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rope. These institutions are of much more 
recent origin than hospitals, yet the first of the 
latter (at least, of which we have any record) 
was not established until a.d. 460. This was 
founded by Nonus, a benevolent bishop, at 
Edessa, in Mesopotamia, a place which then 
contained a famous school of theology. Such 
an institution was entirely unknown among 
the Greeks and Romans, notwithstanding their 
high culture and civilization; and even in the 
first centuries of the Christian era, so far as is 
known, there was none in existence. The first 
hospital in Europe was founded at Rome, in 
the latter part of the fifth century, by a lady 
named Fabiola. In the sense, however, in 
which we understand it,—an institution de¬ 
voted exclusively to the reception and care of 
the sick,—the hospital cannot be said to have 
existed until the eleventh century; and it was 
not until five hundred years later that the first 
dispensary was established,—an act of phil¬ 
anthropy for which the world is indebted to a 
woman. In the year 1559, the wife of Chris¬ 
topher, the reigning Duke of Wurtemberg, 
caused an apothecary’s shop to be erected in 
the ducal palace at Stuttgart, for the purpose 
of supplying medicine to the poor; and this 
she maintained at her own expense. 

The dispensary as a permanent institution 
was established in England towards the close 
of the seventeenth century; but in France not 
until 1803, when the Philanthropic Society 
of Paris set in operation five dispensaries in 
that city. In 1805 an act was passed by Par¬ 
liament providing for the establishment of 
dispensaries throughout Ireland, as well in 
the most sparsely-settled regions as in the 
cities and populous towns. In 1836 there 
were four hundred and ninety-four of these 
institutions in existence; and in 1851 their 
efficiency was very greatly increased by a 
second act of Parliament in reference to 
them. 

It appears that to Philadelphia belongs the 
honor of establishing the first dispensary on 
this continent, in 1786. The New York Dis¬ 
pensary, which was founded in 1791 and in¬ 
corporated in 1795, was the first in this city, 
and there are now about thirty here. The 
first one was organized in Boston in 1796. 
As a rule, our American dispensaries are said 
to be better than those of Europe. _ 







come a member. Since the passing of the 
Medical Act, this has been abolished ; but the 
membership of the College is essential to the 
holding of an appointment at any hospital of 
high standing. No matter where the aspirant 
to a hospital appointment has graduated, he 
must pass the examination for membership. 
This is a very fair and honest examination of 
an all-round character, including clinical ex¬ 
amination in the hospital wards. It retains so 
much of its ancient character that each ex¬ 
aminee, after having done a written examina¬ 
tion in Latin, etc., has to stand up and read a 
passage from some Latin author to the Presi¬ 
dent, and translate it before the other ex¬ 
aminers, during his viva voce examination. 
Having thus put their seal upon him, the 
College guarantees his proper behavior, and 
calls offenders^ before its council, and repri¬ 
mands and fines them according to the sum 
of their offences, or, if necessary, strikes 
them off the roll. P'urther, it exercises a 
moral control ouer its members, in that, if 
any one of them conducts himself that he 
cannot be censured, and yet cannot be ap¬ 
proved of, he is denied the Fellowship. There 
are some very successful physicians in Lon¬ 
don, who will never attain the F.R.C.S., even 
if they were to seek it\n sackcloth and ashes. 
Consequently, the movements of the College 
of Physicians always attract attention, at least 
among the leading men id the metropolis. 

In his Croonian Lectures, Dr. Dickenson 
relates a curious case of ^congestion of the 
kidneys, brought on by a Cold drive over a 
Yorkshire moor, where the swelling induced 
was so great that the capsules qf both kidneys 
were rent, and a massive coaghlum of blood 
was found in the gaping tear. \ln this case 
the pain in the loins was so grear v that it was 
supposed there must be a renal calVulus. 

The discussion on Syphilis, at th,e Patho¬ 
logical Society, commenced by Mr. Jonathan 
Hutchinson, seems to have met the fate of 
most matters discussed there, viz.: to^Jiave 
left everybody pretty much where they were 
before. Mr. Hutchinson holds the one-poison 
theory, and thinks that though soft sores are 
usually free from any tendency to infect the 
system, if the matter which produced the 
sore contained syphilis poison,—-just as corn 
^^^contain some poddy seeds, and when 

























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^!T5par ag^mon t of the Braver r oi 
troops, but a conviction of the lack oi capable offi¬ 
cers to guide them, while the superiority in flbis 
respect oi the Southern generals is the theme ol 
general conversation. 

Bad management at head-quarters, i. e., at W ash- 
Ington, is also alleged as the cause of numerous dis¬ 
asters and reverses to the Federal arms* It is im¬ 
possible to make any one believe lust now that the 
•Government at Washington is actuated by, any mo- 




ledical Director Hamlin says that the statistic* 
of |he hospitals of this Dep artment, for the last yeW 
sh ow a remarkable result, giving a ratio of mortality 
of even less than four per cent., while the splendid! 
hospitals of London exhibit a mortality of more- 
than June per cent., and those of Pans more thait 
nineteen per cent. The hospitals of the Bosphorus^ 
during the Crimean war, had a death rate of nearly 
twenty per cent., and those of the Crimea of more 
l^han fourteen per cent. 




*er»iTh« ‘•OTfeifous ot pi _ ^ 

the Cathedral, are requested to leamucu* names wit! 
Hr. Walsh, at the Cemetery office, SUMMER Htreetl 
east of Eighteenth. They will be communicated to the 
Committee, who will meet at the Bishop’s resident*^ 
every Tuesday and Friday evening, at V/± o’clock, unt* 
further notice. 

The following gentlerfeen have kindly consented td 
act as the Committee: Francis A. Dr ex el, A. J. Anteloj 
Wm. Maroney. Charles McKeone, Daniel McDevitt 
and M. J. Dohan, Esquires. 

M “rS. M. M. WOOD, CLAIRVOYAN' 

Cl AN,Trance and Writing Medium. - 

)505 ELLSWORTH Street. Can be consulted from U 
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n „a /"eighty-two hospitals,with a capa- 

citv ofSihty^ur 'thousand four hundred and seventy* 
Uvo heds were in operation at the date of the last 
n«Snalreuort During the summer campaign, it was 

HS Sb® fetssrsjs^s 1 sag 

was better than is usual with troops engaged sp..c# 
st.intiv on active duty and in arduous campaigns. Iso 
destructive epidemics prevailed hi any section, and thO 







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nrmbe’rtJTsick and \v yimflW, although large 
Comparatively small in the proportion it bore to UiJ 
if hole army. At the close of the year, th e n u nab or o f 
dek and wounded, both with, their = commands and in 
[general hospitals, was less than sixteen per cent, of 
[ the strength of the army. The number sick with their 
(respective'commands was four per cent, and in gene- 
[ral hospitals live and three-tenths percent, or the 
strength!' Of the six and forty-six hundredths per cent, 
wejhn'dfedf nearly one per cent, were with their resp.ee- 
"Jtfe commands, the rest in general hospitals. 

The establishment of medical depots within reach of 
irmies in the held, and their prompt supply upon tire 
Jr eld of battle; the transportation of sick and wounded 
fry ambulance, railroad and hospital iransports' the 
Sufficiency ami successful administration or the best 
I system*>f general hospitals; the sanitary precautions, 
Fas well hs all minor details of this department tending 
[to the greater comfort of the sick and wounded, as 
well as to the health and efficiency of the troops, have 
during the year undergone the severest possible test, 
and in no instance have the movements of successful 
generals been impeded or delayed. from any cause 
within control of the medical department 


House bill No. 543, Th 


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eighth union league regiment! 


^.LL THE BOUNTIES PAID ON BEJNG 
MUSTERED IN. 


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Curious Vital Statistics.— Dr. Schwalbe 
has collated the vital statistics of Berlin in a 
curious way, and gives the following results: 
The death rate among those living in the 
cellars of Berlin was 25 and a fraction per 
1000; among those living on the ground floor 
22 per 1000; among those on the first floor (or 
what is generally called here the “second 
story”) 21 and a fraction; among those in 
the next story above about the same, but a 
little higher rate; among those on the third 
floor (fourth story) over 22 per 1000, and in 
the highest story 28 per 1000. The situation 
of the “living apartments” would, from 
these returns, appear to determine the death 
rate of the inhabitants; yet it is only one of 
many influences. Those who live either in 
cellars or garrets in crowded cities are the 
very poor, who are subject to great priva¬ 
tions—those whom vice has ruined or disease 
^has weakened. They are not only at a phy¬ 
sical disadvantage when compared with 
those who live on the ground floor or in the 
I second story, but when attacked by disease 
they are too poor to pay for the medical at¬ 
tendance and treatment which help to re¬ 
duce the death rate of their more fortunate 
| neighbors. Damp cellars and badly venti¬ 
lated garrets help to increase the death rate 
in these places, but the predetermining cause 
of both the death rate and of the situation of 
the “living roojns” is the poverty of the' 









s 


oThe ^resident or the CoventfonT stalfm 
that he was no longer a candidate for God 
y ernor, was then read. Hon. John Ritchie 
of Frederick, nominated Hon. William T 
Hamilton, of Washington. The nomina¬ 
tions were declared closed, and Hon. John 
Lee Carroll was nominated on the first bal- 
lot, receiving GO votes, Mr. Hamilton receiv¬ 
es 50. Mr. Carroll’sl nomination was thei 
maue unanimous. 

I i eV i i K Wo ? lf °rd,of Somerset, was nomi. 
nated by acclamation for Comptroller of the 
Treasury. He is the present incumbent ol 
that position. ^ 

For Attorney General, C. J. M. Gwynn, oj 

Baltimore City, was nominated. ' 

r l he following platform w’as unanimously 
leported by the Committee on Resolutions 
amd unanimously adopted by the Conven- 

First. We do hereby declare our unfalterJ 
ing devotion to those cardinal principles ol 
republican government enunciated by Thosf 
Jefferson in language so clear that It cannoj 
be improved, to wit: “ Equal and exact hu 
tice to all men of whatever State or nej 
suasion, religion or political: the sunl 
port of the state Governments in all thei] 
rights as the most competent aaminiL 
tratiou for our domestic concerns, and thl 
surest bulwarks against anti-republicaf 
teuden*ies;” the preservation of the Genera 
Government in its whole constltutiona 
vigor, as the sheet anchor of our peace 
home and safety abroad; the supremacy 01 
the civil over the military authority • econS 
"»•»£«» public expense, that neb? maT 
be Bghtly burdened; the honest pay mem 
Oi our debts and the sacred preservation ol 
the public faith; the diffusion of7£fo?m2 

ho°,. n Jr nd a , lurtsl ? n ? eilt ci 'hll abuses at thq 
bar of public opinion. Freedom of religion] 







Dr. Edward Cowles, the Superintendent of Boston 
City Hospital, read a paper on the Treatment of the 
Sick in Tents and Temporary Hospitals. The reader 
held that recent observation and experience had shown 
that more favorable results were obtained from the 
treatment of patients in temporary structures than when 
they were placed in regular hospitals. He contended 
that it was a mistake to spend vast sums of money to 
erect costly and magnificent buildings, when a much 
less amount could, with far greater advantage to the 
patients, build a hospital with a view to its removal in 
a few years. He showed a diagram, and gave an ac¬ 
count of the structure of the tents in use at the insti¬ 
tution with which he is connected. 

In the discussion which followed, several members 
coincided with Dr. Cowles in the views he had ad¬ 
vanced, and related their experience in the late rebel¬ 
lion in confirmation. 






. €X ii \ 




course of study at the Harvard Medical School, insuring 
a better education to its! students than under the .old 
system, and that its grafluates would enter upon their 
professional work with $ better preparation, therefore, 
than had been possible before. Reference was also 
made to the trial and <xpulsion of the homoeopathic 
members, as a vindication by the Society of the prin¬ 
ciples and purposes for which it exists. As to the ad¬ 
mission of female practitioners, they had themselves 
settled the question by| putting their school into the 
hands of the homoeopaths. 

