Communications in reference to Advertisements or Subscriptions (Subscription Price $2.00 per annum) should be addressed, Business Manager, BROOKLYN MEDICAL JOURNAL, 214 Madison Street, Brooklyn, N. Y.

Remittances should be made by money-order, draft or registered letter, payable to BROOKLYN MEDICAL JOURNAL, and addressed to Business Manager.

Authors desiring Reprints of their papers should communicate with the Business Manager as soon as the-papers have been read, stating the number of Reprints desired, and the number of JOURNAL pages their papers will occupy, allowing 470 words to a page. Each contributor of an Original Article will receive five copies of the JOURNAL containing his article, on application at the Rooms of the Society, 356 Bridge Street.

Photo-engravings will be furnished authors free of charge, if proper drawings or negatives are provided. Electrotypes of engravings will be furnished authors at cost, when they wish to preserve them for future reproduction.

Alterations in the proof will be charged to authors at the rate of sixty cents an hour, this being the printer's charge to the Journal.

All other Communications, Articles for Publication, Books for Review, and Exchanges should be addressed BROOKLYN MEDICAL JOURNAL, 356 Bridge Street, Brooklyn, N. Y.

EDITORIAL.

SUMMER AND ITS DANGERS.

"Why is it that so many persons return to the city, after a summer's outing, and soon are taken sick with fever?" This question is often asked of physicians; and that it is so often asked implies that there is some basis for it in fact. We imagine that there are many reasons, some of which are known, and others, probably equally potent factors, which are as yet unknown.

In the first place, healthy homes are left behind, for a more or less prolonged stay in malarial regions. Again, the capacity of hotels. which are designed to accommodate fifty persons is stretched until more than twice that number are lodged within their walls, and the means provided for the disposition of the waste of the smaller number are so inadequate that soil-saturation and water-pollution inevitably result. Then, too, city houses are closed for months, and no provision is made for the filling of traps, the water of which gradually evaporates during the absence of its inmates, and when in the fall the family returns it is to a house into which, it may be, the air of a feverinfected sewer has been pouring for weeks.

Of course, the remedies at once suggest themselves to the thoughtful physician, and he should consider it his duty to advise his patients as to what they should do to avoid these dangers, not only to health, but to life as well.

A SENSIBLE SUMMER-RESORT.

One of the most enticing of the many advertisements of summerresorts which we have received is that issued by Mr. W. T. Talbot, of Boston. Unfortunately its advantages are open only to boys, and we

should probably find it difficult to persuade the proprietor of Camp Asquam that we belonged to that class, otherwise we should be tempted to open negotiations.

Camp Asquam is a summer-camp for boys, on the southern border of Lake Asquam, in Holderness, and midway between Centre Harbor and Plymouth, N. H. The situation is unsurpassed in natural beauty by any spot in New England. The land is high and dry, and the camp commands fine views of mountains and lakes. The air is fresh and invigorating, and the best opportunities are offered for boating, swimming, and other healthful exercise.

The chief aim of the camp is to make the boys strong and efficient, and able to think and do for others as well as for themselves. To accomplish this purpose, each boy in turn has an appointed daily service of from one to two hours about the camp, and in this way learns the conditions for wholesome living in the woods. In order to induce a proper physical development, special attention is given to the needs. of each boy, that he may learn the way in which best to perfect himself in breathing, walking, running, jumping, and other exercises; while the largest opportunities are afforded for tennis, base-ball, boating, swimming, as well as other summer sports, and always under proper and competent guidance. From time to time, throughout the summer, exploring expeditions are made in the surrounding country. In case of sickness, suitable nursing is provided at a house apart from the camp.

Far better would it be for our city boys could they spend a summer at such a place as this, rather than at Saratoga or Long Branch; the strength which they would gain and the practical knowledge which they would acquire would be of immense value to them in the battle of life.

PROCEEDINGS OF SOCIETIES.

MEDICAL SOCIETY OF THE COUNTY OF KINGS.

A regular monthly meeting of the Medical Society of the County of Kings was held in the Society rooms, 356 Bridge Street, on Tuesday evening, May 20, 1890, at 8 o'clock. There were about one hundred members present. President Chase in the chair; Dr. D. Myerle, Assistant Secretary.

The minutes of the previous meeting were read and approved.

On account of the absence of the Secretary the usual report from the Council had to be omitted.

The following propositions for membership were received:

F. K. Priest, 64 Grove Street, N. Y. Univ., 1881-82; proposed by Dr. J. H. Droge; James C. Kennedy.

B. F. M. Blake, 120 Reid Avenue, Bell. Hosp. Med. Coll., 1890; proposed by Seth D. Boggs; Walter B. Chase.

R. C Brewster, 134 Lafayette Avenue, L. I. C. H., 1890; proposed by Dr. Frank E. West; W. M. Hutchinson.

Geo. Dominguez, 97 Second Place, N. Y. Univ., 1886; proposed by Dr. L. W. Pierson; Wm. Maddren.

The following, having been favorably reported upon by the Council, were declared elected to membership:

Drs. Wm. Moser, Florence A. Belknap, Peter Scott, Jas. M. Sayles, Chas. J. Peterman, Geo. D. Barney, Wm. F. Dudley, Chas H. Jones, Thos. U. Joyce, R. P. Thompson, Thos. Dixon and John Von Glahn.

SCIENTIFIC BUSINESS.

