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An unole may have bad tubero ulosis. Pa. sputum, focus apparently quiescent as retient denies absolutely any venereal affection; gards general condition. had used alcobol to excess. Had never had The second case is that of an infiltration any reason to believe that he was the subject with moist rales in left infra-scapular region, of a pulmonary trouble until March, 1902, remaining portions of lung in an emphyse. when after exposure on a rainy day, he was matous condition, due to repeated attacks of three days later, when about to go to his work, bronchitis. This subject also keeps in good taken with a severe pulmonary hemorrhage. flesh and in fairly good health between his He stated, a cupful of blood was raised. This broncbial attacks. bleeding was repeated one and one-half hours Both of these men are about 45 years of later. He then went to the City Hospital, and age; and one of them admits a venereal bisduring his stay of seventeen days, he claimed tory. In neitber have tubercle bacilli been to have had thirty hemorrhages.

found in the sputum. The lesions in both, On the 17th of the following May be en- however, appear to be favorably influenced by tered the Mullanphy under the care of our the iodides, but bave never completely cleared predecessor, and from that date to the time up. May not these also be obscure cases of of bis becoming our patient, it was learned pulmonary syphilis? that he had had repeated hemorrhages, many of which were severe. He also lost greatly

DISCUSSION. in weight and strength. All during this time

Dr. H. W. Soper (813 N. 18th St.) stated he was thought to have pulmonary tubercu

that he could recall two cases that had delosis, and was treated accordingly, which re

veloped tuberculosis while under treatment sulted also in some improvement, as he grad. for syphilis. The first case developed the ually became able to leave his bed and be up first evidences of tuberculosis about a year and about the ward for a short while at a

after the syphilitio infection. The patient time, but he was still (June 25, 1903) very

seemed to be responding well to the treatment thin and feeble. Careful physical examina

for syphilis, and bad no lesions at the time. tion at that time showed evidence of infiltra- The tuberculosis was remarkably rapid and tion of right lower lobe posteriorly, and some

the patient succumbed in about one month's subcrepitant rales in right infra-axillary and time. The second case developed it after infra-mammary regions, also scar on fraenum

about two years.

He had kept his weight of penis and a perforation of nasal septum. and general nutrition very good Results of Examination of sputum showed no tubercle

the antisyphilitic treatment was not very bacilli.

favorable at the time. The tuberculosis ran These findings naturally aroused suspicion a slow course. These cases, however, were of pulmonary syphilis, and accordingly he

not believed to be a fair sample of the kind was placed on specific treatment June 28,

that Dr. Smith wished discussed. These 1903, which treatment was continued, on the

went to the bad very rapidly, the second beintermittent plan until his discharge, Septem- ing slower than the first. ber 9, 1903. During this period he had no more hemorrhages. His cough disappeared, Dr. M. W. Hoge (Linmar Building) beand he gained in flesh and strength, so that lieved that a case which he had had under at the time of leaving the hospital

his general treatment a few years ago would be of interest condition was very good.

in this discussion. The patient was an emaA thorough physical examination, made ciated, cacheotic individual, who had never August 21, 1903, showed that all evidence of given any definite history of infection. He pathological changes in his lungs had cleared bad treated her once following an attack of up entirely.

influenza, following which there was fever, During the time patient was under obser. cougbing and bloody sputum. She would vation repeated careful examinations of the cough up sufficient blood to almost call it sputum were made by my associate, Dr. pulmonary hemorrhage. The condition ran Fahlen, with always negative results.

a slow course, the fever diminished and finHere then we have had a case that cer- ally subsided. There was no cavity formatainly behaved in every way like syhpilis of tion that could be determined. She did not the lungs, but, of course, the diagnosis was want a diagnosis made, and would call not oonfirmed by autopsy.

upon the doctor only when there was some I can also recall two other cases, the first serious trouble. Some months after that, in which a man of six feet and weighing 200 she developed a pasal trouble which was re

He pounds has had for several years all the evi: ferred to a nose and throat specialist. dences of a cavity, the size of a hen's egg, recommended that an iodide be given in small just below the angle of right scapula-lungs doses, on account of the lung trouble, probaotherwise normal. He has never raised any bly being tuberoular. Her condition im.

