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and the essay or paper be considered by them worthy of pub. Answer : Fatty degeneration.
Amyloid degeneration. The prize is open for competition to the whole world, but Hyalin degeneration. the essay must be the production of a single person.
The essay, which must be written in the English language, 4. What are tube casts? How are they or if in a foreign language, accompanied by an English translation, must be sent to the college of Physicians of Philadel.
recognized and what is their clinical sig. phia, Pennsylvania, U.S. A., before January 1, 1901, addressed nificance ? to Richard C. Sorris, M. D., Chairman of the William F. Jen ks Prize Committee.
Answer: Casts of the uriniferous tubules Each essay must be typewritten, distinguisht by a motto, and accompanied by a sealed envelope bearing the same
in the kidney, composed of various submotto and containing the name and address of the writer. stances there exuded, and of sufficient con
o envelope will be opened except that which accompanies sistency to maintain their form. They are The Committee will return the unsuccessful essays if re
recognized thru the microscope, in urinary claimed by their respective writers, or their agents, within one year.
deposits, by their shape, size, outline and The Committee reserves the right not to make an award if no essay submitted is considered worthy of the prize.
general appearance. They usually signify JAMES V. INGHAM, M. D., June 15, 1899.
Secretary of the Trustees.
some form of renal inflammation.
5. How do the diphtheritic exudates difUniversity of the State of New York--Medical fer from simple catarrhal exudates? Examination,
Answer : Simple catarrhal exudates con[From the Med. Review of Reviews (rearranged).]
sist of serum, fibrin or pus, mixt with QUESTIONS, WITH ANSWERS, IN PATHOLOGY
mucus degenerated epithelial cells. AND DIAGNOSIS.
Diphtheritic exudate may be that of 1. Describe the process of bone repair. simple catarrhal inflammation, or, as is
Answer: The blood and other exudates more common, may be a fibrinous exudate are gradually absorbed. The neighboring infiltrating the mucous membrane, or, connective tissue cells proliferate and form mingled with pus cells, epithelial cells, granulation tissue. Under the influence blood, granular matter and bacteria, formof the cartilage and periosteum cells this ing a pseudo-membrane over the inflamed tissue changes into cartilage or osteoid tis. tissue. This pellicle alone, or with it the sue resembling bone, but containing no tissue beneath, may undergo necrosis. lime salts. In the course of a few weeks Among the bacteria may be found the this callus becomes truly osseous by a trans- Löffler Bacillus Diphtheriæ. formation practically identical with the 6. What structural changes take place normal development of bone from carti- in cirrhosis of the liver ? lage, periosteal and other fibrous tissue.
Answer: New connective tissue is formed Much of the redundant callus, however, is varying in character, amount and distribuabsorbed, so that the repaired bone ap- tion in different cases. Depending upon proximates the normal size and shape. those variations, the hepatic cells may be
2. Describe the process and terminations flattened or atrophied from pressure, or, of simple inflammation? What is productive from interference with the portal circulainflammation ?
tion, they may atrophy or become fatty, or Answer : The process of simple inflamma- they may become bile-stained. tion is characterized by hyperemia, dilata- The hepatic and portal veids, the gall tion of the vessels and retardation of cir- ducts, and, less frequently, the hepatic arculation; an exudation from the vessels, teries, may become obliterated by pressure. of lymph and blood cells and a prolifera- 7. Thru what avenues do bacteria enter tion of the cells exuded and of the tissue the system and how are they eliminated? involved.
Answer : The nose and respiratory tract, Such a process may be acute or chronic. the mouth and alimentary canal, the anus, Its termination may be resolution with the genital tract and thru abrasions of the absorption of exudate and return to nor- skin. mal condition, or suppuration may occur, Elimination may take place by egress or other specific inflammation supervene. thru any of the above avenues, or inside
Where the exudate becomes organized, the body by simple death, or by destrucas it often does when that exudate is tion by the systemic reaction, leucocytes, fibrinous or the process is chronic, new phagocytes, etc., or artificially by means vessels permeate the tissue and connective of antiseptic drugs. tissue cells form. This is called productive 8. What secondary changes take place inflammation.
in the heart in chronic mitral regurgita3. What degenerative changes take place tion? in arteries?
