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IP E O C E E D IN G. S
OF THE
MICHIGAN STATE MEDICAL SOCIETY.
ANNUAL ADDRESS OF THE PRESIDENT, FOR THE
YEAR, 1868.
By J. H. Jerome, M. D., Saginaw City, Mich.
Gentleman Members of the State Medical Society of Michigan :
I enter upon the duties of this hour with no ordinary emotion.
My memory instinctively calls back the scenes of forty years
since, when, in company with my parents, brothers and sister,
after a voyage of six days on board the old William Penn, from
Buffalo, we made our landing at the City of the Straits.
Then in the freshness of my early boyhood, I soon knew all
there was in Detroit—each inhabitant by name—her chief citi-
zens, and her physicians, too, I well remember.
Drs. Henry, Hendry, Chapin, Hurd, Brown, Hall, Clark and
Whiting.
The latter two are the only survivors of that number, and the
early reminiscences of Dr. Whiting, given by himself on a con-
vivial occasion one year since, very much interested the members
of this body.
Of her chief men, few in number, were Woodbridge and Cass,
Majors Biddle and Kersley, Abbot, Conant and the Larnards,
Williams, Newberry, Chipman and Sibley, Richard Witherell,
Palmer and Wells, the most of whom have passed into silence.
The latter two, like the weather-beaten oak, have withstood the
shocks of time, and now upon the outer verge of human life, in
mental freshness and vigor, stand the honored and loved of all
who know them.
4 PROCEEDINGS OF THE
My honored sire, also, whose remains, consigned by the vener-
ated Wells, have slept in yonder cemetery for thirty-eight years,
still await their final summons.
These were not only the representative men of Detroit, but
were the representative men also of Michigan; as but little out-
side this, then embryo city, existed within the limits of the
Peninsular State, to mark or indicate its present or prospective
greatness.
The liner went forth with his chain and compass, meandering
her rivers and lakes—establishing base lines and meridians, divid-
ing the territory into counties and towns, and the latter, except
upon the principal meridians, were divided into thirty six sec-
tions, each one mile Square, and upon section sixteen in every
township was erected a pole, upon which was inscribed as the
foundation of the chief prospective glory of the State—“Sacred
to Public Education Stock.”
The foreign capitalist was not long in discovering the arable
nature of the soil—the beauty of its rivers and lakes—the rich
pineries of the more northern portion—the wide and deep waters
which so nearly surround it, insuring a more equitable climate
than that enjoyed by any of its sister States, as well as giving
unlimited facility to its commerce, and the sure guarantee of an
educational fund, quite equal to the fondest parental wish.
These were his warrant, not only for the investment of his
money in wildest measure, but for the creation of fancies more
vague than those which characterized the hardy Spaniard and his
compeers, who, under the reign of Ferdinand and Isabella, sought
in the new world untold wealth and honor from the ornamented
savage and the sparkling sands of every river and stream tending
to the coast of Florida—resulting, it is true, in the acquirement of
a State to their Sovereign, but in the most mortifying discomfiture
to the immediate actors in that tragic drama.
Such as remember the scenes of ’85 and '36, and the grand
finale of '37, in which the mere speculator in lands and paper
cities, which were as abundant as the varied imaginations of the
visionary men who fancied their El Dorado found in this new and
uncultivated State, will also remember that their fate was little
STATE MEDICAL SOCIETY. 5
less deplorable than that of the unsolaced Spaniard. Yet, not-
withstanding their discomfiture, an impetus had been given to the
slow, though steady and permanent developments of the sturdy
pioneer, who sought in it a home and a country, content with the
ordinary rewards of prudent industry. And the results which have
followed only demonstrate the correctness of the original theory—
the restoration of lost fortunes of the many, order from confu-
sion, universal thrift among the masses, only awaited the purify-
ing influences of time, and the development of the underground
and hidden resources in the realization of which we are now so
justly proud.
She has her representative men also, who are not only the
representative men of Michigan but the representative men of
this nation—holding no mean rank in the struggles through which
we have so recently passed.
Who but looks with honest pride at the record of achievements
of her braves upon the ensanguined field, amidst our struggles
for national existence—and by whom have our national repre-
sentatives been overmatched ?
Her salt, her ore and her lumber marts are scarcely equaled
upon this continent.
Yet there are other sources of gratulation to which educated
and philanthropic men may look with emotional interest.
Her common school system, securely based upon section sixteen,
sending forth her branches to culminate in the varied higher insti-
tutions of learning. *
In what State or country of no greater age is found so wide
diffusion of educational privilege 2
There is no pupil of whatever name, color, age or sex, but finds
an open door for an improvement of their stock of knowledge in
the common schools of Michigan.
This benign forecast has already wrought a great work, not only
in furnishing means of advancement to such as were already
here, but has contributed largely to swell the tide of emigration
hither. *
The time has fully come when the dependent classes every-
where are looking with eager solicitude for such advantages as
6 PROCEEDINGS OF THE
these; for few there are so poor, so abject, or so mean, as not to
desire for their offspring this rich inheritance.
How sacred, then, the obligation which binds the custodians of
this priceless legacy.
She has also her houses of refuge and her reformatory schools,
where the viciously inclined may learn and practice a better way.
She has her hospitals, infirmaries, and asylums, too, which stand
as beacon lights to the providentially bereft of the comforts of
home and domestic friendships when overtaken by casualty, or
under the depressing influences of mental or physical disorder.
Is there anything more God-like in this world than the erection
and full equipment of institutions where the sick, the lame, the
palsied, the blind, the deaf, the speechless, or those providentially
bereft of reason, may find a home and a shelter from the pitiless
awards of individual charity ? And so far as human agency may
or can go to assuage their sorrows, relieve their sufferings, restore
their reason, and bring into communion with the rest of mankind
the sightless eye-ball, the palsied auricular drum, and the tongue
that fails of utterance.
Who could covet a greater honor than a recognized agency in
the establishment and endowment of institutions of this character?
Such names will live when the mere speculator in lands and
lucre will have perished and been forgotton.
Is it arrogance in me to claim with unpretending confidence
that foremost in the creation, maintenance and perpetuity of
these institutions were the members of the medical profession in
this State 2
Such has been the history of kindred institutions elsewhere,
and I hesitate not, therefore, to claim for you, brethren, this high
prerogative.
If these achievements are mainly the result of isolated and
individual labor of the physicians of this State, how much more
may and ought to be accomplished by the combined and organ-
ized effort of the entire membership of the medical profession ?
If nothing more is done than to imitate the example of the
older States, these institutions will find valuable auxiliaries in the
local and general organizations of medical men.
STATE MEDICAL SOCIETY. 7
To what institutions do the inhabitants of every city, town and
neighborhood of the Empire State look with more self-gratulation
and honest pride than her houses of refuge, her insane asylums,
her asylums for the benefit of the mute, the deaf and the blind,
each enjoying a State patronage, and diversified in their location
for common convenience and benefit 2
In her great city of New York, too, who prides herself in her St.
Luke's, her Bellevue and her New * hospitals—each securely
based upon the people's affections and benevolence, dispenses its
, good offices alike to the victims of casualty or disease.
Of what denizen of that great city might you inquire for the
whereabouts of these several institutions who could not point you
to their precise locality?
They are in their thoughts and in their affections. Their great
hope centers there, when self-reliance pales before the inroads of
disease or unforeseen accident. And just across the channel—
upon Blackwell's Island—the last earthly home of the fallen, the
degenerate, the outcast of either sex, from every garret, cellar,
lane or by-way of that great world in miniature—where the frag-
mentary remains of the human form divine are assisted to rally
their shattered mental and physical forces, and for a brief day,
with as much of reason's power as to them remain, retrospect a
misspent life, and perchance seek, and obtain pardon of Him
against whom they have offended.
Are these some of the monumental trophies due to the toils and
the sacrifices of medical men of that great city and State 7
None so foolhardy as to deny what most gladly affirm.
Also is it true in degree in every other State of this Union.
And if we chance to trace our lineage across the water, we shall
find in the hospitals of London, of Paris, of Dublin, of Edin-
burgh and Berlin, our great prototypes whose antiquity and well
deservings are known and appreciated in all lands. º
These achievements spring not, gentlemen, from the brain of
the men of one idea; they originate in no pathy nor ism; no
day dreamer or sir oracle has brought them forth; they come not
of incantations or juggler's device; but upon the farther side of a
gulf, so rugged, so deep and wide, that none of these might safely
8 PROCEEDINGS OF THE
pass, are found the men of large and cultivated minds, with the
broad domain of nature spread out before them, arranging their
chemical laboratories and dissecting rooms; invoking to their aid
the greatest degree of microscopic power; taxing all science and all
learning to their utmost tension, in bringing forth integral
and well authenticated facts; arranging and classifying their
material; testing their application to the human organism, in
health and in disease; laying deep and broad the foundations
upon which to build the great (in part realized) superstructure of
rational medical science.
And from this class of investigators, spring the varied institu-
tions to which we have alluded, with as unvarying certainty as the
blossom and the fruit from the parent stock, firmly rooted in
genial soil, and watered by the dews and rains of Heaven.
Such then is our ancestry, and could you have done less, gentle-
men, and not proven recreant to the high trust handed down to
you through the long ages of patient toil of these devoted men,
leaving not only their accumulated trophies but a record of their
attainments and methods of investigations?
Thus endowed, could the medical men of Michigan have sat
tamely still and added no brick nor stone to this edifice, and been
content?
Does each member of this State organization feel their personal
responsibility to do something by which he may mark the sands
of time, and leave his footprint there? Can we fail to emulate
our ancestry and strive with our co-laborers of the present day to
add new material to the accumulated wealth of ages? Such is
our manifest duty, and such, too, gentlemen, is our high privilege.
And to this end, I trust our present organization tends with most
unerring certainty. *
Were I a member of the medical fraternity of the antediluvian
stock, and just rallied from my long and dreamless slumber, to
behold the status to which my postdiluvian brethren had attained;
their accumulated libraries, with no evidence of having been satu-
rated by the flood, their institutions of learning, and all the fruits
that have germinated and ripened therefrom, I might readily
conceive that there could have been no hindrances or lions in
STATE MEDICAL SOCIETY. 9
their path; nothing to detract from or mar the edifice; but the
rather, that all had brought their contributions hither, and with
pious devotion cemented them together with their prayers and
their tears.
Such fancies however, gentlemen, will not bear the test of his-
toric record: as from the beginning, and through all time, indeed,
the gateways to the temple have been thronged with the represen-
tatives of isms and pathies, and doctrines, and dogmas, each
emblazoned upon their front and rear, in large and golden letters
—Eureka / Eureka f Eureka 1—and multitudes of obsequious
disciples have said–Amen.
The domain of medicine has been a sort of fairy region, where
the visionary theorists, with their air-built castles and speculative
fancies have roamed in search of the hidden elixir of life. Such
investigators have astonished the world hitherto with their discov-
eries; their isms and pathies in counter numbers have swarmed
along the pathway of medical science, and their adherents, too,
have sounded out their praise with trumpet tongue.
There has been vitalism and organism, humoralism and
mechanicalism, eclecticism and galvanism, beside a multitude with-
out number of minor isms. And where are they now 2 Echo
alone answers where. They have dissolved into thin air, like the
frost-work of an autumn's night; or have crumbled away from
their own inherent rottenness, or overborne by their own unsup-
ported and top-heavy weight, while around their final rest-
ing place their few remaining disciples who had hoped their
deliverer come from the pains and penalties of a broken law,
gather to pay sepulchral honors.
Are they dead, brethren, or do they sleep? They are not dead,
but as the caterpillar of to-day coils himself in some nook or
cranny, to await the coming of the new year, when his successor
on gilded wing shall come forth far more beautiful and attractive
than the original worm,
With my own views of the correct basis of antagonism, with
the varied isms and pathies of the day without unusual reason I
could not in this presence make mention of a living pretender,
And what I may deem proper to present on this occasion of
2
10 . PROCEEDINGS OF THE
kindred character I trust will find a sufficient warrant in the
circumstances which call it forth.
In the enumeration of institutions which have arisen to benefit
mankind within the limits of this new State, I did not make men-
tion of the crowning glory of the educational system.
In the abundant provision made for the common schools in the
bestowment of sections sixteen, the higher educational wants of
the many, who otherwise would seek such advantages elsewhere,
were not overlooked by the general government, hence the award
of seventy-five sections of government land as the foundation of
a University where, superadded to the ordinary acquirements of
an educated man, the well settled principles of science, of law, of
medicine and surgery, might lend to it their luster and attractive-
ness. With this understanding, and in the spirit of legitimate
rivalry the foundations of this institution were laid, and after the
few years of its juvenile experience were, successfully passed was
enabled to lay aside its swaddling bands and assume a bolder
front, and press the soil with firmer foot.
Seventeen years since the medical department was organized.
The professors of the several branches to be taught entered upon
their respective duties, conscious of the disparity of their frontier
position, remote from hospitals or clinic of any kind, the privi-
leges of which are so highly important to the medical student.
Opposed to these were the benefits of a comparatively free
tuition afforded in the University.
Kindred institutions, like situated elsewhere on the basis of full
tuition, were dwarfed—however well appointed with teachers—
with laboratories and museums. *
The success or failure must, therefore, depend upon the genius
and ability of the professorial Board.
The present condition of the University, its reputation at home
and abroad, must attest to the manner in which each has dis-
charged the high duties assigned them. - w
If we examine the catalogues of the medical department from
year to year, which is the true test of widening popularity and
growing importance, we find that Michigan, though nearly a unit
STATE MEDICAL SOCIETY. 11
in its patronage, furnishes but a small proportion of the five
hundred or more which annually congregate there.
Nearly every State in this Union, as also the British provinces,
furnish their regular quota, evincing the esteem in which the
institution is held by the medical practitioner far and near.
And whilst a member of a medical faculty, in a sister State,
with no endowment, we were compelled to acknowledge your
attractive power and yield homage thereto. t;
And such has been the experience of all unendowed institutions
void of varied and available clinic,
In the national medical counsels no institution took higher rank
through their representatives than the medical department of the
University of Michigan.
Their labors to advance the standard of medical education in
this country is a recognized and felt existence. And in the con-
vocation of medical teachers at Cincinnati a little over one year
since, the requirements of the University in this direction were
listened to with most profound attention.
It may not be anticipated by the friends of this school that it
can rank with New York, Philadelphia or Chicago, as a graduat-
ing institution, as the wants of hospital and clinic advantages are
insuperable barriers to this. Its highest aim, therefore, is to
become a first class primary school, whose paper shall never beat
a discount with any institution in this country, but a ready pass-
port to favor wherever presented. Its success in a pecuniary
sense, also, cannot fail to attract commendatory notice from those
who watch over its financial interests. While the remaining
departments, save one, have failed in a most signal degree to meet
the current wants from the amounts received of pupils attending,
demanding constantly large sums from the avails of the original
grant for the payment of its corps of teachers. -
The medical department has met all the pecuniary demands
upon it from the mere nominal sums paid by each student attend-
Ing. \ , &
I feel illy competent, gentlemen, to pay the tribute due to the
profession at large, who have so nobly seconded the efforts of the
Faculty in their great endeavor, and much less to speak in fitting
12 PROCEEDINGS OF THE
terms of the Faculty themselves. It is a pleasing duty to honor
merit wherever found, and to the medical practitioner the suc-
cess of his alma mater is the joy of his thoughts, and to be worthy
of this is the great hope of the teacher. That an institution of
this character in the midst of a rural population, destitute of all
the prerequisites to a medical education, with no prestige to plead
in extenuation of the temerity of the undertaking, should have
arisen to its present altitude of moral grandeur, is the problem
which challenges the attention of every educator of medical men
at home or abroad, and to-day stands without a parallel upon
this continent.
I speak thus in no spirit of arrogance, as it was not my privi-
lege to share in this great accomplishment. I am comparatively
a stranger in your midst, but as a stranger may be permitted to
weave a garland to your memory, and honor the achievements
which you have attained. A
“The heights by good men reached and kept,
Were not attained by sudden flight;
But they, while their companions slept,
Were toiling upward in the night.”
That this most wonderful success should entitle the professors
of this department to the lasting consideration and gratitude of
the legal guardians of this institution is the common understand-
ing. No other conclusion can be reached from any stand-point
based upon the touchstone of experience and success.
Yet when the University, as a whole, demands enlargement for
the better accommodation of its growing patronage, and the main-
tenance of its prestige, requiring aid beyond the limits of its
original endowment, and an application is made to the State
Legislature for such purpose, they are met at the threshold with
the seducer's proposition—that if the only self-sustaining depart-
ment in the entire institution, with the single exception of the
law, will doff its chastity, prostitute its virtue, lay aside its dis-
tinctive characteristics, and cohabit with the merest tissue of
fanciful speculation that ever issued from the brain of a pre-
tended philospher, and give tone and character to a more than
half extinct dogma—the sugar-plum of their debasement shall be
meted out--a proposition more monstrous who can conceive?
STATE MEDICAL SOCIETY. 13
It is not my purpose, gentlemen, to characterize the Legislature
with hard and uncouth names, but simply to indicate their inapt-
ness to judge of the merits of a profession, the alphabet of which
they have never known.
Would it be too much for me to hazard the opinion that there
are those who have exercised the right to vote upon this question
who know so little of their own organism as not to know whether
they expectorate from their liver or lungs, or whether digestion is
performed by the heart or stomach, and that very few of that
body can explain to you to-day the manner in which the body is
nourished, or the circulation of the blood maintained.
Their good intentions, perhaps, we may not question, yet the
recorded examples of unadvised political interference in regulat-
ing cures, and medical institutions, prompted by their own know-
ledge or speculative wish, fail to commend themselves to the test
of time and experience,
Once in the exuberance of sympathy for the smitten of hydro-
phobia, the Legislature of the Empire State gave a large pecu-
niary reward to an inventor of a cure for that terrible malady,
and whether the cure or the money were the first to disappear
history does not affirm. And another example is found in the
Quarantine Hospitals of the port of New York, in which not
only the State of New York but the entire West are so deeply
concerned, which became a prey to political doctors, and not-
withstanding the large yearly appropriations for the establishment
of suitable quarantine hospitals and grounds for the reception and
care of those sick with the various infectious and contagious dis-
orders who arrive at that port, the only provision for the last
eight years which has existed, is the hulk of an old steamer,
divided into different apartments—launched upon the restless
waters of the bay of New York, where it can only remain during
the summer season—swaying to and fro by its cables, as the
receptacle of patients sick with yellow fever, ship fever, small-pox
and cholera. An abiding commentary upon purely political
regulations for the sick.
This entirely inadequate provision is the prolific source of our
malignant typhus fevers and cases of small-pox, so often found
14 PROCEEDINGS OF THE
among the newly-arrived emigrants, from which the older inhabi-
tants suffer so much from unavoidable contact. To the honor of
the Board of Regents it may be said that the legislative proposi-
tion was so repugnant to their sense of justice and propriety as
to cause them to repel with just indignation the proffered aid,
pregnant with such humiliating conditions, and for a time
the friends of the University, reposing confidence in the virtue
and stability of these guardians of a sacred trust, felt no con-
cern for its safety or welfare.
Such tempting bait, however, could not long remain on any con-
ditions within their grasp, without producing its usual effect.
And the solution of the difficult problem was undertaken upon
a purely financial basis, and after a year's delay and a habit of
familiarizing the mind with the subject once so abhorrent to their
better sense, and the interposition of Divine Providence in the
removal of an honored member of their board, with most unfortu-
mate substitution, the obstacles once so formidable were so far
modified as that this legislative bantling might be led by some
circuitous and unfrequented route to the rear portals of this
temple of science, and introduced to fellowship.
“Vice is a monster of so frightful mien,
That to be hated needs but to be seen ;
Yet seen too oft, familiar with its face,
We first endure, then pity, then embrace.”
Thus much having been accomplished by the Regents of the
University, left no alternative for the professors of the medical
department, other than to retire from the field of their long and
cherished labors, in obedience to the behests of those who had the
legal right to control its destinies.
However much the profession may deprecate this necessity,
none, I trust, will fail to appreciate and honor the conclusions to
which they have arrived, and give to them their practical and
most cordial support.
Thus situated, we may pertinently inquire, what becomes the
duty of this organization ?
Are we, therefore, to spend our force in combating this puerile
dogma, which from its infinitesimal proportions and power of self-
adjustment, is enabled to insinuate itself like an unpleasant odor,
STATE MEDICAL SOCIETY. 15
through the smallest imaginable crevice, and raise its tiny head
upon the other side of the dividing wall which separates between
medical science founded upon analytical research and rational
induction, and the dreamy fancy of this German pretender 2
Whoever may answer this in the affirmative I trust will give it
no wider latitude of meaning than that the onward duties of the
profession involves a perpetual antagonism to every species of
superficial device.
These occasional wounds serve as additional stimuli to urge to
greater diligence the devotee to medical science. The popular
eclat which so frequently attends the introduction of some new
born delusion, may not mislead you. Neither should it in the
least degree swerve you from the path of duty rendered so plain
by the fruits of centuries past, and so thoroughly attested by your
own experience in the many trials to which you have been sub-
jected in the course of practical life. The problem of the Univer-
sity will work its own solution.
The signs of the times but too plainly indicate the determina-
tion of the medical world upon that subject. Having been set at
defiance by the guardians of this honored institution, and the
attention hitherto given it by the profession canceled by their own
deliberate act, no alternative remains but the simple exercise of
a wholesome self-respect.
And if we may not cherish, we are not forbidden to let it alone.
And this, I trust, will be the only method of antagonism
adopted by the State Society. & *
Let it alone—there are other fields to cultivate, and having no
time to fritter away in wordy combat for the mere bauble of fleet-
ing popular applause, our only legitimate endeavor should be in
the direction of still higher attainments through the instrument-
ality of the organization here adopted.
These yearly convocations, gentlemen, where we may meet and
greet each other, bringing to the common storehouse the fruits of
the past year's experience, are to the medical profession as the
oasis of the desert to the weary traveler, who, after many days'
journey over the heated sands, and scorched by the rays of a ver.
tical sun, approaches the cluster of trees and herbage with their
16 PROCEEDINGS OF STATE MEDICAL SOCIETY.
verdant branches, and the cool spring bubbling in the midst, where
he may loose himself from the trials and cares of the journey,
relax his wearied muscles and overwrought nervous energies, slake
his parching thirst, recount his toils past, and estimate the future.
To him who rightly weighs the responsibility of the charge so
often committed to the physician's care, the many hopes and the
many fears that center in him, whose every expression of eye and
feature cheers or saddens the hearts of cherished friends, while
the life of one dear to them all is quivering in the balance,
depending next to his God upon the skillful and well directed
agencies of the physician of his choice.
The result is no matter of indifference to him—and if perchance
death waits upon his charge, and the many hopes which were
centred there are blasted forever, where is the solace for him who
has been baffled in the combat and overwhelmed with defeat.
If found at all it is in the reflection that I have discharged an
intelligent duty.
What a priceless boon—professional self-complacency based
wpon competent knowledge.
To this attainment, gentlemen, allow me most cordially to invite
you.
MINUTES OF THE CON WENTION
FOR THE ORGANIZATION OF A
STATE MEDICAL SOCIETY,
Held at Detroit, June 5th, 1866.
ON Tuesday, June 5, 1866, the Convention assembled at the
Supreme Court room, in Detroit, there being present about one
hundred gentlemen, representing all parts of the State.
The proceedings were initiated by appointing Dr. Gunn to the
chair, and Dr. Axford, of Flint, as Secretary.
Dr. Morse Stewart, on behalf of the medical profession of
Detroit, addressed the delegates as follows:
JPhysicians of Michigan—Gentlemen :
I am honored by being called to represent the fraternity of
Detroit in welcoming you to our city. The business which has
brought you among us concerns every member of the profession
throughout the State, and I need scarcely assure you that we here
are in full sympathy, in respect to this matter, with our brethren
of the interior. The truth is, by neglecting to keep up our
organization during the last four years, we have failed to promote,
properly, the advancement of medical science, individual growth
and development, and through these the great and ultimate
object of our profession, the welfare of society. While interests
as important as those which involve the health and lives of our
fellow-men are intrusted to us, we should be derelict in omitting
any means of conserving them. All experience teaches that con-
cert of action and thought is essential in every enterprise in
which communities are engaged. Especially is this the case with
the practice of medicine; for in it there is need as much for
analysis, classification, and arrangement, as for close and careful
3
18 PROCEEDINGS OF THE
observation of numerous and varied phenomena, in educing facts
and evolving principles which are to be the guide of coming gem-
erations. In medicine, peculiarly, experience is the great
educator, and every physician, whatever his talent or position in
society, may, and ought, to give his quota to the general stock;
but it all needs to be assorted and combined. For this purpose
organization and union are indispensable. We have come
together now to atone, as far as in us lies, for the past, and by
this reunion to reorganize and revivify our State Medical Society,
How, with an almost oppressive sense of personal responsibility,
in view of the relation which our profession sustains to the well-
being of man, and with hearts expanded by an enlarged charity
so as to exclude individual selfish aims, should we enter upon the
duties which are before us! I doubt not, gentlemen, that under
the promptings of such feelings you have assembled here, and that
your deliberations will be marked by harmony, and so conducted
as shall tend to the increase and diffusion of medical knowledge
amongst us. In behalf of Detroit and her citizens I bid you, as
representatives of the various sections of our still young, but
already great and prosperous Michigan, a cordial welcome to this,
her commercial capital.
On motion of Dr. Platt, of Grand Rapids, a committee of five
was appointed to report a Constitution and By-laws for the action .
of the Society. Drs. Platt and Armor, of Detroit, Wood, of
Grand Rapids, Ranney, of Lansing, and Andrews, of Niles, were
designated as the committee, and withdrew to prepare their
report, during which time proceedings were suspended.
Upon the adoption of the report of the committee, it was
moved and carried that the Constitution be adopted section by
section. After considerable discussion the Constitution was
adopted nearly as reported by the committee, and is embodied in
the following items:
Resident members, who become such upon furnishing the proper
credentials, paying the initiation fee of two dollars, and signing
the Constitution and By-laws, are required to be members of
local Societies, where such exist, and to furnish to the committee
an admission certificate of membership from each society.
STATE MEDICAL SOCIETY. 19
Honorary members are limited to one hundred, and are to be
elected by a two-third vote of the members present.
The officers are a President, four Vice-Presidents, a Treasurer,
a Recording and a Corresponding Secretary; each to be elected
by ballot and majority vote. The standing committees are four in
number, to be appointed by the President, and to consist of five
members each. The committees are : 1st, Executive; 2d, on
Finance; 3d, on Publication ; 4th, on Medical Ethics. A Com-
mittee on Admissions shall be elected annually by ballot.
The By-laws provide that the time and place of each meeting
shall be determined upon by the Society at the previous meeting.
Fifteen members constitute a quorum.
The Code of Ethics adopted is that of the American Medical
Association.
The election of officers was next proceeded with, and the follow-
ing gentlemen hold the first term of office :
Dr. C. M. STOCKWELI, President, Port Huron.
Dr. A. PLATT, First Vice-President, Grand Rapids.
Dr. J. H. JEROME, Second Vice-President, Saginaw City.
Dr. J. H. BEACH, Third Vice-President, Coldwater.
Dr. — BONINE, Fourth Vice-President, Jackson.
Dr. HENRY F. LYSTER, Treasurer, Detroit.
Dr. GEO. E. RANNEY, Recording Secretary, Lansing.
Dr. G. P. Andrews, Corresponding Secretary, Detroit.
Committee on Admissions—Drs. A. Platt, Grand Rapids;
Stebbins, Armor, Stewart and Brummé, Detroit.
A communication was then read by the Secretary from the
Mayor, inviting the Convention to visit the House of Correction
on Wednesday at nine o'clock.
The Society then adjourned to meet in the evening.
Evening Session.
The meeting having been called to order a resolution was passed
to accept the invitation of the Mayor.
The question of the time and place for the next meeting coming
up, after a good humored discussion the first annual meeting was
appointed to be held at Detroit, on the first Wednesday in June,
1867.
20 PROCEEDINGS OF STATE MEDICAL SOCIETY.
Dr. Jerome, of Saginaw, then moved that the following commit-
tees, to consist of three members each, be appointed to report at
the next annual meeting, upon the following topics:
1. Medical Hygiene—Upon which were appointed Drs. A. B.
Palmer, of Ann Arbor; D. O. Farrand, of Detroit ; C. Paddacke,
of Pontiac.
2. Vital Statistics—Drs. Stewart and Noyes, Detroit; Richard-
son, Niles.
3. Surgery—Drs. Gunn and Lyster, Detroit; Knight, Utica.
4. Practice of Medicine—Drs. Axford, Flint; G. P. Andrews,
Detroit; Topping, Bay City.
5. Obstetrics—Drs. E. W. Jenks, Detroit; Plessner, Saginaw
City; Chipman, Grand Rapids.
6. Zymotic Diseases—Drs. J. H. Brown, Detroit ; E. P. Chris-
tian, Wyandotte;
7. Epidemics—Drs. DeCamp, Grand Rapids; Cornell, Ionia;
Mitchell, Saginaw City.
8. To Examine and Decide upon Voluntary Contributions for
Presentation to the Society—Drs. Theodore A. McGraw and E.
W. Jenks, Detroit; Jno. Brady,
The Society voted to sustain, by their support and patronage,
the Detroit Review of Medicine and Pharmacy.
The following gentlemen were appointed delegates, with power
to name substitutes, to the next meeting of the American Medical
Association: Drs. J. R. White, Saginaw ; D. A. Post, Ypsilanti;
C. T. Southworth, Monroe; DeCamp, Grand Rapids; J. R.
Thomas, Bay City; Wm. Brownell, Utica; T. Foster, Kalamazoo.