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proved very rapidly, and there was no injuri" ous effect shown on the long. The result was rather favorable. Subsequently when this patient came to the doctor in a run down

Issued Tenth and Twenty-Fifth of Every Month. condition, she was usually benefitted by a

Under the Editorial Direction of specific treatment. The speaker could not

FRANK PARSONS NORBURY, tell whether the lung trouble was tubercular

THOS. A. HOPKINS,

CARL E. BLACK. or syphilitic. If it was syphilitio, it showed

With the following staff of Department Editors the benefit of the treatmeut. If it was tuber

0. E. LADEMANN, Internal Medicine. cular, the trouble was not increased.

JOHN MCHALE DEAN, Surgery.
R. B. H. GRADWOHL. Pathology and Bacteriology.

W. H. VOGT. Obstetrics and Gynecology.
Dr. Albert E. Taussig suggested that in WALDEMAR FISCHER, Ophthalmology.

A. LEVY, Pediatrics. obscure cases like the one reported, it was W. T. HIRSCHI, Therapeutics. often worth while to inject some of the spu

A. F. KOETTER, Otology.

HERMAN STOLTE, Laryngology and Rhinology. tum into the groin of a young guinea-pig. If F. P. NORBURY, Nervous and Mental Diseases.

T. A. HOPKINS, Genito-Urinary Diseases. the sputum contained tubercle bacilli, even ROBERT H. DAVIS, Dermatology. in numbers so small as hardly to admit of detection by means of the stained spread, a general tuberculosis would develop in the in

EDITORIAL oculated animal. If on the other band no such tuberculosis developed, this result would speak, so far as it went, for some other diag. Medical Society, held May 15, 16 and 17,

The Springfield meeting of the Illinois State nosis. In the case reported, the possibility

was the largest in atof a tuberculous condition was the confus

tendance in the history ing feature, and light might thus bave been The Meeting of

of the society.

Three thrown upon the matter by animal experi- the Illinois

factors contributed to ment.

State Medical

making this a large and

Society. Dr. Fischel in closing the discussion, stated

profitable meeting: that the patient bad had lesions fourteen years

first, the location, which before and that his hair bad come out. Special is central and accessible, with ample hotel emphasis was laid upon the peculiar gait, and acommodations; second, the increased mem- . this, the doctor stated, could not be accounted bership of the society, due to the extension for on any other ground. He could not be of organization, every county now but one in certain as to the absence of tubercle bacilli. the State being organized, and this factor is All of the many tests were negative. The of inestimable importance alone, in the fulpatient had improved wonderfully since the filling of the aims and purposes of the soiodide potassium treatment commenced. The oiety; third, but not least, the growing interest doses were increased up to 40 drops three of physicians in the progress which medicine times a day, and unly stopped then because as a science is making by reason of more muthe results were good, and there was no good tual interest being shown by physicians in reason for increasing the dose. As to the each others work and the work of the proguinea-pig test, the dootor wished that it fession at large. Fully seven hundred and could be tried in the City Hospital, but Sfty, physicians were present during the the facilities were not at hand.

Springfield meeting with a registered list of actual members present of over 500.

This number emphasizes the importance of FOURTEEN women physicians of Detroit re- having the society convene at central and ac. cently organized a suciety whose membership cessible points, where hotel accommodations is liioited exclusively to women practitioners. are sufficient to meet the demands of this It is designated the Women's Academy of growing society, and we hope that at not a far Medicine, and is the third of its kind in the distant day it will be decided that Springfield country, the others being located at New York will be chosen as the regular meeting place of City and Ruchester, New York. Women this society, because of the above mentioned physicians in Michigan who are members of reasons. The program of the meeting was their county society are eligible to member- excellent throughout, perbaps too many papers ship in the new guild. The following officers were contributed, which fact hinders, some. were elected for the ensuing year: President, what the value of discussion and creates Dr. Lucy J. Utter; vice-presdent, Dr. Mary hurry and over-time sessions, in order to G. Haskins; secretary, Dr. Anna Starring; comply with the requirements of this society treasurer, Dr. Minta P. Kemp; councillors, in having papers read, before permitting their Drs. Florence Huson, Louise Rosenthal publication in the transactions. Thompson and Isabella Holdom,

