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THE BEST RECONSTRUCTIVE 

PHILLIPS 5 

PHOSPHO-MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE GHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol. XIV. MAY 19 09. No. 1. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

j PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mail Matter. 


Panopepton 

In Refractory Cases 

T O use Panopepton in a case that has been proving refractory to both treat- 
ment and management is often to bring about an immediate change for 
the better in all the conditions — especially where there has been difficulty 
iri getting nourishment adapted to the taste and toleration of the patient. 

Panopepton is well designed to meet the essential desiderata of a food for 
the sick— in agreeability, assimilability, and substantial peculiar nutritive value. 
It presents, in a form ready for absorption, the entire nutritious substance of 
beef and wheat — is a complete solution of all the nutrient, savory and stimulant 
nitrogenous and inorganic constituents of these typical foods. 

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ble solids, with a “nutritive balance ” of one of proteids to two of carbohydrates. 
There is absolutely no cane sugar in Panopepton, nor any chemical preservative. 

Panopepton may be used alone, gradually supplemented with other suita- 
ble foods, until finally ordinary forms of nourishment are again available. 
When digestion is much impaired, it is sometimes given to advantage combined 
with Fairchild’s Essence of Pepsine — equal parts. 

FAIRCHILD BROS. & FOSTER 

New York 


1 ' 

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Effervescent Tablet, nf {aSSKASS? gram. 

Uric acid Solvent, alkaline urinary antiseptic. 

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Where Cyrtogen is indicated, Litbia is of advantage; 
Where Lithia s prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

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Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablet?) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 


SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 


Professor Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectnm, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Reot&l Dept., St. Joseph’s Hospital. 
Surgeon to L. & N. R. R. 


Quiz Master Theory and Practloe of Medlclna, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this clasB of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. G. and MAX HENNING, 

Long Distance Telephone 478. 13 8. Main 8t., MEMPHIS, TENN. 

JV-Dnring the session of the Memphis Hospital Medical Collage from November to April, 
all charity calet of Surgical or Rectal Diseases will be treated Free of Charge— the patient 
paying his board, S10.00 per week. 


MISSISSIPPI IEIIGIL MONTHLT 


Vol. XIV. MAY 1909. 


No. 1 


PRESIDENT’S ADDRESS. 


J. W. GRAY, 

CLARKSDALE. 


Members of the Mississippi State Medical Association ; Ladies 
and Gentlemen : 

Since our official program seems to be well filled with 
the strong meat of science, as much as you will probably care 
to attempt to digest, 1 deem it wise to offer you, instead of an 
annual “oration”, a simple statement of the condition of the 
Association, and such suggestions as appear to me may per- 
haps be helpful in promoting its power and usefulness. 

The report of the secretary shows that two new societies 
have been organized and fifty-three new members have been 
added to our rolls, and, while this is the largest increase in 
the history of the Association, it does not reach the goal of 
“twenty-five per cent, increase in membership and fifty per cent, 
increase in interest” set in the beginning of this administra- 
tion. Still it is extremely gratifying, and I desire to thank the 
councilors and county secretaries for the earnest efforts they 
have put forth for the good of the Association. 

The increase of forty-seven per cent, in the contributions 
to the program by actual members of the Association is a strik- 
ing evidence of the increased interest, and, in the name of 
the Association, I desire to express my sincere appreciation 
to the chairmen of the sections for their faithful and some- 
times strenuous work in carrying forward the first movement 
to hold an “All-Mississippian” meeting of the Mississippi State 
Medical Association. 

I cannot refrain from bringing to the attention of the 
Association the very valuable work which has been done by 
the State Board of Health during the past year. The very 
high standard of qualifications required of licentiates to prac- 
tice medicine promises much good to the people, and to the 
profession. The immense public interest being aroused through 
the efforts of the board in matters of hygiene and public sani- 
tation is really remarkable, the more especially when we re- 

l 


. * 1 ? lJ 


2 


member the very niggardly and grossly inadequate appropria- 
tion at the disposal of the board. Since “ mens sana, in sano 
cor pore” in the individual is the most valuable asset of the 
State, an appropriation of fifty times the present amount would 
seem much the wiser policy. 

The medical profession is regarded as the final authority 
in matters of hygiene and sanitation, and it is proper that it 
should have a larger influence in the making of the laws gov- 
erning these problems. 

The Committee on Public Policy and Legislation has re- 
ceived but scant courtesy at the hands of the law makers. 

I believe this lack of consideration shown to the views of 
the profession is due to the fact that usually we have begun 
our agitation for reforms too late. 

Any candidate is much more susceptible to reason and 
proper influence before the election than after he is safely 
seated. I very earnestly recommend that the Committee on 
Public Policy and Legislation be appointed for a period of five 
years, the terms of no two members to end the same year, and 
that an auxiliary committee be formed, consisting of one mem- 
ber from each county society in the state. That the duties of 
the regular committee be the same as now, and after the 
policy and legislation desired shall have been decided upon and 
outlined, the conclusions shall be communicated to each county 
member, and by him presented to the various candidates for 
Senate and House, and pledges of support secured. The united 
strength of organized medicine in the state is a force which, if 
properly used, at the psychological time, will cause a would-be 
Solon to awaken to reason. The determined, insistent purpose 
and action of our profession can put any just law we want 
upon our statute books. Since the vigorous discharge of the 
duties of the chairman of the committee under this program 
would entail much labor and expense, 1 recommend that a liberal 
appropriation for clerical expenses be made to him, especially 
during the year of a general election. 

While it is true that “no organization can live or grow 
that is occupied exclusively with the question of maintaining 
its own existence”, it is equally true that no organization can 
prosper that does not protect its own members. The increasing 
number of black-mailing mal practice suits against physicians 
suggests the necessity of this Association adopting some plan 
of co-operative medical defense. The prevailing impression has 
been that mal practice suits are more numerous in the larger 
cities, and that we of Mississippi, having few large cities, do 
not need such means of protection. The experience of other 


3 


states shows conclusively that this is not true, but, on the 
contrary, such suits are much more frequent in the rural dis- 
tricts. 

While such a step may seem to be in advance of the needs 
of the present, I am fairly convinced that it is time to begin 
its serious consideration, for the reason that such suits are 
increasing, and for the further reason that practical insurance 
of defense, for such a small sum as would be necessary, would 
make the Association more attractive to the physicians of the 
state and aid materially in keeping up the membership, and in- 
suring the prompt collection of dues. 

An attorney, regularly retained, could be of great service 
to the Association. He could examine and report upon the 
laws of the other states governing sanitation and hygiene, and 
bring to the attention of the legislature what other states are 
doing and, comparatvely, how little our state is doing. He 
could act as the official spokesman of the Association before 
all legislative committees, and, being on the ground, could ac- 
complish much which our committee could not ; at the same 
time he would become a specialist in that branch of jurispru- 
dence governing the relations between physician and patient, 
and be ever ready and competent to advise upon all questions of 
law of interest to the doctor. 

“Greater love hath no man than this, that a man lay down 
his life for his friend.” 

The world, the nation, but more especially the south, owe 
a debt money can never pay to that soldier volunteer who first 
allowed himself to be inoculated from a yellow-fever iufected 
mosquito and by that act enabled science to take the first 
rational step to tight back the yellow-fever scourge from our 
Southland. 

I understand that the aged mother, the wife and the seven 
little children of that man are in want. 

As some evidence of our appreciation of such heroism, I 
earnestly recommend that the Association appropriate not less 
than one hundred dollars to the widow of Dr. James Carroll. 

I had intended not to bore you with listening to my re- 
marks to-night, but to read my address by title oulv, and then, 
as our congressional bi’ethren do, ask leave to print. But 
a friend suggested that such a course would do too great vio- 
lence to precedents. However, as I am afraid I am about to 
commit an assault and battery on precedents, as well as some 
other hoary notions, I do not think it would have been of any 
great moment. 

Our constitution recites that the president shall be the 


4 


l’eal head of the profession of the state during his term of 
office, and, as such, I consider it my duty, as it will be my 
pleasure, to tell you a few plain truths about yourselves. 

As individual physicians, in your relations to your pa- 
tients, no nobler, kinder nor more charitable men ornament 
the earth. But, as an organization, and in the discharge of your 
civic duties, you have been stung by the tse tse fly,, and a 
curative serum must soon be found, or you will sleep your 
lives away. The purposes of this organization, among others, 
are to aid in the “Enactment and enforcement of just medical 

laws and in the enlightenment and direction of public 

opinion in regard to the great problems of state medicine, so 
that the profession shall become more honorable and capable 
within itself, and more useful to the public in the prevention 
and cure of disease”. 

And how are we discharging these sacred duties? By meet- 
ing in annual session, giving birth to most commendable and 
altruistic resolutions and memorializing the legislature! 

What has become of the movement to establish a State 
Bacteriological Laboratory, by the aid of which we hoped to 
educate our people, and check the decimation from preventable 
diseases? We met in annual session, memorialized the legis- 
lature, and then — went to sleep ! 

Where is the effort to establish a department of vital stat- 
istics, than which no measure can be of more far-reaching ben- 
efit? We memorialized the legislature, and then — went to sleep ! 

Where is the pure food law, the absence of which from our 
statute books is a disgrace to the state, and an ignominious con- 
fession of our impotence when opposed by the puny strength 
of cowardly greed? We memorialized the legislature, and — 
went to sleep ! 

What has become of the great central state charity hos- 
pital that we spent the whole of a session of the Association 
in recommending? We memorialized the legislature, and — 
went to sleep ! 

In our efforts to raise the standard of medical education 
by requiring that all applicants to the State Board of Health 
for license to practice medicine shall be graduates of some 
reputable medical college, we memorialized the legislature, and 
then — went to sleep ! 

In our wholesome zeal to rescue the State Board of Health 
from partisan politics by making all of its members elective by 
this Association, we worked ourselves into a frenzy, appointed 
a special committee to — memorialize the legislature, and then — 
went to sleep! 


5 


In the limbo of unaccomplished things, we may find many 
measures of great importance to the state, and to the pro- 
fession, that were pressed forward with fine enthusiasm ; that 
were discussed and earnestly recommended by the Association, 
and then, we memorialized the legislature— and went to sleep! 

Gentlemen, periodic paroxysms of per-fervid oratory and 
spasmodic attacks of strenuous travail have never yet accom- 
plished useful results. We may memorialize the legislature 
until the end of time, and, unless we put some force behind the 
memorial, we shall continue to be treated with the paltry con- 
sideration we have always received. 

The physicians composing the Mississippi State Medical 
Association are honest, faithful and conscientious, and justly 
enjoy the esteem and confidence of the laity. We have the 
power, through our votes and influence, to elect or defeat any 
candidate for any office within the gift of the people; and the 
only reason we do not control the policy of the state in matters 
relating to our profession is because we do not use our power 
rightly. The average politician is an exceedingly discerning 
individual, and once he sees we intend to lay aside our petty 
jealousies and partisan politics, and propose to throw the whole 
might of an active militant organization for the man who de- 
clares himself in favor of just medical-practice laws, and 
modern sanitary regulations, he will quickly “see a great white 
light”, and we then will not need to “memorialize the legis- 
lature”. 


SfltMg TrrrcfcEiltngs. 


Harrison County Medical Society held a regular meeting- 
in Gulfport in the rooms of the Commercial Union, April 20th. 
Those present were: Drs. Lebaron, West, Sheely, Richardson, 
Mohler, Strange, Henry, Folkes, Hopper, Rainold and Ander- 
son. I)r. Folkes, our delegate to the State Association, made 
a report on the State meeting and what was done in Jackson. 
Drs. Henry and Mohler also made talks on the convention. 
The resignation of Dr. Scruggs of Handsboro and Dr. Greaves 
of Biloxi were read and accepted. On motion the secretary 
was instructed to draw up suitable resolutions and send the 
same to the widow of Dr. Tarry of Long Beach, who re- 
cently died, the doctor being a former member of our society. 
Dr. Richardson of Gulfport read a paper on the medical laws, 
dealing largely with the non-enforcement of the same. He 


6 


paid his respects to the street-fakirs of medicine, one of whom 
we have had in Gulfport for the past few weeks. Dr. Folkes, 
discussing the paper, said that the carelessness of the pro- 
fession is partly responsible for conditions as they are. Also 
the ignorance of the public is a chief reason for their running 
after fakirs. Dr. Hopper said that the best we could do was 
to educate the public, especially the younger generation. A 
general discussion on patent medicine and various medical 
fads followed. Dr. Lebaron, as health officer, stated how diffi- 
cult it was to enforce sanitary laws on account of the prejudices 
of the public. Dr. Folkes moved, in regard to the trouble with 
the New York Life Insurance examinations, that the secretary 
be instructed to write Dr. Capps a letter plainly telling him 
that he must at once give up making examinations for less than 
a five dollar fee, or by contracts which evade the spirit of the 
insurance resolutions, or be expelled from the society. 

H. H. West. 


Lauderdale County Medical Society met in the Ormond 
building March ISth. and the following officers were re-elected : 
Dr. James Bennett. President; Dr. J. T. Houston. Vice-Pres- 
ident; Dr. S. H. Hairston, Secretary-Treasurer; Dr. K. L. 
Turner, Delegate; Dr. H. S. Gully, member of board of censors. 
The society passed resolutions that from now on the meetings 
would be held every Thursday night instead of once a month. 
The meetings so far have been well attended and the society 
promises to be one of the best in the state. 

S. H. Hairston. 

Tri-County (Pike. Lincoln. Copiah) Medical Society 
met in regular bi-monthly session at McComb City April <»th. 
with thirteen members present. Malaria, dislocations and dis- 
eases of the joints constituted the program, which was carried 
out according to the American Medical Association course of 
study. A healthy condition of the society was shown by the 
fact that several members not on the program volunteered to 
take the places of those absent, so that an excellent meeting 
was had in spite of the fact that only one man down on the reg- 
ular program was present. Six new members were added. Res- 
olutions of respect in re the deaths of Drs. A. B. Pitts. J. T. 
Simmons and J. W. Bennett were adopted and copies ordered 
sent to their respective families. The next meeting will be held 
at Brookhaven June 8th. 


D. W. Jones. 


PIISSISSIPPI PlEDlCm IT10HTHLY. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D.. Vicksburtr. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D.. Biloxi. M. H. BELL M.D., Vicksburg. 

S. MYERS M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


The Forty-second annual session of the Mississippi State 
Medical Association has now become a matter of history and 
since these meetings are the milestones that mark our work 
it is well to pause a moment and review the situation, to 
see how it compares with that of previous years, to “take 
stock” as it were, that we may know how we are succeeding. 

It was argued by the section chairmen in the beginning 
that the stand taken by President Gray for an “all-Mississippi” 
meeting would work to the detriment of the Association, that 
there could not be found enough Mississippi physicians who 
would write papers to till out a program, and that the meeting 
would fall flat without the stiffening of outside talent. That 
they were mistaken was amply proven by the results. The 
program was as well tilled as of yore, the membership of the 
Association increased by about fifty over all previous records, 
the attendance for the first time approached the three hundred 
and fifty mark, largely in excess of any previous record, and 
there were as many papers read as could possibly have been 
handled. True a small proportion of the foreign element did 
slip through the meshes of the president’s net, but not enough 
to materially hurt the plan, in fact they but served to empha- 
size the wisdom of the president since an examination of the 
program will show that those sections having the most Missis- 
sippians had the largest attendance and handled the greatest 
proportion of papers. Best of all, some of our good friends 
of whom it was said that they were hurt and would not help 
us again came to the meeting and showed by their manner 
that they were as staunch allies as of yore. 

Altogether, then, lfifll) is our banner year and we should 
take to heart this lesson that our Association can walk on its 
own feet, without stay or prop from without, and its members 
should hold themselves erect and feel a pride that they are 
part and parcel of a body of men which can hold its own 
with any. 


8 


TOisstssippi Stats ^ll^ritcnl ^ssnctatinn. 

MINUTES OF THE HOUSE OF DELEGATES. 


The House of Delegates of the Mississippi State Medical 
Association was called to order by President J. \Y. Gray of 
Clarksdale in the Pythian Castle, Jackson, April 12th. 1909 at 
8 P. M. 

On roll-call the following responded : — ‘Councilors Dye of 
the First District, Brown of the Fourth, Williams of the 
Eighth, Ullman of the Ninth, Carter of the Tenth. Delegates 
Butler of Amite, Allen of Attala. Barksdale of Carroll. Boyd 
of Chickasaw, Weeks of Choctaw, Bouse of Clarke, Buck of 
Coahoma, Little of Copiah, Jones of DeSoto, Stewart of Hinds, 
Scudder of Issaquena, Craft of Jones, Anderson of Lauderdale, 
Teunison, of Lawrence, Keyes of Lee, Frizell of Lincoln, Lips- 
comb of Lowndes, Cox of Madison. Boatner of Marshall, Weudel 
of Monroe, Baskervill of Montgomery, Wright of Panola, Dick- 
erson of Pike, Lowry of Pontotoc, Bynum of Prentiss, Norman 
of Rankin, Tullos of Smith, Booth of Sunflower, Ellis of Tate, 
Stone of Washington, Finch of Webster, Hagaman of Wil- 
kinson. 

The secretary’s report was read, received and ordered re- 
ferred to a special committee. 

Vicksburg, Miss., April 10th. 1909. 

Secretary’s Report to the House of Delegates of the Mississippi 

State Medical Association. 

Gentlemen : — At the meeting at Xatchez last year, certain instruc- 
tions were given your secretary. Of these the most important were the 
revision of the Constitution and By-Laws and taking out a Charter for 
the Association. Feeling himself too feeble to bear the responsibility of 
such a burden as the revision of our laws would entail, 
Amendments J T ° ur secretary took the president and councilors into 
camp and after compiling such amendments as suggested 
themselves to him, sent copies to these officers and made 
the final suggestions — which are submitted to you as Exhibit A of this 

*At later sessions of the House there were seated Sessions of Adams, 
Butler of Bolivar, Young of Calhoun. Ringold replacing Barksdale of Car- 
roll, Sadler replacing Boyd of Chickasaw, Barron of Claiborne, Hubbard 
of Clay, Davis of Covington, Butler of Franklin, Ratliff' of Green, Giles 
of Grenada, Ross of Forrest, later replaced by Donald, Folkes of Harri- 
son, Christmas of Holmes, Rape of Jackson, Shields of Jefferson, Rowland 
of Lafayette, Stevenson replacing Anderson of Lauderdale, Alford replac- 
ing Teunison of Lawrence, Dickins of Leflore, Nimocks of Pearl River, 
Beacham replacing Dickerson of Pike, Gillespie replacing Lowry of Ponto- 
toc. Abernethy of Quitman, Pevey of Scott, Miller of Sharkey, Harris of 
Tallahatchie, Murry of Tippah, Coker of Tunica, Berryliill replacing Finch 
of Webster, Jackson of Yalobusha, Johnson of Yazoo. 


9 


Finances. 


report — from their majority vote. These amendments, together with one 
presented at Gulfport and two at Natchez, have been sent to the county 
societies as the law provides and are now ready for your final action. 

The question of a charter was simplified by discovering 
Charter. that a certified copy of the original charter could be ob- 

tained from the Secretary of State and, by permission of 
Dr. Rowland, chairman of the committee that suggested the instructions, 
this was done. This copy shows that our original charter was issued Sept. 
ISth. 1895 and is therefore, in the opinion of your secretary, preferable to 
a new charter since, in matters of this sort, age adds dignity. The certified 
copy is appended, as Exhibit B of this report, for your inspection. 

The money collected as dues for 1908 have been turned 
over to Treasurer Sutherland and a statement for your 
secretary’s accounts, together with vouchers for the sum 
paid to the treasurer, constitutes Exhibit C of this report. 

Owing to the fact that so many of the county societies delay until 
the last minute in making their reports, and some of them do not come in 
until late in the year, your secretary has adopted the plan of balancing 
his accounts with the treasurer on the first of January and has not, 
therefore, made any statement or paid him any money this year. The 
balance on the treasurer’s statement, therefore, represents the amount 
that the Association was ahead at the end of the last fiscal year. On 
the secretary’s books will be found the dues received for 1909 and as these 
books are kept very simply your auditing committee can check them up 
with almost the facility of a statement. The money is deposited in the 
Delta Trust and Banking Co. of Vicksburg and the bank book is sub- 
mitted as a voucher for the amount. 

The membership of the Association totaled nine hun- 
dred and two for 1908. This is a loss of two as coin- 
embership. pared with 1907 and is probably due to our insurance 
resolutions, several societies having gone further than the 
Association and made compliance with them a test of membership. 

Exhibit D consists of such histories of deceased members 
as your secretary has been able to secure and is pre- 
sented to facilitate the work of the mortuary committee. 
Exhibit E consists of numerous communications from the 
American Medical Association and the Southern Medical 
Association. Since some of them are extremely voluminous 
it has not been deemed advisable to incorporate them in 
in this report, but all of them should receive consideration and some of 
them are of importance, therefore it is suggested that a committee con- 
sider them. 


Deaths. 


Communi 

cations. 


It is with a feeling of hesitation and regret that your 
Papers secretary ventures to call your attention to some irreg- 

read at ularities, to put it mildly, that have been practiced on the 

meetings. Association by some of its visitors. For some years past 

it has frequently happened that some of these gentlemen 
have violated, unknowingly in some instances but certainly not in others, 
the letter as well as the spirit of Chapter V, Section 5 of the By-Laws, 
which reads as follows: — “All papers read before the society shall be its 


10 


property. Each paper 9hall be deposited with the secretary when read.” 
Frequently papers are carried ofT — to he read elsewhere or to be sent 
to some publication having a wider circulation than those of this Asso- 
ciation — and it often happens that a visitor presents a paper that is 
merely a reprint of one previously read elsewhere or written for some 
journal. Last year both of these indignities were practiced upon the 
Association and your secretary ventures the suggestion that in future all 
members or guests guilty of such conduct be quietly blacklisted and 
prevented from further participation in our programs. 

Respectfully submitted. 

E. F. HOWARD, 

Secretary. 


Secretary’s Report— Exhibit C. 

Vicksburg, Miss., Jan. 4th. 1909. 

E. F. HOWARD, Secretary, 

In account with the 

' Mississippi State Medical Association. 

Business of 1908. 

Balance on hand last report $1,480.00 

Received from ■ 

Clarksdale and Six Counties 2.00 

Yazoo 42.00 

Attala 34.00 

Chickasaw 28.00 

Tri-County (P. L. C.) 2.00 

Yazoo 2.00 

Tippah 16.00 

Washington 6.00 

Lauderdale 4.00 

Tri-County (P. L. C.) 4.00 

Monroe 41.50 

Tishomingo 14.00 

Tri-C'ounty (P. L. C.) 2.00 

La layette 4.00 

Tri-County (P. L. C.) 8.00 

Newton-Neshoba 4.00 

Amite 2.00 

DeSoto 8.00 

Tate 4.00 

Clarksdale and Six Counties 2.00 

Tri-County (M. C. W.) 8.00 

Harrison 2.00 

Marshall 32.00 

Issaquena 2.00 

Grenada 4.00 

Leflore 2.00 

Tri-County (M. C. W.) 6.00 

Panola 2.00 

Perry-Greene 2.00 

Monroe 4.f,0 

Pearl River-Marion 16.00 

Leflore 2.00 

Wilkinson 2.00 

Newton-Neslioba 6.00 

t Total $1,800.00 


11 


By cheek to Treasurer April 22nd. 1908 $1,480.00 

By check to Treasurer Oct. 9th. 1908 310.00 

By check to Treasurer Jan. 4th. 1909 10.00 

Total $1,800.00 


VOUCHERS ATTACHED. 


E. F. HOWARD, 

Secretary. 


Barksdale called up the constitutional amendment offered 
at Natchez in 1908: 

“Resolved, that the constitution be so amended that the election of offi- 
cers shall take place on the afternoon of the day previous to the day of 
adjournment on the floor of the House of Delegates.” 

This was put to a vote and lost. 

Wright of Panola called up the amendment offered at 
Natchez in 1908 : 

“ Resolved , that the constitution be amended so as not to debar delegates 
from election to any office.” 

This was put to a vote and carried. 

Frizell of Lincoln called up the amendment that was offered 
at Gulfport in 1907 and has lain on the table ever since: 

“Resolved, that the constitution, Article VIII, Section 3, be amended 
to read ‘at the evening session of the first day ’ instead of 'on the morning 
of the last day’ ”, 

This was put to a vote and lost. 

The Treasurer’s report was read, received and referred to 
a committee to be appointed by the chair. 


Treasurer’s Report. 


H. L. SUTHERLAND, Treasurer, 

In account with 

The Mississippi State Medical Association : 

1908. 

Apiil 25. To Check of Secretary for balance in his 
hands as shown by report of Auditing 


Committee $1,480 00 

May 7. To Check, J. F. Hunter 781 01 

Oct. 10. “ “ E. F. Howard, Secretary 310 00 

1909. 

Jan. 8. “ “ E. F. Howard, Secretary 10 00 


12 


1908. 

April 28. By Draft for Secretary’6 Salary 500 00 

“ 28. “ “ “ “ Sundries 52 31 

May 1. “ “ “ Clarke & Co 3 65 

“ 2. “ “ “ S. W. Johnston 3 00 

“ 2. “ “ “ Mississippi Printing Co 84 00 

“ 2. “ “ " C. M. Coker 14 25 

“ 6. “ “ “ M. C. Lilley & Co 3190 

“ 6. *• “ “ Columbus Dispatch 8 10 

“ 6. “ “ “ J. B. Bullitt 23 40 

“ 9. “ “ “ H. E. Baxter 25 00 

June 25. “ “ “ Frank Bell 15 00 

July 24. “ “ “ Transactions by Mississippi 

Printing Co 724 16 

1909. 

April 7. “ Balance on hand ...; 1,096 24 


$2,581 01 2,581 01 

H. L. SUTHERLAND, 

Treasurer. 

The president appointed as a committee on the reports of 
the secretary and treasurer: — Frizell of Lincoln, Baskervill of 
Montgomery, Wright of Panola. 

Baskervill of Montgomery and Secretary Howard offered 
an amendment to the by-laws giving the treasurer a seat in the 
House of Delegates. 

The following constitutional amendment was introduced by 
Little of Copiah and Councilor Brown: 

“ Resolved , that the Constitution, Article VIII, section 3, be amended 
to read ‘at the evening session of the second day’ instead of 'on the morning 
of the last day ’ ”. 


Then the House took up the amendments offered by the 
secretary and passed the following: 

CONSTITUTION. 


Article IV, Sec. 4. In the first line strike out the word “ distinguished ” 
and change the third line so as to read “an officer of the Association ” — 

Article VI. Strike out the entire section. 

Article VIII, See. 2. Change the last sentence to read as follows: — 
“All of these officers shall serve until the adjournment of that session at 
which their successors are elected”. 

Sec. 3. Strike out the words “but no delegate shall be eligible to any 
office named in the preceding section, except that of councilor.” 


13 


Article IX. Amend tins article in the third line by striking out the 
words “an equal” and in the third by adding the words “the membership 
of” before the words “each county society” and by striking out the words 
“to be fixed, by the House of Delegates”. The article will then read 
“Funds for meeting the expenses of the Association shall be arranged tor 
by the House of Delegates by per capita assessment upon the membership 
of each county society,” etc. 

Article X. Strike out the entire section. 

BY-LAWS. 


Chapter 1, Sec. 1. Strike out entire section. 

Sec. 2. Strike out the words “or list of delegates,” in the second line. 
In the fourth line after the words “roster of the society” add “or by 
presentation of receipt for dues from his county secretary.” 

Sec. 3. Strike out entire section. 

Sec. 4. In the second line, change the words “on the registration book ” 
to “at the registration bureau.” 

Sec. 10. Add the following: “Delegates shall be received from such 

societies — one delegate from each society in the federation”. 

Section 11. Strike out the last sentence. 

Sec. 13. Strike out the section. 

Sec. 14. Strike out the section and substitute the following: — “It 
shall publish the minutes of its meetings in the official Transactions of the 
Association”. 

Chapter VI, Sec. 4. On the fourth line, strike out the words “in sep- 
arate record books”. 

On lines eleven and twelve, strike out the words: — “and upon request 
shall transmit a copy of this list to the American Medical Association for 
publication” . 

Chapter VII, Sec 1. Add to section: — “and shall publish this report 
in the official Transactions of the Association.” 

Sec. 2, lines 2 and 3, strike out the second sentence. 

Sec. 4. Add to section, between the first and second sentences: — 
"It shall approve all memorials and resolutions issued in the name of 
the Association before the same shall become effective”. 

Amend the last section to read as follows: — “Such committees, except 
Committee on Arrangements which is provided for in Section G, shall be 
appointed by the president within thirty days after the adjournment of 
the annual session”. 

Sec. 5. Strike out this section. 

Chapter IX, Sec. 2. Add to section: — “Provided, that a member who 


14 


has paid his dues to the secretary of his county society and holds a re- 
ceipt for same, shall be allowed to register on his presenting the receipt 
and the amount of his dues to the secretary of the Association, who must 
issue him a receipt for same. This receipt shall be his voucher when he 
demands reimbursement of dues paid to the county secretary.” 

An additional chapter as follows: 

Scientific Sections. 

Section 1 . The scientific sections of this Association shall be as 
follows: 

Section on Medicine, 

Section on Surgery. 

Section on Obstetrics, 

Section on Gynecology, 

Section on Materia Medica. 

Section on Pediatrics, 

Section on Nervous Diseases, 

Section on Venereal Diseases, 

Section on Hygiene, 

Section on Dermatology, 

Section on Bacteriology, 

Section on Diseases of the Eye, Ear, Nose and Throat. 

Section on Electro-Therapeutics, 

Section on Tuberculosis. 

Sec. 2. The chairmen of these sections shall be appointed annually 
by the president. 

On motion of Councilor Dye the selection of a nominating 
committee was made the order of the next session. 

The House then adjourned and reconvened at 8:30 A. M. 
April 13th. 

The following were selected as a nominating committee: — 
1st. District, Booth of Sunflower; 2nd. District, Wright of 
Panola; 3rd. District. Keyes of Lee; 4th. District, Feemster of 
Monroe; 5th. District, Baskervill of Montgomery; (>th. District, 
Scudder of Issaquena; 7th. District, no representation; 8th. 
District, Craft of Jones; 9th. District, Frizell of Lincoln; 10th. 
District, Boss of Forrest. 

The House then adjourned and reconvened at 8:30 A. M. 
April 14th. 

The amendment of Baskervill of Montgomery and Secre- 
tary Howard, seating the treasurer in the House of Delegates, 
was called up and passed. 


15 


The courtesies of the House were extended ex-President 
Martin. 

On motion of Treasurer Sutherland the House appropriated 
one hundred and fifty dollars for the relief of the family of 
Dr. James Carroll. 

The credentials of Dr. John B. Elliott Jr., fraternal dele- 
gate from the Louisiana State Medical Society, were read and 
the House extended the courtesies of the meeting to Dr. Elliott. 

The House then adjourned and reconvened at 3 P. M. 

The report of the legislative committee was presented and, 
after slight amendment, adopted as follows: 

Jackson, Miss., April 12th. 1909. 

To the House of Delegates, Mississippi State Medical Association: 

Gentlemen : Your Committee on Public Policy and Legislation beg leave 
to report as follows: 

I. We would recommend the printing and distribution for the in- 
formation of health and sanitary officers, and the public generally, by the 
State Board of Health, of a “Sanitary Code”, such as is now issued by the 
Louisiana Board ; and we would like to pledge the influence of the Asso- 
ciation to the said State Board of Health in securing the enactment of 
such legislation as may be necessary to this end. 

II. We ask the, endorsement by th/s Association of the following pro- 

posed legislatiop, Co •be'' submitted at the next meeting of our State Legis- 
lature: „ 1 

AX AOT'to amend sections 3690 and 3691 of the C'Oje.of 1906 in rela- 
tion to bbysicians- in-sp-far. a» .they relate io the, practice, of midwifery by 
females? who arp TKVt' pltysidpfns. - . » ■ ■' 

Section 1. Be it enacted by the legislature of the State of Mississippi 
that Section 3690, Mississippi Code of 1906, is hereby amended to read as 
follows: 

3690. (3253) Females practicing midwifery. It shall be unlawful 

for any and all persons, other than physicians, to practice obstetrics or 
midwifery, after having received or with the intent of receiving therefor, 
either directly or indirectly, any bonus, gift, profit or compensation, unless 
they can show a certificate from the health officer of the county in which 
they reside certifying that they are proficient in the art, which certificate 
shall be given only after an examination of the person applying therefor 
by the health officer, whose duty it shall then be to file a duplicate of said 
certificate with the clerk of the Circuit Court in the county in which the 
licentiate resides, and for which service he may collect the sum of five 
dollars from the person applying for the certificate. The penalty for vio- 


lation of this law shall be not more than twenty-five nor less than five 
dollars and imprisonment in the county jail for a period of not more, 
than thirty nor less than ten days, for each offense. 

Section 2. Be it enacted by the legislature of the State of Mississippi 
that Section 3G91, Mississippi Code of 1906, is hereby amended to read as 
follows: 

3691. Practice of medicine defined (Laws 1896, ch. 68). — The practice 
of medicine shall mean to suggest, recommend, prescribe, or direct for the 
use of any person, any drug, medicine, appliance or other agency, whether 
material or not material, for the cure, relief or palliation of any ailment 
or disease of the mind or body, or for the cure or relief of any wound or 
fracture or other bodily injury or deformity, or the practice of obstetrics 
or midwifery, after having received, or with the intent of receiving therefor, 
either directly or indirectly, any bonus, gift, profit or compensation. 

AN ACT to amend Sections 1234 and 1235 of the Code of 1906 relating 
to the production of abortion. 

Section 1. Be it enacted by the legislature of the State of Mississippi 
that Section 1234, Mississippi Code of 1906, is hereby amended to read as 
follows: 

1234. (1156) The same; killing of an unborn child. — The wilful 

killing of an unborn child, by injury to the mother of such child, which 
would be murder if it resulted in the death of the mother, shall be man- 
slaughter. An infant in the mother’s womb, whether viable or not viable, 
is hereby declared a human being. 

Section 2. Be it enacted by the legislature of the State of Mississippi 
that Section 1235, Mississippi Code of 1906, is hereby amended to read as 
follows: 

1235 (1157) The same; ^iypg. ynHln«iHc i .etc., to pregnant woman and 

thereby destroying the prodtfdt '<£ ptmdfeiitiftfii Every person who shall ad- 
minister to any pregnant trtuvnfn 'any medicine) drug \>r .substance whatever, 
or shall use or .enijJpV. ifny instrument! pi* ■, other means to destroy such 
product of concvpVioii, and shall thereby; destroy it, shall, upon couviction 
thereof, be guilly'au manslaughter^ except in the case of a physician doing 
it when it is neCessary to pfdtd-L the 3i fee 1 f>f ;tlje, wojmiii, ; • ! . < ' 

1235 B. The same*; a* Wo ilia if wmpelled‘ to < testify against the person 
who has produced an abortion upon her. The woman upon whom an abortion 
has been produced shall be a competent witness against the person pro- 
ducing the abortion and may be compelled to appear and give evidence 
in the manner of other witnesses, but the testimony so given shall not be 
used in any prosecution or proceeding, civil or criminal, against the 
woman so testifying, and the fact that she testified thereof shall be a bar 
to any prosecution against her for such offense, nor shall her unsupported 
evidence be sufficient to convict the accused. 

AN ACT to amend Section 1528 of the Code of 1906 by adding a clause 
revoking the license of a practitioner of medicine who has been convicted 
of doing a criminal abortion. 

Be it enacted by the legislature of the State of Mississippi that 


17 


Section 1528, Mississippi Code of 1906, is hereby amended to read as 
follows: 

1528. (1455) The same; convict of felony not to vote, practice med- 

icine, etc. — A person convicted of bribery, burglary, theft, arson, obtaining 
money or goods under false pretenses, perjury, forgery, bigamy or abortion, 
shall not be allowed to vote, practice medicine or dentistry, nor be appointed 
to hold or perform the duties of any office of profit, trust or honor, unless 
after full pardon for the same. 

Respectfully submitted, 

D. W. JONES, 

J. W. GRAY, 

E. F. HOWARD. 

The committee on the president’s address reported as fol- 
lows : 

We, your committee to which was submitted the address 
of the president, beg leave to offer the following resolution and 
amendment to the by-laws : 

Resolved, that a committee of three be appointed to investigate and 
report to the next annual session of the Association the practicability of 
adopting some plan of co-operative defense, as recommended in the pres- 
ident’s address. 

Resolved, that Chapter VIII, Section 3, of the by-laws be amended to 
read as follows: 

The committee on public policy and legislation shall consist of three 
members, together with the president and secretary ex officio, the three 
to be appointed for a period of three years so that the term of no two mem- 
bers shall end the same year. Under the direction of the House of Delegates 
it shall represent the Association in securing and enforcing legislation in 
the interest of public health and of scientific medicine. It shall keep in 
touch with professional and public opinion, shall endeavor to shape legis- 
lation so as to secure the best results for the whole people, and shall 
utilize every organized influence of the profession to promote the general 
influence in local, state and national affairs and elections. Its work shall 
be done with the dignity becoming a great profession and with that 
wisdom which will make effective its power and influence. It shall have 
authority to be heard before the entire Association upon questions of great 
concern at such time as may be arranged during the annual session. 

There shall be an auxiliary committee consisting of one member from 
each county having a component society, to be elected by the local society, 
senate and, where it is possible, secure pledges on all legislation recom- 
mended by the general committee. The auxiliary committee shall take its 
instructions from the general committee and make its report to same. The 
general committee shall be supplied with sufficient funds to carry on its 
2 


18 

propaganda, provided that not more than five hundred dollars shall be 
expended in any one year. 

Respectfully submitted, 

T. M. DYE, Chairman. 

The report was received and adopted. 

On motion of Folkes of Harrison, the House endorsed the 
stand taken by Dr. Wiley in his efforts for pure food legislation. 

The auditing committee presented its report as follows: 

Jackson, Miss., April 13th. 1909. 

To the State Medical Association : 

Gentlemen : We, your auditing committee, after having carefully ex- 

amined the books and accounts of your secretary and treasurer, beg leave 
to report the same correct and neatly kept. 

Respectfully submitted, 

GEO. BASKERV1LL, 

W. H. FRIZELL, 

E. WRIGHT, 

Committee. 

On motion of Baskervill of Montgomery the House recom- 
mended that the committee on public policy and legislation 
present to the legislature bills providing for compulsory vac- 
cination among the school children and requiring the boards 
of supervisors to provide free vaccine and free antitoxin for 
charity cases. 

The following accounts were allowed on recommendation 
of the auditing committee: — M. C. Lilley & Co., $30.00; J. B. 
Bullitt, -|22.10; E. F. Howard, $03.85; D. J. Williams, $3.40; 
H. L. Sutherland, $17.35; J. S. Ullman, $17.95; Mississippi 
Printing Co., $124.55; T. M. Dye, $15.00; Clarke & Co., $10.45. 

Invitations for next year’s meeting were extended by Ox- 
ford through Rowland of Lafayette, by Greenville through 
Stone of Washington, by Hattiesburg through Donald of For- 
rest. Oxford’s invitation was accepted and on motion of Bask- 
ervill of Montgomery the thanks of the Association were ex- 
tended to Greenville and Hattiesburg. 

Harrington of Yazoo rose to a question of personal privi- 
lege and made a statement in defense of those members of the 
State Board of Health who were appointed by the Association, 
it having been stated that some one or more of these gentlemen 


19 


had been guilty of violation of the insurance resolutions. He 
stated that the rumor was due to error and that none of the 
accused were guilty. Dr. Cheek of Areola, another of the 
members in question, appeared before the House and being 
granted the courtesies of the meeting made a similar statement. 
Frizell of Lincoln spoke in defense of the three absent members, 
he having personal knowledge of the subject. 

The House then adjourned and reconvened at 9 A. M., 
April 14th. 

On motion of Secretary Howard the thanks of the Associa- 
tion were tendered Dr. and Mrs. Julius Crisler, the Hinds 
County Medical Society, the Jackson Board of Trade, the Lamar 
Life Insurance Company, Hon. Hilary Quin. Hon. R. V. 
Fletcher and Rev. Geo. F. Chaplaine for courtesies extended the 
Association during the meeting. 

The commissioner of agriculture, Mr. Blakslee, was ac- 
corded the courtesies of the House and spoke of a plan for 
bringing a tuberculosis exhibit to Jackson during the state 
fair. On motion of Treasurer Sutherland this plan was en- 
dorsed by the House. 

After prolonged debate on the situation in regard to fees 
for insurance examinations, the following addition to the reso- 
lutions as passed at Gulfport in 1907 was adopted : 

Resolved, that the Association re-affirms the Gulfport resolutions, and 
that it is the sense of the Association that the acceptance by any member 
of an insurance-examination fee of less than five dollars is a tacit ad- 
mission on his part of professional inferiority to his fellow members who 
demand the five dollar fee. 

Councilor Dye rose to a question of personal privilege and 
stating that he had a resolution to offer that he was afraid 
President Gray would rule out of order, asked that Vice-Presi- 
dent Bullitt would take the chair. This being done he offered 
the following resolution, which was unanimously adopted: 

Resolved, that it is the sense of this Association that in the adminis- 
tration of Dr. J. W. Gray an unusually high standard of intelligent and 
active efficiency has been reached, and that largely as a result of his un- 
tiring labors the Association has reached its highest point in enrollment, 
in attendance, in loyalty and in a scientific program of Mississippi talent. 


20 


The nominating committee presented the following report: 

Jackson*, Miss., April 13tli. 1909. 

To the House of Delegates, Mississippi State Medical Association*: 
We, the Nominating Committee, after due deliberation and consider- 
ation, beg leave to submit the following: 

For President: D. J. Jones, Brookhaven; P. R. Brown. West Point; 

J. W. Young, Grenada. 

For Vice-President: J. S. Sanders, Scranton; J. C. Armstrong, Water 

Valley; Thos. Purser, McComb City. 

For Councilor, vacancies to be filled in First and Second Districts: 
First District: T. M. Dye, Longwood. 

Second District: J. B. Bullitt, University. 

For Delegate to American Medical Association: J. W. Gray, Clarks- 

dale. 

For Alternate Delegate to American Medical Association: *H. A. 

Minor, Macon. 

L. C. FEEMSTER, Chairman, 

W. S. CRAFT, Secretary, 

E. WRIGHT, 

W. H. SCUDDER. 

T E. ROSS, 

C. T. KEYES, 

GEO BASKERYILL, 

B. H. BOOTH, 

W. H. FRIZELL . 

Roll being called it was found that there were fifty-five 
votes in the House. 

The vote for president was taken and resulted as follows: 
— Jones 32, Young 20, Brown 3. 

The secretary was instructed to cast the vote of the House 
for the other nominees. 

I)r. Jones being sent for and informed of his election, 
thanked the House for the compliment paid him. 

The House then adjourned sine die. 

E. F. Howard, 

Secretary. 


Dr. Minor being ineligible, there was no election in his case. 


MISSISSIPPI ME1IG1L MONTHLY 


VOL. XIV. JUNE 1909. No. 2 


*“ INDIGESTION ” FROM A SURGICAL STANDPOINT. 


JOHN DARRINGTON, 

YAZOO CITY. 


When we review the recent progress of medicine and sur- 
gery we are impressed with the fact that while the great 
medical discoveries and wonderful surgical achievements have 
been the means of saving lives and restoring to many pallid 
cheeks the glow of health, yet there are a much larger number 
of chronic sufferers who through ignorance of what surgery 
can do for them are to-day harboring curable maladies. A 
large per cent, of these consist of those chronic cases having 
some lesion in the stomach, duodenum, gall-bladder or gall- 
ducts and the entire symtomatology of these various conditions 
is covered by the layman in one word : ‘‘indigestion”. 

Many of these cases are drifting from one physician to 
another, they lire given all kinds of digestive mixtures and 
frequently, in desperation, resort to self-treatment with patent 
medicines. They do not improve, they cannot improve, and we 
see the case with a chronic ulcer of the stomach gradually 
lose strength and hope, and who can say he is unlucky if a 
perforation suddenly ends his sufferings here and ushers him 
into the next world. There we hope he is free from pepsin 
and bismuth and there we trust he can look at a mince pie 
without having a pyloric spasm. 

It is our duty to teach these patients that they can be 
cured by surgical means, and as this idea gains ground and 
operations for the relief of these conditions become more com- 
mon, the family doctor as well as the surgeon will have the 
moral support of the public, which you know is a valuable 
asset in doing surgical work among ignorant people. 

The knowledge of the general public regarding the neces- 
sity for an early operation in acute appendicitis is illustrative 
of the good work done along the educational lines, and each 
year we see fewer cases of neglected appendicitis. The old 

* Read before the Mississippi State Medical Association at its Annual Meeting in 
Jackson. 1909. 


21 


22 


rule, you kuow, was to purge aud poultice for at least three 
days before sending for a doctor. 

There are many lesions of the upper abdomen, that inter- 
fere more or less seriously with the proper digestion of food, 
that are no more amenable to medical treatment than is a 
chronic, inflammatory process of the vermiform appendix, yet 
these cases are treated along so-called conservative lines, and 
they usually die a conservative death rather than have any- 
thing radical done. 

Of the many diseased conditions producing symptoms of 
indigestion, ulcers of the stomach or duodenum and their 
sequelae, such as stenosis of the pylorus, perforations, adhesions, 
etc., together with the inflammatory diseases of the gall- 
bladder, liver-ducts and pancreas, are the chief offenders. We 
must never lose sight of the fact that cancer of the stomach 
is unfortunately exceedingly frequent, and no doubt neglected 
chronic ulcers are responsible in most cases for the cancer. 
This fact alone is an urgent plea for us to do early surgery. 

1 am not going into the differential diagnostic symptoms 
of the surgical diseases of the stomach and the adjacent 
organs, for such information can easily be secured by referring 
to recent text-books, or current medical literature. I will say, 
however, that while in most cases the correct diagnosis can 
be made, there are others presenting such complicated symp- 
toms that you can only say you are sure of a lesion in 
the region of the stomach that in all probability can be cured 
by surgical interference. It is of no importance to the patient 
whether his trouble is in his stomach, duodenum or gall- 
bladder. He wants relief, and you are justified in advising an 
operation when you have a positive pathological diagnosis. 

There is no department of surgery that produces more 
brilliant results, that is more gratifying to both .patient and 
surgeon, than a posterior gastro-duodenostomv performed on 
those cases where this operation is clearly indicated, and I 
think it is clearly indicated in all chronic ulcers of the stom- 
ach or duodenum, or for adhesions or contractions of the 
stomach or duodenum that interfere with digestion. 

This operation is the ideal treatment for all conditions 
about the pylorus which prevent the food from readily passing 
from the stomach into the intestines. It is also advised as a 
life-saving measure in cases of repeated hemorrhage, in acute 
ulcer of the stomach and as a palliative procedure in inopera- 
ble malignant conditions. 

I operated upon a case a few months ago, doing a posterior 
gastro-duodenostomy, using a McGraw ligature. This patient 


23 


had a stenosis of the pylorus, caused by the cicatricial con- 
traction of a chronic ulcer. This old woman was unable to 
eat, greatly emaciated, of course, and in fact was actually 
starving to death. She gained about thirty pounds in six 
weeks, and is now in perfect health. 

The contrast in these cases, before and after operation, 
must be seen to be appreciated. The patient comes to you, 
pale, weak, anaemic and cadaverous; his whole thought and 
entire time are given to his stomach ; his conversation is confined 
to one topic — his stomach ; his own existence is miserable and 
his gloominess and depression are reflected in the faces of his 
entire household. After the gastro-duodenostomy is performed 
for his ulcer, or his stenosis, there is a complete change in the 
picture. He is free from pain, can take food and digest it and 
that tells the whole story. He gains rapidly in weight and im- 
proves in spirit and, quoting my friend, Frank Jones, “is sud- 
denly changed from Gloomy Gus to Sunny Jim”. 

In an article read before this Association two years ago 
on gastro enterostomy, I stated that this operation was strictly 
a drainage operation, and that the great benefit secured by 
the patient was due to the drainage. I am compelled, how- 
ever, to revise that statement now, for the investigations made 
during the past two years show conclusively that the neutral- 
ization of the excessive acidity of the stomach by the alkaline 
secretions of the liver and pancreas is no less important than 
drainage, and is a large factor in the cure of the chronic ulcer. 

The digestive disturbances, due to gall-bladder infection, 
also rapidly disappear after drainage of this organ. The 
question frequently comes up as to the advisability of draining 
or removing a gall-bladder. It has been my rule to drain, 
unless the pathological condition of the gall-bladder, or the 
cystic duct, was such as to lead me to believe that the gall- 
bladder would not resume its function. 

I only mention the most important of the various causes 
of indigestion, for in a short paper it is not possible to deal 
with the physiology of digestion, or the pathology of indi- 
gestion, nor is it possible to describe the various operations for 
the relief of the surgical lesions of the stomach or its neigh- 
bors, but to call your attention, in a general way, to the great 
possibilities in this line of work, and to urge upon you the 
importance of keeping these very common troubles in mind, 
and not allowing yourself to fall into the error of treating 
with medicine those cases that can only be cured by surgery. 


24 


*THE NEGLECTED CYNECOLOGICS. 


L. C. FEEMSTER, 

NETTLETON. 


I have read that ‘‘The genital apparatus of woman is the 
pivotal point around which her life revolves”. This is meas- 
urably true but should not be taken too literally, for fear we 
dwarf our conception of one of the greatest branches of med- 
icine, gynecology. 

The man who limits the field of his vision to the genitals 
of woman and is guided in his practice by that limited vision, 
is a discredit to the profession. A woman in perfect health 
is a product of heritage and a properly regulated life — she 
bears the earmarks of “firmness of fibre, symmetry of form 
and the grace and beauty of healthful habits and environment. 
She is a thing of beauty and a joy forever”. 

Social duties, or rather abused social duties, and altered 
conditions of life frequently are responsible for many of the 
diseases of woman. The negro woman as she exists in the 
African wilds in what seems to be her natural habitat is 
found to be almost entirely free from uterine fibromata, but 
as found in her semi-civilized state among us she becomes a 
frequent prey to this form of gynecological pathology. 

One of the greatest errors that I have noticed in dealing 
with gynecologics is the very frequent mistake of many of 
the physicians with whom I have had the pleasure to come 
in contact of overlooking the genital diseases of woman, espe- 
cially when treating the unmarried of all ages. Practical and 
systematic examinations have been neglected and the sufferer 
has constantly grown worse until she had the good judgment 
to consult some physician who is in the habit of examining 
his patients before prescribing. 

There is but little to choose between marriage and “single 
blessedness”. Married women are more frequently sufferers 
from cervical cancer and the multiplicity of conditions con- 
comitant and subsequent to parturition, as laceration of cervix 
and perineum, subinvolution, cystocele, rectocele and prolapsus 
uteri. Unmarried and sterile married women are far more 
frequently sufferers from fibroids and cancer of the corporeal 
uterus. “Celibacy brings its own train of evils incident to 
an unnatural mode of life.” 

The failure to accord the puerperant proper advice, atten- 

* Road bofore the Mississippi State Medical Association at its Annual Meotine in 
Jackson, 1009. 


25 


tion and prompt treatment in ease of tears and other accidents 
incident to child-birth is one of the most frequent and serious 
needs of gynecological attention. This includes on the part 
of the obstetrician the neglect to have the patient antisepticized 
and aseptieised before labor has begun and the repair of any 
laceration that may have occurred during labor, also a proper 
care of the patient for the remainder of the puerperium, main- 
taining a strict guard against septic infection. 

Septic and specific infections are among the most common 
causes of diseases in the female. A large per cent, of her ail- 
ments are due to one or the other of these causes. Both are, 
almost without exception, due to carelessness or inexcusable 
ignorance on the part of the medical attendant or nurse. 

Gonorrhoeal infection gives rise to many of the most grave 
conditions to which hundreds, yea thousands, of the fairest 
daughters of our beloved state are heir, and the darkest picture 
of it is that it is due to her ignorance of the subject and her 
trust in the man she loves and he not having a clean bill of 
health. 

Septic and gonorrheal infection may start in the lower 
genitalia and by extension involve the entire reproductive or- 
gans, verily not ceasing its death-dealing force there but con- 
tinuing to all the pelvic and abdominal viscera unless death 
intervenes and relieves the sufferer from its devastating march. 

In a limited way we have been considering the gynecologics 
from a social and obstetrical field of vision, so let us turn, if 
you please, and take a physiological view of the subject and see 
if much of the suffering is not laid in childhood and 
adolescence. 

If she is hindered in her development, she will never 
attain the mental and physical vigor to which she is entitled. 
Both moral and mental natures are closely associated with the 
physical. Sound mind and sound morals belong to a sound 
body. The exceptions to this rule are few and usually are only 
apparent. 

The question is, therefore, how is it with us in the educa- 
tion and instruction in our homes and in the homes of our 
clientele as regards the physiological development of the girls 
of our several communities. 

She is taught to observe the proprieties of w r omanhood 
from early childhood, consequently denied the health-giving 
pleasures of the rougher sports from wdiich her brother comes 
w ith glowing cheeks and a vigorous appetite. 

She spends most of her time in the house done up in 
stays and tight-fitting clothes, yet is put to study at the same 


26 


nge or earlier than the boy and expected under these adverse 
conditions to compete with him in her studies. 

‘•She has been and is being reared and educated for in- 
validism, incapacity, a frail and delicate body, a high-strung 
and unstable nervous organism and life-long suffering.” 

The remedy for these evils is, in my opinion, proper dress, 
mental and physical exercise with the elimination of competi- 
tive examinations, and the elimination of very hard and ex- 
haustive studies during the establishment of her menstrual 
function, and pleasant and congenial company. 

The great and intelligent sun of gyneeie pathology has 
risen and is spreading his munificent light over the obstetrical 
and gynecological world so that it will only be a few years 
until all educated people will discard as rust-worn every phy- 
sician who neglects to give these cases the proper advice and 
a prompt and correct treatment. 

Bibliography: Gilliam, Garrigue, King. Hirst, Srnythe. 


* ENTERO-COLITIS IN CHILDREN. 


G. S. BRYAN, 

AMORY. 


Mr. President and Gentlemen: 

I shall not consume much of your valuable time in this 
paper, although the subject is of great importance. And for 
the sake of brevity I shall not refer to the literature bearing- 
on the subject other than to say that I have read practically 
everything that has been written on it by those who are con- 
sidered authorities. 

I have not only read much on this subject but I have 
given it the best thought of which I am capable. I have not 
only read and thought much on this subject but I have had 
something more than my share of these cases to treat. So I 
do not think it immodest or egotistic to claim to speak with 
some degree of authority; for if I do not know this subject I 
am incapable of learning medicine, and if I can reach that 
conclusion I am ready to abandon the practice. 

I make these statements simply as a basis for the conclu- 
sions I shall draw and as an apology for the dogmatic way I 
shall state them. 

Now for a few of my conclusions. First permit me to say 

* Read before the East Mississippi Four County Medical Society. 


27 


that I shall not consider the cases due to purely constitutional 
causes, but rather those occurring in previously healthy babies. 
In such babies there are two causes or classes of causes for this 
trouble, namely, improper feeding and nervous reflexes. Under 
the head of improper feeding I would, of course, include over- 
feeding as well as feeding with indigestible, impure and un- 
wholesome food. I assume that you are all perfectly familiar 
with this phase of the subject and that there is no difference 
of opinion ; so I shall not go into details. 

Under the head of “nervous reflex” I would class insuffi- 
cient sleep, intestinal parasites, adherent prepuce and, above 
everything else, “dentition”. 

The symtoms and pathology I have not elected to discuss. 

How grave the prognosis is, we all know from personal 
experience. 

Treatment. It is here I expect to appear and want to be 
dogmatic. But before advocating or condemning any special 
line of treatment let me insist on prophylaxis. It is here we 
can do the most, and all too often we do the least. 

By way of digression, permit me to say that it seems to 
me the doctors have gone wild over special lines of work until 
every conceivable line has become over-crowded with so-called 
specialists and at the same time the great and fertile field of 
preventive medicine is lying fallow before our very eyes. 

Then I assert that when a previously healthy child, one 
free from constitutional taint, develops entero colitis, somebody 
has sinned — either through ignorance or carelessness, it may 
be, but somebody has sinned. 

But be that as it may, they do fall sick of this fearful and 
fatal disease. 

The question then arises “What shall we do with these little 
patients?” “Ay, there’s the rub.” But there is still a more 
important question, namely, “What shall we not do?” I un- 
hesitatingly say that most of the things done and advocated 
should be transferred to the negative side of this important 
equation. Indeed, if you will stop doing what ought not to be 
done, frequently there is little that will become necessary to do. 
Of course you are first to decide if possible what is the cause 
of the individual attack and remove the cause, remembering 
that both classes of causes frequently enter into the case. 

In all cases, all feeding should be promptly stopped. Good 
judgment on the part of the doctor is necessary to determine 
when feeding may be resumed as well as what shall be fed and 
how much shall be allowed. 

I do not believe it possible to antisepticize the bowel, 


28 


hence I have no use whatever for the great majority of the rem- 
edies generally prescribed in the treatment of this trouble. 

But if you ask me if I discard all drugs, I answer “no”. 
While I have absolutely no faith in the virtue of a great many 
of the generally-used drugs, I have faith in a very few. Indeed 
there are three and only three that are nearly always depend- 
able in these cases: opium, mercury and castor oil. And I 
verily believe if these drugs are properly used most of the 
little ones will recover. 

Of course I want to be understood as advising that water 
should be freely used, both externally and internally. It is 
the best diuretic and I am almost persuaded it is the only 
sure and safe one for infants. 

Once more permit me to digress. I have seldom seen 
babies die of any sickness with unimpaired kidney function 
and still less frequently have I seen them recover after sup- 
pression. 

Going back to dentition, allow me to say that I am aware 
that the ultra-scientific would have us believe that since denti- 
tion is a physiological process it is necessarily a harmless 
process. I am also aware that they regard the theory that 
teething has any causative bearing upon this trouble as being 
a superstition that has been kept alive by and through ig- 
norance. I am also aware that these same scientists regard 
and denounce the practice of incising the gum above an ap- 
proaching tooth as a relic of barbarism. But if these same 
scientists could see, as I have seen, a peevish, fretful, nervous 
child immediately fall asleep after having a gum incised, and 
see an immediate change in the character of the discharge from 
the child’s bowels, I think it possible they would be less sar- 
castic and bitter when referring to this theory and practice. 

In conclusion, permit me to say that if you will dignify 
this paper and honor me by discussing its merits or demerits 
as the case may be, I will attempt, in closing the discussion, to 
go somewhat more into detail and will try to establish the 
rationale of the positions I have taken and the conclusions I 
have drawn. 


The Sixtieth Annual Session of the American Medical As- 
sociation will he held June 8th., 9th., 10th. and 11th. 1909, at 
Atlantic City, N. J. The House of Delegates will convene at 10 
A. M. on Monday, June 7th. The general meeting, which con- 
stitutes the opening exercises of the scientific functions of the 
Association, will be held at 10:30 A. M., Tuesday, June 8tli. 


MISSISSIPPI MEDIUM. MONTHLY. 


E. F. HOWARD B.S., M.D., Editor and Publisher. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D.. Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D.. Vicksburg. 

S. MYERS M.D.. Vicksburg. 


OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


All good and loyal members of the Association and all rep- 
utable physicians of Mississippi who are not members are re- 
quested to read the letters to the editor published in this 
issue and then stand up and cheer. If the New York Life will 
pay five dollars to one man it will do the same to another, 
and now for a physician in this state to make an examination 
for the three dollar fee is simply a statement on his part that 
he does not care for the other two dollars. 

Aside from this, all non conformists are requested to “read, 
mark, learn and inwardly digest” the new resolutions passed 
at Jackson. For the benefit of those who did not have the 
good fortune to be in the House of Delegates we reprint them 
here: 

Jackson 1909. 

Resolved, that the Association re-affirms the Gulfport resolutions, and 
that it is the sense of the Association that the acceptance by any member 
of any insurance-examination fee of less than five dollars is a tacit ad- 
mission on his part of professional inferiority to his fellow members who 
demand the five dollar fee. 

We have frequently had it said of us that we seemed to 
have no idea on earth except the insurance question, at least 
in the last two years, and probably our critics will be glad to 
see that the fight is nearing an end, for of course it isn’t en- 
tirely finished yet, so that we can write about something else. 
We admit that we have occupied our columns with the business 
of the New York Life Insurance Company’s fees to a great 
extent, and if we have contributed in any degree to the final 
outcome we are amply satisfied. Note we say “the final out- 
come”, for any doctor who now accepts the three dollar fee, 
knowing that he can get five, is so surely lacking in gray matter 
that a writ de lunatico inquirendo ought to speedily rid us of 
all the “cut-rates”. 


30 


TOtssissippt State TOeriital frssmxnixm. 


Brook ha vex, Miss., May 18th. 1909. 
To the Medical Profession of Mississippi: 

In this issue of the Monthly appears a list of section 
chairmen for our next association year. A special letter has 
been sent to them, requesting that they make up the program 
of home talent as far as possible. 

The object of this ‘‘open letter” is to call on the profession 
of the state to rally to the aid of these section chairmen in 
demonstrating that Mississippi doctors can get up as good a 
program as that of any other similar organization. We have 
the talent, as fine a body of men as can be found in any state 
association in the South, but they are modest and diffident, 
lacking the initiative. 

Now we want you to come forward and lend us these 
talents for the credit of your Association. Flease do not wait 
for the section chairmen to call on you, but volunteer your 
services. If you have had a valuable experience, illustrating 
a general principle, embody it in a short paper and offer it to 
the chairman of the appropriate section. 

Heretofore, chairmen of sections have complained that the 
doctors of Mississippi have treated them with scant courtesy, 
seldom answering their letters, much less complying with their 
requests for contributions. Please do not let that apply this 
year. At least extend them the courtesy one gentleman is 
always due another — a prompt reply to a request. If asked 
simply for a contribution, and you are not ready to give your 
subject, say that you will oblige them later, and set a date 
for a definite reply. The chairmen are requested to round up 
their program so that the section may present as far as pos- 
sible a complete form ; so that they should be the judges of the 
kinds of papers wanted. 

The chairmen are requested to get their programs in shape 
by January 1st. if possible; so they should take up the matter 
now soon. Please remember this, and be governed accordingly. 

The motto of this administration is “The best year’s work 
in the history of the Association”: will you help to make it so? 

Yours for progress, 

D. W. Jones, 

Pres't Miss. State Med. Ass’n. 


31 


SECTION CHAIRMEN. 


Medicine 

.B. L. Culley 

Jackson 

Surgery 

.F. M. Sandifer. . . 


Obstetrics 

.G. S. Bryan 


Gynaecology 

.T. M. Jones 


Materia Medica 

.E. Wright 


Pediatrics 

J. M. Dampeer. . . . 

. Crystal Springs 

Nervous Diseases 

. G. W. Stephens . . 


Venereal Diseases .... 

. Robt. Donald. . . . , 

Hattiesburg 

Hygiene 

.J. S. Ullman 


Dermatology 

.R. M. Sadler .... 

Okolona 

Bacteriology 

. W. S. Leathers. . 


Eye, Ear, Nose, Throat 

.D. G. Mohler . . . . 

Gulfport 

Electro-Therapeutics . . 

.Rosa Wiss 


Tuberculosis 

,P. R. Brown 

West Point 


SfltMg Trtftmltngs. 


East Mississippi Four County Medical Society met iu 
Aberdeen May 11th., Dr. Feemster being in the chair. Dr. O. 
S. McCown of Memphis, Tenn., was extended the courtesies of 
the floor and, after a brief address on the necessity of regular 
attendance, read a paper on the “Prognosis And Treatment Of 
Extra-Uterine Pregnancy”, which was discussed by Drs. Feem- 
ster, Lee and Wendel. After closing, Dr. McCown was ex- 
tended a vote of thanks. The author being absent, Dr. R. P. 
Wendel read a paper on “Ethical Medicine” by Dr. H. H. 
Kinney, which was discussed by Drs. Lee and Wendel. Dr. 
Feemster, calling Dr. Gatliings to the chair, moved that the 
August meeting of the society be held in Houston, Chickasaw 
County, which motion met with hearty approval by all present. 
Drs. Gatliings, McCown, Sadler, Rogers and Wendel gave short 
talks on society work. On motion of Dr. R. M. Boyd, seconded 
by Dr. Rogers, a vote of thanks was extended the Aberdeen 
physicians for their many courtesies during the day. The sec- 
retary read an invitation from Dr. G. S. Bryan requesting each 
and every member of the society to come to Amory to dine 
the second Tuesday in June, and regretting that his enforced 
attendance on the young aspirants at Jackson prevented his 
being at this meeting. On motion of Dr. Wendel, the society 
accepted the invitation. After adjournment the members of the 
society were the guests of the Aberdeen physicians at dinner. 

