Dr. Knapp's well-known skill. We have not tense activity manifested to determine these space to enter into a discussion of this dis- problems has already produced grand reease here and now. But after a considerable sults. Both physicians and surgeons are inobservation, we may say that we have never duced to re-study the conditions under which seen an eye lost, nor have we ever heard of the various forms of septic poisoning occur. one being lost, from ophthalmia neonatorum Surgeons and hospitals have entered a race in which the conjunctiva was thoroughly to determine which shall reduce to the lowest cleansed by tepid water at frequent intervals point the mortality from blood poisoning of, say from fifteen minutes to one or two after wounds and operations. It has come hours, according to the stage of the disease to be regarded as a disgrace to have a paand the severity of the attack. The disease tient die from septic poisoning. The adis self-limited, and if injury to the cornea can herents of each aforementioned theory are be prevented while it runs its course a favor- equally earnest in this race, and equally able result will be gained. Let every one with their opponents claim to have gained apprehend this fact and understand the best the goal. It is a noble struggle, one fraught methods for cleansing the inflamed conjunc with the most beneficent results to both tiva in its posterior as well as its anterior science, art and humanity. Let it be rememfolds, and we think the number of eyes lost bered that the aim of all good surgeons is from this source would be reduced to a min- the same-the absolute prevention of septic imum. That an expert should be able to do poisoning after surgical operations. The better than this by the judicious application two prevailing methods are the complicated of powerful remedies, we are fully aware.- or Listerian and the simple. The former is EDITOR DETROIT LANCET. well known to all. The latter is well discussed by Dr. Wm. S. Savoy (Brit. Med. Four., August 9, 1879.) Respecting Lister's theory, he makes one point that strikes us as unanswerable. Thus he says: "If the germ theory in its past and present state contained the truth, the whole truth, and nothing but the truth, what possible explanation is to be given of that which is witnessed daily and hourly-the kindly repair of exposed wounds. I will venture to say that any one who had no clinical experience, but who accepted all that he could read on the germ theory, would inevitably come to the conclusion that to expose any wound unguarded to the atmosphere would be to seal the fate of the patient. But what is the

THE

The Detroit Lancet.

LEARTUS CONNOR, A. M., M. D., EDITOR. Septic Poisoning in Practical Surgery. HE key note of modern medical and surgical thought is septic poisoning. The effort is being made to show that septic poisoning is the cause of the exanthematous, continuous and malarial fevers, of erysipelas, diphtheria, pyæmia, septicemia, and a variety of other disorders more or less confined to special organs. Those chemically inclined have endeavored to prove that the septic poison consists of organic matter fact? Who requires to be informed? Then in varied stages of decomposition. The is it not clear that the whole truth has not biologically inclined have on the other hand yet been told?" He further shows that tried to prove that the septic poison consist- wounds are harmlessly sometimes bathed ing of animal or vegetable germs pervades the with fluid that injected in the blood would atmosphere and special localties. The latter produce the most intense septic poisoning. view has been passively or actively held by Or the foulest matter may be pent up in an a large part of the thinking medical profes- abscess without any visible disturbance of sion. That either view has been positively the general health. Thus it is a fact that, demonstrated none can claim, as the chemist under certain circumstances, blood poisoning has not isolated his septic particles, and does not follow the contact of putrefying shown that those of this composition will matter with produce typhoid fever and those of that ery- Healthy granulation tissue seems to prevent sipelas, etc. Nor has the biologist demonstrat- the absorption of the poisonous putrefying ed what species of bacteria will certainly pro- matters in contact with it. Aught that in. duce each particular disease. But the in- terferes with the integrity of this granula

wounds and raw surfaces.

Chloral Inebriety-Its Symptoms.