Answer: The left ventricle becomes
dilated and hypertrophied. Later the a little lower than the ensiform. In the right ventricle is hypertropbied, and in female and the child the border is below the last stages may become dilated.
the costal border. 9. What aids to diagnosis are utilized To the left the liver extends just beyond in the treatment of persons affected with the median line, to the right it lies against stomach lesions ?
the chest wall. Answer: The stomach tube and wash- 13. What are the characteristic lesions ing of the stomach.
of typhoid fever? Give pulse and temElectricity-illumination for diagnosis, perature chart. electrization in treatment.
Answer: The solitary and agminated Regulation of diet.
glands of the intestine are swollen in the Surgical procedures.
first week; they then become ulcerated 10. What causes general anemia ? Make and more or less necrosed, and finally - a diagnosis of general anemia.
healed in the fourth week. The inflamAnswer: (1) Loss of blood, hemorrhage. mation may involve only Peyer's patches (2) Improper assimilation of nutritive or the solitary glands as well, or the soliproducts and lack of sunlight. (3) Abnor- tary glands in the colon. mal expenditure of blood constituents, Temperature Chart-First week, steady, pregnancy, lactation, etc.
gradual rise of temperature, higher in Diagnosis — The symptoms and appear- evening and lower in the morning, but ance of the patient readily suggest the each day this difference becomes less; diagnosis.
second week, a steady, high temperature, Differentiated chlorosis by the fact that with but little variations; third week, the hemoglobin is not reduced dispropor- greater variations, the morning temperationately to the loss of red cells.
ture beginning to fall; fourth week, deIn pernicious anemia megaloblasts are cline of both morning and evening temfound.
peratures by graduallysis. This chart In leucocy themia the white cells are varies almost infinitly. greatly increast in proportion to the red. The pulse chart is not characteristic.
In pseudo-leucocythemia there are en- In an uncomplicated case the pulse rapidity larged glands.
follows the heighth of the temperature. 11. Mention and differentiate the species 14. Differentiate varicella from variola. of taenia.
Answer: Varicella is a much less severe Answer: Tenia solium-Head with four disease than variola. There is slight rise suckers and a beak of twenty-five or more in temperature when the eruption appears, hooks. Top of head pigmented. The instead of a high fever and fall of tempermature segment contains the central uterus ature with the appearance of the eruption which bears eigbt or ten branches on each in the latter disease. The eruption rapidly side, which ramify like a tree.
dries up, not going on to severe suppuraTenia mediocanella-Head, four suck- tion. The history of the patient and ers, but no hooks. The segments broader knowledge of existing epidemics aid the and thicker than the solium. The branches diagnosis. of the uterus are twenty or more in num- 15. Make a diagnosis of renal colic by ber, and branch dichotomously.
exclusion. Bothriocephalus latus—The largest tape- Answer: From nephralgia by general worm. The head a little club-like swelling knowledge of the patient, not hysterical, with two slit-like suckers on the side. The not menstruating, etc. adult segments short and wide; the uterus From biliary colic by watching the course thick and tortuous, but not branching of the symptoms and locality of the pain, with the sexual opening on the ventral and by absence of digestive disturbances surface, instead of at the side, as in the and jaundice. preceding.
From constipation by noting the condi12. Give the normal boundaries of the tion of the bowels and giving a cathartic. liver.
From appendicitis by the character of Answer : The upper border or surface is the pain and absence of tumor and local opposite the fourth intercostal space. tenderness.
The lower anterior border is about even From cancer by age and general condiwith the right free costal border in the tion of patient. In cancer hemorrhage adult male, except at the left, where it lies might be very profuse.
