century we ought certainly not to be behind the age which preceded the Christian era. Let us look back and see how the "Father of Medicine," as Celsus calls him, Hippocrates, viewed this subject. An epitome of his opinion may be found in the oath which was required of his pupils before receiving the diploma and entering upon the duties of a practicing physician. We must remember that Hippocrates lived five hundred years before the Christian era and was a heathen, among heathen, according to orthodoxy, and ignorant of the moral precepts given by the Jewish Lawgiver by Divine inspiration. Still we must confess that, if not divine, he seemed divinely instructed, when we contemplate the purity of his life and precepts. It would seem that in framing his oath his great soul looked prophetically far down the centuries, grasping the tenden

cies which, through human frailty and turpitude, might lead to a lowerof the high standard which he held for his Art, and that he left this memorial to be to each generation a touchstone, even as it was to his own students. Allow me to read this oath.

'I swear by Apollo the physician, and Esculapius, and Health, and All-Heal, and all the gods and goddesses, that according to my ability and judgment I will keep this oath and this stipulation-to reckon him who taught me this art, equally dear to me as my parents; to share my substance with him, and relieve his necessities if required; to look upon his offspring on the same footing as my brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every mode of instruction, I will impart a knowledge of the art to my own sons and those of my teachers, and to disciples bound by stipulation and oath according to the law of medicine; but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious or injurious. I will give no deadly medicine to any one, if asked, nor suggest any such counsel; and in like manner I will not give a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my art. I will not cut persons laboring under the stone, but will leave this to be done by the men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and further from the seduction of females or males, of freemen or slaves. Whatever in connexion with my professional practice, or not in connexion with it, I see or hear in the life of men which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men in all times; but should I transgress and violate this oath, may the reverse be my lot.'

"How far these rules have been observed by the profession, since the day of their author, it is not my design now to speak. I may say that the sentiments found in this oath, have been promulgated and enforced by some of our schools of medicine. I know of none except the College of Physicians and Surgeons of N. Y. city."

What Hippocrates enforced under an oath, we need to bring about by an honest endeavor, through moral suasion. I have more particularly in mind the subject which Dr. Stewart so ably handled at our last meeting, viz.: "Criminal Abortion." There may be a difference of opinion respecting the crime as there referred to, some doubting the existence of a soul at an early period of pregnancy; but the observations of the physiologists noticed in the article of Dr. S., show that even as

early as the 14th day of gestation, the germs of the nervous system were visible, and that soon after, the heart was distinctly formed, so that if the ovum is destroyed, at least the animal life of a human form is cut off; in relation to which let me quote from Celsus, who says "it is the duty of a prudent man not to do any thing that can be construed to cause death, and in every way to show the difference between him and the charlatan." The age in which we now live is rife with 'quackery; it finds its votaries in this boasted nineteenth century, among the learned and professedly good, in the highest standing of morals and good order. Whoever will consult the Father of medicine on the subject of the sacred disease, will find he did not spare such persons whether priest or king, and why should we? Have we not a right to demand respect for principles laid down, and made as rational by fair induction, and acknowledged as such since the days of the father of inductive philosophy, (see Bacon) as much as the teacher of the perfect code of morals, that we should hold fast the faith once delivered to saints?

The time has arrived, when our principles should be known by the public, on the subject contemplated, and others affecting the interest and morals of the profession.

Let there not be a double minded man among us-let us strongly oppose the abettors of false philosophy and practice, and since we will not tolerate a double-mindedness in others; see to it that we do not fall in the same dissembling, for the sake of pecuniary friendship, or for a good name among those who, in high positions, tempt us to violate nature's holy laws. To do this we shall be called upon to make some sacrifices of feeling and money. Rather let us sacrifice friends, money, if needs be the good opinion of the church itself, than to tamely submit to use our profession for vile purposes.

The physician has a right to claim as delicate-more responsible, if anything a position in the sick-room, as the clergyman; he ought to be as good and chaste in his administration to the sick, and pure in life equally, and thus put to shame the quackery found among them if such exist, and receive the plaudit of "good and faithful servant" from the public mind.