The effects of alcohol, opium, chloroform or ether intoxication are well known to all

tion tissue favors blood poisoning. Thus in 'surgical blood poisoning there are two elements, "A fluid potent for evil and a surface ready to transmit it." Clearly to conduct a in the profession and the most of the laity. patient safely through recovery from But the introduction of chloral into medical wounds and injuries demands both the practice being quite recent, the effects of its exclusion from the wound of all foul fluid continuous use are less clearly understood. and the fostering of the soundest and most Dr. J. B. Mattison has in a late paper colrapid process of repair. It is well to ex- lected numerous cases of chloral inebriety, clude the poison, but it is better to do this and given us a clear outline of the usual at the same time that such conditions are in- symptoms. Its earliest morbid phenomena duced as render its absorption impossible. relate to the digestive system. Nausea and Dr. Savoy says that by the employ- vomiting come on; the tongue is covered ment of the simplest means at St. Bartholo- with whitish fur; appetite is capricious, and mew's Hospital there have been only 18 in well marked cases almost extinct; the deaths after 1,235 operations, or a death rate breath is fetid, or gives off the odor of chlofrom this cause of 1.44 per cent. He claims roform or alcohol; jaundice appears, though that on the whole these results are unsur- oftener there is a pallid, anæmic look from passed by any other plan of treatment. blood vitiation; the bowels are torpid, and Now, what is the plan by which this result the alvine dejections are hard and peculiarly is reached? Simply the most scrupulous pale. Respiratory movements are diminishcleanliness and the most perfect rest-clean ed in frequency, and attended with more or wounds and clean air. There is no new less dyspnœa. principle, but the perfect application of old established principles of surgery. As Lis ter's plan does not furnish so low a rate of mortality, Dr. Savoy thinks that he has no adequate grounds for changing his methods of practice. He admits that Lister's method is better than many other methods, but he claims that its results are inferior to those obtained by far simpler means. In a pestilential atmosphere Lister's method is safer, but then operations should be stopped until the atmosphere can be purified.

The hearing is dulled, with tinnitus. aurium, and vision obscured or lost. The ophthalmoscope reveals great retinal anæmia.

The pulse becomes weak, rapid and irregu lar; heart sounds feeble, and a tendency to syncope. The jaundiced skin and ash colored evacuations point to an interferance with the hepatic functions.

There are peculiar pains in the limbs, simulating neuralgia or rheumatism, yet, unlike the former, they are not limited to the Dr. Savoy makes a strong argument in course of the nerve, and differ from the favor of old principles of surgical practice. latter in not being exactly in the joints, but From a practical standpoint his position rather girdling the limb or finger just above seems impregnable. There is still one class or below them, without pain on pressure, and of cases in which, in so far as we are aware, unaggravated by movement The loss of Lister's method gives better results than power in the lower extremities is sometimes any other; viz.: Those in which joints are very marked and strongly suggestive of opened with impunity. It does not appear serious spinal mischief. From its influence that Dr. Savoy's simpler method at all on the nervous system there may be anæsequals the anti-s eptic dressings. Perhaps thesia, hyperesthesia, or both; tremors of these operations would do well enough with the tongue and muscles, subnormal temperaout the spray if only the air was reasonably ture, 97° or under}; chilliness, profuse sweats, pure. In their search for methods of pre- sometimes cold; again, a peculiarly dry venting blood poisoning after wounds, sur- skin, irregular wandering pains, general irrigeons have been compelled to study numer- tability, restlessness, insomnia, exhaustion, ous physiological processes and other depart- vertigo, inability to stand erect, with tenments of natural science. They are driven dency to fall forward, as in ataxic trouble; to first principles, and as they ground their art on these so will their positions be impregnable.

lack of co-ordinating power, so as to be unable to write, whistle, etc.; facial paralysis and progressive failure of motor power to

Dr. J. V. C. Smith died in Richmond, mental power may appear in a few months Mass., August 20, 1879. In 1823 he started or not for years. There may only be slight the Medical Intelligencer, the first medical irritability of temper or complete imbecility weekly in this country. Since he has been or dementia. The evidences of enfeeble- connected with the Boston Medical Journal ment of the intellect or moral sense appear and the Medical World, Mayor of Boston, earlier and are more profound than those from opium or alcohol.