Toasts were given and speeches were made by the 
Chaplain of the day, Re*v. Mr. King, of Roxbury, by 
Dr. Allen, by Dr. Colting, the President elect, by Dr. 
Parker, formerly of China, Dr. Green, of Boston, etc., 
etc. Dr. Stone, of YVellfieet, read an original and hu¬ 
morous poem. J 

Thus ended a very pleasant session of this venerable 





















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January 16, 1875] MEDICA 


preserved that not a scratch or other blemish was 
visible. * •" t * 

Such floors are easily cleaned, impenetrable to moist¬ 
ure, and can be kept in perfection with but little and 
unskilled labor. If there is a single objection to 
them, it is that they are so slippery that there is great 
liability to fall on them ; and I recall the guarded man¬ 
ner in which I walked over them. 

The advantages of these enamelled floors in a hy¬ 
gienic view are apparent, and the appearance of the 
wards is rendered very attractive by them. 

This hard and polished surface is produced by the 
simple process of occasionally rubbing them with a 
mixture of ordinary yellow wax and turpentine. The 
proportions of the combination do not seem to be very 
important, but enough turpentine is added to melted 
wax to give the mixture a very viscid consistence when 
cold. The rubbing is performed with woollen cloths on 
which a small quantity of the mixture is spread. The 
cloth is wrapped around a block of wood that is fur¬ 
nished with a long handle, so that the operator stands 
erect whilst at work. 

This light work of polishing almost supersedes the 
more laborious duty of scrubbing the floors, and it can 
be performed by ordinary attendants or may be a light 
exercise for convalescent patients. 

I commend the process as worthy of general adop¬ 
tion in the hospitals of this country. 

R. J. Levis. 









1 


TIMES. f [January 16, 1875 

♦ i 


existence until they have tfeen weaned.” We are as¬ 
sured that this assertion “ Is a simple fact.” All we 
have to say in comment'isth|it as the human conscience 
may be annihilated by repeated crime, so does it seem 
to us the human intellect m%y iose the divine power of 
distinguishing truth from falsehood by being employed 
upon the work of a partisan temperance lecturer. We 
sincerely hope Dr. Edmunds|s book may have some in¬ 
fluence in arresting intemperance, but certainly cannot 
think our readers will ever want to peruse more than 
one page of it. 

The Diseases of the Stomach. By Wilson Fox, 

M.D. H. C. Lea, Philadelphia, 1875. 

This is a reprint of the thild English edition of the 
Diagnosis and Treatment of the Varieties of Dyspepsia, 
a not absolutely fresh work, since the author’s preface 
is dated October, 1872. This “third edition” was really 
in a considerable degree a new book, since, besides 
minor contributions, articles on ulcer and cancer of the 
stomach were added. These chapters, while containing 
nothing that is new, are well-written resumes of our 
knowledge upon the diseases of which they severally 
treat, and contain an elaborate bibliography of the sub¬ 
ject. Dr. Fox seems to be ignorant of the great value of 
turpentine in some cases of chronic ulcer not attended 
by hemorrhage, and we thinkjunderestimates the value 
, of nitrate of silver. 


GLEANINGS FROM OUR EXCHANGES. 


Koumiss ( The Peninsular Journal , December, 1874). 
-Mr. E. C. Saunders quotes DnTa£i£l£]^^jJta||M 












































At the Massachusetts General Hospital there was a 
surgical visit, with operations. Opportunity was also 
given to inspect the two new wards, the Warren and 
Jackson, which have been recently opened. They are 
thus^Sescribed in the last report of the hospital: “ These 
structures are modelled somewhat upon the plan of 
army field-hospitals, with such modifications as climate 
and greater permanency require. The dimensions are 
forty-five by fifty-five feet, by fifteen and a half feet 
high to the eaves. Frames and outside walls of iron ; 
high-pitched trussed roofs, at apex of which are venti¬ 
lators, ten feet square, with chimney-stacks in centre. 
They are connected with the main hospital by corridors. 
Warren ward is one story high, without interior divi¬ 
sions, forty-four feet square inside, sixteen feet high at 
walls, and twenty-two and a half feet high in centre ; 
arranged for twenty beds, allowing about one thousand 
eight hundred and forty cubic feet of space to each 



bed.” Windows are arranged upon three sides, and so 
open as to allow a circulation of air without a direct 
draught upon the beds. For heating-purposes, a chim¬ 
ney-stack is placed in the centre of the ward, on two 
opposite faces of which are open fireplaces, and on 
the other two open Franklin soapstone stoves. Steam 
radiators, hung beneath the floor, and supplied with 
fresh air from without, also assist in heating. “ A glazed 
door opens upon a platform in the south front, over 
which is to be an awning in hot weather. Jackson 
ward is similar in construction and dimensions, except¬ 
ing that the interior is divided into eight rooms, each 
twelve by eighteen feet, fifteen and a half feet high, 
containing three thousand cubic feet of space, and of 
sufficient size for two beds each. Each room has an 
open Franklin soapstone stove. The ward is divided 
by a centre and a cross corridor, twenty-one and a half 
feet high, which, as well as the rooms, are connected 
with the large ventilator in the roof.” 

At the City Hospital there was also a surgical visit, 
with operations. Of great interest was the exhibition of 
patients in the two tents that were spread in the yard. 
Several cases which, while confined in the walls of the 
Hospital, were in extremis , are fairly on the road to 
recovery since they began to camp out. 












Publish 


The Philadelphia Medical Times is an independent journal , 
devoted to no ends or\ interests whatever but those common 
to all who cultivate the science of medicine. Its columns are 
open to all those who wish to express their views on any sub¬ 
ject coming within its legitimate sphere. 

We invite contributions , reports of cases, notes and queries, 
medical news , and whatever may tend to increase the value of 
our pages. 

All communications must bear the name of the sender 
{whether the name is to be published or not), and should be 
addressed to Editor Philadelphia Medical Times , care of the 
Publishers. 


every Saturday by 

J. B. LIPPINCOTT & CO., 

715 and 717 Market St., Philadelphia, and 25 Bond St,, Neiv York. 


THE VISIQN OF MALTHUS. 

TVT OT long since, we took occasion to lay before 
^ ^ our readers some statistics showing that the 
average subsistence and means of comfort for the 
race were increasing. This it appears is true chiefly, 
if not solely, in what we may call the enlightened 
nations,—those which are in reality or in origin 
European. In India, on the other hand, the vision 
of the much-derided s£er seems to be taking the 
grim outlines of a reality. It appears that the popula¬ 
tion of that country is now, for the first time within 
the historical period, rapidly increasing. Formerly, 
the constant wars between the numerous native 
princes, the deadly arts lof the Thugs, the family 

broils, the secret practices of the poisoners, the 

.. 

suttee, the car of Juggernaut, and, above all, the 
universal practice of infanticide, kept down the 
population. The English rule has, however, closed 
most of these outlets, and the result is daily becom¬ 
ing more apparent. In Bengal the traditional popu- 


SATURDAY, JUNE 20, 1874. 












The building should be only one story high, with 
ventilation amply provided for at the apex of the roof; 
undoubtedly t l^e pavilion-plan is the best. Such a plan 
has been carried out at Leipsi c. as I learn by an admi¬ 
rable article in the Nm) York Evening Post of March 
| 23. At the gates of Leipsic the re is an immense shed- 
• hospital consisting of lourteen large “ sheds/’ if such 
a name can be given to what are really handsome 
pavilions. They are detached, one-story, substantial 
frame buildings, filled in with brick, connected through 
'"an-nnte-chamber by a gallery, and facing a garden. 
They are one hundred feet by thirty-two feet in size 
inside, with a height of fifteen feet to the eaves and of 
'"Twenty feet to the roof-ridge. 

They stand sixty feet apart, are raised on stone piers 
four feet higher for the sake of ventilation. There are 
also ridge-ventilators, with movable sashes to furnish 
""protection from cold during a part of the day in winter. 

Each “ shed” has twenty-four beds, with nurses’ room, 

" baths, kitchen, and closets complete. There are isolated 
sheds for contagious diseases. No lying-in women are 
admitted. During twelve months, frona August, 1872, 
to 1873, Professor Wierseh, who has direction^ of the 
surgical clinic, performed two hundred and sixty-six 
serious operations and did not lose a case from pyaemia, 
while prior to the construction of the pavilions, in the 
old stone hospital, which is now the central building, 
he lost from forty to fifty amputations from this cause 
annually. 

The more space for free circulation of air our hos¬ 
pitals can secure, the nearer we can come to the 
Leipsic model, the better will be the economical and 
sanitary results. __ _ 














pulmonary artery, where the current was less forcible 
than in the aorta. The slight obstruction thus produced 
would still further embarrass the feeble right ventricle, 
and this circumstance would favor the closer blocking 
of the vessels. Hence, violent respiratory efforts would 
ensue, the blood *not having access to the aerating 
organs, and death was the result of mechanical 
asphyxia. 

Dr. Packard called attention to the fact that in this 
patient, the subject of cancer, there were evidences of 
the former occurrence of tuberculous deposit in the 
cicatrices at the top of each lung. 

The viscera were referred to the Committee on Mor¬ 
bid Growths for further examination, who reported May 
7, 1874, as follows : 

“ Your committee found in Dr. Packard’s specimen a 
large-sized gall-stone impacted in the ductus choledo- 
chus, where it had caused the lining membrane to ul¬ 
cerate. The portion of the tube lying in front of the 
foreign body was pervious, although its mucous mem¬ 
brane was very much swollen and congested. The 
gall-bladder itself was contracted, and contained a 
small quantity of thick, dark, grumous bile ; its walls 
were covered with a layer of fatlralf an inch in thickness. 
The head of the pancreas was found very much in¬ 
durated, and somewhat increased in size. This was 
found upon examination to be due to an excessive de¬ 
velopment of connective tissue between the normal 
secreting parenchyma.” 


MEDICAL SOCIETY OF THE COUNTY OF 
ALBANY. NEW YORK. 





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their success* They are small, and are readily removable. The old 
C* ydea of warehousing diseases on the largest possible scale, and of 
CSi making it the boast of an institution that it contains so many hun- 
0^> dred beds, is abandoned here. The old idea of building an institu- 
"*** tion so that it shall stand for centuries, like a Norman castle, but, 
** unlike the castle, still retain its original character as a shelter for the 
afflicted, is abandoned. The still more absurd idea of building hos- 
* pitals for the treatment of special organs of the body, as if the diff er- 
<0*1 ent organs could walk out of the body and present themselves for 
treatment, is also abandoned. 

It will repay us a minute of time to look at one of these model hos¬ 
pitals. One is the fac simile of the other, and is devoted to the ser- 
u vice of every five thousand of the population. Like every building 
in the place, it is erected on a subway. There is a wide central en- 
^ trance, to which there is no ascent, and into which a carriage, cab, or 
^ ambulance can drive direct. On each side the gateway are the 
houses of the resident medical officer and of the matron. Passing 
down the centre, which is lofty and covered in with glass, we arrive at 
two side-wings running right and left from the centre, and forming 

< cross-corridors. These are the wards: twelve on one hand for male, 

< twelve on the other for female patients. The cross-corridors are 
J twelve feet wide and twenty feet high, and are roofed with glass. 

f f ;' The corridor on each side is a framework of walls of glazed brick, 
^ arched overhead, and divided into six segments. In each segment is 
> a separate, light, elegant removable ward, constructed of glass and 
iron, twelve feet high, fourteen feet long, and ten feet wide. The 
cubic capacity of each ward is 1,680 feet. Each patient who is ill 
enough to require constant attendance has one of these wards entirely 
to himself, so that^he. injurious influepces on the sick, whi&h are- 

' V* 


I ^ 


H •* 


r 



illy . .sy people, 

are comparatively silent. The subways relieve the heavy traffic, and 
the factories are all at short distances from the town, except those in 
wiliest the work that is carried on is silent and free from nuisance. 
This brings me to speak of some of the public buildings which have 
relation do our present studies. 

