perature 102.8°. Patient placed in blankets, and salicylic acid, ten grains every hour during the day, ordered. March 20th. Pain and swelling entirely gone. Acid continued, in ten-grain doses ter die. March 24th. Acid omitted. No return of pain. RÉSUMÉ. Case 1. No effect from salicylic acid. 2. Alkalies for a month; then acid, eight doses, with relief. 3. Alkalies for twenty days without relief; acid in one day gave relief. 4. Acid for seven days; patient well. 5. Alkalies two days; acid seven days with entire relief. 6. Relief after four doses of acid; this was continued four days. Re covery. 7. Acid three days without relief. Followed by tincture of chloride of iron for fifteen days. Recovery. 8. Alkalies gave relief in four days. Recurrence. Acid given four days with entire relief. 9. Acid three days; no relief. Alkalies for twelve days. Recovery. 10. Acid seven days with entire relief. 11. Acid refused by stomach. Alkalies during eleven days with re lief. 12. Acid for nine days. Complete relief after the first four days. Except in one or two instances, the salicylic acid was given in wafers. LETTER FROM WASHINGTON. MESSRS. EDITORS, — The event of this month for the profession here has been the commencement exercises of the three medical colleges. By their united efforts these colleges have succeeded in sending forth thirty-two graduates to swell the list of M. D.'s: Howard University graduated seven, the University of Georgetown thirteen from a class of thirty-seven, Columbian University (National Medical College) twelve from a class of fifty-four. With this irruption comes the annual moralizing in the profession about the multiplying of medical colleges and the advantage or injury thereby to those already in the ranks of practitioners. The reason for the establishment of new medical schools is very easily given; it is probably found in the same causes here as in other communities, the chief of these being the fear of too great prominence on the part of a few men who hold hospital appointments, and who secure therefrom consultations and corresponding profits. The National Medical College is by far by the oldest of our professional schools; it is now in its fifty-fourth year, and this certainly entitles it to the respect due to age. It has always pursued the even tenor of its way, disturbed only by the outbreak of the rebellion, which necessitated a temporary suspension. The Medical Department of Georgetown University is now in its twenty-eighth year. It is rumored that there will be several important changes in its faculty; its oldest professor, who stood at the head of the list upon its organization in 1849 and has retained that position to the present day, Dr Noble Young, delivered a feeling valedictory at the late commencement, on resigning his post. Other resignations have taken effect or are contemplated. Howard University Medical Department is an institution existing on the broad ground of no fees and no distinction of color or sex. The question of advantage or disadvantage to the profession arising from a multiplication of schools involves also the consideration of preliminary education, of a proper length of time for study, and of a sufficiently high standard. for graduation. The members of the profession not connected with the colleges have the power, if they choose to exercise it, of controlling in these particulars. At present no preliminary education is required beyond the ability to read, write, and cipher, and that is taken for granted. There are students now attending lectures, who are considered as above the average, who have no knowledge of Latin or mathematics, and who, when commencing their studies, had no knowledge of chemistry. Two years and a half of study are really all that is required; the term of three years is the time specified, but a few months make but little difference according to the usual reasoning, and this, too, as applied to men the most of whom work from nine o'clock in the morning to four in the afternoon daily in earning a living at an occupation entirely distinct in its interests from that of medicine. During this time the most are so entirely left to their own resources that it is not unusual to see a man begin the study of medicine with Rindfleisch as a text-book. The final examination is purely oral, with the practical application of such instruments as the forceps, for example, the recognition of pathological appearances in prepared specimens, the description of drugs, and a few chemical tests. At least such is the rule in one of the colleges; but the examination is deficient in that there is no fixed and uniform standard which each candidate must reach. Each examiner fixes for himself an arbitrary standard, and decides within his own mind as to whether the candidate has passed him or not. It is true that every examination must be conducted in the presence of other members of the faculty, but it is very difficult for those who are merely listeners to concentrate their attention upon matters of but little personal interest to them, and which they have in most instances forgotten long ago; it is doubtful whether they take more than a passing