F. J. Underwood. 


32 


Harrison County Medical Society met in Gulfport May 
18th. with the following members present: West, Morris, Car- 
roll, Capps, Parker, Caraway and Mohler. Minutes of previous 
meeting read and adopted. Dr. Morris reported a case of un- 
known growth on a patient’s tongue. After discussion by 
various members it seemed to be the consensus of opinion that 
it was malignancy. Dr. West reported a case of ulcerated 
throat which he thought was malignant. As the patient had 
lost the vocal organs and palate and had great difficulty in 
swallowing, he advised going to the hospital in New Orleans 
and gave a tonic of elix. iron, quinine and strychnine. Strange 
to say the ulcerations healed at once and the patient refused to 
go anywhere. Dr. Carroll reported a case of keloids, which 
was discussed by all present. Dr. Parker told of a case which 
he had operated on recently for appendicitis; all went well 
for five or six days, when the patient suddenly developed 
uremia and died. The doctor wanted to know what caused it, 
as the wound was perfectly healthy in every respect, as post- 
mortem showed. Dr. Capps reported a case of rectal ulcer 
which had puzzled him much. Various opinions were offered 
as to diagnosis and treatment. Dr. Morris mentioned a case 
of supposed mushroom poisoning which was commented upon. 
Dr. Carraway reported a case of tetanus and the treatment he 
used, which was fully discussed. Dr. Capps reported about 
the New York Life Insurance fees. On motion Dr. Capps was 
entirely exonorated and thanked for his fidelity to the society. 
The New York Life Insurance Company is now paying the 
straight five-dollar fee, Dr. Capps showing a certificate from 
the agent to that effect. On motion the subject of scarlet fever 
was carried over to the next meeting. H. H. West. 

Histfln) (Df The 

Mississippi State Medical ^sseciatien. 

By far the most important work in medical legisla- 
1889. tion yet undertaken by the Association, with the pos- 
sible single exception of the original medical practice 
act, was inaugurated at the 1889 meeting, having its origin in 
a paper by Dr. B. F. Kittrell. The practice act passed in 1882 
had proven unsatisfactory in that it had created several boards 
of examiners and now it was decided the time was ripe to at- 
tempt the passage of an act creating one general examining 
board. 


33 


There was also entered, at this meeting, a formal protest 
against a ten dollar tax that had been imposed by the 1888 leg- 
islature on physicians. A committee was appointed to secure 
the repeal of this law and satisfactory results were reported at 
the next meeting. 

In the minutes of the 1890 meeting we find re- 

1890. corded one of the quaintest relics of the methods of 
older days to be found in all our annals. On sev- 
eral previous occasions the minutes of the meetings re- 
cord the expulsion of a member for unprofessional con- 
duct, but here is a record of a member being called 
before the president and by him publicly reprimanded, in open 
meeting; a remarkable testimony to the loyalty and self-control 
of the erring member when we consider how comparatively 
feeble the Association was at that time. The meeting in 

Meridian the following year, 1891, was without incident 

1891. of interest, the Association pursuing its scientific pro- 
gram and devoting itself to its own internal affairs. 

The Association went to Natchez for its 1892 meeting. 

1892. Acting on the recommendation of President Murry, an 
effort was made towards the establishment of local soci- 
eties as nuclei from which an increased membership might be 
drawn. The secretary presented a list of the books in the 
library of the Association, consisting chiefly of volumes of 
Transactions of various Associations. One of the features of 
this meeting was a steamboat excursion tendered the members 
by the citizens of Natchez. 

A called meeting was held in Jackson Nov. 2nd. of this 
year for the purpose of revising the Constitution and By-Laws 
and to elect members of the Board of Health. A draft of laws 
had been provided by the president and this, with recom- 
mendations and amendments, was laid on the table for action 
at the regular meeting. Five members of the Board of Health 
were elected as provided by statute. This is of interest as 
being the only called meeting in the history of the Association. 
In 1893 the Association returned to Jackson. Action 

1893. was taken on the revised Constitution and By-Laws in- 
troduced at the called meeting in November. In the 

minutes of this year is found an intimation that the records 
of the Association were carelessly kept, a committee being ap- 
pointed to find the missing charter. 

The 1894 meeting, held in Jackson, was chiefly of in- 

1894. terest from the quantity of scientific work accomplished. 
There was a movement set on foot for the establishment 

of a public bacteriological laboratory. 


34 


In 1895 the Association turned its attention to the cre- 
1895. ation of a Department of Public Health, which was soon 
afterwards passed upon favorably by the legislature, and 
took up the question of a Medical Department of the State 
University. The charter inquired about at the 1893 meeting 
had evidently failed to materialize, for a committee was ap- 
pointed to prepare and record one. 

The 189(1 meeting was held in Vicksburg, where the 
1890. Association relaxed somewhat from its strict adherence 
to scientific work and business and indulged in a ban- 
quet and steamboat excursion, tendered by the citizens. The 
question of a medical department for the State University was 
again agitated, the president stating in his address that the 
legislature had committed itself to such a step. 

The Association returned to Jackson for its 1897 meet- 

1897. ing. One feature of business at this meeting that at- 
tracts attention was the establishment of a monthly 

journal to be published in lieu of the Transactions, by taking 
over the Mississippi Medical Record which had just been estab- 
lished as a private venture. This plan of publication was con- 
tinued by the Association for four years, after which the jour- 
nal was discontinued and the Association returned to its former 
method. 

The 1898 meeting was particularly notable because of 

1898. an organization of a “Department of Public Health”, 
established by legislative enactment. This Department 

had for its object “the collection of vital statistics, the develop- 
ment of medical literature and a general superintendence over 
the health interests of the state”. For several years the report 
of its chairman was one of the features of the annual meeting 
of the Medical Association, there being each year a brief men- 
tion of it in the Transactions until 1904, after which it appar- 
ently failed to excite interest among its members or to do any 
work. 

The 1899 meeting was comparatively free from matters 

1899. of more than scientific interest. The Association took 
issue with some recent resolutions of the American 

Medical Association and spent an exciting morning hauling 
the “Vicksburg Herald” over the coals for wrongly reporting 
the ideas put forward in one of the papers read before the 
meeting, but with these exceptions the members attended 
strictly to scientific business. 

Once again the Association abandoned the beaten track 

1900. and went from Jackson for its annual meeting, Meri- 
dian being the place selected. Unprecedented Hoods in- 


35 


terfered with the attendance of many of the members, there 
being only twenty-three who answered the first roll-call and 
most of these being members resident in Meridian. Adjourn- 
ment was taken for twenty-four hours in the hopes that more 
would come in, but the next day it was decided that the at- 
tendance would not justify a continuance so an adjournment 
was taken for a month, the meeting being held in May, when 
the Association reconvened in the same city and held an in- 
teresting meeting. The legislature was petitioned to provide 
quarters for the Board of Health in the new capitol building 
and the Board was endorsed in its actions during the epi- 
demics of the previous year. An excursion to Arundel Springs 
was enjoyed by the Association as a body. 

1901 saw the Association back in Jackson. The theory 
1901. of transmission of yellow fever and malaria by the 
mosquito had the floor in a most interesting discussion. 
Drs. Hunter and Gant of Jackson presented a paper on Con- 
tagious And Infectious Diseases that was ordered printed for 
distribution among the members of the legislatiure and a com- 
mittee was appointed to present the facts contained therein 
to them at the next session. 

{to be continued) 


^ssuriatirm Vxmxdmts. 


L. SEXTON, New Orleans, La. 

President 1888-89. 

Luther Sexton was born at Crystal Springs, Miss., Oct. 
7th. 1858, his parents being natives of Virginia and Massachu- 
setts. He was educated at the University of Mississippi and 
graduated in medicine from Tulane in 1882. From the date 
of his graduation until 1890 he practiced his profession at 
Wesson, thence moving to New Orleans, La., where he after- 
wards became Instructor in Minor Surgery at Tulane and later 
Professor of the same branch. He married in 18S6 Miss Kath- 
erine McLaurin Hartwell of New Orleans. 

Dr. Sexton was three years interne at Charity Hospital, 
New Orleans, winning the competitive gold medal on his grad- 
uation. He was a member of the Mississippi Board of Health 
from 1886 to 1890 and of the Louisiana Board of Health from 
1896 to 1897. He is now Medical Director of the Louisiana 
National Life Insurance Co., and besides his county, state and 


36 


national affiliations is member of the Academy of Railroad 
Surgeons, of which he was president in 1902. 

Personal Notes 1907. 


J. E. HALBERT, Mound Landing. 

President 1889-90. 

J. E. Halbert was born in Greene County, Ala., December 
2nd. 1850 and died in New Orleans August 27th. 1892. While 
yet an infant his father emigrated to Scott County, Miss., in 
the common schools of which he was educated. Taking his 
degree from Jefferson Medical College, he settled in Forest 
and became associated in practice with Dr. T. H. B. Williams. 
Later he moved to Leota, Washington County, where he re- 
mained ten years, going to Florida for his health. One year 
later he returned to Mississippi, going to Mound Landing in 
Bolivar County, where he passed the remaining years of his life. 

Dr. Halbert served in the lower house of the legislature 
in the session of 1888-9, doing good service for the medical 
profession. He never married. 

Transactions 1893. 


G. W. TRIMBLE, Grenada. 

President 1890-91. 

G. W. Trimble was born in Limestone County, Alabama, 
in 1822, being the only child of Archibald and Margaret Reese 
Trimble, and (lied March 23rd. 1901. 

Archibald Trimble was of Scotch-Irish parentage and had 
three brothers in the war of 1812. He was one of the first set- 
tlers of Alabama. The maternal grandfather. Rev. Solomon 
Reese, was a Cumberland Presbyterian minister of North Ala- 
bama. 

The subject of this sketch began life on his own account as 
a small boy in a printing office in Nashville, Tennessee, and 
continued this business until his twenty-third year, being at 
that time editor of the Aberdeen Bee. He then began the study 
of medicine with his half brother, Dr. J. A. Trimble of Rus- 
selville, Alabama, and graduated from the Medical College of 
Louisville, Kentucky, in 1852, settling in Grenada. At the 
outbreak of the war between the states he was appointed as- 
sistant surgeon of the Second Mississippi Infantry, but had 
the misfortune to break a leg shortly after and so saw little 
service. He spent the remainder of his life in Grenada, being 
associated in practice for a number of years with Dr. J. W. 
Young. 


37 


Dr. Trimble was married in 1842 to Miss Ella Barksdale 
of Pickens County, Alabama, and to this union was born one 
son, Joseph. In 1856 he married Mrs. Rebecca Thomas, a 
native of South Carolina, who became the mother of Mary and 
Charles Trimble. 

A resident of Grenada for half a century, and being the 
strong man that he was, he left the imprint of his high char- 
acter on the people of both county and state. His virtues were 
many, his faults few, and he left a rich legacy of good deeds 
well done. He was a true husband, a kind father, an honorable 
physician and a good citizen. 

Dr. J. W. Young. 


JNO. Y. MURRY, Ripley. 

President 1891-92. 

John Y. Murry was born in McNair County, Tenn., May 
6th. 1829, of Carolina stock, his father being a veteran of the 
war of 1812, serving with Gen. Jackson in the battle of New 
Orleans. He had one course of lectures in the medical depart- 
ment of the University of Louisville in 1848-9 and was grad- 
uated from the Jefferson Medical College in 1885. He has 
been engaged in practice at Ripley since March 1849, except 
during the civil war when he served as a captain in the Thirty- 
Fourth Mississippi Infantry, with the Army of Tennessee, 
under Gen. Bragg. He has served his county as treasurer, as 
sheriff and as representative to the legislature. He was for 
ten years chairman of the Democratic executive committee of 
Tippah County and was a delegate to the Democratic national 
convention of 1880, in Cincinnati. Besides his county, state 
and national medical affiliations, he is a member of the Tri- 
State (Miss., Ark., Tenn.) Medical Society. 

In 1849 Dr. Murry was united in marriage to Miss Emily 
Holcombe of Ripley, who died in 1859 leaving four children : 
Sallie, wife of J. W. T. Faulkner, an attorney of Oxford; Dr. 
Wm. M., a physician of Dumas ; Emily V., wife of J. S. Harris 
of Ripley ; and Elizabeth, the widow of Dr. E. N. Hunt, who 
has been for many years librarian of the University of Missis- 
sippi. In 1860 Dr. Murry married Miss Mary Miller of Ripley, 
by whom he had six children: J. Y., an attorney of Ripley; 
Mary E. ; Dr. Chas. M., who is associated in practice with his 
father; Margaret T., wife of E. R. Richey, a druggist of Ripley ; 
Anna M.; and Julia M., wife of Robt. A. Cox, a banker of Hico, 
Texas. 

Rowland’s History of Mississippi 1907. 

2— M 


38 

lattes ta the gdtor, 


Gulfport, Miss., May 4th. 1909. 

Dr. E. F. Howard, Editor, 

Vicksburg. Miss. 

Dear Doctor: 

It appears that the Harrison County Medical Society was 
misinformed at its last meeting. Now, in justice to myself 
and in regard for the truth, I will ask you to kindly publish 
the following statement: I am not examining for the New 

York Life for a stated sum or salary. I am not examining for 
the New York Life for less than five dollars. 

Very truly yours, 

Henry S. Capps M.D. 


Gulfport, Miss., May 19th. 1909. 

Dr. E. F. Howard. Editor, 

Vicksburg, Miss. 

The Harrison County Society has at last got the vexed life 
insurance examination matter settled. When the life insurance 
business first came up, all members of the society signed the 
five-dollar resolutions and we also got every doctor in the 
county who was not a member to sign the same. Later a doctor 
in Biloxi, a non-member, went back on his word and made 
examinations for the New York Life Insurance Company. The 
society could do nothing in this case. The company then sent 
special agents to Gulfport and made various propositions to 
all the doctors but did not succeed in getting an examiner 
among the members or non-members ; later they got Dr. Gal- 
loway in Mississippi City to examine on a salary basis. The 
society at once notified Dr. Galloway and he resigned at once; 
it seemed that the doctor misunderstood the insurance resolu- 
tions. Some mouths later they got Dr. Capps of Gulfport to 
examine for them on a salary basis. We called Dr. Capps’ 
attention to tbe matter and he resigned. The company then 
made various propositions to the doctor which he would not 
accept. Finally they came across with the straight fee, the 
agent giving a certificate to that effect. I give the certificate: 

“Gulfport, Miss., May 6th. 1909. 

“This is to certify that Dr. Henry S. Capps has never made 
an examination for me for less than five dollars and further- 


39 


more that I have no secret agreement with him to supplement 
his fee in any way whatever. 

J. T. Burnside, 

Agent New York Life Insurance Co. 

Dr. Capps states that he gets a full five dollars for each 
and every examination and that he has no salary agreement 
with the company. All the other companies doing business in 
this county have come across with the five-dollar fee. We 
presume that the New York Life is still paying the doctor in 
Biloxi the three-dollar fee. He is not a member of our society. 

H. H. West, 

Secretary Harrison County Medical Society. 


Stank lUmms. 


SANDERS POCKET MEDICAL FORMULARY with an appendix 
containing posological tables, etc., etc., by William H. Powell M.D., 
ninth edition. Thoroughly revised, enlarged and adapted to the U. 
S. P. VIII. W. B. Saunders Co., Philadelphia, 1909. Price $1.75 net. 

This little work is perpetrated by one of the jokesmiths 
of the medical profession. It is indeed wonderful to relate that 
it has passed through nine editions, therefore indicating that 
in some parts of our fair country there exist physicians who 
buy a book of ready-made prescriptions and give the formula 
indicated, regardless of the dosage or other circumstances in- 
fluencing the patient. Everything is treated in the book, and 
we cannot see why its possession by every householder should 
not abolish the physician altogether. Why pay a physician to 
copy a prescription out of this invaluable formulary when the 
book itself can be bought for less than the price of one visit. 
The most interesting feature is the blank leaves interposed 
between the sections. On opening the book, the first subject 
treated of is abortion, and we were in some doubt as to whether 
the author meant that to be the title page of the book. Closer 
inspection revealed the fact that it gives prescriptions for every- 
thing from abortion to yellow fever! Hurrah! for scientific 
education ! Myers. 


ERADICATING PLAGUE FROM SAN FRANCISCO. Report of 
the Citizens’ Health Committee and an account of its work. Prepared 
by Frank Morton Todd, Historian for the Committee. 

The transmission of plague having been demonstrated, the 
efforts of this committee, under the direction of Dr. Rupert 


40 


Blue of the P. H. and M. H. S., were directed to the destruction 
of rats, fleas and flea eggs. As a demonstration in preventive 
medicine the San Francisco epidemic is an object-lesson to the 
world, not only as to what can be done by scientific methods 
but as to the absolute necessity for co-operation on the part of 
the people during times of stress, and is on a par with the 
work done in many of our Southern cities during the yellow 
fever epidemic of a few years ago. 

Howard. 


CONSTIPATION AND INTESTINAL OBSTRUCTION. By 

Samuel G. Gant M.D., LL.D., Professor of Diseases of the Rectum 
and Anus in the New York Post-Graduate Medical School and Hos- 
pital. Octavo of 559 pages, with 250 original illustrations. W. B. 
Saunders Company, Philadelphia, 1909. Cloth, $6.00 net ; Half Mo- 
rocco, $7.50 net. 

Constipation being a subject that all of us are called upon 
to treat more frequently, probably, than any other, and the 
results of the treatment being so generally unsatisfactory, all 
will welcome this masterly work of Dr. Gant with eagerness 
and read it with satisfaction. The chapter on etiology is alone 
worth the x>riee of the book, the different causes of constipa- 
tion being so beautifully described that average common sense, 
applying them, can in many instances outline the treatment, 
which for the most part, in the simple cases, is nothing but 
hygienic living and the use of proper food. The chapters on 
surgical conditions are well and clearly written and while ap- 
pealing more to surgeons, of course, give a very clear and 
definite idea of how far the phyician should go before referring 
his patient to the specialist. The illustrations and presswork 
are the best that could be asked. 

Howard. 

INTERNATIONAL CLINICS, A Quarterly Of Illustrated Clinical 
Lectures And Especially Prepared Original Articles edited by W. T. 
Longcope M.D. Vol. I, Series 19. J. B. Lippincott Co., Philadel- 
phia. Price $2.00. 

This latest edition of the well-known and justly popular 
quarterly contains in addition to the customary line of articles 
a review of the year’s work in treatment, medicine and surgery. 
It is a bad move, though not altogether new, making of what 
was our best clinical quarterly a combination journal and year- 
book that is neither fish, flesh nor good red herring. If the 
quarterly had been a failure we could understand this going 
out from the beaten track, but it is so much beyond the average 
work of fins class that we can but wonder why the editors take 
so much pains to spoil a good thing. Howard. 


miSSISSIPPI DIEDICHL IONIHLY 


VOL. XIV. JULY 1909. No. 3 


* PROPHYLAXIS OF INSANITY. 


J. M. BUCHANAN, 
MERIDIAN. 


The most serious problem that confronts the student of 
sociology to-day is the prevention of the increase of defectives, 
both criminal and insane; and, as these two classes are so 
closely allied, we cannot speak of the one without taking into 
consideration the other, although the purpose of this paper is 
to deal with the mental defectives. This question has been 
prominent in associations dealing with political and sociolog- 
ical problems for several years. 

There has been much discussion and some legislation re- 
garding the matter, but so far not much good has been ac- 
complished. Those who have given the question thought, be- 
lieve the problem before us is to stamp out hereditary dis- 
eases, to prevent offspring by those predisposed to crime and 
insanity and to prevent offspring from those who by heredity 
or otherwise have uncontrollable desire for alcoholic drink and 
drugs. 

In speaking of the stamina of the race, Dr. Van Meter, of 
San Francisco, in an article last year, made these strong re- 
marks: “Can anyone imagine what a race of beings we might 
be if, starting with pure blood for fifty generations, there is 
not a contaminating element allowed to enter? It would be 
a race Solomon-like in wisdom, Samson-like in size and 
strength, and Adonis-like in symmetry and beauty. Except 
from some indiscretion in food or drink, in dress or from 
exposure, there would be no disease, and death would only 
come from violence and senility”. 

The purpose of this paper is to bring before this body 
the means by which these glorious results might be obtained, 
but before dealing with remedial agencies, let us for a short 
time review the cause and effect of these stigmata. That there 
is a palpable increase of insanity beyond the increase of popu- 
lation is an evident fact, but not so great as would appear from 

* Readbefore the Mississippi State Medical Association at its Annual Meeting in 


41 


42 


statistics, because of the faulty former census methods, and the 
constant addition of new hospitals for the insane, which gives 
greater facilities for caring for and congregating the defective 
classes. 

It will be impossible to deal with all the etiological causes 
of insanity, and I shall only consider the most potent factors. 
Of these, heredity, ill health, bodily diseases, such as syphilis 
and diseases of the nervous system, toxic poison, alcohol and 
narcotics, are regarded as the chief factors. 

Peterson speaks of the etiology of insanity as being de- 
scribable in two terms, ‘‘heredity and strain”. 

Heredity which renders the nervous organization unstable; 
the strain which causes the unstable nervous system to collapse. 

The question of heredity alone would consume more time 
than is allowed to this paper, and we can only touch on the 
most important points. 

In determining the factors of heredity, we must not be 
content with ascertaining the existence of psychoses in the 
ascendants, but we must also consider some of the hereditary 
equivalents, such as epilepsy, chorea, neurasthenia, general 
nervous diseases, drunkenness, etc., for these equivalents inter- 
change from one generation to another, and it is the unstable 
organization that is inherited — not the particular psychosis. 
(Peterson) 

Mereier on “Sanity and Insanity”, in speaking of the law 
of heredity, points out that besides the direct inheritance of 
unstable nervous system, there is another law of heredity 
which is known as the law of consanguinity. 

Two parents may be perfectly stable and have normal or- 
ganisms and yet produce offspring with unstable and abnormal 
nervous systems, because of the unsuitability of the sexual ele- 
ments of the parents to each other. The perfect organization 
of the progeny is the result of three factors: the quality of 
the germ, the quality of the sperm and the suitability of the 
one to the other. If both parents are wanting in the same 
units, then the offspring will also be wanting in that unit. 
For example, two congenitally blind people are more than likely 
to produce blind children, but if one unit is lacking in the 
father and a different unit is lacking in the mother, then the 
children may be healthy. This point emphasizes the danger 
of consanguineous marriages, where the same units are more 
than likely to be found wanting in members of different 
branches of the same family. 

When we come to study the principle of heredity, re- 
membering that there is alwa}s a danger of latent hereditary 


43 


taint, and that there is also a variation in the degree of 
hereditary taint, we can explain some of the puzzling features 
of heredity, why it is that all children of neurotic parents do 
not suffer from some form of psychosis, while in children of 
apparently healthy parents these troubles manifest themselves. 

Most of the authors give heredity as the cause of insanity 
in from fifty to seventy per cent., which I believe would be 
larger if we were able to obtain a correct history of all the 
antecedents. 

Alcoholism, either directly or indirectly, is possibly the 
next greatest factor in the production of degenerates. I be- 
lieve that hereditary influence has been pursued with more 
accuracy in regard to criminal defectives than with the in- 
sane; and to show to what terrible extent one depraved family 
may vitiate the human race, I want to call attention to the 
statistics gathered by The Prison Association, of New York, 
in regard to a criminal family by the name of Jukes, and, as 
figures cannot lie, the tale is well worth considering. 

Five Jukes sisters in seventy-five years had one thousand 
two hundred descendants, embracing every form of degenerates. 
Paupers, two hundred and eighty; criminals, one hundred and 
forty ; thieves, sixty ; murderers, seven ; immoral women, one 
hundred and sixty-five; illegitimate children, ninety-one; loath- 
somely diseased, four hundred and eighty known cases. 

No sane man can believe that their maternity was any- 
thing less than criminal. 

With these brief but important facts before us, it is evi- 
dent to every one that it is our duty to strike at the root of 
this evil. This question is easily solved by the savage races, and 
in the study of such races we find the smallest per cent, of 
insanity. Heredity is practically eliminated, from the fact 
that the insane and degenerates are either put to death, or 
die from neglect, and the stamina of the race is preserved by 
the law of the survival of the fittest. In the struggle for exist- 
ence, the weaklings, either moral or physical, succumb early 
and only the strongest survive. 

On the plains where the wild herds of cattle and horses 
roamed at will, it was always the strongest male that stood 
sponsor for the herd. Such is not the case in civilized races, 
and with the highest type of animal, man, there is nothing done 
to improve the race by selection, and the most unfit often bring 
into the world the greatest number of children. The only 
thing that saves the race, is the fact that in a few generations 
this class naturally becomes sterile, but before that generation 
is reached undesirable progeny is scattered broadcast. 


44 


It is time that something be done, for if this increase of 
deficients continues, each man will be called on to care for his 
defective brother, and the race will decay and pass away. 

Kace improvement should be the earnest desire of every 
public-spirited citizen. 

The first apparent object of civilization is to set an equal 
valuation on human life, and the prolonged continuance of 
human lives is the first object of effort. 

This is the principle reason why the more civilized a coun- 
try, the more multiplied become its deficients and dependents, 
and the greater the demand for charities. 

By improved sanitation, more scientific medication and 
more abundant necessities of life, the average length of human 
life has been raised to about forty years. 

This is accomplished by bringing up the more numerous 
short-lived, from childhood to adult life, where they propagate 
their kind. 

Very little is done to prevent the naturally greater in- 
crease of the number of defectives. This is a perplexing ques- 
tion, and one most difficult to solve humanely. 

The remedial measures so far proposed are restricted mar- 
riage and the unsexing of all deficients. (T. J. Searcy) 

Some legislation has been obtained prohibiting the marry- 
ing of people affected with certain diseases, and in some states 
it is lawful to make defectives sterile by surgical operations. 

Iso law of this kind can be made effective unless it is 
national and uniform in all states, for no good can be accom- 
plished if one state prohibits marriage without a medical cer- 
tificate when there is no restriction in bordering states. 

It is also to be remembered that we are dealing with 
reasoning beings, possessed of uncontrollable natural appetites, 
who would oppose such restrictions, and they cannot always be 
handled at will. 

My personal observation leads me to believe that some good 
can be accomplished by such means. It is not uncommon 
for patients, both men and women, to be returned to the 
asylum after being at home for five years, and during that time 
children were born to them. 

If restrictive measures are confined to the inmates of in- 
sane hospitals and penitentiaries, no appreciable effect will be 
had on the next generation, for such classes are recruited in 
a large majority from all deteriorating ranks of society, rich 
and poor alike, and it would be impossible to place such sur- 
gery where it would do the most good. 

I- believe the greatest good can be had through education, 


4.S 


and laudable attempts have been made of late to increase gen- 
eral information on the subject of sexism. How to teach this 
subject to the innocent has been a theme for discussion among 
educators. 

It can be properly approached by teaching the principles 
and truths of biology. The continuance of species is the living 
thread that holds the study together. 

It could be approached in a way to give least offense to 
usual ideas of propriety, by first teaching the scientific propa- 
gation of species in plant life and then taking up the animal 
kingdom, showing the value of selection in the production of 
the finest strains in animals, and then the physiology of the 
reproduction of human species would naturally follow. This 
would remove all mystery and correctly instruct the natural 
inquisitiveness, which all children have, in a legitimate way. 

This education begun in school must not cease, for unless 
the mother can be taught the great responsibility that she owes 
to her progen } 7 but little good can be accomplished. 

“The women, the wives, the mothers, must be taught the 
truth, they must be told the facts and learn the results to them- 
selves, their children and the world at large, of perpetuating 
the diseases and imperfections which threaten the race, and 
that bringing into the world degenerates, imbeciles, drunkards 
and consumptives is a crime against the child, against the home 
and against the nation.” (Mrs. Alice Lee Lemoque) 

Emerson has said : “A man is what his mother made 

him”, and while education and environment may accomplish 
some good, no mother love nor maternal care after birth can 
ever make up to a child for the sins committed against it by 
forcing it into being unasked, to suffer the penalty imposed by 
nature for broken laws. 

In the education of the young, training and instruction 
should follow the indications of nature. While the children 
are young and alike, the same methods and subjects of in- 
struction can be properly pursued, but as they begin to put 
on sex changes, subjects and methods of education should 
diverge; whatever education is given should be in line with the 
natural specialty of each child. 

In this respect our public schools are at fault. It takes 
a man of more temerity than I possess to attack our public 
school system, and I am not here for that purpose, but a mis- 
take is made when a class of children is started in our graded 
schools with the hope and expectation that all are to be forced 
through a fixed and hard curriculum for ten years. 

It has been claimed by some that if all the children of a 


46 


community were subjected to the same environment of training 
and education they would make equally successful and ethical 
citizens. Of course it is a great advantage to a person to have 
him placed in an environment where good training and edu- 
cation are administered to him, but the inherited abilities for 
acquiring knowledge cause a great difference in the output of 
environment. 

Then, since all children are not equally endowed, either 
mentally or physically, no one should be forced beyond its 
capabilities, and the first effect of strain is felt in a school of 
fixed grades. 

If a child is health}’, bright and ambitious, he may com- 
plete the course without injury, but if delicate the strain to 
keep iip with the class may cause collapse before the course is 
finished. If a boy is neither bright nor ambitious he becomes 
careless, discouraged, indifferent and finally vicious ;then he is 
sent home and, the parent being discouraged, the boy is allowed 
to drift, finally terminating in one of the classes of deficients. 

We aften boast that two million dollars are given to the 
common schools for the common child, and we should be 
ashamed of the fact that nothing is given for the uncommon 
child. Special schools for this class would save many children, 
and they could be taught to become useful citizens and bread 
winners, instead of criminals and dependents. 

Technical and manual training schools should be added to 
the public school system, and when children are found to be 
unable to take the literary course with ease and satisfaction, 
they should be placed in the other schools. Their peculiar 
tastes for a certain line of study or work should be considered, 
and, if intelligently bandied, they would become interested and 
developed, whereas the forced effort to carry them through the 
regular curriculum might result in permanent injury. 

In this connection, the family physician could render valu- 
able assistance to the family by advising with the parents in 
regard to the course of study each child should pursue, for he 
should know the peculiarities of the child and be able to 
direct with intelligence the line of work for which he is best 
fitted. It would be a long stride in the right direction if our 
schools were under the supervision of an intelligent physician, 
who should advise from time to time with the principals of the 
schools. 

Toxic poisons, including alcohol and drugs, are said to be 
responsible for twenty to thirty per cent, of defectives, and 
direct injury to the general nervous system from this cause is 
wide spread throughout the land. 


47 


Perhaps a more general awakening to this danger than 
any other is being aroused all over the country. Prohibitory 
laws to prevent and restrict their sale and use are being 
enacted by almost all the states, and associations of men and 
women are organized for the purpose of combating these evils. 
Alcohol stands first, because of its direct injury to the brain, 
but the anodynes, morphine, cocoaine, caffeine and the like, all 
do brain injury and tend to develop latent predisposition to 
mental abnormalities. They also develop a neurasthenic con- 
dition, which in turn may become a dope-diathesis to be in- 
herited by the children of such victims. 

The medical profession is largely responsible for the de- 
velopment of the morphine habit and its far-reaching conse- 
quences. 

In almost every instance, the beginning of taking drugs 
can be traced to some physician, and we cannot be too careful 
in administering this drug, and it should never be given except 
in extreme and transient cases. 

So far my remarks have been directed to deterrent agencies, 
such as vitiate the constitution of the individual, and have 
tried to show 7 how 7 psychoses appear most readily in those w 7 ho, 
either from heredity or direct injury to the various nerve 
centers, are deteriorating in tone. Now 7 , in conclusion, let me 
say that a deterioration in the general health of a person 
tends to bring out any inherited or defective physiology in his 
brain, as well as in other organs. 

The question of public health, then, is a most vital one, for 
whatever conditions tend to vitiate general health also affect 
the mentality of the community. 

Due credit is given Dr. Peterson, Dr. Searcy and Dr. Van 
Meter for information obtained from their articles along these 
lines. 


* USE AND ABUSE OF THE NITRITES. 


P. W. ROWLAND, 

OXFORD. 


A certain medical professor in the city of Detroit made 
this statement: “Diagnosis is the thing; any damn fool can 

treat disease”. 

Let’s see. All physicians treat disease; any physician may 
be a damn fool; this physician treats disease; ergo: this physi- 
cian may be a damn fool. 

* Read before the Mississippi State Medical Association at its Annual Meeting in 
Jackson, 1909. 


48 


I certainly do not agree with the learned but erratic pro- 
fessor. Men cannot successfully practice medicine by science 
alone. The diagnostician is not the master of disease. He who 
unites with the skill of the diagnostician the art of applying 
remedies to the treatment of disease is the master. 

It is not to be denied that this sentiment expressed by the 
learned physician in question has too long dominated the minds 
of many of our profession, leading to its logical end, thera- 
peutic nihilism. I maintain that the study of therapeutics is 
just as important as that of diagnosis, and we are to be con- 
gratulated that a revival of the study of this branch of medical 
science has begun. 

I wish to call your attention at this time to a group of 
drugs in common use, and yet, to my mind, very frequently 
misapplied; namely, the nitrites. 

They are frequently called, but erroneously so, ‘‘vascular 
stimulants’’, “heart stimulants”, and in very many conditions 
are prescribed for the purpose of stimulating a weak heart. 

The nitrites are pre-eminently vaso motor dilators, and 
have no direct effect on the heart. Let us notice, for a moment, 
the symptoms incidental to the administration of a few drops 
of amyl nitrite. The phenomena are practically the same in 
other members of the group. There is at once a dilatation 
of the meningeal vessels which is followed by redness of the 
face, heat, throbbing in the head, and sometimes headache. 
These symptoms are accompanied by a rapid fall of blood 
pressure, with increased rapidity of the heart beat. These 
phenomena are due to the dilatatiou of the blood vessels of 
the body, both arterioles and veins, and to a paralyzing effect 
on the cardiac inhibitory center. This is the result of moderate 
doses; larger doses slow and weaken the heart owing to the 
depressing effect of the drug on the heart muscle. It has never 
been shown by any experiments that the nitrites stimulate the 
heart muscle, either by direct application of the drug to the 
heart or upon the nervous mechanism controlling the heart, and 
the administration of any member of this group, amyl nitrite, 
sodium nitrite or nitro glycerine, for the purpose of stimulating 
a weak heart is altogether irrational. 

It may be said that there is practically only one thera- 
peutic indication for the use of the nitrites; namely, in in- 
creased blood pressure, and in certain conditions where this is 
the controlling indication to be met, they are, perhaps, the most 
important agents at our command. The habit of prescribing 
the nitrites in fevers as a heart stimulant should be condemned, 
since in this case there is no increased resistance, and the 


49 


heart is already weakened, and an increased lowering of the 
blood-pressure could result only in harm. 

In those cases of pseudo-angina pectoris, when the blood- 
pressure is very high, due to a contraction of the walls of the 
blood vesesls from nervous excitation, no more valuable drug 
than amyl nitrite by inhalation, or nitro glycerine subcutane- 
ously, is to found. 

On the other hand, in true angina pectoris there is a thick- 
ening in the vessel walls, particularly of the coronary arteries, 
and a narrowing of the caliber of the vessels due to arterioscle- 
rosis. Only temporary benefit may be expected in this class 
of cases from the use of the nitrites. 

In the symptom of asthma, the result of so many forms of 
nervous irritation, both functional and organic, the nitrites are 
very frequently our sheet anchor. 

In fatty degeneration, where the weakened heart is incapa- 
ble of overcoming the resistance in the vessels, and where digi- 
talis would be eontratindieated, the nitrites are of great value. 

There is one point which must not be overlooked in the 
administration of these drugs: they are very rapid in their 
rate of absorption and excretion. In the case of the inhalation 
of amyl the effects are instantaneous, and pass off within a few 
seconds, the effect not lasting longer in the human than half 
an hour. In the case of trinitrin, ethyl nitrite, sodium nitrite, 
the effects appear in a few minutes, and last somewhat longer, 
one-half to two hours. Erythol nitrite appears after a much 
longer interval and lasts much longer than the others, some 
three or four hours. In cases of valvular disease of the heart 
complicated by nephritis the nitrites do valiant service, espe- 
cially when administered along with digitalis. In these cases 
the accompanying vaso constriction is to be overcome, and at 
the same time the weakened heart must be strengthened, and 
in no way can this be better accomplished than by the con- 
joined administration of the two drugs. The nitrite, on ac- 
count of its more rapid action and excretion, must be adminis- 
tered more frequently than the digitalis. 

Conclusions. Nitrites are indicated in arterio-sehlerosis, 
in spasm of the arteries, angina pectoris, asthma, cold extrem- 
ities, in hemorrhage due to high blood pressure. 

Contraindicated in weak heart when not due to increased 
resistance. 


Dr. H. N. Street, formerly of Gloster, has removed to 
Little Rock, Ark., where he has accepted the position of asso- 
ciate professor of gynecology and pelvic surgery in the College 
of Physicians and Surgeons. 


50 

* THE NERVOUS REFLEXES AND COMPLICATIONS DUE TO 
PREGNANCY : THEIR CAUSES AND TREATMENT. 

I. H. C. COOK, 

HATTIESBURG. 


The principal nervous, or so-called nervous, reflex of which 
1 intend to speak, is the extreme nausea accompanying the 
majority of pregnant women. 

This usually begins about six weeks after the cessation 
of the menses, the beginning of the conception, and lasts for 
several months. 

Most authors whose writings I have investigated claim that 
this extreme nausea and vomiting is due to nervous reflex, 
which they claim is carried from the uterus through the con- 
necting nervous supply. This is no doubt true as far as it 
goes; the question of how this reflex is brought about is another 
thing; why the cessation of the menstrual flux and beginning 
conception and growth of a fetus in utero should cause these 
violent disturbances in the digestive aparatus, has been the 
subject of investigation for ages past among the profession. 
Edgar and some others say that it due to a stretching of the 
uterine muscles, bringing on an irritation of the uterus and 
reflexly irritating the stomach. 

I do not know that what I have to say in regal'd to this sub- 
ject will be entirely new or not; I have not seen this idea ad- 
vanced by anyone. 

I believed for many years that there was a congestion of 
the spinal sympathetics. brought about by the change caused 
by pregnancy, but for twenty -five years past I have changed 
this view, and believe now that the opposite condition results, 
\iz: an anaemic condition of the sympathetic ganglia, caused 
by the congestion which takes place in the uterus, due to in- 
creased blood supply necessary for new life. 

The weight of the uterus is increased, and pressure on the 
surrounding organs, bladder and rectum, as well as other im- 
portant adjacent organs, the nerves, blood vessels, etc., pro- 
duces such a change, that not only do they have nausea or stom- 
ach irregularities, but pressure on the rectum causes consti- 
pation, with all that follows. 

I do not believe that one cause alone is responsible for the 
nausea which accompanies pregnancy. Uterine engorgement, 
causing prolapsus, pressure on rectum producing constipation, 

* Read before the Mississippi State Medical Association at its Annual Meeting in 
Jackson. 1909. 


51 


thereby causing absorption of ptomains, brings on other ner- 
\ous troubles besides indigestion, loss of appetite, anaemia of 
spinal sympathetics, which cause irregular heart action and 
pseudo-hysteria and finally convulsions. 

To come to the point, then, we have uterine engorgment, 
stomach irritation at first, partial paralysis of the bowel, and 
an anaemic condition of the sympathetic ganglia as a result, 
and finally circulatory disturbances, and partial paralysis of 
function in these ganglia. Now these, in my opinion, are the 
causes of these complications and neuroses. 

Now as to treatment, the removal as far as possible of 
the causes. The engorged uterus can be relieved by several 
different means. 

First is the use of cold douches in the vagina, cold hip 
baths, some support of the uterus, such as a soft cotton wool 
tampon saturated with twenty-five per cent, solution of boro- 
glycerine, confining the patient to the reclining position. 

A laxative of a pleasant nature, such as aromatic cascara, 
with elixir celery compound, or some other preparation best 
suited to the taste of the patient; enemas of soap and water 
injected into the rectum at least once daily, give relief. 

If the case has received no attention, and is of several days 
or weeks duration without treatment, there is generally a very 
tender condition of the ganglia of the stomach, spinal sympa- 
thetic, due to its anaemic condition. Friction, with a strong 
liniment, a mustard plaster, or dry cups, repeated as often as 
needed to increase the blood supply in this ganglia, will give 
great relief. 

In the worst cases, all medicine per orem should be left 
off, and the indications met by rest of the stomach, and medic- 
inal treatment given by the rectum, and counter-irritation over 
the seat of the sympathetics, as mentioned above. 

Chloral hydrate, fifteen to thirty grains, combined with 
double the quantity of bromide of potassium, dissolved in a 
teacup of warm water or chicken broth, and introduced slowly 
into the rectum high up, and allowed to remain, thus producing 
quiet and sleep for several hours duration, has, in all cases I 
have had to contend with, given the greatest satisfaction. 

The desire for food soon returns, so that we can begin with 
any kind of food of a bland and easily digested nature. Of 
this I usually allow them to partake just what they specially 
desire. Usually the fruit juices are desired and prove beneficial. 

I nearly always find it necessary to aid the stomach and 
bowel digestion by the use of a proper digestive, in the worst 
cases. The various malt preparations suit best in my experi- 
ence. 


52 


I Lave used the treatment suggested by Dr. Marion Sims, 
that of painting the cervix with iodine, which has relieved 
some cases where there was a granulated cervix. Dilating the 
cervix has been recommended by some writers, but that is 
somewhat risky and should seldom be resorted to, except in 
very extreme cases, and where milder means have failed. 

Whenever there is much disturbance during the latter 
months of pregnancy, I have found great benefit in an abnormal 
supporter properly fitted by the physician. 

The complication of constipation is not always due to the 
pressure of the rectum, but to nerve paralysis, which can be 
overcome only by the stimulating effect of enemas of magne- 
sium sulphate, or by large clysters of warm water and soap. 

The circulatory disturbances are best overcome by keeping 
the alimentary canal cleared out and the kidneys in good 
action with alkaline laxatives of lithia and magnesia, admin- 
istered by the mouth, well diluted with water. 

In some cases where they are complicated with inaction 
of the liver, a few doses of mild chloride of mercury, combined 
with ingluvin, repeated every two or three hours until the 
tongue is cleared off, are very helpful, and sometimes seem to 
be an absolute necessity. 

The extreme nausea and other nervous phenomena are very 
much aggravated by displacements of the uterus, and these 
special cases are not relieved except by replacing the dis- 
placed organs, or by abortion, either by the efforts of nature, 
or by artificial means. They usually relieve themselves by 
abortion. 

Where the uterus becomes impregnated while in a dis- 
placed condition, and is bound down by adhesions, there is no 
other remedy I know but an abortion or an operation intra- 
peritoneally, and the adhesions torn up, and the uterus re- 
placed and fixed. This, I think, could hardly be accomplished 
without resulting in abortion. 

These cases are really complications of pregnancy, and 
depend upon it, but have to be met and treated nevertheless. 




The Association has lost the following since the April 
meeting: 

Alex. Fairley, Mount Olive, Covington County, May 29th. 
A. M. Newman, Meadville, Franklin County, June 14th. 

J. H. Plunkett. McComb City, Pike County, April 29th. 


MISSISSIPPI MEDICm mONTHLY. 


E. F. HOWARD B.S., M.D., Editor and Publisher. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 

S. MYERS M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


Among other changes in our laws made at Jackson, is one 
providing for an auxiliary committee to the committee on 
public policy and legislation. This auxiliary body is to consist 
of one member in each county, to be chosen by the county 
society, whose duty it shall be to co-operate with the committee 
on public policy and legislation by influencing opinion on those 
matters that the committee deems it advisable to present to 
the legislature. 

The House of Delegates has already instructed its com- 
mittee as to some recommendations to be presented at the next 
session and it only remains to be seen whether they can be 
brought before the legislature at that time. It is believed, 
however, that the governor will give the necessary assistance, 
and if he does this will be an excellent opportunity to test the 
value of the auxiliary committee; therefore we venture a few 
comments on the selection of its members by the county soci- 
eties, since the selection of county officers is not infrequently 
made in a purely perfunctory way or influenced by personal 
teeling or personal motives. 

The auxiliary should, in the first place, be a man of energy; 
and by energy we do not mean necessarily the kind of energy 
that makes for success in his profession, but energy that will 
take him out into the highways and byways and make him 
spend the necessary time in getting at his legislators. 

It is absolutely necessary that he should be loyal to the 
Association. By this we do not mean that he should sink his 
own personal opinions and work for the Association’s legis- 
lation if he believes it ill-advised or harmful. We do not be- 
lieve that a committee of the Mississippi State Medical Associa- 
tion would ever advocate legislation that any member could 
not heartily endorse, but honest differences of opinion will 
always arise and should such exist here, or the man chosen 
be so situated that he cannot do the work, he should say so 

53 


54 


frankly and ask to be relieved, for lax and half-hearted work 
has been our great source of failure ever since we first began 
to “memorialize the legislature”. We can stand for differences 
of opinion for, as Mark Twain says, “that’s what makes horse 
races”, and we should always accept legitimate excuses — for if 
we force a man to take this place we will find we have made 
a mistake. We must have the right sort here. 

Finally the auxiliary should be chosen from among the 
friends of his county representatives. There is little use in 
sending a man who is politically opposed to a legislator to 
ask of him a political favor — for that is the way many will 
construe it. The auxiliary close in touch with his representa- 
tive can do much more to influence him, both in his opinion 
and his vote, than can a man who worked and voted against 
him at the last election, and we are not reflecting on our legis- 
lators when we say this, for law-makers are as human as any- 
one else. Therefore let us have specialists for this work. 


Untorsitg uf TOtsstssippt. 


The medical department of the state university has been 
singularly fortunate in securing the services of the well-known 
bacteriologist. Dr. William Krauss, as dean and professor of 
pathology. The new official is well known both as a scientist 
and as an educator and in his selection Chancellor Kincannon 
has again displayed that unerring judgment that has character- 
ized his administration of the university affairs. The pro- 
fession in Mississippi is to be congratulated on its latest 
acquisition. 

Dr. William Krauss was born on his father’s estate near 
the city of Kaiserslautern. Rhenish Bavaria, Germany. His 
course at the gymnasium in his native city was interrupted by 
his emigration to America. In 1883 he graduated from the 
department of pharmacy of the University of Maryland with 
the highest honors. He received medical instruction in the 
medical department of Washington University (St. Louis) and 
in the Memphis Hospital Medical College, from which school 
he graduated in 1889. He then took special instruction in 
histology, pathology, bacteriology and post mortem work in 
the universities of Keil and Wurzburg, Germany. 

I)r. Krauss had specialized in pathology even before he 
graduated, and began teaching in his final year at college. He 


55 


equipped the first chemical and microscopic laboratories of the 
Memphis Hospital Medical College and later attended to the 
equipment, curriculum and credentials work of the College of 
Physicians and Surgeons of Memphis. Dr. Krauss resigns the 
chair of pathology and tropical medicine in the latter insti- 
tution, the position of pathologist to the City and Lucy Brink- 
ley Hospitals in Memphis and has transferred his own private 
laboratory and practice to other hands, to take charge of this 
school. He is a believer in high standards of medical education 
and feels that this can be accomplished best in state insti- 
tutions. 

Dr. Krauss, in commenting on medical education, says: 
“The education of physicians is an important factor in the 
material, moral and hygienic uplifting of a commonwealth. The 
wealthy citizens of the state should aid medical education by 
liberal endowments. Medicine should be taught in the section 
where it is practiced and by men having special experience and 
training in the diseases peculiar to the climate. We of the 
south must write the texts of the diseases of the southland, 
and not the men in New York, Boston or Philadelphia, and the 
public-spirited citizens of the state should see that the teachers 
be given proper facilities.” 

Dr. Krauss has also been identified with public health 
work, having been secretary of the Memphis board of health, 
member of the Tennessee state board of health, and special 
diagnostician for the United States public health and marine 
hospital service. 

Dr. Krauss will establish his private laboratory in Vicks- 
burg and will be temporarily located at the Vicksburg In- 
firmary, where he will receive specimens for examination. 


SntMg TrHceedtngs. 


East Mississippi Four County Medical Society met in 
Amory June 8th. at 2 P. M. The president being unavoidably 
absent, Dr. W. J. Grady was selected as chairman of the 
meeting. Dr. Burdine of Amory presented a case of hook 
worm disease. The doctor had the patient present, and also 
had a liberal quantity of the worms, which had been ex- 
pelled and bottled in alcohol, for those present to examine. 
Three interesting cases were presented by Dr. A. F. Wicks 
of Wren. The cases, after thorough examination and the estab- 
lishment of diagnosis, were discussed by Drs. Elkin, Burdine, 


56 


Lee, Bryan, Grady and others. Dr. F. E. Lee reported four 
of his recent cases. Drs. Tubb, Lee and Boozer were received 
as members of the society. Some very important business was 
postponed until our meeting in Tupelo in July, because of 
limited time. Those who were present and took part in the pro- 
ceedings of the meeting were as follows: Drs. Bryan, Burdine, 
Tubb, Lee, Grady, Elkin, Wicks, Boozer and Underwood. The 
visitors were given a nice dinner by the Amory doctors. The 
meeting adjourned at 5 P. M. to meet at Tupelo the second 
Tuesday in July. 

F. J. Underwood. 


Tri-County (Copiah, Lincoln, Pike) Medical Society 
met at Brookhaven June 8tli., with the following members 
present: Arrington, Butler, Chisholm, Frizell, Dodds, Flowers, 
Higdon, Jones D. W., Jones R. E., Johnson, Little, McLeod, 
Magee D. W., Montgomery W. E., Neville, Rice, Segrist, Thomp- 
son. Visitors: McCaleb and Ratliff. Dr. Bridges, first on the 
program, was absent, but Dr. Arrington took up the subject, 
cystitis, and made quite an instructive talk. It was discussed 
generally by Drs. Little, Jones, Frizell, Rice and Johnson. Dr. 
Frizell was next on program, and presented the subject “Anat- 
omy And Diseases Of The Stomach’’, illustrating by charts and 
drawings. This was discussed generally by members present. 
Dr. R. E. Jones read a masterly paper on “Gunshot Wounds Of 
The Abdomen”, which was discussed generally. The doctor 
is one of our oldest and most active members, always coming 
up with a valuable contribution when on the program. Dr. 
Rice followed with a good discussion of “Internal Suture”, 
illustrating on the black-board different methods of suturing. 
This closed the regular program hut some interesting clinical 
cases were presented, among them a case of Banti's disease and 
one of Quinke’s disease. These being very rare conditions, were 
most interesting. Dr. Ullman, councilor for this district, being 
present, was invited to address the society, which he did. speak- 
ing more particularly on the subject of local post-graduate 
courses. It is very likely that such courses will be taken up 
by the larger towns in our territory. The society, being the 
guests of the president and secretary on this occasion, now 
repaired to the dining room of the Brookhaven Sanitarium, 
where refreshments were served. Next meeting will be held at 
Brookhaven, August 10th. 


D. W. Jones. 


57 


Htstrrrg (Df Tft:e 

TOssissippt Stats ItMinrI ^sstrcratinn. 

At the 1902 meeting the executive committee presented 

1902. for the consideration of the Association the laws re- 
lating to county health officers and coroners, urging 

that the salaries and duties of the former should be equalized 
by legislative enactment and that steps be taken to see that 
the latter be always chosen from among the members of the 
medical profession. These recommendations were referred to 
the committee on legislation with the endorsement of the Asso- 
ciation but nothing was accomplished. 

The 1903 meeting marks the beginning of an increased 

1903. interest in organization on the part of the physicians of 
Mississippi. This meeting was to have been held in 

Greenville but, owing to prolonged overflows in the Delta that 
made traveling by rail uncertain, the committee in charge 
found it advisable to transfer the place of meeting to Vicks- 
burg. 

Dr. McCormack, organizer of the American Medical Asso- 
ciation, was in attendance at the invitation of President Suther- 
land and addressed the Association, advocating re-organization 
on the lines suggested by the A. M. A. committee. A com- 
mittee spent two days considering the plan and recommended 
its adoption, which recommendation was adopted by a unan- 
imous vote. The wisdom of this move was soon ap- 

1904. parent, as is manifested by the report of the secretary 
at the 1904 meeting: “We have, through our councilors, 

effected organization in 46 counties, with a total membership 
of 520. Of these, 142 were already members, leaving a net 
gain since our last meeting of 378 members; the largest gain 
by far for any year in our history”. 

At this meeting the Association decided to resume relations 
with a monthly publication and adopted as its official organ 
the Journal of the Mississippi State Medical Association, pub- 
lished in Vicksburg, the name of which was changed in 1900 
to the Mississippi Medical Monthly. The Association also took 
steps to perpetuate the records of the Surgeons of the Con- 
federate States from Mississippi by appointing Drs. J. C. Hall, 
J. A. Rowan and H. Christmas a committee to take the matter 
up with and to assist the Department of Archives and History 
of Mississippi. 

2— M 


58 


There is little of interest to be noted in the year prior 

1905. the 1905 meeting. The officers apparently rested on 
their oars and were satisfied with the results of the 

previous twelve months and the natural gain in membership 
that would necessarily accrue from them, for the minutes of 
the meeting, which was held in Jackson, show nothing of work 
or progress beyond the introduction of a resolution requesting 
the county societies to bestir themselves in an endeavor to 
secure from the legislature an appropriation for a state bac- 
teriological laboratory. 

During the year prior to the 1906 meeting the work of 

1906. the Association was severely handicapped by the pro- 
longed illness of its secretary but this was in a great 

degree compensated by the energy of the president. Dr. E. H. 
Martin, of Clarksdale, who personally conducted a campaign 
for increase of membership and succeeded so well that the 
meeting in Jackson over which he presided was by far the best, 
both in attendance and in work accomplished, in the history 
of the Association. The secretary's report shows an increase in 
membership of 138. with five organized counties not reporting, 
and an increase of seven in the number of organized counties. 
At this meeting the Association contributed one hundred dol- 
lars to the N. S. Davis Memorial. 

One of the most interesting items in the minutes of this 
meeting is the following resolution : “Resolved, that the grat- 
itude of this Association has been earned by Dr. C. Kendrick 
and other physicians of our State Legislature for their indefati- 
gable and earnest labors for the protection of the public health 
and the interests of regular medicine in Mississippi’’. 


^sstfriatmn ftosirimts. 


E. P. SALE, Aberdeen, 

President 1879-80. 

Eugene Paul Sale was born in Cortland. Ala., June 15th. 
1845. His father, Jno. B. Sale, was a circuit judge, and his 
mother was of the Sykes family. Soon after his birth the family 
moved to Aberdeen, Miss. He died in Memphis, Tenn., June 
8th. 1901 from the results of an intracapsular fracture. 

Dr. Sale was educated at LaGrange College, Ala., and grad- 
uated in medicine from Tulane in 1869, at once entering prac- 
tice at Aberdeen. He went to London in 1874-5 where he 


59 


did post-graduate work at St. Thomas’ Hospital. In 1888 he 
did further post-graduate work at the New York Policlinic 
and Post-Graduate Medical Schools. In January 1889 he moved 
to Memphis, Tenn., where he later held the chair of materia 
medica and therapeutics in the Memphis Hospital Medical 
College. 

As a young man, Dr. Sale served in the Confederate Army, 
being wounded several times, and was present at the historic 
siege of Vicksburg. As a physician he enjoyed an enviable 
reputation, having considerable surgical ability and being the 
originator of several surgical appliances. He was married 
in 1871 to Miss Mollie Edmunds Sykes, who, with a daughter, 
survived him. 

Mrs. Eva Sale Michie. 


P. J. McCORMICK, Yazoo City, 

President 1876-7. 

P. J. McCormack was born in Ireland in 1828 and died in 
Yazoo City in January 1905. He came to America as a youth, 
settling in the South, and was engaged in the practice of med- 
icine in Meridian, Miss., at the outbreak of the civil war. He 
entered the Confederate Army as a surgeon and served through- 
out the four years. His son, Dr. J. I. McCormick, is a prac- 
titioner of Yazoo City. 


W. G. KIGER, Brunswick, 

President 1892-3. 

William G. Kiger is the son of Col. B. G. Kiger, a well- 
known planter of Warren County and was born on his father’s 
plantation at Eagle Bend, near Brunswick. He received his 
academic education at the University of Virginia and grad 
uated in medicine at Tulaue, in New Orleans, in 1876. 

Dr. Kiger is a man of varied accomplishments and great 
breadth of intellect. In addition to the practice of his pro- 
fession he has had to devote much care and attention to his 
extensive planting interests, hut has found time to serve the 
slate as member and president of the State Board of Health, 
his administration being markedly successful. He has also 
served as state senator from his county and his career as a legis- 
lator was a boon to his profession. 


60 


Brmk lUuinus. 


CLINICAL DIAGNOSIS AND TREATMENT OF DISORDERS 
OF THE BLADDER with Technique of Cystoscopy. By Follen 
Cabot M.D. Professor Genitourinary Diseases, Post-Graduate Medi- 
cal School; attending Genitourinary Surgeon, Post-Graduate and 
City Hospitals, New York. 8vo, 225 pages, 41 illustrations, 1 colored 
plate. Prepaid $2.00. E. B. Treat & Co., Medical Publishers, 241-243 
West 23d Street, New York. 

Although not as elaborate as many works ou the subject, 
this book by its conciseness and clearness of statement will 
appeal to many who are weary of wading through long-winded 
discussions and have been compelled to separate the wheat 
from the chaff at the expense of much labor. Cystitis is fully 
covered and the technique of bladder instrumentation is made 
so clear that “he who runs may read”. 

Myers. 


LEGAL MEDICINE AND TOXICOLOGY. By R. L. Emerson M.D., 
formerly instructor in Physiological Chemistry, Harvard University 
Medical School. I). Appleton & Co., New York. Price $5.00. 

Dr. Emerson has produced a work on legal medicine and 
toxicology that may well be recommended to the students of 
any medical school as a safe and sure exposition of this abso- 
lutely necessary though much neglected branch. Each and 
every subject is discussed with a fulness aud clearness that 
wins admiration, and the last section is made up of extracts 
from the laws regulating practice in all the states, an exceed- 
ingly valuable aud timely compilation. 

Myers. 


NEW AND NONOFFICIAL REMEDIES. Articles which have been 
accepted by the Council on Pharmacy and Chemistry of the Ameri- 
Medical Association, prior to January 1909. Chicago: Press of the 
American Medical Association, 103 Dearborn Avenue. Paper, 25c; 
cloth, 50c. 

There are three small works that every scientific physician 
should have ou his desk within easy reach; namely, “The 
Pharmacopoeia And The Physician”, “The Propaganda For 
The Reform Of Proprietary Medicines” and lastly this invalu- 
able little book that completely covers the field of the newer 
remedies up to date. With these at hand, any reputable physi- 
cian ought to be a match for the detail man who seeks to make 
him an unpaid peddler of his nostrums. 


Myers. 


MISSISSIPPI IHEDIC8L DIOHTHLY 


Vol. XIV. AUGUST 1909. No. 4 

*THE ETIOLOGY AND PROPHYLAXIS OF MALARIA AND 
SOME OBSERVATIONS IN THE MISSISSIPPI DELTA. 

J. T. LONGINO M.D., 

JONESTOWN. 


In selecting the subject malaria, I realize that I select 
one that is the subject of frequent discussion and one that 
has been the title of many papers ; but considering the prev- 
alence of the disease in our locality it is one that should 
never grow stale to us and one about which we cannot learn 
too much. At present we find a tendency among the leading 
physicians of our land to arouse an interest in the prophylaxis 
of disease, and to educate the public to the best means of pre- 
venting disease. 

In our own state our present Board of Health has launched 
a campaign to this effect, which promises much good to the 
public health aud well-being of the people. A great crusade 
against the spread of tuberculosis is developing all over the 
world. Great efforts are being made to vaccinate the people 
and immunize the human race against small pox. The medical 
profession now r is so familiar wdth the mode of transmission 
of yellow fever that its spread can easily be prevented. In fact 
there is a growing tendency to educate the public and do more 
efficient work against the spread of all infectious and con- 
tagious diseases. 

In our efforts along this line we must not forget the prev- 
alence of the infection of malaria and the importance of its 
prophylaxis. Since the discovery of the malarial parasite in 
1880, and since the discovery of the mode of transmission of 
this parasite from one man to another by a particular species 
of mosquito in 1898, the prophylaxis of malaria is w y ell nigh 
under our control. In this paper it is more particularly the 
prophylaxis of malaria that I wish to emphasize and impress, 
and in as simple, brief and condensed form as possiblq. 

With our present knowdedge of malaria w r e can teach our 
clientele the prophylaxis of malaria in such a simple manner 

*Read before the Clarksdale and Six Counties Medical Society. 

61 


62 


that they can institute an effective prophylaxis in their own 
homes, around their own premises and in their every-day 
vocations. The etiology of malaria is now known to be a 
parasite, which was discovered by Lavern in 1880 and has 
received the somewhat inappropriate name of plasmodium 
malariae. 

The transmission of these parasites is now known to be 
through what is termed the mosquito-malarial cycle. 

Older writers attributed the presence of malaria to certain 
telluric and climatic conditions, and they observed that the 
cultivation of the soil and malaria were two factors that 
flourished counter to each other ; that where husbandry did not 
exist malaria was luxuriant, but when the soil was tilled 
malaria diminished and even diappeared. They designated 
malaria a telluric disease and confirmed it with the fact that 
ships’ crews were safe so long as they remained on board the 
vessel, even though the vessel lay near an infected coast, but 
that a few hours sojourn on land was sufficient to contract the 
disease. They observed that people who slept some distance 
above the ground suffered less from malaria than those who 
slept near the ground. They observed that laborers lost their 
lives in the excavation of the ground in building railroads, 
canals, fortifications, streets, and the clearing of the woods and 
the cultivation of the virgin soil. 

They considered also that heat had a considerable influence 
as a causative agent in the production of malaria, because mala- 
ria was more prevalent and malignant nearer the equator and 
diminished as it proceeded toward the poles, and that malaria 
was more prevalent in summer than winter. Moisture was 
also given as an important factor in the production of malaria, 
and they observed that malaria was more prevalent during and 
after abundant rainfall and that more malaria existed on the 
banks of rivers, coasts of seas, in swamps and marshes, and 
in places in which existed small water basins, ponds and pud- 
dles, and in countries subject to natural inundations or arti- 
ficial flooding. As a matter of fact, all these conditions of 
warmth, moisture, and soil, are necessary for the development 
of malaria, but we know now they are simply factors which 
influence the mosquito and the parasites they convey. 

Just a few years ago it was thought that the infection of 
malaria gained entrance into the human organism through the 
digestive tract and some articles of food. Our hard pump 
water has long been held responsible for the prevalence of mala- 
ria in the Mississippi Delta, and we have often heard the ex- 
pression that there is a chill in every cucumber we eat. 


63 


It was thought that malaria was miasmatic and infected 
the human system through the air passages. How well do we 
remember that only a few years ago the older and wiser heads 
among us, could with such confidence and plausibility, explain 
to us the theory that the deadly miasma arising from the decay 
and putrefaction of vegetable and animal organic matter, and 
the stench emanating from the foul marshes and swamps would 
enter our nostrils and infect us with malaria. We know now 
that these conditions have nothing to do with the production of 
malaria except in a way that they have influenced the produc- 
tion of the mosquito. Therefore the study of the etiology of 
malaria embodies the study of the mosquito. The numerous spe- 
cies of mosquitos are classed into families, subfamilies and gen- 
era, and it is a wise provision of nature that the power to 
transmit malaria is limited to the female of a few genera of 
the subfamily anophelinae, of which the anopheles is one of 
the most commonly known, and for the sake of convenience, 
in referring to the malarial mosquito, I will use the name 
anopheles, and for the purpose of this paper it is only neces- 
sary to mention the names of three genera of the mosquito, the 
culex, the common gray, gutter mosquito; the stegomyia, the 
brindled, yellow fever mosquito; and the anopheles, the dap- 
pled-winged, malarial mosquito. 

The anopheles has a proboscis that makes an angle of about 
fifteen degrees with the body, while in the other genera the 
angle of about forty-five degrees. As a result the anopheles has 
an owl-like appearance ; the others are hump backed. The 
anopheles can be recognized by its attitude while at rest on 
the wall. The body projects from the wall at an angle varying 
from five degrees to ninety degrees, while in the others the 
body lies more parallel to the wall, with the posterior end 
closer to the wall than the thoracic end. 