It has N^jeen found in our towns, generally, that men and women 
who are engaged in industrial callings, such as tailoring, shoe¬ 
making, dre^s-making, lace-work and the like, work at their own 
homes amongst their children. That this is a common cause of dis¬ 
ease is well understood. I have myself seen the half-made riding- 
habit that was ultimately to clothe some wealthy damsel rejoicing in 
her morning ride, a^t as the coverlet of a poor tailor's child stricken 
with malignant scarM-fever. These things must be, in the ordinary 
course of events, under our present bad ordinary system. In the 
model city we have in ouXniind's eye, these dangers are met by the 
simple provision of workman's offices or workrooms. In convenient 
parts of the town there are blocks of buildings, designed mainly after 
the manner of the houses, in which each workman can have a work¬ 
room on payment of a moderate srnn per week. Here he may work 
as many hours as he pleases, but he ffiay not transform the room into 
a home. Each block is under the clWge of a superintendent, and 
also under the observation of the sanitar^authorities. The family is 
thus separated from the work, and the wdrking man is secured the 
same advantages as the lawyer, the merchant, the banker now pos¬ 
sesses: or, to make the parallel more correct, he has the same advan¬ 
tage as the man or woman who works in a factory and goes home to 
eat and to sleep. 

In most towns throughout the kingdom the laundry system is 
41 dangerous in the extreme. e For anything th^jhealthy householder 



A CITY OF HEALTH. 71 

t »» ' 

3 "'* ^ ** >■-*■<> 4 *“ ' * * ' v 

l ** \ w • “ 

created by mixing up, in one large room, tlie living and the dying 
those who could sleep, were they at rest, with those who cannot 
sleep because they are racked with pain ; those who are too nervous 
or sensitive to move, or cough, or speak, lest they should disturb 
others; and those who do whatever pleases them; these bad influen¬ 
ces are absent. 

The wards are fitted up neatly and elegantly. At one end they 
open into the corridor, at the other towards a verandah which leads 
to a garden. In bright weather those sick, who even are confined to 
bed, can, under the direction of the doctor, be wheeled in their beds 
out into the gardens without leaving the level floor. The wards are 
warmed by a current of air made to circulate through them by the 
action of a steam-engine, with which every hospital is supplied, and 
which performs such a number of useful purposes, that the wonder is 
how hospital management could go on without this assistance. 

If at any time a ward becomes infectious, it is removed from its 
position, and replaced by a new ward. It is then taken to pieces, 
disinfected, and laid by ready to replace another that may require 
temporary ejection. 

The hospital is supplied on each side with ordinary baths, hot-air 
baths, vapor baths, and saline baths. 

A day sitting-room is attached to each wing, and every reasonable 
method is taken for engaging the minds of the sick in agreeable and 
harmless pastimes. 

Two trained nurses attend to each corridor, and connected with 
the hospital is a school for nurses, under the direction of the medical 
superintendent and the matron. From this school, nurses are pro¬ 
vided for the town; they are not merely efficient for any duty in the 
vocation in which they are always engaged, either within the hospital 
or out of it, but from the care with which they attend to their own 
personal cleanliness, and the plan they pursue of changing every gar¬ 
ment on leaving an infectious case, they fail to be the bearers of any 
communicable disease. To an hospital four medical officers are 
appointed, each of whom, therefore, has six resident patients under 
his care. The officers are called simply medical officers; the distinc¬ 
tion, now altogether obsolete, between physicians and surgeons, being 
discarded. 

The hospital is brought, by an electrical wire, into communication 
with all the fire-stations, factories, mills, theatres, and other import¬ 
ant public places. It has an ambulance always ready to be sent out 
to bring any injured persons to the institution. The ambulance 
drives straight into the hospital, where a bed of the same height, on 
silent wheels, so that it can be moved without vibration into a ward, 
receives the patient. 

The kitchens, laundries, and laboratories are in a separate block at 
the back of the institution, but are connected with it by the central 
- corridor. The kitchen and laundries are at the top of this building, 
the laboratories below. The disinfecting-room is close to the engine- 
room, and superheated steam, which the engine supplies, is used for 
disinfection. 

The out-patient department, which is apart from the body of the 





72 A CITY OF HEALTH. ' 



hospital, resembles that of the Queen’s Hospital, Birmingham: the 
first out-patient department, as far as I am aware, that ever deserved 
to be seen by a generous public. The patients waiting for advice are 
seated in a large hall, warmed at all seasons to a proper heat, lighted 
from the top through a glass roof, and perfectly ventilated. The 
infectious cases are separated carefully from the rest. The consult¬ 
ing rooms of the medical staff are comfortably fitted, the dispensary 
is thoroughly officered, and the order that prevails is so effective that 
a sick person, who is punctual to time, has never to wait. 

The medical officers attached to the hospital in our model city are 
allowed to hold but one appointment at the same time, and that for a 
limited period. Thus every medical man in the city obtains the equal 
advantage of hospital practice, and the value of the best medical and 
surgical skill is fairly equalized through the whole community. 

In addition to the hospital building is a separate block, furnished 
with wards, constructed in the same way as the general wards, for the 
reception of children suffering from any of the infectious diseases. 
These wards are so planned that the people, generally, send sick 
members of their own family into them for treatment, and pay for the 
privilege. ■v _ ^ 

Supplementary to the hospital are certain other institutions of a 
kindred character. To check the terrible course of infantile mortality 
of othear Lmge cities—the 76 in the 1,000 of mortality under five years 
of age—^fhnes for little children are abundant. In these the destitute 
young* are carefully tended by intelligent nurses; and mothers, while 
following their daily, fallings, are enabled to leave their children 
under efficient care. 

In a city from which that grand source of wild mirth, hopeless 
sorrow and confirmed madness, alcohol, has been expelled, it could 
hardly be expected that much insanity would be found. The few 
who are insane are placed in houses licensed as asylums, but not 
different in appearance to other houses in the city. Here they live, 
in small communities, under proper medical supervision, with their 
own gardens and pastimes. 


The houses of the helpless and aged are, like the asylums, the same 
as the houses of the rest of the town. No large building for the poor, 
of pretentious style, uprears itself; no men badged and badgered as 
paupers walk the place. Those poor who are really, from physical 
causes, unable to work, are maintained in a manner showing that 
they possess yet the dignity of human kind; that, being worth pre¬ 
servation, they axe therefore worthy of respectful tenderness. The 
rest, those who can work, are employed in useful labors which pay 
for their board. If they cannot find work, and are deserving, they 
may lodge in the house s and earn their subsistence; or they may live 
from the house and receive pay for work done. If they will not 
work, they, as vagrants, find a home in prison, where they are com¬ 
pelled to share the common lot of mankind. 

Our model city is of course well furnished with baths—swimming 
baths, Turkish baths, playgrounds, gymnasia, libraries, board schools, 
fine art schools, lecture halls, and places of instructive amusement. In 
every board school, drill forms part of the programme. I need not 






: \V,' : . 


~ \ 


29 


the additional subscription of $250,000. This 
appropriation was unanimously voted, and when 
on November 15th, the subscription reached the 
required sum "of $250,000, application was made 
to the State Treasurer, and the amount appropri¬ 
ated ($100,000) was paid. 

Finding that as the sum of the subscriptions 
rapidly increased, it would be possible to erect a 
much larger hospital than was at first deemed 
possible, application was made in May, 1872, to 
the City Councils for a lot of ground as a build¬ 
ing site; and by an ordinance, approved May 
18th, 1872, a piece of ground (extending between 
Thirty-fourth and Thirty-sixth Streets, embrac¬ 
ing nearly six acres in immediate continuation 
of the remaining property of the University), 
was given to the Trustees in trust as a building 
site for the proposed hospital. In return the 
Trustees agreed to complete the building within 
five years, and to permanently maintain in it at 
least fifty free beds for the use of the poor of the 
community disabled by accident or sickness. In 
addition to the smaller private subscriptions, the 
sum of fifty thousand dollars has been contribu- 

Ik 

ted by a generous and benevolent gentleman, 
payable so soon as the endowment fund shall 
actually amount to $250,000. 

As the plans that have been adopted for the 




“I 




I 


80 



hospital will involve an outlay of over $200,000 
in building alone, it has been decided to apply to 
the Legislature for a second sum of $100,000, 
contingent upon the securing of an additional 
$100,000 by subscription.* If this application 
meet with the success which is hoped for and 
confidently anticipated, it will put the Trustees in 
possession, on account of the hospital, of nearly 
six acres of ground, free from all incumbrance; 
a building fund, given by the State, of $200,000; 
and an endowment fund raised by contribution 
of $350,000. 

During the past summer a Building Commit¬ 
tee, with the aid of the University architect, elabo¬ 
rated the plans for the hospital with the greatest 
care. The proposed building will harmonize in 
architecture with the already completed Depart¬ 
ment of arts and science, and like it will be in the 
University Gothic style. Its plan is specially 
designed to admit of the continued growth and 
extension of the hospital without injury to its 
unity or to its architectural symmetry. It com¬ 
prises a central building and a series of lateral 
pavilions, each designed to accommodate ninety 
patients. The central building consists of a 
basement floor, three stories, and a Mansard roof. 


* This sum has been appropriated by the Legislature. 




m 

V 


31 


It is sixty feet front by one hundred and fifty 
deep. It contains a lecture room on the basement 
floor for two hundred persons, and a great amphi¬ 
theatre in the upper portion, capable of seating 
seven hundred. It contains, also, the general 
kitchen, offices of administration, sleeping rooms 
for Resident Physicians, apartments for private 
patients, etc. 

It is proposed to erect at present but two pa¬ 
vilions, which are to be connected with the cen¬ 
tral building by corridors about forty feet long. 
The entire structure will be about two hundred 
and twenty feet long, and will front on the south 
side of Spruce Street but a short distance back 
from the curb, so as to allow as much space as 
possible in the rear for exercise and ventilation. 
Each pavilion will consist of a basement floor 
(devoted to dispensary work, servants’ rooms, 
cells for mania a potu patients, etc.), two main 
floors, and a Mansard roof, with rooms for ser¬ 
vants. The laundry and heating apparatus will 
occupy a building immediately in the rear of the 
centre building; and the entrance for patients, 
waiting room, morgue, and pathological labora¬ 
tory another small building on Pine Street. 

The foundations of the central building and 
west pavilion are already far advanced. 

It is generally known that the Board of Trus- 




tees of the University determined to sell the 
ground where we now stand in order to obtain 
funds for the erection of the new buildings in 
"West Philadelphia, and also that a Commission 
appointed by the Government of the United 
States has reported in favor of its purchase as a 
site for the public buildings required in this 
city. The Congress has made an appropriation 
for this object, and now it only remains for the 
Secretary of the Treasury to approve of the re¬ 
port of the Commission, which was presented 
several months ago. There is every reason to 
believe that this approval will not he withheld.* 

r 

As soon thereafter as possible, a building for the 
Medical. Department will be erected in the imme¬ 
diate vicinity of the University Hospital. These 
two buildings will harmonize in architecture with 
that of the Department of Arts, whose beauty is 
well known, and when they are completed, and 
the grounds around them appropriately inclosed 
and adorned, they will be among the finest public 
edifices of Philadelphia. 

The Medical Department, possessed of a model 
hospital entirely under its own control, will also 
be at the very doors of the Philadelphia Hospi¬ 
tal, one of the largest in the United States; and 


* Since the delivery of this Address the Report has been approved. 









HOSPITAL 


OF TUB 


UNIVERSITY OF PENNSYLVANIA, 

T. W. RICHARDS, Architect. 


PLAN OP FIRST FLOOR 


MATRON 


STEWARD 


NURSE 


NURSE 


linen 


DINING RM 


SEWING RH 


LINEN 


KITCHEN 


KITCHEN 


DINING 


DININGROOM 


LINEN RM 


PANTRY 


VERANDA 


ENTRANCE 


ENTRANCE 


WARD. 10 BEDS 


APOTH ECARY 


STEWARD'S OFFICE 


WARD IQ BEDS. 


IIISITTINC 


BOARD 


OFFICE 


ROOM 


4 

































































































































■ -: • , 



V v 





















The Cost of Hospital Buildings .—The 
cost of the site for the new St. Thomas’s 
Hospital, London, we learn from the 
Lancet , July 26, 1873, is £148,545. The 
total cost of the building is £383,948; 
that of the furniture upwards of £10,000 ; 
the total outlay being upwards of £552,- 
000. The cost per bed is a little more than 
£530, with a cubic capacity of 1800 feet 
for each patient. 