The first paper of the evening by Dr. J. Fuhs, entitled "Spasmodic Urethral Stricture," was read and discussed by Drs. Bolton Bangs, of New York, and Dr. H. W. Rand.

Dr. A. Ross Matheson then read the second paper of the evening, entitled "Report of a Case. Was it Hydrophobia?"

There being no further business, the meeting adjourned.

D. MYERLE,

Asst. Secretary.

PROGRESS IN MEDICINE.

SURGERY.

BY GEORGE R. FOWLER, M. D.,

Surgeon to St. Mary's Hospital, and to the Methodist Episcopal Hospital, Brooklyn.

TRIGGER FINGER.

Du Poirier (Arch. génér. de méd. August, September, 1889, Centralblatt f. Chirurgie, May, 1890). The peculiar conditions present in cases in which an arrest of the movement of a finger until a special effort is made, when it is completed with a jerk, generally occurring in flexion, more rarely in extension, had previously been investigated by Menzal, (Centralblatt f. Chirurgie, 1874), who attempted to support the

theory that this was due to narrowing of the sheath of the tendons, and knot-like thickenings of the same. P., however, in a series of investigations upon the cadaver failed to find a single instance of such narrowing or thickening, but on the contrary found certain changes in the joint, in which the articular extremity of the metacarpal bone, instead of representing a section of a complete globe, had undergone changes which resulted in the development of an eminence or impaction upon the smooth surface. The radius of motion, at this point, is lengthened by the riding of the opposing bony surface upon the eminence, and the lateral ligaments are placed strongly upon the stretch as this part of the movement is accomplished. The effort at flexion or extension continuing, the eminence is surrounded and the obstacle overcome, the tension upon the lateral ligaments is released suddenly, and the movement is completed with a jerk. The peculiar attachment of the lateral ligaments at the head of the metacarpal bone obliquely downward toward the epiphysis of the adjacent phalanx favors this mechanical condition. In the normal condition the lateral ligaments are sufficiently lax to permit free gliding movements.

The causes of this condition refer to rheumatic affection and traumatism. Similar conditions may occur in other points: for instance, the knee-joint. As for treatment, P. recommends anti-rheumatic treatment, massage and longitudinal extension. In traumatic cases, partial division of the ligaments is recommended.

EXTRIPATION OF TUBERCULOUS SEMINAL VESICLES.

Emerich Ullmann, Wien. (Centralblatt f. Chirurgie, No. 8, 1890). As far back as 1829 Dalmas mentions a chronic inflammation of the seminal vesicles in such terms as to allow the inference that he had to do with a tuberculosis of the same. Since then, this disease has been studied by Albert, Jay, Nauman, Humphry and Kocher, and observed particularly as a secondary affection in pulmonary tuberculosis by Rayer, Cruveilhier and Reclus, and in later times more accurately described by Guelliot.

Tuberculosis of the seminal vesicles as a secondary affection, occurs not only as a sequel to pulmonary tuberculosis, but likewise, as it would appear, still more frequently as following primary tuberculosis of the epididymis, either through the further progress of cheesy degeneration upon the vas deferens and from there to the connective-tissue capsule of the seminal vesicles, or by means of direct attack from the direction of the prostate.

Primary tuberculosis of the seminal vesicles is essentially a rare affection, and still more rarely is it recognized as such, as the absence of a primary pulmonary or epididymis affection throws one off the

track in making up the diagnosis. Hand in hand with the incomplete knowledge of the diseases of these organs, goes the fact that, up to the present time surgical interference in the same was not undertaken.

A trial of the operative treatment of the condition described was made by N. in the case of a lad of 17 years, who came under observation with a right-sided tuberculosis of the epididymis; castration was performed. The disease made such progress that in 40 days following the first operation, extripation of the seminal vesicles was performed as follows: a half-circle-shaped incision was made at the perineum between the anus and scrotum, the base directed toward the sacrum. The finger of an assistant being placed in the rectum to guard against injury thereof, the perineal septum was separated. After separating the portions of the levator ani coming from the os pubis, and arresting the rather free hæmorrhage which occurs, the prostate is found to be completely bare. The rectum is further loosened, and with a sound in the bladder, the anterior wall of the latter is arched forward, whereby the vas deferens and the seminal vesicles are made visible to the eye and easily accessible. These latter organs, together with diseased portions of the vas deferens, and even of the prostate, may be then extirpated. The wound may be closed by buried sutures, or, in case the hæmorrhage demands such a course, tamponning with antiseptic gauze may be resorted to. In the case reported by N the wound was first sutured, but the occurrence of an alarming hæmorrhage compelled a resort to the use of the tampon. In this case also, urine flowed from the wound for a short time.

Finally, according to N., the operation is to be recommended as justifiable in the following: 1. In case of primary tuberculosis of the testicle or epididymis, when suspicious symptoms have not occurred upon the sound side, and when upon the diseased side the seminal vesicles are entirely diseased. Should both seminal vesicles be involved and one vas deferens is not diseased, the latter is left undisturbed, the prostatic sinuses however being removed. 2. In case of primary tuberculosis of the seminal vesicles themselves.

The occurrence of permanent impotence is not to be urged as an objection to the operation, in view of the fact that, in all reported cases of tuberculosis of the seminal vesicles, this occurred in a comparatively short time, and indeed, it is believed to be a cardinal symptom of the disease.