Their manner of reproduction consists in the deposit, by 
the full-grown female anopheles, of the eggs on the surface of 
the water. The eggs hatch and develop into the successive 
stages of larva, pupa and imago or the matured mosquito. By 
close observation in a barrel of water we can see the develop- 
ment of the mosquito in the various stages. While in the stage 
of larva they are commonly known as wiggletails. In the 
anopheles it requires about thirty days for the development 
from the egg to the matured mosquito and about twenty days 
longer to lay eggs, so that it requires about fifty days to the 
generation. In other genera the time of a generation is much 
shorter. During one summer there may be two or three gen- 
erations of the anopheles according to the temperature. As to 


64 


the breeding places of the mosquito, there is no collection of 
water, however insignificant, which it is safe to disregard as 
a possible source of larvae. From the large open sheets of 
water to the small collections in the hollows of the leaves 
in the jungle, the larvae may he found. In cess pools, tanks, 
deep wells, cisterns, and in all well-known sites about domestic 
dwellings, as small puddles, pots, pans, tubs, rain-barrels, old 
tins, and broken bottles, in back eddies in running streams, 
in canals, lakes, bayous, ponds, in swamps and marshes, in 
pockets in solid rock, in the bottom of old boats, in pig 
troughs, and in the foot prints of cattle. It is true, how- 
ever, that the breeding places are different in different genera. 
The anopheles seem to be more select in their breeding places 
than the culix and stegomyia. They prefer clearer water 
and are more commonly found in the back eddies of run- 
ning streams, near the banks of lakes, in ponds, bayous, 
marshes and pools of water made by recent rain, in fields and 
swamps. It is the culex and stegomyia that breed in the foul 
and dirty water generally found about dwellings and tenement 
houses, as in cess pools, barrels, tubs, gutters, and old tins. 

As to the time of feeding we find that the anopheles are 
as a rule nocturnal in their habits, and if we succeed in pre- 
venting the bite of the mosquito at night we usually escape 
malaria. As a rule the height of their flight doesn't exceed 
twenty feet from the ground, which explains the fact that 
people sleeping in the second and third stories of buildings 
are less apt to conti*act malaria than those who sleep nearer 
the ground. The anopheles do not travel far from their breed- 
ing-places, but are considerably influenced by wind and rain. 
They have been blown long distances by wind and they seek 
shelter from the rain and gain entrance into the homes of the 
people. It is a fact, however, that if all domestic dwellings 
were built some three or four hundred yards away from waters 
that are favorable to the reproduction of the anopheles the 
occupants would be practically safe from their infection. We 
should condemn the practice of the people in this country, of 
trying to build their homes near water courses, lakes, etc., 
and our farmers in trying to build all their tenement houses 
even on the banks of bayous and ponds. 

The length of life of the anopheles is not exactly known, 
but if properly fed they will live two or three months. In 
temperate climates they pass the winter in two forms, by hi- 
bernation of the insect and by hybernation of the larva. The 
hybernating insects are all females and all fertilized. In the 
spring they arouse from hibernation, lay their eggs and die. 


65 


The hibernating insects have often been found in dwellings, 
outhouses, stables and cellars. The hibernating larvae can be 
found in water, mud, and has even been found in ice, and 
after receiving the proper amount of warmth would arouse to 
life and activity. 

' Wherever malaria exists some genera of the anophelinae 
exist. The converse, however, is not true. The anophelinae 
do exist in localities in which there are no malaria. The 
anopheles must become infected with the malarial parasite be- 
fore it can transmit malaria, and this can only be done by the 
female anopheles sucking the blood of a human being infected 
with the malarial parasite and besides taking into its stomach 
the malarial parasites the anopheles must get at least one of 
a particular kind of parasite called a merozoite, which is a 
young parasite that possesses both male and female elements, 
and grows into two different sexual cells. Eventually the male 
penetrates the female and fertilization takes place. The result 
is a newly-formed nucleated cell. This nucleus now proceeds 
to divide into spores and the spores subdivide into sporozoits, 
and by this time they have passed through the membranes of 
the stomach of the anopheles into the circulation and then 
find their way into the salivary glands, and when the anopheles 
inserts its proboscis through the skin into the blood and forces 
saliva into the tissues, with which to dilute the blood, the 
sporozoits are injected into the blood, and another individual 
is inoculated with malaria. This completes the sexual cycle 
in which the anopheles is the immediate host. The sporozoits 
now constitute a new infection and undergo a new cycle of 
development called the asexual cycle in which man is the 
definitive host. The sporozoits divide by fission into spores and 
these spores are called merozoits, which brings us back to the 
starting point of the mosquito-malarial cycle. 

The spores in the blood of man develop into the mature 
parasite and sporulate again, and it is at the time of this 
sporulation that the malarial paroxysms occur. They are classi- 
fied as follows: those that sporulate in seventy-two hours and 
cause a chill and fever on the fourth day are called the quartan ; 
those that sporulate on the third day, forty-eight hours, are 
called the tertian; those that sporulate on the second day, 
twenty-four hours, are called the quotidian. The quotidian, or 
every-day chills and fevers, are sometimes caused by a double 
infection of the tertian or a triple infection of the quartan, 
in which the sporulation of one generation occurs one day and 
the sporulation of the other generation occurs next day. 

In the quotidian and tertian varieties are observed para- 


66 


sites that sporulate and form crescents. There may be sev- 
eral generations of one variety of parasites, multiple infection, 
or several different varieties, or a mixed infection, which causes 
irregular or remittent, or more malignant fevers. Some authors 
group these into one group called the estivo-autumnal variety. 
In some instances in these mixed infections, the fever from the 
sporulation of one generation doesn’t have time to subside be- 
fore the sporulation of another generation, and the fever be- 
comes continuous, giving rise to our commonly known ‘‘slow 
fever’’, and it is from some varieties of this crescent-forming 
group that we get our more irregular and pernicious fevers, 
black-water fevers and hemorrhagic fevers. 

In microscopical examination, the tertian parasites are 
found readily in the peripheral circulation, while the quartan 
and more especially the estivo-autumnal seem to exist more 
abundantly in the more central circulation as in the spleen, 
liver, brain and bone marrow. 

It is the tertian variety that is so amenable to the quinine 
treatment and in which quinine is absolutely a specific, but it 
is less so in the quartan, and almost of no avail in the estivo- 
autumnal. 

The prophylaxis of malaria consists absolutely in the pre- 
vention of the inoculation of the malarial parasite by the in- 
fected female anopheles, which we sum up briefly under the 
following three heads: by preventing the infection of the 
anopheles with the malarial parasite; by preventing the inocu- 
lation of man by the anopheles with the malarial parasite; by 
preventing the reproduction of the anopheles. 

If a case of yellow fever should occur in this country at 
present all that would be done would be to screen the patient 
so that the stegomyia could not gain access to him and get 
infected, and a yellow fever epidemic would be prevented. The 
same principle, while not so practical, is just as applicable in 
malaria as in yellow fever. 

It is not practical because so many people are infected 
with the malarial parasite and don’t know it, but we can at 
least confine our malarial patients under mosquito bars while 
they are sick enough to be confined to bed. This will often 
prevent the infection of other members of the immediate house- 
hold. But when the female anopheles sucks the blood of an 
individual infected with malaria and becomes herself infected 
with the malarial parasite, then we have to institute a warfare 
and fortify against the enemy. If there should be any ano- 
pheles in our homes, we should fumigate till they are anni- 
hilated. Then we should screen our doors, windows, and all 


67 


entrances into our homes through which they might gain en- 
trance. As the anopheles are mostly nocturnal in their habits, 
we must more especially screen our sleeping apartments, and 
even this is not sufficient, but we must take a double precaution 
and sleep under mosquito bars. 

If it were possible to prevent all standing water, the breed- 
ing places of mosquitos would all be destroyed and the mos- 
quito family would disappear and the malarial parasite would 
become extinct. This is scarcely possible, but great good can be 
done along this line by a system of levee-building, canalization, 
drainage, and leveling the soil. Magnificent results have been 
accomplished along this line in the oldest and best developed 
countries in the old world, and even in our Mississippi Delta. 
For a brilliant example I refer to Holland. She, by her sys- 
tem of levees, canals, wind mills and drainage, has converted 
swamps and marshes, that were actually below the sea level, 
from veritable hot-beds of malaria into cities, villages and 
fertile fields that are practically free from malaria. 

In the first settling of this Mississippi Delta, malaria showed 
an endemicity, that from a standpoint of malignancy and per- 
niciousness, was scarcely behind that of the coast of West 
Africa, and other tropical countries. We have seen the trans- 
formation of large areas of timbered land, swamps and marshes, 
into cultivatible fields, the building of levees and a prevention 
of the annual inundations of our land from the Mississippi 
River, the improved conditions of drainage, the development 
of industry, the increase of population, the improved condition 
of the people, the development of hygiene, and along with this 
a diminution of the prevalence and malignancy of malaria. 
Who knows what the next decade may bring about. Already 
our government, both national and state, has appropriated 
funds and our citizens have organized drainage districts of 
gigantic plans and the digging of canals has actually begun. 
I believe the time is coming when the Mississippi Delta will 
be referred to as one of the most healthful localities of the 
south, because typhoid fever is not endemic here, and some 
other diseases don’t seem to be as prevalent here as in higher 
climates, and when we get rid of malaria we won’t have much 
left. 




68 

*OUR STATE MEDICAL LAWS. 


H. X. RICHARDSON M.D., 

GULFPORT. 


It is always a source of pleasure to me to be present at 
these meetings and listen to others read papers and discuss the 
various subjects proposed, but when it comes to taking part 
or reading papers myself I feel like most physicians and the 
officers do when called upon to enforce the laws in regard to 
the practice of medicine, and want to say “Please excuse me; 
1 don’t feel that this comes in my line of business.” 

However, I shall on this occasion act as I think they 
should. I will do my best if I fail. I naturally feel an interest 
in this subject, as it was my fortune to be a medical student 
at the time the law was proposed and had as my preceptor one 
of the foremost, if not the foremost agitator of the proposition. 
I say one of the foremost, because I remember reading, section 
by section, a similar, if not the same, document to that which 
finally passed the legislature regulating the practice of medi- 
cine. It had been written by him and had never yet been 
printed. He was also a member of the State Board of Health 
and one of the first who examined applicants under that act. 
I speak of Dr. J. M. Taylor of Corinth, whom perhaps none of 
you knew but who is well remembered by many of the older 
physicians as an enthusiastic and energetic worker in this 
cause, and one who after the law became effective used every 
means possible to have it enforced. 

As an example of the meaning of the law as the writers saw 
it and intended it, I give an incident that occurred while I 
was studying in his office. I went down on the public square 
for something and there saw one Dr. Lightliall from the town 
of Peoria, 111., the long-haired, wild-west, Indian doctor, selling 
“soap”. He would sell a two-cent cake of soap for twenty- 
five cents and give the buyer a two-bit box of corn salve. 
This was done in order to evade the medical law just 
passed, the purpose of which everyone then knew but have now 
seemingly forgotten, that of preventing quacks and nostrum 
dealers from plying their schemes and plundering and poison- 
ing the people. This man knew better than to propose to sell 
his medicine outright, hence did not attempt it. I went back to 
the office and told the old doctor what was being done. I could 
see an angry flash in his eye at once. He took his hat and 
started for town. In half an hour Dr. Lighthall was under 

* Read before the Harrison County Medical Society. 




69 


arrest, cursing and fuming and talking about what a h — 1 of 
a town we would have if such a procedure continued. He was 
told that the law was made for just such as he and that he must 
keep out of the state. 

The difference beween the enforcement of the law then and 
now was plainly shown in Gulfport last week and may be 
going on now. We saw a negro up on a platform using all 
kinds of foolish, silly talk to draw a crowd so that he could 
tell them of a wonderful remedy and its originator, a great 
doctor whom they could consult by stepping inside. As a 
result many dollars of good money have left the people of 
Gulfport just when it is so much needed. Some think it hurts 
the doctor. Not by any means, except by making the people 
for whom he works poorer and less able to pay him. I know 
it has given me work. I have just done six dollars worth of 
work for one poor victim. When I went in the patient was 
in such a rage that I asked “What have you been doing to her?” 
A woman rushed out and soon returned with a bottle about a 
foot long containing a pinkish liquid which appeared to be 
almost as strong as Water. About one-fourth had been taken by 
the patient. She said : “I am not going to take another dose.” 
Her husband replied: “Then I will have to take it to save it. 
It cost me a dollar and I can’t lose it.” I told him that he 
ought to be compelled to take it for being so silly as to buy it, 
but that he must never impose upon his wife in that manner 
again. 

I came down town and asked why such traffic could not be 
stopped and it was suggested that the “doctor” was putting 
it in some of the drug stores, by whom it was sold. If that is 
the case the “doctor” and the druggist who sells it constitute 
a partnership who are prescribing and practicing medicine 
without a license. Some of our physicians have interests in 
drug stores, but I cannot think that any physician in Gulfport 
would permit a store iu which he was interested to assist street 
peddlers in violating the medical law, nor do I think we have 
a store that would shelter such violators. 

This man was practicing without a license, and why? Be- 
cause we, the doctors, permitted it. We can’t do a thing. If we 
have one arrested he is released. How long would this be the 
case if we, every doctor in the state, would refuse to assist in 
the election of any officer who would not promise to punish 
all who violate this law? 

Suppose one of our best young men should attend four 
regular courses of lectures at, and graduate from some good 
college and come here and locate without securing a license. 


70 


Do you suppose he could practice and not be arested? If this 
is the case when one is competent and well informed, why 
should we sit still and permit such violations as we have all 
seen in the past few days? Is it not high time we were assert- 
ing ourselves and putting a stop to all such proceedings? 

The law was first intended for the protection of those who 
know no better than to be gulled by every shark who passes. 
Shall we continue to punish the good and let the wicked go 
free? Cannot some remedy be suggested? If not, suppose we 
drop the whole thing and let all have the same privilege. 


TOisstssippi State TOeriiral ^ssrrttaitan. 


OFFICERS 1909-10. 

President — D. W. JONES 
Vice-President — J. S. SANDERS 
Vice-President — J. C. ARMSTRONG 
Vice-President — THOS. PURSER 
Secretary — E. F. HOWARD 
Treasurer — H. L. SUTHERLAND 


Brookhaven. 
Scranton. 
Water Valley 
McComb City. 
Vicksburg. 
Rosedale. 


STANDING COMMITTEES. 

Committee On Public Policy And Legislation. — P. W. 
Rowland, Oxford; L. C. Feemster, Nettleton; N. Stewart, Jack- 
son; D. W. Jones, Brookhaven; E. F. Howard, Vicksburg. 


CHAIRMEN OF SECTIONS. 


Medicine 

. . B. 

L. CULLEY 

Jackson 

Surgery 

. .F. 

M. Sandifer. . . 

Greenwood 

Obstetrics 

. .G. 

S. Bryan 

Amorv 

Gvnaecologv 

. .T. 

M. Jones 


Materia Medica 

. .E. 

Wright 


Pediatrics 

. . J. 

M. Dampeer. . . 

..Crystal Springs 

Nervous Diseases 

. .G. 

W. Stephens. . 


Venereal Diseases 

. . Robt. Donald 


Hvgiene 

. . J. 



Dermatology 

. .R. 

M. Sadler 


Bacteriology 

. . W. 

. S. Leathers . . 

University 

Eye, Ear, Nose, Throat. 

. .D. 

G. Mohler 


Electro-Therapeutics . . 

. . Rosa Wiss 


Tuberculosis 

. .P. 

R. Brown 

West Point 


MISSISSIPPI MEDICAL MONTHLY. 


E. F. HOWARD B.S., M.D., Editor and Publisher, 
associate; editors 

B. B. MARTIN M.D.. Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D.. Biloxi. M. H. BELL M.D.. Vicksburg. 

S. MYERS M.D.. Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


With the confederation of the German states and the unifi- 
cation of the standards of the twenty-two state universities 
under the Kultus Ministerium, Germany at once took front 
rank among the nations of the world in scientific and medical 
education. In America, where any corporate body of men can 
obtain a charter from a state to confer any sort of degree under 
any sort of title we had two hundred and forty medical schools 
who turned out graduates in unlimited numbers, many of them 
uneducated, even illiterate. 

Gradually, however, many factors contributed to bring 
about a change in the order of things. State examining boards 
required higher standards of education, the diplomas from 
many schools failed of recognition outright, such graduates not 
even being permitted to stand for examination. The Associa- 
tions of Medical Colleges, and, later, the Council on Medical 
Education, worked in harmony for better standards. The 
progress of medicine, laboratory study of physiology, pharma- 
cology, the clinical, biological, chemical and other laboratories 
required the undivided time and services of highly trained men 
who had to be paid salaries, and the commercial medical school 
no longer got dividends out of tuition fees. Spectacular 
amphitheater pyrotechnics, the educational value of which is 
equal to nil, had to give place to individual work in the labor- 
atory, the dispensary and in the hospital ward, the corps of 
teachers had to be increased, while, on the other hand, the sizes 
of the classes continued to decrease, and the last raison d’etre 
of the commercial school has disappeared. A few independent 
schools, whose “professors” find compensation in the collateral 
profit arising out of being medical teachers are doing good 
work, but such motives are only temporary stimulants to ambi- 
tion, and the school proper is the side issue in the careers of 
the teachers. 

With these changes in standard and method, medicine in 

71 


72 


America has come into her own. The art will share with the 
Liberal Arts, Law, Agriculture, Handicraft, etc., the privilege 
of being taught in state institutions, a diploma from which is 
a guarantee of professional and moral fitness to practice 
medicine. 

With the opening of the new university medical school at 
Vicksburg the Mississippi boy can complete his medical edu- 
cation at home, with the assurance that his diploma is equal 
to that from any members of the American Association of Med- 
ical Colleges before state licensing boards. The university no 
longer has the competition of independent schools. 

With the advantages offered by a state university having a 
corps of salaried teachers there is no longer any excuse for the 
young man wanting to qualify as a doctor of medicine patron- 
izing independent schools whose diplomas and certificates of 
attendance are not recognized. The honor of being the pos- 
sessor of a medical diploma from the University of Mississippi 
is worth, many times over, the extra effort required to obtain it. 


StfcMt) Vznttt dings. 


East Mississippi Four County Medical Society held its 
regular monthly meeting at Tupelo, July 13th. Meeting was 
held in the court house with electric fans all around and ice 
water in abundance. President L. C. Feemster occupied the 
chair. The visitors were Drs. Win. Krauss of Vicksburg, Dur- 
ley of Aberdeen, Stephens of Amory, Weaver of Mooresville, 
Senter of Fulton. Hughes of Kirkville, Carruth of Chesterville. 

On motion of Dr. G. S. Bryan of Amory the courtesies of 
the floor were extended the visitors. 

Call by the president for report on clinics showed two 
cases : one by Dr. Keyes, case of lymphatic oedema. Discussion 
by Drs. Krauss and Wendel. The other clinic was an eye case 
from Beuna Vista furnished by Dr. A. J. Brand, of that place. 
This clinic being one of the prominent citizens of Buena 
Vista. 

Upon call for papers Dr. Krauss read an interesting paper 
on the Diagnosis of Malaria, with exhibition of slides and 
methods of obtaining same. This paper was heartily approved 
by Drs. Durley, Anderson, Wendel and Stephens. Dr. Krauss 
also very ably and interestingly discoursed on Blastomycosis. 
The society voted thanks to Dr. Krauss for his paper and 
talk. 


73 


Before adjornment the thanks of the organization was ex- 
tended to Sheriff Trapp for courtesies shown the members in 
furnishing the court house for metting place. 

At this point an invitation was received from the St. Clair 
Drug Company extending the courtesies of the store. The 
entire delegation repaired to the store, where soft drinks, etc., 
were served liberally without price. 

The convention adjourned to meet in Houston on the 
second Tuesday in August. 

The visitors were banquetted at Hotel Read at 8 o’clock 
P. M., where an elegant repast, with music, was served by this 
noted hostelry. 

The president appointed on the Committee on Public Pol- 
icy and Legislation : Dr. R, P. Wendel for Monroe County, 
Dr. W. C. Spencer for Lee County and Dr. R. M. Sadler for 
Chickasaw County. The appointment for Itawamba was con- 
tinued until the Houston meeting. 

Harrison County Medical Society met on July 13th. The 
meeting was called to order with Dr. Morris, Vice-President, in 
the chair. Those present were Drs. Morris, Parker, West, 
Sheely, Mohler, Shipp, Cox, Hood, Henry, Richardson and as 
visitors Drs. Howard and Martin of Vicksburg. There were no 
clinics or discussion of cases. Dr. Sheely read a paper on 
‘‘Pure Food And Pure Food Laws”. The paper was discussed 
by several of those present. Dr. Howard, who is secretary of 
the State Medical Association, mentioned that one difficulty 
about pure food legislation was that the public at large 
are indifferent and that the physicians meet and pass resolu- 
tions to legislature, etc., then quit and do nothing more. He 
suggested that the physicians hold public meetings to instruct 
the public and arouse public opinion. Dr. Parker said that it 
was useless to talk to the public about the use of preservatives 
when ninety per cent, of them use preservatives in their 
domestic preserving. Dr. Shipp called attention to the differ- 
ence between preservatives and adulteration in the pure food 
discussion. Drs. Mohler and Sheely said that preservatives 
were largely used to preserve decayed and inferior articles. 
Dr. West suggested that the medical society have various mem- 
bers to write articles along this line and have them published 
in the newspapers under the auspices of the society. After 
some discussion Dr. West moved that a committee be appointed 
to arrange for public meetings and newspaper articles. Motion 
carried and Drs. West, Mohler and Sheely were appointed as 
publicity committee. Dr. Shipp objected to a $1.00 fine, as he 


74 


had his paper all ready to read. It was moved that Dr. Shipp 
be requested to read his paper at next meeting. Motion car- 
ried. Dr. Howard was called upon to speak before the society. 
He made a most excellent talk, and among other things men- 
tioned his connection with the Medical Department of the State 
University. He called especial attention to the facilities offered 
and the need of sending the Mississippi student to our own 
school. Dr. Martin of Vicksburg made an interesting talk, 
making various suggestions as to the best means of obtaining 
results in a legislative way by the medical fraternity. He also 
commented upon the facilities offered by the Medical Depart- 
ment of the University. Dr. Morris made a short report on 
mushroom poisoning, mentioning that the symptoms of such 
poisoning were similar to insanity symptoms. There being no 
further business, the society adjourned. 


Htsiurg (Df Tire 

TOisstssippi State Itferitral frzztttmixm. 

The 1907 meeting, held at Gulfport, was notable for the 
1907. launching of an organized movement for the upholding 
of fees for insurance examinations and the passage of 
resolutions requesting the legislature to require a diploma 
as a requisite for application for examination for license. 

The question of the insurance fees was one that had ex- 
cited much interest for the year prior to the meeting. Adams 
County being the hottest storm-center, and a number of the 
county societies had already taken action in the matter. The 
Association did not make adherence to the resolutions passed 
by the House of Delegates on this occasion a test of membership 
and therefore there was some falling off, but much good was 
accomplished by them. 

The resolutions are as follows: 

Whereas, the class of examinations required by life in- 
surance companies is of a nature which entails responsibility 
and which in justice to the medical profession should not be 
made for less than $5.00 ; and 

“Whereas, we charge a similar fee for examinations of a 
like character; therefore be it 

“ Resolved , that we, the members of the State Medical Asso- 
ciation, hereby agree to make no examinations for any old-line 


75 


life insurance company for a minimum fee of less than $5.00 ; 
and 

“ Resolved further, that the officers of all county societies 
request, and if possible obtain, from all reputable physicians 
who are not members of our association, an agreement to co- 
operate with the local societies in maintaining the $5.00 fee for 
such examinations. 

'‘Resolved f urther, that no member of this association enter 
into any compact or agreement with any corporation, society, 
association, company or individual to examine applicants for 
insurance for any stated salary or lump sum, thereby evading 
the spirit and intent of these resolutions. 

“ Resolved further, that the payment of all fees shall be 
authorized by the home office of the society or corporation to 
which such application is made, and under no circumstances 
shall an examiner receive or accept any part of a fee from an 
agent or any other person unless the full fee be paid by 
authority of the home office. 

“Resolved further, that each member of this association 
pledge himself or herself that in case a fellow-member be re- 
moved from the position of examiner for any corporation or 
society solely because of this action of the association, that he 
or she will not accept an appointment from such corporation 
or society as examiner, nor make any examinations for the same 
in Mississippi. 

“And Be It Further Resolved, that these resolutions go into 
effect on and after their passage. 

The following year, 1908, the Association went to 
1908. Natchez, where it was given a royal welcome. The finan- 
cial stringency of 1907 had caused a slight falling off in 
membership and the inaccesibility of the place of meeting re- 
duced the attendance very materially, but those who were pres- 
ent were amply repaid for their extra exertions by the social 
attentions, which exceeded anything in the recent history of the 
Association. 

Dr. J. N. McCormack, of Bowling Green, Kv., the national 
organizer of the American Medical Association, was a guest of 
the Asociation on this occasion and entertained and delighted 
the members with an address replete with humor, eloquence and 
good advice. 


76 


^sstfriattcm Vztsxdmis. 


E. L. McGEHEE, New Orleans. 

President 1893-4. 

Edward Earned McGehee, a grandson of Judge Edward 
McGehee of Mississippi, was born on the Westwood plantation, 
near Woodville, Miss., April 4th. 1852. He was educated at 
Southern University, Greensboro, Ala., taking his bachelor’s 
degree in science in 1871, and graduated from the Medical De- 
partment, University of Louisiana, in 1874. He practiced his 
profession eighteen years in Wilkinson County and then moved 
to New Orleans, where he has lived ever since, devoting his 
attention especially to matters of hygiene and being particu- 
larly interested in educating the public in regard to tuberculosis. 

Dr. McGehee was married March 4th. 1875 to Miss Anna 
Overton Webb of Greensboro, Ala., and has five sons : three 
practicing physicians living in Louisiana, one medical student 
in Tulane University and one student of dentistry. Besides his 
local, state and national medical affiliations, Dr. McGehee is a 
member of the National Public Health Association. 

Personal Notes. 1908. 


P. W. ROWLAND, Oxford. 

President 1894-5. 

Peter Whitman Rowland was born at Oakland, Miss., Feb. 
25tli. 1801, of Virgina stock. His great-grandfather, Michael 
Rowland of Virginia, who took part in the Revolutionary war, 
being present at the battle of Guilford Court House, traced 
his ancestry to John Rowland of Surrey, England, who came 
to America in 1635. Creed Rowland, a son of Michael, moved 
to Mississippi about 1840 and settled in Lowndes County, later 
going to Aberdeen, near which place he died, 1866. His son, 
Dr. Win. B. Rowland, was the father of the subject of this 
sketch. Dr. Rowland’s mother was a Tennesseean, a descendant 
of Chas. Moorman of Louisia County, Va., who emancipated 
his slaves in 1778. 

Dr. Rowland was educated in the private schools of Mem- 
phis, Tenn., and at Oakland Academy, took his medical degree 
from the Memphis Hospital Medical College in 1882, and settled 
in Coffeeville where he practiced fifteen years prior to his re- 
moval to Oxford. In 1887 he took post-graduate work in the 
hospitals of New York and Philadelphia, attending a course at 
the New York Polyclinic. He was appointed a member of the 


77 


Board of Health in 1900 by Gov. Longino and re-elected to 
this position in 1904 by the Medical Association. In 1903 he 
was elected to the chair of Materia Medica, Pharmacology and 
Hygiene in the Medical Department of the University of Missis- 
sippi. He is also physician to the University. 

Dr. Rowland married, Jan. 15th. 1885, Miss Eugenia Susan 
Herron of Coffeeville, and has four children : Mary Victoria, 
Francis Herron, William Brewer and Peter Whitman. 

Personal Notes. 1907. 


Hmk Harems. 


BACTERIAL FOOD POISONING. A Concise Exposition of the Eti- 
ology, Bacteriology, Pathology, Symptomatology, Prophylaxis and 
Treatment of So-Called Ptomaine Poisoning, b'y Dr. A. Dieudonne, 
Munich. Translated and edited with additions by Dr. C. A. Bold- 
uan, Research Laboratory, Department of Health, New York. E. B. 
Treat & Co., 241 W. 23rd St., New York. Price $1.00. 

We doubt if as much actual value for the money is offered 
in any other medical work as in this small volume of one hun- 
dred and twenty-eight pages. Covering the ground of meat 
poisoning, fish and mollusc, cheese, ice cream, potato, canned 
goods, and metallic poisoning, followed by an extensive bibliog- 
raphy and a complete index, it presents concisely and accu- 
rately a subject on which many are poorly informed and which 
it is impossible to find considered with any accuracy as to 
symptomatology or treatment in the average text-book. 

Myers. 


SAUNDER’S QUESTION COMPENDS. Essentials Of Bacteriology 

by M. V. Ball M.D., formerly Instructor in Bacteriology at the Phila- 
delphia Polyclinic. Sixth edition, thoroughly revised. 12 mo. volume 
of 290 pages, with 135 illustrations, some in colors. W. B. Saunders 
Company, Philadelphia. Cloth, $1.00 net. 

All eompends are more or less objectionable since they pro- 
mote laziness in the student, but some have much material in 
them that is good so far as they go and this is one of that class. 

Sproles. 


THE PRACTICAL MEDICINE SERIES, comprising ten volumes on 
the year’s progress in medicine and surgery. General Medicine, series 
1909, edited by Frank Billings M.S., M.D. and J. H. Salisbury A.M., 
M.D. 

This little book is an altogether excellent summary of the 

2— M 


78 


year’s work in general medicine and makes a good and work- 
able quick-reference that not only enables one to find a desired 
subject quickly but has in itself no small degree of information. 

Howard. 


THE PRACTICAL MEDICINE SERIES, comprising ten volumes on 
the year’s progress in medicine and surgery. General Surgery, edited 
by Jno. B. Murphy A.M., M.D., L.L.D., Professor of Surgery in the 
Northwestern University, etc. Series 1909. The Year Book Publish- 
ers, 40 Dearborn Street, Chicago. Price $1.50. 

In this volume the same general plan in the selection and 
abstracting of articles has been followed as in former years, 
giving most excellent results. One can scarcely comprehend the 
degree of efficiency with which the book is gotten up ; but it is 
regretable that the limited space compels so much curtailment. 

Martin. 


INTERNATIONAL CLINICS. A Quarterly Of Illustrated Clinical 
Lectures And Especially Prepared Original Articles. Volume II, 
Series 19. Edited by W. T. Longcope M.D., Philadelphia. J. B. 
Lippincott Co., Philadelphia. Price $2.00 

There is the usual collection of interesting articles in this 
number of our best, certainly our most elaborate, quarterly. 
There are articles on immunization against typhoid fever, the 
treatment of syphilis, and of pneumonia in children, a dis- 
cussion of hyperchlorhydria, and of diabetes, a paper on ano- 
rectal fistula and one on the diagnosis of pelvic diseases in 
women, besides others of almost equal interest. 

Howard. 


THE PRACTICAL MEDICINE SERIES. Vol. III. The Eye, Ear, 
Nose and Throat. Edited by Casey A. Wood C.M., M.D., D.t'.L. 
Series 1909. The Year Book Publishers, 40 Dearborn St., Chicago. 
Price $1.50 

Comprising a review of the more important contributions 
to the literature of the past year, this small volume well fills 
its purpose. The abstracts are so well edited that it is un- 
necessary to look up many of the references. 

Bell. 


THERAPEUTICS OF RADIANT LIGHT AND HEAT AND 
CONVECTIVE HEAT bv Win. Benham Snow M.D., Author of 
“A Manual of Electro-Static Modes of Application, Therapeutics, 
Radiotherapy,” “ Currents of High Potential of High and Other Fre- 
quencies.” Editor of the Journal of Advanced Therapeutics, and late 
Instructor in Electro-Therapeutics in the New York Post Graduate 
Medical School. Scientific Anthors’ Publishing Co., 349 West 57th 
St., New York. Price $2.00 net. 

Graduates of more than four or five years will find in this 


79 


text-book an accurate description of the subjects named in the 
title, and which as yet receive only the barest mention in the 
average work on therapeutics. After a consideration of radiant 
light and heat, the author discusses the sources of radiant 
energy, the electric arc, the incandescent light, the mercury 
vapor lamp, the Finsen, minim and other lights. The applica- 
tion of these to the treatment of disease follows, and a good 
description of their uses in simple inflammations, infections 
and dermatology is valuable reading. The second section on 
convective heat explains the principles of applying dry and 
moist heat and will make clear to any owner of a hot-air ap- 
paratus the scientific principles on which he should use this 
agent. 

Myers. 


HANDBOOK OF DISEASES OF THE RECTUM by L. J. Hirsch- 
man M.D., Lecturer on Rectal Surgery and Clinical Professor of 
Proctology, Detroit College of Medicine, etc. One hundred and 
forty-seven illustrations, chiefly original. C. V. Mosby Medical Book 
and Publishing Co., Metropolitan Building, St. Louis, Mo. Price 
$4.00. 

This is an altogether excellent hand-book, practical, well 
written, well illustrated and worthy of consideration and study 
by anyone doing rectal work. Abnormal conditions and dis- 
eases of the rectum are described clearly, methods of examina- 
tion and points in making diagnoses are well described, and 
the treatments are outlined in a way that all may grasp. 
Without being too voluminous for ready reference, it contains 
enough of the esseutials for all practical purposes. 

Martin. 


VACCINE AND SERUM THERAPY, Including Also A Study Of 
Infections, Theories Of Immunity, Opsonins And The Opsonic Index. 
By E. H. Schorer B.S., M.D., Assistant Professor of Pathology and 
Hygiene, University of Missouri. C. V. Mosby Co., 715 Metropolitan 
Building, St. Louis. Price $2.00. 

The practitioner not in possession of an up-to-date text on 
pathology or bacteriology who desires to gratify his scientific 
curiosity concerning the opsonic index and bacterin therapy 
will find these two subjects clearly explained. As a laboratory 
guide it is lacking both in detail and in illustrations. The 
subjects “Infection’’, “Immunity” and “Serum Therapy” are 
treated in too sketchy a manner to deserve notice. While not 
exhaustive, the book is well up-to-date, and the information 
where not ambiguous from extreme brevity is correct and re- 
liable. 


Krauss. 


80 


MEDICAL AND MINOR SURGICAL DISEASES OF WOMEN by 

Samuel Lile M.D., late surgeon in chief to Lynchburg City Hospital, 
surgeon in chief to St. Andrew’s Home, etc. Southern Medical Pub- 
lishing Co., Baltimore. 

Dr. Lile has given us a book of unusual practical value. 
The introductory chapters on climate, education, social condi- 
tions, ventilation and food and their influence on women are 
in themselves worth more than the price of the book. He con- 
siders the points in diagnosing the different conditions and dis- 
eases peculiar to women in a clear and easy style that is emi- 
nently attractive and practical and his suggestions for treat- 
ment are sound and concisely given. 

Howard. 


IISSISSIPPI D1EDIGHL DIOHTHLY 


VOL. XIV. SEPTEMBER 1909. No. 5 


* THE DIAGNOSIS OF MALARIAL INFECTION. 


WILLIAM KRAUSS M.D., 

VICKSBURG. 


The term “Malarial Infection” is to be preferred because 
such infection is not necessarily a fever. The usual term 
“Malaria” is unscientific, and the whole name of the disease 
is really a misnomer. “Bad air” has nothing to do with what 
we call “Malaria”. 

According to the text-books, the diagnosis of malarial in- 
fection is made in three ways : by the clinical symptoms, espe- 
cially the temperature chart, by the therapeutic test, and by the 
examination of the blood. The method almost universally prac- 
ticed outside of hospitals is to give quinine to the point of 
saturation for several days, and if this does not eliminate the 
fever a new hypothesis is followed therapeutically until this 
has to be abandoned. This method has nothing to recommend 
it except the law of averages. Since the diagnosis of fevers 
not malarial has a chance to clear up clinically this extensive 
waste of time does not often prove disastrous. It is different, 
for instance, in the intermittent fevers of pulmonary tubercu- 
losis and in pyogenic and other fevers. In such cases, nay 
even in typhoid fever, such actively toxic therapy is distinctly 
harmful by itself, without even considering the disadvantage 
of delay. But even though we are actually dealing with “mala- 
ria”, we can handle the disease infinitely more satisfactorily 
when we know what the blood is doing under the treatment and 
what form and intensity of infection we are coping with. We 
can also recognize multiple groups about to become active, and 
tabulated results in well-conducted hospitals show substan- 
tially better prognoses than other cases treated in the old way 
in the same hospitals. We will waive the point that it is not 
a scientific diagnosis. 

Considering the objections urged against blood examina- 
tion, we are told that it consumes valuable time, delaying treat- 
ment, costs money, is difficult to do, requires skill and special 


* Paper embodying remarks at the meeting of the Four County Medical Society 
Tupelo, July 3rd. ; and at the Tri-County Medical Society, Brookhaven, August 10th. 


81 


82 


technic and equipment, consumes time that cannot be spared 
from other duties, and generally adds to the doubt, leaving the 
patient unprotected by treatment. It is true that a single ex- 
amination does not always give us a diagnosis in malarial in- 
fection, most especially in latent and estivo-autumnal infec- 
tions. Any “negative” in diagnosis usually means “I don't 
know’’, and good judgment must direct the course until we 
do know. It is true also that, all the conditions for success 
to be presently enumerated having been complied with, the 
physician may overlook or fail to recognize the organism, or 
else, mistake something else for it. In the last few years not 
a few text-books have appeared giving reliable colored plates; 
these should be studied. 

It is my purpose to refute the objections to blood exam- 
ination. to elucidate its advantages, and also to describe a 
simple and never-failing technic. In the first place, if the ex- 
amination of the blood were made the rule instead of the ex- 
ception, patients would begin to realize that there is something 
to “malaria” besides calomel, quinine and chill-tonic. They 
should be instructed in respect to their responsibility to their 
relatives and to the public at large with reference to carrying 
around “resting bodies” which is the result of incomplete qui- 
nine therapy not controlled by blood examination. If we all 
take to blood examination for cases of malarial infection or 
have it done by others if too busy to do it ourselves, malarial 
infection will in course of time be eradicated. Patients will 
learn to come to the doctor for their chills and “biliousness”, 
especially if he has been able on former occasions to tell them 
that their ailment was something else and required entirely 
different treatment. This will discourage counter-prescribing 
and patent medicine traffic. Physicians must bring into prom- 
inence the necessity for a correct diagnosis. There is no better 
way of increasing a medical practice than by showing how 
much pains we take to make a certain diagnosis. Don’t be 
afraid to admit that you don't know until you do know. Don't 
be a fakir. 

One of the causes of failure to make a diagnosis is pre- 
vious cinchonization. From a good spread the expert can do 
it even then, but this is too much to expect of the general prac- 
titioner. It can be done by the differential count, provided 
there is a good history by which diseases having similar counts 
can be eliminated. The polymorphonuclear variation is not a 
disturbing factor then. As soon as the patients have been edu- 
cated to come for a diagnosis they will learn to stop spoiling it 
for you by previous therapeutic tampering. A few times with 


83 


each patient will make him see the importance of it, especially 
if you impress it upon him that the quinine he takes now has 
no effect on the present paroxysm; all he can do for that is to 
get relief from the fever and distressing symptoms; quinine 
only aggravates these. For the purpose of checking the in- 
vasion of a new group of cells there is time, during which the 
diagnosis can be made. For diffuse broods of parasites the 
therapeutic technic is slightly different. Always remember 
that quinine is only a paratoxin for parasites — it fixes the 
hemoglobin and starves them. It is in the interest of the 
patient to prevent invasion rather than cause the death of in- 
fected cells while the endoplasmodial toxin is active and can 
be poured out to exert its destructive effect on uninfected blood 
cells. This is really the mechanism of hemolysis in hemo- 
globinuric fever. We have then three potent reasons for dis- 
couraging therapeutic tampering. 1st. the prevention of rest- 
ing bodies; 2nd. the necessity for a diagnosis; 3rd. the possi- 
bility of provoking hemoglobinuric fever in latent and chronic 
infections. This is not a contraindication for the use of it 
but it is one for unskillful tampering. 

Another reason for failing to find parasites is obtaining 
blood at the wrong time. The best time to get blood smears 
is at the end of a paroxysm, and any time after that until that 
group is nearly mature after which time they retreat to the 
spleen. Just after the emergence from the spleen we have a 
leucocytosis ; during this they are scarce in the peripheral blood 
but a mixture of eighty or ninety per cent, polymorphs with a 
balance of nearly equal proportions of the two mononuclear 
forms is equal to a positive diagnosis. In other words, if the 
balance of thirty per cent, mononuclears of a normal mixture 
contains five per cent, large mononuclears, there is no dispro- 
portion but if the balance of fifteen per cent, contains as many 
it bespeaks a doubling of these elements, and a blood picture 
which, with the clinical picture, gives us a diagnosis of mala- 
rial fever. 

It is possible to find parasites at any stage of the cycle, 
easy, in fact, in rich infections, especially after an antipyretic, 
and unusually not difficult in intermittents except just before 
the chill and up to two or three hours after. This affords a 
wide latitude; usually, the messenger can be questioned as to 
that and the visit timed accordingly, a palliative being sent for 
the urgent symptoms. At the first visit the blood is taken and 
word left that the prescription will be telephoned after diag- 
nosis. This will contrast with what the patient has been used 
to in this respect. It will compel your competitor to do like- 


84 


wise. And don’t forget to charge for the examination. It is 
the most valuable service you are rendering, and it will teach 
you to ‘“have time” for it. 

The next cause of failure is making bad smears. My tech- 
nic, repeatedly published, is as follows:* 

“1. Wash the hands and rub off with alcohol. 2. Prepare 
six slides by wiping first with alcohol and then drying with 
plain gauze. 3. Seated on the right of the patient, facing in 
the opposite direction, grasp the lobule of the patient’s right 
ear between the thumb and index finger of the left hand so as 
to cause turgescence; rub it briskly with gauze dampened — 
not wet — with alcohol. 4. Plunge a new steel pen from which 
one nib has been broken off or a special blood lancet into the 
presenting end of the lobule with a quick stroke to the depth of 
one-eighth inch. Squeeze very gently, and wipe off the first 
drop — the next will flow more freely and spread better — let 
it collect in a small, globular, drop on the surface. 6. With 
the right hand pick up one of the slides, lower its distal end 
on the index finger of your left hand and gradually depress 
the proximal end until the drop is just touched, being careful 
not to squash it. The drop on the slide should be the size of 
the head of a match. 7. By pronating the right hand, the 
slide is tilted toward the operator, taken into the left hand, 
the drop being now on the upper surface of the slide close to 
the grasping thumb. 8. With the right hand a second slide 
is now taken up, its lateral edge placed transversely to the 
surface of the first slide and proximal to the drop, tilted for- 
ward at an angle which with the particular drop will give the 
best smear, and gently, slowly, “fiddled” across the smear-slide, 
somewhat like spreading butter. 9. Fan the filmed slide rap- 
idly in the air until dry. The remainder of the slides are filmed 
in the same way, a fresh drop being extruded for each smear.” 
(Note: The drop must be small enough not to extend entirely 
across when smeared out; the smear should be an inch long.) 

It is necessary to practice this technic in blank and after- 
ward on a volunteer or on your own ear before a mirror. After 
a few trials good smears can be made. By having a number of 
them, a good one can be selected, others being reserved in case 
the staining fails. 

Of other published methods, as well as of examining fresh 
blood, I can only say that they are ways bitter and disap- 
pointing experience has led me to discard. This also refers to 
method of staining now to follow. It is useless for you to 
repeat for yourselves my own failures. I have letters from 
physicians all over the South thanking me for this never- 

•Southern Medical Journal. July 1908. 


85 


failing technic. I claim originality only for the method. You 
can therefore only speak of it as “Krauss’ adaptation of the 
Romanowsky method to the Giemsa stain.” A simpler name 
is the “aqueous Giemsa method”. 

Equipment required. A standard microscope, like the BB8 
or its equivalent in other makes, with mechanical stage, hand 
centrifuge with Krauss slide attachment, a pair of Pasteur 
dishes, some absolute methyl alcohol, pure aceton, distilled 
water. All these are essentials in a doctor’s equipment. The 
extra things required are 10 grams Gruebler’s eosin, w.g., and 
1 gram Gruebler’s azur II ; the latter is very expensive but it 
is enough to stain a large number of films. We also need two 
stopper-ground pipet bottles. The patent acid droppers are not 
suitable. The pipets must deliver drops of the same size and 
must never be interchanged, as the stains precipitate each other. 

We now make up one per cent, solutions of the two dyes, 
just enough to nearly fill the 1 oz. bottles, say 0.25 gm. to 
25 cc. These stains should never be bought in solution. 

To stain, invert a slide in the bottom half of a Pasteur 
dish, resting one end on a piece of toothpick; pour in about 
2cc. of the methyl alcohol, seeing that the under, smeared sur- 
face of the slide is well covered; then cover up with the lid 
of the dish. Kow, in the graduated centrifuge tube, measure 
off 7 cc. distilled water; drop into this 4 drops of the eosin 
solution, shake, add 6 drops of the azur, shake again, remove 
the lid of the dish from the alcohol and pour this solution into 
it. Then transfer the slide, still face down and wet with alco- 
hol, into the staining solution, letting one end of it rest on the 
edge of the dish. At the end of five minutes (or longer, as it 
cannot overstain) remove the slide from the stain, rinse with 
distilled water and dry on the centrifuge. If the slide appears 
pink, the azur was insufficient; another is then stained, correct- 
ing this error. The solution in the dish must look blue, not 
purple. If the slide is too blue it need not be rejected. Flood 
it with a weak solution of tannin in water, about one per cent., 
rinse well with distilled water and dry again on the centrifuge. 
Old slides generally stain too blue. In such cases two drops 
of eosin and azur, staining for one-half hour, often give splendid 
pictures with smears a year old. 

If the slide has a violet color, it is examined under the 
low power. At the edge the leucocytes are seen. Here we can 
control the success of the process. The nuclei must be an 
intense purple, the cytoplasm of the lymphocytes a rich blue. 
We now know that any parasites present must have taken the 
stain. The red cells are generally a clear, pale orange, against 


86 


which the sky-blue of the parasites contrasts well. If they are 
slate-colored, wiping the dry slide over with a wisp of cotton wet 
with aceton will clean them; it also removes precipitates, but 
these rarely appear when this method is used. The staining 
solution can only be used once ; two slides can be stained simul- 
taneously in the one dish. When the one staining is completed, 
most of the stain will have precipitated. These precipitates can 
be saved and used for Wright’s stain. All this is no more diffi- 
cult to do than it is to read it, and takes scarcely any longer. 
The time for the fixation of the slide in the alcohol should be one 
minute. It takes about this long to make up your solution. 
This is all the time required, and the slide needs no attention 
at any time. The staining can be left to itself indefinitely, 
being sure of your minimum of five minutes. Your office boy 
or maid can do it while you are busy at something else. There 
is no room for a personal equation ; the process is automatic. 

There is now one more “if”. We must be able to recognize 
the plasmodia. They are never any color but blue; anything 
purple, pink, orange or gray is not a plasmodium. Also, it 
must be within a red blood corpuscle. Crescents and other rest- 
ing bodies are, apparently only, not within red cells. With 
careful focusing we can make out the pink rim around these, 
just a capsule of red cell-substance. The material which repre- 
sents the nucleus of the parasite takes a deep carmin color. 
In the ring-form this is at the thinnest part of the ring. In 
deeply stained specimens we can make out difference of species, 
especially in the partly grown forms. The easiest way is by 
the effect on the blood corpuscle. The tertian parasite causes 
the cell to be pockmarked with fine carmine granules, “red 
stippling” (Schuffner’s dots). The estivo-autumnal parasite 
causes a “blue strippling”, the so-called basophilic degenera- 
tion, seen also in lead poisoning, in pernicious anemia, cachexia, 
hemolysis, etc. In the latter type we sometimes also see un- 
infected cells showing degeneration. Maurer explains this on 
the ground that the mammalian red cell has a “distributed” 
nucleus, which is only visible when much of the hemoglobin 
has been dissolved out of the cell. 

Pigmentation. The quartan parasite gives us the blackest 
and coarsest pigment. The parasite being more compact and 
thicker, stains more deeply blue. The tertian shows pigment 
early, but it is too fine to be seen until the organism has at- 
tained some size. Even then, because of its fineness, it looks 
brown rather than black. The estivo-autumnal parasite, if it 
shows pigment at all, it is late, and in one or two solid clumps. 

Artefacts and nuclei. A blue smudge extending across a 


87 


cell will probably extend over it and others, clearly outside of 
the cell, can be seen in other fields. Karyokinetic figures in 
nucleated cells are seen in pernicious anemia. Sometimes they 
simulate parasites to a remarkable degree. They never show 
the carmin particles belonging to malarial organisms. Platelets 
are seen singly or in numbers, in the latter case emerging from 
red cells, making one think of segmentation. If a real seg- 
mentation is ever seen, this mistake will not be made. When 
the staining is insufficient platelets may be somewhat bluish; 
in such cases plasmodia are not stained at all. 


*THE FINANCIAL ASPECT OF THE MEDICAL PROFESSION. 


D. G. MOHLER M.D., 

GULFPORT. 


I have been requested by the society to submit a paper 
upon the financial aspect of the medical profession. 

This is a branch of the profession upon which we are all 
too derelict. 

Having had some fourteen years experience in the prac- 
tice, during which my time has been wholly devoted to my work, 
trying to keep fully abreast with the rapid advances, and 
having come in direct contact with nearly every phase of human 
nature, I have tried most strenuously to make a study of 
human nature ; hence, the well known quotation : ‘‘The proper 
study of mankind is man”. Above nearly everything else, you 
touch the tenderest part of man when you touch his pocket- 
book. You may have a friend or an associate and toil along 
ir. the most congenial clime, but when the question of dollars 
and cents comes up, if you are not very careful to use much 
discretion and tact, an estrangement will arise when you least 
expect it. The consensus of opinion among the laity is that 
in entering the medical profession you at once have entered 
the arena through which Croesus passed in supplying himself 
with great riches. They never take into consideration the cap- 
ital invested, length of time spent and the hard struggle we 
have to undergo in preparing ourselves for our work. Many 
are they who think us grafters, yet, I am glad to say, there 
are some exceptions to this rule among the most intelligent. 

I do think that every physician should be strictly honest 
with himself and with his patrons, for you cannot be honest 
with the one without the other sharing equally. 

* Read before the Harrison County Medical Society. 


88 


My platform has certainly been laid along this line and 
I have not, at any time, intentionally departed from it. 

Again I think the physician should always be cognizant of 
the trust imposed in him, and keep himself fully prepared and 
thoroughly equipped to give his patient the advantage of the 
best treatment that environments will permit. 

There is no profession that demands the best and most 
sacred of all principles as does ours, for our work involves 
the closest and most sacred associations with our patients, 
second only to the family direct. I deem our calling one of the 
noblest and to me the dearest, and we should fervently give to 
it the best we possess. 

Now in order to live up to these principles and to keep 
ourselves thoroughly in a position to discharge the many duties 
devolving upon us it is absolutely essential that we give some 
thought in a substantial way to the financial aspect of our 
profession, for it is sad to say that for the amount of prepara- 
tion, hard work and deprivations involved there is no pro- 
fession that can show less material gain, taken as a whole, than 
ours in the way of a competency laid up. 

There is nothing that handicaps a doctor more than limited 
finances. It detracts more from his usefulness, progress and 
independence than anything else, and has a most dwarfing effect 
upon his intellect, for to have to stop and think how we are to 
meet this or that obligation in the midst of our professional 
work, adds anything but a stimulus to our brains. 

My experience has taught me that the best, most thankful 
and satisfactory patients are those from whom we collect our 
bills. 

We will first take the common laborer from whom the 
world draws its greatest sustenance. It has been my custom 
when patients of this class present themselves for treatment to 
first get their names, occupation, for whom working, whether 
firm or individual, and whether each is responsible as to meet- 
ing his obligations promptly with the employee as promised. 
I next find out the amount of salary per day, week or month 
of patient, and on what days he collects his pay, next as to 
whether married or single, how many in family that are de- 
pendent on the patient for support, whether he has a great 
amount of sickness in the family, what doctor has formerly 
done his work, and right along here I note particularly how 
he speaks of the doctor who has formerly been serving him. 
If the patient speaks favorably of him and assures me that 
he has been paid you may depend on that patient, but if he 
speaks unfavorably of the former, you had best hands off and 
let him go. 


89 


After getting the desired information I size the applicant 
up. I then ask him how much money he can pay down. If he 
has none on hand I then inquire as to whether his employer 
would be willing to give me an order stating that he would be 
responsible for the bill. If this cannot be done, I then ask what 
security can he give in the w r ay of a bill of sale or deed of trust 
on some cattle or property. If none of these options are re- 
sponded to, unless I feel reasonably sure that I can collect the 
bill I invariably demand cash on delivery or security before I 
take the case. 

Of course if the party is an object of charity or in distress, 
I never ask any questions, but respond promptly and unhesi- 
tatingly, regardless of pay. 

The next class of patients that w r e have to contend with 
are the ones the w T orld looks upon as perfectly responsible and 
who really do expect to pay their bills if you will give them 
their ow r n sw r eet time. We often hear of them remarking that 
“Dr. so and so is making plenty of money and can afford to 
wait. I have other bills of more importance that I must pay 
first.” They are the very ones, though, w’hen they are in need 
of medical services that come post haste after you, expect you 
to drop everything, neglect everyone else and respond promptly 
to their call, and if you do not rush to their bidding are the 
first to hurl anathemas at you. With this class I lose no time 
in presenting my bills as early as expedient after services are 
rendered and if I do not hear from them very soon I send 
another statement requesting them to kindly settle the bill; 
that I, like themselves, have obligations to meet. I continue 
to send them similar reminders and rarely ever hold up until 
I receive some substantial understanding, or know’ that further 
efforts on my part will be useless. I investigate every case as 
far as possible. 

The next class of patients is the one that I have taken 
special pains and delight in starting in with on an even basis, 
and I have had some success in handling. I dub him the run- 
about. He is often a hypochondriac, but frequently has troubles 
that have assumed a chronic form due to the patient’s own 
carelessness and neglect. He comes into your office and before 
you ask him any questions he begins to turn his tongue loose 
at both ends; gives you in detail a complete history of his 
case, makes the diagnosis for you, tells by how r many doctors 
he has been treated, how many places he has been to, how 
much money he has paid out and yet has reaped no benefit 
from any source. I listen very intently, knowing frequently 
the doctors he mentions as having treated him, doctors w^hose 


90 


integrity and ability no one questions. I know them to be 
fully as competent as myself, and know that they had made 
the proper diagnosis of the case and instituted the proper line 
of treatment, but the trouble was that the doctor had only 
seen the case once, put him on treatment, never got any re- 
muneration for his services and the patient never even carried 
out his directions and in most cases never even had the pre- 
scriptions filled for the medicine, but sailed away to the next 
doctor to do him the same way. So the first step I take with 
this patient is to give him a most critical physical examination, 
frequently undressing him almost from head to foot and after 
completing my examination, before I have suggested any line 
of treatment, I tell him that upon close examination I 
have every reason to believe that I can get good or permanent 
results provided he is willing to abide strictly by what I say, 
keep up the treatment as long as I direct and especially if he 
is able to pay in advance for the treatment, which necessarily 
requires a good fee, as conditions demand it. I then proceed 
to collect my fee or to bind him up in some way so that I know 
I am going to get it ; this I invariably do before suggesting any 
line of treatment. If he cannot pay the fee or secure it in 
advance I send him on unmolested to graze in other pastures. 
By making such demands of this patient I am able to hold 
him and make him carry out my treatment and so as a rule 
get good results, for their troubles usually are not of a serious 
nature. 

Now comes the chief of all fiends, the so-called “dead beat”. 
Like the poor, we have him with us always. He comes fre- 
quently in the guise of a genteel, refined looking, well-dressed 
gentleman with perhaps a wife and a couple of children, all 
well dressed and easy in ways. He has no home but has 
recently moved to town, finds him a boarding house or perhaps 
puts up at one of the best hotels, draws a fairly good salary 
either as salesman of some lumber firm, book-keeper, clerk, etc. 
This same gentleman walks into your office with his Chester- 
field manners and tidy looks and impresses you at once as a 
gentleman of the first type. He makes his wants known in a 
very concise, business-like way and you proceed at once to give 
him the asked-for attentions, possibly call on his family and 
treat them through a long spell of sickness. After your ser- 
vices are tendered he thanks you kindly for your extreme con- 
sideration, speaks words of praise for your skill in handling 
the case so successfully, then tells you to be sure to tender 
your bill for services promptly on the first of the month. With 
a glad heart you do so, only to meet him a few days after the 


91 


first and have him to apologize for not meeting the obligation as 
promised, but that it will be only a few days before he will send 
you a cheek in full. Well, you wait and, to make a long story 
short, in a few days you hear of the departure of this fine bird. 
He has moved to another town and left only as traces many 
others that he has duped in the same way as yourself. He has 
no property, and you have no recourse nor any means by which 
you can collect the account, so it goes reluctantly to profit and 
loss. Now it has been among this class that I have suffered 
most, until I observe with a critical eye when a stranger walks 
into my office. It matters not how fine an appearance he pre- 
sents, in a delicate way I find out all I can about who he is, 
where from and his occupation, and as soon as possible after 
we have had our conference I get on the outside and get all the 
dots I can as to his reliability and standing. If the comments 
I get are favorable I proceed with him as I would any other 
responsible patient, if unfavorable I then meet him in a busi- 
ness-like way when he approaches me for further attendance 
and insist upon money being paid before we can progress 
further. 

In conclusion, I have formulated a few rules which have 
served me a fair purpose in the past. 

1st. Always put your own valuation on your services and 
never allow your patient to dictate, for if you do not value 
your own services your patron will not and his confidence in 
you will at once be shaken. 

2nd. Never pose as doing work cheaper than others; al- 
ways charge the regular fees; for if you are a “Cheap John” 
you will be treated accordingly. 

3rd. Collect a cash fee as often as possible; when this 
cannot be done send out your statements regularly on the first 
of every month and continue to send them with each succeeding 
month, or oftener, insisting on payment until collected, for 
the sooner you collect the bill the better feeling will exist be- 
tween you and your patients. They will appreciate your ser- 
vices more and patronize you oftener. 

4th. Never apologize for sending a statement, even if you 
have a “please remit” on it, but let them undersand that it is 
your custom and that you want your money. 

5th. Always be prompt in giving any one his bill when he 
asks you for it, for no one appreciates slack business principles 
even though they are without business principles themselves. 

6th. Be careful never to make any references outside to 
what party owes you, for no one enjoys having his business 
aired to the world. 


92 


7th. Be tactful and use great discretion in adjusting mat- 
ters when any dissention or controversy arises over a bill pre- 
sented. Keep yourself composed, but gently push your claim, 
trying at the same time to retain the good will of the patron ; 
but above all things do not compromise yourself to do it. If 
he will not resort to reason give him to understand that you 
can live without him. 

8th. Be independent, courteous, kind and gentle with all, 
giving to the most humble the same deference as you show to 
your best trade, for from the small acorn the largest tree some- 
times springs. 

No collecting agency is worth the paper upon which the 
contract is written. I have never been able to secure the ser- 
vices of any one who could collect my accounts as well as 
myself. 


* WHY JOIN THE COUNTY SOCIETY? 


M. J. ALEXANDER M.D., 

TUNICA. 


When I consented, on invitation of my friend, Dr. Dye, 
to contribute a short paper on th subject “Why join the county 
medical society?” I had no idea that it would tax my limited 
cerebral faculties to the extent that it has. Not that I found 
it difficult to enumerate the many reasons for joining the 
county society, but the benefits and advantages are so apparent 
and, you may say, elementary, that I doubted my ability to 
present an interesting discourse on the subject. Were the ques- 
tion, “Should all physicians join the county society?” it goes 
without the saying that the prompt answer would be a unan- 
imous “yes”, and the man who had the temerity to ask why, 
would create ridicule and disgust. And yet there are reasons 
which we perhaps may not consider in their singleness, but 
we do agree that it is an advantage — it is good to belong 
to the county society. The benefits, however, do not only con- 
cern ourselves alone, but also affect our patrons and our be- 
loved profession, and are in a way as important to one as the 
other. Therefore we would not go wrong when we look upon 
the life of a true physician in the light of a trinity of duties. 
I will consider then the extent of the benefit to the individual 
doctor, and why he should join the county society for selfish 
reasons. This society is a gathering of men who have selected 

‘Read before the Clarksdale and Six Counties Medical Society. 


93 


this noble profession for their life work; their aim is to succeed, 
and success can only come to us by knowledge and the proper 
use of the same. The frame-work of this knowledge is received 
at the medical school, the further construction can only be 
accomplished by additions from time to time during our pro- 
fessional life, as we procure the material by well-directed and 
honest endeavor. We must use all efforts possible to possess 
ourselves of the same from all sources available, and he who 
gathers the best and most will have built the edifice sooner and 
better. 

The county society is one warehouse, well supplied with 
material. We enter and are welcomed by familiar faces who 
meet us cheerfully; they also are looking for material, we find 
they are willing to give in exchange and it is easy to trade. We 
get experience and ideas from them in return for those which 
we possess, but our advantage is in that we give our own alone, 
and receive that of all the others. 

This society is much like a gathering of kinfolks in a small 
village; we are received with open arms, glad to see one 
another; our environments and labor, aye, our joys and 
troubles, are alike; we tramp over similar grounds, and when 
we find a hidden path or a comfortable nook we tell each other 
about it. 

Thus we gain mutual knowledge pleasantly. And what 
else? We get closer to each other in spirit, and form friend- 
ships of a lifetime, learn to appreciate and know each other, 
and in our broadening minds find that our neighboring brother 
physicians are as good as we are. And when we make our 
annual trips to a larger warehouse, supplied with somewhat 
more elaborate material, it is not as strangers in strange lands ; 
we will find there many whom we have associated with nearer 
at home, and will feel at ease. It is again like kinfolks at 
home, meeting in the mansions of the kindred abroad. And 
what would have been a gloomy and dull affair, becomes a 
pleasant and profitable meeting, ending in a still more extensive 
acquaintance and the gathering of more knowledge. And this 
same experience recurs again and again as we go on through 
a good and well-spent professional life. But it also increases 
our self-respect, not that contemptible feeling of the bloated 
“ego”, but a satisfaction that we are gaining knowledge and the 
correct respect of and for our brothers. We feel at ease as 
listeners and talkers, and when we know a thing we can talk 
about it with understanding and profit. 

I remember myself, when I first attended the State Medical 
Association, before we had this county society, I sometimes 


94 


recognized an opening to make a point in a discussion, but my 
natural timidity, augmented by the fact that nearly all were 
strangers, held me to my seat. 

Intimately connected with our own individual reasons for 
joining the county medical society are those as they touch our 
patrons, the people who entrust to us their comforts, health and 
lives; and when such confidence is bestowed upon us, it is 
expected that we perform our duties as physicians conscien- 
tiously and actively, the most important requisite being the at- 
tainment of proper knowledge. The laity now-a-days expects 
that their “Doctor” keep abreast with everything pertaining 
to the profession; they not only think that he should belong 
to the medical societies, but that he should also attend the 
meetings. No physician should deceive himself that his pa- 
tients of intelligence do not know his conduct; they keep up 
with him and some day will ask him questions, the truthful 
answer whereof might be embarrassing. And they will know 
that you cannot belong to the State or American Medical Asso- 
ciation unless you are a member of the county society. 

The doctor’s membership in whist clubs, lodges and other 
social gatherings is frequently appreciated by his friends, but 
their respect for us, as their medical advisors, is measured 
largely by the attention we give to everything in connection 
with medicine. If we are not a member of the county society, 
why not? When I come to consider the question of joining the 
county medical society as a duty to the grand profession, it is 
a duty obvious that active membership is a paramount neces- 
sity. Through the wisdom of our medical organizers it has 
become necessary that we join our county society before we are 
accepted for membership in the State or American Medical 
Associations, and I want to give it as my opinion, that unless 
we thus affiliate, we should not be considered of good standing 
in the profession. The opportunity is afforded us and it is our 
duty to avail ourselves of the same to add strength to the 
medical profession in its fight against disease and the maligners 
who have ever endeavored to deprive it of its just rights. We 
want nothing but what is best for the happiness and welfare 
of humanity, and if we cannot reach this aim by peaceful means 
let us all to a man unite and fight for our rights to make 
this world healthier and happier. 




MISSISSIPPI SIESISSL IIITILT. 


B. 

H. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

ASSOCIATE EDITORS 

B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D.. Rosedale. 

M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 

S. MYERS M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


Although delightfully phrased and appealing to the better 
nature of man as well to his love of the beautiful, we have often 
wondered if we can really echo Burns’ immortal wish to see 
ourselves as others see us. Such a condition of affairs would 
undoubtedly help us to better things in a large proportion of 
instances, but how about the others? We are reminded of a 
story told by Dr. Matas of New Orleans, illustrating his sen- 
sations when introduced to an automobile. A friend had taken 
him for a ride in a new car, resplendent with brass mountings 
and handsome fittings, and after the trip had removed the 
seats and showed him the engine and tanks over which they had 
been sitting. The doctor likened his feelings to those that 
sometimes came to him in his early days when, doing a gen- 
eral practice, he would receive in his office some lady beauti- 
fully dressed, only to have his artistic sensibilities ruffled by 
what was revealed at the subsequent examination. 

It is often bad enough when the one seeing is gifted with 
exact vision, but we are quite sure that even the inspired Burns 
would have shrunk from inspection by some of the astigmatic 
or strabismic individuals who constitute themselves, unasked, 
the judges of others. 