The Herbert Hospital—one of the best 
constructed pavilion hospitals in Europe 
—with a cubic capacity of 1200 feet per 
head, cost £320 per bed. The Lariboi- 
sidre Hospital, at Paris, with a cubic 
capacity of nearly 1900 feet per patient, 
is said to have cost £440 per bed; and 
the expense of the Hotel-I)ieu, at Paris, 
now in course of erection, with a cubic 
capacity of 2300 feet per head, is re¬ 
ported to be £750 per bed if intended for 
800, or as much as £1500 per bed if the 
number of these be reduced, as proposed, 
by half. Taking, therefore, the average J 
j cost of these great hospitals, the average 
cost per bed will be a little over £500, 
and the average cubic capacity 1800 feet. 









This work has long been the acknowledge^ 
its present improved shape it is hoped that 
valuable assistance in the treatment of a fn 
disorders. 


STURGES’ CLINI 


AN intro: 

TO THE STUDY OF C 

BEING A GUIDE TO THE IN' 

FOR THE USE 0| 

By OCTAVIUS STUB 

Assistant Physician to the W 
In one neat volume , royal 1! 

We hope that the generation of medical stu¬ 
dents who are now entering upon hospital prac¬ 
tice will have the sense to buy this capital book, 
and to thoroughly imbue themselves with its 
spirit. The book is full of plain practical hints; 
it does not talk of things in general, but of things 
which are constantly coming under the student’s 
notice and puzzling him to know what to do with 
them. The language is clear and concise, and the 
size and shape of the little volume are conve¬ 
nient.— Lond. Practitioner , June, 1873. 

Is likely to be extremely useful to all students, 
who, in taking cases, must necessarily follow a 
similar, if not exactly the same, mode. Nor is 
it only to the student that this book is likely to 
be of use; many practitioners will find their di¬ 
agnosis all the more clear, and their ideas of the 
nature of their patient’s illness probably much 


s: ho: 










pitals 


’E learn from a recent exchange that the 
English government is offering iro^ hos- 


or 


they are to contain lwcivc 

'MW he. seTmTand made r ^dxJoLg££ HP atlon 
STT^nnt h. and~are"said to be wjth^ water-clo sets, 
nurse^rooms, wash-rooms, etc., complete, xi-mcy 
be what they seem, these iron hospitals appear to 
solve the question of hospital construction,_cost-_ 
j n ff . we should supp ose, furn ished, not more tha n 

"one hundred dollars a bed. 


k 





























N 


tea^her la £, f Pr0f ' MiHer ^ n0t ° nly a great writer and 
< her, but a most accomplished practitioner, a Chris- 

ian gentleman, and a warm-hearted philanthropist 

morih^a^d"? h ‘ S f ff ° rtS t0 su PP ress vice and im- 

classes of people in h.s Own and in foreign countries 
Subscnptrons may be fitted directly to Edinburgh 
to the address of Dr. A.', G. Miller, or to Dr Barton ’ 
to my rare, Eleventh afyi Walnut Streets Medical 
journals, friendly to the object, will please copy 

and olredient^ervant^ y ° Ur friend 

Philadelphia, October 15, 1873., ^ROSS. 

^ILLHR Memorial HoWe. ’-Shortly after the death 













































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November 29 , 1873 ] 



g 

MEDICAL 


TIMES. 


139 


t 

A 


4 


**%> 



received with great satisfaction. It is a question equally 
momentous on both sides of the Atlantic ; and therefore 
O -sL 1 call the particular attention of American surgeons to 
v* y it. The creed of Mr, Erich sen is stated so broadlv and 
/ clearly that I shall do best to quote the passage in which 
he re-states and endorses Simpson’s figures: 

“Without going into details, which would here be 
alike unnecessary and tedious, it may be stated broadly 
that, having collected a large and nearly equal mass of 
statistical returns of consecutive operations performed 
in large and in small hospitals, in country, mining, and 
private practice, he found that of 2089 cases of amputa¬ 
tions in large hospitals in this country, 855, or 1 in 2.4, 
had died; whilst of 2098 in country and^private prac¬ 
tice th e deaths were only 226, or at the rate of i ih' QTiE 
“ It is quite possible that Simpson’s figures may not 
be absolutely, but only approximately, correct, and that 
certain sources of fallacy have introduced themselves 
into his tables. But, making all reasonable allow¬ 
ance for every possible source of error, the differ¬ 
ence is so great between the operation of amputation in 
and out of hospital that the material result cannot be 
> affected,-—viz., that a mortality of 1 in 2.4, or, in other 

i words, of more than 40 per cent., is not a necessary re- 
j ~'^sult of amputations ; that it is greatly the result of the 
d circumstances in which the patient is placed after the 
operation ; and that it may be materially reduced,—ac- 
* cording to Simpson, by nearly three-fourths,—so as to 
Vv amount to less than 12 per cent., by an alteration of 
these circumstances; and that the mortality so de¬ 
pendent on circumstances which admit of alteration, of 
modification, and probably of rectification, is certainly 
equal to that which exceeds 1 in 9, or 12 per cent. 

“But, when we come to analyze these results more 
closely, some startling facts are elicited. Thus, ampu¬ 
tation through the forearm cannot surgically be consid¬ 
ered a very serious operation. It is not likely to prove 
fatal by any conditions dependent on or inherent in it, 
—as, for instance, by shock or hemorrhage,—but can 
only become fatal by the intrusion of other and ad¬ 
ventitious circumstances dependent on causes existing 
outside the operation itself. Well, what is the result ? 
That of 377 cases occurring in private and country 
practice only 2 died, whilst of 244 in hospitals no less 
than 40 died, being 1 in 188 against 1 in 6. 

“Surely here is a condition of things most unsatis¬ 
factory in itself, and not very creditable to modern 
surgery, and one in which we may hope that the further 
cultivation of the science may do much to aid the pro¬ 
gress of the art of surgery.” 

Accepting thus sincerely Simpson’s figures as unim¬ 
peachable, it is not surprising that Mr. Erichsen should 
ask, “ Must hospital surgeons ever remain content in 
losing from one-third to one-half of all their amputa¬ 
tions, and nine-tenths of some?” or that, addressing 
the students, he should say to them, “ Here, then, is a 
vast and most fertile field, to which you who are com¬ 
mencing your studies may direct your attention with 
the greatest advantage, and which you who after this 
session will go forth into the world to practise may cul- 






tivate with a double advantage, to humanity and to 
yourselves.” 

It happens, however, that some others than students 
just commencing their studies have been directing their 
attention to this most fertile field, and have endeavored 
to ascertain what the utmost care and a judicious and 
minute attention to the recognized rules of surgery can 
do to reduce hospital mortality after operations to a 
par with anything that can be claimed for domiciliary 
surgery. Prominent among these has been Mr. George 
Callender, F.R.S., one of the surgeons to St. Bartholo- 
mew’s Hospital, who has succeeded to the charge of 
Sir lames Paget’s wards in that ancient and noble in- 
stitution. Mr. Callender read a paper making known 
his results at theTasEmeeting oTThe British Medical 
Association, London, August, 1873. I n this paper he 
gave a table showing the results of the treatment of 
compound fractures and of amputations during the last 
four and a half years, the whole period of his surgeoncy. 
The table is a very remarkable one : it reads thus : 


TOTALS. 

DIED. 

RECOVERED. 

FATAL CASES. 

Operations (excluding 





those for hernia) 

i99 

6 

193 




*—- 

— 

I. Ovariotomy. 

Compound fractures 

28 

O 

28 

2. Ovariotomy. 



— 

— 

3. Nephrotomy. 

Amputation at the thigh 

14 

O 

14 

4. Lithotomy. 

“ “ leg 

I 4 

O 

14 

5. Syphilitic lar¬ 

“ “ arm 

2 

O 

2 

yngitis. 

t( ts forearm 

3 

O 

3 

6. Cystic tumor. 


33 

O 

33 



Thus it will be seen that there has been in these 
wards during four and a half years a death-rate after 
all operations (excluding hernia) of but three per cent., 
and that of the thirty-three cases of amputation, includ¬ 
ing fourteen of the thigh and fourteen of the leg, all 
have recovered. The twenty-eight cases of compound 
fracture have likewise all recovered ; and this explains 
the absence of cases of primary amputation in the list. 
It may be doubted whether the results of any surgeon in 
private practice ever exceeded this ; and hence some 
lectures which Mr. Callender is now publishing in the 
journal of the Association ( British Medical Journal ), 
explaining all the details of his treatment, are attracting 
great attention. They, however, contain little thatis new 
in principle,—indeed, they do not profess to do so,— 
but they are highly interesting, as showing how important 
is the attention to small things, and how greatly results 
are influenced by the most conscientious devotion to 
details. Rest, isolation, scrupulous cleanliness, anti¬ 
septic applications (without the exclusion of air), and a 

minute and intelligent supervision of everything which 

■ ■ — 

can avoid septic poisoning of the wound and improve 

the patient’s condition,—these are the secrets of Mr. 

- .. - • • • - 

Callender’s success. I should say that Mr. Callender 
is a man remarkable for scrupulous exactness in word 
and act; he is as conscientious in what he says as in 
what he does; and, besides the fact that all his cases 
are controlled by public record in the books and papers 
of the hospital, there is no one here who hesitates to 
accord the most implicit reliance to his statements, as 
being sure to be entirely free from every conscious ex¬ 
aggeration, and certainly from every kind of statistical 


















140 


MEDICAL TIMES. 


[November 29 , 187 


o 


juggle. The whole question of hospital mortality is 
likely, therefore, now to be transferred from the region 
of paper statistics, in which it has rested for a long time, 
to its proper field, that of actual clinical experiment in 
the wards of great hospitals. I shall have again to 
return to this subject (which I do not doubt that you will 
agree with me in thinking of deep interest) ; for Pro¬ 
fessor Erichsen and Dr. Lauchlan Aitken (who assisted 
the late Sir James Y. Simpson in preparing his statistics) 
are likely to take the field again shortly on his side of 
the question, while the series of lectures which Mr. 
Callender has now commenced will give a minute 
review of his methods and results, and of those o f hi^ 
colleague at the hospital, Mr. Morrant Baker, which 
have been hardly less interesting and successful. 

The Societies have recommenced, but as yefvTlthout 
any promise of papers of more than ordinary interest. 
The next meeting of the Clinical Society will, however, 
produce two interesting papers by Sir William Gull, 
which may be worth discussion. The most ordinary 
topics of interest are the preparations for the Ashantee 
expedition, which is to be a\doctors’ and an engineers’ 
war chiefly. A few years ago “ a doctors’ war” would 
have been a phrase not easily Understood by the million. 
Now, however, it is beginning tp be pretty well under¬ 
stood that in a tropical campaign “ the wise physician 
skilled our wounds to heal” (and to prevent) is some¬ 
times “more than armies to the pubKc weal.” 

A very general and most unusually'earnest and out¬ 
spoken feeling of grief has been caused by the almost 
sudden death of Dr. John Murray, who, though under 
thirty years of age, was well known as sub-editor of a 
medical paper, and was already physician to two lead¬ 
ing hospitals. He was carried off suddenly by an attack 
of erysipelatous inflammation of the fauces, followed 
by rapid oedema of the larynx. His remains were re¬ 
moved to Aberdeen, his place of birth: they were met 
at the railway-station by upwards of four hundred of 
the best-known London practitioners, and a funeral 
service was there conducted of singular solemnity and 
strangely sad impressiveness. A tablet and bust will 
be erected to his memory. Some excellent Latin and 
Greek lines have been published in nientoriam. As 
classical tributes of the kind to the memory of physi¬ 
cians are becoming unfortunately rare, and as both are 
from the pens of London medical men, I will quote the 
Greek, which is much admired for its point and classic 
neatness of diction : 


T i tovto , Qdvare ; d^apirdoai donslg 
J larpbv w(5’ dvijj3ov, 6g rexvr/g (pdovtiv; 
Ovk eotc teal yap kyyeypap,pevog (ppeolv 
Qllcjv, nevrjTov, rravrog iarptov yevovg, 
v A Troy 77 ape an, ical ae vucr/oei Oavuv. 