ANEURISM OF EXTERNAL ILIAC ARTERY-POLLOCK.

Selections.

ANEURISM OF EXTERNAL ILIAC ARTERY.

UNDER THE CARE OF MR. POLLOCK.

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The plan adopted in the two following cases was new to this country, although it has been employed, we believe, in one case in America. Two objects were aimed at in the substitution of silver for silk or hemp in the ligature: 1st, to encourage healing of the wound by the first intention, never altogether practicable where the end of a ligature passes through it; 2d, to lessen the risk of the occurrence of secondary hæmorrhage. The first of these objects was not attained in either of these cases, since inflammation took place in the track of the wound. As regards the other point, however, the condition of the artery after death in the fatal case must be considered favorable. The coats were not cut through; circulation had been stopped by lessening the calibre of the vessel. Mr. T. Pick, pathological registrar, has obliged us with notes of the first case:

George H, aged fifty-one, painter, admitted on the 11th of September, 1865. Six months ago he fancies he strained himself while opening some sheets of lead, for he felt pain in the groin at the time, and the following morning he noticed a pulsation in this situation. He has continued his work since "on and off," and a week ago he noticed a swelling at the seat of pain.

On admission there was a circumscribed, pyriform swelling in the right groin, about three inches long by two broad. It was situated under Poupart's ligament, and extended from about one inch above to two inches below it, in the course of the femoral artery, from which it could not be moved. There was a very distinct and forcible pulsation, consisting of a dilatation from above downwards: there was no distinct bruit to be heard. Pressure on the external iliac above the tumor almost, but not entirely, stopped the pulsation. The tumor could be emptied by pressure, but speedily refilled. Pulsation was much stronger in the posterior tibial of the left side than the right. There was a slight aortic murmur with the systole of the heart.

Sept. 14th. The patient having been placed under the influence of chloroform, a semilumar incision was made just above Poupart's ligaVol. 2, No. 1,—4.

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ANEURISM OF EXTERNAL ILIAC ARTERY-POLLOCK.

ment, and, the various layers of the abdominal wall having been cut through, the artery was exposed. It was then encircled by a loop of silver wire, which was tied; this completely commanded the circulation in the vessels; the wound was brought together with silver sutures.

15th. Last evening he complained of pain in the belly; it however soon passed off, and he slept pretty well. He now complained of rheumatic pains in both knees and ankles, otherwise he was comfortable. Pulse was 120, full; skin warm; tongue white. The wound was perfectly quiet, and the leg, which had been swathed in cotton wool, was warm. About noon he began to complain much of cough, and his countenance began to assume an anxious expression. Mucous râles could be heard over both lungs.

16th. His pulse was 136, thrilling; respirations 44 in a minute; mucous râles over both lungs. The wound looked quiet; no redness, but a little discharge. The tumor was consolidated. The foot felt extremely hot, and there was a discolored vesication on the top of the great toe.

17th. He lay in semi-conscious state, with extreme dispnoea. Respirations 54 in a minute; pulse 128, running; mouth dry; tongue dry, brown, and furred; skin hot; face flushed. There was considerable diffused cellular inflammation around the wound, and a hard, brawny place in right flank; skin over it of a dusky red. The spot on the toe was rather less discolored. An incision was made into the inflamed cellular tissue, and one of the sutures was removed from the wound. He was ordered brandy. His breathing became more and more oppressed, and he died the same afternoon.

On examining the parts after death, there was found to be a tubular dilatation of the whole calibre of the external iliac artery just at the point where it becomes femoral. The aneurism was about the size of a peach, and on its lining wall was a very considerable deposit of laminated fibrin, whilst its centre was occupied by a clot. About an inch above the aneurism the vessel was tightly embraced by a silver ligature, which, however, had not in any way cut through or destroyed the coats of the artery. The vessel between the ligature and the aneurism, as well as above the ligature for some distance, was filled with decolorized clot, which was partially adherent to the lining membrane of the vessel. No other parts were examined.-Lancet.