SURGICAL CLINICS OF THE MASS. HOM. HOSPITAL. SUMMARY. CASES. OPERATIONS PERFORMed. No. of Operations. Cured. Improved. Not | Remaining. Abscess of scalp ; necrosis of occipital bone. . . | Opened and curetted. . Opened joint; fixation Amputation Opened and curetted Iridectomy. Whitehead's operation. Partial extirpation Extirpation... 1 Supra-vaginal hysterectomy. Supra vaginal hysterectomy. Extirpation.... SOCIETIES. -:0: BOSTON HOMEOPATHIC MEDICAL SOCIETY. The regular monthly meeting of the Boston Homœopathic Medical Society was held at the Women's Industrial Union, 264 Boylston street, Thursday evening, Dec. 3rd, 1891. President Geo. B. Southwick, M.D., in the chair. The records of the last meeting were read and approved. Drs. Wesselhoeft and Talbot not being present, the discussion upon Typhoid Fever was opened by Dr. J. Heber Smith. His experience with this fever had been mostly with the neurotic type, and the remedies used the cerebro-spinal, as arsen., hyos., and where extreme nervous excitement, opium, one drop to one half glass of water, and in teaspoonful doses; one drop of the tincture producing results in twelve hours, while the third decimal required from twenty-four to forty-eight hours. Agaricus where the pulse was 120 to 130, given in ten to fifteen drops of the tincture in water did good service. Baptisia not specially indicated since well-water had been done away with. Diarrhoea in both private and hospital practice was infrequent, and was due to faulty nutrition. Where the cerebral symptoms are prominent, milk with, or in alternation with barley gruel in tablespoonfuls every two hours, was the diet, as it never produced vomiting. The treatment from the beginning should be sustaining, not expectant. Dr. Lougee thought baptisia supplemented by arsen. and rhus tox. was a good remedy now. The type of fever, now prevailing in his vicinity, was peculiar. In one case the cerebro-spinal symptoms predominated, in the next the abdominal, while in a third the stomach seemed the most effected. Dr. French quoted Dr. Alonzo Clark as saying, "You could not break up typhoid fever, but must carry it along upon hygienic principles." You want a good nurse, good air, bathing freely, and a milk diet. Milk warm, and from four to six ounces every two or three hours. Hot milk in most cases stimulated better than whiskey. If diarrhoea occurs, use arsenicum; but do not start in with vigorous treatment. Dr. Packard exhibited a new method of ether inhalation, vaporizing the ether instead of saturating anything to cover the patient's face. The air inhaled was charged with ether by pumping the air through the ether and so producing surgical anæsthesia. By this method the patient returns to consciousness in a few moments, and with only slight nausea. Dr. W. S. Smith also exhibited an ether inhaler consisting of a perforated tin cylinder into which etherized air was forced while behind it and entering the ring could be found the cord. By means of a tube and artificial light, perfect illumination could be obtained, and a diagnosis of hydrocele was made. July 25th. Patient was etherized. Incision was made through the scrotum down to the tumor, the anterior portion of which was isolated before it was punctured. It was then opened, the contents, a clear, straw-colored fluid, was evacuated, the greater portion of the sack was entirely removed, a drainage tube inserted, and the wound closed with catgut. There was no pain following the operation although the scrotum became quite cede matous. On the fifth day the tube was removed, and on the tenth day the wound was entirely closed. He was discharged on Aug. 7th. After the reduction of the hydrocele, careful examination, both at the time of the operation and subsequently, failed to show the external ring open or distended. ; age, 63. Admitted Sept. 5th. CASE II. H. T. M Diagnosis, hydrocele. About one year ago had considerable pain through the right spermatic cord, at times severe, and the scrotum began to enlarge until it was much distened. It was not sensitive to manipulation, except upon deep pressure at one point, which indicated the location of the testicle. The tumor could be illuminated, and gave forth indistinct fluctuation. It had been diagnosed as sarcoma of the testicle, and he came to the Hospital expecting the testicle to be removed. The patient was etherized, and a small incision made through the scrotum down to the tunica vaginalis. The sack was found to be exceptionally thin and delicate, and was opened and the contents evacuated. The greater portion of the sack was dissected out, drawn through the wound, cut away, and the wound closed with catgut, without drainage. It healed immediately; the patient was up on the fifth day, and discharged on the ninth. CASE III. N. L; age, 69. Admitted Aug. 30th. Diagnosis, indirect inguinal hernia of the right side; hydrocele of the left; phymosis. This patient came to the Hospital because