The Ohio State Medical Journal

Murphy, J. W., Cincinnati: "Brain Infection of
Optic Origin; Report of Five Cases"; Laryngo-
scope, Oct., XXV, No. 10. "Acute Middle-Ear In-
flammations"; Lacet-Clinic, Nov. 6, CXIV, No. 19.

Malceod, J. J. R., Cleveland: "Protein Metab-
olism"; Jour. of Lab. and Clin. Med., Nov., I, No. 2.
Perkins, R. G., Cleveland: "Epidemiology of

Whooping Cough and Diphtheria in Cleveland in

1914"; Clev. Med. Jour., Sept., XIV, No. 9.

Pearce, R. G., Cleveland: "Criticism of Bang

and Lewis-Benedict Methods for Estimation of

Blood Sugar"; Jour. of Bio. Chem., Oct., XXII,

No. 3. (Abs. Jour. A. M. A., Nov. 13.)

Philips, J., Cleveland: "Cases of Hemorrhagic

Conditions in Infants"; Clev. Med. Jour., Aug.,
XIV, No. 8.

Ryan, N., Cincinnati: "Social Service Handi-

craft Shop"; Lancet-Clinic, Oct. 16, CXIV, No. 16.

Reed, R., Cincinnati: "Clinical Study of Stam-

mering"; Lancet-Clinic, Oct. 16, CXIV, No. 16.

Rachford, B. K., Cincinnati: "Obscure Fevers

of Infancy, and Childhood," Lancet-Clinic. Oct.,

CXIV, No. 14.

Richardson, M. L., Cleveland: "Branchiogenic

of Gallbladder Following Injury"; Ann. of Surg., Oct., LXII, No. 4.

Tuechter, J. L., Cincinnati: "Medical Results at Tuberculosis Dispensary in 1914"; Lancet-Clinic, Nov. 6, CXIV, No. 19.

Thoburn, T. W., and Hanzlik, P. J., Cleveland: "Salicylatis; Methods for Quantitative Recovery of Salicyl from Urine and Other Body Fluids"; Jour. of Bio. Chem., Nov., XXIII, No. 1.

Stone, W. J., Toledo: "Differentiation of Cerebral and Cardiac Types of Hyperarterial Tension of Vascular Disease"; Arch. of In. Med., Nov., XVI, No. 5. (Abs. Jour. A. M. A., Dec. 4.)

Stewart, G. N., and Scott, R. W., Cleveland: "Studies on Circulation in Man"; Jour. of Pharm., Baltimore, Oct., VII, No. 3. (Abs. Jour. A. M. A., Nov. 6.)

"Mental Disease"; Ill.

Sawyer, C. W., Marion: Med. Jour., Oct., XXVIII, No. 4. Southworth, R., Cincinnati: "Non-Drug Therapy"; Lancet-Clinic, Oct. 30, CXIV, No. 18.

Sollmann, T., Cleveland: "The Handwriting on the Wall"; Jour. A. M. A., Dec. 25, LXV, No. 26, "J. W. Mueller, on Transfusion-Retrospect"; Clev. Med. Jour., Aug., XIV, No. 8.

Woolley, P. G., Cincinnati: "Lesions in Experimental Infection and Bacterium Tularense"; Jour. of Infect. Dis., Nov., XVII, No. 3. "Intestinal Stasis and Intestinal Intoxications"; Jour. of Lab. and Clin. Med., Oct. 1, No. 1. (Abs. Jour. A. M. A., Nov. 27.)

Warner, A. R., Cleveland: "Manufacture and Administration of Nitrous Oxid for Anesthesia: the Experience of Lakeside Hospital"; Jour. A. M. A., Dec. 4, LXV, No. 23.

Woltmann, H., Mansfield: "Transfusion by the Citrate Method in a Sixty-Hour-Old Baby with Melena Neonatorum"; Jour. A. M. A., Dec. 18, LXV, No. 25.