interest in an occasional question. These examinations are always confined to the members of the faculty, not even the medical men on the board of trustees of the college itself being present. Under such circumstances it must seem as if examiners with the best of intentions would at times be partial. Undoubtedly the colleges would appreciate in due time any improvement upon such a system; but where such rivalry exists one institution will not readily take a step which may drive its students to another rival school. It seems imperative upon the medical society here that it shall demand a certain knowledge of the attainments of those graduating in its midst, some of whom are to be consultants with its members. This can be attained only by representatives of the society being present at all of the examinations, and by written questions, the answers to which must reach a certain standard, to be filed away for reference. If this were done, a very great step in advance would, I think, be taken, and one which would make it easier to follow in the footsteps of Harvard, which insists upon a preliminary examination and a graduated course of study regulated by examinations at certain intervals. In a previous letter, I stated that a report of Columbia Hospital was in preparation; the report has been published by the Interior Department, and five thousand copies have been struck off, although few have been as yet distributed. It bears the date July 1, 1875, and is an octavo of some eighty pages. The report is solely that of the surgeon-in-chief, there being no reference in any way to other medical men connected with either the hospital or the dispensary, save incidentally. It embraces a summary of the working of the institution from June 30, 1872, the date of the last report, to the present time. The results of treatment which are claimed are very noteworthy; thus, during this period, there were eight hundred and sixty-seven in-door patients. and six thousand two hundred and thirty-nine out-door patients, making a total of seven thousand one hundred and six. "Some of the most important operations known to surgery have been successfully performed, and in no case has death occurred as the result of surgical interference. . . The proportion of deaths to the number treated may be rated as even lower than the deathrate of the general population of the District of Columbia." Following the statistical portion and prefatory remarks, the report comprises detailed cases of fibroid tumors of the uterus and rupture of the perinæum, with observations thereon. Minute details of operations are given to meet the purpose of the report in its "distribution chiefly in country towns and villages." Under the head of fibroid tumors of the uterus, the first ten cases mentioned compose a brief of those reported in detail in a previous report; then follow sixteen more, six of which were treated in private practice, and had no connection with the hospital; and of the remaining ten, eight occurred in the service of the dispensary under the charge of another physician; they are not reported by him, but by the then apothecary and clinical recorder. In two of these cases death followed the introduction of the sponge-tent, which caused in the one instance metro-peritonitis, in the other, tetanus. Under the head of rupture of the perinæum there are said to be sixty successful cases detailed, only thirty-seven of which, however, appear in the report as printed. The report terminates abruptly, and it is to be presumed from this that it is not complete. In the introduction to this part, three or four pages are copied verbatim from the previous report, including a reference to figures which are not given, but intended to illustrate the text. Of the thirty-seven cases of ruptured perinæum, thirty-four are transcribed directly from the previous report. Apropos of the navy, one of our Sunday papers published on the 12th inst. a circular issued by a committee of officers of the line and intended to be private, which calls for funds from line officers to present a petition to Congress, employ counsel, and in other ways effect a repeal of the six-year clause in the United States navy regulations; this regulation at present allows a staff officer, a doctor for example, on his entrance into the service to take rank with line officers who have served six years, or in other words with ensigns. As the line officer's term of service dates from his entrance into the naval academy, he is about six years receiving an education at the expense of the government; while the medical officer must be thoroughly educated at his own expense at the commencement of his term of service. This is said by the line to be liable to abuse, and is highly objectionable to them, but precisely in what manner is not easily understood by those not in the service; in fact, the whole subject of staff-rank is very puzzling to the civil practitioner, particularly when it comes to giving doctors other titles and a little more or less of gold lace, when considered irrespective of increased pay and other emoluments to which those interested say it is inseparably conjoined. The