Upon the Executive Committee were appointed Drs. Pitcher,
Armor, and Brown, of Detroit. Upon the Committee on Publica-
tion, Drs. Andrews and Lyster, of Detroit, and Ranney, of Lam-
sing. The Committee on Ethics are Drs. A. Platt, of Grand
Rapids; Farrand, of Detroit.
Upon motion the Convention adjourned to meet on the first
Wednesday in June, 1867, in Detroit.
VISIT To THE HOUSE OF CORRECTION.—On Wednesday the
gentlemen of the Convention who were still in town, escorted by
Mayor Mills, visited the House of Correction, where the Superim-
tendent, Mr. Brockway, accompanied them through the establish-
ment, and explained the details of management.
MINUTES OF THE FIRST ANNUAL MEETING
OF THE
MICHIGAN STATE MEDICAL SOCIETY,
Held at Detroit June 5th and 6th, 1867.
THE members of the Society assembled at the Supreme Court
room at 11 o'clock. The President, Dr. C. M. Stockwell, not
having arrived, the Society was called to order by Vice-President
Dr. A. Platt. While awaiting the announcement of the order of
business, on motion of Dr. Jerome, Dr. Palmer, Chairman of the
Committee on Hygiene, read an interesting paper on the subject
referred to that committee, which, on motion of Dr. Topping, was
accepted and referred to the Committee on Publication.
Dr. Armor, Chairman of the Executive Committee, then
reported the following order of business:
1. Reading of the Minutes.
. Annual Address of the President.
Reports of Standing Committees.
Voluntary Communications.
. Miscellaneous Business.
. Election of Officers.
The Committee on Admissions recommended the following
named gentlemen to become members of the Society:
J. S. Caulkins, Thorneville.
A. E. Leete, Romeo.
PIamilton E. Smith, Detroit.
Alonzo Harlow, Detroit.
Gordon Chittock, Jackson.
:
22 PROCEEDINGS OF THE
P. P. Gilmartin, Detroit.
T. A. Fairbairn, Detroit.
J. M. Swift, Northville.
J. M. Bigelow, Detroit.
James Harvey, Romeo.
S. W. Allen, Grand Rapids.
Louis W. Fasquelle, St. Johns,
Charles Shepherd, Grand Rapids.
C. B. Gilbert Detroit. t
I. H. Bartholomew, Lansing.
Henry O. Walker, Detroit,
G, Archie Stockwell, Port Huron.
Samuel P. Duffield, Detroit.
Wm. Brodie, Detroit.
O. E. Bell, Oxford.
J. C. Wilson, Flint.
* Z. Pitcher, Detroit.
P. F. Taylor, Bellevue.
H. F. Ewers, Union City.
E. P. Christian, Wyandotte.
On motion of Dr. T. A. McGraw these gentlemen were declared
elected members of the Society.
The Secretary read a communication from Mr. Frederick
Stearns, inviting the members of the Society to accept the hospi-
tality of his house during the evening, which was accepted.
On motion the Society adjourned to meet at 2 o'clock P. M.
Afternoon Session.
The session was resumed at 2 o'clock. President Stockwell in
the chair. º
The minutes of the morning session were read and approved,
after which the President delivered his Inaugural Address, which,
on motion, was referred to the Committee on Publication.
The report on vital statistics was called. Dr. Noyes, from the
committee appointed to report on this subject, stated that no pro-
vision existed in the State for keeping such statistics, and the
committee were unable to obtain any general information upon
STATE MEDICAL SOCIETY, 23
the subject that would be of value to the Society at the present
time.
Dr. Jenks, Chairman of the Committee on Obstetrics, made
quite a lengthy and very able report, which was referred to the
Committee on Publication.
Dr. Lyster, from the Committee on Surgery, read an interesting
report, which was accepted and referred to the Committee on
Publication.
Dr. McGraw stated that two volunteer papers had been pre-
sented, which, with permission of the Society, would be read,
Granted.
Dr. Bigelow then read an interesting paper, announced as
“Facts relating to medicine in the topography, climatology, and
ethnology of the Southwestern States and Territories.”
Dr. Palmer then addressed the Society regarding the proceed-
ings of the Teachers' National Medical Association at Cincinnati,
Adjourned until 9 o'clock Thursday morning.
SECONID DAY.
THURSDAY, June 6.
The Society re-convened at 9 A.M. at the Supreme Court room.
The minutes of the previous meeting were read and approved.
Dr. Bigelow read a voluntary communication, entitled “Notes
on a species of fungus growing upon the Nesaea verticillata.”
This fungus is a sort of outgrowth of a plant harmless in itself,
Drs. Mitchell, of New York, Raffinesque, Lindley, Tully and
others, have reported in various publications upon the effects of
the Nesaea or Decodon verticillata as being baneful to farmers in
causing abortion in various domestic animals, such as sheep, cattle
and horses, browsing upon it. The general character of the order
to which this plant belongs is well known to be so mild and
inert as to excite surprise with regard to such effects being attri-
buted to it. In collecting specimens last winter, it was found that
there were great quantities of a parasitic fungus growing upon
it. From analogy it is argued that this fungus is the cause of the
24 , PROCEEDINGS OF 'THE
•
mischief produced in animals, and if such be the fact there can
be no doubt that it possesses some of the peculiar properties of
ergot, as ergot, in addition to its echolic powers, possesses.other
highly poisonous principles, which render it exceedingly hazard-
ous, and as this fungus does not seem to possess those poisonous
principles, the inference is that it is a much safer article to use in
common practice. The object of the paper was to bring to the
attention of physicians practicing in the State what little we
know with regard to it, so that reliable, practical observations and
results may be attained. f :
The communication was referred to the Committee on Publica- .
ition.
On motion of Dr. Jenks, of Detroit, a committee of five was
appointed by the Chair to report on the therapeutical effects of
the medicine discussed in the essay, and collect such facts pertain-
ing thereto as may be of interest to the profession, to be presented
at the next annual meeting, consisting of the following gentlemen:
Drs. Jenks, Jerome, Platt, Brummé and Sheppard.
y
Dr. S. P. Duffield then read an essay on “Gelsemium,” giving a
description of the plant, its history and use. It is sometimes
called wild jessamine, yellow jessamine and woodbine. He desired
to call the attention of the regular profession to its properties, in
order to place it in a true light in the United States Pharma-
copoeia. It now occupies the secondary list, and will continue
there until the profession determines more explicitly its medical
properties. He also urged the benefits such a study would be to
the cause of Toxicology. The paper was referred to the Commit-
tee on Publication. -
Dr. A. Platt then read a short obituary notice on the late Dr.
John Delamater, formerly professor in the Cleveland Medical
College, speaking in high terms of his abilities and worth as a
physician and educator. {}
Drs. Jerome, Platt and Noyes, were then appointed a committee
to draft a biographical sketch of the life and death of Dr. Dela-
mater, of Cleveland, Ohio, and they subsequently reported as
follows: *
STATE MEDICAL SOCIETY. 25
Resolved, That in the death of Dr. John Delamater, of Cleveland, we
acknowledge the beneficence of an all-wise Providence in prolonging to a
ripe old age one whose life was so ardently devoted to the good of his
race; ennobling thereby the profession of his choice, through which
medium he was enabled to accompli h the great amount of good which
we this day recognize, and to recommend his many and known virtues to
his surviving co-laborers in the medical profession.
The resolution was unanimously adopted.
A communication was read from Dr. Stebbins, of this city, who
was unable to be present, in reference to the law on the registra-
tion of marriages, births and deaths. He spoke of the objec-
tions the law met with when the subject was before the Legis-
lature, and urged the necessity of prompt action by the medical
profession to see that the law was faithfully enforced, claiming
that unless it was, no good would result therefrom. He wished
the matter submitted to a committee, to report a resolution to be
brought before the Society for the purpose of expressing an opin-
ion of what ought to be done, and what the Society will do
towards urging its enforcement. If something is not done by the
Society, he believed the law would become a dead letter.
Dr. S. L. Andrews moved that a committee be appointed to
confer with the Secretary of State, to investigate as to what are
the best means to be adopted for carrying into effect the law on
registration adopted by the last Legislature, and report at the
next meeting. The motion was adopted, and Drs. S. L. Andrews,
T. A. McGraw, Bartholomew and Stebbins were appointed such
committee.
Dr. Bartholomew, of Lansing, stated that the reason why a
better registration law was not passed by the Legislature, was,
that the members were wholly unacquainted with the needs of
the medical profession in this respect, and moved that Dr. A. B.
Palmer be appointed a committee to prepare a suitable bill, to be
submitted to the Legislature at its next session, for passage, and
that the committee report at the next meeting of the Society.
Motion laid on the table.
Dr. Klein, of this city, favored a more stringent law on the
subject of registration, and stated that in all European countries
the law is very strict in this respect, and the births, marriages
4
26 PROCEEDINGS OF THE
and deaths are recorded very shortly after they occur. The
manner in which the subject of registration is treated in this
country, he considered to be disgraceful in the extreme, and
stated that there were large numbers of Americans who were
unable to name the day or even the year in which they were
born, because they were not in black and white. He believed
this subject should be brought before the Constitutional Conven-
tion. The subject was then temporarily laid upon the table.
The Chairman acknowledged the receipt of a printed copy of
the Proceedings of the New York State Medical Society, and on
motion of Dr. Armor, a vote of the Convention instructed the
Secretary to return its thanks for the documents, and transmit a
copy of the resolution to that body.
Dr. Brodie suggested that the time of the meeting of the Soci-
ety be changed, deeming this a very unfavorable time for a large
attendance of members. Dr. Bartholomew, of Lansing, concurred
in this, and suggested that the meeting be held at Lansing on the
third Wednesday of January. The Legislature would then be in
session, and he felt assured that the proceedings of the meeting
would be ordered published by the Legislature. He made a
motion that the next meeting be held at Lansing at the time
above mentioned, which was adopted.
Dr. DeCamp gave notice in writing, that, at the next annual
meeting of the Society he should offer the following:
Resolved, That an additional section be added to article 4, section 2, of
the By-laws, which shall require of each member the payment of two
dollars annually, which sum shall entitle him to one of the printed copies
of the Society's transactions, whenever published.
Sec. 2. Any member failing to pay the same for a term of three years
shall no longer be considered a member. *
On motion of Dr. Andrews, of Romeo, the thanks of the Soci-
ety were tendered to Mr. F. Stearns for the pleasant entertain-
ment he had given on Wednesday evening.
Dr. Foster, of Otsego, offered a resolution, which was adopted,
that no physician admit into his office a student until he was sat-
isfied that the applicant possessed all the fundamental qualifica-
tions necessary to make him an ornament to the profession, inas-
STATE MEDICAL SOCIETY. 27
much as it was a duty which every practitioner in good standing
owed to the public, and it would have a tendency to rid the State
of men who were not qualified for the practice of medicine.
The following resolution was then passed:
Resolved, That in the Detroit Review of Medicine and Pharmacy, we
recognize a medium through which the members of the medical profession
of Michigan may hold that kind of interchange of thoughts and expe-
tiences, which challenges our universal patronage.
On motion of Dr. Brodie, the Treasurer was authorized to pay
the publishers of the Review $50, to reimburse them for publish-
ing the Minutes of the Society, and to pay the janitor of the
Supreme Court Room for his attention in keeping the hall in
order, $15. Adopted.
By the same, that a committee be appointed by the Chair to
nominate all the officers of the Society for the ensuing year except
President and Vice-presidents. Carried.
Drs. Brodie, of Detroit; Shepherd, of Grand Rapids; Leete, of
Romeo; Foster, of Otsego, and Bartholomew, of Lansing, were
appointed such committee.
The Chairman then, in behalf of the Society, acknowledged the
receipt of a bottle of Swedish leeches of a rare variety, from J. A.
Drexel, of Detroit, who had recently imported them from Europe.
The Society then adjourned till 2 P. M.
AFTERNOON SESSION.
At the appointed hour the Society met, the President in the
chair, The Secretary read the Minutes of the morning session,
which were approved.
Dr. Brodie offered a resolution to continue the Special Com-
mittee on Registration, and that they be instructed to report at
the next meeting such amendments as are necessary for the per-
fection of the law desired. Adopted.
On motion, the convention then proceeded to ballot for Presi-
dent. Dr. J. H. Jerome was elected on the second ballot, and
the vote made unanimous. Drs. Charles Shepherd, of Grand
Rapids, Samuel G. Armor, of Detroit, J. H. Bartholomew, of
28 PROCEEDINGS OF STATE MEDICAL SOCIETY.
Lansing, and Albert E. Leete, of Romeo, were elected Vice-
presidents.
The report of the Special Committee on Nomination of Officers .
was received and accepted, and Dr. Zina Pitcher, of Detroit, was
| selected to cast the vote of the Society, and the result was the
choice of Dr. Geo. P. Andrews, of Detroit, as Corresponding Sec-
retany, and Dr. A. Platt, of Grand Rapids, as Treasurer.
Drs. Brodie and Jenks were appointed a committee to conduct
the newly elected President to the chair. He briefly thanked
the Convention for the honor they had conferred upon him, and
asked the aid of the members in discharging the duties of the
position.
On motion of Dr. McGraw, a vote of thanks to the retiring
officers was passed.
A committee of three, to revise the Constitution and By-laws,
was then appointed, consisting of Drs. Brodie, McGraw and H.
E. Smith, all of Detroit.
On motion, a vote of thanks was tendered to the Chief Justice
of the Supreme Court for the gratuitous use of the Supreme Court
Room during the session of the Society.
On motion, the Society then adjourned to meet at Lansing on
the third Wednesday of January, 1868.
GEO. E. RANNEY,
Recording Secretary.
MINUTES OF THE SECOND ANNUAL MEETING
OF THE
MICHIGAN STATE MEDICAL SOCIETY,
Held at Detroit June 3d and 4th, 1868.
THE MICHIGAN STATE MEDICAL SOCIETY assembled for its
second annual meeting in the Supreme Court Room at Detroit,
at 11 o'clock, A. M., June 3d, 1868, Dr. J. H. Jerome, of Saginaw
City, President of the Society, being in the chair. The roll of
members was called by the Secretary, and the following gentlemen
answered to their names:
Carl Brumme, Detroit. J. H. Jerome, Saginaw City.
E. W. Jenks, { { Chas. T. Southworth, Monroe.
N. D. Stebbins, { { Wm. H. DeCamp, G'd Rapids.
Henry F. Lyster, “ A. B. Palmer, Ann Arbor.
D. O. Farrand, { { A. Sager, & 4
T. A. McGraw, { { George E. Ranney, Lansing.
James F. Noyes, “ I. H. Bartholomew, “
M. H. Andrews, “ Alanson Cornell, Ionia.
P. Klein, ( & Edward Batwell, Ypsilanti.
G. P. Andrews, {{ A. E. Leete, Romeo.
Morse Stewart, & 4 Gordon Chittock, Jackson.
J. M. Bigelow, { { Louis W. Fasquelle, St. Johns.
Sam'l P. Duffield, “ G. A. Stockwell, Port Huron.
Wm. Brodie, { { O. E. Bell, Oxford.
Z. Pitcher, ( { J. C. Wilson, Flint.
P. P. Gilmartin, “ P. F. Taylor, Bellevue.
E. P. Christian, Wyandotte.
30 PROCEEDINGS OF THE
The Secretary then read the minutes of the last annual meet-
ing, which were approved.
On motion of Dr. Brodie, Dr. King, Post Medical Director of
the Army at Detroit, was elected an honorary member of the
Society; and, on motion of the same gentleman, the order of
business was suspended, and the hour of three in the afternoon
was fixed for reading the President's annual address.
Dr. King thanked the Society for the compliment extended him,
and, in return, the President assured him of the cordial feelings
entertained for him by the members of the Society.
Dr. Zina Pitcher, of Detroit, on behalf of Hon. H. P. Baldwin,
extended to the members present, a cordial invitation to visit that
gentleman's house on Wednesday evening. The invitation was
accepted.
On motion of Dr. Brodie, it was
Resolved, That all resolutions touching the action of the Regents of the
University in establishing a School of Homoeopathy, be referred to a com-
mittee of five, without debate.
The Chair appointed the following as such committee: Dr. Wm.
Brodie, Detroit; I. H. Bartholomew, Lansing; Charles Shephard,
Grand Rapids; Charles T. Southworth, Monroe; and J. B. White,
Saginaw City.
The Society then adjourned till 2 P. M.
Afternoon Session.
The Society reassembled according to adjournment.
Dr. Brodie, chairman of the committee appointed at the annual
session of 1867 to revise the Constitution and By-Laws, reported
sundry amendments, which, on motion, were adopted. The Con-
stitution and By-Laws, as amended, read as follows:
CONSTITUTION.
The association shall be called the “Michigan State Medical
Society,” and shall be composed of resident and honorary members.
The Society shall constantly have in view:
1. The association of the profession, for the purpose of mutual
recognition and fellowship. -
STATE MEDICAL SOCIETY. 31
2. The maintenance of union, harmony and good government
amongst its members, thereby promoting the character, interest,
honor and usefulness of the profession.
3. The cultivation and advancement of medical science, of liter-
ature, and the elevation of the standard of professional education.
The resident members shall be regular practitioners of medicine
and surgery in the State of Michigan, who shall be elected by
vote of a majority at any regular meeting, their eligibility having
been previously reported upon by the Committee of Admission.
Honorary members shall only be admitted by a vote of two-
thirds of the members present at a regular meeting, having been
first recommended by the Committee of Admission. The whole
number of honorary members shall not exceed one hundred.
A vote of two-thirds of the members present shall be requisite
for the expulsion of a member, which vote shall be had in conse-
quence of a report from the Committee on Ethics, and at the next
regular meeting subsequent to such report.
The officers of this Society shall be a President, four Vice-
Presidents, a Corresponding and Recording Secretary, and a
Treasurer, all of whom shall be elected annually, except the
Recording Secretary, who shall hold his office two successive
years; the President only, to be elected by ballot and a majority
vote, at the regular meeting. They shall severally perform the
duties assigned in the By-laws, as shall also the standing com-
mittees.
The following standing committees shall be annually appointed
by the President, and shall each consist of five members: 1st, an
Executive Committee; 2d, a Committee on Finance; 3d, on Pub-
lication; 4th, on Medical Ethics; 5th, on Admissions.
BY-LAWS.
ARTICLE I–MEETINGS.
Section 1. The regular meetings of the Society shall be held
annually, at such time and place as the Society may from time to
time determine.
Sec. 2. At all meetings, the presence of fifteen resident mem-
bers shall be necessary to constitute a quorum.
32 PROCEEDINGS OF THE
ARTICLE II.
Section 1. The President shall be elected annually at the regu-
lar meeting by ballot and majority vote. He shall preside, enforce
a due observance of the Constitution and By-laws, see that all
members of committees and officers perform their respective
duties, appoint all committees not otherwise provided for, give
the casting vote only, sign diplomas and all other official docu-
ments requiring his signature, and perform such other duties as
appertain to his office by usage and custom; also, when, in his
opinion, the interests of the Society may be enhanced, is author-
ized to appoint delegates to representation in other State Medical
Societies.
Sec. 2. The Vice-Presidents shall assist the President in the
performance of his duties; in his absence, shall preside in order
of seniority—rank being determined by the order of their
election. -
Sec. 3. The Corresponding Secretary shall conduct all the cor-
respondence of the Society, sign diplomas, certify to all official
acts, and conduct such other business as the Society may direct.
Sec. 4. The Recording Secretary shall keep the minutes, prepare
the records of the Society for publication, receive the signatures
and initiation fee of newly elected members, and do such other
business as shall be required, or as the Society may from time to
time direct, in his department.
Sec. 5. The Treasurer shall receive all moneys due the Society,
and pay all bills indorsed by the Finance Committee and counter-
signed by the President, keeping correct accounts of the same,
and making a full and detailed report at the annual meeting.
ARTICLE III—STANDING COMMITTEES.
Section 1. Standing committees shall keep regular minutes of
their proceedings.
Sec. 2. It shall be the duty of the Committee on Admissions,
upon receiving the names of candidates for membership, to make
due inquiry, and report such as may be found worthy to the
Society, which may thereupon elect them. Should the committee
STATE MEDICAL SOCIETY. 33
fail to report upon nominations submitted to them, any member
having made such nomination may renew the same directly to the
Society, in which case a vote of four-fifths of the members present
shall be requisite to constitute an election.
Sec. 3. The Committee on Ethics shall hear all complaints of
breach of etiquette or violation of Medical Ethics; it shall decide
all questions of ethics submitted to it. If any member shall be
charged, in writing, with any violation of the Constitution or
By-laws, or with unprofessional conduct, a copy of such charge
shall be furnished him, and himself and his accuser cited to appear,
when the committee shall proceed to hear the case, reserving its
decision to be reported to the Society; when its action may be
affirmed by a vote of a majority of the members present.
Sec. 4. The annual dues shall be one dollar, and any member
failing to pay the same for two successive meetings, shall forfeit
his membership until the indebtedness be liquidated, and the fact
notified to the Society.
Sec. 5. The Committee on Finance shall superintend the mone-
tary affairs of the Society, inspect and audit all bills and the
accounts of the treasury, and make such an assessment, by a pro
Tata tax upon the resident members, as may be necessary for inci-
dental, expenses, which, however, shall not exceed the sum of one
dollar per annum.
Sec. 6. The Committee on Publication shall superintend the
printing of such papers as may be ordered to be published, so that
they may be issued upon uniform paper, under the title of
“Transactions.” º
Sec. 7. The Executive Committee shall digest and prepare the
business of each meeting, provide suitable rooms for the purpose
of the Society, recommend plans for the promotion of its objects,
and in all things protect and superintend the general interests of
the Society.
ARTICLE IV.
Section 1. Any resident member vacating his membership, shall
thereby be divested of any right or title to any portion of the
funds or other property of the Society.
34 PROCEEDINGS OF THE
Sec. 2. Every member, on admission, shall pay the sum of two
dollars as an initiation fee, and sign the Constitution and By-laws;
nor shall he be entitled to the rights of membership until the
same is done.
Sec. 3. All vacancies in office shall be filled ad interim by the
President.
Sec. 4. These By-laws may be suspended by a two-thirds vote
at any regular meeting, and they may be repealed or amended by
a similar vote, notice of the same having been given in writing at
any previous meeting.
Sec. 5. Rules of order, and all questions arising upon the same,
shall be determined by parliamentary rules, and the code of Medi-
cal Ethics of the American Medical Association.
On motion, a recess of ten minutes was taken, to allow members
to pay the annual dues, as required by the Constitution and By-
laws.
The hour of 3 o'clock having arrived, which had been appointed
for a special order of business, the President, Dr. J. H. Jerome,
proceeded to deliver his annual address. *
On motion of Dr. Brodie, a vote of thanks was tendered to the
President for his able address, and a copy was requested for pub-
lication.
On motion of Prof. Palmer, of the University, the order of
business was further suspended, and the following preamble and
resolutions were submitted by Dr. Christian, of Wyandotte, which
were referred to the committee appointed to report on the action
of the Board of Regents of the University of Michigan:
Whereas, The action of the Board of Regents of the University, in
creating a Professorship of Homoeopathy in the Department of Medi-
cine, and the present status of the Medical Faculty in that institution,
resulting from this measure, justifies some expression of sentiment from
this organization of the medical profession of the State; therefore,
Resolved, That we regard this measure as in the highest degree detri-
mental to the best interests of the University, and subversive of the very
first principle and object of its organization, viz., the inculcation of truth
and the eradication of error.
That we regard it as casting an opprobrious indignity upon the Medical
Faculty, by thus proclaiming that a wild theory, an insane hypothesis, and
STATE MEDICAL SOCIETY. 35
proved imposition, because successful in point of numbers of its apologists
and patrons, is entitled to the same consideration and official recognition
as legitimate science, founded upon the universal and indisputable deduc-
tions of reason and experience; and by arraying in comparison with the
art of medicine—embracing in its catholic spirit all the legitimate deduc-
tions of reason and facts from whatever source—the narrow, contracted
ideas of a school, sect or system, by its own confession.
That it is a culpable disparagement of the claims and rights of rational
medicine to a recognition as a science; by setting up, as of equal merit, a
phantasy, whose chief claim to recognition and favor is that it professes to
supersede all the accumulated knowledge of the greatest masters of the
art in all ages, either before or since the advent of this school.
That it is a blow aimed against truth, in the encouragement of an “ism”
that denies all claims of rational medicine, while at the same time it
unblushingly steals all the merit it possesses from the source it vilifies, and
professes in theory what it has never been able, nor even essays to verify
in practice, and thus, while professing one thing, is in the constant prac-
tice of what it emphatically condemns and vilifies.
That while recognizing these facts, we perceive and appreciate the more
clearly the great necessity of creating an enlightened public sentiment on
these matters, where so much ignorance exists; that error must be com-
bated instead of ignored; that truth must be disseminated, and not hid
under a bushel; that we recognize the great importance, in regard of the
weal of the University, the interests of the medical profession, and the
advancement of truth, that the medical chairs should be filled by honest,
capable and enlightened gentlemen, instead of falling into the occupancy
of those of inferior acquirements and capacity; and, therefore, we urge
upon the Professors the duty and expediency of retaining their positions,
and request them not to offer their resignations.
The regular order of business was then resumed.
The chairman of the Committee on Obstetrics, Dr. A. Sager, of
Ann Arbor, then read a carefully prepared treatise on that sub-
iect, which was accepted, and referred to the Committee on
Publication.
Dr. E. P. Christian, of Wyandotte, chairman of the committee
appointed to report on “Zymotic Diseases,” then read a lengthy
and interesting paper upon the subject referred to that committee,
which was accepted and similarly referred.
Dr. T. A. McGraw, of Detroit, as chairman, read the report of
the Committee on Surgery. The report was quite lengthy and
exceedingly interesting, and was likewise referred to the Commit-
tee on Publication.
On motion, the Executive Committee were made the Committee
36 PROCEEDINGS OF THE
on Admissions, who reported the following named gentlemen as
duly qualified to become members of the Society: Dr. Wm. R.
Marsh, Fenton; Dr. J. Burgess Book, Detroit; Dr. W. C. Gustin,
Detroit; Dr. A. B. House, Memphis; Dr. Alex. Ewing, Dexter;
Dr. Julien H. Axtell, Tuscola; Dr. Johann Flinteman, Detroit;
Dr. Richard Inglis, Detroit.
Adjourned until 9 o'clock Thursday morning,
SECOND DAY.
THURSDAY, June 4,
The Society reassembled at 9 A. M., the President in the chair.
Drs. Shephard and White, who were appointed the previous
day as members of the committee to report on the medical depart-
ment of the University, not having put in their appearance, Dr.
DeCamp, of Grand Rapids, and Dr. H. E. Smith, of Detroit, were
appointed in their stead. tº
On motion, that portion of the President's address which refer-
red to the medical school of the University, was referred to the
special committee appointed to report on matters relating to that
department.
REPORTS OF COMMITTEES CONTINUED.
Dr. J. F. Noyes, chairman of the Committee on Opthalmology,
then read an able and interesting report, which was accepted and
referred to the Committee on Publication.
Dr. E. W. Jenks, of Detroit, as chairman of the Committee on
Diseases of Women, then read an able report, treating principally
of uterine diseases, which was listened to with interest.
The report of the Committee on New Remedies being called for,
Dr. Samuel P. Duffield, chairman, first read a paper handed him
by Dr. Bigelow, of Detroit, another member of the committee,
which paper treated of “New Preparations of Opium.” After-
ward, Dr. Duffield read the remaining portion of the report on
STATE MEDICAL SOCIETY. 37
“New Remedies,” prepared by himself. The report was accepted,
and referred to the Committee on Publication.
VOLUNTAIRY PAPERS.
The next order was the reception of voluntary contributions.
Dr. DeCamp, of Grand Rapids, read a paper on a new method of
preserving anatomical and pathological specimens. The Doctor
exhibited a number of specimens in different states of preservation,
illustrative of his theory. The best combination he has discov-
ered is that of sugar, water and alcohol, and either chloride of
zinc or carbolic acid. The proportions of these have to be varied
according to the transparency desired in the particular specimen
under preparation. For most articles the following formula is the
nearest correct: concentrated simple syrup, one pint; alcohol (98
per cent), four ounces; carbolic acid, one drachm. The specimens
require to have the blood removed by maceration, or it will dis-
color the specimens. The best menstruum for this purpose is some
of the same compound, and then a transfer to the permanent Solu-
tion, after a few days or weeks.
Dr. DeCamp also read a paper on case of the bending of bones
without fracture. Within the past twelve years four cases had
come under his notice. All occurred in the forearm. The Doctor
showed a photograph of a boy of ten years of age, whose arm had
been curved by the fall of another child upon the forearm of the
former. -
On motion, Dr. DeCamp's papers were referred to the Com-
mittee on Publication.
SMALL-POX—WACCINATION.
Dr. Lyster, of Detroit, read a paper on the neglect of vaccina-
tion, which provoked considerable discussion. He contended that
this neglect of a preventive of disease was a public evil, and
advised some expression of opinion from the State Society, urging
the legislative authorities to compel vaccination.
Dr. Brodie, of Detroit, took exception to the statement that
vaccination was greatly neglected in this city. He objected to
6
88 |PROCEEDINGS OF THE
such ideas being disseminated from the Society. His experience
was that vaccination is well attended to in this city.
Dr. Lyster remarked that the neglect was chiefly confined to the
lower classes of society.
Dr. Brodie said that he had generally found the poor people
more careful in this matter than others.
