small bill, and vice versa. This is all wrong. While it may be a small matter to the practitioner immediately concerned, it is of much moment to many others in the same place, who are more or less affected by this method of doing business. Again, we believe that our fees do not sufficiently vary, according to the financial position of the patient. For instance a person having an income of £400 a year, would, in all probability, be charged £5 for an accouchment and subsequent attendance; while another, whose receipts yearly are over £1000, pays no more. In Manchester, England, the local Medical Society has just revised the tariff of fees, dividing the patients into three classes, and taking the amount of rent paid, as the test of the class to which they belong. This, we think, is a very fair means of judging. At all events, we think that here, we have quite as much reason to alter and specify our fees as they have in England. Everthing has risen so much within the last few years, that it costs almost double as much per year to live now as then, and yet for all that, our fees have remained the same. We hope that wherever medical societies exist, the matter will be brought forward, and we should be happy to chronicle the results. Other professions adopt a uniform tariff, and we can see no reason why the medical profession should stand in its present anomalous position. MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. A regular meeting of this society was held on the 24th of November. Dr. Hingston, vice-president, in the chair. After the transaction of routine business, including the election and proposing of new members, the following gentlemen were elected honorary and corresponding members of the society :-George D. Gibb, M.D., of London, England; Dr. William Frazer, Lecturer on Materia Medica at the Carmichael School of Medicine, Dublin; and Joseph Workman, M.D., Superintendent of the Toronto Lunatic Asylum. Dr. Hingston having vacated the chair, it was taken by Dr. R. P. Howard. Dr. Hingston then gave a synopsis of a most valuable and interesting piper on the relations of the climate of Canada to life and health; and particularly its influence on Europeans resident here. The synopsis occupied over an hour, and gave but a small outline of the interesting material contained in the very lengthy paper. A vote of thanks was unanimously carried to Dr. Hingston for his valuable contribution. A discussion then took place on some of the more important points that had been brought forward; after which, the probability of a visitation of cholera next spring was taken up. After brief remarks from the members, the full discussion of the subject was adjourned till the next meeting of the society. At a meeting of the members of the "Quebec Medical Society," held the 16th November, the following gentlemen were elected officers for the ensuing year: President, O. P. Tessier; Vice-President, L. J. A. Simard; Librarian and Treasurer, J. B. Blanchet; Secretary, L. Catillier. PRESENTATION TO DR. WORTHINGTON, OF SHERBROOKE. We owe an apology to our friend, Dr. Worthington, of Sherbrooke, for not sooner taking note of an interesting event in the history of his professional life, which occurred on the 11th of September last. On that day he was presented with a handsome silver tea set, with salver, the gift of some four hundred of his patients and friends. The salver bears the following inscription :-"E. D. Worthington, M.D., from the people and medical men of Sherbrooke and adjoining townships." An address accompanied the testimonial, which was read by the Rev. Mr. Reid. It alluded in feeling terms to their sincere regard for him as a kind-hearted and skilful physician, and to his gratuitous services to the poor during the long term of his professional career. It concluded by wishing him continued prosperity and usefulness. Dr. Worthington replied in suitable terms. We would congratulate our friend upon this well-earned expression of public feeling, all the more grateful from the fact that such occurrences, so far as members of our profession are concerned, are few and far between. Messrs Kenneth. Campbell & Co., forwarded to us some three months ago, a bottle of pure medicinal Cod Liver Oil manufactured by Hazard and Caswell of New York, and prepared from fresh Cod Livers, at Cape Cod, (Massachusetts), and Rock Island, (Rhode Island). Since its introduction into this city by Messrs. Campbell, we have employed it in several cases, and can therefore speak of its merits from experience. The results from its use are equal to the ordinary Cod Liver Oil of commerce, but it possesses the advantage of being in a great measure free from the smell, so objectionable, as a rule, to patients. Persons whose stomach will not bear the ordinary oil-will, we believe, from the results of two cases, be able to take and retain this oil; and to children, usually such bad patients for the administration of Cod Liver Oil, we believe that of Hazard and Caswell's manufacture will be found to be the most easily taken. From Kenneth Campbell & Co., we have also received a box of their New Cough Lozenges, also a note giving us the prescription from which they are made. We have no doubt they will be found beneficial in ordinary cases of Catarrh so prevalent at certain seasons in this city. We notice with much pleasure that Mr. Abraham Godfrey, a graduate of McGill College of last session, passed his examination for the double license of the Royal College of Physicians and Royal College of Surgeons of Edinburgh, on the 3rd November. We have again to apologise for the late issue of the Journal. Two causes have prevented its earlier appearance-the first being the want of original matter-no original communications having reached us till after the middle of