“ And didst thou think, O death, to gain 
A victory by having slain 
Him so young, so full of skill ? 

Ah, no ! for he is living still. 

He lives enshrined in many a heart, 
Friends, brothers, debtors to his art. 

Thus, though absent, present, he 
In dying, death, shall conquer thee.” 


From a physician much honored I must pass to Qrtef" 
who has incurred professional censure. A well-known 
physician of St. I homas’s Hospital, greatly to the sur¬ 
prise of his professional brethren, lately undertook to 
edit a column, entitled “ Our Medical Column,” in a 
weekly paper called “The English Mechanic.” This 
is entirely contrary to obvious rules of professional 
ethics. He defended himself vigorously and defiantly 
when called to account by the medical papers, and 
alleged—no doubt truly—purely philanthropical mo¬ 
tives. But, whatever the motive, the course was 
obviously wrong; and, after a very brief struggle, he 
has succumbed, not without some loss of consideration 
among his professional brethren here, who do not easily 
pardon such a breach of professional rule. The struggle 
was so brief that the College of Physicians and the 
staff of his hospital have been relieved from the neces¬ 
sity of interfering. 

The death is announced to-day of Sir Henry Holland, 
a physician who has occupied the highest social position 
for many years, and who was of great literary and 
scientific distinction, but who was not very well known 
personally in medical circles, from which he held him¬ 
self unduly aloof. He died at the age of eighty-five, 
quietly in his bed, after a very few hours of languor, 
having recently returned from one of those long vaca¬ 
tion-rambles far afield (this time to the fair at Nijni 
Novgorod in Russia) in which he had annually indulged 
throughout his long and active life. He was a frequent 
visitor to America, and the friend of many distinguished. 
American citizens,—among others, the personal friend 
of six Presidents of the United States. His first wife 
was a daughter of the late Canon Sydney Smith, 


Philadelphia, Nov. 20, 1873. 

To the Editor of the Philadelphia Medical Times. 

Dear Sir:—I send the following clipping from the 
Ptiblic Ledger. What chance have the hospital doctors 
against an accoucheur with a baby of seventeen and 
three-quarters pounds weight? 

“X Bouncing Boy Baby.— Mr. John Brooks, 1728 
Warnock Street, has been furnished by the attending 
physician. Dr. Prall, with the following particulars con¬ 
cerning his, new-born son, Henry C. Brooks, born on 
Tuesday last>. November 18 : 

Weight 


Length 


17I pounds. 
22J inches. 

T p. 1 f i 

r 92‘ 


I7J 

i7i 

16 


i ( 


i l 


a 


Measure around the shoulders 
Measure around the waist. 

Measure around the chest 
Measure around the head . 

I 

“Perhaps some of our Experienced doctors, or affec¬ 
tionate mothers, may be able to present cases approach¬ 
ing the dimensions of this young gentleman on his 
birthday: if so, the Ledger will help to make an 


enduring record of the fact.” 


Yours, 


Contributor. 















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THE MEDICAL RECORD. 



was held back by the assistant before you introduced 
the tube. This was done after the isthmus was 
divided, hoping to relieve the pressure on the trachea. 
The cast you sent me shows the trachea encircled by 
the gland, and its internal diameter no larger than 
you state. 

“ I am very respectfully; 

4 ‘Your obedient servant, 

v “B. S. Hovey.” 

A PORTABLE BOOK-RACK FOR THE USE 
OF MYOPIC CHILDREN AND ADULTS. 

By WILLIAM SHAW BOWEN, M.D., 

OPHTHALMIC AND AURAL SURGEON TO THE HARTFORD HOSPITAL. 

A few years since, when Dr. Cohn, of Breslau, in Silesia, 
published the results of examining the eyes of 10,060 
school children* in the lower, middle, and upper 
schools of that city, his statistics attracted great at¬ 
tention, and students of ophthalmic science have be¬ 
come impressed with the extreme importance of the 
subject and the results thus shown. Dr. Cohn was 
induced to undertake this task from ascertaining, when 
revising the statistics of Prof. Forster’s clinic, that 750 
short-sighted people had presented themselves within 
four years, and that of these 750 over 400 had applied 
on account of severe annoyance dependent upon the 
refractive defect. The result of Dr. Cohn’s investiga¬ 
tions discloses the fact that out of the 10,060 children 
examined 1,004 were myopic. The tendency to short¬ 
sightedness increased as the scholars advanced from 
the elementary schools upwards. In the middle schools 
the proportion was one-tenth, and in the examination 
of the educational centre of the city, the University of 
Breslau, two-thirds of the students were myopic. 

These investigations have since been pursued by 
other competent authorities in Germany; and Drs. 
Webster and Cheatham, of New York, Thompson, of 
Philadelphia, and E. Williams, of Cincinnati, have 
published valuable information as to the refraction of 
the eyes of school children in this country. While the 
proportion is not so large as in Germany, it is still 
sufficient to cause the question to be asked, What can 
be done to prevent the development and increase of this 
scourge, as it were, that is overshadowing our children 
and subjecting them to constant annoyance and often¬ 
times danger to future vision. Of course this subject 
is plain to the ophthalmic specialist; the general hy~ 
gi2ne of myopia has been for a long time reduced to 
exact and simple principles, and by him communi¬ 
cated with emphasis to all myopes who come under his 
professional care; but the attention of physicians in 
general practice has not been adequately directed to the 
extreme importance of the matter; for they are the ones 
who are called upon in the great majority of cases for 
advice as to the proper regimen for the short-sighted 
child, who perhaps complains of pain and smarting of 
the eyes after a hard day’s work over school-books, and 
by them the hygienic rules to be f ollowed should be dis¬ 
seminated as widely as they disseminate the laws of 
health pertaining to proper ventilation, sewerage, and 
the care of the body. The demand for a higher and 
more rapid educational system are heard on all sides; 
it is typical of the race for life. The average American 
follows, and the so-called best and perfect schools are 
those in which the youth is forced to the utmost of his 
powers, the eyes sharing in the overwork as well as the 
mental faculties. The statistics of reliable observers 
show the results of this “ forcing system,” and nothing 


# u 


Untersuchung. der Aiigen von 10,060 Schulkindern,” Leipzig, 


can be more conclusive than the results of Cohn’s re¬ 
searches in Breslau. The writer has not systematically 
examined the refraction of all school children's eyes in 
this city, but in one room in an intermediate school 
nine out of forty-one were myopes. 

The general hygienic rules to be followed by short¬ 
sighted children, and those having an hereditary ten¬ 
dency thereto, are simple,—such as parents can be made 
to comprehend. Proper illumination, natural or arti¬ 
ficial, a moderate use of the eyes if myopia exists, and 
avoidance of the stooping or recumbent position while 
engaged in study or when using the eyes for near ob¬ 
jects requiring convergence of the optic axis, together 
with suitable glasses, comprise the chief of these laws, 
and simple as they are it is astonishing how thorough¬ 
ly they are neglected. Our school furniture, usually a 
subject of pride, on account of architectural neatness 
and elegance, is usually sadly deficient as regards the 
height of desks, the angle at which they incline, and 
the distance between them and the seats. Dr. Cohn 
examined the school furniture at the Paris Exposition, 
and found the American desks as deficient in these re- 
pects as those of European make, as he has shown in 
an article, 44 The School-houses at the Paris Exposition, 
from a Hygienic Point of View.” The child is com¬ 
pelled to stoop and to bring his face close to the desk, 
in order to see the letters, the type of school-books be¬ 
ing generally small and defective as regards clearness, 
and this stooping position and the straining of the in¬ 
ternal recti muscles in efforts of convergence causes 
congestion, which may cause the refractive error, if an 
hereditary tendency thereto exists, or increase it if it 
already exists in an extremely moderate degree. Stoop¬ 
ing and excessive convergence cause congestion of the 
tunics of the globe; congestion by mechanical pressure 
tends to increase the bulging at the posterior pole, 
thus increasing the myopia. Aside from the use of 
improper glasses, these two last are the most important 
factors in causing progressive myopia, and conse¬ 
quently to keep the head erect, to bring the book to 
the face and not the face to the book, should be the 
desideratum of all myopes. 

This, however, experience teaches, is exceedingly 
difficult to do. The child will not hold up the book ; 
he becomes tired, and finds it is easier to lean over the 
desk where the book finds support. It is with diffi¬ 
culty that the adult myope of average intelligence can 
be induced to systematize the position of book or pa¬ 
per, although he may be the subject of progressive 
posterior polar atrophy, and its consequent fatal re¬ 
sults to vision fully made known to him. 

In considering this subject the writer has frequently 
imagined a school desk, which, by its strict regard for 
the hygiene of the eyes in the way of construction and n 
its relation to the seat, might avert in a certain degr* e 
some of the evils above mentioned. After careful in¬ 
quiries of builders of school furniture, and of school 
committee-men, it was ascertained that any radical 
change of form, unless of such a nature that all could 
be uniform, would increase the cost of the article so as 
to prevent a ready sale. Economy of first cost enters 
largely into the consideration of the average school 
committee-man in fitting out his school room, and as 
a desk built on strictly hygienic principles would be an 
innovation of a marked character, it was impossible to 
find a manufacturer who could be induced to consider 
the importance of the subject sufficiently to build 
desks that would correct existing evils. A portable 
rack that can be adapted to any of the present style of 
desks has been made by a firm in this city,'* that got s 


* 0. D. Case & Co., School Furniture Manufacturers. 


















6 


THE MEDICAL RECORD. 


a long way towards aiding the accomplishment of one 
of the hygienic rules, viz., to enable the scholar to 
read easily and without fatigue, with the head erect, 
and to avoid the stooping position. The diagram 
shows the rack in position, and partially folded to 



be packed away in the desk when not in use. It can 
be made at a very small cost, is provided with metal 
springs to keep the book in position, may be made at 



any angle from the horizontal plane of the desk top, 
and is provided with rubber bands on its support to 
prevent noise in its motions when in use. They are 
useful for myopic adults as well as children, and can 
be used on the office desk and in the library, and when 
not in use can be folded and laid aside. It involves 
no new principles in its construction; it is the practi¬ 
cal adaptation of old and well-established ones; is 
simple and not liable to get out of repair, and can be 
made at very small expense, so as to be within the 
reach of all. 

Hartford, Conn., Nov. 1, 1875. 


Reports of Ujospttals. 


\ BELLEVUE HOSPITAL. 

Notes op Practice and Peculiarities op Treat¬ 
'S, MENT. 

cnfi^Nic brigiit’s disease. 

The following is'*a summary of a plan of treatment 
recommended: \ 

DIET. 

This class of patient sVhould abstain as much as pos¬ 
sible from meat. The opinion was expressed that the 
excessive animal diet accounts for the great prevalence 
of the disease in this country. Milk should be substi¬ 
tuted for meat, and should, be associated with lime. 
Butter may be used; eggs if Biey agree, and fresh fish 
in the morning. Fried fats should be carefully ex¬ 
cluded, but cream may be takenuvithout stint. Vege¬ 
tables and fruits are always goodMiut those should be 
selected which contain the least ‘amount of woody 
fibre. Rice and potatoes, there fore^onay be used, but 
asparagus, turnips, cabbage, and notably beans, which 
contain woody fibre in large quantitiesy\should be as¬ 
siduously avoided. Onions may be eateb with impu¬ 
nity, and are rather beneficial. \ 


FOR THE ANAEMIA. 

Iron should be administered from first to last, and 
by preference, the tincture of the chloride. This pre¬ 
paration is assimilated with difficulty, hence should 
not be given alone, but combined with mix vomica, 
and to this spirits of nitre may be added to assist the 
determination towards the kidneys. For example, ten 
drops of the tincture of the chloride of iron, ten drops 
of tinct. nux vomica, and one drachm of sweet spirits 
of nitre may be given three times a day. 