Dr. Klein, of Detroit, denied that the Germans, as a people,
neglected vaccination, as had been insinuated by the remarks of
one of the gentlemen who had preceded him. The true Germans
were very particular to enforce vaccination. It was only the class
who had been corrupted by Americans, and who were therefore
no longer Germans, who neglected vaccination.
Drs. Palmer, Brummé and others took part in the debate. It
was contended that no action on the part of the Society was
necessary, because a law existed enforcing vaccination before chil-
dren can be admitted to the public schools, though this enactment
is very loosely observed.
The President, Dr. J. H. Jerome, of Saginaw City, vacated the
chair, in order to speak on this interesting subject. He felt
assured that the very imperfect quarantine regulations at New
York were the prolific source of small-pox, as well as the various
types of fevers, being brought into the country by emigrants.
Dr. Klein advised the enactment of a compulsory vaccination
law. It should then be made the duty of each township and city
clerk, to call the attention of the accredited physicians, so that
they might perform the process on each child at a proper period.
Such was the custom in his native land, and until a similar prac-
tice is observed in this country, immunity from this noxious
disease will not be secured.
REGISTRATION OF BIRTHS.
Dr. Bartholomew, of Lansing, chairman of the committee to
confer with the Secretary of State in reference to the best means
of carrying into effect the Registration law, reported that the law
required the supervisors and assessors to ascertain and report to
county clerks the number of births and deaths which have occur-
red in their respective townships and wards during the year.
STATE MEDICAL SOCIETY. 39
The law was not passed until March 27, 1867, and proper blanks,
etc., could not be supplied and distributed until the spring of
1868. The proper officers, however, had neglected to perform
their duty, alleging as one reason that they received no additional
salary for this increase of their duties. The committee believed
that this latter complaint in some cases is just. The law is defi-
cient in this particular, and should be amended.
The report was accepted and adopted, and referred to the Com-
mittee on Publication.
WACCINATION AGAIN.
The paper of Dr. Lyster, on vaccination, was also similarly
disposed of, with the additional instruction that a committee be
appointed to urge the matter on the State Legislature at the next
session.
THE UNIVERSITY DIFFICULTY.
Dr. Brodie, from the Committee on Resolutions, then read the
following report, which included the action of the committee in
reference to the portion of the President's address which referred
to the University question, and also the resolutions presented by
Dr. E. P. Christian on the same subject:
Whereas, The growth and position of the Medical Department of the
University of Michigan has been the just pride of the medical profession
of the State, self-sustaining, and not a pecuniary burden to the general
fund; and,
YWhereas, The recent action of the honorable the Board of Regents, will
and does have a direct tendency to depreciate the same and alienate the
affections of those who have so long labored to foster and encourage its
growth and usefulness; therefore, e
Resolved, First, that, without any desire to dictate to the honorable the
Board of Regents what their action in the premises should be, we yet trust
that it will be of such a character as to maintain the Medical Department
in its present prosperous status.
Resolved, Second, that, until such time arises that the honorable the
Board of Regents change the curriculum of the Medical Department, we
are of the opinion that the Professors thereof should continue to hold their
respective chairs; but, should such changes be accomplished as would
directly affect such curriculum, we believe that, in honor to themselves, the
profession to which they belong, and whose sympathies they receive, they
could not consistently remain, and their resignations should be respectfully
submitted.
40 PROCEEDINGS OF THE
Resolved, Third, that the preamble and resolutions presented by Dr.
Christian be entered on the minutes of the Society.
Signed by Wm. Brodie, J. H. Bartholomew, C. T. Southworth,
Wm. H. DeCamp, Hamilton Smith.
Dr. Klein, of Detroit, first spoke on the subject. He heartily
agreed with the spirit of the report, and in this respect he begged
humbly to dissent from the views expressed the previous day in
the President's address, to let the matter alone. He could not let
it alone, and by thus doing countenance a wrong. Michigan
University occupied a prominent position, and its graduates
ranked second to none in the Union. He was proud to Say.
that there is yet a living nucleus in the University who hold on,
and he trusted that the State Society would not only sustain those
men, but would also counsel those who had resigned to retract
their resignations. He perceived that some of the latter had
accepted a position in connection with a new enterprise projected
in this city, which course he regretted, because he had doubts of
its success, though he had the utmost confidence in the ability and
honor of the gentlemen who had projected the new enterprise.
The Doctor continued to enlarge upon the merits and demerits of
the new project, until Dr. Jenks rose and called the speaker to
order, as the Detroit school was not under discussion.
The Chair sustained the exception. Dr. Klein concluded by
hoping that the Society would vote that the gentlemen, the pro-
fessors, should retain their seats.
Dr. Palmer, one of the ex-professors of the Michigan Univer-
sity, said he was aware that remarks he might make would be
liable to be understood. He felt deeply on the subject. The best
part of his life had been spent in the University. He could not
think thereon without emotion. (At this period the veteran pro-
fessor was compelled by emotion to cease speaking, for which he
apologized to the Society.) He believed that their action in
resigning had been generally sustained by the profession of the
State. He would not question the motives of the Board of Regents.
They needed the money and accepted it, he believed, without any
love for homoeopathy; still he could not help thinking that it
would have been better had they declined accepting the money
STATE MEDICAL SOCIETY. 41
on the conditions preferred, and had made an appeal to the next
Legislature to have the vote reversed. The action of the Board
of Regents he felt deeply at the time, and indited his resignation
in rather strong terms. He contended that no honorable medical
man could affiliate with homoeopathy. Subsequently they received
letters from eminent medical gentlemen approving their action,
while a few disapproved. He had also conferred with many med-
ical gentlemen, and they all strongly advised the professors to
retract their resignations, and not leave the University until
homoeopathy is thrust upon them. Uncertain as to the action of
the Board of Regents, he had accepted a position in a new enter-
prise, which he believed would succeed. In this Detroit School
of Medicine, where instruction of a clinical character will be
given, he had consented to give instruction on a certain subject
not treated of in the Michigan University.
Dr. Palmer then concluded by saying that he would endeavor
to act in the matter to the best interests of the profession to which
he belonged. The question of the power invested in the Board
of Regents is before the Supreme Court, and will not be decided
for four weeks. *
The report was then unanimously accepted, and, on motion of
Dr. Pitcher, of Detroit, the President of the Society was requested
to notify the President of the Board of Regents of the action of
the Society in this matter.
"PUBLICATION.
Dr. Brodie offered a resolution that each member of the Society
be assessed one dollar to furnish sufficient means to procure the
publication of the proceedings of the Society, so that a greater
interest be awakened among the public in the deliberations of the
Society.
The resolution was adopted, and the Society adjourned until 2
o'clock.
Afternoon Session.
WACCINATION.
On the reassembling of the Society, the President announced
that Drs. Ranney and Bartholomew, of Lansing, and Topping, of
42 PROCEEDINGS OF THE
1)ewitt, would constitute the committee to confer with the Legis-
lature on the subject of vaccination.
EXAMINING COMMITTEE.
On motion, a committee, consisting of Drs. G. P. Andrews, H.
F. Lyster and A. B. Palmer, were appointed to examine certain
medical preparations and instruments, and report of their char-
acter as early as practicable.
NEXT ANNUAL MEETING.
A motion prevailed that the next meeting be held on the second
Wednesday in June, 1869, at such place as may be hereafter
named.
DELEGATES TO THE NATIONAL CONVENTION.
A motion prevailed that the next President appoint the usual
number of delegates to the National Medical Convention, to be
held in New Orleans, next May, the President to notify the mem-
bers of their appointment, and obtain from them a refusal or
acceptance.
CONSULTATION WITH FEMALE PRACTITIONERS.
Dr. Batwell, of Ypsilanti, offered the following resolution:
Resolved, That this Society deems it derogatory to its members, and in
direct violation of medical ethics, to counsel with or hold any communica-
tion with female practitioners, unless satisfied that they are graduates of
regular organized schools. *
The resolution gave rise to considerable discussion of a more
amusing than profitable character.
Dr. Pitcher moved to refer the resolution to three unmarried
members, mentioning the names of Drs. Noyes and H. E. Smith.
Finally, by a unanimous vote, the resolution was tabled.
COMMITTEE ON REGISTRATION.
The following resolution was then adopted:
Resolved, That the committee on registration of births and deaths be
continued, and be instructed to use such influence with our Legislature, at
its next session, to so amend the existing law upon the subject that the
assessors shall be paid for their services by the State.
STATE MEDICAL SOCIETY. 43
Ex-TREASURER'S REPORT FOR 1866.
June 8, 1866. Received from members for initiation fees, $136 00
Papended.
Publishing notices of meetings--------------- $28 50
Recording Secretary, for blanks, etc.---------- 3 18
Janitor, per order of Society ---------------- 15 00
Editors Detroit Review of Medicine and Phar-
macy, for publication of proceedings------ 50 00
$96 68
Remitted to Dr. A. Platt, Treasurer for 1867- - - 39 32 -
— $136 00
(Signed) HENRY F. LystER,
Treasurer.
On motion, the above report was referred to the Finance Com-
mittee.
Dr. George P. Andrews, chairman of the committee appointed
to examine certain medicines and instruments, then offered the
following, which was adopted:
Resolved, That we have examined the preparations presented by Mr.
Stearns, of Detroit, and that they present a very elegant appearance, par-
ticularly the effervescing granules of various medicinal salts; also, the
Elixirs of Valerian, Iron and Strychnia. The preparation put forth as
Sweet Quinine we cannot recommend, as we are not informed of its
ingredients.
That among the specimens sent in by Messrs. Duffield, Parke & Co.,
ºf Detroit, special commendation is expressed in regard to the chloroform
and ether, both of which meet very fully the wants of the profession, as to
their effects.
That the display of surgical and orthopaedic instruments by Mr. A.
Kuhlmann, of Detroit, proves him to be a workman of high ability, and
that in the way of temper and finish, nothing further is to be desired.
A MATTER, TO BE INQUIRED INTO.
Dr. Pitcher, of Detroit, said that since the morning session he
£ad heard that Dr. Stockwell, a member of this Society, and a
member of the Board of Regents, had proposed and voted for the
homoeopathic measure which caused such annoyance, and moved
44 PROCEEDINGS OF THE
that a committee be appointed to inquire into the truth of the
charge.
Prof. Palmer thought Dr. Pitcher had been misinformed, but
favored the motion, and the Chair appointed Drs. Pitcher, Brodie
and H. E. Smith, to constitute the said committee.
ELECTION OF OFFICERS.
The Society then proceeded to elect officers for the ensuing year.
It was urged that the honor of President should be bestowed on a
representative from the Grand Rapids district, as to that section
the Society was indebted for its origin.
Drs. DeCamp and Shepard, of Grand Rapids, were nominated.
Thirty-six votes were cast on the first ballot, of which twenty
were for Dr. DeCamp. On motion, that gentleman was declared
unanimously elected.
The other officers were elected viva voce, as follows:
Wice-Presidents—Drs. J. C. Wilson, of Flint; Richard Inglis,
of Detroit; Alanson Cornell, of Ionia; Charles T. Southworth, of
Monroe.
Treasurer—Dr. Wm. Brodie, of Detroit.
Jºecording Secretary—Dr. Geo. E. Ranney, of Lansing.
Corresponding Secretary—Dr. Geo. P. Andrews, of Detroit,
TEIE PRESIDENT ELECT.
Drs. Noyes and Jenks were appointed a committee to conduct
the newly elected President to the chair.
Dr. DeCamp, of Grand Rapids, the President elect, briefly
returned thanks for the honor conferred on him, and expressed
his determination faithfully to perform the duties thereof to the
best of his ability.
COURTESIES ACKNOWLEDGED.
The thanks of the Society were voted to the retiring officers,
and also to the Judges of the Supreme Court, for granting the use
of their room to the Society.
A resolution was then unanimously adopted tendering the
thanks of the Society to Hon. H. P. Baldwin, of Detroit, for
STATE MEDICAL SOCIETY. 45
his very generous and courteous entertainment of the members of
the Society at his residence, on Fort street, on Tuesday evening.
A vote of thanks was also tendered to the New York State
Medical Society for a copy of their Transactions for the year 1867,
and the Secretary directed to reciprocate the favor.
TEIE PLACE OF NEXT MEETING.
A motion prevailed that when the Society adjourn, it do so to
meet in Detroit at the appointed time next year.
STANDING COMMITTEES.
The time for the appointment of the standing committees was
extended, with the exception of those on publication and finance.
As Committee on Publication, the President appointed Drs. G.
P. Andrews, T. A. McGraw, J. F. Noyes, Wm. Brodie and H. F.
Lyster, all of Detroit. As Executive Committee, Drs. P. Klein,
J. A. Brown, Morse Stewart, H. E. Smith and E. W. Jenks, all
of Detroit.
On motion of Dr. Alvord, of Clinton, the Corresponding and
Recording Secretaries were instructed to give a more extended
notice of the next annual meeting, by way of printed addresses,
to the profession throughout the State, in order that a larger
attendance be insured thereto.
The Society then adjourned, to meet in Detroit on the second
Wednesday of June, 1869.
GEO. E. RANNEY,
Recording Secretary.
REPORT ()N () BSTETRICS,
BY PROF. A. SAGER., M. D.
THE following report on obstetrics is respectfully submitted by
A. Sager, M. D., Professor of Obstetrics in the University of
Michigan :
Perhaps there have been few periods in the history of our art
that have evinced greater activity of the professional mind
than the year that has elapsed since the former report to
the Society was submitted. Original works, new editions of
old standards, monographs, essays and reported cases, have con-
tributed in full proportion to swell the tide of professional
literature.
An analysis of these, though of the briefest character, would
consume more time than even the most patient indulgence would
permit. It is, moreover, rendered quite needless, as the various
abstracts, retrospects, compends and journals generally accessible
furnish the most ample material, and in, at most, half-yearly
installments.
With a very brief notice of some of the most valued treatises,
your committee beg to select from some of the most important
topics. The medical literature of France has been enriched by
the publication of the systematic treatise of Joulin. The Traité
Complet d'Accouchments, without disparagement to the admirable
works of Chailly and Cazeau, must be regarded as more com.
pletely representing the present state of obstetric science in
France, than either of its competitors, Impressed on every paş
with the characteristic traits of the French mind it is eminently
systematic in the arrangement and discussion of its several topics
PROCEEDINGS OF STATE MEDICAL SOCIETY. 47
The style is lucid and full, yet without redundancy. In happy
contrast with the illiberal sectionalism so unworthy of science,
that affects to ignore the labors of other nations (yet but too
common with many French writers), M. Joulin shows himself well
posted in, and appreciative of, the recent literature of the Con-
tinent and Great Britain. The illustrations, though rarely
original, are well selected and abundant, and, for the student,
greatly enhance the value of the work. For the advanced stu-
dent and practitioner, the copious bibliography at the end of each
subject adds another and most estimable claim to his high regard.
In Germany, Scanzoni had added new laurels to his well merited
fame by the issue of a fourth edition of his Lehrbuch der Geburts-
kunde, in three volumes, and thoroughly revised. Of this great
work, which, unfortunately, has hitherto found no translator and
publisher sufficiently enterprising and zealous to present it in an
English dress, it would be impossible to form an adequate idea
by a few words of general characterization. While it treats with
sufficient fullness every subject embraced within its scope, yet
the very important practical subjects of eclampsia, puerperal
diseases, deformities of the pelvis, and the operations of obstet-
rics, receive an especial, and, I need not say, an admirable
elaboration.
Some idea of Scanzoni's acuteness of observation and discrim-
inating judgment, as well as the thoroughly self-reliant character
of the man, may be formed from the translation of a translation
of the first edition (a third is just issued) of his Diseases of
Women. We take leave for the present of these authors, with a
promise hereafter, in another connection, to allude to their views
on some special subjects. The medical literature of Great Britain,
meanwhile, has received a valuable contribution in the elaborate
lectures of Dr. Barnes on obstetric operations and instruments,
and a compendium by Dr. Meadows, besides new editions of the
well known works of Churchill and Ramsbotham. In the same
period, too, new editions of the American classics, Bedford and
Meigs, have appeared, proof conclusive that science, unlike proph-
esy, never fails to impart honor even in its own country. Here,
too, a new candidate for fame has arisen in the author of “The
48 * PROCEEDINGS OF THE
Obstetric Clinic,” Dr. Elliott, of New York. Claiming no
recognition as a systematic treatise, and presuming in the reader
a competent knowledge of the anatomy and physiology of the
reproductive system, it marches at once to the reconsideration of
the most recondite and difficult subjects in the whole range of
obstetric science, and avoiding a theoretic discussion of the prin-
ciples and practice involved, he appeals at once to the record of
facts drawn from an ample experience, observing facts as only a
well trained mind is capable of observing them, and recording
them with the utmost fidelity and conscientiousness, evinced in
the candid statement in his preface—“I have published many
cases which interested me most deeply, and especially such as
terminated fatally.” His views on albuminuria, eclampsia
and the chloroform treatment, on hemorrhage, ante and post-
partem, the induction of labor, version, the forceps, embryotomy,
funis presentations, and certain inflammatory puerperal condi-
tions, are illustrated by the history and treatment of a great
number of cases, furnished by the ample wards of Bellevue Hos-
pital. On some of these topics we may recur again to this work.
We omit an analysis of the various reports of lying-in hos-
pitals, which, however useful for patient study, involve too minute
details for present purposes.
Among the most valuable contributions to the anatomy and
physiology of the uterus, are the monographs of Helie, of Mont-
pelier, and of Frankenhauser, of Jena. The former comprises an
admirable description of the arrangement of the several planes
of fibers, as revealed by a most careful dissection of a gravid
uterus, and may be regarded as an extension, with greater accu-
racy of detail, of the well known dissections of Boivin and
Deville. A minute description might be deemed superfluous.
The work of Frankenhauser embraces by far the most elaborate
and pains-taking account of the anatomy and physiology of the
nerves of the uterus which has hitherto appeared. Through these
investigations, an indispensable anatomical basis has been acquired
for the solution of many questions in the physiology and the
pathology of the organ, which was hitherto wanting, or but imper-
fectly possessed. Not only has he traced their origin from the
STATE MEDICAL SOCIETY. 49
solar plexus, and variously intertwined with the renal and sacral
plexuses, by moderate aids, to the body of the uterus, and from
the sacral nerves of the spinal system to the cervix, but, by the
aid of the higher powers of the microscope, has been able to
trace them through the substance of the uterus to their final
termination, even into the nucleoli of the smooth fiber-cells of the
organ. In the physiological portion, he takes occasion to correct
certain errors of interpretation of pathological phenomena. The
strong contraction of the uterus which follows the ligation of the
aorta, are ascribed by Speiljelburg and Körner to the suddenly
induced anaemia. This Frankenhauser finds to be due to irritation
of the motor fibers of the uterine plexus, which are partially dis-
tributed to the aorta. He finds, also, in the connection of the
fibers of the renal ganglion with the uterine plexus, a clue to
many pathological phenomena, as the albuminuria of pregnancy,
which, he thinks, has falsely been attributed to pressure on the
uterine veins. Denying, also, the uremic origin of eclampsia, he
looks to the irritation of the utero-spinal nerves for the cause of
the convulsive paroxysms. e
On one branch of the literature of abortion, and especially of
its etiology, viz., the diseases of the placenta, very little has of
late been contributed since the essays of Dr. Barnes. Dr. A.
Verdier, of Paris, has issued an essay on this subject, in which he
describes, under the name of hematoma of the placenta, the prin-
cipal diseases of the organ. He has studied the recent effusions,
the so-called apoplexies of the placenta, as well as the more
ancient, to which he limits the term hematoma. The blood
coagula that occur in the placenta undergo various regressive
metamorphoses, the different forms of which have been described
by writers as schirrus, fibrous, and fibro-fatty degenerations, which
conditions, he thinks, have no existence as primary tissue forma-
tions, but are distinctly traceable to the progressive changes in
the ancient coagula or hematomes.
Various writers have also treated of placentitis with the result-
ant formation of abscesses in the organ. These, too, he regards as
errors of observation, and refers them all to that ultimate stage of
regressive metamorphosis in which the disintegration of particles
50 PROCEEDINGS OF THE
of fibrine have become complete. The ossifications, also, which in
the slighter degrees are not unfrequently met with, he regards as
but another of the final changes—a stage of complete quiescence,
which the effused fibrine may undergo. +.
Furthermºre, the recent researches of Prof. O. Weber have
taught us that the clot may become more or less completely
organized. The congestions and consequent hemorrhage the
author refers to an antecedent morbid dynamical condition of
either the decidua serotina, or chorial villi. And when we reflect
on the importance of the organ to foetal life, the frequency of
abortions, and the general occurrence of hemorrhage from the
placenta as the first indication of threatened abortion, we shall
not deem these morbid conditions likely to be over-estimated.
On the other hand, in Virchow's Archiv., Hegar and Maier
relate with minuteness of detail the history of a case of interstitial
placentitis, in which, together with atrophy, and various forms of
degeneration of portions of the placental tissue (results of a chronic
morbific process), in other parts the structure was soft, friable,
reddish brown or gray, and very similar to the condition of the
lung tissue in the second stage of inflammation; the chorial villi
and maternal vessels had also become changed in structure, and
partially obliterated. In respect to the etiology of this form of
placentitis, although nothing is yet known with certainty, yet that
it had its origin in either chronic catarrh, or subinvolution, pelvi-
peritomitis or uterine displacements, which existed prior to the
beginning of pregnancy, is thought most probable. The influence
of this condition on the progress of gestation is varied by the
degree of the tissue involved, and the grade of activity of the
morbific process, and may result in atrophy, or even death of
the foetus and abortion. Another most important bearing of this
degenerated condition will be felt in the process of parturition,
and in the puerperal period, in one case necessitating manual
intervention for the removal of an adherent placenta, and in
another imperiling the life of the mother from secondary hemor-
rhage, or from pyamia. * *
The condition of the placenta materna at the end of pregnancy
is thoroughly investigated in an essay contributed by Prof. Hegar
STATE MEDICAL SOCIETY. 51
to the Monatschrift der Geburtskunde. He arrives at conclusions
confirmatory of the views presented by Simpson, Duncan and
others, that the several portions of the maternal placenta and
membranes undergo during pregnancy, and especially near the
close, a regressive fatty metamorphosis, occurring early in the
decidua reflexa, and at a later period in the decidua vera and
serotina, in consequence of their more abundant vascularity.
That while the more superficial layers thus become senile and
deciduous, a process of proliferation simultaneously occurs in the
profound layers, whereby a new mucous membrane replaces the
old after parturition. Hence, at the end of pregnancy, the
changes in the , placenta materna, and in the placenta foetalis,
the fatty degeneration in the former, and the rarefaction, calcifica-
tion and obsolescence in the latter, have proceeded so far that one
is quite justified in speaking of this condition of one of caducity.
Dr. A. Farre and Schroeder von der Kolk represent the vessels of
the chorial villi as forming in the early months of gestation a
perfect capillary plexus, which is replaced at a later period by
simple loops in each branch of a villus. These statements would
seem to indicate that intra, as well as extra uterine life, is
marked by corresponding periods and stages of incipience, of
maturity and decline, preparatory to a change in the mode of
existence, a veritable metamorphosis.
Among the rarer abnormities of the placental attachment, is
one recorded by Mr. J. C. Richardson, in the obstetrical transac-
tions. The foetus presented nothing abnormal; the umbilical cord
was single, and contained the usual number of vessels. After the
completion of the second stage, there was considerable hemor-
rhage, which was arrested by the delivery of the secundines. On
inspection, it was discovered that two distinct placentae were
present, separated about two inches, but connected by the mem-
branes. The cord was attached to one, but large vessels were
sent off to the second. They were respectively not much less
than the usual size. The writer justly remarks that the case pre-
sents a twofold interest—a practical one, showing the necessity
of care in the delivery in the third stage, as the completeness of
each might, if detached with a part of the membranes, have been
52 PROCEEDINGS OF THE
regarded as final, and a hemorrhage follow the extrusion of the
remaining one; and a medico-legal one, as connected with the
possibility of a concealed birth. The writer does not allude to
another point of curious interest, viz., the strict homology here
presented with the normal arrangement existing in the quadru-
mana, as admitted by comparative anatomists, and beautifully
illustrated by Breschet.
Prof. J. Hall Davis narrates with detail an instructive case of
early pregnancy, complicated with uterine fibroma, causing retro-
version, death and putrefaction of the foetus, with death of the
mother from apparent pyaemia. The history covers a period of
four months; during only the last month and a half was she
under close observation. In addition to the usual sympathies,
severe pain was felt in the right iliac region, and painful and
difficult micturition, which was relieved with liq. pot. with opium
and hyoscyamus, and warm baths.
Soon after, a tumor was detected behind the uterus, displacing
the neck forward, the rapid growth of which soon rendered the
assumption of the kneeling posture necessary to the use of cathe-
terism. The uterus was now found to be retroverted, a condition
Supposed to be caused by pressure of a tumor on the fundus.
This was relieved by colpeurysis. But the pain, abdominal ten-
derness and vomiting, were soon augmented, accompanied with
rigor, heat, frequent pulse, and great weakness. These were only
partially and temporarily allayed by opiates, fomentations, hypo-
dermic morphia injections of one grain, mercurial inunctions,
effervescing draughts, etc. An offensive discharge now occurred
from the uterus, the abdomen rapidly enlarged, the general symp-
toms increased, requiring the free use of brandy and beef tea.
Flooding at last supervened, followed by expulsion of a putrid
foetus of four months, and, notwithstanding the use of the most
supporting treatment, she died on the next day. The autopsy
revealed no lesions in the thorax; no peritonitis; but a chronic
inflammation of the bladder, the pelves of the kidneys, and with
Small abscesses in the left one. The walls of the uterus were
much thickened, containing several small interstitial fibroids, and
another weighing about five pounds, attached to the posterior
STATE MEDICAL SOCIETY. 53
surface of the fundus by a short but thick pedicle. A slight
sloughing of the lower border of the cornea, with, perhaps, the
renal abscesses, and the general fever with prostration, were the
evidences of pyamia. Whether the rupture of the membranes
and consequent putrefaction of the foetus was spontaneous, or due
to the incautious use of the sound, does not appear. The rapid
growth of the tumor the writer justly ascribes to the condition of
gestation, and suggests that the early removal of the contents,
after dilatation of the os, would have been the appropriate line of
treatment, followed with dilute antiseptic injections, and a restora-
tive general treatment.
In the proceedings of the Dublin Obstetrical Society, Dr.
Ringland reported a case of pregnancy, complicated with subacute
peritonitis, with spontaneous cure of the dropsy after parturition.
The peritoneal affection commenced as early as the second month
of pregnancy, with pain in the umbilical region, extending and
radiating over the abdomen. So slow was the progress of the
effusion, that until the end of the fourth month dyspnoea was not
felt. From this period gradually augmenting dyspnoea, with con-
stant diarrhoea and great ascitic accumulation, were the prominent
symptoms, until somewhat premature but natural parturition
occurred, from which she experienced much relief. Twenty-four
hours after the labor was completed, a discharge of many quarts
of serous fluid per vaginam took place, with complete subsidence of
the abdomen. This was followed in an hour by another but much
Smaller quantity. Her convalescence was rapid. Soon after,
however, reaccumulations and spontaneous discharges occurred
on four subsequent occasions, with intervals of two days. In
forty days after parturition, her health and strength were com-
pletely restored. In explanation of this peculiar mode gº elimi-
nating ascitic fluid, the writer suggests the plausible hypothesis
that under the influence of the vis medicatrix naturae, the fallo-
pian tubes became enlarged in caliber, and were converted into
drainage pipes for the specific purpose. This hypothesis derives
confirmation from the acknowledged fact that through the same
channel the fluid of a mono-cystic ovarian dropsy has sometimes
also been evacuated.
8
54 PROCEEDINGS OF THE
In an instructive essay contributed to the Western Journal of
Medicine, Dr. J. C. Reeves, of Dayton, Ohio, discusses the subject
of post-abortion hemorrhages, resulting from retention or incom-
plete removal of the Secundines. After a few introductory remarks,
touching the special causes of retention of the placenta during
the early period of gestation, viz., the undeveloped physical and
dynamical condition of the uterus, and the intimacy of the organic
attachment subsisting between that organ and the placenta, he
cites several instances of the continuance of hemorrhages for
months, assuming in some instances the form metrorrhagia, in
others inducing excessive menstruation, and ceasing only with the
complete expulsion of the remains of the secundines.
After making successive trials of the various astringents, echolics
and the tampon, with but partial and temporary success, he at
last resorted to the sponge tent to secure dilatation of the cervix,
and permit the introduction of the finger, but a twofold object
was accomplished by the tent—the simultaneous dilatation of the
neck, and the contraction of the corpus uteri, thus effecting the
facile extrusion of the placenta. In one instance, however, he
was obliged to supplement this procedure by the injection of a
dilute solution of the liq. ferr. Sub. Sulph. *-,
After reviewing the literature of this subject, and showing that
although recent writers have generally recognized hemorrhages as
a result of incomplete abortions, yet only Joulin and Devilliers
have in some measure indicated the only efficient procedure, and
that to the late Prof. Breslau, of Rome, whose recent death
science deplores, we are indebted for a full exposition of the
nature, cause and treatment of these cases. Placing little reliance
upon ergot and astringents, the peculiarity of the treatment of
Breslau, consists in the dilatation of the cervix with lammaria or
Sponge tents as a preliminary for diagnosis and treatment ; the
subsequent use of the bimanual exploration, supplemented, if need
be, by the use of a long and slender forceps to procure small pieces
of the contained mass. These should be submitted to the micro-
scope to determine by the presence or absence of the chorial villi
whether we have to deal with polypi, dysmenorrhoeal membranes,
or placenta. If in rare instances this mode of investigation
STATE MEDICAL SOCIETY. 55
becomes impracticable he resorts to incision of the cervix with
immediate effect upon the hemorrhage, and without unfavorable
sequel. It is but an act of justice to Prof. Simpson, and the late
distinguished Naegele, of Heidelberg, to state that both have
anticipated recent writers in the use of the sponge for dilatation;
the former recommending it in 1844, and the latter in 1851 in the
case under consideration. More recently, Dr. Priestly in an
essay in the Obstetric Transactions for 1861, and Dr. Duncan in
the Edinburgh Journal, in 1863, have repeated the recommenda-
tion. For the cure, says Dr. Duncan, nothing is required but
the complete evacuation of the offending structures from the
interior of the uterus. This is effected by the use of the sponge
tent, the polypus forceps, and the double catheter injection appa-
ratus.