QUESTIONS IN OBSTETRICS.
probability, in these days of quite general the female internal organs of generation and the symptoms are irregular. The medi
1. Give a brief anatomic description of vaccination, it is a case of varioloid. There and mention the function of each. 2. In what manner is fecundation ac
cal student sticks a pin into the fact that a complisht? What changes in the ovum patient with excruciating backache should follow fecundation ?
be suspected of having variola ; unfortu3. How is the placenta formed? What nately the first case of it he meets may not is the function of the placenta ?
complain of backache at all. What he does 4. What precautions should be taken have is a patient with fever, developing a against infection during labor and in the suspicious rash. What about reporting it puerperal state?
to the Board of Health ? 5. What are the indications for the in
It is a clear case of -d if you do and duction of premature labor after the begin. the gratitude of the patient or his family.
d-d if you don't. You hardly expect ning of the eighth month ?
6. State the principal causes of abortion If the diagnosis should be erroneous, due to general maternal conditions.
human nature is not yet up to the plane of 7. How may the knee be distinguisht forgetting it the next time any members of from the elbow when presenting?
the family are sick. Reporting an un8. Mention the different varieties of ver- doubted case will bring upon you the malesion and state how each is performed.
dictions of the business men because the 9. Define and classify placenta previa trade of the town is seriously injured at and state how it should be dealt with.
once. The one case is magnified to twelve 10. What are the causes of albuminuria in the neighboring towns, and farmers in pregnancy? What does it indicate and dare not drive through the place. how should it be treated ?
Nevertheless, as a conscientious physi11. State diagnostic symptoms of a dead cian you cannot do otherwise than do your fætus in utero, and give the management best to preserve the health of the commuof such a condition.
nity ; at your next visit a red card is on the 12. Define ectopic pregnancy.
house. You feel repaid for the lamentaits symptoms and how does it occur ?
tions of the family, and the bad feelings of 13. Describe the application of the for- the business men by the satisfaction of ceps to the fetal head, moveable above the knowing that you are a public benefactor, inlet.
and that you have by your timely warning 14. In case of an after-coming head, kept the dread disease from claiming many what are the symptoms and the manage
other victims. ment?
How does the public express to you its 15. Mention two distinct methods of appreciation and gratitude? In all sorts of dilatation of the cervix uteri in obstetric fashions, giving you glimpses of human practice and describe in detail one of the nature you had not before experienced. A operations.
respectable number see nothing surprising [Answers to these questions will appear They expect, of course, that you always do
or worth mentioning in the whole matter. in next World.]
Some friends continue to come into
the office and you feel that they will stand A Physician Who Has A Small-Pox Case.
by you tho you are in trouble. But It is rather interesting to consider the certain ones will maintain that it is shameposition of a physician who has the misfor- ful that you go on the street after coming tune to be called to a case which develops out of a pest house. Many will back away symptoms of small-pox. It is self-evident from you if they find themselves by chance that the patient is to be pitied. If it occurs in proximity. Your practice will be alin a city too small to support a regular hos- most limited to the few who have not heard pital for contagious diseases, the sugges- that you are the small-pox doctor. You can tions for his management will vary from not play whist in your club, you can not go shooting him to a shanty in the suburbs. It to church, you can not go anywhere, for is not to his predicament, however, that there are sure to be some nervous bodies we would call attention, but to the less there whose misery would spoil your commanifest troubles of his medical attendant, fort.
They begin with the question of report- Of course you have changed all your ing the case to the health board. In all clothing and left your old suit to be burned;
you have scrubbed up with bichloride but contracted the disease, and have enjoyed you get to have a very active sympathy perfect health during their residence among with the lepers of Palestine. However, this us, especially if varied with flying visits is all a part of a doctor's life, and the moral to their mother country. No northerner, is that you ought not to have been a doctor. however, should unnecessarily expose his
You are finally able to cheerfully answer person to the possibilities of contracting all sorts of fool questions about small-pox, this disease, altho the type found here is and to be contented with your one patient, mild, and, under the new regime, we but you do finally lose your temper over a expect to see it entirely extirpated from thing unworthy of your notice. Somebody the island.'' who objects to the compulsory vaccination “ There are certain precautions a forof his children proclaims that the whole eigner must observe while residing in the affair has been gotten up by the doctors tropics. He should wear light linen outer who have faked a case because their busi- clothing and thin undergarments; he ness got dull. - Charlotte Med. Jour. should bathe frequently. He must not, at
first, expose himself too much to the sun Lacti: Acid in Alopecia.