Prof. M. B. Wright died at his home in Cincinnati August 15, aged 75. The cause The accomplished London correspondent was the impaction in the esophagus of a of the Amer. Pract. says: "Dyspepsia with plate of gold containing an artificial tooth. a clean tongue, whether accompanied by He will long be remembered as a medical menorrhagia or leucorrhoea, or both, with in- teacher, lecturer, writer and practitioner. tercostal or facial neuralgia, is never, or hardly ever, primary; it is reflex and ovarian in origin."

The latest dressing for wounds is powdered

E. Blitz has discovered that a paste of

aloes. Dr. Millet states that it acts as a ci- powdered ergot, with water, will remove catrizant and as a means of occlusion- from the hands or utensils the odor of musk. assuages severe pains instantly and requires We learn that the Kentucky School of renewal only at long intervals. Medicine has at last been entirely severed A correspondent of the Boston Medical from the Louisville Medical College. It Fournal says that "Drs. Louis Bower and henceforth will pursue an independent life, William Hazard have inaugurated a new and we doubt not one alike honorable and medical college" at St. Louis, Mo. There are already five medical colleges in that city and two elsewhere in the State, making in all seven for Missouri.

useful.

"People reduced to servitude, or who have emigrated in order to support themselves, are rarely sober. The Irish, Poles and Chinese are illustrations.”—Richet.

Dr. C. F. Mauder, a well-known English operator, teacher and writer, died July 11th. "In giving chloroform much depends upon During June Prof. Neubaur died at Weis- the disposition of the patient. If he be baden and Prof. Trommer at Greifswald. courageous and resolute, there will be no Graves says: "In all feverish complaints difficulty in producing insensibility; but if he where, during the course of the disease, the is filled with a dread of the operation, it is stomach becomes irritable without any obvious cause, and where vomiting occurs without any epigastric tenderness, you may expect congestion or incipient inflammation of the

brain or its membranes."

The St. Louis Clinical Record states that St. Louis will soon be graced by a new weekly medical journal. Further, the St. Louis Medical College will begin operations in August. Among its requirements are a preliminary examination, a three-years' graded course, and final examinations of great severity. It is naively remarked that "St. Louis has finally a medical college worthy of the

name."

The British Medical Journal circulates weekly nine thousand copies, and annually

contributes to the funds of the British Medical Association upwards of twenty thousand dollars. A brilliant success in medical jour nalism.

necessary to use great care; for there is in such cases a greater tendency to syncope. Moreover, he will resist for a long time the action of chloroform, so that more will be required than if he abandoned himself willingly to its effects.”—Richet.

Prof. L. P. Yandall writes the Louisville Medical News that in London, Eng., “getting into practice is here as elsewhere slow work; and while merit is probably the best means. of securing a business, manners and machinations, the Sunday-school and church dodge, and the total abstinence game and judicious. lying about skill and success, and stealing other men's ideas and putting them in print, are roads to prosperity no more neglected here than in our own enterprising country.”

Dr. H. M. Lyman (Med. Record, Sept. 6, 1879,) concludes a paper on "State Protection for Syphilophobists" as follows: "State protection for the vicious is the most thorThe Louisville Medical News has decided oughly unscientific thing that can be proto change its name with the beginning of its posed, as every one who has comprehended next volume. It will then rejoice in the the theory of evolution must necessarily perappellation of Medical Age, a name, we are ceive. But since sentimental people are informed by its distinguished editors, at once sentimentalists by reason of their incapacity "distinctive, euphonious, cosmopolitan and for certain kinds of knowledge, every effort dignified." We confess to a preference for its present name. Still, so long as the same large head and heart continues to shape its pages, we are content that it shall be called by any term that fancy dictates.

Richet says that, in general paralysis of the insane, the anatomical lesion is an alteration of the deep cortical layer of the gray cerebral convolutions.

thus to address them with scientific arguments must be as fruitless as would be the attempt to discuss politics with a pig."

Dr. Bock says that the nervousness and peevishness of our times are chiefly attributable to tea and coffee. The snappish, petulent humor of the Chinese can certainly be ascribed to their immoderate fondness for Beer is brutalizing, wine impassions,

tea.