publication of this circular, it seems, was rather premature, as it has not yet been presented in any shape to Congress, but we shall probably hear more of it before long. With regard to the army staff rank there is little to be said beyond what has already been published. The consideration of Senator Logan's bill, which meets with approval from medical officers, and which reduces the number of assistant surgeons to one hundred and twenty-five, abolishes the office of medical store-keeper, and allows four surgeons of the rank of colonel and eight surgeons of the rank of lieutenant-colonel, to be promoted by seniority, is anticipated with considerable interest. It was feared that the usual legislation of retrenchment which precedes our presidential elections, with the efforts at false economy for political effect, would fall heavily upon the army this year by cutting down the appropriation for the Army Medical Museum. The sum required is ten thousand dollars, one half of which goes to the library fund and is its only support. If the usefulness of this library were seriously endangered by any legislative action it would become the duty of the whole profession to protest against it, as it is indeed a national repository which is peculiarly accessible to the whole profession. The manuscript catalogue by Dr. Billings enables one to control in a few moments all the journal and special literature upon any one subject, and there are men in the profession here who have access to the library who would be very willing to act clerically as experts in seeking out information for those at a distance. The library of the American Medical Association should in fact be of equal importance, but from present indications it will require many years of slow and tedious growth to attain an approach to such eminence. The fifth lecture of the Toner course was delivered a few weeks since by Dr. W. W. Keene, of Philadelphia, on the surgical complications of continued fever ; in the course of a couple of months it will be given to the profession as one of the Smithsonian publications. In the case of the young acrobat Pole, mentioned in a previous letter, an appeal to a higher court resulted in a reversal of the decision of the judge, and a pretty plain expression of opinion that Mr. Gatchell, the complainant, had no right under the circumstances to interfere. The boy was remanded to the care of his brothers, who, however, and very inconsistently as it would seem, had to bear the expenses of the trial. It appears that with the abolition of the old internal revenue tax we by no means got rid of such annoyances; it is now proposed to levy a personal tax of twenty-five dollars a year upon all members of the profession in the District of Columbia for the privilege of practicing medicine. HOмO. WASHINGTON, D. C., March 14, 1876. COMPARATIVE MORTALITY-RATES FOR THE WEEK ENDING MARCH 25, 1876. THE Association of the Medical Alumni of the University of Michigan was organized in March, 1875. Dr. R. C. Kedzie, of Lansing, was elected president, and Dr. W. F. Breakey, of Ann Arbor, secretary. It is urgently requested 'that all who learn of the organization will promptly forward to the secretary their own address and that of any alumni they may know; also the names of any they may know to have died, with any interesting facts of their professional lives, and of the time and place and circumstances of their death. MESSRS. EDITORS, — In the last number of the JoURNAL, page 364, I referred to a single case of extreme relaxation of the symphysis pubis from pregnancy, and not to “cases,” as I was reported to have said. Yours truly, J. B. S. JACKSON. BOOKS AND PAMPHLETS RECEIVED. - Urinary Calculus. A Synopsis of Thirty-Seven Cases treated. By W. F. Westmoreland, M. D. Read before the Georgia Medical Association, April, 1874. Atlanta. 1874. Medical and Surgical Memoirs, containing Investigations on the Geographical Distribution, Causes, Nature, Relations, and Treatment of Various Diseases. By Joseph Jones, M. D., Professor of Chemistry and Clinical Medicine, University of Louisiana. Volume I. Observations on Diseases of the Nervous System. New Orleans. 1876. The West Riding Lunatic Asylum Medical Reports. Edited by J. Crichton Browne, M. D., F. R. S. E. Volume V. London: Smith, Elder, & Co. 1875. A Manual of the Diseases of the Eyc. By C. Macnamara, F. C. U., Surgeon to the Westminster Hospital. Third Edition. Philadelphia : Lindsay and Blakiston. 1876. (From A. Williams & Co.) Clinical Lectures on Diseases of the Heart and Aorta. By George William Balfour, M. D. Philadelphia : Lindsay and Blakiston. 1876. (From A. Williams & Co.) Royle's Manual of Materia Medica and Therapeutics. By John Harley, M. D., F. R. C. P. F. L. S. Sixth Edition. Philadelphia: Lindsay and Blakiston. 1876. (From A. Williams & Co.) Animal Parasites and Messmates. The International Scientific Series. By P. J. Van Beneden. With Illustrations. New York: D. Appleton & Co. 1876. (From A. Williams & Co.) The Student's Guide to the Practice of Midwifery. By D. Lloyd Roberts, M. D., M. R. C. P., Lond. Philadelphia: Lindsay and Blakiston. 1876. (From A. Williams & Co.) |