posium feature gave interest and value to the

The sym

it was

presentation of timely subjects, thus giving Dr. J. F. Percy, of Galebsurg, Ill., the the opportunity for a full disoussion of prac- newly elected president of the society, is one tical and valuable phases of the varied dis- of the wbeel-borses of the society, and has eases selected for discussion. The society been ever since his election to memberwas honored by a very thorough and scien- ship. A man truly great in his qualities of tific address by Governor Chas. S. Deneen manhood, devotion to the spirit and letter of on some features of Criminology derived from the profession and his professional acquirepersonal observations during his term of ser- ments. It is certainly a high commendation vice as prosecuting attorney of Cook county of the regard with which he is held in the soWe bope to present this address in full at a ciety by the fact, that he was elected by aclater date. The president of the society Dr. clamation and with no opposing candidate in H.C. Mitchell, of Carbondale, delivered a very the field. exhaustive, earnest, belpful and suggestive We congratulate the Illinois State Medical address in the opening meeting, covering Society in its selection of this lovable, good many of the essential features of practice, and earnest man as its president, and we conshowing the relationship of the profession to gratulate Dr. Peroy on his selection to this the public, following along the lines which high office, the gift of his fellows, and we are Dr. McCormick has so zealously advocated sure he will make this year one of deserving in bis soul-stirring addresses tbroughout the honor to himself and the society. F.P.N. country. We congratulate Dr. Mitchell on the fulness of his address, and the true spirit of serve, which he exemplifies and so earnestly THE 1906 meeting of the Missouri State presented. It is from the living examples Medical Association made good all that bad that ideals grow and from whom young men

been predicted for it, get their inspirations and for this reason we

a delightfully

The Meeting of believe such addresses as that of President

profitable occasion.

the Missouri Mitchell should be published in various

Jefferson City proved a

State Medical journals that the young wen in medicine, es

most satisfactory meet

Association. pecially, may build for themselves realities in

ing place, true there was practice, which will make them earnest, ser

a lack of hotel accomviceable and true followers of the nobler mo- modation, but the citizens of the capital city tives of our profession.

opened their homes and comfortable quarters The House of Delegates in its sessions were found by all and many more might have passed a number of resolutions which will been cared for. The division of the scienti. show to the world that prufessional dignity, fio work of the association in two sections true reform and earnestness of purpose is again emphasized the fitness of the selection of markedly in evidence in the Illinois State the meeting place, the legislative halls of the Medical Society. Among these are one urg- capitol serving most conveniently, and holding a law requiring the publication of the ing the integrity of the work as could not formula on the bottle of proprietary medi. have been with the sections in different cines; one thanking Collier's and the Ladies buildings. Home Journal for their work in the proprie. Tbe programs presented at both the surgi. tary medicine evil; one for the creation of law cal and medical sections were of pleasing exrequiring inspection of the eye sight and cellence. A surprising feature was the bearing of the pupils in the public schools; strength of the attendance at the medical secone for State work in the care of cases of tu. tion, which was at all times considerably berculosis; one requesting members of the so- larger than at the surgical, and is a healthful ciety not to make an examination for life in- indication. The uniform excellence of the surance (old line companies) for less than five program makes it impossible to select feadollars. A number of other deserving beas- tures of exceptional interest. The discussion ures were discussed.

of abortion, wbich was introduced by Dr. The election of officers for the next year Lockwood, of Butler, showed the interest of resulted as follows:

the association in the present time of cleansPresident-J. F. Percy, Galesburg.

ing, it appears that the association is a unit First vice-president-H. A. Nickerson, in favor of an end to this evil. Quincy.

