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lute barrier to the escape of discharges originat- prostatic epithelium, muco-pus, and a few muing behind it.
cous shreds often cast off the follicles and Follicular, prostatitis, hypertrophy of the prostatic ducts. 6. There are often associated prostate, and one or two other affections of this with these conditions a certain amount of sexual gland often produced a slight discharge at the excitability, frequent erections and premature meatus. The chief diagnostic points in a ejaculations during attempts at intercourse. chronic gleet due to some affection of the pros- In addition to the various well-known methods trate are the following: 1. Undue frequency of of treatment, the application of cold in the micturition with pain felt at or near the end of form of a jet of water and the employment of the penis at the conclusion of the act.
massage are to be recommended. The bidet feeling of weight or fullness in the perineum should be used persistently and thoroughly at and rectum, especially during the passage of least twice daily-once after the evacuation of hardened fæces. 3. Diminution in the force of the bowels and once upon going to bed. It was the stream of urine associated with dribbling well at both times to wash out the rectum with toward the end of the act. 4. The first portion warm or tepid water, and then to employ the of urine passed, if collected in a glass is found cold jet directed against the perineum. The more turbid than the second portion. 5. The patient should spend as much time as possible sediment in the urine will be found to consist of in the recumbent posture.
IMMENSE ANTHRAX OF BACK. OPERATION. RECOVERY.
BY H. C. DALTON, M. D., SUP'T CITY HOSPITAL, ST. LOUIS, MO. John McG., æt. 59, single, Irish, laborer, en- deep, healed rapidly by aseptic granulation. At tered the hospital Nov. 21, 1888. Patient's present the patient is about well and ready for family history was good. He had used alcoholic discharge. stimulants freely for some years.
Had inter- This was the third patient suffering from mittent fever for several months before coming carbuncle upon whom I tried campho-phenique. to hospital. Hygienic surroundings had been It is not only one of the most excellent antiseppoor. For several weeks had been suffering tic and germicide remedies. I have ever used with boils on back of neck; had lost considerable but an analgesic as well, relieving the pain flesh, was weak and feeling generally "out of promptly and effectually. I had operated on sorts."
carbuncles before without the use of camphoWhen I saw him he was anæmic, pulse 110, phenique, but never had the wounds heal so temperature 104°F., no appetite. On lower rapidly, nor saw the patients suffer so little pain. part of neck and upper portion of back was found a very large carbuncle, circular in form, XEROSTOMIA.—Under the name of xerostoand about eight inches in diameter at its broad- mia or dry mouth, Dr. Hadden gives a brief acest part. A smaller one, also circular in form, count of an affection which has been described situated two inches higher up the neck, was by himself and by Mr. Hutchinson at the possibly two inches in diameter. Upon the
Clinical Society. All the subjects were women, surface of the larger one were many large fistu- mostly between the ages of 50 and 65. The lous openings. It was considerably elevated disease began suddenly in these cases, preceded above the surrounding skin.
in two by a severe mental shock. In all After anæsthetizing, I made a crucial incision, the cases the condition of the mouth was the carrying the knife well down to the healthy tis
The tongue was red, devoid of episue, and dissected up the flaps. With scissors thelium, cracked and absolutely dry, its appearand sharp curette I removed as much as possi- ance being like that of raw beef. The inside ble of the necrotic tissue, under constant irriga- of the cheeks, the hard and soft palates, were tion of a 1-2,000 bichloride solution. I then also dry; the mucous membrane soft, shiny and packed the wound full of absorbent cotton, satu- pale. The salivary glands appeared normal, rated with campho-phenique.
and no mechanical obstruction was detected in Patients' pulse, the day following the opera- their ducts. The general health remained untion, was down to 76, temperature 99°F., and impaired, and in spite of the absence of saliva, has rarely been above the normal since. His no digestive disturbance resulted. Articulation progress toward recovery has been rapid and is difficult in consequence of the absence of uninterrupted. The wound, which after the moisture, and swallowing has been assisted by removal of the dead tissue was nearly two inches constant sipping.