An instance of this kind of inspection has recently come 
to light in the Yazoo City Sentinel, which, commenting on the 
refusal of the Jackson News to comply with the request of the 
Hinds County Medical Society that it refrain from mentioning 
the names of physicians in connection with its accounts of 
accidents, operations, etc., says : 

The Sentinel cannot agree with the News when it says it has all due 
respect for the code of ethics of the medical profession. We think the so- 
called medical ethics is the biggest humbug on earth. The average doctor 
likes publicity in connection with his professional dutfes, so long as he 
does not have to pay for it, and so long as he thinks he can escape the 
criticism of his brother who is not fortunate enough to get his name in 
print in connection with a case, he is not going to kick very vigorously. 
The chances are about ten to one that the author of the resolution intro- 


95 


96 


duced by the Hinds County Medical Society, is some patientless doctor 
who is jealous of some other Jackson doctor who has outstripped him in 
a professional way, and very naturally has come more into public notice 
as a result of his success than his less fortunate medical brother. 

In our journalistic career we have known a number of reputable phy- 
sicians of high professional standing who would throw a fit, if you sug- 
gested that they do some legitimate advertising at regular rates, but would 
urge you to be present to 6ee a difficult operation performed, and give 
you a line of dope as to how it should be written up with the nonchalance 
of an advance press representative of a circus. 

In our opinion, the so-called medical ethics is largely a sham. If the 
newspapers were to heed the advice offered by the Hinds County Medical 
Society and refrain, absolutely, from mentioning the name of any doctor, 
under any circumstances, the medical men would swell up, and declare 
that the newspaper man “ had it in ” for them about something. 

The author of this unwarranted bit of vituperation is un- 
doubtedly a new-comer in the state. His statement in the 
second paragraph quoted, that he has known a number of 
reputable physicians who would urge a layman to be present 
at an operation, cannot refer to the profession in the town 
he is now honoring with his presence since we know the major- 
ity of the Yazoo City physicians personally and are quite sure 
that they would not stand for such a violation of the code in 
their territory; but if. as may possibly be the case, this journal- 
istic penny-a-liner has gotten hold of even one physician who 
would so far forget his dignity, and magnified him, as news-' 
papers are prone to do, into “a number”’, we would suggest 
that it is time for the board of censors of the society in Yazoo 
to “get busy”. 


Sfltteig Vxntzttimys. 


East Mississippi Four County Medical Society met at 
Houston Aug. 10th. at 2 P. M.. Dr. Feemster being in the 
chair. The society entertained the following visitors : Coleman 
of Aberdeen, Stevens of Amory and Walker of Houlka. J. 
R. Williams of Houston presented a clinic. R. P. Wendel of 
Aberdeen read a paper on tuberculosis, which was discussed 
by Bryan of Amory. Stevens of Amory, Boyd of Houston and 
Feemster of Xettleton. A vote of thanks was extended Dr. 
Wendel. A motion prevailed that the society extend its sym- 
pathy to Dr. J. S. Evans of Chickasaw County, who has re- 
cently sustained a fracture of the right leg. Resolutions ex- 
pressing profound sorrow and regret at the untimely death 
of our beloved comrade in arms Dr. Walton S. Greene were 
read by a committee and adopted by the society. Five appli- 


97 


cations for membership were received : Hamilton and Coleman 
of Aberdeen, Walker of Houlka, Guinn of Prairie and Stevens 
of Amory. A vote of thanks was extended the physicians of 
Houston and the local officials, especially naming the deputy 
sheriff, for courtesies extended. Next meeting will be held at 
Aberdeen Sept. 14th. at 1 P. M. Underwood. 


Harrison County Medical Society met at Gulfport Aug. 
10th. with Dr. Lebaron, president, in the chair. Those present 
were Drs. Lebaron, West, Mohler, Welch, Hood, Richardson, 
Folkes, Parker, Carroll, Strange, Morris, Rowan and Hopper. 
Dr. Rowan of Wiggins presented before the society a case of 
pellagra ; the patient was a child of about ten years of age. 
The doctor saw the case last summer and treated him for an 
eruption on hands and feet; he did not pay much attention 
to the case at the time. This summer the trouble was much 
worse, with marked nervous symptoms, and he diagnosed it as 
a case of pellagra. All the doctors present examined the case 
and concurred with Dr. Rowan’s diagnosis. There was a 
lengthy discussion taken part in by all present concerning pel- 
lagra, its history, cause and treatment. Dr. Lebaron mentioned 
a case which he lately had in the hospital. He did not think 
of pellagra at the time but since then he thinks it might have 
been the disease. The discussion changed to anemia and hook 
worm disease. The publicity committee made a partial report 
and on motion was given extended time. West. 


Tri-County Medical Society met in the parlors of the 
Inez Hotel on Tuesday, Aug. 10th. with several members and 
two visitors present. The subject of obstetrical hemorrhages 
was the order of the day; and Dr. D. W. McGee led the dis- 
cussion with credit to himself. Several members who were on 
the program being absent, the regular order was now dropped 
and the society entered upon a general discussion of the sub- 
ject of pellagra. Dr. Denman presented a clinical case, and 
others mentioned cases that had come under their observation 
recently. It seems to be fairly common in this section. Dr. 
Krauss, the guest of honor, was now presented, and gave a very 
scientific discussion of malaria, illustrating with the micro- 
scope. The members and guests now repaired to the dining 
room, where refreshments were served, compliments of the 
Brookhaven P. G. Club. Next meeting at Brookhaven, Oct. 
12th. D. W. Jones. 

2— M 


98 


^ssnriatinn Vicmxtimtz. 


H. H. HARALSON, Vicksburg. 

President 1895-6. 

Hugh Hardin Haralson was born in Wetumpka, Ala., 
March 10th. 1854, his father and mother being natives of 
Georgia. Dr. Haralson, the youngest in a family of eleven 
children, was educated at Cooper Institute, Lauderdale County, 
Miss., entered the drug business in Harperville in 1877 and 
was graduated from Tulane Medical College in 1883. He began 
the practice of medicine in Harperville but shortly after went 
to Forest and later to Biloxi, from which place he moved to 
Vicksburg in 1898. He served on the State Board of Health 
for twelve years, being successively appointed by Governors 
Stone, McLaurin and Longino, and was actively engaged in 
the epidemics of yellow fever in 1897, 8 and 9. He also served 
as a representative of the State Board during the epidemic at 
Vicksburg in 1895. 

Dr. Haralson was elected recording secretary of the Asso- 
ciation in 1886 and served for several years, making an ex- 
cellent record as an executive officer. In 1897 he founded the 
Mississippi Medical Record which he turned over to the Asso- 
ciation the next year, resuming publication of it in 1900 when 
it was abandoned by the Association. 

In 1878 Dr. Haralson married Miss Belle Lack of Harper- 
ville and to this union were born seven children, two of the 
daughters being now married to professional men in Vicksburg. 

Rowland's History of Mississippi. 1907 


J. W. GILBERT, Verona. 

President 1896-7. 

James Washington Gilbert was born July 9th. 1845 in 
Rogersville, Ala. To give their children better educational ad- 
vantages, his parents, W. A. and S. E. Gilbert, moved to 
Moulton, in 1853, where Dr. Gilbert was put to school a few 
years later, but before completing his education he joined the 
4th. Alabama cavalry and served in the Confederate army until 
the close of the war between the states. Returning home after 
the surrender, he married Miss Laura Harris, whose death, a 
year later, was the cause of his decision to study medicine. 

After reading under Dr. C. A. Crow for more than a year, 
Dr. Gilbert spent one year in Louisville attending lectures and 


99 


then went to New York, where he received his diploma from 
Bellevue in March 1870. Returning to Alabama he settled 
in Tuscumbia, where he married Miss Naomi Harris and to 
this union were born three children — Minnie, Ed and Tom. 

Before leaving Alabama he assisted in organizing the North 
Alabama Medical Society, served as its secretary one year and 
was elected president in 1875, but before the completion of his 
year of office moved to Yerona, Mississippi, where two years 
later he lost his second wife. In 1882 he married Miss Ella 
Anthony, daughter of Dr. J. A. Anthony of Verona, to which 
union were born three children — Cecile, James and Grace. 

Dr. Gilbert was health officer of Lee county for several 
years. In 1896 he went to Corinth and in January 1891 
moved to his present home, Roff, Oklohoma. In 1893 he was 
elected president of the Chickasaw Medical Association and in 
1905 censor for the southern district of the Indian Territory. 
He has recently retired from practice and is engaged in mer- 
cantile business, with his youngest son as a partner. 

Personal Notes, 1908. 


W. M. PAINE, Aberdeen. 

President 1897-8. 

Concerning the date and place of birth of W. M. Paine, 
and his family history, to quote a legal phrase, “deponent 
sayeth not”. He is said to have attended Emory and Henry 
College in his younger days and to have taken medical courses 
at the University of Nashville and Vanderbilt, and to have 
graduated from the last named institution in 1881. It is a 
matter of record that he was for some years a member of the 
State Board of Health. Dr. Paine has for a number of years 
been engaged in banking business in Aberdeen, though con- 
tinuing to do some practice. 

E. F. Howard. 




DIET IN HEALTH AND DISEASE. The New (3rd.) Edition. By 
Julius Friedenwald M.D., Professor of Diseases of the Stomach in 
the College of Physicians and Surgeons, Baltimore; and John Ruh- 
rah M.D., Professor of Diseases of Children in the College of Physi- 
cians and Surgeons, Baltimore. Third revised edition. Octavo of 
764 pages. W. B. Saunders Company, Philadelphia and London, 
1909. Price, cloth $4.00; half morocco $5.50. 

Former editions of this book have met with an appreciation 


100 


that will no doubt be accorded this one. The changes made 
consist chiefly in a revision of the articles on milk and alcohol 
and additions to those on tuberculosis, the salt-free diet, rectal 
feeding and the caloric needs of infants, together with tables 
showing the caloric values of foods and a description of the 
simpler methods for detection of food preservatives. 


TREATMENT OF THE DISEASES OF CHILDREN. By Charles 
Gilmore Kerley M.D., Professor of Diseases of Children, New York 
Polyclinic Medical School and Hospital, etc. Second revised edition. 
Octavo of 629 pages, illustrated. W. B. Saunders Company, Phila- 
delphia and London. Cloth, $5.00 net; Half Morocco, $6.50 net. 

We have no better work on the treatment of diseases of 
children than this of Dr. Kerley. It is practical and forceful 
and the chapters devoted to the general care of the baby, its 
nutrition and growth and the information that its mother 
should have to enable her to care for it intelligently should be 
carefully studied by every practitioner. Texts on pediatrics 
are too prone to ignore therapeutics, or to treat this feature 
of the subject slightingly, and so this book will be found to 
meet a very considerable want. 


BIER’S HYPEREMIC TREATMENT IN SURGERY, MEDICINE 
AND ALL THE SPECIALTIES : A Manual Of Its Practical 
Application. By Willy Meyer M.D., Professor of Surgery at the New 
York Post-Graduate Medical School and Hospital : and Professor Dr. 
Victor Schmieden, Assistant to Professor Bier at Berlin University, 
Germany. Second Revised Edition. Octavo of 280 pages, illustrated. 
W. B. Saunders Company, Philadelphia and London. Cloth, $3.00 net. 

Passive hyperemia after Bier's methods has become a rec- 
ognized weapon of modern medicine and. although in the hands 
of the general practitioner it will be found to have greater 
limitations than one would imagine from reading the literature 
of the subject, has an undoubted place in therapeutics. The 
authors of this book have given an excellent description of the 
principles of this treatment and the methods of its application. 


THE PRACTICAL MEDICINE SERIES, Comprising Ten Volumes 
On The Year’s Progress In Medicine And Surgery. Volume V. 
Obstetrics. Edited by J. B. DeLee A.M., M.D., Professor of Obstet- 
rics, Northwestern University Medical School. The Year Book Pub- 
lishers, 40 Dearborn St., Chicago. 

These little handbooks offer a convenient way of deter- 
mining the progress of medicine during the stated period and 
as a rule the abstracts are quite representative of the literature 
of the subject. 


I1SS1SSIFPI IREDIGOL I0MTHLT 


VOL. XIV. OCTOBER 1909. No. 6 


* THE TREATMENT OF TUBERCULOSIS IN MISSISSIPPI. 


R. P. WENDEL M.D., 

ABERDEEN. 


I wish to express my pleasure at being with the members 
of the Four County Medical Society, and my appreciation of 
the benefits to be derived therefrom. I have always found the 
mutual interchange of ideas beneficial, and on every occasion 
have embraced the opportunity to learn something. I wish also 
to state that I have an apology to offer for introducing such a 
time-worn subject for your attention and discussion, for the 
reason that there has never been a time when the subject was 
of such importance as now. The alarming prevalence of tuber- 
culosis and the mournful fact that every man thinks he is 
competent to treat it along the same old lines and with the 
same old results, is, to my mind, ample justification for my 
theme. 

The giving of systemic medication and the injunction to 
“rough it”, are responsible for more deaths than the disease 
is by right entitled to. The old advice to the patient was to 
go west and “rough it”. I respectfully offer that this is, and 
always has been, a mistake. Why? Because these patients, 
not being able to take exercise, must have absolute rest, plenty 
of fresh air and an abundance of nourishment of the best kind 
and variety. These three factors in recovery it is impossible 
to obtain in the western country, except at enormous expense, 
and then the patient almost invariably meets a melancholy 
end ; one that tends to discourage the rest of the sufferers. 
A case cured at home is the best educator in the world ; and 
that it can be cured at home I know from experience. I, 
myself, with my limited experience and perhaps the want of 
adequate professional skill, have within the past few years 
cured six cases, and now have under treatment two cases, both 
of whom are progressing toward recovery. 

The matter of climate need not be discussed here in the 
treatment of tuberculosis as we are dealing with the facts 
of getting them well at home. 

* Read before the East Mississippi Four County Medical Society. 

101 


102 


In the next place, it is as certain as anything can be that 
a patient with tuberculosis who is running a temperature 
ought not to make any exertion whatever. This is a dictum 
from which there is no appeal in any case, as too many patients 
have found out to their cost; hence we see the importance of 
absolute rest in bed. I may add also that direct exposure to 
rays of the sun is also bad, in that it will cause an immediate 
rise of temperature and some giddiness. It is always best, 
therefore, to have the patient screened from the direct rays of 
the sun. 

The diet should be especially rich in nitrogenous matter, 
and should be a mixed one. It is best to feed the patient five 
times a day. Say a good breakfast on rising in the morning; 
at ten o’clock a glass or two of milk with one or two raw 
eggs; then at noon a regular dinner in which meat and fat 
predominate; then at four P. M. a glass or two of milk with 
one or two raw eggs; then at eight P. M. a regular supper; 
and again at ten P. M. it is not a bad idea to give another glass 
of milk and one raw egg. This may seem a great deal of food, 
but it is a fact that, if the amount is gradually increased, the 
most delicate stomach can take, retain and assimilate the 
amount herein set forth. True it is that once in a while it 
happens that the patient will get a little too much, and it will 
have to be reduced for a few feedings; then going back to the 
original amount. This will be shown by a vomiting right after 
meals. It is interesting to note that under this diet regime 
patients never suffer from constipation. The patient should 
be weighed once a week on the same scales and always with the 
same clothing on, or rather with no clothing as we have them 
in bed. The temperature should be taken and recorded twice 
daily, at eight A. M. and six I*. M. As long as the patient is 
holding his own. or is gaining, the course of the disease is 
undergoing an arrest and the patient is going up hill irre- 
spective of the other symptoms. 

We will now discuss the most important means of cure 
both from a theoretical and a practical standpoint; and, that 
is undoubtedly fresh air, or to state it differently, life in the 
open air, without which all other means are absolutely without 
avail. By fresh air I mean that the patient should absolutely 
live out of doors all the time, and not simply be content to sleep 
with the doors and windows open, as this is a mighty poor 
make-shift. I may say that I have reached the point where I 
positively refuse to treat a case of tuberculosis unless the 
patient will agree to do exactly as I advise in every respect, 
more especially as regards dieting and living out of doors. 


103 


This is sometimes a difficult matter to persuade people to take 
up, but if the subject is placed before them in the proper light, 
and they are given to understand candidly that it means the 
difference between getting well and dying, they will be ready 
enough to do as directed. The difficulty in the way of complete 
compliance is met with only in the cases of ladies and girls, 
and this difficulty can be easily overcome by the use of a little 
house, which I am now having built for use in all cases under 
my care. It affords the necessary privacy and yet does not 
interfere in the least with through and through ventilation. It 
must be so constructed that it is absolutely fly and mosquito 
proof. This can be easily done as is shown in the little model 
which I brought for your inspection, and can be built by any 
carpenter at a moderate cost. Now it is well known that no 
tent with a canvas is inhabitable in Mississippi when the sun 
is shining, as the glare is terrific and unbearable; so it is best 
to have a house with a shingle roof, and have one side weather- 
boarded. The end should always face the southwest, as all 
our storms and rain come from that point of the compass. A 
patient should be put to bed and not allowed to get up at all 
until the temperature has been normal for two weeks, and then 
only tentatively, and should take a little exercise around the 
room ; pulse should be rated and temperature recorded and the 
effect of such exercise made a matter of record. In case the 
exercise does not unduly accelerate the pulse or cause a rise in 
temperature, the same should be gradually increased with great 
caution ; if untoward effects are noticed patient should be again 
put to bed and the same rigid regime established as before. 
Another thing I think a mistake, is to have the patient take 
breathing exercises, as the damaged lungs and pleurae need as 
nearly absolute rest as it is possible to obtain. Most certainly 
this is true as long as the disease is active and the patient is 
having fever. 

As regards dress, the patient should dress as the tem- 
perature of the atmosphere warrants. When it is cold simply 
put on more clothing, and when it is warm let him have sleep- 
ing garments only. By a nice adjustment of the body covering 
it is possible to avoid a contraction of colds altogether. You 
very well know that too much clothing, by inducing free per- 
spiration, predisposes to so-called colds. It is remarkable how 
quickly the patient becomes inured to the exposure, as some 
may choose to call it, and find that they are not comfortable if 
carried in doors. I have had some patients continue to stay 
in their little houses long after the disease had undergone an 
arrest. The patient must be supplied with a lot of ordinary 


104 


toilet paper on which to expectorate, and this must be placed 
in a close receptacle after use and then burned so that no 
re infection can take place. Of course the patient should be 
supplied with their own eating and toilet utensils, and the 
same should be washed, disinfected and kept altogether in his 
own house. It will be found, however, that one placed in the 
open air at the beginning of the disease will soon quit cough- 
ing. expectoration will cease and further danger as regards 
danger to others, or auto-infection, will be at an end. 

The medical treatment of tuberculosis will now be taken 
up; and I will promise not to consume much time in dis- 
cussion, as I am not a believer in it at all. From time to time 
various drugs have been vaunted as specifics, among them 
almost every drug in the pharmacopoeia, as well as the various 
proprietaries, and all of them have been sent to their place at the 
bottom of the list, at the end of the experimental period, by 
all careful and well informed practitioners. The values of oils, 
essential or otherwise, have all been tried and found wanting. 
Creosote has been used more extensively than any of them, and 
there may be some little benefit to be derived from its use. As 
ordinarily used, however, I am quite convinced that it does 
no good; but used as advised at the Phipps Institute I have 
thought that it may have helped some in the restraint of 
coughing, and possibly have acted in some cases as a soothing 
agent to the lung tissue; however, I do not think that it is 
in any sense a specific. When it is used, it is necessary to 
give it in massive doses, and this can only be done according 
to the plan outlined by I)r. Francine in his book on the modern 
treatment of tuberculosis. The idea is to give a drop in a table- 
spoonful of hot water one-lialf hour before each meal; dose 
should be increased one drop every day, not every dose, adding 
a spoonful of hot water for each drop of the creosote given in 
this way. I have never seen a patient who could not take 
twenty to thirty drops three times a day without any dis- 
comfort or toxic symptoms. The use of small doses of strych- 
nine and digitaline every day has seemed in some cases to 
give relief where used for a pulse of low volume, just as it is 
in any other condition with similar symptoms. It may do 
good by promoting an increased flow of blood to the parts. 

The use of opium in any form is mentioned, only to be con- 
demned, where is it given to relieve coughing, or for any other 
purpose. It locks up the secretions and thus interferes mate- 
rially with the process of elimination, and therefore with the 
patient's well being. If the patient has not a mixed infection 
the use of the open air treatment will render the giving of 


105 


opiates for the relief of coughing unnecessary. For all diar- 
rhoeas that may supervene give bismuth or some of the newer 
preparations, such as protan ; and regulate the diet or reduce 
it for a few days. I think that the use of active astringents 
may be classed with the use of opiates, only to be strongly 
condemned as contra-indicated. 

As regards the use of tuberculin, there is nothing particu- 
larly difficult about it if the physician will be very careful and 
follow out the directions laid down by Trudeau. It is neces- 
sary to have the graduated pipettes that he advises, and to 
always have on hand some fresh Koch’s tuberculin (old). This 
can be easily obtained from any good house that sells the 
various sera, or from a great many private laboratories. The 
serum, used properly, seems to have a favorable influence, but 
is an instrument for great harm if the physician is not well 
equipped and extremely careful. The dilutions are not hard 
to make for any one who has some knowledge of laboratory 
methods and understands the metric system ; one who does not 
is not justified in attempting this line of treatment. Dr. Tru- 
deau and other eminent authorities are unanimous in saying 
that patients treated with serum have less liability to relapse 
than those who have not had it, and he uses it in all cases not 
too far advanced and in whom it does not produce too violent 
a reaction. The dose of the serum should be minimum to com- 
mence with, that is one ten-thousandth mgr., and should be 
given at eight P. M. The temperature should then be taken 
every two hours for twenty-four hours, and it will be found 
that there has been a more or less local reaction at the point 
of infection, a slightly higher temperature curve and an in- 
crease in cough. If the reaction is too violent, the dose should 
be reduced, if not at the next dose increase to one-thousandth 
mgr. The dose should be thus increased until the full dose 
of one mgr. can be given without reaction, unless unfavor- 
able symptoms develop, or the general health begins to dete- 
riorate, in which case it should be stopped. Every case is a 
law unto itself, should be treated on its merits, and should be 
watched with exceeding care and closeness. 

As regards hygienic handling of the case it is only neces- 
sary to say that the ordinary rules of hygiene as applied daily 
by all of us are eminently proper in these cases; such as bath- 
ing, massage and the giving of an alcoholic rub once a day; 
the latter seems to be a good stimulant and certainly seems to 
promote the patient’s comfort. 

In conclusion let me add, that while it may seem a lot 
of details have been set aside and a lot of old junk, in the way 


106 


of medicine, cut out, ret I must insist that this is the only 
way known to modern medicine to do these sufferers any good. 
And, let me also add, that in order to get his patients to stick 
closely to the rigid regime the physician must be frank with 
them, encouraging them all the time; and must see to it that 
he gets his cases in the incipient stage, and the only way to 
do this is to make it a routine practice to examine carefully 
all suspicious cases, both physically and bac-teriologically, and 
if the disease is found, at once tell the patient and explain 
that by this method only can he or she expect a recovery or a 
long lease on life. You owe this to yourself, to the patient and 
to the country at large. 

If I have seemed didactic in stating my opinions, 1 must 
pray your indulgence because of the importance of the subject, 
and because, as I stated in the beginning, I have succeeded by 
this method in relieving several of these sufferers. 


* THE DIAGNOSIS AND TREATMENT OF CYSTITIS IN 

THE MALE. 


S. A. EGGLESTON M.D., 

SHELL MOUND. 


Mr. President and Gentlemen : 

I have always thought it was not hard to make a diagnosis 
of cystitis. To locate the cause and decide how best to treat the 
trouble have seemed much more difficult propositions. There 
are certain symptoms, more or less always present, which are 
very characteristic. 

Firstly, there is frequent urination. Moullin says “this 
symptom is never absent unless there is some unsurmountable 
obstacle”. The bladder walls and posterior urethra being in- 
flamed and irritable, the bladder cannot stand any tension and 
as soon as the smallest quantity of urine accumulates, it is 
expelled. Ordinarily very small quantities are passed at a 
time. The desire to urinate may be constant and accompanied 
by straining and tenesmus, which may be very painful. 

Secondly, there is painful urination. In acute cases the 
pain over the bladder is almost always present. It is made 
worse by urinating and straining. The pain gets worse as the 
desire to urinate comes on. It is felt in the bladder and rectum, 
the end of the penis and down the thighs. In stone and pos- 

* Read before the Leflore County Medical Society. 


107 


terior urethritis the pain is made worse by emptying the 
bladder. There may be stranguary, the pain being continuous 
and the patient straining to urinate, and passing only a few 
drops of blood-stained urine at a time. Pain in rectum and 
head of penis indicates involvement of the bladder neck and the 
posterior urethra. If felt above the pubes, it indicates trouble 
ht the fundus of the bladder. Pressure over the bladder above 
the pubes, with finger in rectum, causes considerable pain. In 
the chronic form of cystitis there is little, if any, pain, or if 
present there is very likely an enlarged prostate with the bladder 
hypertrophied and contracted. 

Thirdly, the character of the urine is altered. In acute 
cases the amount may be greatly diminished. At first clear, it 
soon becomes turbid and appears to be mostly blood mixed with 
shreds and flakes of lymph from the surface of the mucous 
membrane. 

If the posterior urethra is involved the urine is especially 
cloudy and blood is seen at the end of micturition. In cys- 
titis the blood is mixed with the urine. Blood is present in 
all forms of cystitis and is caused from rupture of capillaries 
in the bladder walls. 

Fourthly, there is pus in the urine in a short time in all 
cases. I have noticed this particularly, but it is claimed that 
if the urine is acid in reaction the pus appears as a cloud dis- 
tributed through the urine; but if the reaction is alkaline and 
ammoniacal the pus is coagulated and takes the form of a 
viscid, tenacious, ropy mass at the bottom of the vessel. When 
decomposition sets in the odor becomes ammoniacal and very 
offensive. 

Besides these things we must consider the constitutional 
effects of a case of cystitis. Not so much, I think, to arrive 
at a correct diagnosis as to get an idea as to the nature and 
severity of the inflammation. This depends upon the amount 
and rapidity of the toxines absorbed. If constitutional symp- 
toms are slight we know the bladder is emptying pretty well 
and taking care of itself and absorption is not taking place, 
while if the reverse be true the effect may become grave. 
Chronic urinary fever may become fatal. 

This, I think, pretty well covers the principal points to be 
considered in the diagnosis of cystitis. Of course there is a 
perceptible difference in the acute and chronic forms. In the 
latter there is not so great frequency of urination, not so much 
tenesmus or pain. Ordinarily, very little absorption takes place 
and constitutional symptoms are slight. The urine is very char- 
acteristic, being turbid and ammoniacal and containing so 


108 


much mucus as to sometimes entitle it to the name “Chronic 
Catarrh of the Bladder”. 

I merely mention the cystoscope, said to be inadmissible in 
chronic cystitis. By its use one may exclude cancer, tuber- 
culosis and calculus; also detect the presence or absence of 
enlarged prostate. 

The microscope is of use also to determine the character of 
micro-organism, the urinary deposits, etc. I am sorry to say 
I am not familiar enough with these instruments to discuss 
them. 

In considering the treatment, it is important to know that 
suppurative cystitis is always caused by micro-organisms and 
that under normal conditions, the bladder able to thoroughly 
empty itself, most of these organisms are entirely harmless and 
may be injected into the bladder without producing any ill 
effect. Also that these germs are always with us and ordinarily 
are harmless, but ever looking for a place of attack and when 
a suitable place is found become exceedingly virulent. Local 
foci of infection in the urethra and around the genitals, where 
germs can thrive, should be kept clean. All conditions inter- 
fering with the emptying of the bladder should be attended 
to and, lastly, all syringes, sounds and catheters should be made 
sterilized before being used and the external genitals cleaned be- 
fore their use. 

I think results would be better if all patients would con- 
sent to go to bed and stay there until the acute stage is passed. 
Rest is essential. The bowels should be kept open. This re- 
lieves any pressure on the inflamed parts from overloaded bowel 
and at the same time helps to get rid of the main source of colon 
bacilli, which is by far the most frequent cause of cystitis. 1 
prefer a good dose of calomel at the beginning and give a lax- 
ative each day if necessary. 

Hot applications over the bladder make the patient more 
comfortable by relieving pain and tenesmus. Hot sitz baths 
are highly recommended. 

The diet should be mostly milk. No alcoholic stimulants, 
and meat had better be left off. The patient should have plenty 
of water, though one author claims, if the desire to urinate is 
frequent and urgent, the amount of liquid had better be 
limited. 

The urine should be frequently and carefully examined 
and, if highly acid, some alkali such as potassium acetate, ten 
to fifteen grains every three or four hours, may be given to 
allay the irritability. But on account of decomposition of urea 
or from a fixed alkali, the urine is usually alkaline in reaction 
and alkalies as a routine should be given. It has always been 


109 


a question with me just where to draw the line. I have no 
fixed rule. 

To relieve pain and restlessness it is often necessary to 
resort to opium. Patients cannot sleep, they suffer almost con- 
stantly day and night, and I believe a hypodermic of morphine 
occasionally is the best thing to do for them. I have used but 
have never seen what I considered much, if any, good come 
from small doses of preparations of opium locally in bladder 
troubles. If the bladder wall is unbroken, it is said morphine 
and cocaine cannot be absorbed by it. If broken, too much 
might be absorbed. So at best they are unreliable and if they 
must be given, I prefer the other way. 

Suppositories of opium, belladonna and such anodynes, I 
suppose, are good, but I confess I have not used them enough 
to form any very definite idea as to their value. A prescrip- 
tion highly praised is a suppository consisting of one grain of 
powdered opium and one-sixth grain extract belladonna every 
three hours. 

The balsams are always to be thought of in urinary trou- 
bles. In the acute stage it is said they allay the frequent desire 
to urinate and the pain ; and later on when the pus has 
diminished and the urine begins to clear up, such remedies as 
turpentine, copaiba, cubebs, cantharides, dissolved in alcohol, 
quickly cause a cessation of the suppuration and clear up the 
urine. My idea has always been that they are too irritating and 
I have not used them very much. 

Urinary antiseptics are valuable and should be given. I 
think a good combination is five grains salol and half as much 
quinine every three or four hours. If the urine is alkaline, boric 
acid or benzoic acid, twenty grains in a day, have good effect. 
One of the best urinary antiseptics is urotropin, given in 
doses not larger than fifteen to twenty grains in a day. Methyl 
blue is also said to be good. 

In acute cystitis the bladder should not be disturbed by 
instrumentation or washing. To relieve painful and frequent 
urination, when bladder is able to empty itself, Morton recom- 
mends an instillation of twenty drops of a solution of nitrate 
of silver, one to ten, deposited every second or third day in the 
posterior urethra. The bladder must be empty before using. 
If retention occurs, use a soft catheter. 

In chronic cystitis the patient need not be kept in bed, 
although much exercise is harmful. He should be careful as to 
his diet and exposure and to his general health. In this stage 
the antiseptics are most useful and should be given freely. 
Boric acid and urotropin are among the best. 

The treatment here is mostly local. The cause must be 


110 


found and. if possible, removed. If a stone or tumor in the 
bladder cause the irritation, or if stricture or enlarged prostate 
prevent the emptying of the bladder, they must be attended to 
before a cure can be hoped for. Urine must not be allowed 
to accumulate in the bladder. If necessary a catheter may be 
tied in. but under these circumstances I think it best to consult 
a surgeon and have a perineal section made. It is in chronic 
cystitis that irrigating the bladder is especially useful. By 
means of a fountain syringe two to four ounces of a solution 
of nitrate of silver, one to four thousand to one to one thousand, 
is allowed to flow into the bladder and then out. This to be 
repeated until it comes out clear. This should be done every 
two or three days. If much pain is produced the bladder may 
be washed out with salt solution. Permanganate of potash, or 
boric acid, four per cent, solution, or salicylic acid, three to 
one thousand, as well as other antiseptics, may be used. It is 
suggested that in cases of contracted bladders where much pain 
is present, instillations, as mentioned in treatment of acute 
form, may be employed with success. 

Of course in both acute and chronic forms any constitu- 
tional symptoms must be properly treated when necessary. 

I want merely to mention, in conclusion, an article by Dr. 
Ross, formerly pathologist to the City of London Hospital for 
diseases of the chest, in which he claims to have cured with 
injections of appropriate baeterins (such as we use in treating 
gonorrhea) cases of cystitis due to the pneumococcus, the bac- 
illus communis, by the way the most frequent cause of cystitis, 
and tubercular bacilli. I know nothing of this personally, but 
it seems that with the aid of the microscope we might find out 
the cause, and it may be have in this remedy a very simple and 
effective treatment. 


•RHEUMATISM IN CHILDREN. 

W. P. PATTERSON M.D., 

BEAUREGARD. 


The subject assigned me for this occasion demands a few 
preliminary remarks on the literature of the physiology of in- 
fancy and childhood, and to say that the more the truth is 
forced home on one the more it is seen how little that can be 
of value in practice is known. Nor are we likely to advance in 
our really useful knowledge until further steps in the direction 
of a molecular physiology have been made. Few of the text- 
books upon children’s diseases have much space allotted to the 
study of physiology. 

* Prepared for the meeting of the State Medical Association 


Ill 


The growth and development of the infant are subjects of 
importance; the chemistry of its secretions bears upon the 
great question of dietetics; the study of its excretions gives 
us an index to its tissue changes. The guide to the mainten- 
ance of its health includes much that is of absorbing interest 
to the student of biology but what has already been ascertained 
of the physiology of infancy is mostly theoretical or not clearly 
applicable in nature. Yet we must endeavor to garner a few 
practical bearings and to follow a clear, if meagre, outline 
rather than a confused picture of details. 

Though not always true, yet as a rule, to understand thor- 
oughly the therapeutics of an infection, we must at least have 
a correct conception of its nature and cause. Unfortunately as 
regards rheumatism, in spite of all the study given to it, we 
know merely that it is very probably an infectious disorder, 
while of some of the other disease manifestations called rheu- 
matic we are entirely uncertain as to their nature or their 
actual relationship to the articular affections. Our knowledge 
of the therapeutics of rheumatism is therefore necessarily 
empirical and unsatisfactory. Articular, as a qualifying word, 
is to be avoided in this connection since it is especially in 
children that rheumatism manifests itself in many other ways 
than by involvement of the joints. Articular symptoms are 
indeed often absent or but slightly developed at this period. 
Tendinous nodules, tonsillitis, chorea, erythema or inflamma- 
tion of the endo- or pericardium may be the first or the only 
lesion occurring, or they may be variously combined, or one or 
more of them appear in connection with articular involvement 
and in varying sequence. 

Those different lesions are therefore not to be regarded as 
complications of rheumatic arthritis in children, but as inde- 
pendent evidences of rheumatism. And this should be borne 
prominently in mind in discussing treatment. Although the 
attacks of rheumatism in children are probably less severe than 
in adult life, yet much greater tendency to recurrence of some 
form of the disease is shown in young subjects. This renders 
prophylaxis especially important. Particular precautions in 
rheumatically -disposed children, or in those with a rheumatic 
inheritance, must be taken against over heating, exposure and 
over-fatigue, and since the child lives near the floor, where 
draughts are most felt, there is great danger of chilling if this 
precaution is not observed. After free perspiration from active 
exercise out of doors, the child should not be allowed to sit 
or stand about unprotected. After accidental wetting it should 
be quickly undressed, rubbed vigorously until dry and warm, 
and redressed in dry clothing. Careful systematic hardening 


112 


should be sought by use of moderate cool baths, followed by 
vigorous friction. In many cases change of climate is of great 
value, especially in the spring and winter months. 

A dry, warm, equable climate is preferred, since cold, damp 
regions distinctly favor the development of the disease. High 
altitudes, however, although dry, are not favorable as the 
changes from hot to cold are too sudden. The influence of 
diet is questionable. The eating of meat rather than starch 
has been recommended, but the effect does not seem to be 
proven. Rheumatism is extremely common in early life, far 
more common than is generally supposed. It is frequently over- 
looked, and becomes more and more frequent, and the joint 
affections more pronounced, as each year of life passes, up to 
six or seven, continuing from this period up to puberty at about 
the same relative frequency. Quoting from a cyclopaedia of 
the diseases of children by Dr. Keating we find our writer 
recording a case in a child ten months old. Another refers to 
two other cases of only a few weeks old, and another records 
a case of an infant twenty-three days old. I have never met 
with an undoubted instance of rheumatism in a child under 
two years of age, but I have very recently had a case in a boy 
ten or eleven years, a school boy, confined to the house for 
several weeks. This was a very pronounced case of sciatic 
rheumatism caused from trauma, having fallen on his left hip, 
striking a brick or stone, just posterior to the joint, putting 
this boy to bed with the best treatment that I could give for 
two weeks, when the pain and rheumatic symptoms were wholly 
transferred to the knee articulations, which developed much 
oedema and the inflammatory symptoms of arthritic rheuma- 
tism. Two weeks longer were spent on the bed, when the pain 
and all rheumatic symptoms had disappeared from the hip and 
knee, but no sooner did he realize that he was free from pain and 
felt well in the left leg, than the affliction was transferred to the 
right leg and knee articulations and he suffered the same 
agonies as with the former attack in the left hip and leg. I 
have not the time now to go into any etiological display on 
the capers of this case, but will ask some or all of Dr. D. 
W. Jones’ best Tri-County Society members for some patho- 
logical reason for cause and effects. It is impossible for us to 
picture this disease in all forms afforded by varying combina- 
tions of the different pnenomena, so it may be the safest plan 
for us to consider each manifestation and symptom apart, 
and to look for any special features which attach to them in 
early life and to know more of the common combinations 
which occur in the rheumatism of childhood. 


MISSISSIPPI PlEDICflL IHOWTHLY. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D.. Vicksburg. H. L. SUTHERLAND M.D.. Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D.. Vicksburg. 

S. MYERS M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

SUBSCRIPTION ONE DOLLAR PER ANNUM. 


The medical department of our state university is now 
completely rounded out, the Junior and Senior courses being 
taught in the Vicksburg division that opened Sept. 30th. In 
the university hospital, formerly the State Charity Hospital, 
is ample material for clinical teaching and in addition to this 
the members of the faculty have opened a dispensary that will 
give excellent training in office work. In the new college build- 
ing, on the hospital grounds, are ample lecture halls and labor- 
atories, the latter being splendidly equipped. 

One feature of the new school, however, leaves much to be 
desired — the library. A few volumes have been received, as 
gifts from friends, but hardly enough to be considered a start, 
and donations are earnestly requested. The dean, Dr. Wm. 
Krauss, will be personally in charge of the books, to prevent 
their being injured or removed, and members of the profession 
are invited to assist in stocking the shelves. 

With the numbers of physicians that we have in Missis- 
sippi, every few days there is a vacancy in the ranks and some 
well-chosen library, that represents careful thought and the ex- 
penditure of hard-earned dollars, is scattered and wasted. If 
you cannot spare anything from jour own library you can at 
least use your influence in preventing such waste of that of 
your departed neighbor and you can even prevent the waste of 
your own by arranging that in the event of your death it 
shall be given to the University. And don’t put off the making 
of such arrangements. You know how uncertain life is — we 
certainly can carry nothing into the life to come, and even if 
we could there would be no assurance that medical books would 
be received as legal tender in exchange for either harps or ice. 

113 




114 

StftMg Vxnttt dings. 


East Mississippi Four County Medical Society met in 
the Elks’ parlors, Aberdeen, Sept. 14th. at 2 :30 P. M., Dr. Feem- 
ster in the c-hair and the following members present : Keyes, 
Bryan, Burdine, Grady, Hamilton, Durley, Coleman, Wendel, 
Catchings, McCown, Lee, Rogers, Brand and L T nderwood. The 
application of Dr. Taylor Dabbs of Nettleton was received. 
Drs. Grady, Bryan and Burdine reported cases of pellagra that 
they have under observation. Papers were presented as fol- 
lows : “The Diagnosis Of Chronic Gonorrhea” by Dr. Durley of 
Aberdeen ; “Ergot” by Dr. Lee. The thanks of the society were 
extended these gentlemen. Next meeting will be held at Amory, 
Tuesday, Oct. 12th. 

Harrison County Medical Society met in the rooms of 
the Gulfport Commercial Union, Sept. 14th. Meeting called 
to order by Dr. Lebaron, the president. Those present were 
Drs. West, Welch, Lebaron, Morris, Richardson. Caraway, 
Hood, Mohler, and Dr. Bond of St. Louis, a visitor. Dr. Welch 
reported a case of pancreatic tumor which was accompanied 
b\ marked disturbance to the general health. After discussion 
most of the doctors seemed inclined against an operation, on 
account of the condition of the patient and the danger of an 
operation on the pancreas. There was a general discussion of 
pellegra, which was the subject of our last meeting, several 
more cases being reported in the county. Dr. Welch of Wool 
Market read a paper on “Hook Worm Disease”. It was an 
excellent paper and was freely discussed by all present, many 
cases being recalled by the various doctors. Dr. Welch thinks 
that in the rural districts of the South the greater part of the 
population are infected, giving rise to much ill health and loss 
of efficiency. The publicity committee reported and was given 
extended time. 

West. 

Jackson County Medical Society held a regular meeting 
at Scranton Sept. 1st, at which were present Drs. Cox, Duke, 
Evans, Fuller, Sanders, Tabor and Rape. Dr. W. E. Sharp 
was elected a member of the society. Dr. Rape was elected to 
represent this county on the state committee on Public Policy 
and Legislation. After some routine business. Dr. Evans pre- 
sented a clinic, a child with infantile paralysis, and on account 
of the progressive character of the disease after three years 


115 


standing it proved to be of more than ordinary interest. Dr. 
B. F. Duke read a splendid paper on Sub-Acute Nephritis, and 
Dr. J. S. Sanders followed with an excellent one on Pericarditis. 
Both papers were instructive and were discussed freely by all 
the members with a great deal of interest. Dr. Evans was 
assigned to deliver an address at the next meeting, which will 
be held at the Cottage-By-The-Sea-Hotel, Pascagoula. 

Rape. 


^sstfriatmn Vxzsxdtnis. 

C. KENDRICK, Kendrick. 

President 1898-9. 

Carroll Kendrick was born in Hardin County, Tenn., May 
24th. 1852. He has his M. A. degree from Hiram College, Ohio, 
and his M. D. from the University of Louisville, where he won 
the faculty medal in 1893 from a class of two hundred and 
fifty. Coming to Mississippi, he settled in Tishomingo County, 
where he served as health officer and where he was twice elected 
to the lower house of the state legislature. Moving to Alcorn 
County, he was sent to the state senate from the counties of 
Alcorn, Prentiss and Tishomingo, and served ten years. Later 
he was again elected and served four years. During his entire 
service in the legislature, Dr. Kendrick spent his best efforts in 
the interest of medical legislation and in 1906 the Mississippi 
State Medical Association formally placed its appreciation of 
his services on record by a vote of thanks tendered him in ap- 
preciation of his good work. In 1904 he was appointed trustee 
of the State University, to serve six years, and for a number 
of years he has been president of the Department of Public 
Health of the state. 

Dr. Kendrick has been twice married : in 1882 to Miss 
Gayle Adams of Corinth, Miss., who died in 1901, and in 1903 
to Miss Mary McAnulty of Kossuth. He has no children. 

Personal Notes. 1907. 


R. E. JONES, Crystal Springs. 

President 1899-1900. 

Robert Elam Jones was born at Utica, Miss., Oct. 5th. 
1843. His father was of Virginia and his mother of Georgia 
ancestry, the former being also a practitioner of medicine. 


116 


Dr. Jones was educated in the schools of his native place, 
entered the Confederate army in 1862 and served until the end 
of the war. He was in the campaigns of Mississippi, Georgia 
and Tennessee, being in the sieges of Vicksburg and Blakely, 
Ala., as first lieutenant Co. K, 36th. Mississippi. At the latter 
place he surrendered with his command and was a prisoner 
at Ship Island until the close of the war. He was present and 
took part in the battle of Atlanta, where he was wounded. He 
graduated from the Medical Department of the University of 
Louisiana, now Tulane, in 1869 and settled in Utica, going later 
to Crystal Springs. He has always been engaged in general 
practice. 

Dec. 16th. 1869 Dr. Jones married Miss Elizabeth McKey, 
and is the father of seven children. 

He is a member of his county organization, the Tri-Countv 
(Bike, Lincoln, Copiah) Medical Society, the State Association 
and the A. M. A. 

Personal Notes 1908. 


H. A. MINOR, Macon. 

President 1900-1. 

Henry Augustine Minor was born in Mooresville, Ala., Feb. 
25th. 1835. His father. Dr. Wm. T. Minor, was a Virginian, 
a graduate of the Jefferson Medical College, a veteran of the 
war of 1812 and a physician of note in North Alabama, where 
he practiced medicine from 1818 until his death in 1854. He 
was a brother of Jno. B. Minor, the distinguished jurist and 
professor of law at the University of Virginia. Another 
brother, Lucien, was professor of law at William and Mary 
College. Dr. Henry Minor’s mother was Miss Fanny Washing- 
ton of Virginia. 

Dr. Minor was educated at a high school near Nashville, 
Tenn., and spent one year at Lagrange College, Ala. He grad- 
uated in medicine from the University of Virginia in 1857 and 
began the practice of medicine in Decatur, Ala., moving to 
Macon two years later, where he was associated with Dr. J. J. 
Shelton. In 1861 he enlisted as a private in the 11th. Missis- 
sippi but was in a few months made assistant-surgeon of the 
19th. Mississippi, and in February 1862 received appointment 
as full surgeon, with rank of major, in the 9th. Alabama, then 
attached to A. P. Hill's corps of the Army of Northern Virginia. 
At the first battle of Manassas Dr. Minor received a bullet 
through the leg and was disabled for several months. After 
Gettysburg he remained in the field hospital, in charge of the 


117 


wounded of his division, and was sent with the other prisoners 
to Fort McHenry, Baltimore. Being exchanged later, he served 
with his command until the surrender at Appomattox. 

Walking home from Appomattox, he resumed his practice 
at Macon, where he has remained ever since, fifty years in har- 
ness. Besides his county and state affiliations he is a member 
of the Tri-State (Miss., Ark., Tenn.) Medical Society, of the 
Association of Railroad Surgeons and of the Association of 
Confederate Surgeons. For many years he has been health 
officer of Noxubee County. 

Dr. Minor has long been prominent in his church, the 
Methodist Episcopal South, and his reputation as an earnest 
and devout Christian is co-extensive with his acquaintance. A 
sketch that failed to emphasize his piety and deep religious 
convictions would omit one of the most conspicuous features of 
his life. 

In 1865 Dr. Minor married Miss Mary Anne Dent of 
Macon, a niece of Gen. James Longstreet, and from this union 
are six children : Anna, wife of A. T. Dent, an attorney of 
Macon ; H. D., an attorney of Memphis, Tenn. ; Frances, wife of 
T. P. Crimes of Hattiesburg; H. A. Jr., an attorney of Macon; 
Lucien, who died in infancy; and L. L., a physician of Holly- 
wood. In 1893 he contracted a second marriage with Mrs. 
Ellen R. Baechtel. 

Though seventy-three years old, Dr. Minor continues in 
active practice, never refusing a call on account of bad weather 
or roads. Hale and strong and with unabated courage, he still 
vigorously pursues the calling he believes to be the noblest 
profession of man. 

H. A. Minor Jr. 1907. 


letters tv th£ gdxtrrr. 


Macon, Miss., Sept. 10th. 1909. 

Dr. E. F. Howard, Editor. 

Dear Doctor: In the just published Transactions of Mis- 
sissippi State Medical Association for 1909, on page 129, Dr. 
H. M. Folkes is credited with having read a paper discussing 
the theme of “Criminal Irresponsibility”, by Dr. E. L. Green. 
Now I wrote and I read that paper myself. 

This is a small matter; but I am not at all sure that our 
mutual friend, Dr. Folkes, would feel flattered by this ascrip- 

2— M 


118 


tion to his pen: while I — well, I am disposed to claim my 
progeny — good or bad. 

I see no way to correct this save that you might put in a 
word or two in explanation in your journal. 

With kindest regards, I am 

Yours truly, 

H. A. Minor. 


Vaiden, Miss., Sept. 13th. 1909. 

Dr. E. F. Howard, Secretary, 

Vicksburg, Miss. 

Dear Doctor: In the “Transactions”, in my discussion of 
“Disturbances Of The Organs Of Regeneration As A Causative 
Factor In Insanity”, I am made to say “the opening was not 
more than a quarter of an inch in diameter.” As this may 
place me in a somewhat ridiculous light, I would be glad if you 
would make the correction in the next issue of the Monthly. 
What I said was that “the ovaries were not more than a 
quarter of an inch in diameter.” 

Thanking you in advance, I am 

Sincerely, 

J. W. Barksdale. 


Philadelphia, Pa., Sept. 11th. 1909. 
Dr. E. F. Howard, Secretary, 

Mississippi State Medical Association, 

Vicksburg, Miss. 

Dear Doctor: We have had recently several complaints 

from your vicinity that some one is going through the state 
making contracts in the name of the Lippincott Publishing 
Company, collecting money thereon and failing to furnish the 
stipulated goods. 

We are not known as the Lippincott Publishing Company, 
nor do we know whether such a company exists or not; but 
our reputation is possibly being traded upon. We have no 
one in our employ under any of the names given, and 
our men have ample credentials to show and do not collect 
money in advance, as it is not permitted. The material sent 
here has all the ear marks of a swindle, and as the name and 
location changes constantly we thought you might like to notify 
members of the Mississippi State Medical Association through 
their Journal to beware. 


J. B. Lippincott Company. 


119 


1418 Eutaw Place, 
Baltimore, Md., Sept. 16th. 1909. 
Mississippi Medical Monthly. 

Dear Sir and Editor: I am engaged on a Cyclopaedia of 

American Medical Biographies to comprise all dead medical 
worthies who have done anything worthy of note even outside 
the medical profession, such as geologists, zoologists, etc. Mis- 
sissippi seems one of the hardest states to work, as at present 
I have only five names and only two of these written up : 
B. A. Duncan, N. L. Guiee, Claiborne Martin, D. L. Phares 
(done) and C. A. Rice (done). 

I would be very greatly obliged if anyone would sell or 
lend me books or pamphlets regarding the noteworthy doctors 
oi your state. 

Faithfully yours, 

Howard A. Kelly. 


^00k Itaieix rs. 


ESSENTIALS OF LABORATORY DIAGNOSIS. Designed For 
Students And Practitioners. By Francis Ashley Faught M.D., 
Director of the Laboratory of the Department of Clinical Medicine 
and Assistant to the Professor of Clinical Medicine, Medico-Chirurgi- 
cal College, etc., etc., Philadelphia, Pa. Containing an indican color 
scale in colors, six full page plates and numerous engravings in the 
text. Philadelphia: F. A. Davi6 Company, Publishers. 1909. 

There are some good things in this book. Like all “Es- 
sentials”, it is sure to disappoint. There is doubtful utility in 
the sketchy treatment of animal parasites, without illustra- 
tions. The part on malarial parasites had better have been 
omitted; it is useless. If a novice should have performed the 
miracle of staining a blood-smear by the methods given, as 
described, and made a differential leucocyte count, he would 
have been obliged to turn to a text-book to find out it diag- 
nostic indications. The book will be useful in the hands of the 
laboratory-trained interne. 

Krauss. 


CONSERVATIVE GYNECOLOGY AND ELECTROTHERA- 
PEUTICS. By G. B. Massey M D., Attending Surgeon to the Amer- 
can Oncologic Hospital, Philadelphia, etc. Sixth Revised Edition. 
F. A. Davis Company, Philadelphia. 

The author in his enthusiastic efforts to put before the pro- 
fession the subject of electro-theraphy, has laid entirely too 
much stress on its importance in conservative gynecology. In- 


120 


deed some of his methods are contrary to the teachings of most 
of the authorities on surgery and are dangerous of application. 
A most notable example of this is the application of electro- 
therapy in cases of carcinoma of the breast, uterus and rectum. 
The claims that the major application of zinc-mercury cata- 
phoresis offers a most effective method for the destructive ster- 
ilization of mammary cancer in its early stages without risk 
of the infective cells gaining access to the lymphatic spaces as 
may happen in a cutting operation, should be considered dan- 
gerous temporizing. 

Daugherty. 


MEDICAL SOCIOLOGY. A Series Of Observations Teaching 
Upon The Sociology Of Health And The Relations Of Medicine 

To Society. By James Peter Warbasse M.D., Surgeon to the Ger- 
man Hospital, etc. D. Appleton & Co., New York. Price $2.00. 

Some of the essays of which this little volume consists were 
written when the author was editor of the New York State 
Journal of Medicine — and evidently awfully hard pressed for 
copy. All of them were written in the seclusion of the country 
— apparently recuperating from a nervous breakdown. Having 
butted his way into the field of medical sociologic literature 
we trust he will take a long rest — it must be hard work to 
write a book like this. The publishers have done him hand- 
somely in real cloth and gilt top— but neglected to cut the 
pages, and we feel quite sure that most people will agree with 
them that it wouldn’t have been worth while. 

Howard. 


PRINCIPLES OF SURGERY. By N. Senn M.D., Ph.D., L.L.D., C.M., 
late Professor of Surgery, University of Chicago, etc. Fourth edition 
— thoroughly revised by E. J. Senn M.D. and E. Friend M.D. F. A. 
Davis Company. Philadelphia. 

This book is a worthy memorial of the master mind which 
wrote it. To this edition have been added a very comprehensive 
discussion of Wright’s opsonic work and Bier’s treatment of 
inflammatory affections. Notwithstanding the chapters on 
tuberculosis of bones and joints were written twenty years ago, 
they are the most complete and concise treatise on that subject 
te-day. The author has intentionally left out the treatment 
of the subjects of tumors, fractures and dislocations, and to 
this extent only does this work fail of being a complete treatise 
on the general principles of surgery. 


Daugherty. 


MISSISSIPPI MEDICAL IUDNTHLT 

Vol. XIV. NOVEMBER 1909. No. 7 


* SOME POINTS ON DIAGNOSIS AND TREATMENT OF 
ACUTE INTESTINAL OBSTRUCTION. 


J. W. ARMISTEAD M.D., 

SIDON. 


Hidden beneath the abdominal wall there develops a con- 
dition in the bowel which obstructs the onward flow of the con- 
tents of the alimentary canal. The obstruction may be caused 
by any of several abnormal conditions existing in the abdominal 
cavity, of which I will only mention the most important. 

Fecal accumulation in the cecum or sigmoid flexure may 
be of long standing and only cause constipation, when suddenly 
there may appear a closure of the lumen of the bowel causing 
absolute constipation and acute intestinal obstruction. 

Further there may be an accumulation of feces and gases 
where there is diffused paresis of the muscular coat of the in- 
testine, giving rise to a condition known as adynamic obstruc- 
tion — causing marked tympanitis, vomiting and obstruction. 

Another condition known as strangulation, generally found 
in the right iliac fossa, is produced generally by bands of 
adhesion following peritonitis or abdominal section for the 
treatment of some pelvic disorder. 

A fourth condition known as intussusception or invagina- 
tion of one part of the bowel into another, is probably caused by 
a circumscribed, irregular peristalsis of the intestines. This 
condition occurs most frequently in children prior to ten years 
of age, males being more subject to it than females. 

Volvulus or twisting of the intestines is met with com- 
monly at the sigmoid flexure of the colon, caused from a twist 
of the bowel upon itself or relaxed condition of the mesentery 
predisposing to such a condition, giving a complete acute stran- 
gulation which is hastened by an accumulation of masses of 
feces and gases above the twist or by bowel adhesion to ad- 
jacent omentum. This condition is generally found in males 
above the age of forty. 

Other conditions may be mentioned; as internal hernia, 

* Read before the Leflore County Medical Society. 

121 


122 


the most important of which are hernia into the foramen of 
Winslow and the diaphragmatic hernia. 

Meckel ? s diverticulum will at times be found to be the 
cause of acute obstruction. The diverticulum owes its origin 
to failure of the omphalomesenteric duct to become obliterated 
by undergoing fatty degeneration. Obstruction caused from 
this is generally a condition in which the traction of the cord 
on the intestine is so great that it causes the bowel to be bent 
on itself, obstructing the lumen. Another condition is that 
in which the bowel is caught between the bands of the lig- 
aments. 

Obstruction caused from gall stones is more common in 
women than in men. After being passed into the bowels they 
may become arrested in the lower part of the ileum, causing 
local irritation and finally obstruction by constriction of the 
intestines. 

After taking into consideration the history and age of the 
patient as compared with the present condition, much may be 
accomplished toward making a diagnosis. The general appear- 
ance of the patient is very characteristic — the eyes are sunken 
and face pale, there is more or less cyanosis due to impeded 
respiration or shock attending the obstruction. The nose has 
a pinched expression, the skin is cold and clammy, the pulse 
rapid and feeble. In acute conditions, the closure or narrowing 
of the tract develops suddenly aud rapidly and is usually 
situated in the small intestiue. Such an obstruction exerts an 
influence not only upon the whole length of the intestines, but 
also upon the point at which the constriction occurs. Locally 
there is a powerful disturbance of circulation, and conse- 
quently of the vitality of the parts concerned, and with this con- 
dition existing there is usually produced more or less shock. 

Abdominal pain is developed early in the attack and may 
be intermittent and colicy in the beginning but soon becomes 
agonizing and constant. The pain is due to increased peri- 
staltic action caused by the efforts of the intestines to overcome 
the obstruction. It is referred to the seat of constriction or at 
times may be absent entirely. 

Early vomiting and absolute constipation are very con- 
spicuous and important symptoms. The vomitus consists first 
of the contents of the stomach, then of a greenish watery fluid, 
finally becoming stercoraceous, having the characteristic odor 
due to putrid decomposition above the obstruction in the bowel. 

In certain forms of obstruction, as intussusception, there 
may be small stools consisting of blood and mucus, otherwise, 
after the bowel has beeu emptied of its contents below the ob- 




123 


struction, there is absolute constipation. With the above symp- 
toms, of pain, vomiting, absolute constipation, feeble and rapid 
pulse, probably a tumor at the point of constriction and more 
or less shock, we should not hesitate to make a diagnosis of 
acute intestinal obstruction and advise laparotomy or consulta- 
tion with a surgeon as soon as possible. 

Treatment by the internist may accomplish much by re- 
lieving the distress attending the obstruction pending a de- 
cision of the question of laparotomy. 

The first indication for treatment is the pain and vomiting. 
The former is relieved by hypodermic injections of morphine, 
which does not have a deleterious effect on any of the morbid 
conditions associated with the obstruction, but may mask the 
grave condition and give rise to a fatal delay. 

Vomiting may be relieved by lavage and starvation. 
Liquid may be given by the mouth and a portion of it will be 
absorbed and the remainder serves to wash out the stomach. 
Cathartics when given increase the pain and vomiting, and 
lower the vitality of the patient. They are contra-indicated and 
are only given as a result of faulty diagnosis. 

Treatment by hydrostatic pressure or inflation is recom- 
mended. These methods are to be used when possible. 

The strength of the patient should be kept up by nutrient 
enemas and hypodermics of strychnine. 

We should not wait until our patient has passed beyond 
the hope of relief by our surgeon’s knife — and then hastily call 
for assistance, but we should advise laparotomy in the begin- 
ning, at our earliest diagnosis of acute intestinal obstruction, 
and ask that consultation with a surgeon be had at once. 

Then we should do what we can for the relief of the con- 
dition of the patient while waiting for the consultation. 


CARBON DIOXIDE SNOW: ITS USES AND METHOD OF 
APPLICATION. 


J. H. FOX M.D., 

Instructor in Dermatology, Medical Department University Of Mississippi, 
VICKSBURG. 


Through the kindness of Dr. Henry Iv. Gaskill, of the staff 
of Jefferson Medical College Hospital, the writer has been en- 
abled to note some excellent results from the use of carbon 
dioxide snow as a destructive agent. 

A large number of the most intractable lesions have yielded 
to treatment with this medium. 


124 


The range of usefulness of this remedy is very much greater 
than was first expected. Among those conditions on which this 
remedy can be used with great advantage are lupus vulgaris, 
lupus eythematosus, epitlieliomata, neurosis, warts, powder 
stains, etc. 

The great advantage carbon dioxide snow has over liquid 
air is that it can be so easily obtained and kept. Liquid air 
is very costly and cannot be kept except under great pressure 
or in a vacuum bottle. 

Carbon dioxide snow is made by allowing the gas to escape 
into any porous material wrapped around the vent in the tank. 

Dr. Gaskill uses an ordinary chamois skin. This is wrapped 
around the vent and the gas is turned on. When enough snow 
has been precipitated, the vent is closed and the snow is moulded 
into a ball and then whittled down to the desired point. 

With a pair of tissue foi'ceps the ball of snow can be ap- 
plied to the parts desired to be treated. 

The elfect of the treatment depends upon the pressure ex- 
cited during the application and the duration of the contact. 

It is very necessary to extend enough pressure to prevent 
the formation of a thin layer of gas between the carbon dioxide 
crystals and the lesion or tissue. 

By firm pressure this insulating layer is eliminated and 
the heat is rapidly absorbed from the tissue, resulting in its 
freezing. 

From thirty to forty seconds is the time required for appli- 
cation in the majority of cases, but where there is a bone to 
press against, such as the nose, twenty to thirty seconds are all 
that are required. 

The physiological effect of the freezing varies from ery- 
thema to necrosis ; the blood vessels become occluded, followed 
by anemia, necrosis and atrophy of epithelium. 

The application is not painful but the thawing is somewhat 
so, lasting, as a rule, for about ten minutes. 

Very often when applications are made near the eyes the 
loose tissue may become oedematous, but this will subside in 
a short while. 

The thawing of the tissue requires about the same time 
as the freezing. It at first shows a layer of moisture of 
condensation, which is followed by an erythema and slight 
swelling of the parts. A crust forms during the next few days 
which should not be disturbed. This exfoliates in from ten to 
twenty days. The healing of the treated area is unusually 
smooth and only a slight, pink scar remains, which will disap- 
pear in a short while. 


125 


For the treatment of lupus eytliematosus and the soft hairy 
moles this method is par excellence. 

The following cases the writer had the pleasure of observ- 
ing at the Skin Department of the Jefferson Medical College 
Hospital : 

Case I. Mrs. W., aged twenty-five. Born in England. Gen- 
eral health good. Father and sister died with tuberculosis. 

Four years ago she noticed a small eruption on the side of 
her nose, which soon began to spread over the nose and to 
both sides of the face; then later the same eruption was found 
on the crown of the head, which at present is devoid of hair. 

July 14th. 1907 she was treated at the Liverpool Skin 
Hospital. Evidently pyrogallic acid was used, which left an 
ugly white scar on the side of the nose. She entered the out- 
patient department of the Jefferson Hospital August 16th. 1909. 

Diagnosis of lupus erythematosus was made, and carbon 
dioxide snow was applied to three lesions of the face for thirty- 
five seconds each. Treatment was repeated on other lesions 
seven days later. On this date the crusts of the first appli- 
cation had exfoliated and the clear pink skin could be seen, 
with no sign of the disease in those particular spots. 

After several more weeks of treatment this patient will 
have been relieved of all signs of a most distressing skin disease. 

Case II. Miss C., aged twenty. Born in Pennsylvania. 
Two brothers died with tuberculosis. General health good. 
Eruption appeared below the left eye seven years ago, then grad- 
ually spread over the face. She was treated at the University 
of Pennsylvania with X-Ray, with slight improvement noted. 

She entered the out-patient department of the Jefferson 
Hospital about July 15th. 1909. Diagnosis: lupus erythema- 
tosus. Carbon dioxide snow was applied with marked improve- 
ment. Each lesion which had been treated with this remedy 
exfoliated within two weeks without any noticeable scarring, 
and no spread whatever of the disease in the treated area. 

Case III. Lelia M., aged thirteen. Born in Pennsylvania. 
Family and personal history good. When she entered the out- 
patient department of the Jefferson Hospital she had a dark, 
heavy mole along the outer edge and lobe of the right ear. 

After several applications of the carbon dioxide snow no 
trace of the mole was left and the scar was not noticeable at all. 

Although the method of using the treatment is very simple, 
in its simplicity lies its danger. It is not advisable for anyone 
not familiar with its use to attempt it, but in the hands of 
one experienced with it there is no doubt that the results are 
beautiful. 


126 


CONGENITAL UMBILICAL HERNIA INTO THE CORD. 


C. E. CATCHINGS M.D., 

WOODVILLE. 


The following case is rather an unusual type of congenital 
abnormality, and I therefore consider it worthy of permanent 
record : 

On the night of Sept. 22nd. 1908, while at one of our med- 
ical society meetings, I was called to a negro house a short 
distance from our place of meeting. On entering the house I 
was told that an infant had been born and that there was some 
trouble with the cord. I found the child on an old quilt on 
the floor, and upon examination I found the cord and placenta 
still attached. 