EXTRA UTERINE PREGNANCY.
The current literature of the year past contains an unusual
number of cases of what may be regarded as the greatest error of
nature—that the very act by which she seeks to produce a new
being proves fatal to both parent and progeny. I allude, of
course, to extra uterine gestation. It is, indeed, not improbable
that the unusual number of cases found in the periodicals and
reports of the current year, is due rather to the increasing atten-
tion bestowed upon this abnormity, and consequent improvement
in diagnosis, than to the augmented numerical proportion of cases
actually occurring; and that, as in pelvic hematocele from other
causes, and pelvic abscess, now so frequently recognized as to
attract no especial attention; this pathological condition will be
found to be more frequent as the science improves in its diagnostic
resources. And may we not venture, in the interest of humanity,
to express the confident anticipation that, now that the successful
treatment of vesicco-vaginal fistulae and ovarian dropsy has
become the rule, ere long this opprobrium, too, may be wiped
from our escutcheon 7 Already during this current year, the suc-
cessful treatment of some cases encourage the hope of ultimate
success. To contribute to this end, the following case is now
reported:
56 PROCEEDINGS OF THE
CASE OF TUBAL PREGINANCY,
Mrs. N., 25 years of age, married about five years, menstruated
somewhat irregularly, and often with much pain and hemorrhage.
She had never been pregnant. Her general appearance was
healthy and vigorous. About six weeks previous to her last ill-
ness, I had prescribed for her dysmenorrhoea. She was attacked
near evening, after a day of somewhat active exercise, with very
severe pain in the hypogastrium, and soon followed by faintness.
When I saw her, about an hour after the attack, her face, lips and
tongue were pale; the pulse was scarcely perceptible at the wrist;
she was very restless, and the surface was bathed with profuse and
cool perspiration. The hypogastrium was very tender, and the
right inguinal region was unusually full, but not presenting the
circumscribed limits of a tumor. To the vaginal touch the uterus
seemed slightly enlarged, but no tumor could be distinguished.
The diagnosis founded upon these symptoms, was internal pelvic
hemorrhage, but whether the result of rupture of a tubal preg-
nancy, or from the bursting of Some vessel of considerable size
belonging to the ovarian or utero-tubal plexus, I did not feel pre-
pared to decide. Practically, moreover, it was a matter of little
importance, the indications of treatment being the same in either
event. By the free exhibition of brandy and laudanum at short
intervals, the extreme jactitation, vomiting and pain were allayed,
and full reaction was established in about six hours. The next
morning she was tolerably quiet, but complained of great head-
ache and abdominal tenderness; the pulse was 110, soft, and
moderately full; the abdomen became more tumid, and the ten-
derness more extended; the decubitus was dorsal, with the knees
drawn up. Presuming, from these symptoms, that, with the
reaction, peritonitis had supervened, the brandy was withheld,
and morphine, with Small doses of calomel and veratrum viride,
were pretty freely exhibited. Imagining, however, that the head-
ache was caused by the morphine, the patient failed to take the
medicines with the regularity prescribed. The abdomen was
diligently steeped with warm water and spirits of turpentine
alternately, and the thirst and vomiting allayed with iced lemon-
STATE MEDICAL SOCIETY. 57
ade and bits of ice. The symptoms continued without much
change for the next forty-eight hours, when a slight tenderness of
the gums was perceived. The calomel was then withheld, and
the morphine and veratrum administered in restricted doses.
Beef tea was given as freely as she could be induced to take it,
through her entire illness. On the third day there was a slight
increase of the tympanitis, but the symptoms, in other respects,
were not materially changed. A large blister was applied over
the abdomen, which drew well, and somewhat relieved the ten-
derness. Early on the morning of the fourth day, I was called
to visit her, as she was supposed to be sinking, but being then
engaged with an obstetrical case, another physician was called,
but failed to see her. As soon as I could be relieved, I called,
and ascertained that she had expired an hour before my arrival.
She had risen to micturate, as she persisted in doing, contrary to
my most strenuous injunctions, and, lying back on the bed, imme-
diately expired, undoubtedly, I think, from syncope. The post-
mortem was made twenty-four hours after death, in which I was
assisted by Dr. Lewitt. On opening the abdomen, the intestines
were found but moderately distended with gas, but not a trace of
peritonitis was visible in either the abdominal or pelvic cavities.
In the latter, however, and in the right inguinal region, a quan-
tity of semi-fluid blood was found, estimated at nearly a quart.
Near the middle of the right fallopian tube, a globular enlarge-
ment was seen, about an inch in diameter, containing an ovum
of about five or six weeks. On the external lateral border of the
tube, a small laceration was observed, about three or four lines
long. The ovum, which was covered with a distinctly villous
chorion, was surrounded with infiltrated blood, and in appearance
much resembled an early aborted ovum. Both of the fallopian
tubes were considerably enlarged and congested, as at the cateme-
nial period, but had not contracted adhesions to contiguous parts.
A layer of coagulated blood invested the tumor, and closed the
rent in the tissues. The uterus was but little enlarged, and a
distinct corpus luteum found in the right ovary.
Practically, this was simply a case of pelvic hematocele, so
called, or rather pelvic hemorrhage, for no tumor was formed, as
58 PROCEEDINGS OF THE
the ovum was not extended into the peritoneal cavity, and the
laceration was too small to give rise to symptoms of shock. In
the pathological history of this case there are several points of
interest; first, in regard to duration; for although in common
with all other cases of tubal pregnancy, with the excep-
tion reported by Virchow, and one or two more recently, it
terminated fatally, yet this result was delayed much beyond the
average period, for of the forty-eight cases reported by Dr.
Hecker in the Monatschrift fur Geburtskunde, twenty terminated
in twelve hours, fifteen in twenty-four hours, three in thirty-six
hours, and two in forty-eight hours, while but six were protracted
to from three to eight days, and two even to ten days. The
death in this case, moreover, seems to have been accidental
rather than necessary, as neither shock nor peritonitis, nor the
abundance of the hemorrhage could be assigned as causes either
true or sufficient. As in this, too, so in a large proportion of
Hecker's cases some marked abnormity of the menstrual function
existed sufficient to induce either absolute or relative sterility.
Both Hecker and Virchow agree in ascribing these functional
deviations in many cases to torsion or constriction of the tubes
produced by a local chronic peritonitis, but in the case before us
the tube presented no evidence of external inflammatory action;
and in the absence of positive evidence we may plausibly surmise
that the arrest of the ovum in its transit through the tube to
have been due to chronic inflammatory thickening of the mucous
membrane of that part of the organ, as an extension of the
chronic muco-metritis. Another curious and suggestive fact was
observed in the complete absence of peritonitis, notwithstanding
the contact of blood for more than three days, and with agitation
sufficient to prevent coagulation. It is well known that in cases
of pelvic hematocele not terminating promptly in death, plastic
inflammation is often speedily set up, tending to encyst the effused
blood, and prevent general peritomitis. Why not in the present
case ? -
Was it due to the circumstance that the ovum was not rup-
tured, and its contents, as foreign material, not effused into the
peritoneal cavity? That such an event would have augmented
STATE MEDICAL SOCIETY. 59
the liability to peritonitis may be unquestionable, yet it is equally
true that the spontaneous rupture of an ovarian cyst, with pure
serous contents, generally is absorbed without resulting in
peritonitis, as a case under my recent observation has quite Satis-
factorily shown.
EXTRA UTERINE PREGNANCY.
In a very recent essay Dr. Matthews Duncan reports the
history of three cases that have recently fallen under his obser-
vation. He appends to the narrative of the cases some comments
on the diagnosis, which are well worthy of attention. In this
case he remarks the diagnosis of extra uterine pregnancy was
imperfect in consequence of the absence of metrorrhagia up to
within a few days of the production of the retro-uterine hema-
tocele, and in consequence of my being unable to detect the
presence in the pelvis of any unnatural tumor. This non-
discovery of tumor will not astonish the experienced prac-
titioner; for while, in some cases, it is easy to find so small a
body as the ovary, in others a considerable mass, if lying high
in the pelvis and especially if mobile, may elude, in a tense or
moderately distended abdomen, the most searching examination.
But even had metrorrhagia been present and a tumor of proper
size detected, the diagnosis would not have been one producing a
high degree of assurance. The hemorrhage occurred in this case
when lying quietly in bed, and was attended with feelings of
labor pains. Upon this latter symptom much reliance seems to
be placed as being diagnostic of the fallopian or tubal war, of
extra uterine gestation. Though admitted to possess a very high
value in this regard, as it may also occur in interstitial gestation,
it is not pathognomonic of the accident. When considering the
causation of the symptoms the author remarks that there was in
this case no proportion between the extreme protrasion, and the
actual amount of hemorrhage; for, although the estimate of the
quantity was merely approximate, he felt quite sure that a much
larger amount of bleeding otherwise produced, would have been
a light affair; and hence infers that the shock was more
intimately connected with the laceration of peritoneal and tubal
60 PROCEEDINGS OF THE
tissue, than with the hemorrhage. The treatment of this success-
ful case consisted in supporting the patient with moderate
stimulants for ſhe fortnight after the rupture of the tube, and
until the blood became encysted, then puncturing the cyst behind
the cervix, evacuating it, and injecting with at least twenty
ounces of a weak Solution of permanganate of potash, which,
while it removed some remains of the ovuline structures, yet
lighted up a dangerous degree of inflammation in the sac, and
seriously imperiled the life of the patient. Subsequently only two
ounces of carbolic acid lotion were used, and repeatedly without
evil result. The author suggests a doubt in regard to the pro-
priety of puncturing the cyst. In two cases reported by Drs. Ed.
Martin, of Berlin, and Greenhalgh, of London, of presumptive
tubal pregnancy, a different line of treatment was pursued, but
with an equally auspicious result. Founding their views of treat-
ment upon the recognized fact that when the liquor amnii of the
early ovum was lost, the foetus soon perished, they introduced
delicate trocars into the cysts and drew off the fluid, thus
arresting the growth of the ovum, and causing the gradual
disappearance of the tumor.
In an elaborate, and in most respects admirable essay published
in the Transactions of the American Medical Association, for
1867, from the pen of Dr. Stephen Rogers, of New York, an
attempt is made to establish the propriety of a bolder line of
treatment, viz.: Gastrotomy and removal of the tumor and the
hemorrhage whenever the symptoms justify the conclusion that
rupture of a cyst has recently occurred. With much plausibility
he urged the generally fatal result of the merely expectant or
supporting treatment, and the not unfrequent recovery of a patient
after severe injuries, as in rupture of the uterus, and the removal
of uterine and ovarian tumors. As, however, no certainty of
differential diagnosis exists between this and other forms of pelvic
hematocele, it is not probable the suggestion will be speedily
adopted.
TJTERINE FIBROMA.
The following case of dystocia by the mother's soft parts
is respectfully reported: Called to visit Mrs. H., aged 38 years,
STATE MEDICAL SOCIETY. 61
e
in consultation with Drs. E. and D. Hall. She had been in labor
for more than twenty-four hours. On examination, I found the
os uteri high in the pelvis, and crowded against the upper margin
of the pubis, by the presence of a tumor occupying the pos-
terior lip, and the entire length and breadth of the posterior wall
of the cervix. As nearly as could be estimated it was at least
two inches in diameter, and very firm and elastic. The OS uteri
was pretty freely dilated, but the pains had ceased. By aus-
cultation no foetal heart sound could be detected. It was decided
to make an effort to bring the head deeper into the cavity, to
facilitate craniotomy, if, as seemed probable, it should be required.
The forceps were applied without much difficulty and the head,
with the os but slowly dilating, brought to the floor of the pelvis.
I then determined to continue the traction in the hope that the
resistance of the perineum upon the tumor would enable me to
dilate the os sufficiently to effect delivery. This was, however,
but partially successful; but by firm and steady traction the
tumor in advance of the head passed out of the vulva, and
then yielding to the distending force, a dead child was delivered.
The perineum was somewhat lacerated, but not seriously. The
mother recovered without a bad symptom. About six months
afterwards the patient called upon me, looking very pale and
anaemic. She stated she had been subject to repeated attacks of
of metrorrhagia, occurring often when at stool, in spurts and
gushes. She also suffered much from pelvic pains, uterine tenes-
mus and difficult micturition. The tumor was now found
greatly enlarged, nearly filling the cavity, and resting on the floor
of the pelvis, yet often protruding somewhat externally on making
any tenesmic effort. She was informed that an operation would
be required as the only effectual method of relief; but advised
delay until by the further use of iron and quinine and liberal
food she might be restored to a more favorable condition. Mean-
while an inflated gum elastic and ring pessary were employed
to support the uterus, an office which, however, they very
imperfectly performed. About two months later she called again,
and the tumor now so nearly filled the cavity that the finger
could with difficulty reach the anterior lip, which was stretched
9
62 PROCEEDINGS OF THE
like a thin band over the tumor. The sound was passed about
six inches into the cavity. After a full statement of the danger
attending an operation for the removal of so large a tumor, she
cheerfully consented to anything deemed necessary for relief.
After a few days an operation for enucleation was performed
with the assistance of Drs. E. Hall and Wm. Lewitt; the patient
lying on the left side, and placed under the influence of chloro-
form, a museux hook was inserted near the end of the tumor,
and by very moderate traction caused to emerge partially from
the vulva; an incision was made through the thin walls of the
cyst, and by the aid of the fingers, aided by the hook, it was
detached, and removed in two or three minutes. A large dis-
charge of serous fluid followed immediately, and after the lapse
of ten minutes free hemorrhage took place from the evacuated
cyst, necessitating the use of a sponge Saturated with a diluted
solution of ferr. per sulph. The pulse became very feeble and
frequent, and the sighing respiration so characteristic of hemor-
rhage disclosed the suffering of the constitution, and demanded
the free use of brandy, laudanum and beef tea for two or three
hours, when free reaction occurred, and the patient expressed
herself as feeling very comfortable. The sponge tampon was
withdrawn the next day and the coagula removed. No further
hemorrhage occurred. On the third day the discharge had a
distinct lochial odor, and was pale and moderate in quantity.
Very slight tenderness over the hypogastrium, and no difficulty
of micturition, and no pain. The pulse for the next three days
remained about one hundred, moderately full and soft. Beef tea
and toast, and a moderate use of brandy, constituted the treat-
ment. On the evening of the third day she became a little
restless, and the pulse rose in frequency; slight headache and
hebetude of intellect supervened, which gradually passed into
comatose insensibility, and on the following morning she expired.
Much to my regret an autopsy was not permitted, as the cadaver
was removed some miles distant a few hours after death. Was
uramia, or septicaemia, or simply cerebral congestion the cause
of the fatal termination. Frequent vaginal injections, first of
simple water, and afterward of chlorinated solutions, were
STATE MEDICAL SOCIETY. 63
employed, and no putrid odor characterized the discharge. The
urine was not tested, as no disease of the kidneys was suspected.
The tumor was elliptical in form, six inches in length and four
in transverse diameter, and weighed one pound and a quarter.
It was a solid mass, having the well marked fibrous structure of
uterine fibroma. T. Pridgin Teale reports a case of this disease,
having the same rare location, but of somewhat smaller size,
treated successfully by the same process.
FORCEPS.
No one at all familiar with the history of obstetrics for the last
quarter century will fail to remember the warm controversy
between Sir James Y. Simpson and Dr. Collins, of the Dublin
Lying-in Hospital, on the danger to the mother and child from
protraction of labor. The former appealed to statistics to prove
his general proposition that there existed a geometrical relation
between the danger to the mother and child when the labor was
delayed, and hence that some mode of manual or instrumental
intervention was demanded at an early period, while Dr. Collins
contended that the conclusion of Dr. Simpson was greatly exager-
ated and illogical; and that especially in relation to craniotomy,
“under proper management the death of the child takes place in
difficult and laborious labor before the symptoms become so
alarming as to cause any experienced physician to open its head
for the sake of the Safety of the mother;” another instance of
the truth of the old adage that truth is never found in the
extremes. The subject has been recently re-examined in an able
and logical manner by Dr. Duncan, of Edinburgh, in his work
On Fecundity, Sterility, etc. He seems to have demonstrated
incontrovertibly that mere protraction of labor per se has but
little influence on maternal mortality, that it is but an incon-
siderable item among the many causes of the mortality of women
in parturition and childbed; and while conceding the truth of
Dr. Simpson's proposition that the mortality increases with the
length of labor, he thus sums up the pernicious tendencies of the
doctrine as laid down in an unqualified form by him : “Let us
consider for a moment what such reasoning as Sir J. Y. Simpson
64 PROCEEDINGS OF THE
adopts in this controversy would lead to. It appéars to us that,
if he had looked whither his arguments might lead, he would have
himself been probably deterred from using them. If mere length
of labor be an important element in the causation of deaths
from labor, then certainly patience is no virtue in an accoucheur.
If mere length of labor be as he describes it, then meddlesome
midwifery must, I fear, be declared good instead of bad. If
mere length of labor be as important as he represents it, then any
treatment that will accelerate delivery may be easily defended.
If it be right to disregard all the real causes of danger and death
in labors, as this author does, in order to make prominent the
danger of protraction, with the ulterior view of supporting an
artificial interference which accelerates the process, then a like
reasoning may be used to support the most absurd and unjusti-
fiable measures, and the art of midwifery will be at the mercy of
any specious reasoner, however ill-founded his arguments may
be.”
In discussing the powers of the forceps in his recent lectures
on obstetric operations, Dr. Barnes, after referring to the triplex
power of the instrument as a tractor, a double lever, and as a
compressor, attempts ingeniously to illustrate its action in the
capacity of the first named; and in reply to the inquiry how its
“hold” is effected, says: “It is really due to the curvature of
the blades, which fit more or less accurately upon the globular
head, and the compression of the bows of the blades upon the
soft parts of the mother, supported by the long ring of the
pelvis.” He employs the following illustration: “Take an India
rubber ball slightly larger than an iron ring; place the ball upon
the ring, then seize the ball through the ring with the forceps.
The blades will be opened out by the ball. Then drawing upon
the blades without squeezing them together you will see the
blades firmly pressed upon the ball by gradual wedging; as the
greatest diameter or equator of the ball comes down into the
ring. Just so it is with the child's head, and the pelvic brim and
canal.” *
As a purely hypothetical case the illustration is both true and
ingenious, but as it finds no parallel in nature, it is practically
STATE MEDICAL SOCIETY. 65
fallacious. It is believed to accord with the experience of every
obstetrician that when the forceps are used in cases of obstructive
parturition which necessitate strong traction, a compressive force
of considerable amount upon the handles is required to prevent
the slipping of the blades from the head of the foetus. More-
over, as the obstruction generally occurs in the conjugate
diameter, there is usually so much space in the transverse or
oblique diameters, in which alone the forceps can be applied,
that no external pressure, except from the yielding soft parts,
can be made upon the blades of the instrument, and hence in such
cases (and these are of the most important character) the mere
curvature of the blades can avail little in retaining firm hold
upon the head, such as is often required when used as a tractor.
Again, touching the use of the forceps as a compressor, it is well
known that great discrepancy exists among obstetric writers, the
prevailing sentiment, it is believed, being in favor of such use,
with certain limitations and restrictions. What the limits of
safety are, and how, or in what mode those limits may be reached,
are obviously questions of the highest practical importance. The
experiments of Baudelocque, of Osiander, of Siebold and Velpeau,
by employing sudden compressive force by strong forceps are too
well known to require especial notice. The more recent
experiments of Chassagny, of Joulin and Delore, being in much
closer imitation of the process adopted by nature, justly claim
much higher consideration. These gentlemen, in experiments
designed to demonstrate the utility of continuous compression and
traction by powerful forceps upon the head in difficult labor, have
completely proved that a degree of moulding may be effected
much beyond that commonly observed, the mento-occipital being
increased at the expense of the biparietal diameter. “There are
two limits” says Joulin, “to the reducibility of the head, one an
absolute one, which can only be attained by the use of great force,
yet without necessarily fracturing the bones, amounting to about
two inches, but not admissible in practice. The other, about six-
tenths of an inch, which is quite compatible with persistence of
foetal life, and which is most certainly, as well as most safely,
attained by the aide-forceps,” an instrument of his own recent
66 PROCEEDINGS OF STATE MEDICAL SOCIETY.
invention, the amount of force employed being measured by a
dynamometer attached.
From numerous experiments Delore has reached the conclusion
that only angular and restricted pressure is dangerous; while a
great degree may be employed when uniformly spread over
a large surface. Hence when the common forceps are proposed
for this purpose one should be selected for the extent of the grasp
of the blades. He has also shown that the greater the traction
the greater is the pressure, the latter being equal to half the
former. Hence the traction of 200 pounds often required, would
equal 100 pounds pressure upon the head of the child. Time,
however, is a most important element of safety in these
operations; the danger of the pressure being inversly as the
time allowed for the moulding process. Among the changes that
mark the progress of obstetric treatment in cases of dystocia.
depending on rigidity of the OS uteri, we notice in the recent
lectures of Dr. Barnes the almost complete rejection of the
dynamical measures still appreciated by most writers as v. S.,
nauseants and the warm bath, and the substitution of those
chiefly of a mechanical character, as the vaginal warm douche
water pressure by means of Barnes' gum elastic dilators, manual
pressure, or the conical introduction of the hand by moderate
force and vaginal hysterotomy, as orificial incisions are somewhat
grandiloquently named. These heroic measures may be safe
when judiciously employed, without rejection of the former
methods,
REPORT ON DISEASES OF WOMEN.
BY EDWARD W. J.ENKS, M. D., OF DETROIT.
Mr. President and Gentlemen of the State Medical Society:
Your committee appointed to report at this time upon Diseases
of Women, feel themselves at a loss, as to the manner in which
their report shall be presented, and how much or how little of
the great field, comprehending so wide a scope, and of so great
interest, shall be considered. -
In these days when home and foreign medical literature is so
abundant, and so easily accessible, when volumes are written
upon a single disease, when men devote their lives, energies and
talents to special departments in medicine and surgery, and pub-
lish to the world the results of their investigations; it seems futile,
indeed, for us to attempt to do more, in a paper of the character
prescribed as the report of a Committee on Diseases of Women,
than to present a few generalities, or to select from the great mass
a fragment for consideration. We have therefore taken the liberty
to present our report in the form of a few remarks upon the
diagnosis of a class of disorders usually designated as Uterine,
Diseases.
Diseases of women have always elicited the interest and
attention of the medical profession. The sex and character of
the sufferers, the pains, the frequency, obscurity, and severity of
this class of diseases, with the many physical and mental dis-
turbances, involving the life and happiness of women, in their
various capacities of wife, mother and friend, have greatly
enhanced the interest of medical men, and prompted them to
increased study and investigation.
68 PROCEEDINGS OF TEIE i
It is a fact, which we believe cannot be called in question, that
the majority of physicians of our day have started in practice
having the most meager knowledge of that great class of diseases
peculiar to women, involving the generative apparatus.
Prominent among the causes of this prevailing ignorance has
been the want of clinical teaching as an integral part in the curri-
culum of our medical colleges; as has been truly said, “without
clinical teaching books confuse, and are liable to be misunder-
stood, and it is only after the experience of actual practice, that
their real value is discovered, and the assistance they offer is
appreciated. Didactic teaching without clinical instruction,
imperfectly imparts that knowledge which is requisite to recog-
nize all diseases, including those under consideration.
The diagnosis of a particular disease depends in no small degree
upon a familiarity with its characteristics, and, as has been truly
remarked, “the alphabet of diagnosis is the art of observing,”
and this art can only be made available, and this alphabet, upon
which hinges all further knowledge of the language of disease,
alone can be acquired clinically.
The medical student may have, theoretically, a complete
knowledge of the normal and abnormal sounds heard over the
lungs in health and disease, while practically he may be the
veriest dolt and blunderer in diagnosticating diseases of the chest,
if he has made no application of his acquirements.
So one beginning practice, claiming to be an oculist, skilled in
the treatment of diseases of the eye, taking upon himself the
responsibility of treating the affections to which that delicate
organ is subject, without ever having seen more than a half dozen
diseased eyes, while possessed of all the knowledge which lectures
and books may afford, is yet imperfectly educated, and an
incompetent practitioner of his profession.
If, then, it be necessary for one to be skilled in physical
exploration of the chest, and the diagnosis of diseases of the eye,
that those diseases be understood practically, and not alone theo-
retically; no less true is it that a proper knowledge of diseases
of women must be obtained otherwise than entirely from profes-
Sors and books.
STATE MEDICAL SOCIETY. 69
Your committee desire to express their opinion that the Degree
of Doctor of Medicine possesses but little intrinsic value when its
recipient has had no opportunity of studying diseases, under com-
petent teachers, at the bedside. The stethoscope is considered
almost indispensable as a diagnostic aid in diseases of the thorax.
Scarcely can we comprehend the great advances made in our abil-
ity to diagnosticate diseases and pathological changes, whereby we
may institute intelligent treatment of the heart and lungs, since
the days of Laennéc. Then we have as diagnostic aids for physical
exploration, the opthalmoscope, the laryngoscope, the otoscope, and
various other means whereby medical knowledge has been
increased; but among the many branches of the healing art, none
has had more light shed upon it by the application of physical
means of investigation than gynecology; yet, with the latter fact
staring us broadly in the face, many in our profession calling them-
selves progressive men, without hesitancy using and commending
the first named means of investigating disease, denounce as demor-
alizing to both physician and patient the vaginal speculum and
other modes which modern gynecologists use for diagnosticating
and treating diseases of the pelvic viscera of women.
Assuming that a physician is possessed of pathological know-
ledge of diseases pertaining to the female sexual organs, skill in
diagnosis must precede skill in therapeutics. Not unfrequently,
when a physician suspects uterine disease, a digital examination is
made, followed by a specular one. If there be granular degenera-
tion, ulceration or abrasion, or any of the diseases of os or cervix,
easily seen through a speculum, the diagnosis is easy; but should
the case be otherwise, he may become disheartened, at the same
time forgetting that there are other media by which the disease
may be diagnosticated, as the use of the uterine sound, sponge-
tents, rectal touch, and other modes to which he should have
resorted, for without applying these, even the most skilled diag-
nostician would be at fault, as well as himself.
There are means, at the present time easily accessible, by which
all parts of the pelvic viscera are explorable, and until these are
thoroughly made use of, no one can feel that he has properly
exercised his powers of diagnosis.
10
70 PROCEEDINGS OF THE
The physician duly impressed with his own responsibility and
duty to his patients, will allow no false delicacy to prevent him
from making every requisite inquiry, and using any or every
method of examination which may appear necessary, nor should
he be willing to risk his reputation by giving his opinion in an
important case unless every adequate opportunity has been
afforded him. R
We would not countenance unnecessary and repeated investiga-
tions of the female generative organs, but with the reserve of gen-
tlemen in its strict sense, with a proper regard and consideration
for the opposite sex, we should not exceed a limit which might
cause, in the least degree, the feelings of delicate and sensitive
patients to be outraged. In no class of diseases is it of more
importance to acquire carefully all the data pertaining to diagnosis
than in the diseases we are considering; to this end we should avoid
pre-judgment or too hasty decision in a case. We are prompted
thus to speak, as it is an uncontrovertible fact that if a woman
believes herself to have any disorder of her generative organs, the
first thing which suggests itself to her as the disease, is ulceration
of the uterus. Her conclusion is a reasonable one, for she has thus
been educated by physicians, from a prevailing idea among the
profession that ulceration is about the only disease the uterus is
ever afflicted with. Thus many a woman has suffered much at
the hands of her physicians from cauterization for ulceration, when
perhaps no ulceration existed, and if she did not improve after
repeated applications of nitrate of silver and other escharotics,
was doomed as incurable, and either suspended all treatment or
passed into other medical hands. A learned professor and writer
in our land is in the habit of treating all diseases of the uterus by
means of pessaries, and, judging by his writings, he teaches that
all curable diseases of the female generative organs can be success-
fully treated by curved pessaries, and those which are not cured
by these, are of course incurable.
In the same manner, nitrate of silver (an invaluable remedy),
has been the panacea for uterine disorders in the hands of many.
True ulceration of the cervix uteri we do not believe a very com-
mon disease, but abrasions or granular degenerations are more
STATE MEDICAL SOCIETY. 71
frequent. If a woman has chronic hyperaenia of the uterus, or
chronic metritis, frequently so called, from any of the common
causes which may produce it, compelling the organ, by reason of
its great weight, to occupy a position low down in the pelvis,
aggravated still further by the prevailing style of dress, the cervix
is crowded down upon the pelvic floor during locomotion. In such
a case, mechanical causes added to the diminished vitality of the
organ, may produce abrasion or perhaps ulceration of the neck,
easily to be seen through a speculum. Now, if nitrate of silver, or
any stimulating or escharotic application be made, it may succeed
for the time being in healing the visible diseased surface and ren-
dering the patient for a while more comfortable, but a radical cure
is not effected, for the primary disorder is undetected.