Cod-liver oil increases th^p red corpuscles of the blood, 
because it is digested by tlie liver, and the product en¬ 
ters into them as an ingredient. The irritability of the 
stomach may make it troublesome to take, but it 
should be relied upon as much as in the treatment of 
phthisis. 

TO COMBAT THE pISEASE ITSELF. 

We have one agent which may be regarded as a spe¬ 
cific against increase of connective tissue in the body, 
wherever the interstitial inflammation may occur, and 
that is the bichloride of mercury. It should be given in 
small doses, one-twentieth of-a grain is the usual size, 
and should be combined with a diuretic to make it 
act upon the kidney. For example, one-twentieth of 
a grain of the bichloride, one grain of digitalis, and 
one grain of quinine may be given three times a day, 
with the result of producing a ^specific action upon the 
kidneys, and will raise the specific gravity of the 
urine. \ 

ATTENTION TO THE CONDITION OP THE SKIN 

will materially assist the embarrassed kidneys, and to 
do this we may have recourse to two things. If ex¬ 
cessive oedema is present, the pressure produced shuts 
oft the circulation to a great extent and prevents 
removal*of the fluid by diaphoresis. It is much bet¬ 
ter then to make punctures in the distended skin of 
the legs, and let the water drain away at once. No 
apprehension need be bad with Reference to this tri¬ 
fling operation, if the limb, when the punctures have 
been made, is wrapped with cloths wet in a solution 
of carbolic acid in water, to which has been added 
essence or oil of cinnamon. The latter is to correct the 
smell of the carbolic, and is also equally antiseptic. 

The second thing is, to rub the patient all over once 
a day with sweet oil. If extra diaphoresis is desirable, 
it can be best obtained by placing a blanket in an 
empty bucket, pouring hot water upon it, for in this 
way much less water is required, and then wringing it 
out and quickly applying it around the body and cov¬ 
ering it with a dry blanket. The skin should be well 
oiled before the blanket is applied. 

Such was a brief outline of the general treatment 
for this class of cases, and may be suggestive in cer¬ 
tain particulars. 

\ 

PROGRESSIVE MUSCULAR ATROPHY. 


The interest in this case was the limitation of the 
atrophy, for it affected chiefly, almost exclusively, the 
extensor muscles of the thigh. There had been sim¬ 
ply a gradually increasing weakness of these muscles 
going on during the past thirteen months without loss 
of sensibility or pain. The thigh affected, the right 
one, measured 17-J in. in circumference, while the unaf¬ 
fected thigh measured 19| in. Below the knee the mus¬ 
cles seemed very good. There was no evidence that the 
man had ever suffered from disease of the spinal cord, 
unless the present condition is regarded as due to some 
degeneration of the anterior horns, but there was no 
evidence of pre-existing meningitis, myelitis, etc., nor 
had there been any tremor or peculiar pain. There 



































200 


SCHOOL HYGIENE. 


/ 

The curvature of the spine occasioned was mostly to the right, caused 
no doubt, largely by writing at unsuitable desks. The excess among 
girls is due, no doubt, very much to the fact that they take less active 
exercise and are much less robust, as a rule. Herr Raag, of Berlin, 
says that he has found gymnastics very useful in preventing these spinal 
curvatures. With practical benefits resulting from these exercises, the 
lectures on hygiene, etc., will have much greater force than otherwise. 

For proper school gymnastics it is only requisite that there should 
be space enough about the desks to enable the pupil to advance one 
step and to swing the arms freely. A large hall with a few desirable 
pieces of apparatus, is all that is needed for further gymnastic exercise 
which is to give to the scholars special accomplishments in this matter. 
In Europe halls are now considered absolutely necessary for the uses of 
scholars in the public schools. 


EFFECTS OF SCHOOL LIFE UPON THE EYES OF SCHOOL CHILDREN. 

By Dr. C. R. Agnew. 

This paper was read by Dr. Webster, a co-worker of Dr. Agnew, 
and illustrated by diagrams. 

Dr. Agnew states, that Herman Cohn, of Breslau, published in 
1867 the results of observations made upon the eyes of 10,060 school 
children. He established the fact that school life in his country was 
damaging the eyes of scholars to a most alarming degree. He was 
followed by Erismann, of St. Petersburg, and others who showed that 
elsewhere the same results were being produced. The broad fact was 
evidently demonstrated, that wherever children were brought under 
observation, and the effects of the use of their eyes upon minute ob¬ 
jects carefully noted, nearsightedness, a grave malady , was found to 
exist. That this malady was found less frequently and then generally 
only in a mild form, in young children, but that it increased rapidly in 
frequency and gravity, as these children were pushed forward in their 
education from the lowest to the highest schools. Cohn, for example, 
found that the nearsightedness rate in village schools was less than 2 
per cent, that it had increased, however, to more than 26 per cent, in 
the gymnasium (schools about of the grade of most of our colleges in 
the United States) and that in the Breslau University, out of 410 
students examined not one-third had normal eyes. 

Observations were recently made upon 2,884 eyes in this country. 
The plan followed is essentially that of Cohn, so that the results might 
be compared with those of so industrious and careful an observer. 
The sources from which the data have been drawn are the district, 
intermediate, normal and high schools of Cinci nnati , Ohio (the ex¬ 
aminations made by Drs. D. B. WilliamiTlm3~Xyers), from the 
Polytechnic School in Broo klyn, N. Y. (examinations by Dr. J. S. 
Prout and Dr. ArthurTlatReWsoh), and from the New York College, 
New Y ork (examinations by Dr. W. Cheatham). 

Thelotiowing is a summary of tables accompanying this paper : 
In the Cincinnati schools ? the number of eyes examined was 1,264. In 
the district schools J L^Sl^n er cent, of the scholars were near-sighted. 
In the intermediate schools lOTwere near-sighted, and in the normal 
















V 



done; but a strong sentiment against such injudicious methods is ob¬ 
served to be springing up in the minds of teachers. 

“ Fifth. The amount of study required has not often been found 
so great as would harm scholars whose health is otherwise well cared 
for. 


“ Sixth. Teachers who neglect exercise and the rules of health, seem 
to be almost certain to become sickly or to 4 break down. 5 

“ Seventh. Gymnastics are peculiarly needed by girls in large cities, 
but with the present fashion of dress, gymnastics are impracticable for 
larger girls. 

66 Eighth. The health of girls at the period of the development of 
the menstrual function ought to be watched over with unusual care by 
persons possessed of tact, good judgment, and a personal knowledge of 
their characters. 




u Ninth. One of the greatest sources of harm is found in circum¬ 
stances lying outside of school life. The social habits of many older 
children are equally inconsistent with good health and a good educa¬ 
tion. 55 



GYMNASTICS FOR SCHOOLS, BY DR. S. S. PUTNAM. 


Gymnastic training could not fail to be of use in regard 
to training children who were not naturally strong, and therefore not 
inclined to take part in outdoor sports, which are, of course, beneficial 
to the healthy and vigorous among our children. The benefits result¬ 
ing from systematic gymnastic training are, too, decidedly different 
from those accruing from ordinary outdoor sports. The former scien¬ 
tifically trains special groups of muscles and confers special benefits 
upon the bodily system. Skilled instructors are, of course, required, 
and Dr. Putnam maintained that the result of such training was to pro¬ 
mote general health, and to bestow special accomplishments. 

It is not necessary that very great muscular power should be de¬ 
veloped, as that is not necessarily conducive to good health, nor does it 
always accompany it. One way in which school children may be 
greatly benefited is by helping them perfect the process of respiration. 
This was demonstrated by the work done by Prof. Monroe with the 
children of the Boston schools. Good breathing is by no means com¬ 
mon, and the singing teacher has always much to accomplish in this 
respect. Instruction in this regard may not only give vastly increased 
power to healthy persons, but it may save many who are affected by 
lung disorders from early deaths. Dr. Putnam thought Prof. Monroe's 
little book the best treatise upon this subject, while most German and 
French works on gymnastics, are very deficient in this respect. For 
the exercise recommended by Prof. Monroe no apparatus is required, 
or special costume, and for walking and running a large empty room is. 
all that is needed. 

Proper physical instruction in our schools would also relate to the 
sitting of the scholars, to proper methods of studying or of mental ap¬ 
plication, to proper means of ventilation, etc. It is a notorious fact that 
many cases of injury to the spinal column arise from improper postures 
while sitting. Among 731 pupils at Neufchatel, sixty-two cases of this 
sort were observed among 350 boys, and 156 cases among 381 girls. 













SCHOOL HYGIENE. 


201 


and high schools 22.75 were near-sighted . In the academic department 
Of the Brooklyn Polytechnic 9.15 per cesnt. were near-sighted, while in 
the collegiate department of the same school, 21.83 were near-sighted. 
In the introductory class of the New York College 21.86 per cent, of 
the students were near-sighted ; of the freshmen, 26.2 per cent, were 
near-sighted, and of the sophomores 22.72. The summary of all h 

i T f* A A M 4 14 i. rt "* -1 - 


that, of 2,884 eyes examined, 1,886 eyes 

■■ rr niWinBB iiM it■ nmm- -*'”*""* / */ 


l refVacfioM. 338 

• - >* . - • : ? : • 


were^njeM^igfite^ 1 ^^?''were"oveivilghteil. ^id 152 astigmatlc*': 1 'and of 1 * 

irrir Ill I i II mr-T . . . ... I.,; ■■■ ■ iffl I Iifim ,,. _J 


^r"t!ie refraction was not noted. AcuitjToF"'vision: §,300 eyes had 
vision equal 1 ; 226 equal § ; 106 equal ^; 43 equal 2-5 ; 49 equal 
2-7; 40 equal 1-5 ; 28 equal to 3-40; 19 equal to 1-20 ; 8 able only to 
count fingers; 1 with no perception of light; 4 vision not noted. 


THE HEIGHTS AND WEIGHTS OF SCHOOL CHILDREN. 

Dr. Lincoln explained this subject on a plan prepared by Dr. H. 
I. Bowditch : 

“The object of ascertaining the heights and weights of the pupils in 
the public schools of Boston, is to determine the rate of growth of the 
human race, under the conditions which Boston presents. It is of course 
very d esirable, that similar observations should be made in other parts 
of the country in order to enlarge the number of data from which 
conclusions may be drawn. This country offers an excellent field for 
investigations of this sort, not only on account of the wide range of 
climatic conditions which it presents, but from the fact that the in¬ 
habitants are the immediate descendants of a good number of different 
races. I we can compare, therefore, the rate of growth of a race in 
their native land, with the rate of growth of the same race after immi¬ 
gration to this country, we shall be able to study the effect of trans¬ 
plantation into new climatic conditions ; and if we compare together the 
amount of change which the rate of growth of different races under¬ 
goes after immigration to this country, we shall have data for esti¬ 
mating the relative adaptability of the races in question to the new 
climate. Moreover, if it shall be found that the rate of growth of the 
female sex is more seriously modified by emigration than that of the 
male sex, light may be thrown on the question of the cause of the 
alleged inferiority of the physique of American women. As the value 
of observations of this sort depends entirely upon their accuracy, it is 
important that the height should be measured without shoes on rods 
graduated to one-tenth of an inch. The weight should be determined 
on scales weighing pounds and ounces, and allowance should be made 
for the weight of the clothing.” 


Dr. Lincoln then gave some drawings as to how desks should be 
arranged for school pupils, showing that they should be made so as to 
give as much comfort to the scholars as was possible, and at the same 
time make the position as healthy a one as can be secured. The seat 
should be close to the desk, and any desk so far from the seat as to 
allow the pupil to stand up between them is objectionable; and 
concluded his report with a brief paper, summarizing the Sanitary 
Requirements of School-houses . 











202 


SCHOOL HYGIENE. 


While we regret the want of space to also give an abstract of 
much instructive discussion on the subject of Dr. Lincoln’s report, 
enough has been given to satisfy the attentive reader, that more head¬ 
way may be made by contracting the scope of inquiry. Not that there 
is anything unnecessary in the ground laid out by the secretary, but 
that it is as utterly impracticable for him, as it is for any one else to 
select in advance , “ suitable persons for separate investigation and 
report ” on any subject, with a promise of getting reports that will be 
unquestionably acceptable. 