At the umbilicus was seen the cord, which was greatly dis- 
tended at its point of insertion into the abdomen, forming a 
tumor about two and one-half inches in diameter, and about 
three and one-half inches long. One side or half of this tumor 
was opaque, while from the other side the contents could be 
partly determined through the hernial coverings, owing to the 
thinness of the layers. I had the child removed to a small 
table nearby, made a more thorough examination, and satisfied 
myself that I had a congenital hernia into the cord to deal with. 
This being the first case of its kind I had ever seen, I tried 
by manipulation to reduce the contents, which I soon saw was 
of no avail. I had another physician called and we at once 
prepared to operate, which we did after the usual precautions. 
A slit was made into the transparent side of the cord and with 
pair of blunt scissors the cord was split down to the umbilicus. 
We again tried to reduce; but still no avail. I then enlarged 
the ring by an incision through it and into the abdomen ; then 
by careful dissecting we finally made the reduction. The con- 
tents of the hernia were caecum and appendix, a portion of 
the ileum and some omenteum, all firmly adhered to the opaque 
side of the tumor. The wound was firmly closed with cat-gut 
sutures and the cord cut and tied. There were symptoms of 
shock following the operation, but no peritonitis. In two weeks 
the wound had completely healed and the infant recovered. 

In this case I am satisfied the strangulation would have 
occurred at the neck, through compression of the surrounding 
tissue, had it been left for any length of time. 

Now I have not reported this case as anything new, but 
somewhat out of the ordinary and something that is seldom 
seen by the general practitioner. So far as I can learn there 
are but few similar cases on record. 


127 


Di*. Howard Marsh, in the report of St. Bartholomew’s 
Hospital for 1874, calls attention to the “familiar anatomical 
fact that from about the sixth to twelfth week of intra uterine 
life the caecum and neighboring portions of the ileum are con- 
tained in the part of the umbilical cord which is next to the 
body of the embryo, and that they should subsequently with- 
draw into the cavity of the abdomen. In some cases, however, 
this recession fails to take place and the intestine remains, 
even up to the time of birth, still lodged in the beginning of the 
cord, which is dilated in the form of a membranous sac. Not 
only may portions of the intestine be thus left outside of the 
abdominal wall, but, as in a case then recently operated upon by 
Dr. Warren of the Massachusetts General Hospital, the liver 
was found lying in a hernial sac made from the dilated base of 
the umbilical cord.” 


*HOOK WORM DISEASE OR UNCINARIASIS. 


B. Z. WELSH M.D., 

WOOL MARKET. 


Hook Worm Disease or Uncinariasis has existed for a long 
time in Southern Europe and Africa, the worm being recog- 
nized there as early as 1838, but only recently has it been 
recognized in the United States, the first case being reported by 
Dr. Stiles in 1892. It was most probably brought to the United 
States by the negro long before the civil war. 

I believe it is constantly becoming more prevalent. The 
increase is out of proportion to the increase in the population. 
One who has had any experience with the diseases recognizes 
it on the streets and roads every day. The sallow-faced dirt- 
eating boy has been known for a long time. He is a living dis- 
tributor of Hook Worm Disease, and is moi*e dangerous to a 
community than a tubercular patient. 

The first symptom of uncinariasis is “ground itch”, or 
mazamona. The worm enters the skin causing a papule or ves- 
sic-le, followed by a dematitis. The parasite develops in pol- 
luted soil, and enters the body principally, almost exclusively, 
through the skin. Once in 'the body, it enters the circulatory 
system, passes with the blood and lymph through the heart 
to the lungs, then into the air spaces, bronchial tubes, up to 
the larnyx, down the oesophagus to the stomach, finally reacli- 

* Read before the Harrison County Medical Society, Sept. 14th. 


128 


mg the small intestines, their natural habitat. They then be- 
come blood-suckers. They frequently turn loose their hold only 
to take a new one in a new place. They produce a substance 
that reduces the coagulation of the blood. 

“These numerous bleeding points are the cause of the in- 
tense anemia. The red cells of the blood pass through the 
worm without being changed, the plasma only being used. 
A patient may have anywhere from one to five thousand. If 
one drop of blood was wasted each day by each of three thou- 
sand it would amount to about six ounces daily. It would be 
easy to see how marked anemia would be caused and how one 
patient might have a slight and the other a severe anemia, 
depending on the number of parasites and the blood-making 
ability.” 

It has been shown by Loeb and Smith that the toxine de- 
stroys the coagulation of the blood, and no doubt plays a very 
important part in the disease. There is a reduction in the 
number of blood cells and a greater decrease in the percentage 
of hemoglobin. This is thought by some to account for the 
dirt-eating tendencies of some patients, who are unconsciously 
trying to supply iron. They have a perverted appetite, eating 
sticks, green fruit, and such like. There is an increase in the 
eosinophilic leucocytes. 

The anemia here is not so marked as in Porto Kieo from 
the fact that our soil is not so heavily infected, although I 
saw one case recently in which the color index was twenty per 
cent. The majority of our cases range between forty and sev- 
enty per cent. I have a case to report. Some of you will 
probably remember the case, as I brought it before you two 
years ago. 

Case. Age five years; male. Nothing to be had from fam- 
ily history. The child had always been rather fleshy, and the 
large size of the head attracted considerable attention among 
the neighbors. From what could be learned the child, while 
large, had never been robust. Walked at the age of eighteen 
months. The family claimed the child had always suffered 
from dyspnoea on exertion. Had had an attack of ground 
itch each summer for two years, probably longer. Three years 
ago he had some catarrhal affection of the nose, characterized 
by a very foul odor. An intense anemia was noticed at the 
age of four and steadily increased. 

I saw the child first on July 4th. 1907. Physical examina- 
tion showed a general oedema, abdomen large, head large, lungs 
normal, liver slightly enlarged, tonsils enlarged. On palpation 
over the precordial region you could get a thrill which could 


129 


also be felt over the carotids; more marked over the right. 
There was slight enlargement of the heart to the left. Apex 
beat was both visible and palpable at the nipple. On auscu- 
lation there was a loud murmur, systol was in time transmitted 
to the left axilla and back. Could also be heard over carotids. 
The second sound was accentuated. Pulse regular. There was 
also a hum in carotid region. Blood examination showed hem- 
oglobin reduced to forty-five per cent. Urine normal. One ex- 
amination of feces showed no ova of hook worm. Temperature 
100° F. Bowels regular. Had perverted appetite; ate sticks 
and all kinds of trash. He had gnawed off the corners of the 
dresser and bed posts. Later examination of feces showed ova 
of hook worm. 

Treatment. Allowed no supper, and at bedtime gave half 
ounce of magnesium sulphate. At 6 and 8 A. M. next day gave 
eight grains of thymol each time; at 10 A. M. half ounce of 
magnesium sulphate; at 4 P. M. allowed a little milk and 
crackers. Gave him four treatments one week apart. Got hook 
worms in great numbers. The next day the feces were mixed 
with blood, coming I think, from the small wounds where the 
worms had lost their hold. I have seen this occur in other 
cases, but it never amounts to anything. He passed several 
small pieces of wood, one being one inch long and nearly a 
quarter of an inch in diameter. 

The child began to improve rapidly after the first treat- 
ment. At the expiration of eight months the symptoms had 
all disappeared and the child is now in excellent health. I 
gave him tincture chloride of iron for a few weeks, but I do 
not believe that was necessary. 

The feces of a person suffering from uncinariasis are loaded 
with the ova of the worm, which under the proper condition of 
moisture and heat are soon ready to reinfect the same patient 
or some other person who may come in contact with the pol- 
luted soil. 

In Porto Rico out of 18,865 cases only 791 denied having 
suffered from ground itch. I have never seen a case in this 
section but that confessed to having suffered from it, and every 
one will tell you that he contracted the ground itch in the 
cow lot. Generically identical but specifically distinct in- 
fections occur in cats, dogs, foxes and various other animals, 
but whether the species that infect cows can pass into man or 
not I do not know, though I believe there is some relation. 

The disease is more common among people who come in 
contact with the damp, polluted soil, farmers, miners and all 
people who go barefooted or wear poor shoes. It is a tropical 


130 


and sub tropical disease. In North America the epidemic in- 
fection stops at the Potomac River. 

Dr. Stiles estimates that one-third of the male tenant 
whites of the South suffer from the disease. I believe his 
figures are too small for Mississippi, especially the southern 
part. I believe that ninet}' per cent of the children between the 
ages of four and twenty of the rural districts of Harrison 
County are infected, and 1 believe that ninety-five per cent, 
of the individuals who go bare-footed are suffering from the 
disease. They nearly all have ground itch, and that means hook 
worm. 

It has been shown by the Porto Rico Anemia Commission 
that the negro is just as heavily infected and as dangerous to 
the community as the white man, but that he has a greater 
resistance to the disease. 

It is not known positively how long the infection will last 
if left untreated, but I know of one case, a doctor, in which it 
lasted ten years, or at least it had been ten years since he had 
had ground itch. 

Thymol is the specific. For an adult give sixty grains and 
do not allow any form of alcohol or oil. Give a large dose of 
magnesium sulphate before and after. No danger. 

If the people of the South could be made to fear the hook 
worm in the same degree that many are fearing pellagra, and 
they could be taught how to stamp out the disease it would 
be a great boon to our land. No doubt hook worm disease has 
done, is doing and will continue to do vastly more harm than 
pellagra will ever do. 

The laity need to be instructed and educated in regard to 
the slow but deadly disease. The disease can be eradicated 
by treating all those affected and by preventing the soil be- 
coming polluted from the feces of the infected individual. What 
is being done in Porto Rico can surely be done here. People 
are learning how to prevent tuberculosis; the prevention of 
hook worm disease is much easier. 

I heartily endorse Dr. Bass of New Orleans, who says: 
“I believe that the State is widely infected with a disease 
slower yet more deadly, either directly or indirectly, than yellow 
fever, tuberculosis or small pox. It is dwarfing and destroy- 
ing both mentally and physically a very large percentage of 
her youth, and sapping the very life blood of many of her 
men and women.” 

We should insist on congress taking charge of the disease 
and eradicating it the same as the government is doing in 
Porto Rico. 


131 


HYSTERO-SALPINGO-OOPHORECTOMY DUPLEX FOR 
FIBROIDS. 


W. R. McKINLEY M.D., 

COLUMBUS. 


During my surgical career it has been my fortune to meet 
with probably one of the most unique cases recorded in medical 
literature — that of two uteri in one woman. 

From correspondence with most of the leading surgeons 
and gynecologists of to-day and searching the work and liter- 
ature of many writers and references, I have not been able 
to obtain data or information sufficient to report the frequency 
or number of times with which such anomalous conditions have 
been met. Abnormal development of the uterus and its asso- 
ciate pelvic neighbors are not extremely rare, in fact very 
important congenital malformations are frequently met with 
by most gynecologic operators. The abnormal developments 
vary considerably. Organs are sometimes super-numerous, 
sometimes totally absent. Probably every operator of a fairly 
extensive experience has met with one or more of such mal- 
formations, especially those of lesser importance so far as the 
physiologic possibilities are concerned. In fact these are the 
cases that most frequently give the conscientious obstetrician 
and surgeon most concern. The anatomical development of 
the uterus and appendages may be so nearly pei*fect that preg- 
nancy may occur and at the same time delivery hazard the 
life of foetus and mother. From the practical point of view 
these are the most important cases. The cases in which the 
maldevelopment is so great as to preclude pregnancy are in- 
teresting more on account of their anatomical picture than upon 
surgical possibilities. 

Among the congenital malformations of the human uterus 
we find many types of development, probably eight or ten. 
As we all know, embryologists tell us that the tubes, uterus 
and vagina are formed and developed from the Mullerian ducts. 
This seems to be universally admitted by all the authorities of 
embryology. It is the approximation and fusion of the ducts 
of Muller that form the uterus and tubes. The upper portion 
of this fusion of ducts constitutes the Fallopian tubes, the 
middle portion of the uterus and the lower portion of the 
vagina. So, malformations of the uterus must be due to non- 
appearance of these ducts, or interference in the development 
of the proper fusion of these ducts, or complete or partial 
destruction of these ducts. 


132 


Muller's classification and nomenclature of uterine mal- 
formations are probably the simplest and yet the most compre- 
hensive. He gives about ten different types or degrees of mal- 
formation, viz : 

1st. Complete absence of the uterus — which of course 
must be due to the absence or destruction of that portion of 
the Mullerian ducts from which the uterus is formed. 

2nd. Rudimentary uterus. In this condition the elements 
of the uterus make their appearance, but early and at different 
times during embryonic life they are more or less destroyed. 

3rd. Absence of cervix. 

4th. One horned uterus. 

5th. One horned uterus with atrophied second horn. 

6th. The two horned uterus. 

7th. The two chambered uterus. 

8th. The double uterus. The cause of two uteri in the 
same individual must be due to some interference with the 
fusion of the middle or uterus portion of the ducts of Muller. 
The fusion of this portion of the ducts is prevented probably by 
seme of the abdominal or pelvic organs forcing their way in 
between them. 

9th. Faulty or deficient development. 

10th. Slight anomalies such as congenital malpositions, 
double-mouthed uterus, abnormal openings and communica- 
tions, premature development and hernia of the uterus. 

We are told that frequently in non-viable monsters, and 
occasionally in subjects capable of life, we find two uteri, quite 
distinct and independent of each other, being separate and, 
apart, well developed organs. The case I propose to present 
to you is a case of this kind. Each uterus was distinctly sep- 
arate and independent of the other. Each was continuous with 
an apparently normal Fallopian tube and ovary. Each had an 
apparently well-developed cervix with normal internal and ex- 
ternal os opening into a normal vagina. Each rested respec- 
tively in the left and right sides of the pelvis. There was no 
attachment whatsoever by any kind of tissue between the right 
and left uterus. Each uterus was fibroid. Each had the same 
blood supply. The right was somewhat larger than the left, 
most likely due to more rapid tumor growth or growth of 
longer duration. Each ovary, tube, round ligament and broad 
ligament seemed healthy and normally developed. On intra- 
uterine examination the two cervices were of the same size and 
length ; no atresia or stenosis of either internal or external os. 
Length from external os to fundus was the same on intra- 
uterine examination and measurement of both uteri. Appar- 


133 


ently it was as easy for an ovum to reach the uterus in one case 
as in the other. Microscopically the two were alike in every 
point of development and appeared to be thoroughly in keeping 
with functions naturally expected of ordinary wombs — that of 
gestation and parturition. Each external os presented the ap- 
pearance of slight laceration as one would expect to find in 
multiparous women. Each round ligament held the respective 
uterus outwardly and upwardly to the side. The myomatous 
growth was interstitial in both uteri. The left ovary, tube and 
uterus were removed in toto. The right ovary, tube and all of 
uterus and cervix were removed except a very small portion 
of the cervix. It was not thought advisable to remove this 
completely on account of the extensive opening that would be 
left in the upper vaginal vault from side to side. This was very 
easy because there was no interchange of blood between the 
two uteri. 

Case Report. The patient furnishing this interesting case 
gives a history of being forty-eight years of age. Began men- 
struating at the age of thirteen years. Has had five children in 
four confinements. Been regular in menstruating all her men- 
struating period till about five to eight years ago. All her 
pregnancies and deliveries were normal. The last time she 
was confined she produced twins — boys. Patient clearly states 
that during her last pregnancy she, herself, and husband and 
all her family and friends could see, as she expressed it, “a 
large valley” between the two children. This separation ran 
from below upwards. That she could see and feel two distinct 
enlargements from beginning of pregnancy to birth of both 
children. That one came following severe bearing-down pains, 
when, after quite a rest, the pains began which brought the last 
child. They both lived for a time, when they died of diseases 
peculiar to infants. 

This case was referred to me by a medical man with opinion 
that it was fibroid uterus and that medical means had failed 
to control hemorrhage which had been going for some time and 
which had produced a rather pronounced anemia. She was 
found to be weak and very anemic, with history of severe 
bearing-down pains, with much loss of blood, ceasing only a 
few days during the month, and this state of affairs began just 
after the birth of her twins, eight years ago, and had been grow- 
ing worse every month. 

I contented myself by a confirmation of the fibroid diag- 
nosis and surgical needs, thinking it was a case of multiple or 
nodular fibroids such as we so often encounter on the operating 
table. However, the true physical condition was made clear 


134 


as soon as the abdominal cavity was opened. Very few ad- 
hesions were found. The shock was not extreme and was re- 
lieved by adrenalin chlorid in normal salt solution by hypo- 
dermoelysis and continued per rectum, with whiskey added 
instead of adrenalin. The amount of blood lost was very small. 
Wound was closed wtihout drains and patient made uneventful 
recovery without suffering pain or nausea. 

In brief review I should judge that any special interest 
this report may have centers in the unique proposition of its 
analomous or anomaloid occurrence — that of two separate and. 
apart, distinct uteri, independent and well developed in the 
same individual. And the further fact corroborated by the 
strong probable subjective symptoms and the physical possibil- 
ities of each uterus having become gravid and that from each 
a healthy child was born. 

Literature: Johnston, Muller, Winckle, Hart & Barbour, Garri- 
gue6, Williams. 


TOisstssippi State TOEiltral ^ssariatian. 


OFFICERS 1909-10. 

President — D. W. Jones - Brookhaven. 

Vice-President — J. S. Sanders - - - Scranton. 

Vice-President — J. C. Armstrong - - Water Valley. 

Vice-President — Thos. Purser - - - McComb City. 

Secretary — E. F. Howard - Vicksburg. 

Treasurer — H. F. Sutherland - Rosedale. 


CHAIRMEN OF SECTIONS. 


Medicine 

. B. L. Culley 

Jackson 

Surgery 

. . F. M. Sandifer . . . 

Greenwood 

Obstetrics 

. G. S. Bryan 

Amorv 

Gynaecology 

. .T. M. Jones 

Hernando 

Materia Medica 

. . E. Wright 

Sardis 



..Crystal Springs 

Nervous Diseases 

, . G. W. Stephens . . 

Meridian 

Venereal Diseases 

. . Robt. Donald 

Hattiesburg 

Hygiene 


Natchez 

Dermatology 

. . R. M. Sadler 


Bacteriologv 

. . W. S. Leathers . . 

Universitv 

Eye, Ear, Nose, Throat. 

. . D. G. Mohler 

Gulfport 

Electro-Therapeutics . . 

. . Rosa Wiss 

Meridian 

Tuberculosis 

. . P. R. Brown 

West Point 


MISSISSIPPI IHEDICfll niONTHLY. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

SUBSCRIPTION ONE DOLLAR PER ANNUM. 


As the chairmen go about their work in making up their 
section programmes for the 1910 meeting, they are being con- 
fronted by the same spirit of procrastination that is so charac- 
teristic of our members and that has so militated against the 
success of our meetings in the past. We have a way of grum- 
bling because our chairmen fill the programme with papers by 
visitors, and while it is true that the meetings should be of 
Mississippians, for Mississippians, by Mississippians, we must 
remember that the chairmen cannot do the work unassisted and 
that the man who fails to do his part on the scientific pro- 
gramme has no right to grumble if the bill of fare does not 
suit his palate. 

The committee on scientific work believes that all that is 
needed is a little self-confidence, and an assurance that their 
papers will not be slighted, to bring out an ample number of 
Mississippi authors. In order to increase this assurance the 
committee has recently adopted the following: — “Resolved that 
those sections containing the largest proportion of foreign ele- 
ment (papers by non-residents of the state) shall be given the 
least desirable places on the programme.” This is not intended 
as a dig at any of our friends in other states, many of whom 
have done yoeman service for us in past years, but as an 
assurance to the members of the Association that their modest 
efforts will not be shelved. In its final analysis the matter 
resolves itself into this : The Association is first and foremost 
for the benefit of its members, and all will agree that the man 
who writes the paper gets far more benefit from it than does 
any of his hearers. Therefore let’s have them from home men. 


135 


136 


LIBRARY FOR MEDICAL DEPARTMENT. 

The Dean of the Vicksburg Branch of the Medical Depart- 
ment of the University of Mississippi has had one response to 
the request for books published in the October Monthly that 
has gladdened his heart. The letter from the donor, which is 
given below, tells the story, and Dean Krauss has asked that 
we make this public acknowledgement and expression of his 
thanks, in which we beg the liberty of joining. 

St. Elmo, Miss., Oct 11th. 1909. 

Dr. Wm. Krauss, 

Vicksburg, Miss. 

Dear Sir: — I notice in the Mississippi Monthly a call for 
medical books for the purpose of establishing a library. 

I have on hand two hundred and fifty or three hundred 
books dated from 1700 up to the present time, most of them 
standard works of their day. 

They have been given me, most of them, by physicians who 
have passed away. 

Fifty years of practice and the added weight of eighty- 
three years tell me I can no longer use them. 

If you wish them and will pay the freight on them I will 
cheerfully box and send them to your address. 

Kespeetfully, 

Wm. P. Hughes. 


Mississippi State Merliral ^ssuriatiun. 


Jackson, Miss.. Sept. 22nd. 1909. 

Dear Dr. Howard : 

Below is a list of subjects for which I wish you to allow 
space in the Mississippi Medical Monthly until near the meet- 
ing of the State Medical Association, April next. 

My desire is that the members of the Association shall 
know the subjects, and that any who will may give me a volun- 
tary paper of his own choice in this list, and that all who will 
may be prepared to discuss the subjects. 

I will make special request of some who can give me good 
practical papers on any one of the subjects chosen. 

My further desire is to bring the Section of Medicine up 
to the top notch and that all papers for this section be specially 


137 


suited to those who are in the active line of battle against 
disease. 

Yours truly, etc., 

B. L. Culley, 

Chairman, Section of Medicine. 

Section On Medicine. 

(1) . The Exanthematous Diseases — Cause; Differential 
Diagnosis; Treatment. 

(2) . Malarial Diseases — Cause; Prevention. 

(3) . Tuberculosis — Its relation to State Medicine. 

(4) . Typhoid Fever — Cause; Prevention. 

(5) . Typhoid Fever — Duty of Municipalities and State 
in its prevention. 

(6) . Pneumonia — Cause; Prevention; Treatment. 

(7) . The doctor’s responsibility in preventive medicine. 

(8) . Pellegra — Cause; Treatment. 

(9) . The benefit to the public health by report of all 
specific, contagious diseases to State Board of Health. 

(10). How should the health of the future wives and 
mothers be safeguarded? 


SntTEtg Vzttttztixnqs. 


East Mississippi Four County Medical Society met in 
Amory Oct. 12th. at 2 P. M., Dr. Feemster occupying the chair. 
Dr. I. P. Burdine presented tw r o clinics, lupus vulgaris and 
endocarditis ; Dr. Boozer one, anterior poliomyelitis ; Dr. 
Grady one, pellagra. Drs. Keyes and McCown presented highly 
appreciated papers on “apomorphia” and “tetanus” respec- 
tively. Those present and taking part in the meeting were Drs. 
Burdine, Grady, Lee, Boggan, Cowden, Keyes, Anderson, Na- 
bors, Tubb, Senter, Feemster, Boozer, Underwood and Green. 
The Amory physicians dined the society at the T. P. A. Hotel. 
Next meeting will be held at Tupelo the second Tuesday in 
November at 2 P. M. 

Harrison County Medical Society w T as called to order by 
Dr. Lebaron in the rooms of the Commercial Union at Gulf- 
port, Oct. 12th. Those present were Drs. Parker, Lebaron, 
Welch, West, Mohler, Caraway, Hood, Hopper, Priddy, Strange 
and Anderson. The subject for discussion was pellagra. Dr. 
Parker presented a clinic with all the typical symptoms of the 

2— M 


138 


disease, stated the history of the case and noted especially that 
the patient lived largely on corn products. From the history 
it seems that there had been a number of similar cases in this 
family, with several deaths. A note from Dr. Bass of New 
Orleans was read expressing regret that owing to railroad trou- 
bles he could not get here. Dr. Parker mentioned that he had 
tried to get this case in the hospital here, but apparently they 
did not want it. Dr. Rowan of Wiggins sent a case which was 
presented by Dr. Hood. After discussion a line of treatment 
was suggested, general tonics, with arsenic. Atoxyl was also 
suggested. Dr. Strange suggested that perhaps the trouble was 
altogether of nervous origin and was due to some derangement 
of the nerve fibers. It was moved by Dr. Parker that the 
December meeting be devoted to pellagra and that all the South 
Mississippi societies be invited; also those doctors of New Or- 
leans and Mobile who are interested in the disease, and also 
that we invite the surgeon-general to send a special man down 
to be with us. A committee was appointed to make all arrange- 
ments and send out the invitations. The motion was carried 
and the committee appointed was as follows: Drs. Parker, 

Hood, Mohler and Folkes. Dr. Parker was appointed as a com- 
mittee of one to look after the legislation of medical affairs. 
The publicity committee made a report and was continued. It 
was moved by Dr. Mohler that the society make Dr. Cox of 
Lyman a suitable present at his wedding, which takes place 
Oct. 27th., and that all members who feel inclined are to con- 
tribute towards the expense of the present. Drs. Mohler and 
West were appointed a committee to receive contributions and 
select the present, which is to be sent in the name of the society. 


NOTICE. 

The president of the American Gynecological Society has 
appointed a committee to report at the next annual meeting 
in Washington, on the Present Status of Obstetrical Teaching 
in Europe and America, and to recommend improvements in 
the scope and character of the teaching of Obstetrics in Amer- 
ica. The committee consists of the Professors of Obstetrics in 
Columbia University, University of Pennsylvania, Harvard, Jef- 
ferson Medical College, John Hopkins University, Cornell Uni- 
versity and the University of Chicago. 

Communications from anyone interested in the subject will 
be gladly received by the chairman of the committee, Dr. B. C. 
Hirst, 1821 Spruce St., Philadelphia, Pa. 


139 


Bxrrrk Unitsius. 


THE PRINCIPLES OF PHARMACY. By Henry V. Arny Ph.G., Ph. 
D., Dean and Professor of Pharmacy at the Cleveland School of 
Pharmacy, Pharmacy Department of Western Reserve University. 
Octavo of 1175 pages, with 246 illustratsons, mostly original. W. B. 
Saunders Company, Philadelphia and London. 1909. Cloth, $5.00 
net; Half Morocco, $6.50 net. 

A new text-book on Pharmacy has been written and in its 
completeness, leaves nothing to be desired. It is peculiarly 
attractive in that the author has a style which makes his text- 
book very readable, and causes the reader to forget that he is 
perusing a sometimes dry subject. After discussing very fully 
pharmaceutic operations, the author takes up galenical prep- 
arations, then inorganic and organic chemistry, pharmaceutic 
testing, and concludes with an invaluable chapter on the pre- 
scription. To the average physician this chapter on prescrip- 
tion-writing, especially the article on incompatibles, is alone 
worth the price of the work. 

Myers. 


HUMAN PHYSIOLOGY. An elementary text-bood of anatomy, phys- 
iology and hygiene by John W. Ritchie, Professor of Biology, College 
of William and Mary. Virginia World Book Co., Yonkers-on-Hud- 
son, New York. 

This is well called an elementary text-book. It is entirely 
too elementary for a medical student, though it would serve 
very well for high-school work were it not so top-heavy. 

Howard. 


THE PRACTICAL MEDICINE SERIES. Comprising ten volumes 
on the year’s progress in medicine and surgery. Vol. VI. General 
Medicine. Edited by Frank Billings M,S., M.D., Head of the med- 
cal department and dean of the faculty of Rush Medical College, 
Chicago, and J. H. Salisbury M.D., professor of medicine Illinois 
Post-Graduate Medical School. The Year Book Publishers, 40 Dear- 
born Street, Chicago. Price $1.50. 

This little volume is a concise and well-arranged digest of 
the various articles on medicine published during the year. It 
offers an easy and quick method of reference on this line. 

Howard. 


HAND-BOOK OF MODERN TREATMENT AND MEDICAL 
FORMULARY. By W. C. Campbell M.D., late resident physician 
Methodist Episcopal Hospital, Philadelphia. F. A. Davis Company, 
Philadelphia. 1909. 

As a general rule, we are utterly opposed to the idea of 
physicians using formularies, or any ready prescription writers, 


140 


but this work is really an exception to the rule, in that it is not 
so much as its title implies, a formulary, but that it seems to 
be a compendium of many stray hints and valuable points 
that float, as it were, on the stream of medical journalism. 
The physician will find in it many pointers not found elsewhere, 
many of the little kinks which when used spell success. We 
noticed one error in the work. Under the head of dropsy, 
diuretin is recommended to be prescribed in five-ounce lots, in 
doses of thirty minims. Since diuretin is a solid, it would be 
hard to dispense it in minims. This error is regrettable in an 
otherwise fine work, and it was no doubt overlooked in the 
proof-reading. Myers. 


THE CONFESSIONS OF A NEURASTHENIC. By Wm. T. Marrs 
M.D. F. A. Davis Company, Philadelphia. 

Three or four mild laughs that are second hand and a 
modicum of near-wit, if we may be permitted to coin a word, 
with half a dozen ‘‘original” illustrations that look as if they 
had been made with a scratchy pen on newspaper; the whole 
done up in a red cover, suggestive of the fire into which we will 
now proceed to pitch the volume. Howard. 


TEXT-BOOK OF HYGIENE. A Comprehensive Treatise On The 
Principles And Practice Of Preventive Medicine From An Ameri- 
can Standpoint. By Geo. H. Rowe M.D., late Professor of Thera- 
peutics, Hygiene and Mental Diseases in the College of Physicians 
and Surgeons, Baltimore, etc., and Albert Robin M.D. , Professor of 
Pathology, Bacteriology and Hygiene, Medical Department Temple 
University, etc. F. A. Davis Company, Philadelphia. 

This is a handy little volume, of size convenient for a 
school book and with well-chosen divisions. Several well-known 
collaborators have assisted in getting out this edition, the 
fourth since 1891, and they have succeeded in producing a book 
that will answer equally well for the student of medicine for 
a text and for the practitioner for reference. To further its 
use to the former, a number of questions are put at the end of 
each chapter. Howard. 


THE PRACTICAL MEDICINE SERIES. Comprising Ten Volumes 
On The Year’s Progress In Medicine and Surgery. Vol. IV. — 
Gynecology. Edited by E. C. Dudley A.M., M.D., and C. von 
Bachelle M.S., M.D. The Year Book Publishers, 40 Dearborn St., 
Chicago. Price $1.25. 

This book fulfills excellently the purpose for which it was 
written, i. e. to give brief, concise abstracts of the literature 
on the subject of gynecology for the past year. 

Daugherty. 



MISSISSIPPI MEDIUM. MODTHLT 


Vol. XIV. DECEMBER 1909. No. 8 


* CAUSES OF INSANITY. 


V. B. MARTIN M.D., 

BOGUE CHITTO. 


To have disordered function of the mind, we must have 
disordered nutrition or degeneration of the brain. Without a 
brain there can be no thought, and without a healthy brain 
there can be no healthy thought. 

There are several causes that will produce insanity, if the 
condition continues long enough ; i. e. anemia, hyperemia, toxic 
substances circulating in the blood, drugs or bacterial poisons, 
etc. We speak of disorders of the mind as being mental diseases 
and those of other parts of the anatomy as physical, when in 
fact a diseased brain is just as much a physical disease as if 
it were some other paid of the anatomy. 

We name the diseases of the mind by the symptoms, melan- 
cholia, mania, dementia, “dementia Americania”, etc., which is 
about as rational or as scientific as dropsy, gout, fever and 
colic, conveying as little light as possible of the pathological 
condition of the part of the anatomy affected. 

My observation has been that a large percentage of mental 
diseases are inherited, and if the parents or grand parents or 
the great-grand parents or the great-great-grand-parents could 
have been treated by some well-informed physician of this day 
for a specific trouble, which is very amenable (right here I 
want to say I use the term amenable advisedly, as it takes 
five or six years to cure with our specifics) to treatment, we 
would not have seelerosis, apoplexy and insanity developing in 
our generation of patients, or at least it would be present in 
very much reduced numbers. It is a sad commentary on pos- 
terity but nevertheless true. This disease of which I speak is 
the sin that I think the inspired writer had in mind when he 
wrote that the iniquities of the fathers would be visited upon 
the children even to the third and fourth generation. I truly 
believe that lues is the cause of at least fifty per cent, of the 
insanity at this time, the greater part of which is inherited. 

*Read before the Tri-County (Pike, Lincoln. Copiah) Medical Society. 

141 


142 


In our territory we have had more than our share of cases. 
When I looked over the program and saw that I was slated 
for a paper on this, the most deplorable of all diseases, and 
that my confrere, Dr. Hewitt, was put down on the same branch 
of medicine, or rather of pathology, I began to wonder why 
you should select amateurs for so arduous a task, but soon 
came to the conclusion that it was on account of the epi- 
demic in our community, which had unfortunately gotten out 
on us. 

I have noted as high as four cases occurring in one family 
and one other effected if not affected. The father of this family 
died at about fifty years of age. of sclerosis of the spine. 1 
believe that a certain disease was the remote cause of the 
psychosis in these cases. Keep this picture in your mind, gen- 
tlemen. before pronouncing your cases of lues cured. 

I am firmly of the opinion that we cannot eradicate the 
poison in less than a half dozen years, even with the most 
skillful and persistent treatment. 

If you differ with me. keep a record of your positive cases 
and do not treat them over two years, as some advise. If you 
are a close observer you will find them returning to you in after 
years, presenting a pathological picture of which you will not 
feel proud. 

My observation of uncured cases is that they die prema- 
turely of apoplexy or spinal sclerosis, or develop a psychosis 
and wind up in an asylum. 

Psychosis is sometimes caused by trauma, by depressions 
of the skull pressing on the brain or fractured pieces of skull 
penetrating into the brain. These cases usually get well if the 
cause is removed. Psychosis is caused by mastubatiou and 
excesses in sexual indulgences. These cases usually get well 
if they can be controlled when the mental trouble first develops. 

We sometimes have psychosis from inflammation of the 
womb and its appendages. I recall one case of this kind that 
was sent to the asylum at Jackson. Her former trouble was 
cured and her mind got all right. That was a number of years 
ago and she is still living and in good health. 

Among the drugs we find producing psychosis when con- 
tinued for a long time are opium, cocaine and alcohol. Bac- 
terial poisons that very often produce psychosis are those of 
typhoid fever, scarlet fever, and. last but not least by any 
means, and a disease that is causing the entire profession of the 
United States, and especially of the south, a great deal of worry 
and hard study, is pellagra, or a disease that has been desig- 
nated by that name, but like our nomenclature in psychosis is 
as badly named as could be. since a rough skin is the least and 


143 


usually one of the last manifestations. The poison, whatever 
it is, causes degeneration of the central nervous system. Pel- 
lagra is a disease produced by eating musty corn meal, so 
claimed by foreign authors, but seriously questioned as being 
the sole or only cause by the profession of America. 


* TAPEWORMS. 


H. S. CAPPS M.D., 

GULFPORT. 


Tyson, in his splendid article on animal parasites, says: 
“Out of the vast number of animals which, in one or another 
jteriod of their cycle are parasitic upon some higher form of 
life, the group that infect man, either as a definite host or as 
a host of some intermediate stage, is comparatively small.” 
Of these some inhabit the skin, some are found in the blood 
and muscles, and others infest the alimentary canal. Im- 
portant among the latter will be found the cestodes or tape- 
worms. 

Since my arrival in Gulfport, I have been called upon to 
treat a considerable number of cases of tapeworm both in 
children and adults. Judging from my experience it must be 
a very common affection not only in Mississippi but in other 
states and foreign countries. In fact, one of the things that 
most impressed me in the study of the parasite is its ubiquity, 
or probable existence in every country of the globe. Long be- 
fore I began the study of medicine, I had already seen several 
cases in different towns of South America, and during my 
medical course I saw cases in the clinics at Louisville and 
Chicago. Although the ascaris lumbricoides and uncinaria 
duodenalis are very common in some localities, I do not be- 
lieve that either of them have such a wide geographical dis- 
tribution as the cestodes or tapeworms. As its name implies, 
the tapeworm is a long, flat or ribbon-shaped worm consisting 
or a head or scolex and body or stobile. The head is a very 
small globular, pyriform or club-shaped, inconspicuous object, 
and is not much larger than a pin's head in some species. It 
is provided with two or four suckers and, in some varieties, 
with a crown of hooklets by means of which the worm fixes 
itself into the mucous membrane of the intestines. The head 
and even the hooks and suckers may be seen with the naked 
eve, although it is by no means easy to discover in the stools. 

* Read before the Harrison County Medical Society. Sept. 14th. 


144 


and this requires some little care and experience. I have only 
been able to secure one specimen, which I have preserved in 
alcohol. 

The body or strobile is made up of a large number of seg- 
ments or proglottids. all of which are derived from the scolex 
by a process of segmentation or constriction. The worm varies 
in length from a few inches to forty or even sixty feet, accord- 
ing to the species. I feel certain that in several of my cases 
it was not less than twenty feet. Of the different varieties the 
echinococcus is probably the shortest and the bothriocephalus 
the longest. One strobile contains from a hundred or two to 
four or five thousand proglottids. Each proglottid may be 
regarded as a separate biological entity containing both male 
and female sexual organs. The whole worm may be x*egarded 
as a colony of proglottids derived from a common scolex or 
head and bound together for the ordinary functions of life and 
reproduction. The smaller and newer proglottids are found 
nearer the head, while they increase in size as they become 
further separated from it. making the worm appear larger at 
its tail and tapering towards the head. 

Histologically, the worm belongs to a very low grade of 
animal life and has a very simple structure. It has a very 
rudimentary nervous system, and a so-called “water-circula- 
tion”, composed of a number of anastomosing canals through- 
out the strobile. It has no alimentary canal and its nutrition 
is absorbed directly from the fluids in the intestinal canal of 
its host. 

The most highly developed organs are the organs of gen- 
eration. The male organs are small and consist of the testes, 
the vas deferens and a thread-like penis. The female organs 
consist of the uterus, ovaries and numerous branching ovi- 
ducts. The uterus and ovaries are well developed and are 
readily seen with the naked eye, and are situated generally near 
the middle of the proglottids. If any difficulty is experienced 
in discovering the uterus, the segments may be cleared up with 
a little acetic acid or glycerine. The ova are round or spherical 
and are seen only under a microscope. They are very numerous, 
over a million being found in one parasite and several thousand 
in a single proglottid. 

Like many of the insects and other parasites, the cestodes 
pass through several stages of metamorphosis during their 
evolution. The common varieties of tapeworm present three 
stages in the course of their development. 

The first or embryonic stage is represented by the ova or 
embyros found on grass or herbs and in water where they have 
been scattered through discharged feces. Here they may re- 



145 


main for an indefinite period of time until they are devoured 
by some animal which serves as an intermediate host. In the 
stomach of these animals the thin shells that cover the embryo 
are dissolved and they are taken up by the circulation and 
lodged in different parts of the body where they pass into the 
larval stage. 

The second or larval stage is represented by the cysticerc-us 
or bladder worm found in the flesh of certain animals, espe- 
cially in beef and pork. The most common site of the cysticerei 
is in the muscles of the neck and jaw and under the tongue, 
where by a close inspection they may be seen, as a pale, shining 
ovoid cyst about one centimeter in length. Where cysticerei 
are very abundant, they give the meat a peculiar knotty ap- 
pearance, which is known as “measly meat”. 

The third or final stage is represented by the fully devel- 
oped tapeworm found in the alimentary canal of the human 
being. Autopsies have shown that the worm is usually found 
in the small intestine with its head deeply buried in the mucous 
membrane just below the pylorus. It rarely ever extends be- 
yond the ileo cecal valve, and may remain in this position for 
years, discharging ripe segments and ova. 

Several varieties of tapeworms have been described, of 
which the most important are the tenia lata or bothriocephalus 
latus whose larvae are found in fish ; the tenia saginata or 
medio-canellata whose larvae are found in beef ; the tenia solium 
or dentata whose larvae are found in pork; the tenia canina 
or eliptica whose larvae are found on cats and dogs; and the 
tenia nana or egytica whose larvae are found on rats and mice. 

We are concerned at present with the tenia saginata and 
the tenia solium, as these are the most common varieties in this 
country. Hughes says that the tenia solium is the most com- 
mon, but I believe that he is the only author who is of this 
opinion. Anders says the tenia saginata is the most common 
in this country and in many countries of Europe. Osier says 
the tenia saginata or medio-canellata is certainly the common 
type of this country. 

Tyson says the tenia solium is extremely rare in this 
country, popular opinion to the contrary, notwithstanding. As 
nearly as I could ascertain all of my cases were of the tenia 
saginata or beef worm. Professor Leidy, according to Tyson, 
states that all specimens sent him for examination during the 
past fifteen years were tenia saginata, without a single ex- 
ception. 

The symptoms are rather indefinite. They are local and 
reflex. The local symptoms are colic-y pains and fullness in 
the abdomen, anorexia or an exorbitant appetite, constipation 


146 


or diarrhoea, discharging of segments; they may be accom- 
panied by debility and anemia. 

Among the reflex symptoms are pruritis of the nose and 
anus, restlessness, insomnia, hypochondria, fainting spells, ner- 
vousness and convulsions. One patient, who was under my 
observation, was subject to the most violent epileptic convul- 
sions, which lasted for several hours. I was not able to decide 
whether these were due entirely to the presence of the worm 
or not. 

From the symptoms alone a diagnosis is impossible. The 
only sure sign is the finding of the segments, either in the 
stools or on the clothing. A microscopical examination of the 
feces will reveal the presence or absence of the ova. My patients 
generally come to me with their diagnosis already made, bring- 
ing segments of the worm which they have recovered from the 
stools. 

A diagnosis of the different varieties is not very difficult 
and can be made by a close examination of the head and seg- 
ments. 

The bothriocephalus latus is very rare in this country, but 
its possible occurrence should not be forgotten, especially among 
sailors and immigrants. It is recognized by its large size, 
twenty to forty feet, its large club-shaped head, unarmed but 
provided with two large grooved suckers; its short thick seg- 
ments which are wider than long, and its rosette-shaped uterus 
situated in the center of the segment. 

The tenia solium is also not very common in this country. 
It is recognized by its size, ten to twelve feet long; its small 
pin-head-shaped scolex, armed with a double crown of suckers, 
the shape and size of its segments which are a little larger than 
broad, and its dendritic or tree-shaped uterus, extending long- 
itudinally across the middle of the segments. Its ovarian 
branches are not so numerous as those of the tenia saginata. 

The tenia saginata or medio-canellata is the common variety 
in this country. It is recognized by its pyriform head which is 
unarmed but provided with four suckers placed one at each 
corner; its length, fifteen to thirty feet; its segments, which are 
considered longer than broad ; its dendritic uterus situated 
longitudinally across the middle of the segments like the tenia 
solium. Its ovarian branches are finer and much more numer- 
ous than those of the tenia solium. 

Other varieties of the tapeworm are very rare in this coun- 
try. The tenia eliptica and tenia nana may possibh’ occur in 
children from playing with dogs. They are recognized by 
their small size, only a few inches long; the shape and size of 


147 


their head, the shape and size of the segments, and position of 
the uterus. 

A very important part of the treatment of tapeworms is 
the prophylaxis. This consists in a rigid governmental in- 
spection of all meats; second in burning or destroying all seg- 
ments of the worm ; and in seeing that all meats are thoroughly 
cooked befoi’e they are eaten. Exposure to a temperature of 
fifty or sixty degrees C. will kill the larvae. 

The remedies which have been used are: male fern, kousso, 
pomegranate root, pelleterine, kamalia, turpentine, pumpkin 
seed and thymol. Tyson prefers pomegranate root, or some of 
its preparations. Osier recommends pomegranate root or pel- 
leterine. Hare recommends pelleterine, the active principal of 
pomegranate root. In my hands male fern has been almost a 
specific. In fact I have had no occasion to use any other drug. 
I have never seen it fail when it is properly given and the 
preparatory treatment is carried out thoroughly. I believe that 
a combination with other remedies or with croton oil will make 
it more effective. The following prescription, taken from 
Hughes, Manual, has given me excellent results : 

Olioresin Aspidii - - - dr. ij 

Chloroformi dr. j 

Olii Tiglii gtt. ij 

Glycerinae - - - - q. s. oz. ij 

Sig : — To be taken in two doses at interval of an hour. 

The preparatory treatment is very important and has for 
its object the removal of the mucus and food from the ali- 
mentary canal. I believe that at least half of the failures are 
due to the patients not following the doctor’s instructions in 
this particular. 

I generally direct my patients to fast for one or two days 
before taking medicine; only a little milk or toast is allowed. 
On the day previous to administering the anthelmintic, a saline 
cathartic and an enema are given to clear the bowels. The 
next morning I give the above prescription and follow it within 
two or three hours with another saline. This generally succeeds 
in bringing away the worm. As the treatment is very weaken- 
ing, however, I generally follow it up with a tonic, containing 
brandy or strychnine. If the head is not secured, it will con- 
tine to form segments which will ripen and be discharged 
again within about three months. In this case the treatment 
is to be repeated. If no segments re appear in the stools after 
five or six months, the patient may be regarded as cured. 


148 


* PROGNOSIS, DIFFERENT FORMS OF INSANITY. 


T. E. HEWITT M.D., 

BOGUE CHITTO. 


The prognosis of insanity is favorable in many forms of 
the disease where the surroundings are favorable to the patient. 
Contrary to common belief, insanity is curable if appropriate 
treatment is beguu promptly. Very few’ of the insane succumb 
to the infectious diseases as compared to the general pop- 
ulation. 

Of fifteen thousand tw r o hundred and forty-eight deaths in 
Italian asylums, eight and forty-six one-hundredths per cent. 
w r ere due to tuberculosis. I have no statistics at hand from our 
own state, but I am sure that the mortality is much greater 
here than at that time in Italy. 

The prognosis of insanity in childhood is much more favor- 
able than in adult life, but if the child show’s hereditary evi- 
dences the prognosis is almost always bad. 

The majority of authors contend or agree that the prognosis 
of insanity s sufficient evidence of its incurability, while a few r 
contend that there are cases where there has been perfect re- 
covery. Decidedly the hereditary cases are the most curable, 
although there is more likelihood of relapses than in those in 
which the hereditary tendency is absent. 

It has been estimated that sixty-three per cent, of re- 
coveries take place before the age of tw’enty-five, although the 
young are prone to relapses. The menopause is another period 
of life at which many cases make their recovery. 

The acute forms of insanity in which recovery is especially 
apt to occur are stuporous insanity or so-called primary de- 
mentia; confusional insanity; puerperal and lactational in- 
sanity, and that which follow’s acute physical disorders. 

The secondary or terminal stage, dementia, as w'ell as re- 
current and alternating insanity, is hopelessly incurable. Gen- 
eral paralysis of the insane is almost inevitably fatal; so says 
Henry R. Stedman. 

In mania or melancholia, the prognosis is gloomy and re- 
covery seldom occurs. The tendency is toward fatal termina- 
tion in from two or three to fifteen years. 

The general palsies of childhood, the extent and degree of 
paralysis and the character of the mental changes are im- 
portant aids in forming a prognosis. 

Taken as a whole the outlook is not very bright in any 
case. In acute delirium (or Bell’s mania) the prognosis is 

‘Read before the Tri-County (Pike, Lincoln, Copiah) Medical Society. 


149 


most unfavorable and more so for men than women. Where 
alcoholism or exhaustive diseases or child-birth are the causes 
the prognosis is most severe and the case most always fatal. 

Epilepsy when hereditary is very rarely cured, but it is 
claimed that idiopathic cases are occasionally cured. Anders 
says that he would rather suggest that some cases get well by 
themselves. 

The prognosis of idiocy and imbecility, taking into account 
the pathogeny of the condition, is unfavorable. 

There is at present no means known to medical science or 
art by which a brain defective in structure or organization can 
be made perfect. In some cases where there is contracted 
skull, surgical intervention, to permit the brain to expand, has 
wrought great improvement. 


CONFERENCE ON PELLAGRA. 

At the pellagra conference held at Columbia, S. C., Nov. 3rd. 
and 4th. Dr. Sandwith of London, Eng., stated some general 
axioms that have proven good in Italy and Egypt : 

1. In districts where no maize is cultivated or habitually 
eaten, pellagra does not exist. 

2. There are many districts where maize has been culti- 
vated for many years and yet pellagra has not appeared. 

3. Well-to-do people in pellagra districts, living on varied 
diet and consuming maize as an occasional, and not as the 
staple cereal, usually escape pellagra. 

4. It is uot good maize or good maize flour which produces 
pellagra; the disease requires for its production the habitual 
use of damaged maize in some form. 

There is a vast amount of Italian literatui’e dealing with 
the question of what the damage may be, and there is now a con- 
siderable consensus of opinion in favor of incriminating Pen- 
icillium glaucum or bread-mold in ordinary pellagra. 

5. We are constantly being reminded by skeptics that the 
maize area of the world is infinitely greater than the pellagra 
area. This is not the point. The question is, does not pellagra 
distribution correspond very nearly with the areas on which 
human beings live who eat damaged maize or products made 
from damaged maize? 

The following resolution, adopted by the conference, gives 
the sentiments of its members : 

Resolved , That while sound corn is in no way connected 
with pellagra, evidences of the relation between the use of 


150 


spoiled corn and the prevalence of pellagra seem so apparent 
that we advise continued and systematic study of the subject, 
and, in the meantime, we commend to corn growers the great 
importance of fully maturing corn on the stalk before cutting 
same. 

Journal A. If. A. 


TOtsstssippt State TOerittal ^ssttriatton. 


OFFICERS 1909-10. 


President — D. W. Jones 

Brookhaven. 

Vice-President — J. S. 

Sanders 

Scranton. 

Vice-President — J. C. 

Armstrong 

Water Valley. 

Vice-President — Thos 

Purser - 

McComb City. 

Secretary^ — E. F. Howard 

Vicksburg. 

Treasurer — H. L. Sutherland 

Rosedale. 

CHAIRMEN OF SECTIONS. 


Medicine 

. . . B. L. Culley 

Jackson 

Surgery . 

. . . F. M Sandtper . . 

Grepnwood 

Obstetrics 

. . . G. S. Bryan 

Amorv 

Gvnaecologv 

. . . T. M. Jones 

Hernando 

Materia Medica 

. . . J. C. McNair 

Favette 

Pediatrics 


.Crvstal Springs 

Nervous Diseases .... 

. . . G. W. Stephens . . 

Meridian 

Venereal Diseases .... 

. . . Robt. Donald 

Hattiesburg 

Hygiene 

. . . J. S. Ullman 

Natchez 

Dermatology 

. . . O. N. Arrington . . 

Brookhaven 

Bacteriology 

. . . W. S. Leathers . . . 

University 

Eye, Ear, Nose, Throat 

. . . D. G. Mohler 

Gulfport 

Electro-Therapeutics . 

. . . Rosa Wiss 


Tuberculosis 

. . . P. R. Brown 

West Point 


STANDING COMMITTEES. 

Committee Ox Public Policy And Legislation. — P. W. 
Rowland, Oxford; L. C. Feemster, Nettleton; X. Stewart, Jack- 
son ; I). W. Jones, Brookhaven ; E. F. Howard, Vicksburg. 


MISSISSIPPI MEDICAL MONTHLY. 


E. F. HOWARD B.S., M.D., Editor and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. B- MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 


OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


To the student of history, there is no more striking phenom- 
enon than the one that the character of nations, like that of 
individuals, changes. The England of Elizabeth, the England 
of Cromwell, of Nelson was a self-poised country, meeting good 
and bad fortune bravely, come how it would. A short space of 
one hundred years, short in the lifetime of nations, brings us 
to the hysterical England of the Boer war, with its wild alarms 
and fevers, its mad joy of revelry. In our own country we 
have seen the same change of character. Witness an election 
night in New York, or a New Year revel, and be convinced 
that we too are changing in character. Even the medical pro- 
fession is affected by the removal of that inhibition which cul- 
tured people placed upon their emotions and fancies. And 
nowhere is it better exemplified than in the present tendency 
to become alarmed and hysterical over the discovery that we 
have in our midst cases of the disease that has scourged pov- 
erty-stricken Italy, Roumania and Spain. It would cause no 
wonder if the disease were imported, in view of the large Italian 
immigration. To grow hysterical over it and proclaim, as did 
a health officer in Texas, that he believed there were two 
million cases in the South — that is, that one in every ten has 
pellagra — is absurd to the point of being funny. The symptoms 
of pellagra are well marked. Many of our older physicians 
have practiced here forty or fifty years. Had they seen (and 
being far from consultants, they are self-reliant to a degree 
known only to the doctor who practices alone over a large 
county) a condition which produced symmetrical sunburn on 
all exposed surfaces, the hands and arms, chin, back of neck 
and ears, associated with wasting and diarrhoea, such symp- 
toms recurring every spring and disappearing every winter, it is 
safe to say that they would not have been so unobservant as the 
justly celebrated superintendent of that Peoria, 111., asylum, of 
which he is a proper inmate, who discharged several nurses for 

151 


152 


scalding the patients’ arms, and now re instates them on the 
theory that the scalds were pellagra. Scalds, in our experience, 
appear suddenly; pellagra would last over considerable time, 
and a superintendent might by hurrying reach the case be- 
fore it died in two or three months. Yet this is all of a piece 
with the hysterical article in a recent issue of a popular mag- 
azine. with a map of which South Carolina must be proud, 
and which will induce people to visit her( ?). showing her black 
with pellagra. For Mississippi, we deny, and deny with all 
force possible, that pellagra exists an any quantity in our State. 
That cases exist, no one will deny, that it is increasing is pos- 
sible true, but the cost of living is increasing; meat, corn, every- 
thing is increasing while the earning power is lessened. People 
are eating to-day what ten years ago they would have rejected. 
When the glorious day arrives that the condition of our people 
shall approximate that of Italian peasants, while wealth untold 
is possessed by the few, pellagra will be welcomed as a means 
of escape for its termination is insanity, forgetfulness and 
death. 

Myers. 


TOtssisstppi Stats TOsriical ^ssariatirm. 


President D. W. Jones announces two changes in the 
chairmen of sections for the Oxford meeting. Owing to the 
resignations of Drs. Wright and Sadler, Dr. O. X. Arrington 
of Brookhaven is now chairman of the section on dermatology 
and Dr. J. C. McNair of Fayette of the section on materia 
medica. 


Snnthsrn ^llsdical ^ssatiatinn. 


Fditor Mississippi Medical Monthly: 

As I am particularly anxious for all our Mississippi doctors 
to become interested in the Southern Medical Association. I ask 
the privilege of reporting briefly, through the journal, some of 
the features of the recent meeting in New Orleans. 

In the first place, permit me to say, in a general way, that 
this was pronounced the best meeting that this Association has 
had; and that it was to me one of the most enjoyable as well 
as one of the most profitable meetings of doctors that I ever 


153 


attended. My only regret is that so few Mississippians were 
pi’esent to enjoy the good things with me. 

The program was replete with interesting and substan- 
tial numbers and a very large proportion of the essayists ap- 
peared when called. The discussions were free and cordial 
and devoid, in a large measure, of the spirit of rivalry and 
bickering which so often characterizes medical meetings. The 
chairmen were full of inspiration and presided with tact, so 
that the programs swept along without hitches or dull periods. 

It would take too much time to mention all the papers 
worthy of especial note; but I cannot refrain from speaking of 
the addresses of President Savage, Prof. Dyer and Dr. BuBose. 
Dr. Savage reviewed the history of the Association, commented 
upon its value to southern doctors and bespoke for it the sup- 
port of all within its sphere. His address was an inspiration. 
Prof. Dyer delivered an oration which for chaste language, 
beauty of sentiment and perfection of logic approaches the 
classic. Dr. DuBose, in opening the section on surgery, took 
occasion to emphasize the need of such an association as a 
connecting link between the A. M. A. and the State Associa- 
tion, and showed how it would develop southern talent. 

A large part of the program was given to pellagra, malaria, 
tuberculosis and typhoid fevers, in addition to the special work 
in the sections on surgery and ophthalmology. The clinics on 
pellagra and the microscopical demonstrations of the forms of 
malaria were especially good. 

There was not much done of importance as to the policy 
of the Association, except that its journal was discontinued. 
The council recommended that some other states be invited 
to join the association ; but the recommendation was not ap- 
proved. Resolutions expressing appreciation of the gifts of 
Rockefeller, Carnegie and Mrs. Sage were passed. 

Our TV. TV. Crawford was elected president of the Associa- 
tion, a compliment well deserved by him. Dr. Dowling was 
re-elected secretary. Nashville was selected as the next place 
of meeting. 

Any report of this meeting would be incomplete that did 
not praise the generous manner in which the visitors were 
entertained by the fraternity and the people of New Orleans. 
The New Orleans doctors were unceasing in their attentions 
and courtesies, both as a profession and as individuals. Special 
mention should be made of the “smoker” by the Orleans Parish 
Society; of the luncheon by the Staff of Touro; and of the 
numerous courtesies, including luncheons, by the Tulane 
faculty. 

But pi’incely as was the entertainment by the New Orleans 


fellows, I hear that Nashville has proposed a “raise”. Let us 
all go up next year and “see” their “bid”; and if our “hand” 
justifies it, let us “call” them — for the next meeting. At any 
rate, let us join the A. M. A. and help Crawford to make this the 
best year in its history. 

D. W. Jones. 


ShcMd TmtEBiltngs. 


Clarksdale and Six Counties Society will hold its annual 
big meeting at Clarksdale in December. The advance program 
shows twenty papers: Amoebic Enteritis, A. J. Jagoe, Clarks- 
dale; A. Case Of Uraemia Associated With Motor Aphasia, C. 
J. Marshall, Lambert; Elephantiasis, W. M. Carson, Farrell; 
The Use Of Gonococcic Vaccine In Chronic Gonorrhoeal Af- 
fections, S. T. Wells, Alligator; Gonorrhoea In The Male. T. G. 
Hughes, Clarksdale; Clean Up, Clean Out And Keep Clean, H. 
C. Buck, Friar's Point; Uses And Abuses Of Quinine, F. M. 
Brougher, Belen; Hypodermic Use Of Quinine In The Infant 
As Well As The Adult With Especial Reference To Malarial 
Hematuria, E. R. McLean, Cleveland ; The Quinine Treatment In 
Malaria, J. T. Longino, Jonestown ; The Diagnosis And Treat- 
ment Of Thyroidism, B. W. Fontaine, Memphis; The Treatment 
Of Flat Foot, W. C. Campbell, Memphis; The President's Ad- 
dress — Nausea And Vomiting, J. S. Brooks, Robinsonville ; 
Streptococcic Infections Of The Throat, R. McKinney, Memlipis; 
Report Of A Case, L. L. Minor, Hollywood; Treatment Of 
Pneumonia, S. E. Frierson, Lyon; Report Of Cases. B. Malone, 
Memphis; Some Remarks On Pellagra With Proper Report Of 
Cases, A. W. Rhyme, Beulah. Other authors whose subjects 
are not announced are J. W. Primrose, Sarah; J. A. Crisler, 
Memphis; S. W. Glass, Dublin. The usual banquet will be 
held at the conclusion of the meeting. 

L. E. Pierce. 

East Mississippi Four Counties Medical Society met in 
the court house, Tupelo, Tuesday, Nov. 9th., at 2 I*. M., Presi- 
dent Feemster in the chair and the following members and 
guests present : Bryan, Spencer, Sadler, Burns of Memphis, 
Dobbs. Boyl, Farrar, Brand. Durley, Senter, Anderson, Keyes, 
Bonner, Elkin, Tubb, Burdine, Boggan, Furr and Underwood. 
Dr. Burns made an address on surgery, illustrating by several 
specimens. The local physicians entertained at a banquet at 


155 


the Read Hotel. The Society adjourned to meet in Houston 
Tuesday, Dec. 14th., at which time the 1910 officers will be 
elected. 

F. J. Underwood. 

Harrison County Medical Society met Nov. 9th. in Gulf- 
port at the rooms of the Commercial Union, Dr. Lebaron, pres- 
ident in the chair. Those present were Drs. West, Lebaron, 
Cappa, Sheelv, Richardson, Parker, Rowan, Folkes. There were 
no clinics or report of cases. Dr. Capps read a paper on tape- 
worms. He treated the subject exhaustively, telling of all the 
various varieties, cause and method of treatment. Dr. Folkes 
stated that tape-worms are not so common as Dr. Capps’ paper 
would lead a person to infer. He thought they are more com- 
mon among foreigners. He told of a case where a patient had 
lieen treated by various doctor's for indigestion and recovered 
at once under anthelmintic treatment. Dr. West mentioned 
the frequency among sailors; he had had eight cases on one 
ship. Dr. Sheely related some of his experiences with tape- 
worm. Dr. Richardson spoke of the perverted appetite so often 
found. Drs. Parker, Lebaron and Rowan made interesting talks 
on this subject. Dr. Parker, of the pellagra committee, made a 
report of his progress in arranging for the special meeting in 
December. He told of all the notables who had been invited 
A special arrangement committee was appointed to make all 
other arrangements, Drs. Sheely, Capps and Strange. Dr. 
West, chairman of publicity committee, reported the publica- 
tion of an article on hook-worms and stated the various com- 
ments that had been made. The society has put on foot 
steps for quite a large gathering in Gulfport Dec. 14th., to 
discuss the pellagra situation. 

H. H. West. 

Tri-County (Copiah, Lincoln. Pike) Medical Society 
met in regular bi-monthly session at Brookhaven, October 12th., 
at the mayor’s office. Present : Drs. Arrington, Beavers, Bow- 
man, Dampeer, Dodds, Denman, Frizell, Flowers, Higdon, 
Hewitt, Johnson, Jones D. W., Little E. S., Magee M. M., Magee 
D. W., Martin, McLeod, McRee. Purser, Rice, Rowan, Thomp- 
son F. H„ Thompson F. E. Dr. Martin read a paper on 
‘‘Causes Of Insanity”; Dr. Hewitt on “Treatment Of Insanity”. 
Neither of these papers were discussed, the subject having been 
thoroughly covered by the papers. Dr. Flowers read a paper 
on “Diseases Of The Nose And Throat”, prepared especially for 
the benefit of the general practitioner. Under clinical cases. 


156 


Dr. Denman and Dr. Arrington reported some cases of pellagra, 
now under their care. A general discussion of this subject fol- 
lowed. in the course of which it was brought out that this dis- 
ease is fairly common in this section, about half a dozen cases 
being reported by the members present. The following were 
appointed members of the auxiliary committee on legislation : 
Drs. J. A. Rowan. W. H. Frizell, Thos. Purser. The general 
program committee was instructed to prepare and have ready 
for distribution at the next meeting a Course Of Study and 
Program for 1910. Following committee on entertainment for 
an annual meeting in December was appointed : Drs. Frizell, 
Higdon and Johnson. Next meeting at Brookhaven, Dec. 14th., 
at 2 P. M. 

D. W. Jones. 


33rrrrk xzvaz. 


TUBERCULOSIS. A Treatise By American Authors On Its Etiol- 
ogy, Pathology, Frequency, Semeiology, Diagnosis, Prognosis, 
Prevention and Treatment. Edited by Arnold C. Klebs M.D. 
With three colored plates and 243 illustrations in text. D. Appleton 
& Co., New York and London. 1909. Price $6.00. 

Arnold Klebs has given us a valuable book. Some of the 
authors are not so well known and many well-known ones are 
missed. When we consider that many of these have written 
books of their own. and good books, on tuberculosis, this is 
easily understood. There cannot be too many good books on 
tuberculosis. This one is comprehensive, fully up to date, and 
handles the various subjects in an attractive manner. Some 
of the things the general practitioner should know more about 
are, early diagnosis, climatology, rational hygiene, differentia- 
tion of type and specializing of treatment. The present-day 
idea of tuberculosis is that it is a case for milk, raw eggs and 
fresh air, like syphilis is deemed nothing but a question of 
mercury and iodides; “malaria”, calomel and quinine. The 
epitomizing of treatments cannot be too strongly condemned. 
The physician should know all about tuberculosis. He will 
know much after studying this work. 

Krauss. 


PRACTICAL DIETETICS With Special Reference To Diet In 
Disease by W. G. Thompson M.D., Professor of Medicine in the 
Cornell University Medical College, etc. Fourth edition, illustrated, 
enlarged and completely re-written. D. Appleton & Co., New York 
and London. Price $5.00. 

That the present edition brings the total of copies up to 




157 


thirty thousand is evidence enough that the book is popular. 
We are too apt to limit our instructions regarding diet to “give 
only liquids”, “let it be a light diet” and “avoid greasy food”, 
and imagine that we have done all that is necessary. When 
we read this book we learn differently. 

Howard. 


THE DIAGNOSTICS OF INTERNAL MEDICINE by G. R. Butler 
M.D., Sc.D., L.L.D., Physician-in-chief, Methodist Episcopal Hos- 
pital; Attending Physician to the Brooklyn Hospital, etc. With five 
colored plates and two hundred and seventy-two illustrations and 
charts in the text. Third revised edition. D. Appleton & Co., New 
York and London. Price $6.00. 