In this same unscientific mode of treating disease, patients hav-
ingleucorrhoea are frequently prejudged by their medical attendants
as having ulceration of the cervix uteri, and, on this supposition,
preparations for cauterization are made previous to examination.
Several cases have come under our observation where reputable
practitioners have informed patients that they had this ever
prevailing ulceration, based upon a hasty digital examination;
caustics were applied nominally to the cervix uteri, without the
aid of a speculum, and the patients directed to continue the same
treatment once a week. The difficulties which a physician might
encounter in such an application to the cervix uteri without burn-
ing contiguous parts would be much more enhanced if a patient
were to use the remedy for herself. We have examined some
patients with a speculum who have thus been the victims of self-
torture, and in several instances failed to discover any signs of
ulceration or even local disease, except slight catarrh of the uterus
or mucus flux from the vagina, where constitutional treatment
effecting a cure plainly showed that the difficulties were due alone
to constitutional causes.
One class of medical writers and practitioners áttribute all
diseases affecting the uterus and contiguous parts to local causes,
and direct their treatment accordingly, while another class adopt
the opposite extreme, and place but little value upon local thera-
peutics. On these points, the English and French schools are, to
72 PROCEEDINGS OF THE
a certain extent, in direct antagonism; the former looking upon
all disorders of the uterine system as the result of constitutional
malady, while the latter consider these diseases principally, if not
alone, as local in their character, and the systemic derangements
as secondary and reflective, consequently local treatment is given
the greatest prominence. V
A recent English work by Dr. Wright, on the Constitutional
Influence and Treatment of Uterine Disorders, speaking of the
requisites of success for a practitioner of gynecology, says, “All
constitutional causes producing disorders should be investigated,
all the teachings of physiology and general pathology held in
mind, and all our extended knowledge of the influence of remedies
and of hygienic medicinal methods laid under contribution, in
order to arrive at a correct diagnosis and to insure a good result
from treatment.”
On the other hand, the works of Bennett, Sims, and others of
the French school, advocate, above all kinds of treatment, local or
immediate, ignoring constitutional treatment, make plausible thera-
peutic theories of a taking character, and promise relief as imme-
diate and success as certain. Thus the practitioner is liable to be
misled amid the confusion of theories and the unreasonable exclu-
siveness of the doctrines taught.
Experience and observation, with a somewhat careful and
thorough investigation of the views so dogmatically promulgated,
cause us to be unwilling to accept either extreme to the exclusion
of the other; each containing truth and neither wholly right, the
middle ground, as usual, we deem the true one. In America there
are warm and honest exponents of both doctrines, yet we believe
there is a large class of writers and practitioners who are able to
garner up useful knowledge only by sifting the chaff from each,
and are successful in treating that class of affections known as
uterine diseases by a due regard to both constitutional and local
treatment.
Regarding constitutional causes and general treatment of dis-
eases of the uterus, we cannot forbear quoting the following
passage, favorably commented upon by reviewers, from the work
of Dr. Wright before alluded to : “Due renovation of the uterine
structure requires that the general nutrition be in a healthy con-
STATE MEDICAL SOCIETY. 73
dition. If this be below par, the structure of the womb may just
remain in a state which denotes arrest of the reparative changes,
and with only negative results. As the fat and flabby heart rep-
resents a state of deficient renovation due to ineffective nutritive
action, so the uterus, large, weak and inactive, indicates deficiency
of systemic power, and the general symptoms are explained by a
condition brought under notice by one or another of those local
disorders already mentioned.
The patient may eat well, but what she takes is not turned to
good account. She may be very plump and appear the picture of
health, but the muscles are flabby, the heart has to labor when
unwonted exertion in the least degree accelerates the current of
the blood; there is deficiency of power and of tone in every organ
and structure, and the deposition of fat which plumps out the
frame is rather an evidence of defective action than a sign of
healthy condition. But there is an opposite physical state, no less
important, where food, if taken at all, is not properly assimilated;
where reparation is not effected, because the conditions which
insure due renewal of tissue are not fulfilled. In these the women
are thin, wan and weakly; there is little energy for effort, but
there is still less power to repair the wear and tear which effort
implies.” (Pages 222 and 223.)
We are not disposed now, nor do we deem it advisable in this
paper to discuss, at any length, the relative merits of local and
constitutional treatment, but will reiterate what a somewhat
extended observation has taught us, that treatment of womb dis-
eases may be profitless and worse than useless if we neglect either;
that whatever may be the nature of a local disease or its immedi-
ate cause, we should neither underrate or overlook influences of a
constitutional character and the intimate relationship of different
portions of the body.
Intimately associated with uterine disease and coming properly
under the same category, are those frequent disorders of contigu-
ous parts, consequent upon uterine affections, where not unfre-
quently errors are committed in treating secondary diseases,
neglecting the primary, where disorders of function are mistaken
for disorders of structure, where symptoms are treated and causes
remain unrevealed. *
REPORT ON NEW REMEDIES.
BY S. P. DUFFIELD, Ph. D.
MR. CHAIRMAN —On receipt of the notice of my appointment
as one of the committee to report on new remedies, I issued notice
to my collaborators, and received from them the reply that they
had nothing to offer. I therefore, as chairman of said committee,
offer the following report:
Repler, a celebrated astronomer, once said “that there were as
many comets in the heavens as fish in the sea.” The remark is
equally applicable to the numerous galenical preparations offered
by almost every prominent druggist or manufacturer in the com-
mercial centers. We have now offered to us for indorsement
elixirs of bark, elixirs of bark and iron, elixirs of pyrophosphate of
iron, elixirs of iron, Strychnia and quinia, dragees, sugar-coated
pills, tablets, etc., etc. All these are well enough in their way,
but they really do not deserve the name of new remedies any more
than physicians' prescriptions could be so classed. They are mod-
ified modes of exhibiting these different remedies already known
favorably to the profession.
I am aware that there are some among our number who feel
that they would rather prescribe the full mixture and have the
apothecary put it up than simply write elixir valerianate of ammo-
nia. But in the time of writing the prescription the physician
would fall far short in point of agreeable flavor of his prescription,
were he to attempt to make an elixir similar to Hegeman's elixir of
pyrophosphate of iron. These, then, are pleasanter modes of exhi-
bition, which the physician can avail himself of and save himself
quite an amount of mental labor. We dismiss these articles, there-
fore, as aids, and cannot consider them new remedies.
PROCEEDINGS OF STATE MEDICAL SOCIETY. 75
Among the remedies most popular with the profession at pres-
ent are the bromides, haloid combinations of ammonia, potassa and
Soda. The bromide of ammonium takes the first rank, being supe-
rior in two points:
1st. The equivalent of ammonia being 17, and that of potassa
being K 39 + O.8 = 47, the ammonium salt contains weight for
weight more bromine than the potassa salt. You have also the
arterial stimulation, which is peculiar to ammoniacal compounds,
when you use the bromide of ammonia in preference to potassium.
It should be thoroughly understood that these bromides are incom-
patible with acids, and persons using them should avoid pickles
and acid mixtures, or they will have free bromine evolved, which
will produce irritation of the fauces and larynx. \
Dr. Dunglison, in commenting upon the effects of this chemical,
says it is apt to produce more derangement of the stomach than
the iodide, which the practitioners of the present day cannot
indorse, as it acts more kindly and is better borne than its ana-
logue, the iodide.
Among the new medicinal remedies later than gelsemium, to
which I called the attention of this society at the last meeting, we
have, this past year, brought to our notice by Dr. D. L. Phares, of
Newtonia, Mississippi, the viburnum prunifolium, or black haw, as
a remedy of efficiency in threatened abortion and uterine hemor-
rhages. At the request of several members of the profession, I
made a fluid extract of the bark of the root, which was gathered
in Canada for our house last fall. It proved serviceable in a case
reported by Drs. Pitcher and Farrand, when acetate of lead, ice
applications, and the usual remedies, had no effect. Several of our
city practitioners have used it. Dr. Snow, of Dearborn, has also used
it, and I believe they all report favorably of its virtues, thus sus-
taining the qualities which Dr. Phares claimed for it. The prin-
ciple which seems to be its efficient principle is resinous, called by
the eclectics viburnin, but which regular chemists have not yet
indorsed, on the ground that what they call hyoscyamine is not
a pure principle, but an admixture of resinous and inert matter
with the alkaloid hyoscyamia—proven long ago to exist in hen-
bane. It needs further investigation.
76 PROCEEDINGS GF STATE MEDICAL SOCIETY.
We have in the mineral kingdom a new element discovered,
called thallium, which has the property of entering the circulation
and producing the most offensive odor to the perspiration of the
parties taking it. Dr. Bunsen was compelled to absent himself
from Society for four weeks on this account. This one property
will kill it for all practical use in medicine. Its action is similar
to zinc and iron on the economy, acting as a tonic, and producing,
in large doses, severe headache.
ANAESTEIFTICS.
A new anaesthetic has been proposed, under the name of tetra
chloride of carbon. But from the information culled from different
sources, among which we are indebted much to Prof. Andrews,
of the Chicago Medical School, for an article on the subject, we
do not regard it as promising anything practical.
REPORT ON NEW REMEDIES---00nt'd.
A NEW PEEPARATION OF OPIUM.
BY J. M. BIGELOW., M. D., OF DETROIT.
IT is probable that opium, the name of which is derived from
the Greek word opus, juice par excellence, the juice, is amongst
the oldest articles of the materia medica.
The principal constituents upon which its medicinal efficacy
depends are morphine, narceia, codeia, thebaina, papaverina and
narcotina.
To illustrate how gradually the knowledge of the properties of
these constituents has been developed in the practical experience
of medical men, we need merely to refer to their nomenclature,
for when the existence of narcotina was first made known it was
so named from the supposition that the principal narcotic property
of opium depended mainly upon this substance: whereas it is now
known to be weakest of all in active qualities, if not absolutely
inert.
M. Claude Bernard, an eminent physiologist in the Comptus
Rendus, has detailed a large number of experiments on the physi-
ological effects of these alkaloids, as exhibited on the animal sys-
tem, which are very interesting and instructive. He found, in
fact, that the six principal alkaloids above enumerated, each pro-
duced a different effect; but their action may be properly classed
under these heads: 1st, Soporific ; 2d, exciting or convulsive;
and 3d, poisonous action. The relative power of the alkaloids to
produce these effects stands in the following order:
1st, Soporific.—a, Narceia; b, Morphia; c, Codeia.
2d, Eacitants.-a, Thebaina ; b, Papaverina ; c, Narcotina;
d, Codeia; e, Morphia; f, Narceia.
11
78 PROCEEDINGS OF TEIE
3d, Poisons.—a, Thebaina; b, Codeia; c, Papaverina; d, Nar-
ceia; e, Morphia; f, Narcotina.
Thus it is seen that three only produce purely soporific effects,
but even these varying greatly in character and degree.
Morphia, for example, produces a stupifying effect. The ani-
mal is scarcely insensible, but becomes a sort of living machine;
and will remain in any position in which it is placed. The sensi-
tive nerves are extremely dull, and the extremities may be
strongly pinched without disturbing the animal. When roused
by a noise, it seems frightened, but quickly relapses into narcot-
ism. As the animal wakens it has a haggård look, and the hinder
extremities seem partially paralyzed, so that it walks like a hyena.
The effects of codeia are essentially different. The animal is
tranquil and seems to be in a sound, sleep, but he is at the same
time very excitable; a slight noise wakes him up, and he runs
away. The sensitive nerves are much less affected than by mor-
phia, and no paralysis is observed when the animal awakens.
Narceia seems to produce the combined effects of morphia and
codeia, and also appears to be the most strongly soperific principle
of the opium. The animal sleeps more profoundly, but is not so
stupefied, as with morphia; while at the same time it is not so,
excitable as when under the influence of codeia. It quickly
returns to its natural state, and on awaking is neither frightened.
nor savage. All these effects have been confirmed by repeated
experiments on available animals, and appear to be constant and
invariable. * r
With regard to the poisonous effects of the alkaloids, the
learned author informs us that the thebaina is the most active
poison, a decigramme of the hydrochlorate of this alkaloid injected,
into the veins of a dog killed it in five minutes, whereas double
the amount of the hydrochlorate of morphia injected into the veins
of another dog of the same size failed to produce death.
Codeia stands intermediate as a poison. Thebaina also stands
first on the list as the most powerful agent in producing convul-
sions. -
These inquiries which M. Bernard has thus opened, are most
important and wide spread in its influence on the application of
STATE MEDICAL SOCIETY. 79
this, probably the most universally employed, article of the mate-
ria medica, and he will no doubt follow out his investigations on
the subject with all the skill and care for which he is already so
distinguished. *s * *. -
|The remedy here proposed is the combination of three Soporific
principles—morphia, narceia and codeia—so skillfully experi-
mented with on the animal subject by the learned physiologist.
It is called purified opium, from the want of a single name by
which to distinguish it and from the fact that the poisonous and
convulsive principles, thebaina, papaverina and narcotina, in addi-
tion to the offensive, odorous and resinous principles, are eliminated.
Probably the nearest officinal analogue we have to this prepar-
ation is the extractum opii purificatum of the London Pharmaco-
poeia, much more generally used in the old country than in this.
The principal objection to its use, made by Prof. Wood, is the
want of uniformity in its strength, which varies with that of the
opium from which it is prepared. Another one, not mentioned by
Prof. Wood, is its unfitness in commón prescriptions from its ten-
dency to absorb the moisture of the air, producing an inconven-
ient alteration of its consistence and form.
These difficulties in the present preparation are overcome, the
dose being uniform, by the assay of the morphiometrical strength
of the opium, and exactly proportioned in its preparation.
The highest recommendation that can be made for this article
is its superiority over morphia as a therapeutic agent, and on the
score of economy. The greatest advantage of morphia over crude
opium is the uniformity of its strength. In this uniformity of
strength we successfully compete with morphia.
The headaches and other disagreeable after effects of morphia,
when used in controlling doses, are sometimes so annoying to our
patients, as to preclude its use altogether in slight or trivial cases,
while in graver cases, where probably life is at stake, they are
only reconciled to the bad effects by the greater good of its exhi-
bition. From the combination of the codeia and narceia with the
morphia the effects are so manifestly modified that even large
exhibitions of the medicine may be tolerated, leaving the system
comparatively free from the nausea and headaches so universally
following the exhibition of large doses of morphia.
NEED OF GENERAL VACOINATION.
BY HENRY F, LYSTER, M. D.
GENTLEMEN :—It is one of the great purposes of the profession
of medicine to prevent needless sickness and mortality, and if the
causes and laws of preventable disease are scientifically investi-
gated and fully determined, and if antidotes or preventives are
discovered, on whom will rest the responsibility if they be not
applied ? I maintain that it will be upon the medical profession,
and also that they will be held directly responsible by the people
if vaccination is not generally resorted to in the community.
When consulted in, regard to vaccination, we all agree that it is
necessary and desirable, and should be employed, but in this coun-
try we have failed, as a general rule, to impress the people at large
with the great necessity for its constant adoption. I do not say
that we have not, to a certain extent, exerted ourselves to have
them generally assent to it, but we have not worked with all our
might. It is unnecessary for me to dwell, before this audience,
upon the necessity for its use. How small-pox modifies the con-
stitution of the people favoring the development of scrofula and
constitutional cachexiae and hereditary taint, and diminishes the
vital force and shortens the expectation of life; all these facts are
admitted by those present. In my own experience, in the coun-
try, the army and the city, the fact has been again and again
before me that vaccination should be universal, and that small-
pox should rarely be seen by the physician in general practice.
The time will come when the fact that a community allows itself
to be decimated by preventable diseases will be looked upon as
criminal, and feelings of sympathy will give way to those of con-
tempt and a desire to punish the offenders. The time will come
PROCEEDINGS OF STATE MEDICAL SOCIETY. 81
when sanitary science will be better taught to the public at large,
and the people will demand of the profession the reason that they
have not exerted themselves to disseminate among them the
knowledge that their peculiar avocation has, from time to time,
brought to light !
The charge has been brought, and with much show of justice,
against us by the people, that we have not explained to them
many things that we have known which all could have under-
stood, and which would have been of infinite benefit to them
through life, and rendered more secure that frail tenement, the
body, so fearfully and wonderfully organized; and we as a pro-
fession are now reaping the full harvest in the absurdities, empiri-
cisms and unseasonable measures and unscientific practice to which
so large a portion of the community invariably resort in sickness.
Tares have been allowed to grow up where, with attention to the
field, the good wheat would have been seen standing. I have seen
in the country a whole township thrown into commotion by the
appearance of a case of small-pox, I have known the practice of
a medical man ruined for two months for the reason that a person
visiting him had taken the small-pox while on the journey, and
the doctor's gates and premises well fenced in by the neighbors
and all communication cut off simply because they knew that they
were not protected, knew that they had neglected to have their
children vaccinated, and that under any other arrangement they
would have been at the mercy of that dreadful disease. They
knew that they had not performed their duty to themselves and
families. They could not plead ignorance, or they would have
gladly done so. There was no excuse left to them, for the know-
ledge of the discovery and use of vaccination is as general and
universal as the alphabet. They could not plead want of faith in
its protecting powers, for the people know that it protects as well
as they know that it exists. Some, it is true, will ask your opin-
ion, and appear a little skeptical, although they are fully aware
that it is the physician's only practice, but I have universally
found it to be a cloak to cover their fault and carelessness in not
having resorted to it. In the newly organized regiments of vol-
unteers I have seen the ill effects of a want of general vaccination
82 PROCEEDINGs of THE
among those brave men, to whom I refer with feelings of gratitude
and pride, who, taking their lives in their hand, went down into
the valley of death; and there, too, have been observed the won-
derful effects of vaccination and revaccination in protecting per-
fectly the same regiments when time and attention had been given
to it. . For four years I have watched a regiment passing through
all the varied phases of field, camp and hospital experience, and
have seen it escape entirely the small-pox, that scourge which, in
former years, made so great havoc in garrison and camp. Fully
one-third of those young men, a large majority of whom were from
the country, were entirely unprotected upon coming into service,
and of those already vaccinated a large number took again the
vaccine disease. Revaccination was undoubtedly the great source
of protection to the regiment. In the city, here around us, we
See growing up from one-third to one-half the children utterly
unprotected from the small-pox. I know of a family of five per-
sons at the present time where the three children are to-day sick
with the small-pox; the family next door have two cases; out of
a family of six persons four had the small-pox last winter, and
another family of four furnished three cases. Physicians prac-
ticing here meet it constantly, and yet the people at large are
very negligent, and many of them more so than formerly.
The Germans, for instance, in their own country, are compelled
by law to vaccinate, and one rarely, if ever, sees a German who
has lived to be ten years of age in Germany, who has not been
well and perfectly vaccinated; yet the same people, who certainly
have not deteriorated by emigration, neglect shamefully to have
their children, who were born in this country, protected as well
as their country's laws protected them. The Irish, who at home
are as fully but not as wisely governed, are not as much accus-
tomed to its protection, and consequently are fully as careless
hère. In some parts of Ireland the mortality from small-pox has
reached as high as sixty in one thousand deaths, while on the
other hand, in some of the German States, it has been as low as
two to four in one thousand deaths.
Many persons believe that the common-school directors and
inspectors will see to vaccination, and so they do at different
STATE MEDICAL SOCIETY. 83
periods when public attention is awakened by the prevalence or
vicinity of the small-pox. Still little attention is paid to this
question, even among the scholars at the public schools, as a
general rule, and even if there was it would only benefit the people
in particular sections, where all can attend school. In this city,
unfortunately, how much greater is the number of those who do not
or cannot attend school than those who do? and what school teacher
does not know that, generally speaking, large numbers of their
scholars are unprotected? The object for which I have ventured
to draw the attention of this society to the great necessity for gen-
eral vaccination and revaccination has been to cause some action
to be taken which will throw its weight and influence in favor of
it. This might be done by resolutions to the public expressive of
the feeling of the Society upon this matter, or by the appointment,
of a standing committee of vaccination; or it might, perhaps, more
efficiently be performed by memorializing the legislature to enact
a law, if agreeable to the Constitution to do so, making it obliga-
tory upon the public, for the safety of the general community, to
be vaccinated; or it might be effected in some other way agreeably
to the pleasure of the society. I simply introduce the subject as
interesting to each one of us, and upon which we can take united
action.
ON THE ZYMOTIC DISEASES.
BY DR. E. P. CHRISTIAN.
THE importance of the investigation of the zymotic diseases, so-
called, is to be estimated by the large proportion of all cases of
sickness and mortality which are chargeable to this class of dis-
eases; by the physical disabilities and degeneracy of which they
are the prolific cause, and resulting from these facts, the cost and
tax which they impose upon the body politic, thus adding an
increased interest to the subject by its bearings upon questions of
political economy. sº
The interest of the subject is indicated by the greatly extended
and constantly increasing scope of our knowledge in regard to this
class of diseases, but more by the vastness of the unknown, both
as relates to their specific characteristics and general relationship.
And the progress of civilization is in some degree to be esti-
mated by the statutory provisions and police regulations for the
prevention and restraint of epidemies of these diseases, which are
more susceptible of prevention than of control, and therefore more
successfully to be opposed by hygienic regulations than combated
with the materia medica, as much under the jurisdiction of the
prescriber and administrators of laws as of the prescribers and
ministers of physic.
The increase of our positive knowledge in respect to this area
incognita is mainly to be effected by the critical observation and
correct record and logical classification of facts in their natural
history. The record of the history of such epidemics must
embrace the peculiar and unusual facts in individual cases, and
STATE MEDICAL SOCIETY. 85
especially is it requisite that those facts in the epidemiology of
those diseases should be noted which may have a bearing to indi-
cate specific characteristics or generic relationships. The report
on the subject of zymotic diseases should properly be expected to
contain a record of such epidemics as have come under the
observation of the Committee, embracing at least the period since
their appointment. The past year, however, within the writer's
experience, has been one remarkably free from such epidemics.
The only ones within the past year or more which have come
under my observation being one of typhoid fever, extending
through the months of October, November and December, 1866,
and a mild epidemic of diphtheria in the months of October,
November and December, 1867.
As regards the former epidemic, no specially noticeable pecu-
liarities were remarked in which it differed from epidemics of the
same disease in other years, except it was in its greater virulence
manifested in the severity and tedious convalescence of individual
cases, in the larger number of cases, and what seemed unequivocal
evidences of a contagious element attaching to it. This fact, how-
ever, was also observed, which has been observed and recorded of
other similar epidemics, viz: the almost entire disappearance, at
the time, of agues and the ordinary autumnal bilious fevers. On
the disappearance of the typhoid epidemic, agues manifested about
their usual prevalence, and throughout the past summer and fall
agues and bilious fevers have manifested an almost unprecedented
prevalence, to the entire exclusion of typhoid, not a case of the
latter coming under my observation. The severity of the drought
of the past Summer and fall, exposing to the Sun and the atmo-
sphere the bottoms of ditches and ponds which have seldom if
ever before been exposed, and the consequent malarious emana-
tions of the accumulated stores of years, perhaps may readily
account for the great amount of ague and the potency of the cause
manifested in the attacks of individuals acclimated by years of
residence in the neighborhood, and of those grown old among it
without feeling its effects for years past. But the absence of
typhoid during this aguish season and the disappearance of agues
during the typhoid epidemic, though in accordance with other
observations, is thought of sufficient interest to be noted here.
12
86 PROCEEDINGS OF THE
This epidemic of typhoid fever prevailed throughout a consid-
erable portion of Wayne county, and to what extent beyond I
cannot say. Its contagiousness was manifested in my locality in
numerous cases. The following is one example: H. M., a young
man aged nineteen, sickened with the disease, and, after several
weeks of severe illness, died, having passed into irregular hands.
In the same house there occurred, subsequent to his sickening, five
other cases, manifesting different degrees of severity, but all well
marked. These were brothers and sisters, and his mother.
Another brother, living at some distance, came in perfect health
to see him during the latter part of his illness. He remained
until after the funeral, returned home, sickened soon after with
the fever and died. His wife also sickened with it and recovered.
There were no other cases in their neighborhood.
From the subsidence of this epidemic, none other appeared in
my locality until the fall of 1867. In October, diphtheria
appeared and assumed an epidemic character, and continued until
December. The cases were mostly mild ones, but a few were of a
malignant type. The severest cases were in adults, and the dis-
ease, as observed in previous epidemics, was confined very gener-
ally to females. The two worst cases, however, which have ever
come under my observation, have been in adult males—cases
whose malignity was manifested both by the severity of the local
affection and the constitutional derangement, by the slow recovery
from the local disease and the tedious convalescence from the gen-
eral disturbance. These I have pronounced the worst cases, not-
withstanding they recovered, while others in children, which I
have regarded of less severity, have proved fatal, and this because
I have never observed a fatal case in an adult, and regard such a
termination in adults as at least very rare, while in children, cases
in which there has been much less general involvement of the
fauces and no severe general disturbance, have proved fatal by
extension of the disease to the larynx, or even have proved fatal
from toxaemic symptoms, after the local disease has disappeared,
without very marked evidences of severe constitutional disturb-
ance during the stage of the local disease. Hence, from my own
experience in this disease, I should be disposed to regard it as one
in which the danger of death in adults was very little.
STATE MEDICAL SOCIETY. 87
The treatment which I have found uniformly successful since I
adopted it has been large doses of quinine and tannin, with a
wash of Saturated solution of tannin, and occasionally, in obstinate
cases, a wash of biniodid. hydrarg. dissolved in solution of iodide
potash. 1. gr. of the former and 10 gr. of the latter to 3 viii
water, to be used as a gargle, or in young children on a swab.
But in this epidemic, as in others, occasional observations have
suggested the query, whether naturally or otherwise I do not say,
as to whether this disease is invariably characterized by the pecu-
liar membranous deposits on the tonsils and fauces, whether this
localization is pathognomonic of the disease. The disease is essen-
tially a constitutional affection, and may not other localizations
Sometimes occur, and this, too, sometimes be absent and possibly
the disease sometimes escape diagnostication? The mucous sur-
face beyond the fauces, being outside the scope of the eyesight,
may not diphtheritic deposits occur elsewhere in that tract undis-
covered, and hence the cause of some tedious recoveries where the
fauces have been a long time restored to a healthy state 7
There are cases which are spoken of as the disease having gone
to the stomach; as, for illustration, a young lad came under my
care with the disease manifested in the usual manner, except with
great irritability of the stomach. Under the usual treatment the
throat became healthy in a few days' time, but as that improved
the irritability of the stomach increased, obstinate vomiting super-
vened, and the patient died apparently from inanition. No oppor-
tunity was had of examining the stomach to ascertain whether
there was local disease there which seemed to be indicated by the
symptoms, or whether this was merely the result of blood poison-
ing. We know the capabilities of the membranous deposits
extending by local contiguity; is it not analogically probable that
other parts of the mucous membrane may be disposed to take on
similar diseased action ? I have elsewhere recorded a case which
seemed unequivocally one of diphtheritic deposits in the vagina
in a child, following upon another case of diphtheria in a child of
the same family—the case accompanied with constitutional symp-
toms and yielding to the constitutional treatment adopted in the
other case. We know, too, the fact of blistered surfaces in these
cases manifesting the same condition frequently.
88 PROCEEDINGS OF THE
I have now under my care in the same family, a young lad just
recovering from a severe attack of the disease, and a young girl
sickening with severe constitutional symptoms, with herpes zoster
which looks very like an attempt of nature to eliminate the same
morbid product from the system through a different channel.
This fact has appeared the more note-worthy to me from this
other fact that not unfrequently I have found severe cases compli-
cated in their course by different forms of herpetic eruptions. One
young woman had a large and very painful eruption of herpes
circinatus on her thigh, and another recent case was complicated
before convalescence, with a free eruption of herpes labialis,
extending not only over the lips and nose, but to the cheeks,
similar to what so frequently occurs in agues.
In fine, it is not unusual in families where the disease is pre-
vailing to observe some one or more individuals with constitu-
tional affections, more or less severe, with no affection of the
throat whatever. Other local affections may have existed in these
cases, however, internal and not affording symptoms sufficiently
indicative to discern them.
These epidemies of which I have written appeared, ran their
course and disappeared without any epidemic atmospheric consti-
tution, to use a phrase of one of the older authors, being indicated
by precedent, concurrent or sequent epidemics of zymotics. But
that many of the zymotic diseases are disposed to manifest this
epidemic relationship, too commonly to be regarded as merely
accidental, we think observation has certainly indicated. Such as
typhoid fever and erysipelas, puerperal fever and erysipelas,
Scarlet fever and erysipelas, measles concurrent with or followed
by Scarlet fever, and others. This epidemic relationship has been
expressed by the phrase “epidemic constitution of the atmosphere,”
which does not explain it, but is only another and perhaps better
formula for its expression.