Mr. Eaton, United States Commissioner of Education at Washing¬ 
ton, D. C., said he was much interested in everything that pertains 
to the hygienic condition of schools, and especially in this subject.. 
In regard to ventilation, there is a difference of opinion of prominent 
gentlemen in the medical profession, and then what will suit one State 
in the matter of ventilation and heating will not suit another. The 
procuring of facts relative to these matters, he has considered a matter 
of great importance, and this he has in his office attempted to do. 

This view of Mr. Eaton applies to the whole category of subjects 
presented. A better way would be to select a number of suitable 
persons to investigate each single subject, and let it be the work of the 
section to elaborate from such reports the practical features, as far as 
may be, applicable to all. 

--- 

Amusing the Baby. —When the baby first opens its eyes, it is not 
uncommonly induced to gaze upon the light. “ Ze putty zed yight,” is 
supposed to be exquisitely amusing. Had it power to tell of the tor¬ 
ment thus inflicted, we should hear a very different story. And then it 
is jumped at, screamed at, tossed up into the air, and otherwise startled, 
until its nerves are disturbed beyond quieting without medicine. 

It is a subject of marvel to most people that so many children die 
in infancy, but to an observing mind the wonder is that any children 
live to maturity. When you and I feel miserable, we want to be left 
in quiet. Repose is the sweetest remedy for nervousness or other ills ; 
but baby is trotted, bounced, toted, “ ketchy-ketchied,” chucked under 
its chin, poked in its cheeks, or somebody’s thumb is thrust into its 
toothless mouth, irrespective of a need of ablution, and then if baby 
isn’t happy it is reputed very irritable. Tickling the baby’s feet, creep¬ 
ing the fingers like the motion of a mouse across its breast, and up into 
its fat, sensitive neck-wrinkles, is an another mode of amusing baby. 
Of course the child laughs, and the idiots who torment it forget that it 
is the same expression with which they reply to a similar process from 
the hand of some mischievous but torturing friend; and yet we all 
know that this laugh from a man is an hysterical outcry of nervous 
irritability. When the laugh ceases, weariness brings weeping, or per¬ 
haps a restless and unrefreshing sleep, followed by depression, and 
probably by indigestion and colic. 

Nothing should ever be done to startle a child—even a too frequent 
playing of bopeep, if violent, has been known to bring on St. Vitus’ 
dance. All suprises are dangerous to the nervous system, just as all 
sudden atmospheric or dietetic changes are very unhealthy, and some¬ 
times fatal. If music is selected to please the young child’s ears, it 
should be gentle and soothing. 





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it is of interest to recall a series of experiments 
made some years since by Sir John Herschel, at the Cape of Good Hope. 
Near the extremity of the cape, between*Table Bay on ’the one side and 
False Bay upon the other, is a sandy region known as the Cape Flats, upon 
which the sun pours down its rays without hindrance. Herschel’s attention 
having been attracted by the very high temperature which the surface soil 
of these fiats acquires under exposure to sunshine, he proceeded to make |l 
careful tliermometrical observations in the spring of 1887 (October and De¬ 
cember), and determined that the temperature of the sand and vegetable 
mould was often as high as 140° to lHtr, and ' 111 is lntlxe open field. “ When, 
however, the heat communicated tom IK'e sun 'is' conS'necl and prevented 
from escape, and’ ho forced to accumulate, very high feinpmi lures are at- 
" famed. Thus, in a small mahogany box, blackened inside, covered with 
window-glass fitted to the size, but without putty, and simply exposed per- 
'^encUcuiarly 16 tli o suns rays, an enclosed thermometer marked, on Novem- 

'November 24, 14G 5 ,150°, 152°, etc., etc. When san d 
was heaped round the box, to cut off the contact of cold air, the temperature 
rose, on DecemberU, to 177° ; and when the same box, with its enclosed 
thermometer, was established under an external frame of wood well sanded 
jup at the sides, and protected by a sheet of window-glass (in addition to that. 
of the box within), the temperatures attained on December 3 were, at 1.30 
P.M., 207° ; at 1.50 p.m., 217’5 a ; and at 2.44 P.M., 218°; and that with a 
steady breeze sweeping over the spot of exposure. Again, on December 5, 
under a similar form of exposure, temperatures were observed, at 0.19 P.M., 
of 224° ; at 0.29 P.M., 230°; at 1.15 p.m., 289°; at 1.57 p.m., 248°; and at 
2.57 P.M., 240.5°. As these temperatures far surpass that of Lolling water, 
some amusing experiments were made by exposing eggs, fruit, meat, etc., in 
the same manner (December 21, 1887, et seqT), all of which, after a moder¬ 
ate length of exposure, were found perfectly cooked—the eggs being ren- 
dered hard and powdery to the centre ; and on one occasion a very respect¬ 
able stew of meat and vegetables was prepa red , and eat en w ith ho small 
r elish by the entert ained bystanders. I doubt not that by multiplying the 


enclosing vessels, constructing them of copper blackened inside, insulating 
them from contact with each other by charcoal supports, surrounding the 
exterior one with cotton, and burying it so surrounded in dry sand, a tem¬ 
perature approaching to ignition might readily be commanded without the 
use of lenses.” 


































life and personal character of Louis Philippe. Since 
Queen Marie-Arnelie there have been published portions of a series of letters 
fsom the king to his sister, Madame Adelaide, which escaped the grasp of M. 
Taschereau in 1848. They extend from 1839 to 1845, and embrace all sorts 
of topics, from his first impressions of Lord Palmerston’s Eastern policy to 
the minutest particulars of his domestic life. They are written without any 
constraint to this sister, who exercised such a powerful influence on him, 
and are mere off-hand and familiar talk. We see here all the anxiety of this 
citizen-king, this “ commis-voyageur de la maison Orleans,” as Heine called 
him, for the welfare and safety of his children and grandchildren; his 
Itroubles during the illness of the Comte de Paris, who would be very hungry 
and cry for “ souffle his annoyances caused by the gardeners at St. Cloud 
and the architects at Fontainebleau. He tells of his arrangements for a 
(review, in which he speaks of his desire of pleasing “ ce bon Cass,” as he 
styles the American minister ; and of the suitors who come for the hand of 
the Princesse Clementine, whom he nicknames Clem. We hope the whole 
I of the letters will be published, as they are valuable illustrations of the 
peculiarities and foibles of a king whose motto was “Never mind.” 

—The great work of Dr. Bastlan, “The Nations of Eastern Asia—Studies 
and Travels,” will soon be published in five volumes. The first volume will 
[bear the title of “ The History of the. Indo-Chinese,” and is based on their 
historical books and oral traditions. The author is trying to fill a void that 
has existed already too long, and has availed himself of a long stay in 
Further India to collect materials, both written and oral. The second, third, 
[and fourth volumes will contain the journal of his travels in Burma in 1864, 
[his residence in Siam and travels in Cambodia and Cochin China in 1863, 
[and his journey through the Archipelago to Japan and China, and by the 
[overland route from Pekin through Mongolia and Siberia to the Caucasus in 
[1864-5. To illustrate the literature of the nations of Eastern Asia, transla¬ 
tions of their poems, romances, and fables will be given. In the last volume 
[the author purposes to show the present state of Buddhism as it exists in 
South-eastern Asia, and as he saw it in his intercourse with the monks, and 
| a comparison of it with Foisin and Lamaism. 

—One of the best Hebrew scholars of Europe has just died, Dr. Hupfeld, 
rofessor in the University of Halle. He w T as born at Marburg, in 1796, and 




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THE RELATIONS BETWEEN HUMAN MORTALITY 
AND THE SEASONS OF THE YEAR. 


At the anniversary meeting of the Scottish Meteorological Society, 
a very valuable paper was read bv J)r. A uthor. Mitc hell and the 
Secretary, Mr. Alex. B uchan , giving an account of their investiga¬ 
tions on the subject of EBe influence of the seasons on human mor¬ 
tality at different ages as caused by different diseases. The authors 
have calculated the weekly average^_deathV^e of frondnn for the 
past thirty years for thirty-pne diseases, together with the averages 
of temperature, moisture, rain, etc. Considering the weather ex¬ 
perienced in the course of the year as made up of several distinct 
climates differing from each other according to the prevailing tem¬ 
perature and moisture, and their relations to each other, the in¬ 
fluence of these climates, characterized respectively by cold, cold 
and dryness, dryness and heat, heat, heat and moisture, and cold 
and moisture, on the mortality was pointed out. The weekly mdr^~\ 
tality from all causes and at all ages shows a large excess above the 
average from the middle of November to the middle of April, from 
which it falls to the minimum in the end of May ; it then slowly 
rises, and on the third week of July shoots suddenly up almost to 
the maximum of the year, at which it remains till the second week 
of August, and thence falls as rapidly as it rose to a secondary min¬ 
imum in October. Regarding the summer excess in the death-rate, 
which is so abrupt in its rise and fall, it was shown that it is 
wholly due to one section of the population, viz., infants under five 
years of age, none of the curves for the other ages showing an ex¬ 
cess in the death-rate from all causes during the summer months; 
and it was further shown that the summer excess is due not only to 

the deaths at one age, but to the deaths from one class of diseases,_ 

viz., bowel ‘complaints. The importance of weekly averages in dis¬ 
cussing these sudden fluctuations of the death-rate to the changes of 
the weather was pointedly referred to. Deducting the deaths from 
bowel complaints from the deaths from all causes, the curve assumes 
a simple form, viz., an excess in the cold months and a deficiency in 
the warm months. In other words, the curve of mortality is dictated 
by the large number of deaths from diseases of the respiratory or- ' ve¬ 
gans. The curve of mortality in London, has thus an inverse rela^ 
tion to the temperature, rising as the temperature falls, and falling j 
as the temperature rises. On the other hand, in Victoria, Australia, 
the curves of mortality and temperature are directly related to each 
other mortality and temperature rising and falling together. The 
character of the curve of mortality in Victoria is impressed on it by ( 
the deaths of persons below the age of five ; and among such young 
persons the special diseases which determine this influence are 
diarrhoea and dysentery. This peculiarity arises from its higher 
mean temperature, 57°’6, as compared with that of London, 50 o *0 o 






O 

Character of Weather. 
Cold 

Cold and dry 

Warm and dry 
Warm and moist 
Cold and moist 


In London also during the hottest months of the year the curves of 
mortality and temperature rise and fall together, whereas in Vic¬ 
toria the curves are throughout the whole year directly related ; 
for though doubtless the deaths from diseases of the respiratory or¬ 
gans fall as the temperature rises, and rise as the temperature falls, 
yet the number of deaths from these diseases is, owing to the com¬ 
paratively high winter temperature, never sufficiently large to in¬ 
fluence the curve of the whole death-rate. The curves of mortality 
for bronchitis and pneumonia at different ages, prove that the fluc¬ 
tuation is much less for pneumonia than for bronchitis, and that the 
excess in both cases of infant mortality is great, but not nearly so 
great as the infant mortality for diarrhoea. The curves show that 
the maximum mortality from the different diseases group around 
certain specific conditions of temperature and moisture combined, 
the general result of which, as regards the principal diseases, may be 
thus roughly stated :— 

Maximum Mortality. 

Bronchitis, pneumonia, asthma, etc. 
Brain-disease, convulsions, whooping- 

cough __ 

Suicides, small-pox 
Diarrhoea, dysentery, cholera 
Rheumatism, heart-disease, diptheria, 
scarlatina, measles, croup. 