Dr. C. A. Coleman, Dayton, has been added to the staff of the hospital at the National Military Home, and has established a special clinic for the treatment of genito-urinary diseases. Dr. Coleman will conduct two clinics a week and soldiers resident in smaller hospitals and homes will be referred to the Dayton institution for treatment. The establishment of a clinic for genito-urinary cases will meet a need that has been felt for many years.

FIRST DISTRICT SOCIETY HELD

INTERESTING ANNUAL MEETING

Dr. Lummis, of Middletown, Succeeds Dr. Sproull as President for 1916.

The First Councilor District of the Ohio State Medical Association met in Cincinnati, Thursday, December 16, at the Cincinnati General Hospital. Although the weather conditions were very unfavorable, there was a good attendance.

The meeting was opened by our councilor, Dr. Robert Carothers, who introduced Dr. Bachmeyer, the superintendent of the hospital. Dr. Bachmeyer welcomed the members to our city and especially to the new hospital, and invited each to go through the various buildings. O. T. Sproull of West Union, Adams County, the president of the First District, then took the chair.

The following papers were then presented and well discussed: 1. Anesthesia, by C. L. Bonifield, Cincinnati. 2. Loose Kidney by Robert T. Morris, New York City.

A most appetizing luncheon was served at one o'clock in the students' lunch room at the hospital. This afforded an opportunity for a sociable hour and everybody enjoyed themselves very much. At three o'clock the program was continued in the Pathological Amphitheater. The papers were: 3. Treatment of Fracture, W. P. Carr, Washington, D. C. 4. Fracture of the Back of the Femur, Alexius McGlannan, Baltimore, Md. 5. Clinical Pathological Conference, Roger T. Morris and Paul G. Woolley, Cincinnati, Ohio.

MEDICAL POSITIONS IN STATE SERVICE. The State Civil Service Commission has announced examinations for January 25, for assistant physicians, male and female, for all state hospitals, salary $900 to $1200 with full maintenance. Examinations will be held in Cleveland, Cincinnati, Columbus, Toledo and Dayton. Applicants should have one year's experience, preferably in a general hospital, and special knowledge in psychology, including cause, effect and treatment of insanity. Those with laboratory experience are particularly desired. On January 20, in the same cities, examinations will be held for the position of chief medical examiner of the Industrial Commission, salary $3500. Further information regarding these examinaitons may be secured from the commission's office, corner High and Rich Streets, Columbus.

NEWS OF THE COLUMBUS

ACADEMY OF MEDICINE

Columbus Academy of Medicine closed a splendid year under the presidency of Dr. John Dudley Dunham, with an annual meeting at the Hotel Virginia, on the evening of December 20. More than 150 members gathered at the tables and heard the annual reports and the review of medical progress during 1915.

The report by Dr. Bigelow shows that during the year the Academy held thirty meetings with an average attendance of 110—undoubtedly the largest average in the state. During the year, 19 new members were added and the Academy was the first to reach the One Hundred Per Cent class. Despite the heavy expenses, there was a balance of $409.00 for the year. The Academy is, in fact, in flourishing shape.

Dr. W. J. Means, retiring chairman of the board of trustees, turned over a surplus of $798.00. Dr. H. M. Platter, chairman of the Committee on Public Health, reported upon the advanced sanitation work being carried on in Columbus by the city health department. Dr. G. H. Matson, chairman of the Committee on Legislation, briefly explained the new laws affecting medical practice and complimented the academy upon its prompt response to requests of the committee.

Dr. I. B. Harris reported on surgical progress during the year, confining himself to consideration of gall bladder surgery. Dr. F. O. Williams, in reporting on medicine, cited the great advance in the preventive field, calling particular attention to the wonderful results of prophylaxis in the European armies. He reviewed the progress during the year in medical education, research, and the development of public health education, speaking especially of the addition of courses in public health to several universities. Dr. J. W. Sheets ably reviewed the new things in therapeutics. (His paper is published in this number.)