Now, are there any facts in the natural history of these diseases
or any presumptions from the analogies of nature which may
throw light upon the subject 2 g
In the classification of the animal and vegetable kingdoms, we
observe the “Succession of Life” in a regular gradation of spe-
cies, a law upon which has been founded the theory of the “trans-
STATE MEDICAL SOCIETY. 89
mutation of species.” Beginning at the top with man, we descend
through a succession of species, allied by anatomical structure and
physiological function, to the lowest or what appears to be the
connecting link between the animal and vegetable kingdom, the
sponge; and then again beginning with the higher organizations
of this kingdom, we descend through successive links to the lower,
to the ferns and fungi, to microscopic parasitic growths, of which
class some are supposed to be the cause of certain diseases, at
least, if not a cause are an element of the diseases, and still further
onward in the series of fermentation, upon the presence of which
in the organism is founded the theory of causate or of zymotic
diseases. *
Now, if the same localities and conditions favor the germination
and growth of allied species, which is certainly the case, at least
within certain limits, and if allied species may be supposed to
possess similar natural properties, that is if the same law pertains
to these lower orders of organisms as to higher, and if the theory
of the Zymotic origin of these diseases be correct, we have in these
facts some explanation of their epidemic relationship or concur-
Ten Ce. º
To pursue the analogy further. If, as we observe, is the case
that domestication and cultivation of animal and vegetable species
beyond certain limits results in the improvement of certain traits
and characteristics at the cost of physical degeneracy and prone-
ness to disease, may not civilization, in its different stages and
phases, create a proneness to new and different forms of diseased
action, and a susceptibility to the action of new and diverse
noxious agents?
If there is a presumption of this we may seek other and very
different predisposing causes of these diseases than in bad hygienic
conditions, to which the poor and the dissolute are commonly sub-
ject. These conditions, without doubt, may exert a potent predis-
posing influence by their debilitating effects, but probably a more
direct and more potent one by affording more favorable conditions
for the growth and dissemination of the germs of zymotic diseases,
and consequently greater numbers being acted upon by them, the
disease may be more rife in such localities. But the question may
be candidly asked, are these diseases especially the eruptive ones,
90 PROCEEDINGS OF THE
as measles and scarlatina, or diphtheria, more rife or more fatal
proportionately to numbers among the poorer classes than among
the rich’ My own experience would prompt me to say they are
not. We may then very well believe that if the surroundings of
poverty and ignorance afford a powerful predisposing cause and
inviting field for the ravages of those diseases, so, too, do the
refinements and cultivation of the rich create other susceptibilities
to their influence.
Any theory in regard to the causation, pathology, etc., of these
diseases, to commend itself, must be one which, if it do not explain
all the various phenomena presenting in the course of the diseases,
which could not be expected owing to our very partial and meagre
comprehension of vital physics, as well as of zymosis, should at
least not lead to absurdities regarded from different stand-points.
It would be rational, therefore, to examine this hypothesis from
different stand-points, to ascertain if known and otherwise unex-
plainable facts are in accordance with it.
If we assume, then, the zymotic theory, viz: that the germ of
the disease is organic matter capable of multiplying itself in the
fluids of the body, then, the assumption of the spontaneous origin
of this class of diseases de novo from a concatination of circum-
stances so disposing, must be discarded on the principle of not
exactly “omne vivum ex ovo,”
which can only apply to animal
life, but on the more general one of “omne vivum ex vivo.” And
hence, though this could not be assumed to prove that no new
forms of disease could appear, because the germs of such may be
already in existence, only requiring the proper conditions for their
development in the human organism, even as analagous facts, are
found in the vegetable kingdom, and examples of such zymotic
diseases so originating in modern times, or appearing at long
intervals, may perhaps be cited in cattle-plague, potato-rot and
diphtheria; still it would prove that the germs of these diseases
were of primordial origin.
Such facts as the occurrence of new forms of zymotic diseases,
or of known forms at long intervals, as well as the analogies of
nature in the seeds of some higher forms of vegetable life, and in
the lower orders of animal life, would suggest the probability of
great and lasting tenacity of life in the germs of those diseases,
STATE MEDICAL SOCIETY. 91
and thus we may have the more or less frequent appearance of
epidemics of this class, the appearance of sporadic cases or an epi-
demic form of Scarlet fever, for instange, where the most careful
investigation could trace no exposure to the contagion of the dis-
ease in others; for if the germs be organic, to follow the analogies
of nature, still they must not only be possessed of fertility, but
must be supplied with the requisite elements of nutrition and
fructification to so breed disease. Not every seed cast into the
ground germinates and fructifies, even if possessed of intrinsic
vitality; but soil, temperature, moisture and a host of other con-
tingent circumstances, must be propitious. So these may be
received into systems already favorable and result in speedy
development of all the successive phenomena of the resulting
diseases. As M. Trousseau remarks, for illustration, “May not
the germs of hospital gangrene, malignant pustule and erysipelas
be always present, ready to be developed in the organic matter
which is shown to constitute so large a per centage, in some cases
36 per cent. of the dust of hospital wards?” Or, again, the germs
may have been previously received into the system, and in a state
of incubation remain dormant until accidents or other debilitating
influences have depressed the vital powers and lessened vital
resistance to their noxious action. Examples in illustration of this
may be adduced, perhaps, in such diseases as cow-pox, erysipelas
and hydrophobia. In vaccination, for instance, how common an
occurrence that a child fails to take the disease, even after
repeated trials with the same matter, and under similar circum-
stances, so far as the senses and judgment can determine, as others
which have taken it readily and naturally; and at some future
trial this same child will take it as readily. And how often, too,
has it been noted that vaccination and revaccination will take
readily during an epidemic of small-pox, in those who have
resisted its action at other times? Erysipelas, too—how common
an occurrence for it to be developed in those debilitated by other
sickness, wounds or parturition? In these cases, too, the debility
is probably not the only predisposing cause, but the local lesion as
the wound, or the condition of the post-partum uterus correspond-
ing thereto, may afford the proper nidus and conditions and ele-
ments of nutrition for the germs of the disease.
92 PROCEEDINGS OF THE
Hydrophobia is equally as good an illustration, and for its
leaning on the subject I copy the following table, prepared by Mr.
Renault. Says he: “Having made numerous experiments, for 24
years, at Alfort, for the purpose of learning the period of incuba-
tion of hydrophobia in the dog, of 131 dogs either bitten or innoc-
ulated, 63 had presented no signs of disease for four subsequent
months. Of the other 68, hydrophobia was developed at various
periods, as shown in the following table :
1u I dog between 5th and 10th day. In 9 dogs between 45th and 50th day,
4t 4 tº {{ 10th “ 15th “ tº 2 st {{ 50th “ 55th “
tº 6 tº Çt I5th “ 20th “ « 2 tº 4. 55th “ 60th “
tº 5 tº “ 20th “ 25th “ “ 4 tº {{ 60th “ 65th “
tº 9 tº tº 25th “ 30th “ a 1. “ {{ 65th “ 70th 44
4t 10 tº {{ 30th “ 35th “ “ 1 st {{ 70th “ 75th “
st 2 tº “ 35th “ 40th “ “ 2 “ {{ 80th “ 90th “
“ 8 “ “ 40th “ 45th “ * 1 a “ 100th “ 120th “
Here is a period of incubation of this disease in the dog, cer-
tainly ranging from five days to four months, and probably much
longer, for one-half of the dogs had as yet presented no signs of
the disease, which is no evidence that the disease would not be
developed in them. Indeed, the presumption is that it would,
and thus add we know not how much to the possible period of
incubation. It is probable that in man this period may be equally
or still more prolonged.
Other analogous examples in abundance may be adduced of
depressing influences, accidents, etc., exciting into action latent
diseases. How common, for instance, in malarious localities, for
agues to follow accidents, surgical operations and parturition, in
those who previously had presented no indications of a malarious
taint; and the same is frequently observed to occur in those who
have removed from an aguish district to one where the disease is
not epidemic and is almost unknown. Individuals may have the
disease for the first time after their removal. And the same thing
is very frequently observed in malarious districts in the winter
months, exposure to cold, fatigue or other depressing influences
inducing the attack.
The same thing may be observed in syphilis, which may be
dormant in the system almost indefinitely, if no other depressing
influences reduce the standard of vitality below a certain point,
STATE MEDICAL SOCIETY. 93
and let but scurvy, for instance, depress the constitutional powers,
and how terribly it manifests its presence.
Such are some of the facts which show how the germs of dis-
eases may remain dormant in the system, or in a state of pro-
longed incubation with retention of their vitality. How long suéh
germs may retain their vitality outside the organism, stored up
in the dust or walls of rooms, is another interesting subject of
inquiry. In regard to some of these contagious diseases, the proof
that this may be the case does not rest alone upon the presump-
tive evidence of such general facts and analogies as have been
mentioned, but special cases may be cited bearing with direct
evidence upon the point.
The following illustrative case, by Dr. Richardson, I have taken
from “Clinical Lectures on Scarlatina, and its Sequelae,” by T.
Hillier, M. D., physician to hospital for sick children: “A man
and his wife lived in a cottage with four children. Scarlatina
entered the flock and struck down one of the children. It seemed
to me that I had saved the remaining children by obtaining their
removal to the care of a grand-parent who lived a few miles away.
Some weeks elapsed, when one of them was allowed to return
home. Within twenty-four hours it was seized with the disorder
and died, with equal rapidity to the first. We were doubly cau-
tious with respect to the return of the other children. Every
inch of wall in the cottage was cleansed and lime-washed; every
article of clothing and linen washed, or if bad destroyed. Floors
were thoroughly scoured, and so long a period as four months
allowed to elapse before any of the living children were brought
home. Then one child was allowed to return. He reached his
father's cottage early in the morning; he seemed dull the next
day, and at midnight in the succeeding twelve hours I was sent
for to find him the subject also of Scarlet fever. The disease again
assumed the malignant type, and his child died.”
This same author cites, also, cases showing the period of incuba-
tion of this disease to have varied in different instances from 24
hours to 40 days.
The following cases under my own observation are to the same
point :
13
94. PROCEEDINGS OF STATE MEDICAL SOCIETY.
Two children of Mr. G. sickened with scarlet fever simultane-
ously; a third and younger child was at once separated from the
part of the house in which the others were confined, and continued
So through the whole course of the disease and until convalescence
was fully established. Six weeks after this convalescence, and
nearly three months from the outbreak of the disease in the fam-
ily, the third child sickened with the same disease and passed
through a severe attack.
The family of Mr. O., consisting of four children, had the scar-
let fever in the spring of 1864, one of whom died. In the same
fall, they removed from the house, which was occupied by new-
comers in the village, and in two weeks' time a young woman in
the family was down with well marked scarlet fever, there being
no other cases of the disease in the village at the time nor for
weeks previous. Some four or five months, at least, must have
elapsed since the disappearance of the disease in the house.
The family of Mr. C., consisting of four children, also had the
same disease in the fall of 1864. They removed from the house
in the spring of 1865. The house was immediately occupied by
new-comers, a young married couple, who occuiped the same bed-
room in which previous cases were treated and confined. Within
two weeks from taking possession, both were sick with Scarlet
fever, and there were no other cases in the village at the time.
These cases would certainly indicate the presence of active germs
of the disease in the room for a considerable period extending over
Several months, unless we suppose the cases exposed to contagion
elsewhere; and they show how epidemics may arise without
direct exposure to sick persons.
That such observations are not more frequent we may easily
conceive to be owing to want of information in the attending phy-
sician, or the sick persons and friends, in regard to the antecedent
history of the localities.
In neither of the two last cases cited had the parties any
knowledge of the former history of the premises or their tenants,
nor would another physician have been acquainted with them or
have been likely to have been informed of them.
SURGICAL REPORT TO STATE SOCIETY.
By T. A. M'GRAw, M. D., Chairman of Committee.
Mr. President and Gentlemen :
YoUR committee have been in some doubt as to the nature of
the duty expected of them by their colleagues. The limits of
our report would not admit of a full description of the surgical
novelties of the past year. Nor did we think that the Society
desired it. We did not think it proper to take up time in read-
ing an abstract of surgical inventions and discoveries, when
abstracts and retrospects in abundance are at the command of
even the poorest members of the profession. Treatises on special
departments of surgery seemed out of place in a general report,
and would, besides, be open to the same objections as more gen-
eral reviews, namely, of being repetitions of matters already well
known to the profession through the medical periodicals. We
felt it to be a thankless task to labor in arranging material which
would lack the interest of novelty, when the want of time would
prevent that discussion on the part of the Society, which can
alone interest a body of men, in familiar subjects. Under the
circumstances, we were led to inquire whether the plan at
present adopted by the Society of throwing the onus of the
report on a few individuals, did not actually injure the interests
it was meant to promote. The success of all enterprises depends
in a great measure on the methods by which they are conducted,
and the advancement of our knowledge of surgery by this
Society can only result from a method which will cause all its
members to take an interest in collecting data and making exper-
iments. We have, therefore, thought ourselves warranted in
departing from the usual course, and instead of discussing the
96 PROCEEDINGS OF THE
achievements of others in the past, have determined to call your
attention to the necessity of combined action on the part of the
profession, for the solution of certain surgical problems. We do
this in the belief that the object of the Society is not to do col-
!ectively what we could as well do individually, but to accomplish
by means of association, objects for which individual efforts are
inadequate. There are some branches of surgery which may be
studied almost as well by the isolated surgeon as by organized
societies. He may study the pathology of deformities and the
indications for proper treatment, as well at home, in his own
study, as with his colleagues. He may invent splints, devise
methods of treating fractures, study how to operate and explore
the chemical and microscopical peculiarities of tumors, without
other assistance than that afforded by his books or periodicals.
A society may stimulate him to increased effort, but can hardly,
in these branches of his art, materially add to his means of
investigation. It is entirely different with other departments of
surgery which cannot be thoroughly investigated by the unaided
efforts of individuals, and which, therefore, have especial claims
on the Society for consideration. -
It shall be our object in this report to point out some of the
work which yet remains to be accomplished, and which, by its
very nature, will require many and willing co-laborers, and we
do this the more readily because we are convinced that definite
subjects must be proposed by the Society for investigation, if any
practical good is to be accomplished. The questions which
require united labor to investigate, are, in general, such as relate
to the cause, relations and contagious properties of surgical dis-
eases, questions which are no less important in their bearings on
practice than such as relate to the modus operand of using the
knife or caustic in surgical operations. We propose now to
mention, more in detail, some of the problems which, in our
opinion, await solution at the hands of this, or some other organi-
Zation, and will begin with that disease which, more than all
others, has proved to be the opprobrium of surgery, viz., Cancer.
We do not agree with some surgeons, who look upon death as
an absolute, unavoidable result of cancer, and who believe that
STATE MEDICAL SOCIETY. 97
all cases of recovery have been mistakes in diagnosis—with that
class, in other words, who judge of the nature of the disorder by
its termination, and assert of given cases that death has proved
their cancerous nature, and of others, that recovery has given
the diagnosis the lie; but we must, nevertheless, admit that
recoveries are fearfully rare, that the malady has defied all inves-
tigation and all treatment. Whatever we may do, cancer takes
its course steadily, inexorably, toward the grave. Internal reme-
dies, the knife, caustics, acids, all medicines and all treatment,
are unavailing to arrest its progress. Now there is no disorder
in the long list of human maladies, which has received more
thorough, more devoted study, than cancer. The profoundest
intellects of the profession have labored in vain to discover the
mystery of its malignity. It has been made to undergo the most
rigorous analyses of chemistry, and the best chemists can give
as the result, only vague accounts of diseased albumen. It has
been subjected to the highest powers of the microscope, to the
most minute examination of morbid anatomists, but neither micro-
scope nor dissecting knife have been able to unvail its secrets.
Nor has the experience of clinical teachers been more produc-
tive of positive knowledge. The most experienced surgeons are
frequently baffled in diagnosis, and almost always in treatment.
But with all the study which has been given to this disease by
medical men, certain points have been strangely neglected. One
thing is especially noticeable, namely: that careful, laborious
and methodical investigation has been made only of the last
stage of the disease, that is to say, the stage of its appearance
as a tumor. If we believe that it is essentially a constitutional
disease, if we accept the doctrine that it has existed in the blood
or tissues prior to its appearance as a defined swelling, then it
becomes evident to every one conversant with the literature of
the subject, that we have yet to study its first stages, when it
exists a hidden enemy in the body of its victim. It is essential
for the further investigation of this disease that its clinical his-
tory be completed, that we may discover, if possible, some token
of the malady before it reaches its incurable stage. This hiatus
in the history of cancer must be supplied by the labors of intelli-
98 PROCEEDINGS OF THE
gent and observant general practitioners, who attend such patients:
through their various maladies, for years before the cancerous
infection becomes apparent. That immediate results from such
investigations cannot be expected, is very apparent, but that
careful, accurate observations on these points could not fail to
add valuable knowledge to that which we already have of cancer,
is very evident. We believe that it is especially the province of
the State Society to collect the necessary material, i. e., the facts
and data, for these investigations.
Another point in the history of cancer, which has suffered
from general neglect, is its relations to other constitutional dis-
eases. Dr. Andrews, of Chicago, not long since called the atten-
tion of the profession to the correlations existing between cancer
and tubercle, both being most frequent, as it would appear, in the
same localities, and one taking the place of the other in heredi-
tary descent, or even superseding it in the same individual. The
idea that they might be allied diseases is not a new one, and
has been mentioned and discussed by Paget, in his work on Sur-
gical Pathology. Like many other ideas, however, it has hitherto
never been practically demonstrated. To examine into the rela-
tions between cancer and tubercle or scrofula or other constitu-
tional diseases, statistical data are necessary which do not yet
exist. No organized effort, we believe, has yet been made to
collect cases showing interchange of cancer and tubercle in
hereditary descent, nor their simultaneous occurrence in the same
individual, nor the supersession of one by the other, nor even
their comparative frequency in different localities. And yet
these questions are of great importance in the proper investiga-
tion of the nature of all constitutional diseases. Here again is a
proper field for our State Society. We need statistics which we
cannot get individually, but which may be obtained by proper
action on the part of this organization. n .
Again, the properties of cancer as regards contagion, have as
yet been but little studied. That its contagious properties, if it
have any, are not very powerful, is plain enough when we con-
sider the impunity with which healthy persons eat and sleep and
live with patients afflicted with cancerous diseases, but that its
STATE MEDICAL SOCIETY. 99
contact is not without danger to individuals of a particular
diathesis, is probable from the fact that it has occasionally been
observed in different persons under circumstances which would
indicate that one had been infected by another. Thus, cases
have occurred of husbands and wives, who have simultaneously
suffered from cancer of the genital organs, cases which can hardly
be explained by the supposition of coincidence. The clinical
history of cancer, too, would indicate that when the tumor was
once formed, the disease spread on all sides by the effects of
contagion, first appearing at points nearest the central focus of
disease, and afterward involving the more distant tissues. Thus,
when the breast is first diseased, the skin, muscles and lymphatic
glands of the neighborhood become next infected, and afterward
the whole constitution. When the seat of the disorder is the
penis, the lymphatic glands of the groin next show symptoms of
trouble. For a cancerous disease to first appear simultaneously
in different parts of the body is a rare occurrence, and we are
forced to conclude that whatever may have caused the first
tumor, all its successors are in some way the result of its pres-
ence. These contagious properties, which we deduce from clin-
ical observation, have been rendered almost certain by the result
of certain experiments. Laugenbeck injected the fresh juice of a
cancer into the veins of a dog, and found, afterward, cancerous
disease of the lung. Drs. Follin and Lehert, of Paris, after
injections of cancer juice in the jugular vein of a dog, found
cancerous knots in the heart and liver. Dr. C. O. Weber injected
juice from an encephaloid cancer into the femoral vein of a dog,
and at the same time inserted a good sized piece under the skin.
Sixteen days afterward there was found a large tumor of can-
cerous nature at the place of the operation. These experiments
are too few in number to warrant hasty conclusions, but this
question of the contagious properties of carcinoma is one which
evidently demands careful investigation. Aside from its scien-
tific interest, it is a question of vast practical importance, and,
at a time when the experiments of recent observers have
turned the attention of the medical world to a similar question
regarding tubercle, it merits our especial consideration. For the
100 PROCEEDINGS OF THE
purpose of making this investigation, also, the Society would
prove a powerful auxiliary.
If we now turn our attention to another constitutional disease,
coming within the province of the surgeon, namely, Syphilis,
we find other problems yet requiring solution. First of all,
comes that question which is now agitating the medical world,
of the duality of the syphilitic virus. Surgeons who have studied
the natural history of the disease have noticed that certain con-
tagious venereal ulcers have been followed by constitutional
syphilis, while others have produced only local lesions. Now, the
Question arises, is the difference due to the existence of two
different diseases, or to the peculiarities of constitution of the
individuals affected? a question which has some most practical
bearings. It is not claimed by the advocates of the duality of
virus, that the character of the disease can always be determined
by the initial lesion, but they assert that the chancre which is
followed by constitutional symptoms always causes constitutional
disease in those who are infected by it, that the chancroid, which
is a local disease, always is propagated as a local disease, that
the constitutional disease is never reproduced as a merely local
lesion, and, on the other hand, that the purely local disorder
never causes the constitutional malady in another individual,
and for the proof of their position they refer to clinical expe-
rience. This experience is pronounced by their opponents erron-
eous. For the satisfactory solution of this problem, further exact
clinical observation is necessary, and one authentic case, which
would bear criticism, of the production of one of these diseases
by the other, would overthrow the doctrine of the duality of the
virus, a doctrine whose influence on the practice of surgeons is
becoming every day more manifest. This is only one of a multi-
tude of practical questions to be solved regarding this disorder,
and it is well to remark that the difficulties in the way of their
Solution do not consist in the lack of cases, but in the impossi-
bility of knowing with certainty the true medical history of
individuals who are infected. The country practitioner, who sees
fewer cases of this or other constitutional diseases, but who has
the great advantage of knowing his patients, and of being able in
STATE MEDICAL SOCIETY. 101
many cases, to trace his history almost beyond a peradventure,
has sometimes opportunities for studying individual cases, which
are wanting to city surgeons of large practice. The problems,
which we have mentioned as occurring in two surgical diseases,
are but samples of the multitudes which meet the surgeon in his
practice almost daily. The causes of scrofula and rachitis, the
conditions which predispose to erysipelas, gangrene or carbun-
cle, the bad hygienic influences which induce any surgical disease,
are as fair objects for investigation at the hands of surgeons as
are the methods of curing them after they have been brought on
by the ignorant disregard of natural laws. To deny this would
be to assign a position of inferiority to the surgeon, against which
we would emphatically protest. The proper application of reme-
dies to a case of surgery, as well as to a medical case, depends
upon the knowledge, on the part of the surgeon, of the pathology,
cause, and natural history of the disease or injury. The time
has gone by when the amputation of a limb would confer more
credit on a surgeon than its preservation, and the demand for
light regarding certain surgical diseases is becoming daily more
urgent.
We have thought it proper, in the exercise of our duties, to
call the attention of the Society to the opportunities which it
possesses of enlarging the boundaries of our science by instituting
methodical investigation of these general problems. We would
also, before closing, say a word regarding the methods of prose-
cuting these inquiries to the best advantage. In the first place,
we would urge upon the Society the necessity of presenting at
each meeting some limited and clearly defined subject for the
consideration of its members during the ensuing year. The sur-
gical art and science have become so vast in extent, the matters
of doubt and under discussion by the surgical world are so
numerous, and have been so thoroughly explored, that a com-
mittee appointed to report on the whole Science is inevitably
overwhelmed by the magnitude of its duties. The attention, too,
of the profession is distracted by the multitude of objects which
present themselves for consideration, and as a result, little or
nothing is accomplished. If, on the other hand, certain problems,
14
102 , PROCEEDINGS OF STATE MEDICAL SOCIETY.
clearly stated and of limited scope, were offered for solution, it is,
we think, highly probable that some most important facts would
be brought to light, and data collected, which would materially
advance the whole science and art of surgery. The attention of
such a large body of educated physicians as exist in Michigan,
could hardly be directed to any given subject without eliciting
much that would be new and valuable. Another suggestion
which we would make, is this, namely, that some plan be
adopted which would give every individual member of the Soci-
ety an interest in working for the common good. As it is at
present, with the appointment of a committee, the interest and
responsibility of the rest of the Society ceases, and the members,
who have no special duty to perform, do not take the trouble to
contribute their quota to the common stock of knowledge. We
believe that the committee, if appointed at all, should act only as
agents, to present to the Society in a compact form, the facts and
principles which have been contributed by all combined—not as
substitutes to relieve others of their proper duties. With these
suggestions, which have forced themselves upon us, while con-
sidering the nature of our duties, we will close this meager, and,
we fear, unsatisfactory report.
DACRYOCYSTITIS AND LACHRYMAL 0BSTRUC-
TIONS,
REFERENCES TO THEIR TREATMENT, ANCIENT AND
MODERN, BY INCISION AND DILATATION.
A Paper Read Before the State Medical Society at its Annual
Meeting in Detroit, Mich., for 1868. By J. F. NOYES,
M. D., Professor of Ophthalmology in
Detroit Medical College.
THE lachrymal ducts, like other mucous canals, are exceedingly
liable to inflammation and strictures, and have always been
regarded amongst the most troublesome affections to heal that
present themselves in ophthalmic practice.
It will be my object in the present paper to note some of the
many methods of treating these strictures, especially by sounds
or probes and styles, that have been devised and adopted at
different periods in the history of ophthalmic medicine, and to
indicate the more modern and successful way by incision and dila-
tation through the nātural passages.
From some of the old writers it would appear that the ancients
were in the habit of regarding strictures and obstructions in the
ducts as the “primary and original cause and foundation of
all the train of varied symptoms and troubles presented by the
excreting lachrymal organs.” In lachrymal diseases, says Desault,
obstructions of the nasal duct appear to be almost the only cir-
cumstances against which the treatment recommended by the sur-
geons of France and England have been directed. At a very
early period, therefore, we find a resort was made to measures for
the purpose of meeting and overcoming these difficulties. Mr.
Ware, of London (1708), England, appears to have been the first
104 FROCEEDINGS OF THE
to devise and practice a thorough plan of forcing and dilating
strictures of the nasal duct, by introducing his nail-headed silver
or gold styles through an opening made into the sac immediately
below the tendon of the orbicularis muscle. These styles were
made of different lengths and degrees of thickness, and in shape
to suit the case, so as when once introduced to admit of their
being worn for a long time or even permanently, the tears finding
their way by the side of the style into the nostrils. Immedi-
ately after opening the sac and the probe had been passed and
withdrawn and a little tepid water injected, the style previously
put through a bit of adhesive plaster was introduced from the
Sac into the duct and pushed down so that the bit of plaster
came in contact with the skin. While the style is thus worn the
previous symptoms disappear almost entirely; these styles act-
ing to dilate the duct in the same way as a bougie dilates the
urethra.
About a century later Dupuytren revived again and exten-
sively employed the old practice, which had been allowed to fall
into neglect, of the introduction of a tube into the duct instead
of the style. Mr. Ware and others, however, urged objections
against introducing a gold or silver tube down the nasal duct
there to be left for life, or for an indefinite period of time, since
it was always liable either to sink through the duct into the nos-
tril “ or exciting inflammation, was pushed upward by the swel-
ling of the mucous membrane so as to project under the covering
of the sac and required to be removed.” It was also doubted
whether the tears did actually flow through the metallic canal
thus furnished to them by this contrivance, or descended merely
on the outside of the tube in the same manner as they do along
the surface of the style. For dilating the nasal duct, some of the
old surgeons, Beer after Richter and Scarpa, employed soft
bougies and the common catguts of the violin. Beginning with
the small string E, softening its point between the teeth and dip-
ping seven or eight inches of it in oil, and thus made perfectly
straight, it was introduced into the sac and thence into the duct.
It was passed down slowly till it reached the floor of the nostril
and projected a little out so that the patient himself could seize
STATE MEDICAL SOCIETY. 105
hold of it and withdraw a portion of it each day till the whole
was in this way, for this purpose, used up. “The Superior part
of the catgut was coiled up and inclosed in a piece of linen and
fastened under the hair of the forehead. At the same period,
and since, other substances were used for the same purpose up to
within the last decade; this plan of treatment by probes and styles
thus devised and introduced by Mr. Ware, as likewise that made
use of by Beer and others just referred to, became to be every-
where very generally adopted and practiced.
At about this time, cotemporaneous with Mr. Ware, Anel, a
Frenchman (Turin, 1773), with a view to get rid of puncturing
the sac below the orbicularis muscle, as had been the practice,
invented and employed a set of gold or silver probes, six in num-
ber, varying from # to gº of an inch in thickness, and a very
delicate syringe for the purpose of forcing and overcoming these
obstructions. Introduced by the upper or lower punctum, these
probes were passed through the sac and into the nostril; but they
proved too slender and yielding to be of any practical value.
Not much good was ever accomplished by them, and they passed
out of use, and possess now only a historical interest.
A little subsequent to the discovery of Anel's probes and syr-
inge, Laforest introduced the novel practice of passing probes into
the nasal duct from the nostril, and in throwing injections up into
the sac through tubes passed in the same way. But the difficul-
ties found to attend the introduction of a probe or a tube in most
subjects from the lower meatus of the nostril into the nasal ducts
caused the practice to be abandoned for a long time.
It was again brought into use in France, by Gensaul and
others. These sounds, employed by him for this purpose, are still
known by his name, and up to within a quarter of a century,
were in use among us in America. In England it was revived
also and advocated by Mr. Morgan.
About a century after the introduction of Anel's probes and
syringe, Mr. Travers (London, 1820) devised and employed
larger probes of about five inches long, varying in size. They
were flattened at one end and slightly bulbous at the point.
Entered by the puncta, these probes were passed throughout
106 PROCEEDINGS OF THE
the whole extent of the lachrymal passages to the nostrils. Other
surgeons adopted the plan of Mr. Travers in the use of the style,
as well as the probes, and in our country they were chiefly, if not
at first, used by the renowned ophthalmologist, Dr. Isaac Hays,
of Philadelphia, and it would seem from his account of them, “with
the most gratifying success.” He always introduced the styles
by the lower punctum, and he cautions against the employment
of violence. When the probe was once introduced, he allowed it
to remain one, two, or three, or even twelve or more hours, if it
did not before that time produce inflammation. After withdraw-
ing the style, the passage was syringed out with cold water, by
means of Anel's syringe, and the parts, if they felt sore, fomented
for an hour or more with cloths moistened with warm hop tea.