This is by long odds the best work on diagnosis that the 
reviewer has ever seen and one that should be in the library of 
every practitioner of medicine, not on the shelf but on the 
table where it may be consulted daily. Each step in diagnosis 
is made clear, each point emphasized and its value explained 
fully. The man who studies it carefully can leave his patient 
with a clear conscience and meet his consultant without hesita- 
tion. The hospital resident will find it a Godsend and the gen- 
eral practitioner cannot get along without it. The illustrations 
are excellent and really illustrate. The presswork is typical of 
the publishers. 

Howard. 


RENAL, URETERAL, PERIRENAL, AND ADRENAL TUMORS 
AND ACTINOMYCOSIS AND ECHINOCOCCUS OF THE 
KIDNEY by Edgar Garceau M.D., Visiting Gynecologist to St. 
Elizabeth’s Hospital, and to the Boston Dispensary, Boston, Mass.; 
Consulting Gynecologist to the Quincy City Hospital, Quincy City, 
Mass.; Member of the Massachusetts Medical Society, The Boston 
Obstetrical Society, etc; Published by D. Appleton & Co. Price f5.00. 

The classification of tumors is good. The author has only 
given in the text that which has stood the test of the micro- 
scope. Many of the older texts of tumors of the kidney have 
been disregarded for they were already hopelessly confusing. 
The chapters on carcinoma, sarcoma and adenoma of the kid- 
ney are exceptionally good. There are some seventy -two illus- 
trations and the book is well arranged. 

Martin. 


INTERNATIONAL CLINICS. A Quarterly of Illustrated Lectures 
and Especially Prepared Original Articles. Edited by W. T. Long- 
cope M.D., Philadelphia. Vol. Ill, Series 19. J. B. Lippincott Co., 
Philadelphia. Price $2.00. 

This issue contains an unusually good set of papers. In 
them is remarkably illustrated the trend of the present day 

2— M 


158 


towards a conservative consideration of the patient as a whole, 
in contradistinction to the plan, so common in recent years, of 
considering only, or rather almost exclusively, the diseased part 
or organ. This is of course less marked in the pages devoted 
to surgery but it is a sign for hope to note that it has crept into 
those on gynecology. 

Howard. 


HISTORY OF YELLOW FEVER by George Augustin, with collabora- 
tion of Drs. G. Farrar Potton, Quitman Kohnke, O. L. Pothier, Ham- 
ilton P. Jones, L. F. Salomon, Charles Chassaignac, Fred J. Mayer, 
Henry Dickson Bruns, Louis G. LeBeuf, Jules Lazard and Sidney J. 
Theard. Published for the author by Searcy & Pfaff, New Orleans. 
1909. Price $6.00. 

Since the days of LaRoche there has been no such monu- 
mental work on yellow fever as this one of Mr. Augustin. Not 
alone a history of yellow fever, it begins with general observa- 
tions on epidemics, gives briefly the story of the great epidemics 
of the middle ages, and then takes up the insect transmission 
of the disease. The second part is devoted to a discussion of 
the origin of yellow fever. This is followed by a most ex- 
haustive history of yellow fever by localities, in Asia, Africa, 
Europe and North and Central America. The United States 
is covered state by state. The immense amount of research 
involved in such a history is apparent. The fourth part is a 
history of the the yellow fever epidemics of 1905, and part fifth, 
some seventy pages, is devoted to the modern theories concern- 
ing yellow fever. This volume of one thousand one hundred 
and ninety-four pages is therefore complete in all details and 
must form a part of the library of all interested in that awful 
scourge, which we hope to have conquered for all time. We 
cannot pass this book, however, without expressing a sincere 
regret that it did not fall into the hands of a better publisher, 
one who had some idea of the size of type, arrangement of stat- 
istics, etc. The book is marred by the publisher having used 
several different colors of paper and various fonts of type, now 
large as circus type, now small as brevier. The hand of an 
Appleton or Saunders would have made a different work of it. 
But the facts, collected and correlated, remain, and will be an 
imperishable monument to Geo. Augustin. 

Myers. 


THE PRACTICE OF MEDICINE by James Tyson M.D., Professor 
of Medicine in the University of Pennsylvania, etc. Fifth Edition. 
P. Blakiston’s Son & Co., Philadelphia. Price $5.00. 

This old friend again appears with the changes necessary 


159 


to bring it fully abreast of the times. It needs no introduction 
since it has been for thirteen years one of the popular works 
on practice; used as a text by students and a reference by prac- 
titioners, reliable and trustworthy, “a very present help in time 
of trouble”. There have been many changes from old editions, 
such as the treatment of tuberculosis and the infectious diseases 
generally, diseases of the stomach and of the circulatory and 
nervous systems. Its admirers will find it as reliable as of yore 
and the new edition will no doubt receive as warm a welcome 
and enjoy as great a popularity as did its predecessors. 

Howard. 


THERAPEUTICS; ITS PRINCIPLES AND PRACTICE. By H. 

C. Wood M.D., L.L.D., Emeritus Professor of Materia Medica and 
Therapeutics in the University of Pennsylvania, etc. Thoroughly 
revised and re-written by Horatio C. Wood, Jr. M.D., Associate Pro- 
fessor of Pharmacology in the University of Pennsylvania, Assistant 
Physician to the General Hospital. Fourteenth Edition. J. B. 
Lippincott Co., Philadelphia. 

The mere announcement of another edition of the work of 
the ‘‘Father of American Therapeutics” is stifficient to create 
interest in the ranks of the medical profession, for to it the 
great majority turn for guidance and inspiration in matters 
of treatment. Every revision brings it squarely up to date, 
and no one is disappointed in looking for what he seeks in 
this work, one of the really few landmarks in American scien- 
tific investigation. It is no small thing for a book to have 
passed through fourteen editions and still be welcomed by 
every thoughtful practitioner. Of course nothing can be said 
in regard to the arrangement of such a time-tried work. A 
valuable feature for the student is the summary which, in heavy 
type, precedes the therapeutic section, making the very full 
description of experiments clear to the mind. In the hands of 
the scholarly son of the well-beloved emeritus Professor of 
Therapeutics of the University of Pennsylvania, Dr. H. E. 
Wood Jr., the revision leaves nothing to be desired. In con- 
clusion, we may add that the book has been adopted as the 
text-book on Therapeutics in the Medical Department of the 
University of Mississippi. 

Myers. 


THE PRACTICAL MEDICINE SERIES— Vol. VII, Pediatrics: 
Orthopedic Surgery. Series 1909. Price ten volumes $10.00 ; price 
vol. vii $1.25. 

These little volumes give an excellent resume of the year’s 
work in the different branches of medicine and the one now 


160 


under consideration is no exception to the rule. Pediatrics is 
naturally more fully treated than is orthopedic surgery, but 
both departments fulfill the purpose for which they were in- 
tended very creditably. 

Howard. 


DISEASES OF THE SKIN. A practical treatise by Dr. John Shoe- 
maker, Professor of Skin and Venereal Diseases, Materia Medica, 
Therapeutics and Clinical Medicine in the Medico-Chirurgscal Col- 
lege,, Philadelphia. Fifth Edition, Revised and Enlarged. F. A. 
Davis Co., Publishers, Philadelphia. 

The fifth revised edition of Shoemaker’s already well- 
known text-book on skin diseases is a book that has genuine 
merit, up to date in matter of text, clearly and generously 
illustrated according to the modern idea and well worthy of 
general adoption by students and general practitioners. The 
chapter on therapeutics of the application of remedies to the 
treatment of these special diseases is to be especially com- 
mended. 

Fox. 


THE EXAMINATION OF THE FUNCTION OF THE INTES- 
TINES BY MEANS OF THE TEST DIET. By Prof. Dr. Adolf 
Schmidt, Halle, A.S. Translated by Chas. D. Aaron M.D.. Professor 
of Diseases of the Stomach and Intestines in the Detroit Post-Grad- 
uate School of Medicine. F. A. Davis Company, Philadelphia. 

The author considers the test diet, the examination of the 
feces and the significance of pathologic findings therein, de- 
scribes the intestinal disturbances due to disorders of stomach, 
liver and pancreas, and finally takes tip the independent dis- 
turbances of the intestines, functional and organic, making a 
very complete treatise on enterology. Howard. 


HUSSIS5IPP) DIEDICOL IHOMIHLT 


VOL. XIV. JANUARY 1910. No. 9 


PRESIDENT’S ADDRESS BEFORE THE TRI-COUNTY MEDI- 
CAL SOCIETY, DECEMBER 14th. 1909. 

J. H. JOHNSON M.D., 

BROOKHAVEN. 


Gentlemen : 

To-day marks the third anniversary of the Tri-County Med- 
ical Society, an organization in which every member takes a 
pardonable pride. Prior to this time, we had separate county 
organization; but the more progressive members of the pro- 
fession, feeling that they were not deriving the full measure of 
organized medicine, and realizing that in unity there is 
strength, proposed a union of the county societies of Copiah, 
Lincoln and Pike, which object was accomplished at a meeting 
held in Brookhaven, July 1906, with twenty members present. 
From this small but enthusiastic beginning, the membership 
gradually increased until we now carry on our roll, as true and 
loyal members, nearly every doctor within the confines of three 
counties, and I may well say that the large majority actively 
participate in the workings of the organization. 

During the three years of our existence we have never 
failed to meet at the appointed time and place, nor have we ever 
failed to carry out a designated scientific program. We have 
the distinction of being the first organized medical body — and 
I believe the only one in the state — to direct the public ear to 
matters pertaining to public health. This meeting, as you re- 
member, took place August 1907, at the Crystal Springs Chau- 
tauqua, when a symposium on tuberculosis was read by mem- 
bers of this society and distinguished colleagues from New Or- 
leans and Memphis. 

This innovation elicited a great deal of favorable comment 
at the time, and had it been generally adopted by other societies 
throughout the state, on subjects pertaining to preventive dis- 
eases and public health, I am of the firm opinion would have 
been productive of great good. 

The year 1908 found us no less enthusiastic, attendance 


161 


162 


being good and work thorough. This brings us, briefly, down 
to the beginning of the present administration. 

I wish to express my thanks for the honor which you have 
conferred upon me. I assure you I more than esteem it as 
such. Whatever may be the success attending this administra- 
tion, the credit is due to the individual members, working 
together for the common good. I especially desire to compli- 
ment the younger members for the enthusiasm and active part 
they took in the scientific program ; and. at the same time, 
sound a note of warning to some of the older members that they 
must look well to their laurels. Here let me mention, merely 
to deprecate, the fact that some of our staunchest members, 
who heretofore had scarcely missed a meeting, this year have 
been conspicuous by their absence. I trust that this has been 
due to unavoidable circumstances, and not to lack of interest. 

I feel that I should pause here long enough to lay a tribute 
at the feet of our deceased brethren, Drs. Bennett and Plunkett. 

Dr. Bennett was the sage of our society. Truer man or 
physician never lived. To know him was to love him. Those 
who were his intimate associates will miss his wise counsel and 
helpful sympathy. 

Dr. Plunkett, one of the leading physicians of MeComb, was 
also called to his reward since our last annual meeting. He 
had just reached the zenith of matured manhood, respected and 
loved by a large clientele. 

I shall not dwell upon any special feature of the work of 
this society for the past year, further than to say that it was as 
good as that of any component society of the State Association. 
We are thoroughly in touch with the workings of the larger 
organizations, State and National, and thoroughly abreast of 
advanced thought of the profession in general. 

Our State Association, through its legislative committee, 
is perfecting plans to obtain some much-needed legislation, 
pertaining to public health, among which I mention a statute 
providing for a system of vital statistics, a law requiring a 
diploma from a recognized medical college as a prerequisite for 
license to practice medicine, another requiring the licensing of 
midwives. Our society furnishes one member of the central 
committee and three members of the auxiliary committee. I 
would urge each member of our society to use his influence in 
attaining these much-needed amendments to our now existing 
medical laws, in order to put us in line with our more pro- 
gressive sister states, and lift the practice of medicine from 
a mere means of gaining a livelihood to the exalted position 
which in truth it deserves — the attainment of which should be 
our ideal. 


163 


Our society also furnishes, this year, the president of the 
State Medical Association, one of the vice-presidents and the 
chairmen of two sections. I call upon the membership of this 
society to rally to their support in their efforts to make this the 
“best year in the history of the Association”. Let as many as 
can do so make their arrangements to attend the Oxford 
meeting. 

In this connection, I would like to commend to your favor- 
able consideration the newly-organized Southern Medical Asso- 
ciation. This, as you know, embraces the states of Mississippi, 
Louisiana, Alabama, Florida, Georgia and Tennessee, and is 
now in its third year. It carries on its roster the names of the 
leading men in the profession in the south. The president for 
1910 is a Mississippian, a former Pike County boy, Dr. W. W. 
Crawford of Hattiesburg, and the councilor for Mississippi is 
our secretary, Dr. D. W. Jones. I would be glad to see more of 
our members take an active part in the work of this Association. 
The next meeting will be held at Nashville, in November. 

I feel that I cannot close this address without saying a 
word in commendation of the work of the local doctors’ clubs 
of Brookhaven and McComb. I am more familiar with the club 
at Brookhaven, and would like to tell you something of its 
work. We meet once a week, at which time an hour or two is 
devoted to scientific work, usually in the shape of a quiz, with 
a regularly appointed quiz-master and subject selected at the 
previous meeting; and every member is expected to know his 
lesson ! We find these meetings not only profitable, stimulating 
study and keeping us in touch with the progress of medicine 
and surgery, but also a source of great pleasure, bringing us in 
closer touch socially, where we learn to know each other better, 
and thus learn to appreciate each other more, thereby prevent- 
ing the misunderstandings so common among doctors. I com- 
mend the organization of such clubs wherever feasible. 

And now, in closing, allow me to express my appreciation 
of the cordial support which you have given this administration, 
and to bespeak for my successor a continuance of the same. 


NOTICE. 

The secretary of the State Medical Association requests 
that he be promptly informed of the election of the 1910 county 
officers. There is much business, and of importance, for the 
new year and it will be much handicapped if the Association 
officers are kept in ignorance as to who are guiding affairs in the 
different counties. 


164 


*SOME PHASES OF ECTOPIC GESTATION. 


BATTLE MALONE B.A., M.D., 

MEMPHIS, TENN. 


In bringing up for discussion to-niglit the subject of extra- 
uterine pregnancy I will limit myself to those phases which are 
of most interest to the general practitioner; namely the diag- 
nosis and treatment. From a practical standpoint we are more 
interested in how this condition is to be recognized and treated 
than in an academic discussion of its etiology, varieties, etc. 

It is usual to consider this subject under the classification 
of cases seen preceding rupture and those seen at the time of 
or subsequent to rupture. It is rare for one to make a diagnosis 
of tubal pregnancy before rupture, chiefly because the patient 
does not consult a physician at this period of the trouble. She 
likely thinks herself pregnant and during the first few weeks 
notes nothing abnormal. If, however, for any reason an oppor- 
tunity for examination is offered at this time the following 
points are to be observed: there has probably been a previous 
pelvic inflammation; there is frequently a history of several 
years of sterility; one menstrual period has been missed — some- 
times more; the early evidences of pregnancy are present; the 
patient complains of more or less pelvic discomfort, or slight, 
vague colicy pains, beginning four or five weeks from the time 
of conception ; about the latter date there is an irregular uterine 
bleeding. Bimanual examination at this time would reveal a 
small mass to the side of and close to the uterus. It is of great 
help if the ovary on the same side can be distinctly palpated. 
The vaginal examination should be conducted as gently as pos- 
sible, as frequently the already over-distended tube has been 
ruptured by the manipulation. Diagnosis before rupture is 
greatly to be desired, as of course operation and removal of the 
tube at the time would be attended with practically no risk to 
the patient. 

If we do not see the case until after rupture we have in 
addition to the history as above outlined a further history of 
sudden, sharp pain followed by shock of greater or less degree. 
The collapse following rupture is of course due in great part to 
hemorrhage, and the amount of hemorrhage is dependent upon 
whether the rupture is extra- or intra-peritoneal, and the bleed- 
ing is usually even still less when there is simply a tubal abor- 
tion, but it must not be overlooked that shock per se is as im- 
portant and often the most important element in producing the 
collapse developed at the time of rupture. We are accustomed 

♦Read before the Clarksdale and Six Counties Medical Society. 


165 


to regard severe shock as a necessary and constant accompani- 
ment of rupture, and in lesser degree of tubal abortion. This 
is not true. I do not think that we could have an intra-peri- 
toneal rupture without collapse, but I recall a recent case in 
which I made a diagnosis of tubal pregnancy, as I thought be- 
fore rupture, because there had been no sudden, sharp pain and 
shock. Operation showed that there had been a tubal abortion 
two weeks before. In another case there was extra-peritoneal 
rupture and a haematoma occupying almost the whole pelvis, 
and no history of collapse. These cases, as well as others, 
taught me not to regard shock as a sine qua non in the symp- 
tomatology of rupture. In the absence of this symptom we 
must rely upon the history of the case and upon what is re- 
vealed by the bimanual examination. In those cases exhibiting 
little or no evidence of shock — usually cases of tubal abortion 
— the patient may go on to complete recovery with absorption 
of the blood, and gestation sac, or if infection occurs there is 
pelvic inflammation and abscess formation, usually pointing in 
Douglas’ pouch. It seems to me that the one thing of most im- 
portance in the history of these cases is the irregular flow after 
the menstrual period has been passed — especially if the decidua 
is recovered from the discharge. This flow is too fi’equently 
mistaken for evidence of a threatened uterine abortion. The 
character of the flow is different, it is rarely so great in amount 
and the uterine contractions and bearing-down pains are absent. 
Another difference which I have never seen mentioned, and 
which is based on the observation of a few cases, not sufficient 
to permit of its statement as a fact, is that there is not the 
passage of clots in the flow of tubal pregnancy which is so char- 
acteristic of uterine abortion. An accurate history, then, and 
a careful examination are essential if we are to recognize 
ectopic gestation before rupture. In a typical case, seen at the 
time of rupture, there seems little excuse for failure to make a 
correct diagnosis. In the atypical cases the history carefully 
taken should usually put one on the right track. 

The treatment of tubal pregnancy should, with few excep- 
tions, be the removal of the products of conception by ab- 
dominal section, the time of the operation depending entirely 
upon the condition of the patient at the time seen. If diagnosed 
before rupture there is no argument as to what course to pur- 
sue. Laparotomy should be performed as early as is compat- 
ible with the proper prepax*ation of the patient, for we know 
not when the rupture will occur nor what will be the conse- 
quences. 

If seen at the tixne of rupture there is a diversity of 
opinion as to whether the patient should be subjected to im- 


166 


mediate operation in the presence of shock or whether we 
should await a reaction. If we could know whether the rupture 
was intra- or extra-peritoneal we would operate on the one class 
and wait on the other, but few surgeons are so astute as to 
differentiate between the two forms from the outside. Those 
who advocate immediate operation do so on the ground of fear 
of fatal hemorrhage, but it seems to me that if hemorrhage per 
se is to prove fatal the patient in the vast majority of cases 
would be moribund before a surgeon could be called and make 
the needed preparation for celiotomy. On the contrary I think 
it is exceedingly rare that the hemorrhage is sufficient to prove 
fatal, arid that there is much greater danger from added shock 
due to operation than from hemorrhage. Personally I have 
never seen one of these patients die. I have always waited and 
have been rewarded by seeing spontaneous arrest of bleeding 
and complete recovery from shock, and have operated when it 
could be done with safety. It must be admitted that in await- 
ing reaction we are harassed by the fact that these cases are not 
amenable to the customary methods of treating shock ; we have 
learned to rely chiefly upon the intravenous injection of saline 
and adrenalin in treating shock, especially when there is bleed- 
ing, but the danger of washing out the clots which may have 
formed and thus increasing the hemorrhage, is too great to per- 
mit of the use of these measures when the vessel has not been 
clamped. Nothing which increases arterial tension should be 
used. We must in these cases fall back on nature, and as usual 
the kindly dame does not disappoint us. If the patient is kept 
elevated, and morphine given, she will invariably rally and the 
operation can be performed with a greater degree of safety. 
Usually we can wait several days until reaction is complete, 
always bearing in mind the possibility of recurring hemorrhage, 
or secondary rupture, if it has been primarily extra-peritoneal. 

If the case is not seen, or the condition not recognized, until 
later, and infection has taken place and we find a pelvic abscess, 
this can probably be emptied by vaginal section. 

I have failed to make mention of the form of treatment ad- 
visable in advanced growth of the embryo, for any discussion 
of this point on my part would be entirely theoretical. I have 
had no personal experience with a case of ectopic pregnancy 
which has gone past four months. The handling of a live pla- 
centa during the later months of pregnancy presents as danger- 
ous and perplexing problems as a surgeon is ever called on to 
solve. No rules for guidance can be laid down, as every case 
has to be handled in accordance with conditions peculiar to 
itself. The continued growth of the embryo is, I believe, and 
ought to be less and less frequent, since improved methods of 


167 


diagnosis and more careful observance of the irregularities 
which are early manifested will lead to recognition and proper 
treatment in the second and third months of pregnancy. 


* NAUSEA AND VOMITING. 


J. S. BROOKS M.D., 

ROBINSONVILLE. 


Nausea is one of the most perplexing conditions that con- 
fronts the busy doctor and one of the most distressing that he 
is called upon to treat, and vomiting is only a symptom of a 
large number of diseases and does not necessarily imply that the 
stomach itself is diseased. 

The physician may find nausea as a complication in almost 
any disease. Sometimes it yields to treatment readily and then 
again it may become one of the most stubborn conditions, resist- 
ing almost every treatment laid down in the Pharmacopoea. It 
is not a disease within itself, but a symptom of some patho- 
logical disturbance of the human economy, not so easily ac- 
counted for upon scientific principles but, luckily for the doctor, 
one for which he may ascribe many reasons to his unsuspecting 
patient, none of which may be scientifically correct but which 
satisfy the patient, a condition sometimes to be eagerly desired. 

Let us take a short review of the anatomy of the stomach. 
It is composed, as we all know, of four coats: serous, muscular, 
submucous and mucous. You are all too well informed on the 
anatomy of this organ for me to take up your time in discussing 
in detail the composition of these several coats and the relation 
they bear, the one to the other. 

It is the structure of the mucous coat or membrane that 
concerns us most in the discussion of our subject. This mem- 
brane, when examined under a microscope of moderately low 
power, presents a rather peculiar appearance, showing depres- 
sions and elevations. In the bottom of these depressions may 
be seen the orifices of the gastric follicles, situated perpendicu- 
larly throughout the entire substance of this membrane. The 
gastric glands lie beneath these depressions and these follicular 
orifices are the outlets of this glandular substance, whatever 
that may be. 

There are two varieties of the gastric glands, differing some- 
what in their structure, and it is believed by some authorities 

* President’s Address Before The Clarksdale And Six Counties Medical Society. 


168 


that they differ in the nature of their secretions also. One 
variety is grouped about the pyloric end of the stomach ; called 
pyloric glands. They secrete a serous substance and are com- 
posed of columnar and cubical cells, which gives them a finely 
granular appearance. The peptic glands are scattered somewhat 
more profusely over the surface of the stomach and, like the 
pyloric glands, consist of extremely short ducts into each of 
which open two or more fine tubes. The peptic cells lie for the 
most part between the epithelium and the basement membrane, 
presenting a granular appearance. 

The blood supply of the stomach is from the gastroepiploica, 
indirectly from the coeliac axis as this short artery divides into 
the gastric, hepatic and splenic. The gastric divides into the 
gastroepiploica dextra and sinistra, one branch running to the 
right and the other to the left as their names indicate. The 
former runs along the greater curvature of the stomach and 
anastomoses with the latter, which passes along the lesser curva- 
ture, its branches lying between layers of the omentum, supply- 
ing both surfaces and anastomosing with branches from the 
splenic artery. 

The stomach gets most of its nerve supply from the tenth, 
or pneumogastric, nerve. Branches of the sympathetic also 
ramify the entire substance as well as the muscular and mucous 
coats of the stomach. Through the anastomosis of these two 
great nerve systems, every cell and fibre of the stomach are 
directly or indirectly connected. 

Now any substance taken into the stomach which may irri- 
tate or congest these membranes, or any condition that may 
disturb the equilibrium of this complex nerve supply, produces 
a condition which we call nausea, and an exaggerated state of 
this condition results in the effort of vomiting. This nausea 
exists in different degrees of intensity. A stomach may become 
slightly irritated and a little nausea result, but not sufficient 
to produce the effect of vomiting. The irritation, however, may 
become more extensive and the nausea more pronounced until 
outraged nature attempts to remedy the condition by emptying 
the stomach of the offending substance. This emptying of the 
stomach, with its attending muscular efforts, we call vomiting; 
a purely mechanical effort, whether excited by the motor or 
sensory fibers, and in itself sometimes simple and sometimes ex- 
tremely grave. An instance of this is the vomiting of pregnancy, 
which is sometimes a very simple condition, hardly calling for 
remedial interference, and again so grave as to endanger the 
life of the patient and necessitate the termination of the preg- 
nancy, sacrificing the life of the foetus to preserve that of the 
mother. Where is the physician who has not been called upon 


169 


to wrestle with this distressing problem which sometimes resists 
not only his best efforts but almost everything known to medical 
science. 

The imagination often plays an important part in this com- 
plex condition. In cases of hysteria, for example, you may take 
a small piece of bread and make a half dozen pills, putting 
them in an absolutely clean box and dusting them with a little 
flour, ask a patient whose stomach is easily upset to swallow 
three in succession, one at a time, casually remarking that they 
may make the patient a little sick, and the chances are five to 
one that the patient will vomit before the third pill has been 
swallowed. Of course you must not tell the patient that they 
are counterfeit. Now we all know that there is nothing in the 
bread pill to irritate the stomach, yet a pill of any kind is so 
revolting that the stomach rebels. 

It would be trespassing entirely too much on your time for 
me to attempt to enumerate the various causes of nausea, with 
which you are all so familiar, but instead I will attempt to re- 
view briefly some of the methods of treatment of this trouble- 
some condition. 

First I would suggest that you try to observe the cause, if 
possible, and remove it, which we all know is sometimes ex- 
tremely difficult. If the offending substance should be an irri- 
tant poison or tenacious mucus, it would be good treatment to 
empty the stomach with an active emetic and then wash it out 
with hot water, which may be accomplished by the aid of a 
stomach tube or by putting in large quantities of tepid water, 
and when the offending substance has been removed you should 
exhibit some bland substance such as cerium oxalate, bismuth 
subnitrate or carbonate of soda, or you might anesthetize the 
gastric mucosa with minute doses of a four per cent, solution 
of cocaine or exhibit morphine hypodermatically in quarter 
grain doses until the stomach is settled, though I should not 
advise the repetition of the morphine in less than three or four 
hours. Sometimes counter-irritation has a very happy effect. 
A sinapism or turpentine stupe may be applied, but I would not 
advise blistering. 

I hope this paper will elicit some important suggestions 
in the discussion that may follow, for this is a subject of very 
great importance to the general practitioner and one upon 
which volumes could be written. I have been unable to treat it 
with any degree of thoroughness, and only hope for an active 
discussion. 


170 


* DIAGNOSIS OF CHRONIC GONORRHEA. 


B. H. DURLEY B.S., M.D., 

ABERDEEN. 


Probably no other one of the known agents of infection 
has had its pathologic role so enlarged as has the gonococcus, 
and in social status it may now be said to occupy a position 
quite in excess to that of the tubercle bacillus. There is no 
infection that is so common to us all and the diagnosis so im- 
portant as this one, especially in the chronic form. I think 
almost anyone can diagnose an acute case by the symptoms and 
history, and as easily treat it, whether we cure it in this stage 
or not. In this paper I mean to treat of those cases where you 
have no history of infection, and half of the patients will tell 
you that they never had anything of the kind in their lives, nor 
have you very many symptoms to be governed by; you may re- 
sort to the microscope and examine the discharge with no 
results, the diplococcus not being found. Even milking the 
prostate and examining the secretion, you cannot find the gon- 
ococci in the pus obtained. The prostate is enlarged and 
palpable and furnishes a great opportunity for making an error, 
as considerable induration and enlargement may exist without 
the gonococci, while a small, apparently normal organ may con- 
tain them. As I have previously said, you may not have the 
symptoms, only a muco purulent, scanty discharge occurring 
in the morning, a burning sensation along the course of the 
urethra and there is frequently a slight dribbling of urine at the 
end of micturition. 

In chronic urethritis, the case may be so mild as to have 
no symptoms beyond a turbidity of the urine, due to shreds and 
pus. It is these cases that are so very difficult to get to and if 
they are rot diagnosed and treated will go on for years without 
notice and will infect many others, without such intention. So 
in order to get to these cases it is necessary for us to devise 
some routine means of determining whether they are due to 
gonococci or not. 

My method, for these cases, if I suspect anything, and I 
usually do when 1 find an individual with a muddy urine, or a 
slight discharge, is to make a smear and examine by means of 
the microscope, thus determining the presence or not of the 
gonococci. If the result is negative and the smears from the 
prostate obtained from milking same are also negative, I usually 
inject into the anterior and posterior urethra a small amount 
of silver niti*ate solution, the strength depending on eireum- 

* Read before the East Mississippi Four County Medical Society. 


171 


stances, bj means of a syringe and rubber catheter, thus start- 
ing up an acute inflammation of the urethra. I then have the 
patient to urinate, milk down some of the secretion from the 
prostate into the urethra, sealing the meatus up with collodion 
adhesive and allow to remain until the patient is compelled to 
urinate the next time. Then open and collect secretions and ex- 
amine by means of the microscope. As everyone knows there is 
no better medium for gonococci than an inflamed urethra and 
if the secretions are retained therein, the few gonococci con- 
tained in the secretion will proliferate under such pleasant en- 
vironments, even if they were inactive before. Under these cir- 
cumstances they are much more easily seen, because there are 
more of them and they are more evenly distributed over the 
field. If the first is negative, take smears at twelve, eighteen, 
and twenty-four hours and examine. You will find that lots of 
latent cases, that we think are cured, having discharged them 
and given our consent or permission for them to marry and 
copulate at their pleasure, are not cured at all, but are just 
as able to convey the germ as ever. 

The pus is obtained from the urethra in the manner de- 
scribed, being just as careful as possible to prevent contamina- 
tion. Place on a clean slide, spread, dry, fix by heat and 
stain with any of the analine dyes, as gentian, violet and 
fuschin. I use ordinarily a watery solution of methylene blue, 
stain for one-half minute, wash dry and examine with an oil 
immersion lens. If the gonococcus is present it will present the 
following charcateristics : First. It is a diplococcus, coffee- 

bean shaped with flat sides, together, the couple forming an 
ovoid. Second. They are grouped in pairs, fours and multiples 
of two. Third. It is found both within and without the pus 
and epithelial cells. If not satisfied with your diagnosis, you 
can stain with Gram’s stain to differentate from the other cocci, 
the gonococci being decolorized by Gram. If you stispect gon- 
ococci, stain with Bismark brown, which colors the gonococcus 
and pus a light brown tint, while the pseudo takes a deep purple 
in marked contrast. 

Another thing to take into consideration after the diag- 
nosis of urethral discharge is where does it come from? 
Whether the discharge is from the anterior urethra or entirely 
in the posterior urethra. We can decide this in several ways 
if we have an urethroscope handy. The anterior can be exam- 
ined very satisfactorily providing the discharge is not too abun- 
dant. The instrumentation must be done very carefully, be- 
cause improper instrumentation may intensify inflammation 
and lead to abscess, stricture and the like. In these cases the 
discharge must be reduced by general and local treatment, then 


172 


use the urethroscope. The ulcers are very easy to see after you 
have become usd to the urethroscope. The second method and 
the most common to all of us is the two-glass test, in which by 
allowing the patient to pass several ounces of urine in one 
glass, we then have the washings of the anterior and posterior 
urethra, usually very muddy in appearance. Now draw off the 
rest in a second glass and if it is muddy, showing pus, the 
evidence is in favor of posterior urethritis or that the pus 
comes from higher up above the vesical neck, from the bladder, 
ureter or kidney. This test is not always true because the con- 
tents of glass number one may contain all the contents of 
anterior and posterior urethra, so in order to avoid this you 
may wash out the anterior urethra down to bulb, with boric 
acid solution, then if first glass is purulent it speaks for pos- 
terior involvment also. The third test then can be used to 
differentiate, by using an injection to permanently color the 
anterior shreds. Permanganate of zinc, one to five hundred, is 
preferable. Inject into the anterior urethra and hold for half 
a minute, then half an hour later examine the patient. It 
will be found, if he has chronic anterior urethritis, that some 
of the urethral shreds will be colored brown. These procedures 
seem to be long and difficult to us all, but they are not so 
difficult but that all of us can do them in a short while. I 
do not think it necessary to do all of these tests, but I think 
we owe as much to our fellow-man and the generations to 
follow, to carefully and conscientiously look into these cases 
of chronic form. Diagnose them and prevent the spread of the 
disease by proper treatment, and advise your patient not to 
marry until cured, and be as careful as possible in every way. 
Thus, by prophylaxis, we may lessen the existing conditions. 


CHAIRMEN OF SECTIONS. 


Medicine 

. B. L. Culley 

Jackson 

Snrcrprv 

. F. M. Sandifer. . 

Greenwood 

Obstetrics 

.G. S. Bryan 


Ovnnppnlnorv 

. T. M. Jones 

Hernando 

Materia Medica 

. J. C. McNair .... 

Fayette 

Ppdifltrirs 

. J. M. Dampeer. . . 

. .Crystal Springs 

Nervous Diseases 

. G. W. Stephens.. 

Meridian 

Venereal Diseases 

. Robt. Donalb. . . . 

Hattiesburg 

Hvgiene 


Natchez 

Dermatologv 

.0. N. Arrington . 

Brookhaven 

Bacteriology 

. W. S. Leathers . . 

University 

Eye, Ear, Nose, Throat. 

. D. G. Mohler. . . . 

Gulfport 

Electro-Therapeutics . . 

.Rosa Wiss 

Meridian 

Tuberculosis 

. P. R. Brown 

West Point 


173 


THE DOCTOR’S WIFE. 


C. H. RICE M.D., 

McCOMB CITY. 

Tri-County Banquet. December 14th, 1909. 


I responded to this toast 
Two years ago to-night, 

And spoke with touching pathos 
Of the single doctor’s plight. 
Spoke of his lonely struggles 
In this world without a wife, 

And finished strong by saying, 

“She is the doctor’s life.” 

I was then a bachelor, 

Had not yet begun to live, 

And all I knew of a doctor’s wife 
Was what my dreams could give. 
And so I hoped and prayed for life, 
And dreamed and dreamed until 
I found that I was married, 

And “Of the same opinion still”. 

But there is one thing puzzling, 

That I’ve wondered much about; 
Why do the sweetest women 
Always pick a doctor out? 

No matter whom the doctor, 

Or how lowly he be born, 

He always gets the fairest rose, 
While some layman gets a thorn. 

There seems to a something 
That other men have missed ; 

Some charm about the doctor 
That women can’t resist. 

It passeth understanding, 

I think it always will, 

Why a woman is so willing 
To get married to a pill. 

Seems to me were I a maiden, 

Fair and sweet as any rose, 

And a doctor came a-courting, 

I would simply lift my nose 


174 


And sniff the air while saying: 
“Sir, my heart could ne’er compel 
My nose to get accustomed to 
The way you doctors smell !” 

Surely ’tis a wondrous love 
That naught can ever stop — 
Though we stay at the ladder’s foot 
She thinks we’re at the top ! 

And when we’re losing patients. 

See them dying one by one. 
Though others scoff, she tells us, 
“The Lord's will be done.” 

To-night while we are drinking 
To the wives we left behind, 

We know that they love us 

And we know that love is blind ; 
So let’s make new resolutions, 
“Hitch our wagons to a star”, 
And do our best to ever be 
Just what they think we are! 

To know just why they love us 
Is a thing we can’t expect — 

For the heart that loves the doctor 
Is the heart we can't dissect. 

So now let’s lift our glasses, 

While the sparkle’s in the wine, 
And drink with humble reverence 
To your wives and and to mine. 


NOTICE. 

Dr. Wm. Krauss, Dean and Professor of Pathology of the 
Medical Department of the University of Mississippi, will de- 
liver a public address at Greenville, Tuesday, January 4th., on 
“What The Public Should Know About Tuberculosis”, under 
the auspices of the Washington County Medical Society. Dr. H. 
L. Sutherland of Kosedale and a number of other distinguished 
physicians will speak on other phases of the fight against tuber- 
culosis, and the occasion will offer the citizens of Greenville an 
opportunity for learning how to promote the public health of 
the community such as is seldom enjoyed. 


MISSISSIPPI RIEDIC1L fflONTHLY. 


E. F. HOWARD B.S., M.D., Editok and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 


OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


One of the curious phases of the workings of the human 
mind is seen in the attitude of some of the public officials in 
their interpretations of the Pure Food Law. 

In a country like ours, new, crude and essentially het- 
erogeneous, of course, the medical profession has understood 
that the Pure Food Law would not alone meet with opposition 
in becoming a law but would also be in constant jeopardy from 
a series of insiduous and circuitous attacks which the alert 
American mind would constantly invent to accomplish its over- 
throw. As an evidence of this may be cited the workings of 
the Referee Board in their attitude on the question of the use 
of benzoate of soda. 

It is altogether possible that benzoate of soda in the amount 
used in certain food stuffs may not do harm. 

To lower the standard at the behest of the manufacturers’ 
interest simply means that the law will soon become a farce and 
nullity. 

We might be willing to admit that benzoate of soda, as used 
in the preparation of food stuffs, at present, is harmless, but we 
are not at present considering the scientific aspects of this 
question. Every intelligent American knows that none of our 
laws are perfect and the best we can advocate in our country 
at any time is the greatest good for the greatest number, and 
while I would never be willing to do an injustice to any manu- 
facturer, yet we must admit that the lowering of the bars here 
means the breaking down of the fence elsewhere. 

Let us have no deviation whatever from the strict construc- 
tion of the Pure Food Law. H. M. Folkes. 


Just at this time, and due to the distructive effect of the 
boll weevil on the doctors’ interest in the cotton crop — the “top 
crop” has always been called the doctor’s share — many doctors 

176 


176 


are looking for new fields of endeavor. Many of us no doubt 
would fly from the pest, to other states, but for the medical ex- 
aminations necessary to obtain license. 

Mississippi has inter-state reciprocity with no state in the 
union, and the fault lies in some parts of our medical practice 
act, and it should be amended by our next legislature. Other 
states, even some near us, who had no laws regulating the prac- 
tice until long after we had them, refuse to reciprocate with us ; 
first, because our laws permit undergraduates to receive license; 
and second, because we have no college standard. 

Mississippi, Alabama and Florida are the only three states, 
except a few in the far west, which do not reciprocate with some 
other states. 

Our legislative committee should get busy and have the 
necessary changes made in our laws, to enable us to reciprocate 
with other states. 

It will make Mississippi look better on the map. It will be 
a God send to a lot of doctors. 

H. L. Sutherland. 


Snctett) ftatEBiitngs. 


Clarksdale and Six Counties Medical Society held its 
regular December meeting at Clarksdale on the 8th. with an 
attendance of about fifty. Sixteen papers were read and dis- 
cussed and eight new members were elected. On the auxiliary 
legislative committee were elected : Bolivar, H. L. Sutherland, 
Rosedale; Coahoma, J. T. Longino, Johnstown; Quitman, J. W. 
Henderson, Lyon; Sunflower, E. L. Robertson, Sunflower; Tal- 
lahatchie, J. G. Backstrom, Tutwiler; Tunica, D. W. Coker, 
Tunica. L. E. Pierce. 

East Mississippi Four Counties Medical Society met at 
the court house at Houston, Dec. 14th., President L. C. Feem- 
ster in the chair. Secretary F. J. Underwood being absent on 
account of a railroad wreck, Dr. R. M. Boyd was elected secre- 
tary pro tern. An uncinariasis clinic, presented by Drs. Wilson 
and Boyd, and an unusual ear case by Dr. Williams, were dis- 
cussed by all present. Interesting case reports were made by 
Drs. Evans, Feemster, Abbott, Bryan, Brand, Boyd and Guinn. 
The society, by unanimous vote, decided to take up the post- 
graduate work as outlined by the A. M. A. for monthly meet- 
ings, and each county was urged to adopt the work as arranged 
for weekly meetings. It was also unanimously decided to hold 


177 


one public meeting in each county annually to which prominent 
men will be invited to discuss preventive measures. These 
meetings are to be arranged so as not to interfere with the 
regular work. It was also agreed to have a committee in each 
county, consisting of two members, one of whom shall be the 
county health officer, to be known as a committee on public 
health, whose duty it shall be to inspect public buildings and 
investigate such other things as may endanger the public health, 
and to report to the society annually, that it may take such 
action as it may deem necessary. The retiring president, Dr. 
L. C. Feemster, made an address showing much thought and 
deep interest, including many valuable suggestions, all of which 
were adopted. Genuine appreciation was shown of the wisdom 
of his administration and his devotion and self-sacrificing work 
in behalf of the society. 

With much feeling the society took steps to do honor 
to the memory of one of its best-beloved members by adopting 
the following: 

Whereas, the supreme Ruler of the Universe has in His 
wisdom seen fit to remove from this earth our dearly beloved 
brother, Robert Paine Wendel; and 

Whereas, his life was sacrificed in the performance of pro- 
fessional duty ; therefore be it 

Resolved , by East Mississippi Four Counties Medical 
Soicety : 

First, that he was a great, good man, never forgetting the 
many proprieties of this life, true to his friends and magnan- 
imous to his enemies; as gentle as a child, yet a giant in dis- 
charge of duty; a Bacon in intellect and a Swift in wit, and 
yet at home and perfectly understood in the humblest hut; a 
leader of the profession in the United States, yet as modest and 
unassuming as the least; a man proud of the name he bore, 
with a high sense of honor, and a great soul burning with love 
for his profession and his fellow-man. 

Second, that the state has lost one of its leading physicians 
and the sick, suffering and poverty-stricken one of their most 
sympathetic friends. 

Third, that we miss his gentle smile, hearty hand-shake and 
wise counsel, and are sorely grieved that he should be .cut down 
in the midst of life. And 

Fourth, that we extend to his young wife and little girl 
our earnest sympathy, and inasmuch as he was the first among 
our membership to sacrifice his life in the sacred duties of our 
profession, we feel that of right they are the children of the 
society ; and it is our desire to comfort them in every way 
possible, and to this end we pledge them our friendship, sympa- 

2— M 





178 

thy and love. To all of his relatives, who have lost such a dis- 
tinguished kinsman, and to his clientele, who have lost such a 
noble and able family physician, we offer our sympathy. 

J. S. Evans, 

G. S. Bryan, 

K. M. Boyd, 

Committee. 

Election of officers being next in order, the following were 
unanimously elected: President, R. M. Boyd of Houston; Vice- 
President for Monroe, B. H. Hurley of Aberdeen; Vice-President 
for Lee, T. F. Elkin of Tupelo; Vice-President for Itawamba, 
John Center of Fulton; Vice-President for Chickasaw, A. J. 
Brand of Beuna Vista; Secretary and Treasurer, F. J. Under- 
wood of Xettleton. After Dr. Boyd’s election and induction 
into office. Dr. G. S. Bryan was elected secretary pro tern., and 
served to adjournment. 

After election of officers, there being no further business, 
the meeting adjourned to meet in Abrdeen in January. 

F. J. Underwood. 

Tri-County (Pike, Lincoln, Copiah) Medical Society 
met in the parlors of the Inez Hotel, at Brookhaven, at 2 P. 
M. Dec. 14th. with thirty members and several guests present. 
After the president's address and treasurer’s report, election of 
officers was held. Dr. Thomas Purser was elected president; 
Dr. D. W. Jones, secretary; Drs. Dampeer, Arrington and Rice 
were elected vice-presidents. After some further routine busi- 
ness, the society repaired to the dining hall, where the annual 
banquet was served. Dr. Frizell acted as toast-master, and a 
couple of hours were passed most pleasantly. Toasts were re- 
sponded to as follows : McLeod, “Our Guests” ; Catching, “The 
Family Doctor”; Rice, “The Doctor’s Wife”; Arrington, “My 
First Case”; Martin, “Sweet Charity”; Little, “Mosquitoes”; 
Ramsey, “Bugs”; Magee, “Worms”; Lockwood, “The Doctor’s 
Dreams’’. Editor Hobbs responded to the toast “The Doctor 
And The Press”. He created a good deal of amusement by say- 
ing he would observe the ethics of the profession by ignoring 
this meeting in his paper. Drs. Dickerson and Little spoke of 
the work of the State Board of Health, of which they are mem- 
bers, calling upon the society to help create public sentiment 
favorable to some proposed legislation, chief of which is the 
proposition to make a diploma from a recognized medical col- 
lege a prerequisite for license, and a system of vital statistics. 
Senator Rowan endorsed the movement and pledged his support, 

D. W. Jones. 


Brmk llButctus. 

— 

EXERCISE IN EDUCATION AND MEDICINE. By If T-pte 
McKenzie A.B., M.D., Professor of Physical Education, and T)jlgct^j> 
of the Department, University of Pennsylvania. Octavo of 406 pfig&s, /N 

- • - • • • •• «TT o J r* T*' •’ ' • • 


ciaKiBcou ^ oon & Co., Philadelphia. $1.00 


This volume announces the valedictory which is well. It 
contains also some twenty-two chapters of the author's well- 
known reports of miraculous cures, abuse of oculists, etc. 


H. M. Bell. 


MISSISSIPPI IEDIG1L 101T1LT 


VOL. XIV. FEBRUARY 1910. No. 10 


* THE MECHANICAL FACTOR IN LOBAR PNEUMONIA. 


JNO. W. PRIMROSE M.D., 

SAEAH. 


In this paper I hope that I will succeed in bringing out a 
feature in lobar pneumonia which it seems receives little con- 
sideration in regard to its management. My success then will 
be my excuse for this paper. 

We have two chief factors to contend with in the manage- 
ment of pneumonia, namely, the toxemia and the obstruction of 
the circulation or the mechanics of pneumonia. It is this last 
condition which concerns us most and will to some extent for- 
ever be a factor in its management. I say this because we will 
have at some future time a satisfactory vaccine or antiserum, 
or both, which will cause the subject under consideration to 
concern us but little. I am not among those who say that col- 
ored water is as potent as anything else in its management, and 
he who teaches this should mend his ways. 

We have in this condition a block to the circulation. This 
obstruction is represented by a consolidation in the lung tissue. 
This consolidation being in the lung tissue, acts as a block to 
the right ventricle through the pulmonary artery. If the right 
ventricle is compensating there will be an exaggerated second 
heart sound which is due, I might say, to the hard closing of the 
pulmonary valves. This, the second sound, is a fairly good 
index to the amount of obstruction. 

The right ventricle gets tired of pushing a column of blood 
through the pulmonary artery against this obstruction, and 
should the heart muscle be exhausted, it will cease to contract 
promptly and a dilated right ventricle follows as a result, which 
produces a leaky tricuspid valve and we then have a right heart 
and lung engorgment of venous blood, a condition which is 
responsible for most of the deaths in pneumonia. In this con- 
dition the second heart sound is much diminished. We then 
should give some of our attention to the second heart sound. 

I have had no experience with blood pressure machines, but 

* Read before the Clarksdale and Six Counties Medical Society. 

181 


182 


believe one would be of much service as a control in the treat- 
ment. 

It then becomes our duty to anticipate this possible and 
exceedingly dangerous condition by the administration of good 
digitalis. Inasmuch as this dilatation nearly always occurs 
after the fifth day, it is usually not necessary to begin its use 
before that time. It is far better to anticipate this condition 
and begin too soon than too late, for the heart’s failure is some- 
times rapid and we usually are too late. So, from the above 
reasoning, to start too soon is to be on time. The crisis marks 
the neutralization of the toxins by antitoxins. 

After the crisis there is not so much fear of dilatation, for 
the nervous system has regained vitality by the antitoxins, but 
the digitalis should be continued for several days thereafter. It 
is also necessary that the patient should not get up or raise up 
during the pneumonia, and for several days after the crisis, as 
this causes extra work on the heart. An occasional depletion 
of the blood vessels by salts is a great help, and bleeding is 
sometimes a life saver. It is unnecessary to mention that black- 
smith’s food and second hand air are not needed. 

The future treatment of pneumonia no doubt will be anti- 
serum or vaccine, rest, good air, depleting cathartics, digitalis 
and bleeding — all used with good judgment. 

Nothing has been said in regard to the nervous and digest- 
ive symptoms, pain, fever or consolidation, but under no cir- 
cumstances administer anything for the relief of any of these 
conditions at the expense of the heart. 

In considering this obstruction I did not mention the role 
played by the toxemia on the nervous mechanism of the heart, 
but this toxemia causes the heart to become very easily ex- 
hausted. 

In conclusion let me say that we should not have our minds 
centered on the lung, but we should have as our motto, “Watch 
the heart”. 


* TREATMENT OF PNEUMONIA. 


S. E. FRIERSON M.D., 

LYON. 


In the consideration of this most important subject it is 
necessary to make some distinction between lobar, or croupous, 
pneumonia and broncho, or catarrhal, pneumonia. Lobar pneu- 
monia is self-limited and cannot be aborted or cut short by any 
known method of medication. There is no cure for this variety 

* Read before the Clarksdale and Six Counties Medical Society. 


183 


except death of the bacteria by their own toxins. It does not lie 
within our power to more than modify its course. This should 
be the aim of our efforts. More than this may detrimental to 
our patients, for “meddlesome medicine is harmful”. 

Our treatment in both varieties resolves itself into elimina- 
tion, stimulation and sedation. For this suggestion I am in- 
debted to Dr. Gray. Each of these is important, and may ex- 
ercise the physician’s keenest judgment. Any inflammation, 
wherever found, is attended with more or less waste material, 
and it is important to consider every avenue of escape for such 
material. 

The first to which I wish to draw your attention is the 
bowel. All will agree that the first medication in pneumonia 
patients, where secretions are locked, which means practically 
every one, should be a hydrogogue purge. In this country cal- 
omel is usually the one chosen, followed by a saline or oil. It 
may be necessary to repeat this dosage, and I am very fond of a 
prescription consisting of calomel, blue mass and a small 
amount of opium, always followed with oil or a saline, for it 
is of the greatest importance to guard against salivation. It is 
also important, especially in the old, to guard against too vig- 
orous purging. The mercury serves the double purpose of 
cathartic and diuretic. Elimination by the kidneys is of no 
small importance. I believe that sufficient cold water should 
be given to keep the kidneys active. It is of the greatest im- 
portance that the kidneys should be watched closely and elim- 
ination in this manner encouraged. Emphasizing the import- 
ance of this avenue of elimination, a distinguished physician 
said to me that he had never seen a pneumonia patient die until 
after kidney secretion had waned. The water, taken cold, serves 
the additional purpose of reducing the temperature and toning 
up the nervous system. 

The next avenue of escape for toxins to which I wish to call 
your attention is the lung. This involves the very important 
question of ventilation. In no disease is fresh air more indi- 
cated than in pneumonia, whether croupous or catarrhal. 
Forcheimer claims for it the production of deeper and less fre- 
quent breathing, the power of dispelling cyanosis, and a better 
elimination of carbon dioxide. It reduces toxemia, improves 
metabolism, promotes rest and increases kidney action. Oxygen- 
ation is better and the heart’s burden is less laborious. It is 
stated by Forcheimer that the respirations will be diminished 
by ten per minute when the patient is changed from a poorly 
ventilated room to one that is well ventilated. The ideal room 
for a pneumonia patient is one free from dust, with an abun- 
dance of sunlight, an open fire and plenty of fresh air. The 


184 


temperature of the air outside the room need not be considered, 
as the fire will heat sufficiently to prevent coughing caused by 
irritation of the upper air passages due to the cold air. 

The last eliminating organ is the skin. I call upon the skin 
for very little in this disease. I am opposed to the coal-tar 
preparations as diaphoretics, because of their depressing influ- 
ence on the heart. The patient should be covered with light, 
warm covering and his skin rubbed with alcohol, or hot sponge 
baths may be used. When the fever is high, quinine serves as a 
most admirable antipyretic. Whether it has any specific effect 
on the bacteria or not I can’t say, but think that I have observed 
that after large doses have been given during forty-eight hours 
the temperature is reduced and does not return as high as before. 
Possibly this reduction of temperature was due to the elimina- 
tion which had taken place by this time. Dr. Sutherland states 
in an article on “The Treatment Of Broncho Pneumonia” that 
is has the effect of lessening the toxemia, not only in broncho 
pneumonia, but also in lobar pneumonia, reducing the temper- 
ature, steadying the pulse and equalizing the circulation. In 
another article on “Quinine, Its Therapeutic Possibilities”, he 
says : “I have given sixty grains in a space of ten hours, and 
repeated it in twenty-four hours with excellent effect upon all 
the symptoms, including pain. It not only reduces fever, but 
lowers pulse rate and respiration, is a diaphoretic and refreshes 
the nervous system.” 

There are those who hold that the fever is beneficial. I 
believe that the fever is a normal reaction and its absence might 
indicate a more depraved physical condition. Anders says that 
the fever enhances tissue metabolism and diminishes toxemia. 
This aids in the destruction of the specific poison of the disease. 
It seems to me that katabolism is the only part of metabolism 
that is increased by fever. We are all familiar with the wasting 
that takes place in fever patients. It may be that a temperature 
above normal would lend to the generation of pneumococcus 
antitoxin. I believe that a temperature above 103° will prove 
more rapidly detrimental to the patient than to the etiologic 
bacteria. 

Venesection is practiced by some, but is effects are trans- 
itory. There may one condition when it would be of great value, 
and that is in an overloaded right heart, when cyanosis has 
taken place with congestion of the periphery. It should only 
be practiced in robust patients, and then I would always follow 
it with intravenous saline solution. 

Under the consideration of stimulants, food is entitled to 
first place. It is no small thing to feed a pneumonia patient 
correctly. Our aim should be to give the proper quality and 


185 


quantity of food to support the vital powers and not to give that 
amount or that quality that will engorge the patient or produce 
tympanites, which is one of the most serious complications. 
The diet should consist principally of milk, eggs, either raw, 
soft-boiled, or in eggnog, gelatinized foods and easily digested 
carbohydrates, as rice, cooked three hours, strained oatmeal, etc. 

Of the stimulating drugs I dare say strychnine is entitled 
to first place. In this we have a drug which increases the depth 
and diminishes the rate of respiration. H. C. Wood says it is 
the most reliable respiratory stimulant. It is also a powerful 
stimulant to the vaso motor system, increases vascular tension 
and the heart’s action. In severe cases it should be given in 
one-thirtieth to one-twentieth grain doses every two or three 
hours until its stimulating effects are seen, care being taken to 
see that the patient does not get enough to depress the respir- 
atory center. If strychnine is to support the heart it should be 
started at the earliest signs of lowered tension or heart weaken- 
ing, but care should be taken not to give it while the heart is 
being over-stimulated by the toxins of the disease, for then its 
effect would be towards exhausting the heart. 

Next to strychnine in the list of stimulants it seems to me 
that sparteine is entitled to consideration. Dr. Petty says of 
sparteine that it is the only true heart tonic and that it serves 
in the same capacity as digitalis and veratrum viridi, that is, 
stimulates the heart and relaxes the arterial walls. Unlike dig- 
italis, it does not disturb the stomach. Digitalis contracts the 
peripheral vessels and thereby increases resistance against the 
heart’s action ; in a measure it increases the heart’s work. There 
are some who hold that pneumonia can be aborted by digitalis. 
In advanced cases when the pulse is rapid and thready and 
blood pressure is at a very low ebb, its value in combination 
with strychnine is excellent. Digitalis and sparteine both have 
happy effects upon the kidney, promoting diuresis. Anders 
says they should be used sparingly. The tincture of veratrum 
viridi produces a good effect upon the congestion in the early 
stage, since it relaxes the arterial wall and this bleeds the 
patient into his own vessels and allows the return of blood to 
the circulation when the stage of consolidation is reached. 
Diminishing the pulse tension is the indication to leave off any 
heart sedative. Anders further says that the tincture of aconite, 
owing to its depressing influence upon the heart, should not be 
employed. 

Counter irritants in former days were very much in vogue, 
and are still used to some extent. I am not prepared to say that 
they are entirely without benefit, but think that if there is ben- 
efit from such usage it is that in a reflex way they promote 


186 


better circulation through the underlying organs. Counter irri- 
tants simply give us two inflammations to treat instead of one, 
when carried to the point of blistering. I can see no objection 
to simply producing redness, and this may be repeated once 
daily if desired. 

Expectorants, I think, find no indication in croupous pneu- 
monia. My objection to them is that they upset the stomach 
and I do not see that they aid in clearing the lungs of any 
secretions. In broncho pneumonia they may stimulate secre- 
tions and be of benefit in the latter stage. 

Under the head of sedatives, cold and opium are the two 
most reliable agents. Cold in the form of an ice pack is much 
vaunted by many authors. My experience has been obtained in 
the country, where the ice pack is not available. It is said to 
dispel pain, stimulate the nervous system, reduce temperature, 
refresh the patient and produce sleep. Opium in minute doses, 
either in the powdered form or as Dover’s powders, has always 
served a good purpose in the cases I have treated. It gives rest 
to the patient, produces sleep, thereby refreshing the nervous 
system, and rests the heart. It is contra-indicated when the 
bronchial tubes are filled with secretions. More especially is 
this the case in broncho-pneumonia. After all, many cases of 
pneumonia would recover without treatment. 


*A CASE OF UREMIA ASSOCIATED WITH MOTOR APHASIA. 


C. J. MARSHALL M.D., 

LAMBERT. 


The case I wish to present to you this afternoon was of 
such a peculiar nature to me that, although it may not be so to 
you, I thought it worth mention in a few words. 

On September 24th. 1909 I was called hurriedly, at about 
noon, to visit E. L., colored, male, aged seventy -five, who, my 
informant stated, had been suddenly stricken speechless. 

On reaching the house, I found him sitting in a chair on 
the back porch, looking perfectly healthy in all respects, except 
that he was expectorating rather more than he should. He was 
surrounded by a crowd of awe-stricken neighbors, of course, and 
before attempting anything else I proceeded to try to get the 
immediate history of the case. 

It seemed that he had been engaged all morning in hauling 
some lumber for a building. I will state here that in spite of 
his age, which I have on good authority, from various sources, 

* Read before the Clarksdale and Six Counties Medical Society. 


187 


he looks to be a man of about fifty and is very well preserved. 
Being at the house at eleven thirty, his daughter told him to 
get ready for dinner, which she had ready. He said “all right”, 
went and washed his hands and face, and she handed him a 
towel, addressing some question to him at the same time. It 
was then that she noticed that something was wrong, for, while 
he modulated his voice correctly in replying, and appeared to 
attempt a lengthy sentence, he only enunciated the single syl- 
lable “no”. 

I asked the usual questions as to his appetite, digestion, 
bowel and kidney actions, and was informed that he had ap- 
parently been in the best of health. His pulse, temperature and 
respiration were all normal. I tried to interrogate the patient 
himself, but without success, except as I could judge his replies 
by the varying inflections with which he pronounced “no”. The 
knee and other reflexes were apparently normal. I suggested 
that he lie down, but he could not be persuaded to do so, resist- 
ing violently. On inquiry as to previous head injuries, I was 
told that he had had an accident years before, and had been 
trephined, but I could find no evidence of this, and there was 
no sign over Broca’s convolution. Being puzzled over the case, 
and thinking there might be cerebral hemorrhage, I gave him, 
hypodermically, ergotin 1-10, atropine 1-100, and strychnine 
1-60. After a few minutes I thought I could detect a little im- 
provement, but, in less than an hour he seemed to get delirious, 
and tried to preach a sermon, still uttering unintelligible 
sounds. 

To quiet him, and, if the trouble were due to autoinfection, 
to clean out the prima via, I gave him apomorphine 1-10, and 
hyoscine 1-100 hypodermically, and calomel and jalap, ten 
grains each, orally. After the apomorphine effects had mani- 
fested themselves, we picked him up and put him to bed, where 
he slept quietly. 

At four o’clock I took Dr. Wade around to look at him. He 
was still sleeping. At five I was sent for again, with the in- 
formation that he was having convulsions. I then gave him 
morphine 1-4, and hyoscine, 1-100, hypodermically, chloral hy- 
drate, twenty grains in solution, by mouth, and three drops 
oleum tiglii on sugar on his tongue. He had two more con- 
vulsions, at intervals of ten minutes, after the hypodermic, then 
seemed to sleep naturally, though perspiring profusely. I could 
still detect none of the so-called uriniferous odor on his breath 
or perspiration, however. 

At six-thirty he had another convulsion, and I gave him 
ten grains more of chloral hydrate, and a high enema of two 
quarts of magnesium sulphate solution. At eight o’clock I gave 


188 


one-quarter grain elaterium, as bowels had not moved. He was 
still occasionally having convulsions, though not so severe. At 
ten o’clock I gave two drops oleum tiglii on sugar. At eleven- 
thirty another enema, after which his bowels moved freely. At 
this time I asked Dr. Glass to see the case, but no further 
medication was given that night. 

He was much improved next morning, being conscious, and 
able to enunciate much better, though not perfectly yet. On 
careful tonic treatment for three or four days, he fully re- 
covered, and has had no recurrence since. 

Later questions elicited the fact that he had had a sun- 
stroke the year previous. He claimed that his kidneys had been 
acting well, however, all the time before this attack, but he 
had had occasional attacks of malaise and headache. However, 
he had persistently refused to take any treatment for same. 

I was at a loss at first to name the complaint, and, of 
course, cannot be positive now, but for the want of a better 
name, decided on uremia as being the trouble. As he was illit- 
erate, I could not test the aphasia fully. 

Now I feel sure that a part of my first treatment was un- 
necessary, to say the least, but I would like for some of you 
with more experience in such cases to give me a few diagnostic 
points, so that I may be able to more promptly differentiate 
a similar case in future from cerebral depression or hemorrhage, 
or auto-intoxication, or whatever it may be, and I should like 
to have a few points on treatment. A urinalysis would doubt- 
less have helped me, but at first I did not have a catheter with 
me, and he voided no urine naturally, and later I was more 
interested in quieting the convulsions and securing elimination 
than anything else, so I made none. Did I make a mistake in 
giving the apomorphine, under the circumstances? It unloaded 
his stomach of quite a mass of undigested food, but did I run the 
risk of unduly depressing him in giving it? 


* A CASE OF URETHRO-SCROTAL FISTULA WITH 
EXTRAVASATION OF URINE. 


G. FRANK CARROLL M.D., 

BILOXI. 


B. C., negro, male, aged thirty years, had gonorrhoea nine 
years ago, followed by stricture in deep urethra. Suffered con- 
siderably from same, was treated but did not follow treatment 
to cure. Has suffered from difficult micturition more or less 
since that time. Claims that he has always had more or less 

* Read before the Harrison County Medical Society. 


189 

trouble in urinating, the act being attended with considerable 
straining. 

Two months ago, while working at a saw mill, he noted 
a slight swelling at junction of scrotum and penis, on left 
side. This swelling gave considerable pain on attempting to 
void urine. He thought swelling was due to a strain he had 
received while doing heavy lifting. 

On November 23rd. called in physician on account of ex- 
tremely painful and swollen testicle. 

Examination revealed tense, painful and very swollen scro- 
tum, left testicle very much enlarged, right apparently normal 
in size. Case was thought to be one of simple orchitis, and was 
so treated with no apparent benefit, swelling increasing steadily 
and pain continuing. As scrotum gave evidences of containing 
fluid, a needle was inserted and scrotum aspirated and a small 
amount of sero-sanguinous fluid obtained. This fluid had a 
strong urinary odor, and I then suspected the existence of a 
urinary fistula. Upon patient’s attempting to void urine, a 
small swelling was noticed just below the junction of penis and 
scrotum, which was slightly painful, irreducible and gave no 
fluctuation or impulse of coughing. Patient stated that this 
‘knot had been coming and going for several months, and would 
disappear on voiding his urine.’ 

On the following day it was noted that there was a marked 
discoloration of scrotum over left side of sack which extended 
to and slightly beyond the central raphe. Upon closer exam- 
ination it was decided that this was a gangrenous area with a 
clearly defined line of demarcation. Moist bichloride dressings 
were applied. Patient complained of inability to void urine, 
and on attempting to pass soft rubber catheter, I met with an 
obstruction. Hot applications over bladder were applied with 
satisfactory results. Later upon introducing bougie found 
stricture in posterior urethra and enlarged prostate. 

At this time the gangrenous area began to separate and 
urine was noticed coming from the upper margin of separating 
tissue during the act of micturition. After dilatation of stric- 
ture patient had no further trouble in voiding, and urine stop- 
ped coming through the scrotal opening of the fistula. The gan- 
grenous area separated, coming away en mass , leaving the entire 
left testicle exposed. Under bichloride irrigations and applica- 
tions of aristol the tissues immediately cleared up. After dis- 
appearance of all inflammatory symptoms, dressings were 
changed to bland, soothing applications under which healthy 
granulations immediately appeared. 