The annual address on Medicine by Dr.W. Second vice-president-J. H. Stowell, Chi- G. Moore, of St. Louis, and that on Surgery cago.

by Dr. C. H. Wallace, of St. Joseph, were Treasurer-E. J. Brown, Decatur.

scholarly and in keeping with the day's spirit Secretary-E. W. Weis, Ottawa.

of progress. Rockford was chosen as the place of meet. The social functions were well arranged ing in 1907.

and not allowed to interfere with the real

purpose of the meeting. Never have we ex. ington; 18th, Dr. G. Ettmueller, Jefferson perienced so well developed a spirit of fra- City; 20th, Dr. C. T. Ryland, Lexington; ternity within the association as at this meet- and 22d, Dr. J. R. Buchanan. Dr. W. F. ing, the three days were a continuous meeting Kohn was appointed orator in Medicine, and with good fellows and real friends, and that Dr. Paul Tupper, of St. Louis, orator in in itself made the going worth wbile. The Surgery, for the next annual meeting. dinner with brother Mat. Hall at the peni. Delegate to the A. M. A., Dr.W. J. Frick, tentiary, the reception given by Gov. Folk, of Kansas City; alternate, Dr. O. B. Campand the barbecue were generally enjoyed. bell, of St. Josepb. Jefferson City was The attendance at this meeting was good, selected as the next place of meeting.

The St. Louis was represented by some fifty registration was 348. It transpired later that members and a few friends who should be Dr. Frick was not a member of the A. M. A., members.

Dr. Campbell therefore went to Boston as The election of officers for the ensuing delegate. year resulted as follows: President, Dr. C. This deals liberally with St. Louis and H. Wallace, St. Joseph; vice-presidents, Dr. gives strong men to represent us. F. W. Allen, Callao, Dr. W. G. Cowan, Se- The association journal is to be hereafter dalia, Dr. C. J. Orr, St. Louis, Dr. E. H. more completely devoted to organization and

unifying the association; it is not to be the organ of any county society, and will serve the best interests of each and all. Dr. E. J. Goodwin, of St. Louis, will be its managing editor, a choice wbich assures conservative and wise conduct for a valuable organ.

The association voted to make Jefferson City its meeting place in 1907. The profession and people who made this occasion so enjoyable for us may take the fact that we wish to repeat as an expression of our appreciation.

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DURING the meeting of the Illinois State
Medical Society held in Springfield, May

15, 16 and 17, a unique

entertainment was The Illinois given to those members State Medical

interested in the eye, Society

ear, nose and throat. It Entertained by was called an authors'

an Authors' clinic, and lasted three DR. C. H. WALLACE,

Clinic on the days, commencing TuesPresident-elect Missouri State Medical Association.

Eye, Ear, Nose day morning at the and Throat.

David Prince SanitarTbrailkill, Kansas City, and Dr. H. L. Reid,

ium; Wednesday morn. Charleston. Dr. C. M. Nicholson was re

ing at the St. John's elected secretary, and Dr. G. Franklin Welch, Hospital, and later at the Springfield HospiSalisbury, treasurer. The committee tal. The idea originated with an invitation scientific work was named to consist of Dr. extended to Dr. Otto Freer to demonstrate bis C. M. Nicholson (chairman) and Dr. J. C. operation of window resection for deflected Morfit, both of St. Louis, with Dr. F. E. septum, and grew into the conception of inMurphy, of Kansas City; that on public viting other available authors. health and legislation, of Dr. F. J. Lutz The clinical material was assigned to the (chairman) and Dr. G. Roman, of St. Louis, hospitals, and the individual operator was and Dr. H. E. Pearse, of Kansas City. notified of the time and place of bis demonCouncillors: 1st District, Dr. E. E. Parrish, stration. When possible, operations were Memphis; 3d, Dr. J. D. Brummall, Salis. conducted in adjoining rooms, and on two bury, 4tb, Dr. C. R. Buren; 5th, Dr. E. H. occasions, three operations were conducted

; Miller, Liberty; 6th, Dr. W. E. McKinley, simultaneously. Denver; 7th, Dr. W. T. Elam, St. Joseph; On Wednesday an automobile service was 8th, Dr. L. W. Dallas, Hupnewell; 9th, Dr. established between the hospitals and the C. W. Reason; 14th, Dr. W. F. Kuhn, Farm- place of meeting. All the physicians of

on

were:

Springfield and the adjoining towns co-oper- various grades of arthritic trouble. This last ated to make the experiment a success. theory, perhaps, reconciles the view held by

About forty-five operations were performed those who believe in the specifio coccus with during the meeting.

that of those who regard the attenuated pus Authors of operations who were invited coccus as the casual agent. This, Frissell

believes, is strongly suggested by the results Dr. Otto Freer, Window Resection of Sep- of his own investigations. tum.