THE investigation concerning the manage- to the care of men gathered from the dregs of ment of the Cook County Insane Asylum which politics. Is it any wonder that judicial “roastwas pending in the County Court at the time ings” are necessary? our last issue appeared, has been completed and The deliberate attempt to make the medical the decision from the bench follows the exact superintendent the scapegoat of the county lines which have been maintained by the MED- commissioners failed most miserably. Dr. ICAL STANDARD concerning the proper care of Kiernan's vindication has been complete. The the insane in this county. There have been county board is responsible for the abuses which innumerable "investigations" of this asylum, have so long existed. But will the county board but never before was there anything which ap- now do anything? Most assuredly it will do proached completeness; witnesses were
nothing except bluster and create newspaper compelled to testify, no oaths were ever ad- talk. It will protest that its dignity has been ministered, and the whole power of a corrupt assailed, but it will do nothing more. With board of county commissioners was in every one or two noteworthy exceptions the county instance used to defeat anything like a fair in- board does not contain an individual who has quiry. If under such circumstances charges of the moral or mental integrity which will enable maltreatment were substantiated, and the him to sink his greed for gold and his “party asylum gained the reputation of being a disgrace obligations" and do what he believes to be to the State, it is no wonder that in the present honest and for the best interests of those eninstance, with a judge upon the bench who trusted to his care. could not be influenced by the unscrupulous if not criminal operations of members of the
The decision of Judge Prendergast that the county board, who withstood the bitter denunci
Cook County Insane Asylum is no longer a fit ation of a bankrupt blackmailing sheet, and
place for the reception of patients, is a sad comwith great firmness compelled not only the at
mentary on the management of charitable intendance of witnesses, but even made the
stitutions in this county. county board particeps criminis, it is no wonder
The reform measures proposed by the Judge we say that the revelations made were of such
are such as cannot be easil, arried out at prescharacter as to give the Cook County Insane
ent. The time was when the State would have Asylum, up until the advent of the present ad. ministration, the undesirable notoriety of being but the difficulties now in the way of such a
assumed charge of the fire trap at Dunning, the worst managed institution in the United
transfer are almost insurmountable. A boodle States, if not in the world.
county board will not willingly release its grasp The findings of the court are but the judicial
on an institution which provides so many fat expression of opinions which have long been
places for relatives and friends. They would held by the medical profession as the result of
not willingly pay for the support of the insane if careful, non-judicial investigation.
they had not a hand in the distribution of patThe system of management has been, is now.
ronage. The probabilities are therefore that and always will be radically wrong so long as it
the present overcrowded condition of the asylum remains in the hands of fifteen incompetent
will continue, the commissioners will stand up men, who know as much from personal experi
for contractors who deliver “green” meat and ence about insanity as an Icelander does about
the spasm of virtue which has lately been so sunstroke. The present board of managers is
characteristic a trait of the county commissionprobably no worse than its predecessors, and
ers will relapse into innocuous desuetude and yet with the exception of Dr. Gilmore who as a
the “good old times" of passing bills for stone physician has from the beginning of his official
contracts, etc., will reign in the county building. term inveighed against the "boodle" influence of
Verily, the public is easily satisfied. the Blair's Cools, Kimballs, Sennes, Hodgkins, et al, there is not a single individual on the board who is competent even to manage a hospital for DR. BURDRAGHI has recently ("Med. Absick cats, and yet these are the men who controi stract") discussed the question of murder by the the public charities of Cook county, interestsde- insane. Only two of these cases were transitory manding the broadest intelligence, the deepest frenzy, the great majority having been cases of sympathy and the highest integrity, entrusted delusions of persecution. Eighteen per cent.
were associated with epilepsy, and one was an- tion" mooted by the MEDICAL STANDARD some thropophagous. In fifty-eight per cent. the mur- years ago.