Dr. S. J. Goodman, in reviewing obstetrics, called attention to the increased public interest in this field and cited instances to show that the laity is coming to regard obstetrics as a surgical practice, to be surrounded by all the safeguards usual to surgical procedure. He advocated the establishment in Columbus of a municipal hospital open to all physicians, where the prevailing rate would not exceed $10.00 a week. He praised pituitrin as the greatest advance in modern obstetrics and declared the standardization and regulation of the dosage developed during the past year to be the year's most important contribution to obstetrics. Incidentally, Dr. Goodman in his extremely forceful manner, paid his respects to the so-called "twilight sleep." He branded it as "the arch fake," and charged that certain Colum

bus practitioners had deceived their patients by leading them to believe that they had received "twilight sleep" when as a matter of fact, he said, they had been given merely scopolamin or morphin or even pituitrin.

Dr. Dunham, in a brief presidential address, reviewed the accomplishments of the Academy during the year. He urged general practitioners of the city to contribute more freely to the programs, and the Academy as a whole to take a greater interest in local public health problems.

On motion of Dr. J. E. Brown, the Academy tendered a unanimous vote of thanks to Dr. Dunham for his splendid administration.

The result of the first preferential ballot taken under the new plan adopted by the Academy was then announced. Dr. H. M. Platter was elected president; Dr. Hugh J. Means, vice president, and Dr. I. B. Harris, trustee. Drs. George H. Matson and J. B. Alcorn were elected delegates to the State Association, for a period of two years.

At the Meeting December 13.-The following program was presented: "The Mistreatment of Dysmenorrhoea," Yeatman Wardlow; discussion, Earl Gilliam and W. D. Inglis. "Photophobia and Tinted Lenses," C. F. Clark; discussion, W. K. Rogers and Clayton McPeek.

NEWS OF CINCINNATI

ACADEMY OF MEDICINE

***************************** (Report by W. R. Abbott. M. D., Correspondent) Meeting of November 29.-In his resume of the subject, "Carcinoma of the Stomach," C. T. Souther advanced the four theories which, in his opinion, are the most plausible in the etiology of cancer. First, cell atony or misplaced epithelium; second, embryonic cell nests; third, abnormal cell polarization; fourth, a medium of diminished alkalinity. Cancer is found most frequently in the pyloric end of the stomach, in the colon and in the cervix, all acid media. It is rarely found in the cardiac end of the stomach. In the stomach, the essayist believes, cancer develops on an ulcer base, and, if operated upon early, a cure can be effected. His own experiences seem to bear this out. Dr. Souther took up the pathology, X-ray diagnosis and operative technique, and illustrated his remarks with lantern slides.

Dr. Haines said that though carcinoma is on the increase, mortality from cancer is decreasing. This decreased mortality is due, however, not to better methods of diagnosis, but to the extension of the life age limit. Dr. Seigel believes that many inoperative cases are greatly benefited by the administration of potassium salts, which can be facilitated, according to the essayist, by the additional use of hydrochloric acid. Discussions of this paper also by Drs. J. H. Caldwell, W. Griess, Ricketts and Steinharter.

Meeting of December 6.-Dr. Wm. Ravine, in his paper "The Binet-Simon Test for Mentality," divided defectives into the classes: Idiots, im

beciles and feeble-minded. The test consists of a series of questions and answers, identification of figures, color, size and weights of articles. The result is based upon any deviation from what is considered normal at the different ages. This test must be taken only as a symptom in arriving at a conclusion of the patient's mentality.

Dr. Breese, professor of psychology at the University of Cincinnati, opened the discussion, and spoke of the practical use of this method in examining defective school children.

Dr. Ralph Reed believes good results can be obtained if the examiner uses his own intelligence and judgment, and takes into consideration the emotional state of the child at the time of the examination. Dr. Charles Kiely also agreed with Dr. Reed's views. Dr. North brought up the question as to whether there is anything in child life which might determine psychoses in later life.

Dr. Jesse Wyler reported his results in the use of optochin in external eye diseases, these results being for the most part favorable. Optochin is a derivative of quinine, and is used as an antiseptic and for disinfecting the conjunctival sac preparatory to operating. It is claimed to be superior to silver nitrate, as there is no irritation or symptoms of intoxication following its use.