Allowing an interval of four or six days for the tenderness to
subside, the same probe, or if necessary, one a little larger, may be
introduced. Dr. Hays used probes or styles which vary from No.
17 to 21, of the wire gauge. This process is to be repeated
at intervals, the size of the probes being increased whenever
practicable, until the passage has been dilated to its full extent.
The very frequent, if not uniform, failures which followed this
old practice of laying open the lachrymal sac through the exter-
nal integuments in cases of acute and chronic dacryocystitis with
obstructions of the nasal ducts, as well as the almost numberless
methods which had been adopted for the restoration of the nat-
ural passages, led Mr. Damarres within a few years to revive and
popularize the ancient practice of obliteration of the Sac.
With the old treatment of Beer, Scarpa and Ware, long prac-
ticed in Germany, we saw while there, within the last decade,
obliteration of the sac by the actual cautery, as revived by
Damarres, frequently practiced in aggravated cases. Graefe, of
Berlin, not unfrequently resorted to it on the ground of its being
the speediest way of cure.
This practice did not meet with favor in England. Mr. Powers
states in 1867 that he had never seen or known of an instance in
which it had been adopted. But in America it did not meet with
so much disfavor. Dr. Williams, of Cincinnati, long distinguished
as an ophthalmic surgeon, and having a large practice, says that
STATE MEDICAL SOCIETY. 107
in the first years of his practice he became a zealous advocate for
occlusion of the sac, “using at first Damarres' actual cautery,
and afterwards more frequently nitrate of silver or chloride of
zinc.” He had, he says, no confidence in anything else. “Even
mild cases of blenorrhoea of the sac, as he could not conscien-
tiously recommend the hot iron in so trifling complaints, were
sent away with directions to return when that trouble became so
intensified that they were willing to submit to the operation for
occlusion.” In other words, he says, “I let them ripen for the
roast.”
Now it was in the midst of this general dissatisfaction which so
generally prevailed at the time with any of the then known
methods of treatment, that the “inventive genius of Bowman
“opened up' a new and better way, inaugurating thus a new era
in the history of ophthalmic surgery.”
“From his knowledge of the true physiological action of the
canaliculi and nasal ducts, this distinguished surgeon and physi-
ologist was led to consider the analogy there is between the
mucous tract of these organs and that of the urethra, and
announced as a consequence that the principles of treatment must
necessarily be the same in both.” “The cardinal maxim in the
treatment being this, that whilst we make every effort to regain
and secure patency of the canals, we should avoid with the utmost
care the production of any injury, abrasion, false passage, or other
mischief to the walls in question.”
From a new and brilliant, as well as successful, little operation
for epiphora in cases of eversion of the puncta, by slitting open the
walls of the canaliculus as far as the caruncle, described and
published in the medico-chirurgical transactions in 1851, the
happy thought was suggested to Mr. Bowman of reaching the
lachrymal sac and dilating the nasal ducts by this new and direct
route thus opened. Thus was started a new principle in the his-
tory and treatment of diseases of the lachrymal passages. This
new plan, devised by Mr. Bowman, is now everywhere very gen-
erally practiced and known by his name.
By this new method of his the upper or lower punctum and
about one-tenth of an inch of the canaliculus is laid open by a
108 PROCEEDINGS OF THE
knife or fine scissors constructed for that purpose so as immedi-
ately to admit a sound of the full diameter of the duct. When
this has been passed, one of a larger size may be entered into the
nasal duct in order to explore or dilate that passage. The most
frequent seat of the obstruction, according to Bowman, being at
the entrance of the canaliculus with the sac. Should the obstruc-
tion not yield after applying a moderate degree of force with the
probes, division of it should be made with a knife made for that
purpose.
Mr. Bowman also contrived a bent style to be inserted by the
lower canaliculus and worn for a longer or shorter period. The
styles could be generally worn with very little inconvenience for
a few days, and admitted of being readily removed and reinstated.
It will be observed that the largest probe or style used in the
different methods which have been thus far noticed for dilating
strictures of the nasal duct is necessarily limited to the diameter
of the slightly stretched canaliculus.
In the belief that larger instruments or probes were needed in
treating successfully strictures of the nasal duct, Some surgeons
have not been tardy in adopting the plan of slitting up the entire
length of the canaliculus into the lachrymal Sac, and through this
large artificial opening of passing enormous probes or sounds.
Acting upon this belief, Dr. A. Weber, in 1861, in the Archive
for Ophthalmologie, takes up the whole subject of treatment as
proposed and practiced by Mr. Bowman, and deviates from him
in several important particulars, viz.: He enters the Sac through
the superior canaliculus instead of the inferior. He uses much
larger instruments and he substitutes gum elastic and wax
bougies for the metallic. In order to pass more readily, also, so
large instruments, finding that simply slitting up the lachrymal
canal in this way not sufficient, he at the same time incises the
sac and the ligamentum mediale subcutaneously and has devised
a knife for this purpose. The knife and operation are minutely
described in the Archive. Dr. Weber uses for exploring the Sac
and stricture, graduated conical probes, and injects daily topical
applications through the same opening of sulph. zinc, Sulph. capri
or acitas plumbi of varied strength, in some cases as high as 20
STATE MEDICAL SOCIETY. 109
grains solution of sulphate copper to an ounce of water. For a
more minute and full description of Dr. Weber's probes, his
manner of using them, as well as the treatment, I must refer the
reader to his valuable paper above cited.
My friend Dr. Williams, of Cincinnati, who has had a very
large experience in treating these cases, while admitting that
Weber's idea of selecting the upper canaliculus in place of the
lower, and of using larger probes and more systematic medication
was an improvement upon Bowman's plan, still after repeated
trials of the operation, he became convinced that unnecessary
injury was done to the tear sac and mucous membrane by the
operation as practiced by Weber, and forcible passage of such
large instruments through the stricture, while productive of great
pain, he believes renders also subsequent relapses more liable than
when a milder course is pursued. After a thorough trial of both
of these methods (Bowman and Weber), Williams says he still
found relapses frequent and troublesome, and he has for more
than five years, he states, pursued a treatment that has secured a
larger per centage of permanent results with much less suffering
to the patients. To this method of treatment he gave publicity
in the November number of the Cincinnati Lancet and Observer,
for 1864. His experience since has served to increase his confi-
dence in the advantages of the operation. The essential and
peculiar feature of the treatment consists simply in causing the
patient to wear the style constantly during the whole course of
treatment, instead of its occasional temporary introduction. He
“had a series of silver styles made and numbered from five to
nine of the bougie scale inclusive, the smallest corresponding to
Bowman's largest, and being about one-sixteenth of an inch in
thickness, the largest being one-eighth. They are from one and
three-quarters to two inches long, to suit different cases, and were
made very slighthy conical at one end and flat at the other.” He
had them made straight, so as to bend them in each case to suit
the length of the nasal duct, and the peculiar conformation of the
inner canthus. -
Recently, or since his first published paper above referred to, Dr.
Williams has modified his procedure in several particulars. I will
II0 PROCEEDINGS OF THE
now give his statement of the treatment in detail. As before, he
slits up the Superior canaliculus, but not with Weber's knife as
formerly. A very delicate pair of scissors, with one branch probe
pointed and slightly longer than the other, answers the purpose
admirably. With this the operation is much quicker done and is
less painful than with the knife. He does no longer cut the sac,
but simply slits up the canaliculus down to it. If then the inner
orifice is found to be dilatable, a conical or small probe is used to
stretch it till it will admit his No. 5. If the orifice is found con-
tracted so as not to admit a small conical probe, he then resorts to
Weber's knife, and notches the sac till the No. 5 is easily passed.
Should the canaliculus be found closed at the junction with the
sac, the largest of Bowman's probes, No. 6, is passed at once, and
the Sac and nasal duct explored. There is no danger, he says, of
making a false passage with so large a probe, if it is kept in the
direction of the nasal duct. In case the resistance is very great, a
change is made for a more flexible gutta percha one of the same
size. For better exploring the sac and nasal duct, Dr. Williams,
of Boston, has recently invented a set of styles of silver, like Bow-
man's, only that they terminate by bulbous ends, and are much
..more attenuated about half an inch above, so as to bend easily.
Dr. Williams, of Cincinnati, says he has found them very insinu-
ating and useful for this purpose. The bulb on the end of
the largest, marked 6, is just the size of his No. 5. After
passing them he finds out the peculiarities of the canal to be
traversed, and can then put Bowman's No. 6 through with
greater certainty and assurance. If these all fail he proceeds to
force the stricture with No. 6, being careful to keep to the direc-
tion of the nasal duct. Having now entered the nose the probe
is allowed to remain a few minutes and then it is withdrawn in
favor of a style which is introduced to remain. Before removing
it, however, the point that corresponds to the place of junction
of the Sac and canaliculus, is marked so as to measure off the
required length on the style No. 5, which is now to be bent to fit,
and passed in to remain. With a pair of pliers the flattened end
is bent so as to make it hook down over the lower lid; a second
bends outwards, just below the first, makes it fit much better, and
STATE MEDICAL SOCIETY. 111
prevents the lids from dragging the hook around against the eye.
When thus well fitted it is left in. In most cases the pain caused
by the presence of the style passes off or abates very much in a
few hours, so as to become endurable. It is a rare thing now, he
says, to find a patient that will not bear the style from the very
first. If the pain is excessive, and the swelling increases for a
few hours in spite of morphine internally and cold water locally,
it is taken out and put in again the next day. He now always
fits the patient with the permanent style at the first operation,
and finds that it is now borne as well as later. In twenty-four
or forty-eight hours usually the style is found to be so loose that
it can be easily withdrawn, and the tear sac washed out with
water. After the style is reintroduced, should the patient be
very sensitive and timid, the style is left in several days, or even
a week, before taking it out the first time. After this the style is
removed daily and the sac washed out with tepid water, which
now runs out in a stream at the nose. As soon as the No. 5 is
quite loose and easy, No. 6 is introduced, bending it in the same
form. When this size is attained, an astringent injection is used
each time, or every second day after the water. The solution
generally used is twenty grains of sulphate of copper to an
ounce, of water, of which a few drops are drawn into the syringe
and passed through till it trickles out at the nose. Should the
parts be very sensitive and inflamed, a much weaker solution
(two or three grains to the ounce) is used in the commencement,
and gradually increased in strength. A solution of ten grains to
the ounce, of acetate of lead or sulphate of zinc, or nitrate of
silver, may also be better borne in some cases. In two or three
weeks, and often much earlier, No. 7 may be introduced; and
finally, in adults, No. 8, which is worn for some weeks or even
months longer, till all suppuration or perceptible mucous secre-
tion has ceased. There is much more danger of not wearing the
style long enough than too long. The whole duration of the
treatment lasts, on an average, about three months; but it varies
much in different cases as the secretion diminishes and the previ-
ously dilated sac contracts; the frequency of the injection may be
diminished as well as the strength. Instead of refusing to wear
112 PROCEEDINGS OF THE
them, patients are often reluctant to leave them off, finding them-
selves so much more comfortable than before their use.
The advantages of this method over Bowman's and all others,
in the opinion of Dr. Williams, are many. They are summed up
in his own words as follows: “In the first place it effects a
larger per centage of complete cures. All are greatly and per-
manently benefited by it, and the immense majority completely
relieved. Of the hundreds of cases thus treated, in the past
five years, he does not remember more than four or five that have
not been entirely relieved, and even their condition is far better
than before the treatment, troublesome epiphora being now the
only inconvenience, no serious inflammation, no abscesses, and
but a little mucous secretion. Many patients complain simply of
watery eyes, while they retain the styles; but the epiphora nearly
always ceases in a few weeks, or at most, months, after leaving
them off. Of all the cases treated, he found it impossible to get
through the nasal duct in but one, and that was a case of bony
obstruction following fracture of the ossa nasi, substantiating the
opinion of Prof. Arlt, that such cases are exceedingly rare.
Another superiority of the treatment is, that it is much less
painful to the patient to wear the style than to have it merely
introduced occasionally for half an hour, as practised by others.
When the style is worn all the hurting is at the start, when
people expect to be hurt, and will bear it. Another important
consideration, Williams goes on to say, is that in a couple or three
weeks, the patient can easily take out and put in his own style,
and also use injections, thus Saving much time and expense.
After reaching No. 6, he often lets them go home for a few weeks,
supplying them with a syringe, medicines and the proper direc-
tions. When convenient, they have a larger size put in, and
again go home. When the required size, usually 8, in adults,
is reached, the treatment can be continued at home till such time
as the cure is complete.
I have thus presented in detail, in very nearly his own words,
Dr. Williams' method of treating this troublesome disorder, which,
according to his own showing, the wonderful success he has had
is enough to entitle it to be considered “par excellence the treat-
ment of to-day in this country.
STATE MEDICAL SOCIETY. 113
I may say here in this connection, that for the past four years
the plan of treatment that I had adopted for myself and applied
to these cases, and without knowing his, is the same, with but
few important exceptions, as that so successfully practiced and
urgently recommended by Dr. Williams. I have made my oper-
ation (Bowman's) for the introduction of the style on the lower
instead of the upper canaliculus, and cannot regard it to be of
much importance which is selected for this purpose, the upper or
lower passage. My styles I have had made of lead suitably hard-
ened by a proper admixture of pewter, instead of silver, and
graduated in size and of a shape to answer the wants of the case.
I have not, however, made such free incisions or carried my dilata-
tion so far as he has done. In this way I have succeeded in
relieving and permanently curing many cases. I believe there is
in Some cases, however much the passage may have been dilated,
a tendency, as in strictures of the urethra treated in the same
way, to a closure or recurrence of the stricture. This I have
found especially to occur at the point of entrance, and particu-
larly when it has been incised, of the canaliculus with the sac.
Before I would close this very imperfect sketch of some of the
methods of treatment that have been in vogue, especially by dila-
tation, by the employment of styles and probes in the manage-
ment of this troublesome complaint, I wish especially to refer in
highest terms of commendation and praise of the very sensible
views set forth in an able article upon this subject, by my friend
Dr. John Green, of St. Louis, published in the St. Louis Medical
and Surgical Journal, for January, 1868, and from which I have
taken the liberty to quote somewhat in this article.
In his article, conservative in tone, Dr. Green discusses and
examines the whole subject from the beginning, with marked
ability, and in a spirit of candor and fairness. While admitting
that the method practiced by Dr. Williams, of Cincinnati, to have
been marked by success, still he believes, and we heartily join
with him, that by the method first instituted by Bowman, by
slight incisions and moderate dilatation, a very large proportion
of the cases of lachrymal obstructions as they occur in practice can
be cured, and that only in exceptional cases to accomplish it is it
necessary to resort to the severer mutilations of the natural
passages.
BENDING OF BONES WITHOUT FRACTURE.
By wV. H. DeCAMP, M. D., Grand Rapids, Mich.
SURGICAL writers say so near to nothing concerning this injury
as to leave one to infer that it is of little or no importance, or that
it seldom occurs; the latter reason is most likely correct. s
Dr. S. D. Gross, in his work on surgery, mentions ten cases as
having come under his observation. - -
Within the past twelve years four cases have come under my
notice. All occured in the fore-arm. The oldest person was
fourteen years of age, and in good health. This case had the
arm torn from the body by machinery; the fore-arm being the
part that gave evidence of being the part caught. • *
A dissection of the fore-arm showed a curve in the ulna, of one
inch, with not the slightest trace of fracture.
The photograph here presented, is of the arm of a boy ten
years of age, who showed every sign of good health. • * ,
It was produced by the fall of another child upon the fore-arm.
The curvature of both ulna and radius was full two inches from
the normal line, and yet no signs of partial fracture could be
detected. - . . -
This was straightened by placing the middle of the fore-arm
over the knee, and applying steady pressure upon the wrist and
elbow, with the hands, for about twenty minutes.
A NEW AND IMPROVED METHOD OF PRESERVING
PATHOLOGICAL AND ANATOMICAL SPECIMENS,
By W.M. H. DeCAMP, M. D., Grand Rapids, Mich.
——º-
WHILE we were marching through Tennessee and Mississippi in
1862, I had abundant opportunities for collecting fish and other
objects of natural history, which would be of little interest unless
they could be so preserved as to retain their colors.
From what I had seen in museums, and those I had myself pre-
served in alcohol, or Goodby's Fluid, I had learned that a loss of
color was always to be looked for.
I therefore decided to try and discover some method that
would obviate this objection, at least. From a series of experi-
ments then commenced, and not yet completed, I have been
rewarded with results too important not to be brought to the
notice of our profession.
I first learned that any oil or other substance not capable of
extracting the greater portion of the water naturally contained in
a specimen, would cause it not only to decompose, but also to
macerate, no matter how hermetically sealed it might be. I
have at last found that to preserve a specimen with its colors
the nearest natural, requires so much of the water only to be
extracted by the preserving fluid as will prevent the macerating
of the tissues.
After trying all the articles and compounds that I could learn
had ever been used for this purpose I found them all failures in
the direction I was looking. All the experiments, have also sat-
isfied me that there is no means of endosmotic action that will
supply to the specimen a material capable of preventing shrivel-
ing, or shrinkage.
116 PROCEEDINGS OF STATE MEDICAL SOCIETY.
The best combination I have as yet found for my purpose, has
been that of sugar, water and alcohol, and either chloride of zinc
or carbolic acid.
The proportions of these have to be varied according to the
transparency desired in the particular specimen being prepared.
For most articles the following formula is the nearest correct :
B. Syrupus simp. (Saturated strength.)
Aqua--------------------------------- 2.8, O 1
Alcohol, 95 per cent--------------------- f Ż iv
Acid, carbolic-------------------------- 3 I
Mix.
The specimen requires to have the blood removed by macera-
tion (as it is soluble in this solution), or it will discolor the fluid.
The best menstruum for this purpose is some of the same com-
pound, and then a transfer to the permanent solution, after a few
days or weeks.
Specimens preserved in this manner have nothing of the offen-
sive odor which makes specimens so disgusting when required to
be handled for examination.
The specimens presented here will give a good illustration of its
properties, as you can see, by some of the labels, that some of
them were put up in 1863.
*
*
of THE
rº.
DETROIT :
1876. . .
scripps, PRINTER, TRIBUNE BUILDING.





























PROCEEDINGS
5tate Henical juriciu,
. ANN AFREOF, MICHIGAN,
May 10, 11 and 12, 1876.
Reprinted from the Peninsular Journal of Medicine for June.
DETROIT :
WM. A. Scripps, PRINTER, TRIBUNE BUILDING.
1876.
:st§
PFOCEEDINGS.
The tenth annual meeting of the State Medical Society was
convened at the Opera House, Ann Arbor, on Wednesday
morning the 1 oth ult.
The President, Dr. Wm. Brodie of Detroit, called the meeting
to order, and presided during the sessions.
After an opening prayer by Rev. Mr. Hall of Ann Arbor, the
Mayor, E. D. Kinne, Esq., welcomed the Society in a brief ad-
dress.
On roll call thirty-seven members responded.
Dr. Foster Pratt, of Kalamazoo, offered a resolution, which
was adopted, to the effect that a committee of nine should be
elected by ballot to whom all resolutions concerning the Medical
Department of the University should be referred without read-
ing and without discussion. The committee elected consisted of
the following: Foster Pratt, Kalamazoo; J. H. Jerome, Sag-
inaw ; S. S. Cutter, Coldwater; G. K. Johnson, Grand Rapids;
Gordon Chittock, Jackson ; James A. Brown, Detroit; I. S.
Hamilton, Tecumseh ; H. B. Baker, Lansing ; J. Andrews, Paw
Paw. ^
Pending the election of this committee the Committee on
Membership submitted a report recommending to membership
in the Society the names of twenty-six applicants. Among this
number were four who had graduated from the Medical De-
partment of the University of Michigan at its last commence-
Innent.
Dr. Eugene Smith, of Detroit, offered a resolution that the
names of these graduates be laid on the table until after the
question of homoeopathy in the University had been discussed.
• Dr. MacLean repudiated the insinuation of Dr. Smith that
these graduates had been brought in for the purpose of aiding
the Society.
Prof. Frothingham said that he would consider an objection
by the Society as an outrage. He thought the Society was com-
mitted by not objecting at the meeting last May. Very likely
many students would have gone to other institutions had the
Society at that time objected to the course of the faculty.
Dr. Hitchcock was in favor of admitting the students this
year, and did not think the faculty had attempted to rush in
friends.
Regent Rynd, to promote harmony, finally moved to accept
all the names except last year’s graduates.
Prof. MacLean objected to the name of Dr. W. F. Breakey,
of Ann Arbor, saying that he had charges to prefer showing un-
professional conduct.
By vote of the Society, however, Dr. Breakey was elected.
All the names presented were then elected except those of
last year's graduates, which were referred to the committee of
nine.
The Society then adjourned until 2 P. M.
AFTERNOON SESSION.
The morning trains had brought in accessions to the number
in attendance, and upwards of a hundred responded to their
names at roll-call.
An invitation was read from Dr. S. D. Gross, of Philadelphia,
inviting the Society to unite with others in an International
Medical Congress at Philadelphia during the Centennial Ex-
position.
A paper from Dr. A. B. Palmer, of the University, giving his
views on the homoeopathic question, was received and referred
to the committee of nine chosen at the morning session.
Communications from Dr. Beach, of Coldwater, and from the
Kalamazoo and Jackson County Medical Associations, were also
referred to the same committee.
— 5 —
The Recording Secretary made his annual report, showing
that the Society membership prior to the present meeting was
222. He also reported that charges had been made to him
against a member of the Society for preparing and selling patent
medicines. The report was accepted and the charges referred
to the Judiciary Committee.
The Treasurer reported, showing a balance of $273 in the
treasury.
Dr. J. H. Carstens, of Detroit, presented an amendment to
the constitution providing for four committees of three each,
whose business it shall be to prepare a programme of scientific
subjects to be announced on the morning of each day of future
sessions for impromptu discussion.
A printed protest against a bill providing for a Dental and
Surgical Institute in the District of Columbia, was referred to a
committee consisting of Drs. Carstens, of Detroit, Wilcox, of
Battle Creek, and Christian, of Wyandotte.
The reading of volunteer communications being in order, a
paper on “Puerperal Fever” was read by Dr. Southworth, of
Monroe. The paper was accepted and referred to the Com-
mittee on Publication.
Dr. Frothingham, of Ann Arbor, then presented a lengthy
paper on “Sympathetic Opthalmia.”
Dr. Eugene Smith, of Detroit, moved that a vote of thanks
be tendered Dr. Frothingham for his very able paper. Carried.
Dr. Smith then further remarked that there was but one fault
to find with the paper, and that was that the paper was complete
and exhaustive, and so correct in views presented that there was
no opportunity for any one to add to or criticise it. He was
glad to know that the Doctor's views coincided with his as to
the impropriety of delaying enucleation on account of suppura-
tive inflammatory action.
EVENING SESSION.
At the evening session the President delivered his annual
address.
— 6 —
The address was largely historical, reviewing the vicissitudes
through which the society had passed prior to its organization
on its present basis.
Of the introduction of Homoeopathy into the University, the
address spoke as follows:
“At the last session of the Legislature, and previous to the late meeting
of this Society, an act was passed and approved authorizing the Board of
Regents to establish a Homoeopathic medical college as a branch or depart-
ment of the University, to be located at Ann Arbor, and the Treasurer of
the State was directed to pay over to the Board of Regents the sum of
$6,000 annually to be used exclusively for the benefit of said department.
In conformity to this law the Board of Regents have organized a homoeo-
pathic department of the University, and one course of lectures has been
given. The calendar informs us that only twenty-four students matricula-
ted in that department while in the school of regular medicine 313 were in
attendance. Unless the future develops a larger annual matriculation a
repeal of the law will be imperatively demanded as a too costly luxury for
even its friends.”
MAY 1 ITH-MoRNING SESSION.
Charges were preferred against Dr. B. B. Ross, of East Sag-
inaw, by Dr. J. H. Jerome, of Saginaw City, for going into con-
sultation with non-professionals. Referred to the Judiciary
Committee.
Dr. E. P. Christain, of Wyandotte, presented and read a
record of fifteen cases of foetal abnormalities and deformities
which had occurred in his practice.
Dr. D. C. Wade, of Holly, read a paper on “Etherization,”
in which he explained the use of a new instrument, invented by
himself, for the administration of anaesthetics.
These were a truly valuable contributions and the appearance
of the papers in the proceedings of the State Society will be
awaited with much interest.
Prof. Frothingham read a communication from the Ohio State
Medical Society, stating that they had elected Dr. W. W. Jones,
of Toledo, as a delegate to the Michigan Society. Dr. Jones
was welcomed as a delegate, and was presented to the Society
by the President.
— 7 —
A paper on “Ocular Hygiene’’ was then presented by Dr.
Smith, of Detroit.
Dr. Jenks, of Detroit, said that he desired especially to call
the attention of all physicians to the very injurious effect of the
use of soap upon infants. The use of soap in such cases was
quite unnecessary and exceedingly harmful.
Dr. Maclean presented to the Society a case illustrating one of
the beauties of conservative surgery. The patient had had
anchylosis of the elbow joint for nine years. An operation for
resection some six weeks ago had been so far successful as to
enable the patient to flex the forearm at right angle with the
humerus. The muscles, which from long disuse had become
atrophied, were gradually resuming their normal condition.
On motion of Dr. Topping, of Dewitt, a committee, consist-
ing of Drs. Christian, Southworth and Frothingham, was ap-
pointed to report at this meeting upon the recommendations
contained in the President’s address.
A resolution introduced by Dr. Jenks, of Detroit, was adopted.
to the effect that the Society offer a prize of fifty dollars for the
best essay by any member of the Society on such subject as a
committee appointed for the purpose shall determine.
The special committee to whom was referred the petition to
Congress of the Boston Society of Civil Engineers, recommend-
ing the adoption of the metrical system of weights and meas-
ures, reported that they had considered the same, and being
impressed with the desirability of a uniform standard by all
civilized nations, and that the metrical system has much to
recommend it, presented a resolution asking the action of Con-
gress thereon.
The committee to whom was referred the protest against a
medical institute in the District of Columbia reported favorably
on the protest and submitted a resolution to the effect that
the Society enter a protest against the incorporation of the
National Surgical Institute for the following reasons: There is
nothing to prevent the gentlemen from practicing their profession
\
— 8 —
without special privileges from Congress, and they would have
power to graduate men and give diplomas without restriction.
The question of the use of various anaesthetics brought out
by the paper read by Dr. Wade at the morning session, was
again taken up and discussed at length.
The special order of the afternoon was dispensed with and
the following officers elected :
President—Abram Sager, Ann Arbor.
First Vice-President—Foster Pratt, Kalamazoo.
Second Vice-President—Eugene Smith, Detroit.
Thård Vice-Presidenz—Wm. Parmenter, Vermontville.
Fourth Vice-Presidenz—G. K. Johnson, Grand Rapids.
Recording Secretary—Geo. E. Ranney, Lansing.
Corresponding Secretary—Edward Cox, Battle Creek.
Treasurer—Gordon Chittock, Jackson.
judicial Council—Drs. Brodie, of Detroit; Southworth, of Monroe ;
Owen, of Ypsilanti.
The Society accepted the invitation of Dr. Cox to hold the
next annual meeting at Battle Creek in May, 1877.
Foster Pratt, of Kalamazoo, as chairman of the committee of
nine on medical affairs in the University, then presented a report.
After giving a lengthy history of the establishment of homoeopa-
thy in the University, the committee offered the following resolu-
tions:
That we are not content with the existing situation of the medical de-
partment of the University, because in our opinion it is not calculated to
maintain or advance medicine as a science, nor is it consistent with the
honor or interest of the profession.
That a State under our form of government, cannot successfully teach,
and that the medical profession ought to be its own teachers, and the
guardian of its own honor.
That we regard all legislative interference with the government of the
University as unconstitutional, wrong in principle and harmful in its
results.
That section four of the constitution of this State society be amended so
as to read as follows, viz.:
Section 4. The resident members shall be elected by a vote of a ma-
jority present at any regular meeting, their eligibility having been previ-
– 9 —
ously reported by the Committee on Admission; provided, that no person
shall be admitted to fellowship who proposes to practice in accordance
with any so-called “pathy” or sectarian school of medicine, or who has
recently graduated from a medical school whose professors teach or assist
in teaching those who propose to graduate in or practice irregular medi-
CIIl€.
The report was accepted.
A minority report was presented by Drs. Cutter, of Coldwater,
and Hamilton, of Tecumseh, recommending that the last resolu-
tion be omitted. The report was also accepted.
A motion was then made by Dr. J. B. White, and supported
by several, that the society do adopt the first resolution con-
tained in the report, and on this motion an animated discus-
sion followed.
Dr. Frothingham said he should oppose that resolution,
the last clause of which implied a censure upon the faculty for
retaining their places. The University authorities had not
called upon the medical faculty to associate or affiliate in any
way with Homoeopathy, nor had it placed any restriction what-
ever upon discussion or interdicted in the slightest degree a
dignified opposition to all medical errors. Under these circum-
stances, the faculty could not have resigned without disgracing
themselves and casting a stigma upon medical ethics. All the
Faculty had been asked or expected to do was to teach what
they regarded to be true science, and to teach this to all who
came to the University. One of the greatest philosophers of
modern times had declared that “the only antidote for super-
stition is knowledge.” The history of the world shows nothing
plainer than that no great error was ever completely overcome,
nothing more than replaced by another error, until the truth
which was its antidote, had been discovered and disseminated.