It says: dered persons were relatives, and in forty-two From the beginning of the present century per cent. strangers. The youngest murderer to about the time of the Crimean war, a very was only four years old, a girl who threw into different type of practitioner was introduced into the fire an infant she was left to mind; the old- current fiction. In his student days he est was seventy years of age; the majority (thirty) was wild and full of animal spirits and practical between thirty and forty years.
jokes, being neither very studious nor very sober. As
seventy-five were and He is represented in this stage of his career by twenty-five women; seventeen were quite illit- Mr. Bob Sawyer, Mr. Ben Allen and Mr. Jack erate, and sixty-one very imperfectly educated. Johnson. When duly qualified he developed Religious delusions were present in twelve into a kind hearted, whist playing, middle class, and in five of these were the immediate motive family surgeon, somewhat of a time server and of the crime; twenty-five labored under hallu- a humbug, but honorable withal, and nearly cinations, and fourteen had been previously always found on the side of virtue. This was insane. Fifteen were instances of plural homi- the practitioner of Miss Austen, of Thackeray, cides, one individual having perpetrated no of Dickens, and of the hundred and one novelfewer than eleven. In nineteen no motive ists who came between them. Here the apothcould be assigned.
ecary was never taken as a hero, by any chance, That even excessive joy may subvert the rea- and was often only introduced on the scene to son is proved by the case of a man who, hav- certify to the heroine's dangerous condition, for ing unexpectedly come in for a fortune of
the harrowing of the faithless lover, or at best $10,000,000, killed his wife and children. In was set in the chimney corner to amuse the infourteen, a surprisingly small proportion, was convenient father while the hero and heroine the act premeditated, and in these, as in fifteen enjoyed the sweets of uninterrupted intercourse. per cent. of the whole, considerable ingenuity In Miss Austen's delightful novel, “Pride and was shown in its execution. Twenty-seven Prejudice," the medical man is introduced to sought concealment in Aight, but all sooner attend on Jane's throat with as little notice or or later returned. Three only attempted to approbation as the butcher might receive who prove an alibi. Twenty-three prevaricated, supplied her with mutton chops. but of these twelve had lost all recollection of Mr. Harris, in “Sense and Sensibility” is thelr acts, sixty-seven remembered them, but in only valued for his daily bulletin and unfourteen cases they were committed under the favorable prognosis which is not verified influence of hallucinations; fourteen others, by the event. The surgeon in “Persuasion" though cognizant of what they had done, were attends Miss Musgrave after her accident of very weak intellect, and one was a case of
in a satisfactory manner, but is else a shadow. transitory frenzy. Fifty-four exhibited more or In "Emma” however, we get a full length less remorse, but of these forty-six failed to portrait of this class of practitioner. Mr. realize the heinousness of their crimes; seven Perry was a country surgeon in large practice. gloried in them; twenty-three attempted to ex- His admiring patient, Mr. Woodhouse, says of culpate themselves; thirteen undoubtedly of him, “Poor Perry is bilious, and he has not time weak intellect, simulated insanity; eleven of to take care of himself, which is very sad, but these were subsequently transferred from the he is always wanted all round the country. I asylum to the jail, and six in all succeeded in
suppose there is not a man in such practice escaping from asylums.
anywhere. But then there is not so clever a man Seventy-eight of the hundred homicides
anywhere.” He does not confuse his patients were acquitted of responsibliity on the grounds by variety of climatic recommendations. "Perry" of insanity, fifteen were pronounced to be continues Mr. Woodhouse, “was a week at partially accountable for their acts (a verdict Cromer once, and he holds it to be the best of recognized by German law), and sentenced all sea-bathing places. A fine open sea, he according to various terms of imprisonment, says, and very fine air, and by what I can underwhile eight were found guilty of murder. stand from him, you can get lodgings there quite These statistics demonstrate that the usual legal away from the sea, a quarter of a mile off, very tests of responsibility of the insane are erron- comfortable." He was very attentive to his eous.
better patients. “Poor little Emma,” says her
father, "you were very bad with the measles, “THE British Medical Journal" continues to that is, you would have been bad but for Perry's iscuss the subject of the “Physician in Fic- great attention. He came four times a day for THE MEDICAL STANDARD.