1

whisky infuriates but eventually unmans. The Ohio Med. Recorder says "that Allan's Alcoholic drinks, combined with a flesh and Confidential Business Report of Columbus fat diet, totally subjugate the moral man, O., contains the names of only something unless their influence be counteracted by over twenty doctors-most of whom are violent exercise. But with sedentary habits ranked in the very lowest class-lowest in a they produce those unhappy flesh sponges business sense." The report includes all which may be studied in metropolitan bach- classes, and one carpenter is reported as elor halls, but better yet in wealthy convents. owing a bill to fifteen doctors, a deputy Mr. Henri 1. Stuart, of New York, has sheriff as owing ten, etc. A similar investipresented to the Alumni Association of the gation of most towns would probably reveal Georgia State University a fine portrait of a similar state of things. Notoriously, docDr. Crawford W. Long, whom Dr. J. Marion tors are poor pay as well as poorly paid. Sims styles the discoverer of anaesthesia. "Tis pity, 'tis true, and true 'tis pitiful. Even now the world is divided on the ques- In other columns of this issue we publish tion as to who is entitled to the high honor some correspondence illustrating the nature of introducing anesthesia to mankind. Wells, Morton, Long, etc., all have their adherents, and doubtless will continue to have them for another generation.

Prof. S. D. Gross, at his complimentary dinner address, remarked: "What is fame? Is it a phantom or is it a reality? Few medical works, however meritorious, outlive their authors, and no sooner does a teacher retire from the field of his labor than his pupils worship other gods. Happy, thrice happy is he who, in the evening of his life, as he reviews his past conduct, can say to himself, 'I have been true to my profession; I have been ambitious of its glory; I have done nothing to tarnish its escutcheon.""

Dr. N. D. Stebbins, for so many years an honored medical practitioner in Detroit, writes us from his retirement in Santa Barbara, Cal., concerning the anomalous fevers described in the LANCET by Dr. Gundrum.

of a singular commercial transaction of a Cincinnati drug house in the introduction of alstonia constricta. Last winter this house was active in attacking the reputation of the largest drug manufacturing house in Detroit in the matter of its introducing cascara sagrada. The Detroit house triumphantly passed the ordeal. In the discussion of the matter it was shown that in all respects its business integrity was untarnished and beyond suspicion. Will the Cincinnati firm be as successful?

The Hospital Gazette in an admirable

article on "Doctors Seeking Notoriety," remarks: "A desire for notoriety seems to possess humanity at times with such a force that the bounds of prudence form but a poor guard for man's acts. Ordinary caution and feelings of respect are forgotten, and man, to secure notoriety, and that only, grasps at the opportunity offered, and pays no heed to the mire with which he covers himself in his rash venture. A species of intoxication seizes him and hurls him along so suddenly over old landmarks and through sloughs that not until the glittering bauble that tempted him is in his hands, and is bereft of its attractiveness by its nearness, does he comprehend that he has sacrificed character and position. The thief ventures life in the pursuit of his illgotten gain, and the forger weighs his freedom against other's wealth, the same grasping design controlling their acts. Wealth they secure. They may escape the penalty. He who seeks notoriety surely loses his manhood; an insufficient reward for so great a cost.”

He says: "These fevers were quite common during the years of 1837-40. It was found that quinine was injurious if administered prior to the cessation of the fever. The first treatment should be alterative. After evacuating the alimentary canal, two grains of calomel with half a grain of ipecac should be given every four hours until slight ptyalism appears. Patient should be sponged with tepid alkaline water and diuretics and diaphoretics given. As soon As soon as the fever remits, quinine and stimulants are to be administered. In all such cases the glandular system is perfectly blocked up, and it is folly to expect relief until it is opened." The doctor's great experience in such cases The Philadelphia Medical and Surgical Rerenders his views worthy of careful atten-porter talks indignantly over our 66 "lack of backbone" in discussing the legal restriction

tion.