Dr. Walter Griess read a report of a case of ruptured tubal gestation (four months pregnant) in which he removed the blood from the abdomen, diluted it with 2 per cent solution of sodium citrate, then injected it into the veins. The pulse immediately became perceptible and respiration fuller. If the fetus had been in a ruptured sac, it would not have been advisable to use the patient's blood.

Meeting of December 13.-In his paper, "The Use of Nitrous Oxide in the Production of Painless Childbirth," Dr. Moses Salzer emphasized the following points: That nitrous oxide is without danger to both mother and child; the babies when born are of good color and the mother's recovery leaves her mentally clear and with no unpleasant recollections. This anesthetic can be used at any stage of labor and can be continued indefinitely for hours, if necessary, and is successful in the elimination of pain, when properly administered, in practically every case. The effects of nitrous oxide are, at all times, absolutely controllable. It can be deepened for examination or the patient can be allowed to come completely from under its influence at a moment's notice. Cyanosis, which must be carefully avoided, is never due to too much nitrous oxide, but is due to the exclusion of oxygen.

The essayist believes that gas anesthesia does not retard labor, and can not, therefore, in itself be a cause of uterine inertia. In one case re

ported, where it was necessary to substitute chloroform for gas, due to failure of the latter, the interval between pains were immediately increased. Laughing gas is to be given in the first stage, undiluted with oxygen and at the very beginning of pain.

Dr. Rothenberg, in discussion, objected to the use of morphine scopolamine and morphinenarcophine on the grounds that we have no way of counteracting the dangerous symptoms which may arise. Drs. Bernheim, Mombach and Goldenburg discussed the cases reported. Discussed by Drs. Porter, Gillespie and Johnston, who believe the use of chloroform to be still ideal, particularly in the final stage. Emphasis was laid upon the importance of the proper administration of this anesthetic.

Meeting of December 20.-Dr. J. H. Schroeder in his paper on "The Clinical Control of Diabetes," discussed the various phases of the disease and the means available for any effective control over them. The character of the possible intoxications and the methods of prevention and treatment of these conditions were considered in some detail. The paper embodied a comparative study of eight cases of diabetes that were treated according to the method of Allen, with success. The excretion of sugar in the urine was compared with the hyperglycemia, which was pointed out as the real diagnostic factor.

Dr. Alfred Bettmann opened the discussion and described the experiments which Allen conducted in the formation of his theory, which Dr. Shawl, of Baltimore, spoke of experiments conducted in the clinics of Johns Hopkins as to acidosis from a quantitative standpoint.

Dr. Louis Heyn believes that proper dieting is sufficient in the great majority of oases, but the Allen treatment is of great benefit in the more severe cases of diabetes. Dr. Mitchell agreed with Dr. Heyn. Dr. Rose advised guarded prognoses in apparently fatal cases.

Dr. Otto Seibert presented a very rare condition-hernia of the stomach and the duodenum through the diaphragm and behind the heart. The patient had symptoms of carcinoma. The proper diagnosis, however, was made by the X-ray. Dr. Goosman presented and explained the X-ray plates in this case. The hernia was reduced and the rent in the diaphragm closed by means of chronic catgut suture-a difficult procedure-due to the depth of the wound and the proximity of the large blood vessels in this region. Dr. Johnson said that the heart pushed to one side and a tympanitic note in this region are diagnostic points. He suggested an osteoplastic operation through the chest. Dr. Lang cited several slightly similar conditions, discovered accidentally by the X-ray. Dr. Pirrung has seen one such case, and Dr. Haines reported one in the literature in which the intestines had penetrated the pleural cavity.

NEWS OF CLEVELAND

ACADEMY OF MEDICINE ***************************

(Report by J. E. Tuckerman, M. D., Correspondent)

The one-hundred and twenty-fifth regular meeting of the Academy was held Friday, December 17, at the Cleveland Medical Library; the Presi dent, Dr. C. F. Hoover, in the chair. Attendance, 131.

Annual reports of the following were read: J. E. Tuckerman, treasurer; C. E. Ford, chairman legislative committee; A. S. Story, civic committee; R. G. Perkins, public health committee; Lester Taylor, program committee; G. W. Morehouse, membership committee; J. J. Thomas, for the milk commission.