a week. He said from the first it was a very Ago" published about 1857. He wages an ungood sort, which was one great comfort, but the popular and unsuccessful war against sanitary measles are a dreadful complaint. I hope defects in the little Devonshire coast town where whenever Isabella's little ones have the measles he practices and when in spite of the efforts and she will send for Perry.” Timid Mr. Chillip, in in consequence of the sanitary shortcomings of David Copperfield, and that worthy practitioner the place, cholera breaks out, he and his two who attended little Nell at the village inn, belong friends fight with the disease to the bitter end, to the same class. We all remember how the visiting the sick, warning the healthy, and in all latter felt the child's pulse, “and as he did so, ways attacking the causes of the disease. He eyed the half empty wine glass as though in pro- is an intelligent, kind hearted, gallant, straightfeund abstraction. 'I should give her,' he said forward man. at length, a teaspoonful every now and then of hot The modern novels whose heroes or subsidbrandy and water.' “Why, that's exactly what iary characters are medical men formed on we have done, sir,' said the delighted landlady. such a model, are legion. In “The Ladies of 'I should also,' observed the doctor, who had Beaver Hollow" we have George Mildmay, the passed the footbath on the stairs, 'I should young surgeon, found cheerfully walking also,' said the doctor in the voice of an miles in the night time to the help of a pauper: oracle, 'put her feet in hot water and wrap Mrs. Henry Wood's medical practitioners of this them up in flannel. I should likewise,' said the stamp are many, but she had lived in Worcester doctor with increased solemnity, 'give her some- and took men dear to the British Medical Assothing light for supper, the wing of a roast fowl
ciation for her originals. Miss Yonge, too, now.' “Why goodness gracious me sir, it's Charles Reade, James Macdonald. George cooking at the kitchen fire this instant,' cried Eliot, “Pen Oliver," among others, have given the landlady, and so indeed it was, for the us characters of this kind which will not die. schoolmaster had ordered it to be put down, And so the popular conception of the men of and it was getting on so well that the doctor our profession has grown. From charlatans might have smelt it if he had tried; perhaps he and buffoons they have become in the eyes of did."
their neighbors examples of the very highest and Thackeray has drawn in Pendennis the noblest type of humanity. elder an excellent picture of the same type. Helen Thistlewood had one day hoped for a
THE MEDICAL STANDARD called attention different lot than to marry a little gentleman
some time ago to the growth of the naphtha who rapped his teeth and smiled artificially, habit among the female employes of rubber factowho was laboriously polite to the butler as he
ries. The inhalation of naphtha fumes,produces a slid upstairs in the drawing room, and profusely peculiarly agreeable inebriation. Naphtha is civil to the lady's maid who waited at the bed- used to clean rubbers and is kept in large boilers room door, for whom his old patroness used to to the valve of which the female employes obtain ring as for a servant, and who came with even access and breathe the fumes. The habit was more eagerness. Perhaps she would have introduced from Germany, and is chiefly found chosen a different man, but she knew on the in the New England States. other hand, how worthy Pendennis was, how prudent, how honorable, how good he had been THE strictures which have been passed upon to his mother, how constant in his care of her, medical men who visit Europe, by our foreign and so she married him.
confreres, would seem to be in a measure merIn the Huxters, father and son, Thackeray has ited. We do not believe that the great mass of made a much less engaging sketch of men who the profession in this country are bores; indeed were simply vulgar and commonplace, and in we think that taken as a whole the medical prohis fashionable physician, Dr. Brand Firmin, we fession of America stands as high as any in the see a mere humbug and hypocrite, but as if in world for scientific attainment, politeness and compensation, Thackeray rises to a higher level general gentlemanly conduct. The time has than any of his predecessors in his Dr. Good- come when a person can secure as thorough an enough, a type of medical man, which in its education if he will on this side as on the other. essentials of knowledge, honor and benevolence, But there is a certain class of men who by was as we shall see, to monopolize the fiction of hook or by crook gain entrance to the profession the following generation.