Skin grafting and transplantations to cover denuded area 
were here considered, but after the rapid growth of granula- 


190 


tions I decided to wait and see what nature would do towards 
re-covering this large area. In a short time the skin margins 
began contracting, new skin growing out from edges, and pa- 
tient is now about well, there being only a small spot about 
the size of a five cent piece yet to be covered. 

No urine has come through fistulous tract since dilatation 
of stricture. 

This case was one of urethi*o-fistula, with extravasation of 
urine into scrotum, following gonorrhoea, and goes to show one 
of the many complications and sequelae that may follow the 
ordinary stricture. 

Many of you have seen similar cases of this condition, but 
I report this case because of its unusual occurrence, and besides 
I find no record of a case with such an extensive destruction of 
tissue. 


* UNCINARIASIS. 


T. K. MAGEE M.D., 

HAMBURG. 


In selecting this subject I am not unmindful of the fact 
that there is very little medical literature on the subject, though 
it has been quite freely discussed in the various newspapers of 
the south, to some of which I am indebted for what ideas I have 
with reference to the trouble. It is said to be a disease more of 
warm and damp climates than of more northerly ones, and 
that it is produced by the larvae entering the skin, usually the 
sole of the foot, producing as its first symptom what is com- 
monly known as ground itch, and by a circuitous route through 
the blood vessels the embrjo worm finally reaches the intestines 
where he, or she as the case may be, proceeds to make himself 
comfortable and starts out on his errand of death and destruc- 
tion of the human race. That such a parasite could work the 
destruction that is accredited to it seems almost impossible, but 
I have seen it suggested that it annually claims more victims 
than tuberculosis, or typhoid fever, that it is more close at hand 
than the tariff, and more threatening than the negro question, 
even though Vardanian don’t think so, and in its destruction 
to human life has that much talked of bug, the boll-weevil, 
“skinned a city block”. 

About the best description that I have seen of this min- 
iature creature is that it is a little crawling thing, about the 
size of a silk thread and not half long enough to go around 

* Read before the Jefferson County Medical Society. 


191 


your little finger. Under the eye of the microscope it immedi- 
ately jumps into a wriggling, graceful, eel-like creature, squirm- 
ing with energy and vigor out of all proportion to its diminutive 
size. I know of no disease that, when you have once seen a 
typical case, is more easy of recognition or more amenable to 
treatment, though I must confess that the first case that I saw I 
treated for one solid year for chronic anemia without giving 
my patient any relief at all. 

The disease has existed for an unknown length of time in 
several parts of the old world, but its existence in America 
was discovered not a great many years ago and, if reports be 
true, since that time it has set the pace for all other troubles, 
and now it is “up to us” to do the stunt of extermination. 
Rural people and the poorer classes are more frequently affected 
than those living in cities and towns. This is explained by san- 
itation of the cities and the fact that people throughout the 
country make a habit of going barefooted for a great part of 
the year thus allowing the larvae to enter the foot from pol- 
luted ground. During my limited experience with the disease 
I have not found a single negro affected with it, which would 
not tend to verify the facts just stated. 

Uncinariasis in the young is said to effect the general de- 
velopment. The mental condition is marked by stupidity, with 
slowness of thought and hypochondria; neurasthenia is almost 
always present and melancholia frequently so. The skin has a 
dull, slightly yellow, swarthy appearance very much resembling 
the ordinary dirt or “clay eater” which we have all seen, and the 
strong probability is that we were then treating a patient suffer- 
ing with this disease rather than one eating dirt. They all have 
a peculiar, dull, blank, fish-like stare from the eyes, very closely 
resembling that seen in extreme cases of alcoholic intoxication. 
The tongue is pale, soft, flabby and tooth-indented, resembling 
the so-called quinine tongue. These I believe to be the most 
important symptoms, though there are many more. I rely chiefly 
on the profound anemia and the microscope for diagnosis, the 
latter being the only positive means. A small portion of the 
feces is placed on the slide and thinly and evenly spread, a 
cover glass is then dropped on and the specimen is ready for ex- 
amination. The appearance of the eggs I am unable to describe 
but it may be found in “Practical Medical Series”, Volume on 
Pathology of 1903, Page 99. 

Prognosis is good, especially if treated early. 

Treatment consists in the expulsion of the parasite and the 
rebuilding of the blood and the treatment of any complications 
that may arise. In my cases I have had no complications to 
treat. 


192 


For the expulsion of the parasite, thymol is admitted to be 
the drug above all others to use, and always in the form of a 
powder given in capsules of ten or fifteen grains each, repeated 
every two hours until three such capsules have been taken. Give 
a large dose of Epsom salts on arising in the morning, begin- 
ning with thymol two hours afterwards and repeat the salts 
two hours after the last dose. This insures a copious evacuation 
of the bowels. Allow no oils, fats or alcoholic drinks during 
this treatment, as they are all solvents of the drug and it is said 
that almost all fatalities from this drug have been on this 
account. Repeat this treatment every two weeks until you fail 
to find any of the parasites in the feces. Then put your patient 
on some good iron tonic and see him grow and fatten. 

My first case was treated in this way and at the end of a 
month he was so wonderfully transformed that the next time 
I saw him I could hardly realize that he was the same anemic, 
sallow, pale-faced boy that I had worked so diligently for a 
year to cure of chronic anemia, having given him enough iron 
in its various forms to make a small-sized war vessel, and one 
drachm of thymol did it. 


TOt ssissippi Stats TOerltcal (Association. 


CHAIRMEN OF SECTIONS. 


Medicine B. L. Culley. . . 

Surgery F. M. Sandifer. 

Obstetrics G. S. Bryan. . . . 

Gynaecology T. M. Jones.... 

Materia Medica J. C. McNair . . . 

Pediatrics J. M. Dampeer.. 

Nervous Diseases G. W. Stephens 

Venereal Diseases Robt. Donald. . . 

Hygiene J. S. Ullman. . . 

Dermatology O. N. Arrington 

Bacteriology W. S. Leathers . 

Eye, Ear, Nose, Throat. . . D. G. Mohler. . . 

Electro-Therapeutics .... Rosa Wiss 

Tuberculosis P. R. Brown. . . . 


Jackson 

Greenwood 

Amory 

Hernando 

Fayette 

Crystal Springs 

Meridian 

.... Hattiesburg 

Natchez 

.... Brookhaven 

University 

Gulfport 

Meridian 

West Point 


STANDING COMMITTEES. 

Committee On Public Policy And Legislation. — P. W. 
Rowland, Oxford; L. C. Feemster, Nettleton; N. Stewart, Jack- 
son; D. W. Jones, Brookhaven; E. F. Howard, Vicksburg. 


MISSISSIPPI MEDICAL MONTHLY. 


E. F. HOWARD B.S., M.D., Editor and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D.. Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 


OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


The success of the University Medical School in Vicksburg 
has a far more important hearing on the future of medical edu- 
cation in the South than one not conversant with recent changes 
in medical instruction can appreciate. 

In the old days when two courses of five months each with 
advanced standing on every pretext enabled one to acquire a 
diploma to practice medicine, when half a thousand or more 
students, more or less illiterate, listened to flights of oratory 
and fanciful if not weird ideas of pathology, and saw operations 
in the “bull pen” from the top row of seats in the amphithe- 
ater, the dividends of the stockholders of the medical schools 
were the sole measure of success. 

Slowly, but surely, as the grinding of the mills of the gods, 
the inroads of the scientific branches, the establishment of chem- 
ical, biological, physiological, pharmacological, histological, 
bacteriological and various clinical laboratories, the increased 
requirements of state board, and later the Council on Medical 
Education, reduced the dividends of the independent schools. 
Munificent endowments for equipment and chairs placed the 
great universities so far in advance of the commercial schools 
that the comparison became, without being facetious, “odorous”. 

The very nature of the new system which has crowded 
lecture room teaching almost out of existence demands indi- 
vidual guidance, it demands the services and time of specially 
trained men, men trained in work for which there is no market 
other than college laboratories; it requires a corps of teachers 
approaching in numbers the class to be taught. 

Under this system the profits would become deficits in the 
independent schools and the illiterate would not be able to keep 
pace with degree men in the new order of school work. It may 
indeed be put down as axiomatic that the independent school 
which now pays dividends is so hopelessly below the standard 
as to be indeed odorous. The independent school which makes 

193 




194 

a profit or even operates without serious loss is not doing its 
full duty by the students according to the present standards. 
This being the case, what can be the raison d’etre of its exist- 
ence? The student, like everybody else, follows lines of least 
resistance, and the inevitable result is the unqualified practi- 
tioner, entrusted with the life and health of the citizens of the 
commonwealth, so long as the doors of such schools remain 
open. 

The only solution of the problem is for the state through 
its university to bring back medical instruction where it be- 
longs, on an equal footing with the arts, law and other depart- 
ments. It becomes the duty of the state to equip and finance its 
medical branch so that it can maintain the standards demanded 
in the best centers of learning. The financial loss to the uni- 
versity must be made good by the legislature. It must be under- 
stood that a self-sustaining medical school is a thing of the 
past. The return for the expenditure will be in better qualified 
doctors to look after the health of the individual and the com- 
monwealth. Of all the professions, medicine is the most altru- 
istic. It is not an avocation, it is a vocation, and its devotees 
must be prepared to make the sacrifice demanded of them. This 
can only come through ideals developed and fostered by a state 
university. Some return can be expected in keeping the money 
that students spend away from home within the state. Millions 
are carried out of the state in tuition fees and maintenance. 
Not only this, the personal equation and not the social standing 
should count in the making of a doctor of medicine. This check- 
mates the cry of the commercial schools w r ho tell you they are 
championing the cause of the poor boy who wants a medical 
education. The poor boy who wants to be a physician should 
have an even chance with the poor boy who wants to practice 
law', and get the best the state affords. 

Mississippi cannot expect its university to prosper unless 
her legislature takes care of its medical school and endows it 
with funds to make it as good as the best. We have the hospital 
and the patients, the state pays for their maintenance, and it 
should get educational returns on the investment. The moral, 
material and financial welfare of a people depends more upon 
the health and education of constituent families than upon any 
or all other factors. If the state wants educated physicians 
and wants to low r er the cost of their education, it must maintain 
a well-equipped and well-officered medical school. The Uni- 
versity of Nebraska is building a medical school w r hose palatial 
buildings will cover four acres of ground. What will Missis- 
sippi do? A great wmrk is not a matter of individuals but of 
methods. The University of Mississippi needs a good medical 


195 


school and good teachers. Neither can be had for the mere 
asking. Wm. Krauss. 


The following letter, which has been sent out to the various 
county health officers by Dr. S. H. McLean, secretary of the 
State Board of Health, should be considered and acted on by 
every physician in the state who is looking towards the better- 
ment of health affairs. It is self-explanatory and no comment 
is needed. 

Jackson, Miss., Jan. 14th. 1910. 

Dear Doctor : 

At a meeting of the Legislative Committee of the State 
Medical Association in conjunction with the Legislative Com- 
mittee of the State Board of Health it was decided to have 
each Health Officer in the State co-operate with the committee 
to secure the needed medical legislation. 

With this end in view, you will please communicate with 
your senator and representatives, asking their support of our 
measures. If you feel a delicacy in approaching them, or for 
any reason could not do so yourself, get in communication with 
some one who has influence with them, and push the matter at 
once. 

There are five bills in which we are interested : 

1st. Bill on Vital Statistics. 

2nd. Changing the Medical Practice Act so that only grad- 
uates can apply for license. 

3rd. Fixing the salary of County Health Officers. 

4th. (But not least) a larger appropriation for the State 
Board of Health. 

5th. We oppose the Optometry Bill. 

Please give this matter your immediate attention. 

Yours very truly, 

S. H. McLean, 

Secretary. 

This letter covers well the ground the State Association 
is working except as regards the licensing of midwives. The 
histories we hear of gynecological operations due to improper 
handling during labor, the numbers of still births, which are 
generally unreported, and the necessity for the support of a 
home for blind children by the state, all show the need of more 
intelligent care in labor. It has been pretty strongly intimated 
that this matter is an unpopular one, but it is only so because 
our legislators do not know the necessity for it. If a few physi- 
cians who have, each, the ear of a legislator will tell him the 
simple truth regarding the dangers of infection and neglect, and 


196 


of lack of prophylaxis in the matter of the children’s eyes, this 
amendment will go through the legislature “like the grace of 
God through a camp-meeting”. 


Vxzsxdtnts. 

J. M. BUCHANAN, Meridian. 

President 1901-2. 

James McQueen Buchanan was born at Buena Vista, Chick- 
asaw County, Miss., Oct. 5th. 1855. His parents were of Scotch 
descent and in the thirties had moved from North Carolina to 
Mississippi, where the father, T. J. Buchanan, was a successful 
planter. Dr. Buchanan was raised on the farm and attended 
the county schools in his early youth. He took his B. S. degree 
from the University of Mississippi in June 1878 and graduated 
from the Medical Department of the University of Virginia in 
July 1879 and from the Medical Department of the University 
of the City of New York in February 1880. Following this he 
spent a year in Vienna and three months in the London Hos- 
pital doing post-graduate work. He first practiced in Little 
Rock, Ark., but in the fall of 1884 returned to Mississippi and 
settled in Meridian. After three years he accepted the position 
of assistant physician to the East Mississippi Insane Hospital, 
serving two years under Dr. C. A. Rice, and in March 1890 was 
appointed Superintendent of the Hospital by Governor Stone. 
This position he has held constantly since, limiting his energies 
to this class of work. He was married to Mrs. Leta Mitchell 
Young, March 12th. 1902, and has one living child. 

Dr. Buchanan is a member of his county and state medical 
societies, the Southern Association, the A. M. A. and the Amer- 
ican Medico-Psychological Association. 

Personal Notes, 1907. 


H. L. SUTHERLAND, Rosedale. 

President 1902-3. 

Hugh Lewis Sutherland was born April 27th. 1848 near 
Canton, Miss. He is of Scotch descent, his grandfather having 
emigrated from the north of Scotland to Georgia about the close 
of the revolutionary war. Dr. Sutherland took his A. B. degree 
from University of Mississippi in 1870 and his medical from 
Tu lane in 1873. Since the latter date he has practiced in Bol- 


197 


ivar County, in and around Rosedale, except five years, from 
1878 to 1883, when he lived in Madison County. In January 
1878 he married Miss Ethel Cosby Burns and at this time, 1909, 
has five living children. 

Dr. Sutherland has been one of the most earnest advocates 
of medical organization and is heartily interested in medical 
gatherings. Besides his county, state and national affiliations, 
he is a member of the Tri-State (Miss., Ark., Tenn.) Medical 
Society, of which he was president in 1904-5. Besides his 
service as president, Dr. Sutherland has given much to the State 
Association, being a member of the executive committee in 1899 
and 1901 and of the council in 1905, and for the past two years 
has been treasurer of the Association. He had the misfortune 
to lose a leg in Feb. 1889 but has continued to do a large country 
practice on crutches and is one of the best known men of his 
county. His pen is as ready as his good nature, which is per- 
petually effervescent, and as he is a recognized authority on con- 
ditions peculiar to the Mississippi Delta, his contributions to 
medical literature are widely read and eagerly received. Few 
practitioners are so well known beyond the borders of their own 
bailiwick as is this child-hearted gentleman of genial manner 
and wide information. Dr. E. F. Howard. 


SrrtMg ^rrrt;e;eriings* 


Clay-Octibbeha County Medical Society held its fourth 
quarterly meeting in the parlors of the Hotel Holt, West Point, 
Dec. 30th. 1909. The president, Dr. A. L. Nason, being absent, 
Dr. W. D. Hubbard presided. The following were present : Eck- 
ford, Brown, Unger, Hubbard, Paslay, D. G. Ivey, Deans, Boyd 
and Crumpton. The essayist of the evening, Dr. J. W. Unger, 
read an interesting paper on suggestive therapeutics, which was 
discussed by Drs. Brown, Ivey, Eckford, Crumpton and Hub- 
bard. Dr. Frank C. Spalding of Crawford was received as a mem- 
ber by transfer from the Lowndes society. Drs. Paslay, Crumpton 
and Montgomery were appointed to draft resolutions in regard 
to the death of Drs. C. W. Jordan and J. B. Gresham of West 
Point. The society endorsed the movement to limit applicants 
for license to practice medicine in this state to graduates, and 
also approves of reciprocation with other states having the 
same requirements. The following were elected officers for 1910 : 
W. D. Hubbard, West Point, pres. ; J. W. Crumpton, Starkville, 
vice-pres. ; F. C. Spalding, Crawford, secy.-treas. After an ele- 


2— M 


198 


gant banquet at which the Rev. Dr. Barton was the guest of 
honor, the society adjourned to meet in Starkville March 24th. 
1910. F. C. Spalding. 


East Mississippi Four County Medical Society met in 
regular session at the Elks Home, Aberdeen, Jan. 11th. at 2 
P. M., President Boyd in the chair. Those present were : 
Bryan, Walker, Coleman, Boyd, Tubb, Sims, Furr, Guinn, Dil- 
worth, Rogers, Brand, Durley, Sadler, Hamilton, Darracott and 
Underwood. Dr. Bryan presented a paper on “The Indications 
And Contradictions For Curettage”, which was discussed by 
Drs. Coleman, Durley and Sadler ; Dr. Durley one on “The Diag- 
nosis Of Pelvic Inflammation”, which was discussed by Drs. 
Guinn, Rogers, Sadler and Coleman. The society extended a 
hearty vote of thanks to the essayists. Next meeting will be 
held at the offices of Drs. Bryan and Burdine, Amory, Feb. 8th., 
at 1 :30 P. M. F. J. Underwood. 


Harrison County Medical Society met in regular session 
at Gulfport, Dr. Lebaron, president, in the chair. Those pres- 
ent were Drs. Lebaron, West, Morris, Richardson, Anderson, 
Sheely, Folkes, Carroll, Fahnestock, Welch, Carraway, Hood, 
Parker, Doty, Barnes and Overstreet. The reading of minutes 
of previous meeting was dispensed with and the president sug- 
gested that as several members known to be in town had not yet 
come in, the society should proceed with the transaction of reg- 
ular business and defer the election of officers until the other 
members had arrived. The secretary read a communication 
from Mr. H. L. Harris of New York, relative to the use of 
food preservatives, in which was pointed out the necessity of 
using preservatives such as benzoate of soda and others and ask- 
ing that this association endorse the use of such preservatives, 
contrary to the views advanced by Dr. Wiley, who was endorsed 
by the Philadelphia Medical Society, American Medical Asso- 
ciation, Mississippi Valley Association and others. This matter 
was put to a vote and it was ordered that the secretary be in- 
structed to write Mr. Harris that this society heartily endorses 
the stand taken by Mr. Wiley and the above mentioned medical 
societies. The application of Dr. W. H. Doty of Biloxi having 
been endorsed by the Board of Censors, Dr. Doty was declared 
duly elected to membrship in this society. The yearly report 
of the secretary and treasurer was read and filed. The election 
of officers for 1910 followed, the following being elected : Presi- 
dent, Dr. H. H. West, Gulfport; Vice-President, Dr. H. X. 



/ 


A & Ha 



199 


Richardson, Gulfport; Secretary-Treasurer, Dr. G. F. Carroll, 
Biloxi ; Delegate to State Association, Dr. H. M. Folkes, Biloxi ; 
Alternate, Dr. E. C. Parker, Gulfport. Dr. C. A. Sheeley was 
re-elected to the Board of Censors. The report of the treasurer 
showing a deficit, it was moved that each member be assessed 
one dollar in addition to his yearly dues and be requested to pay 
same as soon as possible to enable the society to pay all out- 
standing indebtedness. The motion was carried. Dr. Folkes 
of Biloxi presented a very interesting paper on “Hemorrhage 
from the nipple”, which was freely discussed by all present, 
several citing cases of a similar nature. The paper by Dr. Car- 
roll, of Biloxi, on “Urethro-scrotal fistula with extra 
of urine followed by gangrene”* was read ° 1 
similar cases being reported but none T 
of tissue. 


Holmes County Medical Socie 
ington Jan. 1 12th. with an 

cial fa ers of Dr? 


200 


Forrest : E. Dill, Hattiesburg, pres. ; F. Champenois, Hat- 
tiesburg, secy. 

Harrison: H. H. West, Gulfport, pres.; G. F. Carroll, 
Biloxi, secy. 

Holmes : W. S. Derrick, Goodman, pres. ; S. A. Eggleston, 
Lexington, secy. 

Jackson: J. A. Tabor, Scranton, pres.; J. N. Rape, Moss 
Point, secy. 

Prentiss: R. C. Cunningham, Booneville, pres.; D. T. 

Price, Booneville, secy. 

Tishomingo : K. F. McRae, Belmont, pres. ; H. D. Waldrep, 
W. Stone, Greenville, pres.; B. T. Oren- 


GES OF ADDRESS. 

•om Tupelo to Aberdeen, 
m Nettleton to Tupelo, 
'upelo to Nettle 4 ^ 
m Savapr 


llSSISSiPPI REDIGIL RGNTHLT 


VOL. XIV. MARCH 1910. No. 1 1 


* SOME REMARKS UPON PELLAGRA WITH REPORT OF 

CASES. 


A. W. RHYNE M.D., 

BEULAH. 


This paper is read with the purpose of agitating the study 
of one of the most veritable scourges we have had to encounter 
for years past. 

When we get the history of pellagra, and find that it has 
been a prevalent and recognized disease in some countries for 
more than a century and a half, and see how little has been 
accomplished towards the treatment of same, we can readily 
see and must acknowledge that we are up against it. 

By good authority we learn that two per cent, of the rural 
population of Spain are pellagrins, that as much as thirty to 
fifty per cent, of some of the districts of Italy are affected and 
that Roumania in 1906, a country of only about six million 
inhabitants, had thirty, thousand cases of pellagra. 

If these countries, which can produce some as good stu- 
dents as we have to-day, have spent millions of dollars in trying 
to eradicate this disease and have accomplished but little in a 
palliative way, what can we expect to do with such a pestilence? 

As to the etiology of the disease, I would not venture an 
opinion, but I believe the prevailing opinion of most students 
to-day is that it is caused from a chemical poison formed in 
immature or spoiled maize. 

Heat, sun and season, seem to stand foremost as predis- 
posing causes. Any condition that would tend to lower the 
power of resistance would be a predisposing cause. Although 
a pellagrin cannot tolerate mercury, even to the slightest ex- 
tent, and I have never seen it given as a predisposing cause, 
I must say that I think syphilis is a great predisposing factor, 
mainly on this ground: the class of patients among which we 
find the disease. 

I believe the disease is very infectious but not contagious, 
for I have had but one case in any family. 

As to the pathology, I know nothing from original study 

* Read before the Clarksdale and Six Counties Medical Society. 

201 


202 


and as for the pathological condition of the brain producing 
insanity, the chronicity of the disease with the thought of 
next spring’s recurrence would have been trying on Job in 
his day and landed him finally in the asylum, if such existed, 
therefore I believe this has much to do with the number of 
insane pellagrins. 

I have never seen a case in the prodromal stage to recognize 
it, but all my cases were fully developed, and after recognizing 
one all others were easily diagnosed. Of course the diagnosis 
was made from the nervous and digestive symptoms and the 
symmetrical erythema, and I think can easily be differentiated 
from any eruptive disease. 

The prognosis has been quite grave in my limited experi- 
ence. for four of the seven cases I have treated have passed into 
a state where the thought of next spring’s recurrence will not 
worry them. 

The treatment with me has been very unsatisfactory. Of 
course it has been mostly symptomatic and palliative. I will 
say for what it is worth that the only perceptibly good results 
I have gotten were from Fowler's solution and Iodalbin. 

I am sorry that I was not properly equipped to get photos 
of my cases, but will try to picture them to you by reporting 
my observations of symptoms both subjective and objective, 
but before reporting these cases I wish to say you are not 
getting the report of pellagrins from my diagnosis alone, but 
nearly all my cases were seen and my diagnoses verified by 
such men as Drs. Sutherland. Johnson and Patterson of Rose- 
dale, Williams and Martin of Benoit, Stone and Smythe of 
Greenville and Coursen of my own town. 

The following are as briefly as possible the cases which 
have come under my observation : 

Case I. June 8th. 1909. M. T.. married, female, colored, 
age sixteen, mother of a seven months’ baby, family history 
good for her class, came to my office suffering from indigestion 
and diarrhoea, which had prevailed for two or more weeks, 
having from ten to fifteen evacuations of the bowels, consisting 
of bloody mucus, every twenty-four hours. 

She had been taking Mississippi diarrhoea cordial, salts 
and laudanum, and everything else suggested by the neighbors, 
with no beneficial results. 

I put her on a palliative treatment and four days later 
saw her with but little change in diarrhoea, and in addition 
thereto burning cramps in the epigastric region, stomatitis, 
temperature 99%° F., pulse 130 and very weak, some vertigo 
and in a drowsy, don’t-care disposition. Complained of her 
hands burning and itching and on examination I found the 


203 


dorsal portion darker than it should have been. I never saw 
or heard from her again until the 12th. of July, when I found 
all previous symptoms much worse and a loss of probably forty 
pounds in weight. Her hands had an elevated black crust on 
the dorsal surface extending to the junction of the middle and 
lower third of forearms, with cracks and crevices on and be- 
tween the fingers, pouring out a bloody, watery discharge. I 
put her on various treatments but to no avail. Saw her again 
on Aug. 14th. in a hysterical, nervous, weak, emaciated condi- 
tion, with erythema on both feet and either side of the nose. 
She was then on her way to Coahoma to her people, where she 
died four days later. I got her previous history from her 
husband later, who said she had a similar attack last year, 
but not so severe, and only noticed the black streak, or crust 
as he explained it, around her neck. From the early part of 
April this year she was drowsy and sleepy all the time, would 
go to sleep standing or sitting, and often when walking across 
the room would stagger to some place for support on account 
of severe vertigo, was hysterical and would send to the field 
for him saying she was going to die. Her child is still living 
and in a healthy condition. She was nursing the child when 
she first came to me. 

Case II. A. W., colored, female, married, age fifty. On 
July 6th. 1909 I was called to see her. Knowing the old woman 
in her normal condition only, she presented a pitiful sight 
when I walked into her room. I found her with a terrible ery- 
thema on dorsal surface of the hands, extending to the middle 
of the forearms, with weeping crevices between fingers, ery- 
thema also on both feet extending above the ankles, and an 
erythematous collar around the neck almost meeting in the 
median line. She had one of the worst cases of stomatitis I 
have even seen. Excretion pouring out of her mouth would 
soon saturate a towel. Very profuse diarrhoea of a bloody, 
mucus consistency. Hot, burning cramps in the stomach. Pulse 
140. Temperature 99° F. Hysterical and very restless. She 
had enjoyed good health this year up to the first of May, when 
she began to suffer with indigestion and diarrhoea, some nausea 
and vomiting. Erythema showed up about the first of June 
and immediately the stomach and bowel symptoms became 
more pronounced. She had treated herself with various pat- 
ents, etc., until her husband called me in. Previous history 
shows that she had had no serious sickness until nine years ago 
when she had all the above signs and symptoms to appear. Her 
physician had treated her each year since for the same trouble 
under the diagnosis of poison oak and flux. In April 1900 
she had her first attack with symptoms similar to those related 


204 


except not so severe, and erythema never appeared on the neck 
and feet until this year. It came on later than usual this year, 
but was worse in everv wav from the verv first. I gave her as 
high as seven grains of powdered opium the first thirty-six 
hours before controlling the diarrhoea; in fact all symptoms 
were almost uncontrollable from the time I saw her and she 
died fourteen days later. 

Case III. J. TV., male, Italian, single, age thirty -four, oc- 
cupation farming. Left Italy in 1895 and came to Sunnyside, 
Ark. He has lived in Sunnyside ten years and four years in 
Arnold. Miss., since coming to this country. Has been a mild 
drinker of whiskey since coming to this country and a wine 
drinker in the old country. Has had several acute malarial 
attacks since coming over here. Eight years ago he had five or 
six chanchroids to appear on the mucus lining of prepuce with 
some inguinal glandular involvement. In the spring of 1S90, to 
his best recollection, he suffered with indigestion and diarrhoea 
with considerable pains in stomach. This occurred each spring 
and with it in 1893 a sun burned appearance on back of hands, 
which would peel off in the fall to appear again next spring. 
This erythema, with indigestion and diarrhoea, has appeared 
every spring since, lasting till cool October or November. He 
came to me on July 25th. of last year with the symmetrical 
erythema on both hands, severe case of stomatitis and pharyn- 
gitis, diarrhoea, indigestion, pains frequently occurring in the 
epigastric region and a complete nervous wreck; could not col- 
lect his thoughts or speak distinctly, very hard to express what 
he wanted to say. If he allowed his hands to hang down, walk- 
ing for two or three hours, they would become very edematous. 
This year the erythema also appeared on neck and nose, sym- 
metrical on either side. I put him on a palliative treatment 
for diarrhoea and gave him the arsenic and Iodalbin. Came 
back to me on August lfith. with most symptoms improved 
and told me he wanted to go to Hot Springs, which I advised 
him was a very good idea. He stayed in Hot Springs until the 
first of October, returning with all erythema gone and the ner- 
vous and other symptoms much improved. 

Case IV. S. K.. female, colored, married, age twenty -eight. 
Came to me August 7th. with pains in stomach, diarrhoea, loss 
of appetite, some nausea and vomiting, hysterical, vertigo and 
a severe pharyngitis. These symptoms had troubled her for 
nearly a month. On inspection I found a symmetrical crusty 
or scaly erythema on both feet, with blebs on legs extending to 
about the junction of upper and middle third, with consider- 
able edema extending to the same height as blebs. I first made 
diagnosis of syphilis and put her on syphilitic treatment. In 


205 


six days I saw her again with the worst case of ptyalism I have 
ever had to treat, also all the above symptoms were worse. 
After relieving the ptyalism I put her on Fowler’s solution and 
Iodalbin with favorable results following pretty soon. I kept 
her on this treatment until the first of October and now she is 
as well apparently as she ever was. This was her first attack 
and I will get to see her again next spring if the disease recurs. 

Case V. K. C., female, married, colored, age thirty-nine. 
This woman was in my office on May 27th. 1909, and while wait- 
ing for a patient under treatment she made some casual re- 
mark about her hands burning and itching. Some few days 
later she sent to me for some kind of treatment for her hands, 
stating they were getting black and burning her. I was sent to 
see her on August 8th. and found a perfect physical wreck. I 
learned she had been in bed for nearly two months. She had 
lost at least sixty pounds in weight, was suffering with a pro- 
fuse diarrhoea, cramps in the epigastric region, very hysterical 
and despondent, pulse 130, temperature 100%° F., also had a 
mild stomatitis. On inspection I found a crusty erythema 
around neck extending to clavicle, also on either side of nose, 
and a symmetrical spot under each eye and on dorsal surface 
of hands, extending up her arms to elbow, with a spot as large 
as a dollar on posterior surface of arms above the elbow, also 
on both feet and either side of vulva. This patient was seen by 
Drs. Stone and Smythe of Greenville and Sutherland of Rose- 
dale with me. They did not think she could live but a few days 
longer, but she did live for a month, with some clearing up of 
the erythema. Diarrhoea was relieved and appetite regained 
but nothing she ate was assimilated. Before dying she had 
complete atrophy of the vulva. This woman said she had an 
attack, though not so severe as this one, in 1907. Also suffered 
with diarrhoea and indigestion through the summer of 1908, but 
did not have the erythema. 

Case VI. M. J., female, colored, married, age fifty-three. 
This woman came to my office on September 19th., after having 
been treated by her family physician since spring for bowel 
and stomach trouble. She was suffering with vertigo, was 
sleepy and drowsy, had stomatitis and pharyngitis, indigestion, 
loss of appetite, nausea and some vomiting, pulse 100, tem- 
perature normal, urine normal. On inspection I found an 
angry, black erythema on both feet, hands and around neck, 
with a symmetrical spot over each breast. Erythema was much 
better than a month previous, she claimed. Instead of having 
diarrhoea she was constipated. She claimed to have suffered 
this way every spring and summer since 1904. Has lived near 
Lobdell for nearly twenty years. I put her on Fowler’s solution 


206 


and Iodalbin, with sodium phosphate as laxative and in a few 
days she began to improve. Have seen her several times since. 
The erythema has disappeared, except the skin is slick and 
darker where the erythema existed. She has promised to come 
to me next spring as soon as the first sign or symptom appears. 

Case VII. L. J., married, colored, female, age thirty-six. 
I was called to see her in April and found her suffering with 
severe stomatitis, with excruciating pain in epigastric region 
and over the gall bladder. Had to give her a hypodermic of 
morphine to quiet pain and hysteria before continuing my ex- 
amination. I had seen this woman the year before, suffering in 
the same way and made a diagnosis of cholecystitis, so put her 
on treatment accordingly and got good results. After com- 
pleting my examination I made a similar diagnosis this time 
and put her on the same treatment. I treated her nearly a 
month from the office but never saw her, when she discontinued 
my treatment and went back to the woods to an old negro herb- 
doctor, staying under his treatment until September 1st, re- 
turning home in bad shape. On September 20th. I was called 
in again and found a most pitiful physical sight. She was 
emaciated, had stomatitis, pharyngitis, diarrhoea, indigestion, 
nausea, vomiting, burning cramps in the bowels and a rough 
erythema on both feet and hands, around the neck and behind 
each ear. There were weeping crevices between fingers and 
toes. The disease would not respond to any treatment, so I 
sent her to Vicksburg to the Charity Hospital in October. They 
sent her back to me one month later with no improvement. I 
was trying to keep her alive to present to you to-night, but she 
died November' 23rd. 

I am sorry indeed that I could not present one of these 
cases to you at this meeting, but the three cases living yet are 
in good shape apparently and would not be of any interest. You 
have noted from my reports that six of my cases were negro 
women, all native Mississippians, and one male Italian, having 
been in this country fourteen years. All of them were chronic 
cases except one, ranging from two to seventeen years standing. 


Henry Phipps, founder of the Phipps Institute in Phila- 
delphia, has presented to the University of Pennsylvania $500,- 
000 to be used in the campaign against tuberculosis. The man- 
agement of the Phipps Institute will fall upon the university 
trustees, and the study, treatment and prevention of the disease 
will be continued in a new hospital to be erected. 


207 


* NASO PHARYNGEAL DISEASES. 


HENRY FLOWERS M.D,, 

BROOKHAVEN. 


The subject of naso pharyngeal diseases is one about which 
quite a large number of large books have been written. The 
very mention of the names and pathological conditions of the 
nose and throat, with their definition, would make a paper too 
long to be read before this society. Obviously then, a paper 
on this broad subject, the reading of which is to be confined to 
a time limit of fifteen or twenty minutes, will necessitate a very 
general statement. 

The advancement of our knowledge of the diseases of the 
nose and throat and of their proper treatment has kept step 
with the marvelous progress of medical science along other 
lines. Until recent times these ailments were perhaps as little 
understood and therefore their treatment was as unsatisfactory 
as were those of other parts of the human anatomy. Even at 
this day we not infrequently find well-informed and intelligent 
physicians who are openly skeptical as to the real value and 
utility of treating the most common disorders of the nose and 
throat. They affect to treat the matter as a joke and appear to 
think one must possess an easy-going conscience to accept 
money for treating them. Of course there are some conditions 
such as long standing atrophic rhinitis whose management is 
often very unsatisfactory, but even in most of these cases much 
can usually be done to promote at least the comfort of the 
patient. But is it not the experience of all physicians in every 
department of medical practice that they are constantly called 
upon to treat diseases, even those which are usually regarded 
as curable, which stubbornly refuse to yield to their pet for- 
mulae and loudly-heralded sheet-anchors? My own experience 
in the treatment of nasal and pharyngeal diseases ha's not been 
extensive, but I have spent the greater part of five years in 
studying them and I am willing to assert that my success here 
has been as satisfactory as it ever was in general practice. 
Yes, it is even more so, for the reason that when one limits his 
practice and devotes his studies to a single subject he ac- 
quires a more definite and thorough knowledge of that subject 
than he can possibly do when he attempts to cover the entire 
field. Therefore when I am consulted by one who suffers from 
these ailments I am usually able to state with reasonable prob- 
ability or certainty what he can expect from treatment. 

The most usual symptom which causes patients suffering 

*Read before the Tri-County (Pike. Lincoln. Copiah) Medical Society. 


208 


from nose and throat diseases to apply for medical treatment 
is excessive secretion, though they sometimes come complaining 
of deficient moisture. This secretion is usually of a mucus or 
muco-purplent nature often troublesome in quantity but per- 
haps as often it is of indifferent quantity but adherent to the 
mucous membrane, requiring considerable hawking and cough- 
ing to expel it. Patients who come to us with a muco purulent 
or simply mucus discharge frequently ask with evident concern 
if they have catarrh. When answered in the affirmative they 
almost gasp with despair. The notion is prevalent among the 
laity, for which the general practitioner is largely responsible, 
that “catarrh”, by which they mean a catarrhal condition of the 
nose and throat, is incurable. Medical men who entertain this 
view lose sight of the fact that a muco-purulent discharge from 
any mucus surface is a catarrh whether it be from the nose 
or throat or other part of the respiratory passage or from the 
eye, ear or any part of the alimentary or urinary tract what- 
soever. Perhaps every mucus surface is sometimes affected by 
a catarrhal condition which resists all efforts to restore it to a 
normal healthy condition. Such a pathological condition of the 
nose or throat is as amenable to treatment as is the mucus mem- 
brane anywhere else, indeed, far more so, since it is more ac- 
cessable to therapeutic or surgical measures. 

Another symptom which frequently forces people to seek 
medical advice and treatment is an obstruction of the nares so 
that they can not get sufficient breath through the nose. It is 
not infrequent that we find them unable to get any air at all 
through the nostril. There is, of course, every possible variation 
between slight obstruction and complete. These obstructions 
may be due to an intumescent condition of the mucous mem- 
brane such as when we are in an early stage of a cold, or to 
a hyperplasia of the middle or lower turbinates, or to a 
deviated and thickened septum or spurs projecting from the 
septum into one or both nares. 

Another not infrequent cause of obstruction is polypus, but 
a far more common obstruction, especially in children and 
youths, is adenoids. This last-named obstacle to nasal breath- 
ing is usually associated with large faucial tonsils. All of 
these named impediments to nasal respiration, the adenoids, 
polypi, swollen mucous membrane, hypertrophied turbinates, 
thickened and deflected septum, spurs, etc., give rise to about 
the same class of symptoms. One of these is a peculiar change 
in the voice, which may be more or less simulated by holding 
the nose in speaking. One’s power to sing is completely de- 
stroyed. Ask one who has a good voice to sing while suffering 
from an acute cold and you will find his voice is not musical. 


209 


Frequent and in many instances almost continual headaches 
result from inability to breathe through the nose. One who 
continually breathes through his mouth is often incapable of 
performing ordinary physical labor. He generally expresses it 
by saying he is short winded. I operated on two able-bodied 
men of this class in March of 1908 who came complaining that 
they had become unable to do the farm work they were accus- 
tomed to doing. By removing the middle turbinates in each 
nostril in one patient and on only one side on the other they 
both say they never did a harder year’s work than they did after 
the operation and are at present in the best of health and work- 
ing condition. 

I am satisfied that a large majority of the cases in which 
the accessory sinuses are infected become so on account of 
either acute or chronic obstruction of the nose. Given a case 
of acute rhinitis grafted upon a more or less chronic muco- 
purulent discharge and you have a very favorable condition for 
infecting these sinuses. People in such cases often attempt to 
clear the nostrils of an annoying collection of pus by closing 
one nostril and blowing strongly through the other, thus greatly 
increasing the atmospheric tension which favors the forcing of 
infection up into the accessory cavities. Of course, in all 
cases there must be present some pathogenic organism such as 
that of diphtheria, scarlet fever, measles and perhaps most 
often the grip bacillus. 

Fetid breath is another symptom which causes some people 
to come to us for treatment. When this is due to a pathological 
condition of the nose and throat we usually find dead bone as 
the causative factor. This may be due to tuberculous or syph- 
ilitic ulcerations of the turbinates or septum or to infection of 
the accessory cavities or to retained secretions due to enlarged 
lower turbinates and thickened septum. In this latter condi- 
tion the secretion comes down from above, and since the patient 
can not blow it out completely, if at all, it collects till it runs 
back into the pharynx or is drawn back by an effort of the 
patient and finds exit through the mouth. 

Many patients come complaining of frequent sore throat. 
The exciting cause is usually sitting in a draught, getting feet 
wet, cold, damp weather, etc. I think this is most apt to 
occur in people who have diseased tonsils. In many cases one 
would not suspect the tonsils were diseased at all, but ex- 
perience shows that such cases often derive immunity from oft- 
recurrent sore throat when the tonsils are removed. These ton- 
sils usually belong to the so-called submerged variety. They 
appear to render the throat more sensitive to the exciting causes 
mentioned above. 


210 


Perhaps tousilitis brings more patients to a nose and throat 
man than any other disease. Comparatively few persons in a 
moist climate escape having trouble with their tonsils at some 
time in life. But a large number of patients who come to us 
suffering from diseases of the nose aud throat, come complain- 
ing, not with the nose or throat, but with earache, discharging 
ears or a loss of hearing. Many of these people are surprised 
when informed that they have a disease of the nose or throat. 
They are still further astonished when told that the patholog- 
ical condition of the nose and throat is responsible for the 
ear symptoms of which they complain. The fact that almost 
all middle ear troubles are caused by adenoids, diseased tonsils 
or some form of nasal obstruction has been thoroughly worked 
out during recent years and should be fully realized and ac- 
cepted by every member of the profession. Who of us has not 
at some time known an anxious mother to be counseled that her 
child will outgrow a chronic suppurating ear? As a matter 
of fact they do not outgrow it. It not infrequently happens 
that the discharge will cease but early loss of hearing will 
ensue porportionate to the extent and duration of the otitis- 
media. It is the rule as one advances in adult life that the ton- 
sils and adenoids atrophy and thus by slow process nature ac- 
complishes finally a cure of the discharge which a rational 
surgery would have effected in a few days or, at most, weeks, 
preventing any damage to the hearing, which the slow method 
of nature’s surgery fails to do. 

Before leaving this part of my subject I desire to make a 
brief statement about adenoids. One accustomed to treating 
patients suffering from them can usually make a diagnosis as 
soon as the patient enters the office, if the growth is large 
enough to prevent nasal respiration. It is observed that the 
patient is anemic, is dull and stupid in appearance, does not 
shut his mouth longer than is necessary to swallow. Ask him 
to close his mouth and he may do so a moment but will open it 
when he desires to breathe. In aggravated cases the patient 
is nervous aud irritable in temper, is always in trouble with 
parent and teachers, has frequent brawls with brothers, sisters 
and playmates, progresses poorly in his books, and is acknowl- 
edged to be a hard case generally. Other nasal obstructions 
may produce all these effects, polypi perhaps most often after 
adenoids; therefore, the above-named symptoms, which are 
usually considered characteristic and almost pathognomonic 
of adenoid growths, are not really so. Previous to an exam- 
ination of a patient having these symptoms one expects to find 
adenoids since they are met so frequently, while other con- 
ditions which give rise to them are comparatively rare. 


211 


There is an intimate relation between the eye and the nose 
which ought to be mentioned. Oculists occasionally are called 
upon to treat cases of blindness in one and sometimes both 
eyes which are traceable to an infection of some of the acces- 
sory sinuses, which infection, as we have stated, is usually due 
to some form of nasal obstruction. In such cases the blindness 
is often completely restored when the nose and infected ac- 
cessory cavities are properly treated. 

The treatment of the various pathological conditions men- 
tioned is mainly surgical. Diseased tonsils must be removed. 
One should not stop short of complete removal. This cannot 
usually be done without thorough dissection of the gland from 
the anterior and posterior pillars. Adenoids and polypi should 
be thoroughly removed. 

If the obstruction is due to an intumescent condition of the 
mucus membranes covering the turbinates, the surgeon can pro- 
duce sufficient retraction by the use of the actual cautery or 
by chromic or tri-chlor acetic acid. Before resorting to this 
method the nose should be swabbed with cotton saturated with 
four per cent, solution of cocaine, followed by an application of 
adrenalin chloride. If this causes sufficient shrinking of the 
tissues to demonstrate that there is no hypertrophy suf- 
ficient to interfere with nasal respiration then there is no use 
to remove any tissue. In such cases the cautery produces a 
cicatrix which ties the mucous membrane down to the bone. 
If there is hypertrophy a sufficient amount of the turbinate 
should be removed to secure ample breathing space but no more. 

Spurs must be removed by saw or scissors or knife or 
snare, whichever is most suitable to the case in point. When 
the obstruction is caused by thickened or deflected septum the 
operation most in use now is the sub-mucus removal of the 
cartilage of the septum. After the cartilage is removed the 
mucus membranes covering it are brought together and ad- 
here in a few days, maintaining the function of the septum. 
The treatment of inflammation of any of the accessory cavities 
of the nose depends on circumstances many of which I can not 
stop to consider. If the inflammation is an acute one relief 
is frequently obtained by local application of adrenalin, which 
by its astringent action on the membrane at the mouth of the 
duct leading to the cavity secures drainage till resolution of the 
acute symptoms has taken place. If there is hyperplasia of the 
tissues at the mouth of the duct sufficient tissue must be re- 
moved to secure permanent drainage of the cavity. This is 
often all that is necessary to be done even in chronic purulent 
inflammation. When there is necrosis or unhealthy granula- 
tions the dead bone must be removed or granulation tissue 
curetted. 


212 


* THE INDISCRIMINATE USE OF DIURETICS. 


S. W. GLASS M.D., 

DUBLIN. 


Diuretics are used to increase the kidney secretion. They 
act by stimulating the renal epithelium to greater activity, 
thereby increasing the excretion of both the watery and solid 
constituents of the urine, or simply increase the watery con- 
stituents by increasing blood-pressure in the kidneys. 

We are taught by physiology that we are dependent on four 
emunctory organs as systemic eliminants: skin, lungs, bowels 
and kidneys. To my mind, of these emunctories, the kidneys 
are the most frequently neglected and overlooked by members 
of our profession in the diagnosis and treatment of any disease, 
in the physical examination of a patient. After the tongue and 
pulse are examined and temperature noted, next follow the ques- 
tions : ‘‘How are the bowels ? When did they last act ? What 
were the color and consistency?” But unless some physical 
symptoms strongly direct, we are prone to neglect a very im- 
portant point which reveals much, namely urinary analysis. 

It is timely here to mention the fact that the reaction of 
the urine plays an important part in our examination. Suppose 
we are treating an aged man with enlarged prostate and cys- 
titis, where the residual urine has undergone an ammoniacal 
decomposition, would it be rational therapeutics to administer 
an alkaline diuretic or palliative measures? In such case the 
urine is already alkaline and such treatment would only be 
adding fuel to the fire. On the other hand, the administration 
of such a drug as benzoic or boric acid would give gratifying 
results. 

In cases of acute nephritis the administration of active 
diuretics, such as turpentine or cantharides, at once appear to 
us unwise, for here we are confronted with inflamed organs and 
the same rule applies here as in any other part of the body and 
rest appeals to us as of paramount importance. This is to be 
obtained by stimulating the activity of the other emunctory 
organs. 

Of all diuretics mentioned in the materia medica, aside 
from water, I think we have only one safe and reliable : calomel. 
This drug seems to promote the general cell activity of the 
entire organ. 

Without deviating or digressing too much, perhaps I may 
mention the indiscriminate use of diuretics in the treatment of 
diseased organs other than the urinary apparatus, as for in- 

* Read before the Clarksdale and Six Counties Medical Society- 


213 


stance when in typhoid fever we administer a turpentine emul- 
sion for its effect on the gastro intestinal canal, never stopping 
to consider its effect on the kidneys, which are frequently in no 
condition to receive such active or drastic stimulation. 

In this malarial country a diuretic is not indicated as often 
as the symptoms suggest, as we always have to contend with a 
torpid liver that is throwing a part of its work on the kidneys, 
which means double duty for these organs. In such cases cor- 
rection of the liver trouble is rational treatment, thereby reliev- 
ing the trouble supposed to be due to defective kidney action. 


TOi ssisstppi State 'ftteritral ^ssanattxm. 


OFFICERS 1909-10. 

President — D. W. Jones 
Vice-President — J. S. Sanders 
Vice-President — J. C. Armstrong 
Vice-President — Thos. Purser - 
Secretary — E. F. Howard 
Treasurer — H. L. Sutherland 


Brookhaven. 
Scranton. 
Water Valley. 
McComb City. 
Vicksburg. 
Rosedale. 


CHAIRMEN OF SECTIONS. 


Medicine 

Surgery 

Obstetrics 

Gynaecology . . . 
Materia Medica 
Pediatrics 


Hygiene J 

Dermatology .... 


Electro-Therapeutics 


. • • . B. L. CULLEY 



Greenwood 

. . . . G. S. Bryan 

Amorv 

. . . . T. M. Jones 

Hernando 

. . . . J. C. McNair 

Fayette 


. . Crystal Springs 

. . . . G. W. Stephens . . 

Meridian 

. . . . Root. Donald 

Hattiesburg 

. . . . J. S. Ullman 


.... 0. N. Arrington . 

Brookhaven 

. . . . W. S. Leathers . . 

University 

t. . . D. G. Mohler 

Gulfport 

. . . . Rosa Wiss 

Meridian 

. . . . P. R. Brown 

West Point 


STANDING COMMITTEES. 

Committee On Public Policy And Legislation. — P. W. 
Rowland, Oxford ; L. C. Feemster, Nettleton ; N. Stewart, Jack- 
son; D. W. Jones, Brookhaven; E. F. Howard, Vicksburg. 


214 


Vtmmixm tontrcl ©f Tnbmulrrsts. 


To the Secretary of each State and County Society and Other 
Interested Members: 

At the last meeting of the American Medical Association 
at Atlantic City the following report of Committee on Miscel- 
laneous Business was adopted: “The Committee recommends 
that the President of this Association appoint a committee of 
five members to inquire into the desirability and practicability 
of the establishing under the auspices of the American Medical 
Association a fund for the assistance of physicians disabled by 
sickness, and for a sanatorium for the treatment of such mem- 
bers of the Association as may be afflicted with tuberculosis or 
similar diseases; such committee to report to the House of Del- 
egates at the next annual meeting of the Association.” 

As a basis for wise action the Committee urges that the 
officers of the State and County Medical Societies, and others 
interested in the subject, should at the earliest possible date, 
forward to the Secretary of the Committee, Dr. A. C. Magruder, 
Colorado Springs, Colorado, answers to illustrate the need for 
provision for disabled members of our profession. 

1. Is there any provision by your State Medical Society, 
or local society for the care of destitute and disabled physi- 
cians and those dependent upon them? If so, how is such care 
provided ? 

2. What number of instances of special need for such as- 
sistance (or sanatorium treatment) have arisen in your locality 
within the last five years, and what number of your members 
need such assistance now? 

3. About how many members of your County Medical 
Society are at present afflicted with tuberculosis or similar dis- 
eases, or have within the last five years died, or withdrawn 
from professional work on account of such diseases? 

It is earnestly requested that this matter be brought before 
each County and State Society at its next regular meeting, and 
that the desired information be furnished our Committee at 
the earliest possible date. 

Fraternally yours, 

Edward Jackson, Denver Colorado. 

Jefferson R. Keen, Washington, D. C. 

A. T. Bristow, Brooklyn, N. Y. 

H. B. Ellis, Los Angeles, California. 

A. C. Magruder, Secy., 305 N. Tejon St., 
Colorado Springs, Colorado. 


MISSISSIPPI TOEDIBm fflOHTHLY. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D.. Rosedale. 

H. M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

SUBSCRIPTION ONE DOLLAR PER ANNUM. 


The committee on public policy and legislation has not 
had entirely smooth sailing to date. As a result of two con- 
ferences at Jackson to formulate plans and prepare propa- 
ganda, the committee had introduced bills bearing on all the 
matters advocated by the Association, a provision for vital 
statistics and an increase in requirements for license to prac- 
tice. On the 17th. of February three members of the committee 
braved a cold wave and a storm of rain and sleet and went 
before the committee of the House where Chairman Rowland 
and President Jones argued so forcibly the reasons for requir- 
ing diplomas of applicants for license that a favorable report 
was made and the members of the committee returned to their 
homes happy, only to learn two days later that the committee 
of the Senate had decided adversely on the measure. Of course 
the matter will not be allowed to rest here but in the face of 
such opposition we cannot hope to win unless all get in line 
behind the measure. 

The bill, in brief, requires that applicants for license shall 
be graduates of some school that teaches four years in medi- 
cine and whose requirements are those of the Association of 
American Medical Colleges. These requirements are simply a 
high school education. 

In this day of graded medical education, when the first 
and second course students rarely see a patient, the necessity 
for the first provision, a diploma, would seem so evident that 
none could overlook it, and the second — relating to the stand- 
ard of the school — was added because without it Mississippi 
will become the dumping ground for the graduates and under- 
graduates of those schools whose diplomas are not recognized 
elsewhere. 

The points seem clear enough but the legislators don’t 
appear able to get at them and unless we interpret quickly it 
may be another two years before we wipe off this blot from the 
fair fame of our state. 


215 


216 


SfltMg Vxnttt dings. 


Harrison County Medical Society met Feb. 8th. 1910. 
Dr. H. H. West, president of the society, being absent, Dr. H. 
X. Richardson, vice-president, called the meeting to order. 
Those present were Drs. Hopper, Hood, Welch, Mohler, Car- 
roll, Richardson and Sheely. Dr. Hood of Bond presented a 
very interesting paper on ‘‘Fibrinous Pneumonia In An In- 
fant”. This paper was freely discussed, especially the probable 
cause of the sudden death seven days after the child had ap- 
parently recovered from the disease. Consensus of opinion 
tended to show that death was very probably due to acute 
dilatation of the heart. Similar cases of sudden death were 
mentioned and various causes shown. Dr. Sheely gave in detail 
his treatment of pneumonia in children and called especial at- 
tention to the importance of recognizing the different stages 
of this disease, as different treatment was indicated in each 
stage. He does not believe in the indiscriminate use of ex- 
pectorants as advocated by many. The report of the Board of 
Censors on the case of the Jackson County Medical Society vs. 
Drs. McEachern and Rehfeldt was read. This report recom- 
mended the acceptance of Drs. Eachern and Rehfeldt, as this 
committee did not consider the evidence obtainable sufficient to 
prove the charges made by the society. Report was received. 
The proposed Constitutional Amendment sent out by the State 
Association was read. This amendment proposes to change 
the time for election of officers by the House of Delegates from 
“the morning of the first day”, as heretofore, to “the evening 
session of the second day”. The question was freely discussed 
and on being put to a vote it was moved that this society 
would not endorse this proposed change upon the grounds that 
the election of officers on the evening of the second day would 
detract greatly from the interest manifested in the remainder 
of the session. The motion carried. A communication from 
Dr. H. W. Wiley was read, in which he extended his thanks to 
this society for its endorsement of his stand in regard to the 
addition of preservatives in food stuffs. Dr. Caraway, who 
was to have read a paper at this meeting, being absent, and no 
other business being before the house, the society adjourned. 

G. Frank Carroll. 


Tri-County (Pike, Lincoln, Copiah) Medical Society met 
at Brookhaven at 2 P. M. Tuesday, Feb. 8th., with fourteen 
members present. The meeting was in the nature of a sym- 


217 


posium on pneumonia. The pathology, symptomatology, dif- 
ferential diagnosis and treatment were discussed fully, with 
Dr. Beacham as leader. Dr. Martin presented the merits of 
the guaiacol treatment, Dr. Jones the quinine treatment, Dr. 
Purser the c-reosotal and Dr. Little the merits of veratrum and 
digitalis. The general conclusion arrived at was that there is 
no specific treatment, but that we must treat the patient rather 
than the disease. Dr. Butler followed as leader in the discus- 
sion of empyema. He presented a paper covering all phases of 
this subject, which was followed by a general discussion. Dr. 
Johnson reported a case of empyema following pneumonia, 
where a resection was done and the Beck bismuth treatment of 
the cavity tried with excellent I’esults. The matter of the pro- 
posed amendment to the by-laws of the State Medical Asso- 
ciation, relative to the election of officers, being presented, it 
was voted that our delegates be uninstructed. McComb was 
elected as the next place of meeting, 2 P. M., April 5th., which 
meeting will be in the nature of a symposium on diseases of the 
skin. 

D. W. Jones. 


Sn TOBmnrtam. 


RESOLUTIONS OF SIMPSON COUNTY MEDICAL SOCIETY. 

Whereas, during the past year our Father above has taken 
from us by death our beloved fellow member and brother Dr. 
C. K. Norman, and 

Whereas, we as individuals and members of Simpson 
County Medical Association are made to feel and to realize 
the loss of our fellow member and co-worker who was ever 
ready to lend his assistance to the fraternity ; therefore be it 

Resolved, that while our hearts are saddened by the loss 
of his presence and earnest work, they are comforted with the 
sublime hope that he has passed into eternal rest. 

Resolved, that we hereby express to the relatives of our 
deceased fellow physician our deep and earnest sympathy for 
them in their bereavement. 

Resolved , that these resolutions be spread upon the min- 
utes of the association and that a copy of them be sent to the 
family of the deceased. 

A. E. Kennedy, 

W. M. Biggs, 

A. F. Kyger. 

2— M 


218 


Brrflk Hbwbws. 


A TEXT-BOOK ON THE PRACTICE OF GYNECOLOGY. For 
Practitioners and Students. By W. Easterly Ashton M.D., L.L.D., 
Professor of Gynecology in the Medico-Chirurgical College of Phila- 
delphia, Fourth edition, thoroughly revised. Octavo of 1099 pages, 
with 1058 original line drawings. W. B. Saunders Company, Phila- 
delphia. 1909. Cloth, §5.50 net; Half Morocco, $8.00 net. 

There are features in this volume which make it especially 
adapted to the use of the student and practitioner. The ar- 
rangement of the book on an anatomic basis permits a discus- 
sion of the methods of examination of each organ before de- 
scribing its diseases, thereby rendering the usual chapter on 
physical examination unnecessary, which on account of gener- 
alization tends to confuse, rather than enlighten, the student. 
This arrangement permits the methods to be studied in succes- 
sion and familiarized in a practical manner. The illustrations, 
of which there are one thousand and fifty-eight, are exception- 
ally well taken. They are drawn from actual apparatus, living 
subjects, dissections of the cadaver and the operative technique 
of authors. Different chapters have been re-written and such 
new matter has been added which brings this, the fourth edi- 
tion, up to modern teachings in gynecology. The author has 
thoroughly covered the subject, giving every detail such minute 
description that nothing is left to the imagination of the reader. 
The volume is one in which will be found explicit statements, 
not descriptions of various methods, hence when consulted one 
gets the ideas of an author whose experience and teaching can- 
not be doubted. 

Sproles. 


A TEXT-BOOK OF THE PRACTICE OF MEDICINE. By James 
M. Anders M.D., Ph.D., L.L.D., Professor of the Theory and Practice 
of Medicine and of Clinical Medicine, Medico-Chirurgical College, 
Philadelphia. Ninth Revised Edition. Octavo of 1,326 pages, fully 
illustrated. W. B. Saunders Company, Philadelphia, 1909. Cloth, 
$5.50 net ; Half Morocco, $7.00 net. 

This is the most distinct disappointment that we have en- 
countered in months and the greatest proof that we have ever 
seen of the statement that Philadelphia is asleep. Naturally 
a Southerner opening a new book on practice looks to the pages 
on malaria, and in this book he meets many flaws in that par- 
ticular section. Perhaps this opinion is due to the fact that 
the reviewer has but recently had the pleasure of reading Dead- 
erick on malaria and also has the good fortune to know rather 
well a number of other men who have studied the subject pretty 
thoroughly, but the fact remains that Anders’ ideas of malaria 


219 


leave nothing but a bad opinion. Passing to acute parenchy- 
matous nephritis we note, under “treatment”, that “the patient 
should be encouraged to drink freely of water”. That was 
taught twelve or fifteen years ago. And so on down the line. 
The book is excellent as an example of what practice was ten 
years ago, and will no doubt be received and highly praised by 
those practitioners who are that far behind the times. 

Howard. 


INTERNATIONAL CLINICS. A Quarterly Of Illustrated Clinical 
Lectures And Especially Prepared Original Articles. Edited by W. 
A. Longcope, Philadelphia. Vol. IV, Series 19. J. B. Lippincott 
Co., Philadelphia. Price $2.00. 

The article that will strike everyone most forcibly in this 
present issue of the well-known quarterly is “Antimeningitis 
Serum And The Results Of Its Employment” by Flexner. This 
is the class of work that will make the medicine of the future 
and put the profession on the therapeutic plane for which we 
are all striving, and no one’s work is received more eagerly than 
that of Flexner. Deaver contributes an article on “Indications 
For Surgery Of The Prostate” that is recommended to all. 
What will strike every reader as a most unusual proposition 
is the suggestion made by Rectenwald in a paper entitled 
“Gravity Method Of Removing Adherent Placenta”, in which he 
recommends tying a half-brick to the funis and hanging it over 
the foot of the bed, as one makes extension in fractures of the 
leg, to make continuous traction. One wonders if he really 
means it; if intended as a joke it is ill-placed since someone 
new to the business might take him seriously. 

Howard. 


EXAMINATION OF THE URINE: A Manual for Students and 
Practitioners. By G. A. DeSantos Saxe M.D., Instructor in Genito- 
urinary Surgery, New York Post-Graduate Medical School and 
Hospital. Second edition, enlarged and reset. 12 mo. of 448 pages, 
illustrated. W. B. Saunders Company, Philadelphia. 1909. Cloth, 
$1.75 net. 

Saxe on the urine is a popular and reliable text. The 
second edition is well up to date. The author uses rare judg- 
ment in selecting simple, practical and reliable methods, ac- 
curately defining their limitations, and clearly describing 
them. Many will differ with him as to ability to differentiate 
epithelial deposits. The spermatozoa in Fig. 74 are drawn too 
small; the head of a spermatozoon can easily contain two pairs 
of gonococci. The differentiability of diseases by urinary diag- 
nosis is also overestimated. 


Krauss. 


220 


A TEXT-BOOK OF OBSTETRICS: Including Related Gyneco- 
logic Operations. By Barton Cooke Hirst M.D., Professor of Ob- 
stetrics in the University of Pennsylvania. Sixth Revised Edition. 
Octavo of 992 pages, with 847 illustrations, 43 of them in colors. \V. 
B. Saunders Company, Philadelphia. 1909. Cloth, $5.00 net ; Half 
Morocco, $6.50 net. 

There is nothing better than this to be found in the market 
to-day. The author is a man of keen observation and wide ex- 
perience, besides having an unusual faculty for imparting 
knowledge. This rare combination he has focused on the sub- 
ject in hand and the result is a work that is the peer of any. 
It is perhaps a little too comprehensive for a student’s work 
in class, but even here supplies a valuable work for parallel 
reading, while to the man in practice it will be found invaluable. 

Howard. 


A PRACTICAL TREATISE ON OPHTHALMOLOGY. L. Webster 
Fox M.D., L.L.D., Professor of Ophthalmology in the Medico-Chi - 
rurgical College, etc. D. Appleton & Co., New York. Price $6.00. 

This is another volume that the reviewer does not see the 
reason for bringing out. It is a thoroughly good and reliable 
guide to present day knowledge of diseases of the eye, but does 
not present anything which cannot be found in other works, 
some of which are certainly better than the one under con- 
sideration. The book would be a very good one for students 
wishing a more comprehensive work than the smaller hand 
books, but does not appeal to me as a reference work for the 
specialist. 

Bell. 


AMERICAN ILLUSTRATED MEDICAL DICTIONARY. The new 

(5th) revised edition. A new and complete dictionary of terms used 
in Medicine, Surgery, Dentistry, Pharmacy, Chemistry, Nursing, and 
kindred branches; with new and elaborate tables and many hand- 
some illustrations. Fifth revised edition. By W. A. Newman Dor- 
land M.D. Large octavo of 877 pages, with 2000 new terms. Phila- 
delphia and London. W. B. Saunders Company, Philadelphia, 1909. 
Flexible leather, $4.50 net; indexed, $5.00 net. 

This is one of the more convenient-sized dictionaries and 
will be found thoroughly reliable as to definitions though weak 
in spots on pronunciation, especially of the Greek deriv- 
atives. The illustrations are worthy of a better cause, since no 
one cares for full page, colored plates of inflamed appendices, 
diphtheria, the pelvic brim and the fetal skull, Leishman-Don- 
ovan bodies, biliary calculi, and others equally out of place in a 
dictionary. They add to the cost and to nothing else. 

Howard. 


MISSISSIPPI H1EDICHL B10IITHLI 

VOL. XIV. APRIL 1910. No. 12 


* AMOEBIC ENTERITIS. 


A. J. JAGOE M.D., 

CLARKSDALE. 


Amoebic enteritis is a peculiar ulcerative condition of the 
intestines and adnexa caused by the amoeba coli (Loesch), 
usually confined to the large intestine. Occasionally it extends 
to the ileum and to the appendix. Abscess of the liver is a 
frequent consequence, say fifteen per cent. 