The absurd theory of Cosmos was never overthrown until by
the circumnavigation of the globe, the earth was shown to be
round. Neither could we expect to reform those who honestly
believe in homoeopathy by any method other than by showing
them how patiently to interrogate nature and learn by what laws
— I O -
she is governed, instead of dictating laws to her as they now do.
Could the faculty refuse to teach true medical science to any
one without violating our most sacred and ennobling principle
of ethics? Could we claim exclusive right to any knowledge,
even though we may have been its discoverers, if that knowl-
edge is necessary for the prevention or relief of human suffering
and diseases? Because the discoverer of the obstetric forceps
kept the discovery for a long while a secret to himself, for the
base purpose of giving him advantage over his rivals, his name
has been handed down to us covered with infamy. If an indi-
vidual secures a patent for any prescription or instrument, do
we not regard him as a quack P. Have we not always as a pro-
fession declared that science is the property of the whole human
family, no matter who had discovered it?
We claim the right to adopt any truths demonstrated by even
erroneous systems, and we have learned much in this way.
Who shall deny, then, the right of those systems to drink from
the fountain of wisdom they have helped us to fill?
Are we a trades-union that we shall put a patent upon knowl-
edge calculated to reform error, and relieve human distress
Shall we, dare we proclaim to the world that we have secured a
patent for our knowledge and skill, and say “die all ye who are
deluded, we have the knowledge to save you, but it is our stock
in trade and it is unlawful to reveal it except to the elect?”
Need I but drag this hideous ethical monster before you to
excite your disgust? Before no civilized people can you sus-
tain such a position as this resolution embodies; but pass it, and
if you can bear the infamy I can bear your censure.
Dr. Rynd, of Adrian, opposed the resolution declaring that
the University had done only what it was substantially compelled
to do ; that the professors had done their duty and regretted the
importation of homoeopathy as much as any one; that such
resolutions were an insult to honorable professors and a stain on
the institution; that their passage would ruin the regular medical
department, and that they were uncalled for and pernicious.
The legislature should be remonstrated with, not the authorities
of the University.
For many years this question had perplexed both the Regents
and the faculty, who were obliged, single-handed to fight the
fight, the State Medical Society persistently remaining aloof.
The faculty had a right to look to the profession of the State for
sympathy; they had expressed a desire for counsel; they had
accepted the present relation to homoeopathy as an accomplished
fact and hoped for counsel from the profession to guide their
future action. Instead of counsel however, they had received
reproach, instead of giving advice, the society, through its com-
mittee would repudiate and disgrace the faculty. During this
long struggle, the society had never sought by word or act to
influence the legislature in the matter and had allowed homoeo-
pathy to get its foothold by default. Once, when the Regents
were to decide whether to comply with the law of the State, de-
manding the admission of homoeopathy, a committee appointed
by the State Society to confer with the Regents “In respect to
the future conduct of the Medical Department, under any con-
tingencies necessitating a change in its organization,” visited the
meeting of the Regents and one of their number, Dr. Christian,
of Wyandotte, had individually entered a protest against the
introduction of Homoeopathy into the University, he, Dr.
Christian, had been then and there reproved by other members
of the committee, among whom were Drs. Pratt and Hitchcock,
leaders in this attack upon the University. Drs. Pratt and
Hitchcock at that time declared that to prevent the introduction
of Homoeopathy was not the object of that committee.
Dr. Foster Pratt, of Kalamazoo, called attention to the fact
that no reflection was contained in the resolutions upon the
faculty of the University. The resolutions discussed facts, and
did not criticise anybody but the legislature.
Dr. Rynd : “Would you have advised the resignation of the
professors of medicine when homoeopathy was put in ''
Dr. Pratt : “I can hardly say that I would at that time.”
— I 2 —
Dr. Hitchcock, of Kalamazoo, said that they had always con-
sidered homoeopathy a humbug, and had characterized it as such.
It has not changed its nature now. Heretofore it has not been
dangerous because it was in the hands of uneducated persons
and was under the ban. Now, however, the University takes the
ban off and proposes to render it respectable by putting it upon
a par with the regular profession. In his opinion it was an out-
rage to render it respectable and to enable the homoeopathists
to gull the public. The regular profession has views of its own
on this question. They do not wish a humbug to be allowed or
assisted in the University or by the profession. It would be-
come dangerous if it were sent out from a learned institution.
The faculty have just the same view as the profession concerning
homoeopathy. They now entertain the same views and yet
graduate homoeopathic students. *
Prof. McLean, of the University, said he deprecated his as-
sociation with homoeopathy as deeply as any of the regular
physicians. Yet he was accused of want of consistency. They
can strangle homoeopathy right in the University, he said, if left
alone two years. He wrote to Dr. Gross when homoeopathy
was put in, proposing to resign his professorship, but by the ad-
vice of friends and physicians he was induced to withhold it.
The situation cannot last much longer. The last session pretty
much disgusted students and also professors with homoeopathy
at Ann Arbor. If, two years hence homoeopathy had any foot-
hold there, he would be greatly mistaken.
Dr. P. Klein, of Detroit, described the character of the society
and noted the fact that the University could not be governed by
this association nor did he suppose that the association could
have any very direct effect through probable action upon the
legislature. He had recently been a member of the House at
Lansing and he knew why the act was passed. It was because
other valuable appropriations for the University depended upon
it. Not one member of the regular profession was there to op-
pose the measure. On the contrary the legislature was besieged
by the homoeopathists throughout the entire session. Dr. Klein
thought that the best course was to leave homoeopathy alone
there. Several students had already become disgusted with
things and more would follow that course. He moved to inde.
finitely postpone the whole subject. The motion was lost by 37
ayes and 63 nays.
A motion was then made by Dr. Parmenter, of Vermontville,
to divide the resolutions, so as to separate the statement from
the reason which was lost by 31 to 61.
The previous question was now moved by Dr. Jerome, of Sagi-
naw City, and was ordered. The first three resolutions were *
then adopted, the resolutions being taken up seriatim.
The following amendment, moved by Dr. Rynd, of Adrian,
was added to resolution three :
“That a memorial be forwarded to the next legislature stating definitely
the position of the State Medical Society on this question, said memorial to
be prepared and duly forwarded by the committee of nine, of which Dr.
Foster Pratt is chairman.”
Dr. Rynd, of Adrian, moved this addition to the fourth reso-
lution :
“And that professors engaged in the teaching of medicine at the Uni-
versity be ineligible to membership in this society.”
The amendment was lost.
Dr. Post, of Ypsilanti, then moved that the fourth resolution be
laid over for one year, as was usual in cases of amendments to
the constitution.
Prof. Frothingham, of the University, said that he would
not submit to such an indignity as this action involved. He
would no longer, after the passage of the first resolution, remain
in the society.
Indeed he could not do so consistently with his self-respect.
He said he hoped the society would complete any work it had
to do, and not hesitate from fear or awe as they contemplated
their victim. He hoped they would not be less courageous than
the hired assassin of Coligni, who seeing the noble countenance
of his victim stood half repentant, but when one of his followers
cried coward in his ear, plunged the boar-spear into his heart. *
The last resolution was then tabled for one year and it was
determined that this action of the association should be for-
warded to local societies and their views be learned prior to the
next meeting of the society.
Adjourned until half-past nine to-morrow morning.
MAY 12TH-MoRNING SESSION.
Society reassembled this morning at ten o’clock.
The committee on an International Congress reported that the
Subject of Organizing such a Congress, including Canada and the
United States, had been brought before several State societies
and before the Canadian society and there was a fair prospect of
eventual success. Accepted.
Dr. Foster Pratt, moved an amendment to the constitution
providing that amendments to the constitution may be made
only on a year's notice. Laid over for one year.
A paper was read by Dr. Parmenter, of Vermontville, upon
“Forms of continued fever, as observed by him.”
It was ordered that all further papers be referred to the com-
mittee on Publication without reading.
Prof. Frothingham, of the University medical department,
tendered his resignation as a member of this Society in the fol.
lowing terms:
To the Michigan State Medical Society :
Since a resolution was adopted by this Society on the IIth inst., which,
in my opinion, declares a purely commercial policy as its guide, and repudi-
ates the ethical principle of the American medical code which makes our
profession a self-sacrificing, benevolent and humane calling, and by an-
other resolution the Society has virtually declared regular medicine un-
worthy a position among the sciences, and also a principle which, fully
carried out, would prevent the State from a proper care of the health and
lives of its citizens, would abolish public medical care of the sick and in-
sane, also all State and other Boards of Health, and carry our civilization
in this respect back to the condition of the Dark Ages, I can no longer,
consistent with my views of ethics, retain my connection with this Society,
and hereby tender my resignation of membership, and ask for its immedi-
ate acceptance, or such other removal as it may please you to grant.
- G. E. FROTHINGHAM, M. D.
ANN ARBOR, Mich., May 12, 1876.
The resignation was accepted.
Dr. F. M. Oakley, of York, offered the following resolution,
which was adopted:
A'esolved, That whenever the proper authorities shall restore the regular
branch of the Medical Department to precisely the same position which it
occupied before the establishment of the Homoeopathic College, whenever
they shall fully relieve the present medical faculty of all complicity in and
responsibility for the teaching of homoepathic students, such action shall
be deemed and shall constitute ipso facto a restoration of the Department
of Medicine and Surgery to the full confidence and favor of the Society.
Dr. Parmenter, of Vermontville, tendered his resignation as a
member of the Judiciary Council, and as Vice-President. Laid
on the table on motion of Dr. Foster Pratt.
The resignation of Dr. Rynd, of Adrian, was tendered in the
following terms:
To the Zhesident of the Michigan State Medical Association :
SIR-From the stand-point of the undersigned the action of your Asso-
ciation has been marked by a narrowness, bigotry and injustice disgraceful
to an honorable and learned profession. Without exercising the courage
to array itself directly against the University, it has become the agent of a
private school to accomplish our virtual dismembership.
You do not propose any measure of relief for the state of medical affairs
at Ann Arbor; you simply propose to destroy. When you cannot control
an institution supported by the liberality of your people, in your own in-
terests and for your own ends, you desire to overthrow. You have been
ably assisted by members of the State Board of Health, itself the creature
of the Legislature, aided and supported by all the prejudice, bigotry and
disposition of a past age.
Your conduct during the session has been unfair to a respectable min-
ority. You have tried to shut off the expression and comparison of views
by the tactics of the politician; when the friends of the University honestly
asked your counsel, your reply has been a notice of its disfranchisement.
Not having any sympathy with the course which you have taken; prefer.
ing personal liberty to the despotism of ideas having their origin with the
— 16 —
burning of witches and other humane acts of a similar nature; choosing
rather to exercise my personal independence than to remain under the des-
potism of an association which represents nothing but itself; believing that
true scienée is not the exclusive property of your association, and that its
interests are not promoted by illiberal codes, I desire respectfully to with-
draw from membership in your association. *
C. RYND.
Every effort was made to prevent the reading of Dr. Rynd's
resignation, but they failed. It was objected to by Dr. Jerome,
of Saginaw City, on the ground that its language toward the So-
ciety was unparliamentary and improper, but President Brodie,
allowed it to be read.
Then Dr. Jerome moved that Dr. Rynd be expelled from the
Society. This did not meet with much favor, and Dr. Foster
Pratt moved that the resignation be accepted and the letter be
tabled. This was adopted.
At this point the new officers were installed and Dr. Foster
Pratt, first vice-president, took the chair, Dr. Sager not being
well.
It was moved and carried that all other business necessary to
be transacted, as appointing committees, be referred to the Pres-
ident and Secretary, and the time of holding the next meeting
is also to be fixed by them.
The Society then adjourned sine die.
— I 7 —
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TAZAE MACH ZGAAW S 7.4 7"A MAE O/CA/; SOC/AE 7"Y A/V/D 7A/A.
OAVI VFA'S/7"V.
The action of the State Medical Society at its last meeting, on
the homoeopathy question at the University was a painful sur-
prise to the friends of legitimate medicine everywhere, and par-
ticularly such to those interested in the welfare of the great State
institution whose interests this action was designed to affect.
It was thought by those, that having experienced the agitation
incident to a somewhat acrimonious discussion during the past
twelve months, a spirit of fairness, candor and equity, and an
honest desire to counsel one with another as to the best means
of dealing with the inevitable question, would characterize the
members of the State Society when they should meet in annual
convention. The Society had it in its power to pour oil upon
troubled waters of medical politics in Michigan, to devise some
plan whereby conflicting parties actuated by unselfish motives
might be harmonized, and good feeling among the profession
preserved intact. But so far from doing, or manifesting any
disposition to do, aught of this nature it has deliberately added
violence to the disturbing elements, and has inaugurated a condi-
tion of affairs in this State whose end it is impossible now to discern.
In our May number we made a request that no fair-minded per-
son could refuse, that should the Society, peradventure, see fit not
to endorse the position accepted by the faculty, that it submit a
less objectionable plan of dealing with homoeopathy. This re-
quest, made on behalf not only of the faculty but of a large
number of the profession, has been unheeded. The Society,
while repudiating the existing relations has made no attempt to
deal with the question, and true to its conduct in the past, has
thrown the responsibility back on the faculty without a word of
counsel or advice. It has pulled down and manifests no desire
to build up, and has by its action brought down upon the pro-
fession of regular medicine the scorn, derision and condemna-
tion of the people and the united secular press of the State.
The faculty has all along held itself amenable to the profession,
— 18 —
and regarded, as it should, the State Society as the legitimate ex-
ponent of professional sentiment in the State. That it should
now repudiate the authority of the Society is a question of duty.
The Society has by its action divested itself of its right to speak
for the profession. If it refuses to advise it has no longer any
authority to censure. It cannot consistently condemn views
held by a large, and perhaps the greater portion of the profession
of the State, if it refuses to accede to the request for counsel.
Had the Society manifested the least desire to deal with the
question, we should for the sake of peace and harmony in the
ranks, have gladly recognized and considered any plan of action
it might have proposed ; but as the matter now stands we cannot
be true to our own sense of duty without denouncing its con-
duct as unfortunate, bigoted, narrow-minded and unworthy the
great profession which has always justly boasted its liberality.
To suppose, however, that the late action of the Society was
representative of the profession of the State would be doing not
only the profession but the Society itself an injustice. It needed
but the most cursory glance at the meeting to convince any one
at all conversant with medical matters and men in the State that
the University had little to hope for a fair and candid hearing
and judgment. The most heterogeneous elements, differing at
all other points, met and found common ground in an intense
hatred from a variety of causes, of the Medical Department.
The animus of these parties was manifested in the action of the
Committee going out of its way by leaving the question Com-
mitted to its consideration to introduce a resolution, striking at
the very organization of the Medical Department, declaring that
it is derogatory to the honor and dignity of medicine for it to
be taught by the State. It may also have been a mere coinci-
dence, but a most remarkable one certainly, that not only the
committee itself, but also the officers of the Society were selected
with but two or three exceptions from among those who had
made themselves conspicuous by their rabid opposition to the
University—this opposition on the part of many dating from
— I 9 —
many years prior to the introduction of homoeopathy. Mem-
bers, too, who for many years have been known as chronic
office seekers, were at the late meeting elevated into power on
the sole recommendation of their being inimical to the University.
In the resolution declaring that medicine should not be taught
by the State was embodied the spirit which originated and kept
alive the disturbance of the last year. A private institution
which arrogates to itself the position of a rival to the Medical
Department of the University, was for very obvious reasons
very much interested not only in having this resolution received
as the sense of the Society, but also in having the meeting do all
that it did, to weaken the confidence of the profession in the
Medical Department. This institution was largely represented
in the meeting by its professors and lecturers who cast a solid
affirmative vote on every question, however remotely antagonistic
to the welfare of the University. In addition to this body of
voters there were present two other classes, not less bitter in
their opposition, though animated by different motives. One of
these was composed of disappointed applicants for positions in
the Medical Department, some of them applicants too since
the present relations to homoeopathy were instituted. The other
class consisted of the advocates and supporters of a contempla-
ted university to which it is proposed to affix a medical depart-
ment. We are credibly informed that overtures have been made
to members of the regular medical faculty of the University to
have them join in the proposed scheme. The disruption of the
medical department of the University, it is not difficult to un-
derstand, would give the proposed college an admirable send off.
These three classes labored assiduously to secure an attend-
ance of the proper complexion to carry an adverse vote against
the University, and managed to enlist some who have since seen
through their designs, but who were doubtless honest opponents
of the present plan. The University made no effort to secure
an attendance, prefering rather to rest its case upon its merits,
than to depend for success on the tactics of the political wire-
– 2 O —
puller. We venture to assert that had the classes to whom we
have above referred, as personally interested in an adverse criti-
cism being passed on the faculty's action, refrained from voting,
the expression of the Society would have been diſferent.
The matter, however, has not yet been settled, and the action
thus far will ultimately redound to the advantage of the Uni-
versity. It has already stirred up a popular indignation which
no private institution can brook. The people will not stand
listlessly by and see the institution in which they take most
pride sacrificed to either gratify the personal animosity of indi-
viduals Smarting under disappointed ambition, or to advance the
interests of a private concern, working under a charter granted
by the State. The gauntlet was thrown down by these parties
at the late meeting of the State Society, and the people will take
it up, and we have little doubt as to who will come out the
victors.
We have an abiding faith in the ultimate triumph of the
right, and that the University is right, is with us a religious con-
viction. z *
We append here with an editorial article from the New York
Medical Record on the same subject:
“The State Society of Michigan, at a recent meeting, and aſter an exciting
debate, adopted a resolution condemning the course of the faculty in regard
to the homoeopathic question. An amendment was offered to the Constitu-
tion, which, under the rules, was laid over until the next annual meeting,
refusing fellowship to any graduate of the University while the present
arrangement continues. Amid the excitement attending those proceedings,
the Society adjourned, with much of its important business unfinished.
Every one interested in the proper solution of the matters in dispute will
be sorry that such radical measures have been adopted, and that such a
spirit of partisan zeal has controlled the deliberations of a strictly scientific
body. Nothing can show more clearly that the Michigan State Society is
absurdly intolerant of homoeopathy than the recent action alluded to. The
extreme attitude assumed is of itself a confession of weakness, an attempt
to force conviction by arbitrary means, rather than a manly and fearless
endeavor to meet the questions at issue, and discuss them with the calm-
ness of men who desire to know the truth, the whole truth, and nothing
— 2 I —
but the truth. If we are ever going to expose the error of homoeopathy
we must give it plenty of light and air. We have dignified it with martyr-
dom long enough. If we are not afraid of it we can afford to offer it every
opportunity for proving its superiority. The faculty of the University, in
view of the issue at stake, should be upheld rather than condemned. The
idea of yielding up the school to the homoeopaths is preposterous. The
liberality of conceding the homoeopaths even what they have, will afford
them the surer means of working out their own destruction.
Homoeopathy is a rank weed that has always flourished in the low and
damp recesses of hypocrisy, and we have fostered this tendency by shadow-
ing it with our prejudices. The longer we do this, the stronger will be its
growth, and the more effectually will it entwine with the ignorance of the
masses. If, on the contrary, we give it the impartial sunlight of truth, it
must sooner or later shrivel into the infinitesimal proportions of its own
doctrines. We, at least, are willing to give it such a chance. It never can
be done, however, by auy such resolutions as were passed by the Michigan
State Society.”
7A/A2 AT/AVCA /AV ZA V ZAV //ED/CAA. AE 7///CS.
The following from the Detroit Tribune is too good to be lost.
While it illustrates admirably the stand taken by the State So-
ciety and its illustrious “committee of nine,” its appearance in
one of our leading secular journals is suggestive, as showing the
ridicule to which the society has subjected the profession among
an intelligent laity:
“The precise form and scope of the resolutions on the University ques-
tion reported by the majority of the State Medical Society's committee in-
dicate that those gentlemen must have recently devoted some of their
valuable time to the profitable perusal of the fascinating novel of Oliver
Twist, and that they retained a vivid recollection of the following portion
of its forty-second chapter, in which Mr. Noah Claypole and Mr. Fagin
discuss and decide upon the plan of business procedure calculated to the
most completely employ and reward the former's peculiar talents:
“What do you think, then 2 ” asked Noah, anxiously regarding him.
“Something in the sneaking way, where it is pretty sure work, and not
much more risk than being at home.”
“What do you think of the old ladies P” asked Fagin. “There’s a
good deal of money made in snatching their bags and parcels and running
round the corner,”
“Don’t they holler out a good deal, and scratch sometimes 2 ” asked
Noah, shaking his head. “I don’t think that would answer my purpose.
Ain't there any other line open P”
“Stop!” said Fagin, laying his hand on Noah's knee. “The kinchin
lay.”
“What's that?” demanded Mr. Claypole.
“The kinchins, my dear,” said Fagin, “is the young children that’s sent
on errands by their mothers with sixpences and shillings; and the lay is
just to take their money away—they’ve always got it ready in their hands—
then knock 'em into the kennel, and walk off very slow, as if there were
nothing else the matter but a child fallen down and hurt itself. Ha! haſ ha (''
“Ha! haſ * roared Mr. Claypole, kicking up his legs in an ecstasy.
“ Lord, that's the very thing !”
The majority of the Committee of Nine in their report curiously omitted
to denounce the Legislature which is primarily responsible for the state of
affairs at the University; nor did they seek to stigmatize the Regents who
were the immediate agents in the establishment of the Homoeopathic, Col-
lege ; nor did they in direct terms affix the brand of their fraternal dis-
pleasure upon Drs. Ford, Palmer, Dunster, Maclean, and Frothingham, of
the Faculty; but upon the young men still in the Medical Department the
full weight of their displeasure fell. These youths—the least responsible
of all concerned-–they proposed to place under the ban at the outset of
their professional careers by refusing them fellowship. The peculiar cun-
ning of Claypole and Fagin figures in this programme. The Legislature,
the Regents, the Faculty—they are powerſul bodies, with strong constitu-
encies behind them, and they may show fight to some purpose. But the
boys on the students’ rolls—their means of resistance are more doubtful,
and thus they invite attack. And so the majority of the committee joined
in Mr. Claypole's enthusiasm over “the kinchin lay,” and it figures in the
formal phraseology of their fourth resolution.
And all this leads to one additional reflection : If rival institutions de—
sired to gain the patronage of a strong medical school, what more adroit
way to gain this end could they devise than to hold up before its students
the bugbear of professional ostracism at the outset of their business lives P.”
AºA2AXOAC 7" OA' THE COMMITZTEAE OF AW/AWE.
The following is the full report of the Committee of Nine on Homoeopathy in the Uni-
versity presented before the State Medical Society:
To the Meedical Society of the State of Michigan :
our Committee, to whom has been referred the various matters affecting the relations
of this State society and the medical profession of the State to the medical department of the
University, beg leave to report that they have given careful, even anxious thought to the
matter so referred, to the end that, if possible, a solation of existing difficulties may be pro-
posed which, if adopted, shall damage no great interest, sacrifice no honor, nor compromise
the dignity of medical science in our State.
the present position of the medical department of the University and our relations to it
bristle with difficulties—difficulties springing, on the one hand, from the legal relations of
the school to the Legislature and to the Board of Regents and, on the other hand, from the
ºlºgness of the profession to hold any parley or make any compromise with irregular
Iſle Cll CI In C.
The controversy arises, as all know, from the establishment by the [legislature and the
Board of Regents of a homoeopathic medical department (so called) in the University.
For the better understanding by our brethren in this and other States of the existing
‘‘situation,” your committee present the following succinct statement of the facts in the
..º. of the movement which has resulted in this new (so called) department of homoe-
Opathy.
Before stating these facts, however, it may be well to say that, by the constitution of
our State the Board of Regents ‘‘haze the general szeźerziszon of the Unizersity, and the
direction azud' contro/ of a// expenditzezes /royz the Unizersity interest ſund ’’ This Univer-
sity fund and the students’ fees, together, constitute a fund absolutely under the control of
the Regents; but, as the University has been expanded and is now managed, this fund is
only about half what is required to defray the annual expenditures of the institution. For
this additional amount the Board are compelled to look to the annual appropriations of the
State Legislature; and in making these appropriations, to meet the pressing wants of the
School, the law making power has, ſrom time to time, seen fit to couple its bounty with cozz-
ditions, upon compliance with which, by the Board of Regent, the money could be drawn
from the State treasury. In several instances, the Legislature has made use of its power of
appropriating money, to practically invade the constitutional function of the Regents, as the
ºling power of the Institution and to dictate to them in matters not legally within its
spnere.
Beginning in 1855, it passed an act providing for at least one professor of homoeopathy in
the University. -
The Regents refusing to comply with this legislative requirement, the Supreme Court in
1856 was asked, by a mandamus, to compel its observance. But the mandamus was refused
by the Court, for reasons, in this instance, not necessary to enumerate.
In 1867 another act was passed appropriating 1-20th of a mill on each dollar of the taxable
property of the State, for the benefit of the University, £zozºided, the Regents would comply
with the law of 1855, and establish one homoeopathic professorship. *
-The Regents agreed to and did appoint two such professorships to be located at some
point outside of Ann Arbor. But the Auditor-General refused to pay the money appropriated
on the ground that this was not a compliance with the act. The Regents now asked the
Supreme Court, by mandamus, to compel the auditor to the payment of the appropriation.
But the writ was refussed, the Court being equally divided in opinion.
In 1869 a mandamus was again asked of the Court, by the homoeopathic interest, to com-
pel the Regents to comply with the original act of 1855. The Court being again equally
divided, the request was again denied.
In 1873 the Legislature passed another act, in this instance without appropriation and
without condition, providing for the establishment of two professorships of homoeopathy by
the Regents.
As before, the Regents refused to comply, denying the power of the Legislature to con-
trol them in their management of the University.
. The usual eſfort, by mandamus, to compel the observance of the act was made, but this
time before the Circuit Court of the county in which the University is situated. The Court
decided it had no jurisdiction and refused the prayer—also refusing to grant an appeal for
the reason that having no jurisdiction of the case, it could take no action from which to ap-
peal. But nothing daunted, and with a zeal worthy of a better cause, the petitioners again
besought the Supreme Court, and were again refused, the Court being again equally divided
and unchanged in the opinions formerly expressed.
But in April, 1875, an act was passed, authorizing the Board of Regents to establish a
new department of medicine in the University— the homeo ic department—and made an
annual appropriation of $6, ooo for the purpose of sustaining
On the 12th of May, 1875, the Regents established a moeopathic Medical College at
Ann Arbor; equipped the new college with two professors—one of practice and one of thera-
peutrics; required five of the former professors—viz: of Anatomy, physiology, surgery,
obstetrics and chemistry—to supplement the defit), encies of the new department, and to be-
come, with the two homoeopathic professors, the teachers of registered homoeopathic stu-
dents, and with this requirement the professors named have complied.
To remove one difficulty in the execution of this plan, the former mode of granting and
executing diplomas was radically changed in every department of the University; the
diplomas of each department, instead of being granted and signed as formerly by the pro-
fessors of the several departments, are now granted by the Board of Regents upon certificates .
of proficiency given to each student of a department by each professor of that department
and are signed ‘‘ ozzly by the President and Secretary’’ of the Regents.
Of the action of the Medical Faculty in accepting acquiescing in these radical changes
of their relations to the medical department, but little need be said. It has been a subject of
much controversy—a controversy which it is now useless to open—and, which, if opened,
will not aid this society in reaching a just and proper conclusion in regard to its relations to
the medical department and its work. . It is enough to say, that Dr. Sager of the Medical
Faculty and for many years its Dean, has refused to approve or accept the amalgamation and
has resigned his position. All the other members of the faculty have remained—whether
because they approved or acquiesced in the arrangement, it is not important to inquire P it is
but proper to state, however, that no evidence has been produced which shows that, as a
faculty, they relinquished, in any degree, their opposition to the introduction of homoeopathy
into the institution, but, on the contrary, we have their personal assurances that, while the
question was pending in the Legislature, they refused to make concessions and when the
act was passed and the Regents decided to incorporate the new department into the Univer-
sity, the situation was accepted by them as an ‘‘accomplished fact” and without approval or
disapproval.
Having thus stated all the facts which seem to be pertinent to our inquiry and which are
needed to guide the action of this society, your committee beg leave to offer a few suggestions
which grow maturally out of their investigations, and which seem to them to be important :
First—The expansion of the University, by the creation of many departments not self-
sustaining, creates a necessity for an annual appropriation by the Legislature for their support
of about $40, ooo. t
Second—The Legislature or those controlling its action from time to time have taken
advantage of this annual necessity to impose conditions not warranted by a true construction
of their powers upon the Board of Regents.
Third—The wants of the University and of its several departments not self-sustaining
have induced the Board of Regents to yield the long-mooted introduction of homoeopathy
into the University.
Fourth—The Medical Department of the institution has been the sacrifice offered to
appease the Legislature and to build up or maintain other departments.
Fifth–That State management of theological or medical schools will, in the nature of
things, be disastrous to their welfare, if not actually destructive of their life.
Sixth —That it remains for the medical profession to provide for its own education, and,
like theologians, to conduct its own schools and take care of its own interests.
In the matter of admitting as member of this society, the medical graduating class of 1876
or members of it, your committee beg leave to say that inasmuch as all, or nearly all, were
entered students in the medical department of the University before the establishment of
the homoeopathic department, and inasmuch also as no homoeopathic students have been
graduated this year, it is recommended that they be admitted members of this society on the
usual conditions.
•
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