Dr. Frank Allport, Ptosis.
Dr. Casey Wood, Excision of the Tarsus

DR. WILLIAM PORTER, St. Louis (Jour. A. for Intractable Trachoma.

M. A., May 26, 1906), discusses some of the Dr. B. L. Ballinger, Enucleation of Tonsil

phenomena of tubercuin its Capsule.

losis infection and

Tuberculosis Dr. Chas. Robertson, Tonsil Excision.

makes a few therapeutic

Infection, Dr. F. C. Hotz, Entropion.

suggestions. The bac. Dr. Wilder, Symblepharon.

illus is the central point Dr. Baird, Advancement of the Reotus.

in most of the experiments and investigaDr. E. Fletcher Ingals, Intranasal Method

tions concerning tuberculosis, and Porter for Frontal Sinusitis.

says that though almost two decades of study Dr. Ostrum, Septum Deflection.

bave been devoted to this organism, he be. Dr. A. E. Prince, Strabismus and Nasal

lieves that we are only in the beginning of Obstruction.

our lesson and that so far as specific antagonDr. A. E. Prince demonstrated his ad. ism is concerned we await the dawn. He de vancement operation, excision of the rectus

scribes in some detail the routes of invasion for paralytic squint, and exercised a general

and states that at present the respiratory tract management of the clinio.

is considered by many observers the main channel, thougb be is convinced that many more pulmonary cases are directly infected through

the DR. LEWIS Fox FRISSELL declares that the

lymphatic and

blood obannels than idea that the disease known as rheumatio

are recognized by the average physician. He also states that fever or acute articular

in nearly all cases of advanced pulmonary The Etiology

rheumatism is of bac-
terial origin is no new

phthisis the faucial tonsils become inoouof Acute one.

Tated and that in about 5 per cent of hy

After discussing Rheumatism. this subject in scme de.

pertrophied pharyngeal tonsils some form tail in the Medical Rec

of primary tuberculosis will be found. He

discusses the danger of autoinfection, and ord, he conoludes that as a result of a careful clinical analysis of the pathology and symp

states that constipation with intermittent

diarrhea is found in most cases of pulmonary tumatology of rheumatism one is forced to

tuberculosis. He deals briefly with the early look beyond the common joint affection to gain a clear idea of such a protean disease at

signs of infection and refers to tuberculin and

the X-ray as diagnostic aids. He states that tacking the joints oftenest, to be sure, but

the cases most difficult to control in his extoo frequently the skin, pleura and heart. Granted a point of entry, probably the ton

perience have been those in which the physi.

cal evidence was most marked in the upper sil, as the frequency of tonsillitus in rheumatism would suggest, the various conditions

dorsal region and calls attention to the fact

that the extent of the local lesion is not alvaguely called rheumatic, as well as the outand-out attack of acute articular rheumatism,

ways a criterion of the general condition of

the patient. seem best explained by cousidering the essen

In regard to the relation of tial condition to be a blood infection. As.

pleurisy to tuberculous pulmonary infection suming this hematogenous origin, the local

he says that no man bas a right to speak ization of the symptoms he says is readily

dogmatioally. He declares that he has seen accounted for by the bacterial em bolus or lo.

cases of pleurisy with effusions that were not

tuberculous and that never became tuberou. cal toxin action. In regard to the nature of the organism at fault he presents five possi

. lous, but admits that these may have been

exceptions. The majority of tuberculosis bilities: An infection caused by the ordin.

cases have pleuritic extension and infection. ary streptocooci or staphylococci with their virulence in some way decreased. Infection by a specifio bacillus. A mixed infection DR. D. L. HARRIS has been appointed city with bacilli and cocoi. An infection caused bacteriologist, and Dr. D. M. Shoemaker by one of a group closely allied organisms, his assistant by Mayor Wells. probably diplo- or streptococoi, which cause pointments are pleasing to the profession.

These ap

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