overheating might bring on tarbardillo' Médicine Moderne, March 18,1899, states (sunstroke), particularly if the individual that many Dutch physicians speak highly is of plethoric constitution. Too much of the efficacy of lactic acid in baldness. exposure to night air in the lowlands is apt It is used in a 33 per cent. or 50 per cent. to cause malaria. The excessive abuse of solution, the oily matter of the hair having alcoholic stimulants will produce deplorpreviously been removed by a mixture of able results. The continuous passage of alcohol and sulfuric ether. The acid is the poisonous alcohol thru the liver, already applied with vigorous friction until the excited to increast activity by climatic scalp is reddened and irritated. The conditions will certainly produce biliousscalp is then dressed with vaselin. A ness, if not an acute congestion and inflamweak application of sublimate lotion after mation of the gland. Dysentery and the acid frictions might serve to prevent diarrhea can usually be avoided with a pustulation.
The bowels should be made to Recently it has been found that a 33 per move regularly, and purges, if necessary, cent. alcoholic solution of the acid is ef- should be taken. The newcomer to Cuba ficacious without producing an unnecessary finds such an abundance of most exquisite degree or irritation.-Medical Review of fruits that he is apt to gorge himself with Reviews.
them and thus bring on intestinal disorder.
Fruits should be eaten in moderation until A Medical Vie of Cuba.,
the system is used to the new order of Henry S. Caimanero, M. D., United things. No water should be used for drinkStates Sanitary Inspector of the Marine ing purposes unless filtered or boiled." Hospital Service at Santiago de Cuba, who has twenty-five years experience in the
The Average Patient. practice of medicine in Cuba, makes these The average patient sends for a doctor observations in a recent paper upon the in haste and repays him at leisure. climate and the conditions surrounding life The average patient is apt to estimate a in the island:
physician's ability by the amount of atmos“Our island in its normal, peaceful con- phere he displaces. dition," he says, “is about as healthy as The average patient likes to be humany country in the world, with the advan- bugged. Any old fad will do so long as it tage that we are free from certain diseases has a new name. which prevail commonly in the United The average patient is willing to pay States, causing great loss of life; and were ten times as much for cutting off his leg as the laws of hygiene attended to properly, for saving it whole to him. and reasonable regulations of sanitation The average patient, when nearly well enforct, no epidemic, I believe, would ever of a sickness, will take a bottle of Rotgut's visit us."
Relief, or a box of Poopendike's Pills, and “The fear of yellow fever seems to be to these he will give all the glory, and the great bugbear of Americans intending " the doctor be d-d." to visit us; this fear is groundless to a The average patient believes that the os certain extent. I have known hundreds of humerus is the funny bone and that the foreigners living in Cuba who have never seat of all the finer emotions is in the
heart, but he thinks he knows more than San Francisco, Cal. This is an elegant volume the doctor, if he could only express
of over 200 pages, and a great many maps and himself.
charts. The latter are very ingeniously planned The average patient has just enuf of cial documents like this contain much excellent
in a way to tell their story at a glance. Offimedical learning to misquote. Best tell matter, which is not as highly appreciated as it him simply that he is sick and that you deserves, I suppose because people do not have to can make him well, perhaps, if he takes pay for it. the medicines according to directions.- The prominent instrument house of Lentz & Denver Medical Times.