The annual election of officers resulted as follows: President, Dr. Wm. Evans Bruner; First vice-president, Dr. R. K. Updegraff; Second vicepresident, Dr. R. E. Skeel; Secretary-treasurer, Dr. J. E. Tuckerman; Trustees, Dr. W. H. Weir and Dr S. L. Bernstein.

After the ballots had been cast the Academy listened to the paper of the evening, "The History of the Discovery of the Secretory Glands and their Function," by Dr. Mortimer Frank, Secretary of the Society of Medical History of Chicago. Dr. Frank's paper gave a chronological review of the development of our knowledge of the anatomy and physiology of the ductless glands, accompanied by lantern slide pictures of many of the investigators. The subject was very interesting and the presentation excellent. Dr. G. W. Crile moved a vote of appreciation.

Dr. G. W. Moorehouse introduced the following resolution: "To the Ohio State Board of Medical Examination and Registration:

"Whereas, In a recent interview published in the Ohio State Medical Journal for December, 1915, Mr. Elbert H. Baker, president and general manager of the Cleveland Plain-Dealer, has stated that he has in his possession evidence of the payment of commissions for the reference of patients for operation, and

"Whereas, The revocation of license to practice medicine is the penalty provided by the laws of the State of Ohio for this offense, therefore, be it

"Resolved, By the Academy of Medicine of Cleveland, that the Ohio State Board of Medical Examination and Registration be, and hereby is, requested to call upon Mr. Baker for such evidence as he may possess and having received it that it take such steps to punish this offense against the public and the profession as are provided by law."

The resolution was referred to the Council for action.

Have you paid your county society dues?

CLINICAL AND PATHOLOGICAL The one hundred and twelfth regular meeting of this section was held Friday, December 3, 1915, at the Cleveland Medical Library, the chairman, S. J. Webster, in the chair. The regular program follows:

1. The Diagnosis of Intracranial Hemorrhage in the Newborn, by H. G. Sloan.

Intracranial hemorrhage in the newborn is divided into two general types, namely, supratentorial and infratentorial, as is indicated by the names. If the clot is of long enough standing, cell degeneration at the site of pressure may take place. Intracranial pressure is largely increased, for the dead cells swell and increase from 20 to 30 percent in size. The loose manner in which the cranial bones are joined in the infant may accommodate for this increase.

Immediately after an intracranial hemorrhage the picture which the child presents may be a normal one. Later the reflexes become hyperactive, and there are twitchings of muscles and othr irritative phenomena such as convulsions. Later there is spacticity of the affected parts. Finally, with cell death, there is flaccid paralysis and finally lethal exitus.

As for the symptoms which such a child presents, whereas the normal infant sleeps for many hours after birth, the infant with intracranial hemorrhage is restless. There is contortion of the facial muscles. The child refuses to take nourishment. The child with a supratentorial hemorrhage is usually pale, and the pulse is slower than normal. The pallor results from a general vasoconstriction which occurs in an attempt to raise the blood pressure. There may be a widened interspace between the bones at the lamboidal sutur on the one side and not on the other. The fontanelles may remain sunken, even tho there are other unmistakable signs of an intracranial hemorrhage. Later, however, they may bulge. The veins of the eye on the same side as the hemorrhage may bulge and the pupil may be contracted. The medulla with its vital centers is not affected in the supratentorial type as early as in the infratentorial type. Of the motor area the face and arms are usually involved first as the blood from the hemorrhage tends to run down. The sternocleidomastoid muscle on the same side of the lesion may show increased tone, pulling the child's head to one side, due to involvement of the spinal accessory nerve. The heart rate becomes progressively faster and the blood pressure falls at the same time. With facial signs, the possibility of an injury to the facial nerve at the time of delivery must be eliminated. To localize the hemorrhage one depends on the ordinary methods of cerebral localization. A rapidly developing hemorrhage is easier to diagnose than one which develops slowly.

Differentiation of the supratentorial from the infratentorial type is possible. If the hemorrhage

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The Ohio State Medical Journal, Svazek 12,Svazek 1916