The deaths from cancer and liver disease show no distinct relation 
to weather. The period of the year least marked by the occurrence 
of maximum mortality from any disease, is the warm dry weather 
which prevails from the middle of May to the end of June. At this 
season the only maximum is a well-pronounced secondary maximum 
for measles ; and the maxima for stiicides and small-pox, which are, 
however, extended from the middle of April into these months. Con¬ 
vulsions, teething, and atrophy and debility have a secondary max¬ 
imum in the warm moist weather of July and August. In the 
United States, where the heat is greater in summer, the secondary 
maximum for convulsions is more distinctly marked than that of 
London; and in Victoria the summer maximum is the only one that 
appears. The contrast offered by certain curves to each other in all 
points is very striking. Thus the curve for whooping-cough begins 
to rise above its average in the middle of December, attains its max¬ 
imum in March and April, and falls to the minimum in September 
and October, while the curve for scarlatina is exactly the reverse of 
all this, having its minimum in spring and its maximum in autumn. 
It was inferred from the general teaching of the curves, that if "aT 
curve representing the progress of the death-rate from a particular 
disease were given for a place whose climate was known, though it 
might be impossible to name the exact disease, it would be possible 
to say with a considerable degree of certainty whether, for instance, 
the nervous system, or the respiratory organs, or the abdominal 
organs were involved in the disorder which caused the deaths.— . 
Nature , July 16, 1874. 


























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VFir^r BRINGS DEATH INTO THE CA 

Dr. Woodward, of the Surgeon-General*a 
bureau, at Washington, has made a brief report 
on some of the more important facts concerning 
the influence of season and region on the camp 
diseases of the army. It refers to the first year 
of the war, ending June 30, 1882, the statistics 
of that year being all that are yet reduced into 
publishable form. From this brief but interest¬ 
ing precursor of the great work in course of com¬ 
pilation we learn a number of facts of high im¬ 
portance, and worthy of .general attejitjon. 

The general mortality rate of the armies of the 
United States during the first year of the Re¬ 
bellion,’was 67*6 per thousand of the average 
strength of those armies for that year. This 
rate includes deaths from wounds and injuries, 
as well as from disease. The mortality from dis¬ 
ease alone was 50*4 per thousand; from wounds 
and injuries, 17*2 per thousand. Very few per¬ 
sons would have believed that three of our sol¬ 
diers die of disease for every one killed in 
battle. 

The results from disease alone are contrasted 
with the annual mortality rates in the United 
States army at other periods, and with those of the 
British army during the Crimean war. During 
eighteen years of peace in our army the rate was 24 
per thousand; in the Mexican war it was 103-8 per 
thousand; in the British army during the Cri¬ 
mean war it was 232 per thousand, and in the 
British army in 1859, during peace, it was but 9 
per thousand. From this it appears that, although 
the mortality rate of our army from disease alone 
during the first year of the war, was much greater 
than that of our own army or the British army 
in time of peace, it was far less than that of either 
of those armies during the Mexican and Crimean 
wars. 

Dr. Woodward’s little pamphlet is illustrated 
by diagrams and tables, which present the whole 
subject of disease in the army, comparatively, by 
season and region , at a single glance. To enable 
him to make these instructive comparisons he has 
considered the armies of the United States as 
consolidated in three great divisions. The first 
consists of troops operating on the Atlantic coast 
between the Apalachia n range and the sea, thus 
including the Army of the Potomac and the coast 
expeditions; the second consists of the troops 
operating in the Central basin of the .Continent, 
between the Apalachian range and the Rocky 
Mountains, including Western Virginia, Ken¬ 
tucky, Tennessee, Missouri, Kansas, &c.; and 
the third consists of the troops on ti^e Pacific 
slope. In the first, or Atlantic division , the i por - 
tality rate f rom disea se alone was 33-40 p e r thou - 
sand; in the sec ond^ or Central divis ion, it was 
82*19 per thousand; and in the third, or Pacific 
chVision, it was 10*76 per thousand - .* 'Thus it will 
be seen that the mortality from disease was two- 
and-a-half times as great in the Central region as 
in the Atlantic region, and three times as great 
in the latter as in the Pacific region. 

These results demonstrate the superior health- 
fulness of the Pacific slope, for the mortality 
there is much less than was ever known in the 
whole United States army in time of peace; and 
they at the same time shew that the greater mor¬ 
tality of the central region over the Atlantic re¬ 
gion have a close relation to tl^..jna|iyjnns ftjjs. 
easesjwhich prevail in the valley of the Missis- 
tributaries. In our armies in the 
division these diseases develope them- 


"and its 


sippi 

central 

selves in the prevalence of camp fever, intermit¬ 
tent fever and diarrhoea. 

The taVies and diagrams presented by Dr. 
Woodward not only show these strong |con- 
trasts of the annual mortality rate from disease 
in our armies according to locality, but they ex¬ 
hibit comparisons as clearly according to seasons. 
But the subject is too broad to be considered 
further in a brief notice like this. Our only pur¬ 
pose in making it is to lay before the public one 
or two Of the principal points, as we have done 
above, and to note the fact that an elaborate 
work is in preparation that will have a profound 
interest for the professional world and for the 
public at large. 























to 


- AT THE BBEAKWAxT? 


Westertfyke Z ^L ISt?*® * £ 0; . b T ri ^ 8 Thos ‘ Walters, 
m* \ rS w ’ ot. Kitts, Jauretcbe A Lavergne: Laowuii? 

J? r i ) £ r ^mer, Pernambuco, John Mason A Co • «S™’ 

Wellfleet,KoWe“cald W eU *c£ 

T^io-hfcl 61, B J 1 I 7 OU 8 5 ; a ’ Boston, Repp Her A Bros J.s! 

bins h BostoiT’c '¥ n &J5t»i, Qm S l r? ia? i* H. Sharp, Rob- 

Braintree, ckstafr*, Sttekney/&VeVS?^ £ r | e S’ 

inK n i i’£ raff £ c ®» A * Corson, Tunnell, Waah- 
Souder aV^^ «X 5 P-i>$tF^ia Maria,Norwood, Lynn,E. A. 
KntKht • H?awi^ h 5 ch ’ p ort Royal Curtis A 

Cn. T«™ii I 8^ atha ’ T ;Dl i ne J r ji Salisbury* C. F. Norton A 
Co, JaniesM 4 gee,LyrifeR, Georgetown, J. R. Tomlinson; 

fef w. 8 A 8 tei fc, Boston, John Street; Mary Tice, 

ChkiviJ* 1 y&tLlSP?' £ tone * Co; W Kennedy 
i»« V?°\?°A Sjl^ester Gessner, Thompson. Annano^ 

Star* do do“Xa be iBicknp, Alexandjfi. R| <5ffiS£ 

r 1 do * Marv d H* Smfe I 1 5 r * w ’ Pe *®rs<m, Fortress Monroe, 
oo, Mary H . Banks, Marts, do. do; John Rocers Tvier 

S° 8 hr! vat^T^ er ® w 5 n ? ? ose ’ Sassafras River, Captain; j! 
s * Stiver, Dennis, Baltimore, A. Groves, Jr. ’ 

—. _ .memoranda. r 

«« er * San Francisco 24th June, for 

«i on A w £ s 8< £ n 30th ult - off Kan tucket. ’ 

tort, for Pbii.idSph& Conkllo > cleare « «* * »rk M 

H T*i or A t j t j . _ 


- - Philadelphia! 

E??S S mm S» Baker, hence at Boston 2d last. 

«t Ciento?go^3d°uil *• fBr,) *" PhUadelpllla > ™> loading 

t Sarah Cullen, Cullen; Abicail Halev fTftidv • 

Va^Dusen D cfl’rrf iCe ’ jr H *M^re, Nickerson’; Maggie 

YSung Ymin/T S 5 SEL& ? at f ers ? 11 ’ Alex. 

Hiab • AnS ^o’r^„ii‘ $ urnt ? t ’ Poland; Robt. Corson, 

and w - G * Audeuri ^ 
Phil^etohil? We111 Iloyt * cleared at Boston, 2d inst. for 

hentlt^aS VaShtl Sharp ’ Haley ’ 

Sep? r P * Sticknej ' G »rwood, hence at Fall River 28th 
Sep^!* 1 ” ^ ori k Baclflc, Marcy, hence at Providence 30th 

8aUed Providence, 

port^mfuitf 8 H ’ Bogers ’ Lan S Ie F. hence atNewbury- 
^hra'nrtSL^ rse ’ B? n *° n » hence at Taunton 28th ult. 

de.pM^s ss?saa ssr*" - ^ forpbiia - 

delphiataUNowpokMto u"l’ ft0 “ Pr0V,dence fotPM »- 

nivwfirt 0< ;y‘'™<> r . Fletcher, and New Zealand. Perham 
SeSf.y r Edgaitown 26th ult. ’ 1 

wfch^M n A.fadSpSS sailed Green- 


jnrosic,^ dA jycjnv^ & c . 

I j. s/miet ee/t^ og ^raMfoTaw 

B allad singing.—me. bishop will repptvp 

Pupae, Oct 5t h, No. 1632 FILBERT M WeL 

C*No 14^4 Ra’cf^S??? ° F PIA 1 5 0 an B VIOLIN, 
_ y JIO. 14 24 RACE street, has re sumed his lessons. 

E Tp THOEBECKE, TEACHER OF TTTF pt a xta 

lfc orte ’ ilo - lii “‘ !toE «s? "ajSV^Si 
N 0 »& c ^,S T Wd HoVk 1 ! 1 

Principal. Third annual term now opened. ° W E K ’ 

©IGNOR CORTESI WILL RESDAfE THE SINGING 
^ Bessons on toe 15th inst., and the Clis for bSSneS 
i on ^ st oi October. Residence, No. 1008 WALNUT St. 


be] 

Gi 


I • w*/-v COLDSBOROUGH, ORGANIST AND 

U^ Piamst (Orcanist 01 St. Paul’s), Third mid Walimt 

BSromS’ removed from No. 717 Arch to No. '2101 

c0rner of hall 

[yyANCING, ETIQUETTE, EXERCISES IN PHYm- 

I Mrs C BEEPH°wtn ent ’ Ele » ance of Deportment, Ac. 
ii.«n rs ‘ BEECH will reopen her academy at the eletrant 

IrSrV a? m \ 8, E *o COrae / of BROAD and SPRTNcf GAR- 
IDEN Streets, on Saturday, the 19th, where «*a v-dHn 

1 Keaso^ d rm^? wLVn® T W an 3 fa ' hi °nable danoeVof 
|meseagon. Days Wednesdays and Saturdays, at 3 o’clock 

P - M * Beferencts*from the%rsfc 'families in t^e city 


Thia 

any] 

Iliii 

catij 

F. 


, M C. CAMPBELL’S DANCING, CLASSES, WAS& 
[8treet. gt0nHal * entrance, No. 810 SPRING GARDEN 

All the fashionable dances In one course of lessons 
Ladies meet Wednesday, 3 to 5; Friday, 7tol0 3 * 

ChSd?S e ^rL ue3d ^ y ’ *' ri $ a J <wid Satu&ay evening 
ChUdren, Wednesday and Saturday, 3 to 5. 

Stage Dancmg taught rudimentallv-. 

Private lessons at hours not occupied by classes. 
Sgireesevery T uesday and Sat urday evenings? * 

sch OOL.—MADAME EG ERIE 
U ,BE MARiIN, aware that many parents obieet to 
pieir children attending public danc^ academic wfn 
Jpen Private Classes at her residence N*o IS^SPrVtof 

rd2itt’^^^°? t0ber Sth'wferevisitfrs^e^t 

'leportoenl 1 ^ HglVe eveiy atteniion to dancing and 

' CLASSES, DAYS AND HOURS 

f For yoimg Ladies and Masters, on Mondays Wednes- 

fen?&2S 1 £L1!S*&$ife w i„ s . 

fcS ESSi » teachl al ‘ th ° & 

ft°^I d I adies ’ Wi ^ Parents or friends, like to learn anv 

ra e hf m Para,0ly - MmC- Marti “ m * ke arraaSSl 

ar Circulars, appl y to Ma dame Martin *8 residence. 

^WI«s 7 ~T<WPEE^&i; ^ 

fCKMAN’S UNRIVALED VENTILATING wtoq 
\ a T^,i^ u Pf. es ’Bodies’Long Hair Braids, Half Wigs 
s, Bands, Ac., cheap. No . 024 CHESNUj 1 Street. 8 ’ 


l DI ES_’ HAIR BRAIDS, WIGS AND CURLS OF 
fevery description. A large assortmen t on han d at the 
[est possible prices. M. HUTOIS, No. 213 S. NINTH 


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