and being moderately well supplied with money The next definite representative of this type imagine that by spending a few months abroad is perhaps Tom Thurnell, whose character their return will be heralded throughout the Charles Kingsley drew in his novel “Two Years land, and patients will flock to them as the foun
tain head of all knowledge, even though that The recent investigation concerning the death head be hydrocephalic to the last degree. Is it of the “mind reader" Bishop has resulted, as every strange then that foreign medical men of high intelligent person supposed it would, in the disscientific education should refuse to allow these charge of the physicians who were accused of medical bores, “globe trotters," as they are, to performing an autopsy on a living person. That pry into private clinics and hospitals and make any intelligent physician could make the miscommon property of private patients, for the take of "posting" a cataleptic is beyond cresole purpose of self aggrandizement and lauda- dence. tion upon their return to American soil? We The assertions, however, of a paranoiac think that the manifest tendency to check this mother and hysterical wife have caused the encroachment upon the rights of private indi- physicians an extraordinary amount of inconviduals, whether at home or abroad, by a class venience, and had the effect of opening up the of ignorant, unscientific, and careless medical vast mine of wonderful stories concerning the men deserves the approbation of that large class burial of live people which a credulous public of studious members of the profession to whom has feasted on to the point of satiety. It is a single well studied case is of more actual sci- about time that some society or body, if such a entific value than a host of "impressions from one can be found, in which the public have foreign clinics” by professional sight seers. confidence, promulgates the fact that burial
alive is an absolute impossibility, a bugaboo
which but serves the sensational ends of sensaOn the evidence of an imbecile whose mental
tion-seeking newspapers and hysterical women. state, moral perversion and tendency to make It is time that the dear public should know that sensational charges are so notorious that almost
it can have complete enthenasia without the every judge in the county refuses to receive disadvantage of shocking a mourning cortege his evidence in the sensational cases where he
by turning over in the coffin. so frequently attempts to testify for pay, Dr. J. L. Gray of Chicago, was indicted by a packed grand jury for malfeasance when assistant The recent meeting of the American Medcounty physician. There is very little doubt
ical Association demonstrated the fact that in that this indictment was secured by a political holding its sessions on the border lines of the intrigue, using this imbecile hired assassin of
country the association does not pursue a wise character as a tool. The vindication of Dr. Gray policy. from the charges is certain, but the annoyance The American Medical Association should in caused is so great that Dr. Gray, in justice to fact as well as in name represent the profession the profession against whom this imbecile of the whole country. To ask delegates and directs his attacks in consequence of certain members to traverse the entire breadth of the delusions of persecution due to previous com- continent, and at the same time provide no remitment to an insane hospital, in which Dr. duced rates for transportation, is equivalent to Gray took part, should see that he is placed inviting the members to stay at home. where he can do least harm.
The MEDICAL STANDARD believes that the
National Association should represent the best The recent attempt to enforce the resigna- element and the best thought of the profession tion of Drs. McLean and Frothingham from the in every part of the country; that it should University of Michigan faculty cannot but prove speak with authority upon every subject relatdisastrous to that institution. The chief crime ing to the welfare of medicine in its broadest of these gentlemen seems to have been a praise- sense; that its sessions should be devoted to the worthy desire to remove the clinical department consideration of those topics which are of vital of the university to Detroit, where it could be importance not only to the profession, but to best conducted. The unfitness of Ann Arbor the community at large; that it should have the for clinical instruction has always been obvious iutelligent and hearty support of every reputable to every impartial observer. The local clique, member of the profession in the United States. however, appear desirous of running the insti- With such an association American medicine tution in their own interests, and hence this at- would stand the peer of any profession in any tack on those imbued with broader views. It is country. to be regretted that so great an anxiety for the But the fact cannot be overlooked that in the local interests of a country town should imperil past the American Medical Association has the welfare of a great State university as this been anything but an ideal national association. feud is certain to do.
While the MEDICAL STANDARD yields to no