the month. This threw us into Christmas week, and brought the second cause into operation, viz., the large amount of work for immediate execution in the hands of our printer. We hope in future to be more regular, and would again ask our brethren to forward us literary aid. MEDICAL NEWS. One hundred and eight persons were knocked down and killed in London, by vans, drays, omnibuses, &c., &c., between the 1st of April and 4th of November of last year. Dr. Hunter, formerly of Canada, but now of London, England, who was accused of having taken improper liberties with a female patient, while under the influence of chloroform, has been acquitted. Dr. Hunter's position as a "consumption doctor" and notorious quack, does not blind us to the fact that the charge was a trumped up one. It is reported that the new and corrected edition of the "British Pharmacopoeia" will be published early next year. A post mortem was made on Lord Palmerston's body. The details have not been made public. The immediate cause of death was abscess of the kidney, and a diseased state of the bladder. ---- An obituary notice of the late Dr. Sewell of Ottawa, is unavoidably crowded out. CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. A Case of Idiopathic Peritonitis. By E. H. TRENHOLME, M.D., C.M., B.C.L., &c. Michael Doughorey, labourer, aged 26, a native of Ireland, was taken ill at 1 p.m., on the 10th December. He complained of stoppage of the urine, and intense pain of the lower part of the abdomen, when I was called to see him at 3 p.m. of the same day. For some time past he had been working in a very exposed place, and often returned from his work with wet feet, and sometimes with wet clothes. On the day preceding his illness, he had partaken rather freely of strong drink, a thing very unusual with him, as he was of temperate habits, and had never been seriously ill before the present time. He says, the pain came on very suddenly at the time above mentioned, and continued unabated, although he had taken hot drinks, in hopes of obtaining relief. On examination, the abdomen was found slightly distended, the walls very tense and tender to the touch. There was marked tenderness over the region of the kidneys. Vomiting and the desire to defecate and urinate, but without the power to do so, were marked symptoms from the commencement. Ordered him hot turpentine epithems over the whole abdomen, till the surface was well reddened, and to be continued till relieved of pain; put him on grain doses of calomel and opium every three hours, and gradually lengthening the interval between the doses up to five hours, and to support him with cold fluid diet. Monday, 10 a. m.--Much worse; passed a sleepless night, vomiting, pain and tension of the abdomen increased. The vomiting is not accompanied with much effort, and is more like regurgitation, and vomited matter consists chiefly of what has been swallowed. He has passed no urine for thirty-four hours. I passed a catheter and drew off about 3iij. The medicine had been taken regularly, but the man would not remain in bed, nor allow the turpentine epithems to be applied as ordered. Medicine and epithems to be continued. Pulse 100. Continued to grow worse up to 8 p.m., when I saw him, in consultation, with Dr. Howard. Meatus urinarius shows some signs of a clap. In addition to the present treatment, was ordered the application of a dozen leeches to right iliac region, and tepid water injection. After the injection, there came away a small amount of fæces. Tuesday. Much the same as yesterday: passed a restless night, slept in his chair but a few moments at a time. Had a pretty free and natural passage of the bowels this evening. Passed a very little urine Pulse 110. Increased the calomel to 2 grains, opium 1 gr., every 4 hours. 9 p. m.-Suffering much pain; cannot lie down. Reduced the calomel to 1 gr., which, with the 1 gr. opium was continued every 4 hours. Ordered beef-tea every 20 minutes, and a tea-spoonful of brandy in water. every hour, and a large bran poultice over whole abdomen, to be followed by turpentine epithems. Wednesday.-Much easier this morning; slept a little during the night; walls of abdomen not so tense; passed about iij urine. During the day not so well, and at night bad as ever with the pains, &c. Vomiting returned. Ordered another poultice, but it gave no relief. Thursday.-Bowels tympanitic and very tender. Drew off about 2 oz. urine. Pulse 130. Breathing laboured. Gave him 8 grains calomel, in addition to the other treatment, but it had no effect on him. Passed a very restless and sleepless night in his chair. Friday. Abdomen more distended, and countenance gives signs of intense suffering. Abdominal tenderness greatest over upper part of right lumbar region. Great depression of vital powers; hands and feet growing cold, and is covered with cold clammy perspiration. Pulse 130. Saturday. Much worse. Has agonizing spasms of abdominal walls. Pulse 140. Omitted the calomel and opium, and gave grains morphia every 5 hours. Vomiting continues; retains nothing on his stomach. - Sunday. This morning at 5, after a violent attack of vomiting, his bowels opened, and had two free liquid dark coloured passages, which gave him great relief. At 9 a.m., was very weak but drowsy. Ordered him small quantities of beef-tea and brandy, alternately, every few minutes; but in place of this, they gave him bread and butter and steak to eat. Pulse, none in left wrist, and very small in right. Surface cold. 12 o'clock. Is dull of hearing, has no pain; eyes set. Ordered the beef-tea and brandy to be given as directed. Had another fluid passage and also passed a little urine. At 5 p.m., had two more fluid motions, when vomiting returned and continued more or less, up to 1 a.m. Monday morning, when he died. |