of inability to urinate, passing but a few drops at a time, which caused almost unbearable pain, while the desire was very frequent. Both sides of the scrotum were enormously distended, so that the penis was retracted and much tension put upon the prepuce. The irritation had resulted in an hypertrophy of the prepuce, with a contraction of its orifice. It was eroded, inflamed, and exquisitely sensitive to touch, all of which was materially heightened by the continual moisture from the urine which was passed almost drop-wise. The pain was so severe at the time of his admission that Dr. May etherized him at once, and found the opening of the prepuce so small that only a fine probe could be entered. Previous to etherization the attempt had been made to pass a catheter, but he could not bear it. The prepuce was forcibly dilated, the catheter passed, and considerable urine found in the bladder. He was comfortable the next day and passed urine without further trouble. Examination discovered on the right side a large swelling completely distending the scrotum, which could readily be diagnosed as an indirect inguinal hernia. It was soft and doughy; and the contents of a well-defined sack could be returned to the abdomen through the ring, but the slightest impulse on coughing brought it back to the scrotum and was communicated to the tumor. The left side was distended almost as much as the right, and the tumor was well defined and resistant, extending up the cord to the ring, but deep pressure showed that it did not communicate with the ring, and that its upper limitations were oval in shape, like the small end of an egg. Skin was tense, fluctuation was indistinct, and no amount of careful detail could give the slightest degree of illumination. Deep pressure at the lower and inner side of the tumor gave testicular sensitiveness. It was diagnosed as a hydrocele, and a radical operation advised. Sept. 5th. The patient was etherized. The hydrocele was first operated upon by an incision through the scrotum to the sack, the anterior portion of which was freed from its connections. The sack was opened, and its contents, consisting of a very dark-colored fluid, was allowed to escape. The color of the fluid was what prevented illumination. The walls of the sack were very thick and the inner surface was highly congested, which accounted for the dark color of the fluid, there having been some hemorrhage into it. A drainage tube was inserted, and the wound closed with catgut. On the third day the tube was removed from the scrotum, and this quickly healed in a satisfactory manner. The hypertrophied condition of the prepuce has entirely disappeared. THREE CASES OF TUBERCULAR GLANDS IN THE NECK. This condition of enlarged, inflamed, cervical glands, which used to be called a scrofula, or struma, but which is now classed by an atomizer, producing anæsthesia in a few moments, with the use of a small amount of ether. Dr. H. C. Clapp said, in speaking of pneumonia, that he did not approve of poulticing. The odor was objectionable, the constant changing exhausting, and the weight impeded the motion of the thorax. Cotton-batting was much to be preferred. Cold compresses were very satisfactory when properly applied, and the temperature was high. Great care should be taken when used upon old people. Stimulants at or near the crisis when heart failure is apprehended, tides over and often times helps where nothing else could. The question of the contagiousness of pneumonia is still an Dr. Clapp considers it a constitutional disease with local manifestations. open one. Dr. Lougee strongly advocated the use of cold-water compresses. Dr. Boothby preferred hot-water compresses to cold. Dr. Farnsworth endorsed the cold compresses, and suggested keeping the feet warm. The meeting adjourned at 10 o'clock. M. E. MANN, M.D., Secretary. MASSACHUSETTS SURGICAL AND GYNECOLOGICAL SOCIETY. The annual meeting of the Massachusetts Surgical and Gynæcological Society was held at the Crawford House, Boston, Wednesday, Dec. 9, 1891, the President, J. K. Warren, M.D., in the chair. The following candidates upon the recommendation of the executive committee were elected to membership: W. N. Emery, M.D., of East Boston; F. A. Davis, M.D., of Boston; J. B. Hines, M.D., of Roxbury; Elizabeth A. Brackett, M.D., of Dorchester; George A. Tower, M.D., of Watertown. The report of the Treasurer, Dr. J. H. Sherman, showed the finances of the Society to be in a prosperous condition with an increasing balance on hand. The following officers were unanimously elected for the ensuing year: President, Dr. C. R. Brown, of Lynn; First Vice-President, Dr. W. B. Perkins, of Malden; Second Vice-President, Dr. W. E. Batchelder, of Danvers; Secretary Dr. L. A. Phillips, of Boston; Treasurer, Dr. J. H. Sherman of South Boston. Amendments to the By-Laws, presented by Dr. G. R. Southwick at the last meeting, proposing an increase of the annual |