Sons, 18 N. 11th street, Philadelphia, have
issued a 5th edition of their catalog of MicroGleanings,
scopes and accessories, Bacteriological Apparatus, Benzoic acid used as a gargle is valuable Diagnosis. This is an attractive catalog of 136
Laboratory Supplies and Instruments for Clinical in sort throat.
pages, and it can be gotten for the asking. But Canabis sativa is a remedy for gonorrhea don't neglect to appreciate it on this account, for and impotence.
its selling price would be about one dollar if got
ten up to sell. This catalog covers a field that is Alcohol is claimed to be a specific in rapidly growing in importance, and the physician, locol carbolic acid poisoning.
whetber old or young, who neglects it will soon Do not overlook the value of nox vomica
be clast among the “fogies." Get this catalog
and see what you need to work with, in the treatment of atonic dyspepsia. Calomel, 80 grains to one ounce of vase / Register --- Directory and Intelligencer for Phila
“Keil's Medical, Pharmaceutical and Dental lin, is said to promptly relieve pruritus delphia and vicinity.” Fifth edition. Publisht vulvæ.
by George Keil, 1715 Willington street. Price, Jaborandi, internally and locally, is said $3. In addition to names, it contains full into give good results in the treatment of
formation as to colleges, hospitals, asylums,
societies, etc. Very useful, or rather indispensaerysipelas.
ble, to those who need this line of information. Salicylic acid, one dram ; boric acid,
We have received a beautiful lithograph entiounce; hot water, two quarts, is tled “The First Meeting of the Medical Society Thiersch's solution.
of London,” suitable for framing, from the Mel. Macrotin is useful at the climacteric: lier Drug Co., St. Louis. If you have not reheadache, mental derangement, fushes, free upon request to the above mentioned firm.
ceived a copy, we think that one will be sent you heats and insomnia. It is claimed that in the enuresis of
Gray Summit, Mo., June 5, '99. children lycopodium is sometimes more Dr. C. F. Taylor, Philadelphia, Pa.
Dear Doctor :- My subscription to THE MEDICAL WORLD efficient than belladonna.
expired with the April number, but I don't feel like I can do
witbout it, so I enclose one dollar for another year. I like Dr. II. T. Patrick says that persistent The World not only for its many interesting and instructyawning may be one of the earliest symp
ing articles on professional subjects, but also enjoy reading
the Editor's Monthly Talks. You argue just as I think it toms of general paralysis.
is a mighty task you have undertaken, but it is a work out of
which much good may come, and of which the toiling mil. Dr. Leuf, of Philadelphia, says that a lions are in dire need If every publisher would show his
patriotism and unselfish interest in this way, we would soon patient with pulmonary tuberculosis and
cease to hear the mouruful cry of oppression and want that is a pulse that remains at or above 100 is now going up from nearly every part of the country. Let
the good work go on, and as it goes on may it gather force doomed. He has watcht this for a long and weight and volume until its power is recognized in
every municipality, and until the great load of oppression time and in many cases, and has yet to that is slowly but surely grinding the bone and muscle of see it fail.-Medical Summary.
the nation into the dust, and dwarting and corrupting our moral and mental abilities, is removed, and its promoters
are made to see and understand the effects of their greed for Book Reviews.
gain without regard to results. Yes, Mr. Editor, "hit 'em again," and keep right on hitting 'em. Success to you and
Yours truly, ** Hand book of Constitutional Law;" by
W. M. WHEELER, M. D.
Our Monthly Talk
A legal friend presents the following thoughts a condensed account of the adoption of our fed
upon the amending of our constitutions : eral constitution and follows it with a full abstract of our federal and State constitutions and
Amending Our Constitutions. amendments thereto, together with the citation "Have our citizens forgotten that all of our of many of the decisions of the courts constru- constitutions, both state and national, make ing the same. This is a very useful book for
ample provisions whereby they can be amended ? those who wish to post up on constitutional law
It seems so. A year or two ago the legislature -and we should all do it.
of Pennsylvania past a law for a graduated Annual Report of the Health Department of taxation of inheritances. The courts held