This form of amoeba was discovered by Loesch of St. 
Petersburg in the stools of some dysenteric patients and by 
him named a. dysenteriae. His decision in this respect is now 
adopted by the profession at large. 

The amoebic and bacillary forms of enteritis, while prev- 
alent in the tropics, are not by any means absent from the 
United States nor this immediate part thereof. This disease, 
in both forms, has always been with us, but it is only lately 
that the different causative agencies have become known to us. 

Water is the vehicle by which the amoeba coli (Loesch) is 
admitted into the system: frequently by vegetables eaten raw 
after being washed with such water. 

The amoeba is a migratory microzoon as demonstrated by 
Sternberg and so may go through the mucous tissue of the 
bowel to the submucosa and there work his mischief, or he may 
enter the blood vessels and be carried to the submucosa at dif- 
ferent distances from the point of entry and thus diffuse the 
trouble. 

The ulcers show a tendency to be undermined, due to lack 
of resistance of the submucous layer of the bowel, when sub- 
sequently the muscularia mucosa, being weakened, collapses 
and an ulcer is formed. 

The infection may be latent or marked, mild, moderately 
severe, or severe, including diphtheritic and gangrenous forms. 

The ulcers are most frequently found in the cecum and 
thence the amoebae travel to the appendix where also they are 
found ; next often in the sigmoid flexure; but the ulcers made by 

* Read be/ore the Clarksdale and Six Counties Medical Society. 

221 


222 


the amoebae are found in every part of the colon. It is likely 
that from the hepatic flexure or through vessels they reach the 
liver and so make the abscess found there as a result of their 
invasion. 

The lesions vary from raised injected spots in which infil- 
tration of the submucosa has taken place, but no ulceration, to 
ragged ulcers which are irregular in outline and of considerable 
extent. They differ from those of the bacillary form by being 
raised above and sharply defined from the surrounding mucous 
membrane, which presents a healthy appearance. Ulcers in the 
bacilliary form increase in size by gradually softening and 
breaking down at the surface; never by necrosis and sloughing 
of the underlying tissue: occasionally they do not penetrate 
deeper than half way through the mucosa ; generally they ex- 
tend into the submucosa but never contain amoebae. 

The most important clinical manifestations in a question 
of diagnosis are : 

I. The bowel evacuations which, in this condition are 
sometimes dysenteric, sometimes diarrhoeic and then again ap- 
parently healthy, their odor and the presence or absence of 
blood. 

II. Abdominal soreness which is increased on pressure and 
extends along the colon (this, taken singly, is one of the most 
valuable aids). 

III. So-called “indigestion headaches”, general lassitude 
with nausea or pain below the stomach after eating (this is 
also prevalent in other conditions). 

IV. Loss of weight, especially in the presence of a good 
appetite, is quite important as one of the best guides to the 
progress being made by the infection. 

Neither one nor all of these symptoms taken together are 
sufficient for absolute diagnosis, but when taken in cases 
where careful palpation reveals a thickened tender colon, in 
places where it may be felt, they make the nearest approach to 
a sure diagnosis possible without microscopic examination of 
the feces. For this last the patient is given a full dose of 
Rochelle salts and the feces passed are carefully examined. If 
amoebae are discovered therein this is confirmatory. 

Constipation is a very prevalent condition with us. particu- 
larly among women, and may frequently mask amoebic infec- 
tion in the early stages and in the latent form until irreparable 
damage may have been done to the colon and liver. 

Complete healing may be accomplished by treatment, or 
chronic atrophic catarrh, which is known as sprue or psilosis, 
may persist, but vigilant and intelligent treatment may avert 
this sequel. 


223 


Drug treatment is principally of use in acute stages of this 
disease when no other form is admissable and then for allaying 
pain and other distressing symptoms when, if possible, the 
patient should be confined to bed and use the bed-pan and when 
active symptoms have subsided direct local treatment should 
be instituted. 

While oral and hypodermic treatment is of service as above 
stated, it is not curative and so we must turn for those cases 
and for those chronic and subacute cases to the direct applica- 
tion of our remedies. 

Loeseh was the first to publish the virtues of quinine and 
it appears to still be the favorite. Irrigations of one to two 
quarts of the quinine solution, commencing with 1-1500, ten 
grains to a quart, gradually increasing its strength up to the 
point of tolerance, not higher than 1-7500, twenty grains to a 
quart. Some recommend the quinine irrigations twice a day; 
quininization of the system must be avoided. 

Before any medicated application is made, the bowel 
should be irrigated through a double-flow tube with sterile 
water until the return flow is perfectly clear. 

F. Billings supplements the quinine treatment with FI. 
Ext. Chaparro Amargose (evergreen oak) in doses of one-half 
to one dram every four hours, and he claims to have obtained 
cures in some cases, benefits in all. 

Other treatments, irrigations, are: water at a temperature 
of 115° F. containing silver nitrate, ten to thirty grains in a 
quart, twice a week ; mercuric cloride 1-3000, six ounces, three 
times daily ; formalin solution, 1-300 or 400 ; hydrogen peroxide 
in weak solution once a day. Copper sulphate, 1-10000, one and 
one-half grains to a quart, is said to have more or less selective 
action on amoebae coli as well as on lower forms of vegetable 
life, far better borne than the quinine treatment and recovery 
more rapid than under any other method. Patients stay cured 
if applications are kept up for a reasonable time after amoebae 
coli are not found in the stools. 

For each of these agents the claim is made that it will kill 
the amoeba and, if so, why not also the bacillus dysenteriae, so 
that whichever form of the disease is present the remedy may 
be effective. 

As in the general practice of medicine, so in the treatment 
of amoebic enteritis, a routine mode of treatment will not be 
effective in all cases and while each of the agents aforemen- 
tioned may be efficient as a curative no one can be depended 
on as a general remedy. We will then have to do the best we 
can according to our light. 

This disease is one which rapidly saps the strength of the 


224 


patient, so it is imperative that sufficient and proper nutriment 
be given at all times : five small meals a day of digestible food 
which I think had better not include turnip greens, mustard 
greens and poke salad, which some of our brethren consider, in 
this disease, a curative. 


* PSYCHO THERAPY. 


J. W. UNGER M.D., 

WEST POINT. 


Introductory to the consideration of psychotherapy, I deem 
it necessary, in order to intelligently discuss the subject, to 
present certain psychological data not usually treated of fully 
by psychologists. Psychologists divide mind into objective and 
subjective, or into conscious and subconscious. From this 
duplex mental mechanism, the phenomena of psychical and 
physical energy enamate, directing the impulses which are 
transmitted to the various organs of the body. Biologists claim 
that individual cells are distinct organisms. If this position be 
correct, man is a confederacy of protozoons and the brain an 
aggregation of uni- and pluri-cellular organisms, and has the 
power to initiate physiological and pathological processes, and 
hence may cause and cure disease. 

Since the dawn of history magic and superstition have 
played no unimportant part in the treatment and cure of dis- 
ease. In proof of this assertion, various methods and cults 
have originated, among which I mention the pythonism of the 
Greeks, the shamanism of the Ural-Attic people, the Psylli of 
Lybia, magnetism, mesmerism, hypnotism, metallotherapy, Per- 
kins’ tractors, mind cure, faith cure, Dowieism, Eddyism and 
the Emmanuel movement. This last is the latest, and is a 
movement in which doctors and theologians diagnose and treat 
disease together. The question arises out of this heterogenous 
conglomeration of cults and isms, to what shall we attribute 
the secret power, the basic principle and the fundamental 
causes that account for and correllate all these forms, systems 
and methods of psychic healing. After a survey of the field, 
and a critical analysis, I have no hesitation in saying that the 
potent factor, the underlying principle, of all forms of cure is 
faith — faith in the man, the means or the method. Another 
question then presents itself, how may faith be excited? I 
answer, unhesitatingly, by the law of suggestion. It may be 

* Read before the Clay-Oktibbeha County Medical Society. 


225 


simple, hypnotic or post-hypnotic suggestion ; by the personality 
of the physician, by medicine, by surgery or by various other 
means or media. 

The time has come when we as physicians can no longer 
ignore the mental factor in causing and curing disease. What 
we need in psychotherapy is something corresponding to those 
splendid conceptions that gave to the world the heliocentric 
theory of gravitation, the undulatory of light, the theory of 
evolution, the germ theory of disease. If some medical genius 
would concentrate and focalize his mental powers on psychic 
healing, equally great and exact laws might be formulated. 
When we have mastered the marvelous intricacies and depend- 
encies of spirit, soul and body, we will have attained to that 
point that will enable us to call on one to help the other, in 
the protean manifestations of disordered function as well as 
in structural changes. 

I agree with Dr. Hack Tuke when he said that active 
practitioners should utilize this mental force, yoke it to the 
cars of the son of Apollo, rescue it from the eccentric orbits 
of quackery, and force it to tread with measured step the 
orderly paths of legitimate medicine. Sir Janies Paget, in a 
letter to Sir Henry Acland, emphasized the importance of the 
potentiality of mind when he said of a clever, charming and 
widely known lady: “She will some day disgrace us all, by 

being juggled out of her maladies by some bold quack, who by 
mere force of assertion will give her the will to bear, or forget, 
or suppress, all the turbulances of the nervous system”. 

The fact is clear that psychotherapy, though disliked and 
ignored by the physician, is the bread of life to all quacks. 

The divison of mind by psychologists into objective and sub- 
jective has aready been dwelt upon, and that faith is the founda- 
tion of all cure, and that suggestion is the excitor of faith, and 
that it is operative only through the subjective mind, and that 
the subjective mind presides over the conditions, functions and 
sensations of the body, and this furnishes the clue to the cure 
of all disease. To be a successful physician it is absolutely 
necessary to employ suggestion either conciously or uncon- 
sciously. A pleasing personality goes for something with pa- 
tients, but is not an absolute necessity. Every physician should 
practice auto-suggestion, for the reason that it has a beneficial 
influence on himself, while at the same time it educates him to 
make healthful suggestions to others. The psychotherapeutist 
must be a man of purpose and have a purpose in all that he 
does. He must do nothing without conscious thought. He must 
envelop his patient with sympathetic attention, and always 
evince confidence in himself as a healer, otherwise he cannot 


226 


hope to inspire confidence in his patients. The conditions that 
contribute to the physician's success and create a favorable en- 
vironment may be summed up in the advice to never antagonize 
any one, no matter how insignificant ; always attempt to main- 
tain the most amicable relations with all, no matter how great 
or overwhelming your psychic power may be; for there is a 
possibility of counter or adverse suggestion upon the part of 
unfriendly attendants, that may tip the balance, and unfavor- 
able influence to the extent of causing the death of your pa- 
tient. Never permit any one, if avoidable, to enter the sick 
chamber who will attempt to create doubt as to your ability; 
you cannot predetermine what the effects may be. With family, 
friends and nurses, always be guarded ; do not give an unfavor- 
able prognosis. Do not, by word or act, unfavorably impress 
your patient. These admonitions are important to those who 
value results. I anticipate that much that I have said may 
bring a smile of contempt or of derision, notwithstanding I am 
firmly convinced that the position I have taken is correct, and 
will cite, in confirmation of my position, the utterances of some 
of the greatest physicians the world has produced. In the edu- 
cational number of the British Medical Journal for August 
1907, I find this statement: “Disease of the body is so much 
influenced by the mind, that in each case we have to under- 
stand the patient quite as much as the malady. This is not 
learned in the hospitals.” Dr. Maudesley says: “Perhaps we 
do not as physicians consider sufficiently the influence of mental 
states in the production of disease. Quackery seems to have 
gotten hold of a truth which legitimate medicine fails to ap- 
preciate or use adequately.” Sir Samuel Baker states that any 
severe grief or anger is almost certain to produce fever in some 
parts of Africa. Dx*. Cliffoi’d Albutt, in speaking of granular 
kidney, says: “It is undoubtedly a clinical fact, that it is often 
produced by prolonged mental anxiety.” B. W. Richai'dson 
says: “Diabetes is caused by mental sti*ain or sudden mental 
shock.” Sir George Paget observes : “In many cases I have 

seen reasons for believing that cancer has had its origin in pro- 
longed mental anxiety.” Dr. Murchison writes: “I have been 
surprised how often patients with primary cancer of the liver 
have traced the cause of their ill-liealth to protracted grief or 
anxiety.” Having quoted several showing that grave diseases 
are px*oduced, I shall next quote how they may be cured through 
the influence of mind. Dx*. Cax*penter says: “That the confi- 

dent expectation of a cure is the most potetft means of bring- 
ing it about, doing that which no medical ti’eatment can ac- 
complish. xxxay be affix*nxed as the generalized result of experi- 
ences of the most varied kind, extending through a long series 


227 


of ages.” Dr. Bruce says that we are compelled to acknowledge 
a power of natural recovery inherent in the human body. Oliver 
Wendell Holmes makes the statement that whatever other the- 
ories we may hold, we must recognize the vis medicatrix naturae 
in some shape or other. Hypocrates stated that nature was the 
physician of disease. Sydenham says: ‘‘Reason dictates that 
disease is nothing else but nature’s endeavors to throw forth 
with all her might the morbific matter for the health of the 
patient.” Sir Andrew Clark states : “It is impossible for us 
to deal knowingly and wisely with various disorders of the 
body, without distinctly recognizing the agency of states and 
conditions of the mind, often in producing and always in modi- 
fying them.” Up to to the very gates of death I maintain that 
a sanguine, cheerful and hopeful expectation is infinitely more 
useful, and more warrantable, on the part of the physician, 
than a brutal candor, which may cut the slender thread that 
holds the vital powers together. Ambrose Pare wrote on the 
hospital wall in Paris: “I dress the wound, God heals it.” 

Bain shows that through the subconscious mind most physio- 
logical processes can be suspended. It controls anabolic and 
catabolic cell action; and there is no doubt that a sound, cheer- 
ful mind, acting through it, is a great protector against disease 
of all sorts ; and if disease has obtained a hold a cheerful mind 
can often cure it. Psychic healing can be applied to the body 
in one of three ways : by the subconscious mind directly in 
spiritual or physical influences and surroundings; by the sub- 
conscious acting on the conscious indirectly — in rousing faith 
in persons, place or remedies; and by the subconscious mind 
acted on by the conscious by direct effect — in the determination 
to get well, and shake off pain and disease. 


* PROMISCUOUS PRESCRIBING. 


W. S. DERRICK M.D., 

GOODMAN. 


In presenting this paper to the society I feel extreme regret 
in acknowledging its unscientific principles when directed to a 
body of men whose lot has fallen with fellow-laborers in the 
deepest and most interesting science known to the human mind. 

There has not been in the history of all past time so much 
progress made in any branch of science as has been made in 
that of medicine in the last quarter of a century, and still we 

* Read before the Holmes County Medical Society. 


228 


as intelligent physicians are too prone to let real scientific 
methods and means go by unawares and fall into loose slip- 
shod, easy methods of doing business. 

With the great advances made in all the departments of 
medicine, and the most modern equipment and apparatus for 
diagnostic purposes, we do not need to go about our work in a 
half-hearted way and really fail to accomplish that whereunto 
we are sent, and for which we all expect at least a moderate 
compensation in a financial way, and I dare say we often look 
for better results in the patient’s condition than the treatment 
would really warrant. 

You will see at the outset that this paper does not deal with 
bedside practice alone, or is not meant so anyway, but with the 
general class of work as we find it from day to day, though I 
would like to lay special stress on the chronic walking class 
rather than those necessarily confined to bed, for in these it 
is generally more difficult to arrive at a proper diagnosis than 
in the more acute affections. 

In every instance where a physician is called upon for pro- 
fessional duty I think it is absolutely necessary as far as pos- 
sible for him to give the patient the benefit of the best scientific 
modes and methods of practice obtainable, not considering the 
amount of work and worry and the time it takes in getting at 
the bottom of the pathological condition. We can all equip 
our offices with such necessary apparatus for quite efficient lab- 
oratory work at small cost, and I deem it utterly impossible for 
any doctor to do good, honest work all the time without the 
aid of some laboratory work. In all cases where the diagnosis 
is obscure, chemical and microscopical examinations should be 
made of all the excreta, more especially the urine and feces, 
and in many instances blood examinations and stained speci- 
mens of the sputum are necessary to confirm the diagnosis. I 
dare say that there has been much more good donated to our 
branch of science through the pipette and test tube than at 
the point of the scalpel, and to-day it is by some of these sim- 
pler methods that we are able to say to the surgeon when he 
can and when he cannot operate. 

I consider, without any exception, off-hand or promiscuous 
prescribing one of the greatest evils that we could possibly 
let creep into our practice for many reasons too numerous to 
mention. To say the least of it, it is strictly unscientific and 
without credit. 

We owe much to the veterans of the profession for clinical 
findings and wide experience with disease which they have 
cheerfully handed down to us from time to time, and we still 
love and cherish the memory of the good old-time doctors, but 


229 


surely our responsibilities to-day are much greater than were 
theirs and if we as practitioners of modern medicine do not use 
the same energy and zeal in promoting the science that they 
used in practicing what they knew, we are really a discredit to 
the profession and a hindrance to progress and civilization. 
Less than twenty-five years ago the general practitioner knew 
nothing of the use or the stethoscope for the purpose of accurate 
auscultation, and nothing of the microscope for detecting with 
his natural eye bacilli and bacteria which are the cause of many 
pathological conditions, of which the diagnosis could not be 
definitely made without it. 

With these and many other advantages familiar to the med- 
ical mind of to-day, why should we not wake up and work up 
to duty and stop giving the specialists and city doctors the creme 
de la creme of our practice. It is generally recognized now by 
the majority of the profession that there are too many special- 
ties and too many specialists, and at the same time it is the 
very same majority who admit the fact who are at fault. If 
we all were to do our duty fully as regards the practice of 
medicine as we know it should be done, each of us would be, to 
some degree at least, a specialist on general medicine within 
ourselves. 

There is another phase of promiscuous prescribing, which 
I shall only mention briefly. We are sometimes consulted by 
the head of a family about some sick one in his home, and to 
his gratification he can get the physician to scroll off a com- 
bination of drugs for the patient without ever seeing him, to 
say nothing of knowing the condition of things as regards the 
nature of the disease. I have been guilty of this offense to my 
own sorrow and possibly to the sorrow of the patient as well. 
I will mention one case for example. I was asked to prescribe 
for a pain in a woman’s “stomach”, the lay stomach, I mean, 
which takes in everything from the mouth to the perineum, 
which I did, giving cathartics, digestives, etc., per os, and after 
unsuccessful attempts in this way I demanded that the patient 
come to my office, which she did, and I found on examination a 
general specific infection of the entire genito urinary tract as 
far as I could make out. Local treatment was applied with 
success. This is only an example of how utterly unscientific 
such practice is, and this one case taught me a lesson that I 
shall not forget soon. 

With these facts confronting us from day to day, I say it is 
high time we are getting down to a solid scientific basis and by 
so doing step upon a higher plane in life and uphold with zeal 
and integrity the dignity of our profession. 


230 

DIAGNOSIS OF CHRONIC INTERSTITIAL HEPHRITIS, 


M. L. POLLARD M.D., 
THORNTON. 


In this the twentieth century, the age of progress, we are 
in a great hurry. We are inclined to push on after new things 
and pass by as unimportant a great many old things. The 
country physician visiting the larger cities will not fail to visit 
the hospitals and strain every point to witness every big oper- 
ation that is done while he is in town and never pay any atten- 
tion to physical diagnosis or materia medica or any of the 
branches in which he is vitally interested. Every day we see 
prominent physicians fall down on the diagnosis of cases that 
ought to be easy for them to make. After seeing a great many 
of these mistakes made, I decided to try to write a paper on 
this most important subject. It is not my object to write on the 
differential diagnosis of chronic interstitial nephritis from 
other forms of nephritis, but to write on the diagnosis of chronic 
interstitial nephritis from diseases of other organs of the body. 
We often hear that this man or that man has tuberculosis, ner- 
vous exhaustion and is run down and needs a tonic, and when 
the correct diagnosis is made we find he has chronic interstitial 
nephritis. According to my mind I don’t believe there is any 
other disease that is so difficult to diagnose and one that is mis- 
taken so often for many other diseases. According to Osier 
the most prominent symptoms are lassitude, sleeplessness, pa- 
tient has to get up at night to micturate, the digestion is dis- 
ordered, tongue is furred, there are complaints of head ache, 
failing vision, breathlessness on exertion. It has been my ex- 
perience in most of the cases that have come under my observa- 
tion that these nervous symptoms have been the most prominent. 
With most of these cases you find a strong incompressible pulse. 
You may find the heart displaced, there may or may not be 
dropsy. 

It is often the case that a person will go to his physi- 
cian with these symptoms I have just enumerated and the 
physician will make just a casual examination and tell the 
patient all he needs is a good tonic and prescribe compound 
syrup of hypophosphites. Not long since a man went to his 
physician and, after an examination, was told he had tubercu- 
losis and was sent to a very celebrated diognostician in Mem- 
phis to corroborate the diagnosis. The specialist examined him 
and charged him a nice fee and told him he had nervous ex- 

* Read at the January 1910 meeting of the Holmes County Medical Society. 


231 


haustion and sent him to a nice, quiet place in the mountains to 
stay a while. To make a long story short the man did not im- 
prove in the pure mountain air and came back home and went 
to another physician, who made a correct diagnosis of chronic 
interstitial nephritis. This disease is insidious; it may not be 
recognized until the autopsy, the patient having died with pneu- 
monia, oedema of the lungs or hemorrhage. In passing let us 
study for a minute the pathology of the kidneys in this trouble. 
The reduction is generally the same in size and weight in both 
kidneys. Both together may not weigh over two ounces. The 
outer surface is red and irregularly granular. The tissue is 
firm and dense and resistant to the knife. The cut surface 
shows a thin atrophied cortex, with dark reddish streaks alter- 
nating with pale portions. The pyramids are darker than the 
cortex and also diminished. These changes take place gradually, 
so slowly that the patient may go on about his daily occupation 
as if nothing was wrong with him for several years. Very often 
the oculist will make the diagnosis, the patient having gone to 
him to correct his failing eye-sight. When we have cause to think 
that a man has nephritis our main source of help comes from 
the urine. It is too often the case that we make an examination 
of the urine and fail to find albumen and come to the conclusion 
at once that the patient is not suffering with Bright’s disease. 
If we make examinations of urine passed at different times of 
the day we will find albumen when we would not otherwise. If 
after repeated examinations of the urine we fail to find the long- 
looked-for albumen then it is that we can resort to the micro- 
scope, which will generally clear up the diagnosis. Under the 
microscope you will find granular and tube casts sometimes 
after repeated chemical analyses have proven negative. If you 
fail to find albumen don’t come to the conclusion that there is 
nothing wrong with the kidneys until you have examined the 
urine microscopically and failed to find anything wrong. If 
you are not prepared to make this microscopical examination 
yourself send a specimen of the patient’s urine to a competent 
microscopist and have him to do it for you. Another point we 
are to consider is the age of the patient. This disease generally 
comes on about middle life or later. I came in contact with 
one patient who had neuralgic pains and persistent head aches 
for several years. Epistaxis is sometimes a very important 
symptom and also a very dangerous one. The nose will start 
bleeding and bleed on in spite of treatment. Cerebral hemor- 
rhage is sometimes a complication in this disease. Where you 
have cerebral hemorrhage as a complication it doesn’t matter 
much whether you make the diagnosis of Bright’s disease or not, 
because the patient passes on to glory anyway. 


232 


“First know you are right and then go ahead” applies to 
physicians with as much or more force than to any people on 
earth. I have no patience with the man who thinks he never 
makes a mistake. If we were to follow such a man for a while 
we would find that he made more mistakes in diagnosing dis- 
eases than some of his less conceited brothers. The young 
doctor just out of school, full of ambition and full up to the 
brim with theory, thinks that diagnosing diseases ought to be 
the easiest thing in the world. When he brushes up against a 
case of chronic interstitial nephritis and calls it tuberculosis 
and some older physician who happens to be his neighbor comes 
along and names it for him, then it is that he learns that there 
is a good deal about medicine that he has not yet learned. 
When your patient comes to you and complains of sleeplessness, 
shortness of breath and loss of flesh, and has a good appetite, 
has to micturate two or three times at night and passes large 
quantities of urine at the time and has failing eye-sight, then it 
is you had better look out for nephritis. It matters not 
whether he has swelling around his lower extremities or not. 
It happens very often that people will suffer with these symp- 
toms for a long while before consulting a physician. It may be 
that the patient consults for his failing eye-sight the man who 
goes around over the country peddling glasses. In that case he 
would not be apt to find out his trouble. It is often the case 
that when there comes to us a man who has passed middle life, 
complaining of having to get up all through the night to pass 
his urine, we will tell him that certain changes that take place 
in the prostatic gland in a man of his age are the cause of his 
trouble. Later on we find out he has chronic Bright’s disease. 

In conclusion I would lay special stress on these symptoms 
I have just mentioned. Would say that when a patient goes to 
his physician with these symptoms I have just enumerated, he 
should not say he has some other trouble than chronic inter- 
stitial nephritis until he has tried every plan known to scientific 
medicine for diagnosing the disease. 

As to the nervous symptoms, don’t be too quick to say that 
the patient has a nervous break down and hustle him off to a 
sanitarium for nervous troubles or, worse still, say he has hys- 
teria. When a correct diagnosis is made in these cases it very 
often saves the patient a good deal of money and adds fame 
and honor to his physician. 


NOTICE. 

Rates of one and one-third fare plus twenty -five cents have 
been granted by the railroads for the Oxford meeting. Get 
your certificate when leaving home. 


MISSISSIPPI MEDICAL MONTHLY. 


B. 

H. 

E. F. HOWARD B.S., M.D., Editor and Publisher. 

S. MYERS M.D., Business Manager. 

ASSOCIATE EDITORS 

B. MARTIN M.D., Vicksburg. H. L. SUTHERLAND M.D., Rosedale. 

M. FOLKES M.D., Biloxi. M. H. BELL M.D., Vicksburg. 

OFFICIAL ORGAN OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 


SUBSCRIPTION ONE DOLLAR PER ANNUM. 


All aboard for Oxford ! Those who are convivially inclined 
will find amusement, those who are out for the strictly scien- 
tific phases of the meeting will find a liberal supply of mental 
pabulum, those who want a few days’ rest can find no more 
delightful place in which to get it. 

The president has received acceptances from Witherspoon 
of Nashville, Dock of New Orleans, Stiles of the P. H. & M. H. 
S., of hookworm fame, and last but by no means least, McCor- 
mack, of the A. M. A., whose addresses are worth going a thou- 
sand miles to hear even when one doesn’t agree with his ideas. 

Altogether it is safe to say that the 1910 meeting will be 
one that will be remembered for many years as something 
unique in the annals of the Association. The visitors are to be 
literally the guests of the town and of the University — as Dele- 
gate Rowland expressed it at Jackson last year: “All you need 
is your railroad fare” — and judging from rumors that are float- 
ing about everyone will come away with dyspepsia. That, how- 
ever, shouldn’t deter anyone, for it will be in a good couse. 
The new University hospital is open and the students probably 
need clinics, so those who fall by the wayside will not have to 
go around hunting a Samaritan. 

The plan of holding a meeting of the Delegates the night 
before the meeting of the Association, as provided in the By- 
Laws, worked so well that it will be tried again. That gives an 
opportunity for the various reports of standing committees to 
be worked off and the routine matters disposed of before the 
general session begins and therefore allows very much more 
time for the members of the House to attend the scientific ses- 
sions. A full attendance is asked for this opening meeting. 

233 




234 

Srrri;et£> f'rtfmrlTngs. 


Clarksdale and Six Counties Medical Society met iu 
Olarksdale the afternoon and evening of March 23rd. An at- 
tractive program of seventeen papers, chiefly by members but 
including five or six visitors, brought out an excellent attend- 
ance. After the evening session was held the customary ban- 
quet, which is always one of the enjoyable features of the meet- 
ings of this society, was held. 


East Mississippi Four County Medical Society met in 
Amory Feb. 8th. The meeting was called to order at 2 P. M. by 
Dr. Richard Boyd of Houston. Secretary Underwood was pres- 
ent. The minutes of the former meeting were read and adopted 
as corrected by Dr. Durley of Aberdeen. An interesting case of 
pellagra was presented by Dr. Burdine. An interesting paper 
was read by Dr. Burdine on the etiology and treatment of 
chronic diarrhoea. The discussion of this paper was general 
and interesting. Dr. Burdine closed in a very masterly resume 
of the subject. Dr. Bryan called the society’s attention to the 
four open meetings to be held during the year. It was decided 
that the president should appoint a committee composed of 
th.ree physicians for each of the towns, viz., Aberdeen, Amory, 
Houston and Tupelo, to arrange for these meetings. The pro- 
gram of each meeting will be carried out almost, if not entirely, 
by home men, that is, doctors residing within the borders of the 
four counties. Dr. Burdine was given a vote of thanks for his 
excellent paper. 

F. J. Underwood. 

East Mississippi Four County Medical Society met at 
the courthouse iu Tupelo Tuesday, March 18tli., at 2:30 P. M., 
with Dr. R. M. Boyd, president, in the chair and Dr. F. J. 
Underwood, secretary, present and performing the duties. The 
members present were Drs. Bryan, Feemster, Keyes, Boyd, 
Gwinn, Sadler, McMillan, Green, Elkin, Boggan, Carruth, Mc- 
Cowen, Anderson and Underwood. An interesting paper was 
read by Dr. L. C. Feemster on etiology and diagnosis of 
malignant diseases of the bile tracts. An interesting discussion 
followed by Drs. Bryan, Sadler and Carruth. The president 
appointed a health committee for each county as follows: for 
Lee, Feemster and Elkin; for Monroe, Keyes and Dilwortli ; 
for Chickasaw, Boyd and Abernetliy ; for Itawamba, Stone and 
Reed. An arrangement committee was appointed for the four 


235 


open meetings this year for each of the following towns: for 
Tupelo, Elkin, Bonner and Feemster; for Aberdeen, Dilworth, 
Durley and Sims, for Houston, Williams, Evans and Wilson; 
for Amory, Bryan, Grady and Burdine. Dr. G. S. Bryan of 
Amory was elected censor for a term of three years, succeeding 
the late lamented Dr. Wendel. After adjournment the members 
were entertained by the Pound-Kineannon-Elkin Company and 
at night were banqueted by the local physicians at the Hotel 
Bead. 

F. J. Underwood. 


Harrison County Medical Society met March 8th., Pres- 
ident West in the chair and Drs. Slieely, Folkes, Rehfeldt, Mor- 
ris, Priddy, Richardson, Strange, Parker, Carroll, Mohler, 
Rowan, Hood, Welch and Cowart present. As there were no 
clinics and the two members who were to have presented papers 
were absent the president called upon the members for reports 
of interesting cases met with. Dr. Parker reported a case of 
labor with renal complications, patient's urine showing large 
percentage of albumen, child born dead. Mother had no ap- 
parent trouble at time of labor, no convulsions, etc. Shortly 
after labor mother complained of inability to breathe and in a 
few minutes was dead. The general opinion tended to show 
cause of death as embolism following labor. Dr. Morris cited a 
similar case that had come under his observation. Dr. Folkes 
of Biloxi reported case of appendicitis, on which he operated. 
Gangrenous appendix, ruptured on removal, spilling few drops 
on peritoneum, carefully cleansed same and closed abdomen in 
usual manner. Interesting to note that peritoneum took care 
of pus that was spilled upon it, patient making uneventful re- 
covery. Dr. Mohler of Gulfport reported interesting case of 
gonorrhoeal ophthalmia of six weeks standing with ulcer of 
both corneas when first seen. Case is now progressing nicely, 
will have good vision in one eye, other partially impaired. Dr. 
Folkes asked for experience of others in regard to the diseases 
of childhood among negro children. Experience of those present 
tended to show that negroes were remarkably free from such 
diseases as diphtheria, mumps, scarlet fever, etc. Other inter- 
esting cases were mentioned by Drs. Strange, Carroll and 
others. Dr. Rowan was called upon to give report upon his 
cases of pellagra. The Doctor stated that one of his cases had 
died, others had shown slight improvement while others showed 
none and were growing worse. Dr. Mohler reported a case of 
eye infection from vaccination. Application of Dr. R. F. Annis 
of Wiggins and Dr. N. W. Cowart of Inda for membership in 


236 


the society were received and referred to Board of Censors. A 
motion was made that the secretary call upon all delinquent 
members to pay up dues at once, as the State meeting is not 
far distant, at which time all who are in arrears will have to 
be dropped from the list of the respective societies. The motion 
carried. 

G. F. Carroll. 


^ssrrriattrm Vxzsxtimts. 

C. D. MITCHELL, Pontotoc. 

President 1903-4. 

Charles Dennis Mitchell was the eldest son of C. B. Mitch- 
ell, sometime legislator and senator from Pontotoc County and 
Speaker of the House in 1888, a noted criminal lawyer. He was 
born in Pontotoc, Oct. 29th. 1866, was educated at the Uni- 
versity of Mississippi and took his degree in medicine from the 
Memphis Hospital Medical College in 1888. He married Miss 
Mamie Herren of Pontotoc Dec. 12th. 1888 and has two sons, 
Chas. B. and Herren Mitchell. He took post-graduate courses 
at the New York Post-Graduate School and the New York 
Polyclinic in 1890 and 1892. 

Dr. Mitchell joined the State Medical Association in 1892 
and has been a regular attendant ever since. He responded to 
the Address of Welcome in 1895, was elected delegate to the 
A. M. A. in 1898, was elected vice-president in 1900 and in 1901 
and president in 1903. He served on the State Board of Health 
from 1900 to 1905 and was first Councilor of the third district 
under the reorganization, serving five years. Besides his 
county, state and national associations, he is a member of the 
Tri-State (Miss., Ark., Tenu.) Medical Association, and is a 
Mason, an Odd Fellow, a K. of P., a W. O. W., and an elder in 
the Presbyterian Church. 

Personal Notes 1907. 


T. J. MITCHELL, Jackson. 

President 1904-5. 

Thomas Jefferson Mitchell was born July 4th. 1830 near 
Huntsville, Ala., of North Carolina and Virginia stock, re- 
ceived his academic degree in 1849 and his medical in 1852. 


237 


The year following graduation he spent in Paris, attending 
lectures at the hospitals. In 1858 he married Miss Annie Mc- 
Willie, daughter of Governor McWillie of Mississippi, and to 
this union were born four children. At the outbreak of the 
civil war he volunteered and was commissioned surgeon C. S. 
A., serving throughout the war. Dr. Mitchell served for many 
years as physician in charge of the State Insane Hospital at 
Jackson, retiring in 1910, and has devoted the later years of his 
of his county society, the Mississippi State Medical Association 
practice exclusively to the study and care of mental and nervous 
diseases. He is a member of the Medico-Psychological Society, 
and of the A. M. A. Personal Notes. 


Brrrtk Uptfiems. 


PREPARATORY AND AFTER TREATMENT IN OPERATIVE 
CASES. By Herman A. Haubold M.D., Clinical Professor in Sur- 
gery and Demonstrator of Operative Surgery, New York University 
and Bellevue Hospital Medical College, New York; Visiting Surgeon 
Harlem and Red Cross Hospitals, New York, etc. 429 Illustrations, 
639 Pages. D. Appleton & Co., New York and London. 1910. 
Price $6.00. 

The intention of the writer to furnish a work from which 
the practitioner can draw information with regard to the han- 
dling of a case to be operated upon from the time the decision 
to operate is reached until the making of the incision, and then 
take up the case again from the time the operative technic is 
ended until recovery is complete, has been well carried out in 
this complete and comprehensive volume. In the text-books and 
systems of surgery too little stress is laid upon the preparation 
and after treatment of individual surgical conditions, so that 
the subject matter of this book is well chosen and much val- 
uable information can be obtained from it by the surgeon him- 
self. Daugherty. 


UNTRITION AND DIETETICS. By Winfield S. Hall M.D., Pro- 
fessor of Physiology Northwestern University Medical School, Lecturer 
on Physiology and Dietetics in Mercy Hospital and Wesley Hospital, 
Chicago. D. Appleton & Co., New York and London. 1910. Price 
$ 2 . 00 . 

This volume is the outgrowth of the author’s ten years’ ex- 
perience in teaching dietetics to medical students and to the 
large nursing classes of two well-known Chicago hospitals, 
and as such is eminently adapted to the classes for which it is 
intended. Of smaller compass than most of the works on this 

2— M 


238 


subject, and without going too much into detail, which so often 
acts as padding, this work provides the practitioner with a 
volume which concisely and accurately presents the latest 
thought in nutrition and dietetics. We will venture to disagree 
with the author in just one point. In rectal feeding, he holds 
“the amount should never be over three ounces, and better as a 
rule one and a half ounces”. These amounts are much to small, 
and we believe six to eight ounces to be a better limit, cutting 
down the number of injections necessary to maintain nutrition. 

Myers. 


THE PROPAGANDA FOR REFORM IN PROPRIETARY MED- 
ICINES. Sixth Edition. Containing the various exposes of nos- 
trums and qaackery which have appeared in The Journal of the 
American Medical Association. Price, Paper, 10 cents; Cloth, 35 
cents. Pp. 292. Illustrated. 

This book presents in convenient form most of the ex- 
posures that have appeared in The Journal of the American 
J Jediacl Association showing fraud either in the composition 
of various proprietary preparations or in the claims made for 
such preparations. Not all of the products dealt with, however, 
are such as are — or have been — used by the medical profession. 
Many preparations of the “patent medicine” type have been sub- 
jected to analysis and the results of such examinations appear 
in this volume. The book will prove of great value to the physi- 
cian in two ways: 1, It will enlighten him as to the value, or 
lack of value, of the many so-called ethical proprietaries on the 
market; and 2, It will put him in a position to answer intelli- 
gently questions that his patients may ask him regarding the 
virtues (?) of some of the widely advertised “patent medicines” 
on the market. After reading the reports published in this book 
physicians will realize the value and efficiency of simple scien- 
tific combinations of U.S.P. and N.F. preparations as compared 
with many of the ready-made, unstable and inefficient proprie- 
tary articles. Myers. 


THE PREVENTION AND TREATMENT OF ABORTION. By 

Frederick J. Taussig A.B., M.D., Lecturer in Gynecology, Washington 

University, etc. Fifty-nine illustrations. C. V. Mosby Co., St. Louis. 

714 Metropolitan Building. Price $2.00. 

The writer has given an excellent study of the frequency, 
etiology, pathology and symptoms of abortion and his chapters 
on prophylaxis and prevention are worthy of careful consider- 
ation. It is a pity indeed that selections from these chapters 
cannot be put into the hands of women’s clubs so that those 
who are most interested in such matters, the women themselves, 


239 


could find out exactly what they are “up against”. The “treat- 
ment” does not differ very materially from that laid down in 
most recognized text-books, save that the dangers of uncared- 
for abortions are emphasized and described in .more detail. 

Howard. 


A TEXT-BOOK OF MATERIA MEDICA, PHARMACOLOGY 
AND THERAPEUTICS. By George F. Butler M.D., Professor and 
Head of the Department of Therapeutice and Professor of Preventive 
and Clinical Medicine, Chicago College of Medicine and Surgery, 
Medical Department Valpariso University. Sixth Edition, Revised 
and Enlarged. Octavo of 708 Pages. W. B. Saunders Company, 
Philadelphia and London. 1908. Cloth, $4.00 Net. 

The book of Dr. Butler needs no introduction to our 
readers, so many of them already possessing it, yet the present 
edition, brought into accord with the U. S. P. Eighth Revision, 
is so complete that one wonders how it can be further revised. 
The work is a splendid answer to those who claim to have lost 
faith in medicine. A perusal of this volume will refresh any- 
one’s armamentarium against disease, and that too in a scien- 
tific manner. The work rightly commences with a description 
of the varieties of pharmaceutical, preparations, solutions, liquid 
mixtures, extractive preparations,: •fixtures, of solid and ex- 
ternal preparation^; ’giyijtg the various pfepdr&tibps under each 
heading, official, nqtibnal for mill, a’i*j r and other 1 tvnse.'* Then fol- 
lows the discussion of the drugs 'in the various cli&pS. Par- 
ticularly s\ ? e‘; wish , to, cppjmeud. the, giving, of; the genitive case 
ending after’ each; i as..pudp^dyyj jUihlpbdoppy lli — a thing 
invaluable to those wlio "cfesire to write correct prescriptions 
and whose Latin is hazy. The section on prescription writing 
is very complete and valuable. We may further say that the 
book has been recommended as a text-book on therapeutics in 
the Medical Department of the University of Mississippi. 

Myers. 


DIAGNOSTIC THERAPEUTICS. Abrams. The Rebmann Co., New 
York. Cloth Bound $5.00. 

This is a volume which physicians should have in their 
offices as it has the great advantage of having under one cover 
many aids in solving questions of diagnosis, which would other- 
wise necessitate a search through quite a number of books. 
Many of the suggestions are quite original with Dr. Abrams, 
who is quite catholic in his views as to what should constitute 
the practise of medicine, wherein he is eternally right. 

Folkes. 


240 


INTERNATIONAL CLINICS. A Quarterly Of Illustrated Clinical 
Lectures And Especially Prepared Articles. Edited byiH. W. Cattell 
A.M., M.D., Philadelphia. J. B. Lippincott Company, Philadelphia. 
Price $2.00. 

This issue contains two articles on serum diagnosis of 
syphilis and one on diagnostic methods of syphilis of the ner- 
vous system, the three forming a series of exceptional interest 
and value. Pellagra comes in for its share of attention under 
both diagnosis and treatment and tuberculosis is with us, as 
always. There are some good surgical, gynecological and pedi- 
atric papers and there is a summary of the progress of medicine 
and surgery of the past year. As has been the custom of late 
in this quarterly, there are numerous illustrations that are mar- 
vels of the book-maker’s art and that add materially to its in- 
structive merits as well as to its artistic value. 

Howard. 


DISEASES OF THE GENITO URINARY ORGANS. By Edward 
E. Keyea Jr., M.D., Ph.D., Clinical Professor of Genito-Urinary Sur- 
gery, New York Polyclinic Medical School, etc. One hundred and 
ninety-five illustrations and seven plates. D. Appleton &Co., New 
York. Price $6.00. 

This is the latest .edition c: the great classic work on syph- 
ilis. None other b as approached if in popularity in earlier 
editions arfd it may be safely predicted that 'this latest issue will 
equal its" predecessors in the number of admirers it will find. 
The y ounger Keyes draws on the vast experience, of his distin- 
guished father, 'hi? leader in this" work, AJfit so has at his com- 
mand a store of material such as has' seldom been available. 
With this working basis he has blended the later ideas and 
methods in a masterly manner, the whole forming a volume 
that is well nigh perfect. No such book on genito-urinary dis- 
eases has yet been published. 

Howard. 


2si0iit£. 


W. B. Saunders Company, the medical publishers of Phil- 
adelphia and London, have just issued a new edition — the thir- 
teenth — of their handsome Illustrated Catalogue. It contains 
notices of some twenty new books and new editions, and beside 
numerous black-and-white illustrations, there are two color cuts 
of special value. We strongly advise every physician to obtain 
a copy — sent for the asking. It will prove a ready guide to 
good medical books — books that we all need in our daily work. 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 

I >, - • . V ■ ■ . ' ’( 

-- ■ ■■ ) 

Tbe Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambnlance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. X X 

[■ .. . / 


Clinical 


The fundamental etiologic factor in 
most chronic catarrhal diseases can be found 
in lowered vitality— in turn the result of nu- 
tritional weakness. Consequently a chronic 
catarrhal process usually subsides as the 
organism gains adequate strength and vitality.' 
This is the reason why '' 

Cray’s Glycerine Tonic Comp^ 
has proven so efficacious in the various forms 
of catarrhal disease. It improves the circu- 
lation, promotes better nutrition and raises 
the vital index. As a weakened mucous 
membrane recovers its normal tone and re- 
sisting power, catarrhal processes invariably 
disappear. 

Samples and literature on request. 

THE PURDUE FREDERICK CO.\ 

298 Broadway. New .York City. 


Notes 


Chrome 
CatarrTial 
Diseases 






To obtain the best results in 



Anaemia, Neurasthenia, 

i 

Bronchitis, Influenza, Pulmonary 
| Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 


% 


fellows’ $yrup 


i 


r 

& 

’k 

> a* 

rh 


■m 


of 


i fiypopftosphites i 




♦ 

♦ 


l 




o 

X 


Contains — Hypophosphites of Iron, 

Quinine, Strychnine, Lime, 
Manganese, Potash, 

Each fluid drachm contains the 
equivalent of l-64th grain of 
pure strychnine. 

Special Note . — 

Fellows' Hypophosphites 

is Never Sold in Bulk. * 

Medical letters may he addressed to 

The Fellows Company of New York, 

26 Christopher St., New York, 


A, 

U J i 


PHILLIPS’ 

MILK OF MAGNESIA 

( Mg H 2 0 2 ) 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the Gastro-lntestinal Irritations of Infant, Child and Adult Life. 

THE CHAS. H. PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV. JUNE 19 09. No. 2. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES , 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at tbe Post Office at Vicksburg as Second Class Mall Matter. 


Panopepton 

' In Refractory Cases 

T O use Panopepton in a case that has been proving refractory to both treat- 
ment and management is often to bring about an immediate change for 
the better in all the conditions — especially where there has been difficulty 
in getting nourishment adapted to the taste and toleration of the patient. 

Panopepton is well designed to meet the essential desiderata of a food for 
the sick— in agreeability, assimilability, and substantial peculiar nutritive value. 
It presents, in a form ready for absorption, the entire nutritious substance of 
beef and wheat — is a complete solution of all the nutrient, savory and stimulant 
nitrogenous and inorganic constituents of these typical foods. 

Panopepton is carefully standardised. The analysis gives 22% of solu- 
ble solids, with a “nutritive balance ” of one of proteids to two of carbohydrates. 
There is absolutely no cane sugar in Panopepton, nor any chemical preservative. 

Panopepton may be used alone, gradually supplemented with other suita- 
ble foods, until finally ordinary forms of nourishment are again available. 
When digestion is much impaired, it is sometimes given to advantage combined 
with Fairchild’s Essence of Pepsine — equal parts. 

FAIRCHILD BROS. & FOSTER 

New York 

I- Atv . *• * s •’ CiX '**■' '*S u' '• • i ‘ 'v.' .1 - 



W togen-dZi th ia 


Effervescent Tablets of \ 3 gr ? in f „ , 

(Lithium tartrate 3 grains 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient ( Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 


C L 4 


SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 


Professor Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Clinical Instructor in Diseases of the Rectum, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Rectal Dept., St. Joseph’s Hospital. 
Surgeon to L. »fc N. R. R. 


Quia Master Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos. 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

49 -During the session of the Memphis Hospital Medical College from November to April, 
all rharity cases of Surgical or Rectal Diseases will be treated Free of Charge — the patient 
paying bis board, 810.00 per week. 





TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff' and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 15 8. X X 



Nervous 

Exhaustion 


Neurasthenia is so^often the all important 
factor in the development of -'many, if not 
all of the usual functional diseases of the 
body, that it should never fail to, receive its 
full share of attention in any icon sistent 
ischeme of treatment.- That'""" 

CRAY'S GLYCERINE TONTC COMPi 

is of unexcelled value as a Serve' tonic, is 
known by countless successful clinicians^ 
It enables the patient to eat, digest and 
assimilate food ; favors natural refreshing 
sleep without the use of hypnotics, and! 
gradually but progressively builds, up QetY 
lyitality and nerve force., 

Samples and literature on request, 

THE PURDUE FREDERICK CO. 

298 Broadway, New York City* 


Notes 


i 



To obtain the best results in 
Anaemia, Neurasthenia, 
Bronchitis, Influenza, Pulmonary 
Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 

follows’ $yrup 

of 


BypopbospWtes 

Contains — Hypophosphites of Iron, 

Quinine, Strychnine, Lime, 
Manganese, Potash. 

Each fluid drachm contains the 
equivalent of 1 -64th grain of 
pure strychnine. 

Special Note . — 

Fellows’ Hypophosphites 

is Never Sold in Bulk. 


♦ Medical letters may he addressed to 
| The Fellows Company of New York, 
| 26 Christopher St., New York. 


THE BEST RECONSTRUCTIVE 

PHILLIPS’ 

PHOSPHO-MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE GHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol. XIV, JULY 19 09, No. 3. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES . 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


Essence of Pepsine — Fairchild 

Presents in solution all the constituents obtainable by ex- 
traction from the fresh mucous membrane of the stomach ; 
is not commercial precipitated pepsin in an elixir body. 


Fairchild’s Essence of Pepsine has always been offered with the 
explicit statement that it is made by direct extraction from the secreting glands 
and presents the essential organic principles of the gastric juice as they are 
normally associated with the entire soluble gland constituents. 

When a physician exhibits Essence of Pepsine— Fairchild— he is there- 
fore really availing himself of a pharmaceutical product of the gastric juice ; is 
making a practical test of whatever therapeutic properties the gastric juice may 
possess. And, during the last twenty-five year^, scientific investigations have 
shown that the gastric juice, like other secretions of the glands, is in itself more 
complex and has more complex functions than was formerly supposed. 

Fairchild’s Essence is very different from the ordinary fluid prepara- 
tions of pepsin; it is not a solution of pepsin precipitated from its natural 
association and dissolved in an elixir or wine ; it is a product that represents the 
properties and active principles of the gastric juice itself. 

Fairchild Bros. & Foster 


New York 


Cystogen- Jlithia 

Effervescent Tablets ef { SSSiilSfl gr.lo. 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis. U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate. ) 


C L 4 


SURGICAL 

AND 

RECTAL DISEASES 


Dr, B, G, Henning, Dr, Max Henning, 


Professor Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectum, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
8urgeon to Rectal Dept., St. Joseph's Hospital. 
Surgeon to L. N. R. R. 


Quiz Master Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 


For particulars address 

Drs. B. C. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Wain St., WEMPHIS, TENN. 

O-During the session of the Memphis Hospital Medical College from November to April, 
all charity cafes of Surgical or Rectal Disease, will be treated Free of Charge— the patient 
paying liis board, $10.00 per week. 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. A A 


The Circulatory Dangers 
Common to Hot Weather 

particularly for the aged and infirnv&re easily avoided by "the' Useof 

Gray’s Glycerine T onic Comp. 

Its administration in two to four teaspoonful doses throughout 
the hot season aids digestion, tones the nervous system, strengthens 
ithe heart, and goes far toward maintaining a safe circulatory balance^ 
Unlike most tonics, Gray’s Glycerine Tonic Comp, has noi 
.contraindications, and can be used with maximum benefit at all 

(seasons andunder all conditions, ... 

THE PURDUE FREDERICK CCK 
298 BROADWAY. NEW YORK CITY 









To obtain the best results in 


Anaemia, Neurasthenia, 
Bronchitis, Influenza, Pulmonary 
Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 

Yellows’ Syrup 

»r 


fiypopbospbites 


Contains — Hypophosphites of Iron, 
Quinine, Strychnine, Lime, 

Manganese, Potash, 

Each fluid drachm contains the 
equivalent of l-64th grain of 
pure strychnine* 

Special Note . — 

Fellows' Hypophosphites 

is Never Sold in^Bulk. 

Medical letters may he addressed to 

The Fellows Company of New York, 

26 Christopher St., New York. 


■ ■ 


.lVf 

ft? 




PHILLIPS’ 

MILK OF MAGNESIA 

( Mg Ho Oo ) 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the 6astro-lntestina! Irritations of Infant, Child and Adult Life. 

THE CHAS. H. PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV. AUGUST 19 0 9, No. 4. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES, 

PUBLISHED MONTHLY AT 714 S. CHEEKV ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mail Matter. 

: — . i. ,, 

•g pr-r ' ■■ - ■ ■ ■ — ■ ■ — 1 v — 1 « ,' H ~; — T"7T* 

Essence of Pepsine — Fairchild 

Presents in solution all the constituents obtainable by ex- 
traction from the fresh mucous membrane of the stomach ; 
is not commercial precipitated pepsin in an elixir body. 


Fairchild’s Essence of Pepsine has always been offered with the 
explicit statement that it is made by direct extraction from the secreting glands 
and presents the essential organic principles of the gastric juice as they are 
normally associated with the entire soluble gland constituents. 

When a physician exhibits Essence of Pepsine— Fairchild — he is there- 
fore really availing himself of a pharmaceutical product of the gastric juice ; is 
making a practical test of whatever therapeutic properties the gastric juice may 
possess. And, during the last twenty-five years, scientific investigations have 
shown that the gastric juice, like other secretions of the glands, is in itself more 
complex and has more complex functions than was formerly supposed. 

Fairchild’s Essence is very different from the ordinary fluid prepara- 
tions of pepsin ; it is not a solution of pepsin precipitated from its natural 
association and dissolved in an elixir or wine ; it is a product that represents the 
properties and active principles of the gastric juice itself. 

Fairchild Bros. & Foster New York' 


w ystogen-JEithia 

Effervescent Tablets of { utWum Strati"! grains - 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 


SURGICAL 

AND 

RECTAL DISEASES 

Dr, B , G, Henning , Dr. Max Henning, 


Quiz Master Theory and Practice o£ Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Rec- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos. 
pltal Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Professor Theory and Practice of Medicine, 

Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectum, 

Memphis Hospital Medical College. 

Consulting Physician, St. Joseph’s Hospital. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to L. <£ X. R. R. 

Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars addrees 

Drs. B. G. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

ff^-During the session of the Memphis Hospital Medical Collet?© from November to April, 
all f bsnfv cases of Surgical or Kectal Diseases will be treated Free of Charge — the patient 
paying his board, S10.00 per week. 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Hurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 15 8. X X 

' 


The Circulatory Dangers 
Common to Hot Weather 

particularly for the aged and infirmrareeasily avoided byTheUBeTof 

Gray’s Glycerine Tonic Comp. 

Its administration in two to four teaspoonful do9es throughout 
the hot season aids digestion, tones the nervous system, strengtnens 
the heart, and goes far toward maintaining a safe circulatory balance; 

Unlike most tonics, Gray’s Glycerine Tonic Comp, has no 
.contraindications, and can be used with maximum benefit at all 

[seasons and under all conditions. . 

7' THE PURDUE FREDERICK CO. 

398 BROADWAY. NEW YORK CITY 




> 1 
\ B 






23 >« 

Sumoof 







To obtain the best results in 
Anaemia, Neurasthenia, 
Bronchitis, • Influenza, Pulmonary 
Tuberculosis, 

and- during Convalescence after 
exhausting diseases employ 

Yellows’ Syrup 

of 


Rypopbospbites 


Contains — Hypophosphites of Iron, 

Quinine, Strychnine, Lime, 

Manganese, Potash. 

Each fluid drachm contains the 
equivalent of l-64th grain of 
pure strychnine. 

Special Note . — 

Fellows' Hypophosphites 

is Never Sold in Bulk. 

Medical letters may be addressed to 

The Fellows Company of New York, 

26 Christopher St., New York. 




THE BEST RECONSTRUCTIVE 

PHILLIPS’ 

PHOSPHO-MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE GHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol, XIV. SEPTEMBER 1909. No. 5. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


Essence of Pepsine — Fairchild 

Presents in solution all the constituents obtainable by ex- 
traction from the fresh mucous membrane of the stomach ; 
is not commercial precipitated pepsin in an elixir body. 


Fairchild’s Essence of Pepstne has always been offered with the 
explicit statement that it is made by direct extraction from the secreting glands 
and presents the essential organic principles of the gastric juice as they are 
normally associated with the entire soluble gland constituents. 

When a physician exhibits Essence of Pepsine— Fairchild — he is there- 
fore really availing himself of a pharmaceutical product of the gastric juice ; is 
making a practical test of whatever therapeutic properties the gastric juice may 
possess. And, during the last twenty-five years, scientific investigations have 
shown that the gastric juice, like other secretions of the glands, is in itself more 
complex and has more complex functions than was formerly supposed. 

Fairchild’s Essence is very different from the ordinary fluid prepara- 
tions of pepsin; it is not a solution of pepsin precipitated from its natural 
association and dissolved in an elixir or wine ; it is a product that represents the 
properties and active principles of the gastric juice itself. 

Fairchild Bros. & Foster 


New York 


Cystogen- Juithia 

Effervescent Tablets of I Cystogen 3 grains 
crrervescent i aniets or j Lithlum tartrate 3 grains 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a gl^ss of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen— Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 


C L 4 


Professor Theory and Practice of Medlolne, 
Memphis Hospital Medical College. 

Clinical Instructor in Diseases of the Rectum, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Rectal Dept., St. Joseph’s Hospital. 
Surgeon to L. <t N. R. R. 


Quiz Master Theory and Practice of Medlolne, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 


Long Distance Telephone 478. 


13 S. Main St., MEMPHIS, TENN. 


*#-During the session of the Memphis Hospital Medical College from November to April, 
all ehae.ev cases of Surgical or Rectal Diseases will be treated Free of Charge — the patient 
paying his board, 810.00 per week. 




SURGICAL 

AND 

RECTAL DISEASES 

Dr , B, G, Henning , Dr , Max Henning, 




TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 

NEW ORLEANS, LA. 

I v * ‘ '■ ' - ■' _ 


hr 

The Touro Infirmary has a capacity of 160 patients and is the most 
up-to date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, §2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Hurses. 
The Attending Physician’s charge is extra. * 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. A: X 


The Girculatory Dangers 
Common to Hot Weather 

particularly for the aged and infirm, are easily avoided by the tiseof 

Gray’s Glycerine Tonic Comp. 

Its administration in two to four teaspoonful doses throughout 
the hot season aids digestion, tones the nervous system, strengtnens 
the heart, and goes far toward maintaining a safe circulatory balance. 

Unlike most tonics, Gray’s Glycerine Tonic Comp, has no 
contraindications, and can be used with maximum benefit at all 
reasons and under all conditions. 

THE PURDUE FREDERICK CO. 

19$ BROADWAY. NEW YORK CITY 






To obtain the best results in 




fittest 





Anaemia, Neurasthenia, 
Bronchitis, Influenza, Pulmonary 
Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 

fellows’ Syrup 

«r 


fiypopbospbites 


Contains — Hypophosphites of Iron, 

Quinine, Strychnine, Lime, 

Manganese, Potash* 

Each fluid drachm contains the 
equivalent of l-64th grain of 
pure strychnine. 

Special Note . — 

Fellows' Hypophosphites 

is Never Sold in Bulk. 

Medical letters may be addressed to 
The Fellows Company of New York, 
26 Christopher St., New York. 


I 


w 


PHILLIPS’ 

MILK OF MAGNESIA 

( Mg H 2 0 2 ) 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the Gastro-lntestinai Irritations of Infant, Child and Adult Life* 

THE CHAS. H. PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV. 


OCTOBER 19 09. 


No. 6. 


MISSISSIPPI MEDICAL MONTHLY 


OFFICIAL ORGAh OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 
Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


PANOPEPTON 

Considered Clinically 

Continued clinical experience with Panopepton shows a net gain 
from its use far beyond the original anticipations which . were so 
thoroughly well justified by the nature of the food itself. 

There are records to show that in cases of extreme intolerance of 
food, Panopepton is often retained after every other form of nourish- 
ment has been rejected : 

In persistent nausea, it renders truly remarkable service in allay- 
ing irritation and preventing exhaustion. And under all conditions 
where such a food is indicated, it acts promptly as a restorative, not 
only by providing nutrition without taxing energy, but by the directly 
stimulating effects of its savory and nitrogenous constituents. 

Panopepton is a wholly absorbable food ; leaves no debris to 
cause complications due to putrefactive changes, and herein the 
patient derives benefits, obvious and potential, that are beyond chemi- 
cal and caloric estimation. 

FAIRCHILD BROS. & FOSTER 
New York 



Cys togen-Jli th ia 


Effervescent Tablets of { tart fit e"! grains 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE— One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystallne Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON RBQUEST. with Sodium Phosphate.) 


- 


C L 4 








SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 


Professor Theory and Practice of Medlolne, 
Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectum, 
Memphis Hospital Medloal College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Rectal Dept., St. Joseph's Hospital. 
8urgeon to L. & N. R. R. 


Quiz Master Theory and Practice of Medlolne, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
turn, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass't to Chair of Gynaecology, Memphis Hos- 
pital Medloal College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

S9-I)urlng the session of the Mumphi# Hospital Medical College from November to April, 
all oh.rit, cases of -Girglcal or Kectal Diaeatei will be treated Free of Charge— the patient 
paying hi, board, SI0.00 per week. 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to date hospital in the South. Three large, fully-equipped operanug 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated it) the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff - and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. X X 



GASTRIC 

ATONY 


A considerable proportion of all 
gastric disorders take their incep- 
tion in insufficiency of muscular 
action. Their correction calls for 
measures restoring tonicity of the 
stomach muscles ; for this purpose 

GRAY’S GLYCERINE TONIC COMP. 

is of exceptional value. Its use not 
only increases muscular power, but 
through improving the blood sup- 
ply, materially promotes glandular 
and therefore secretory activity .- 

As a consequence, indigestion, 
flatulency and distress are promptly 
overcome. 

The Dose. A tablespoonful In •water 
before meals. 

Samples and Clinical Data on request. 

THE PURDUE FREDERICK CO; 

CSS BROADWAY. NEW YORK CITY 



IP 

1 £t 

3* «*■ JV 

♦ 

To obtain the best results in 

Anaemia, Neurasthenia, 
Bronchitis, Influenza, Pulmonary 
Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 

fellows’ Syrup 

Of 

£2&$t§3s3 

£(jo 

; dittos! 

Rypophospbltes 

Contains — Hypophosphites of Iron, 

Quinine, Strychnine, Lime, 

Manganese, Potash. 

Each fluid drachm contains the 
equivalent of I -64th grain of 
pure strychnine* 

Special Note . — 

Fellows’ Hypophosphites 

is Never Sold in Bulk. 

Medical letters may he addressed to 

The Fellows Company of New York, 
26 Christopher St, New York. 


THE BEST RECONSTRUCTIVE 

PHILLIPS’ 

PHOSPHO-MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE CHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol. XIV. NOVEMBER 1909. No. 7. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAI V OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


PANOPEPTON 

Considered Clinically 

Continued clinical experience with Panopepton shows a. pet gain 
from its use far beyond the original anticipations which wete so 
thoroughly well justified by the nature of the food itself. 

There are records to show that in cases of extreme intolerance of 
food, Panopepton is often retained after every other form of nourish- 
ment has been rejected : 

In persistent nausea, it renders truly remarkable service in allay- 
ing irritation and preventing exhaustion. And under all conditions 
where such a food is indicated, it acts promptly as a restorative, not 
only by providing nutrition without taxing energy, but by the directly 
stimulating effects of its savory and nitrogenous constituents. 

Panopepton is a wholly absorbable food ; leaves no debris to 
cause complications due to putrefactive changes, and herein the 
patient derives benefits, obvious and potential, that are beyond chemi- 
cal and caloric estimation. 

FAIRCHILD BROS. & FOSTER 
New York 


Cystogen- eCithia 

Effervescent Tnblets gr,.n. 

Uric add Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Litbia is prescribed, Cystogen is indicated* 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen- Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate) 


C L 4 


SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 


Quiz Master Theory and Practice of Medlolne, 
Memphis Hospital Medical College. 

Ass't. Clinical Instructor Diseases of the Rec- 
tum, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph's Hospital. 

Surgeon to Memphis City Hospital. 


Professor Theory and Practice of Medicine, 

Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectum, 

Memphis Hospital Medical College. 

Consulting Physician, St. Joseph’s Hospital. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to L. & N. R. R. 

Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

fyDurins: the session of the XempHis HoRpltal Medical College from November to April, 
al) cages of Surgical or Rectal Diseases will be treated Free of Charge— the patient 

paying his board, 810.00 per week. 





TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff’ and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves ot the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. X X 



A considerable proportion of ail 
gastric disorders take their incep- 
tion in insufficiency of muscular 
action. Their correction calls for 
measures restoring tonicity of the 
stomach muscles ; for this purpose 

GRAY’S GLYCERINE TONIC COMP. 

is of exceptional value. Its use not 
only increases muscular power, but 
through improving the blood sup- 
ply, materially promotes glandular 
and therefore secretory activity^ 

As a consequence, indigestion, 
flatulency and distress are promptly 
overcome. 

The Dose . A tailespoonfut in <waler 
before meals. 

Samples and Clinical Data on request. 1 : 
THE PURDUE FREDERICK CO; 

29 8 BROADWAY. NEW YORK CITY 












To obtain the best results in 
Anaemia, Neurasthenia, 
Bronchitis, Influenza, Pulmonary 
Tuberculosis, 

and during Convalescence after 
exhausting diseases employ 

fellows* $ymp 

of 


Rypopftosptmes 

Contains — Hypophosphites of Iron, 

Qikinine, Strychnine, Lime, 

Manganese, Potash. 

Each fluid drachm contains the 
equivalent of l-64th grain of 
pure strychnine* 

Special Note . — 

Fellows' Hypophosphites 

is Never Sold in Bulk. 

Medical letters may be addressed to 

The Fellows Company of New York, 

26 Christopher St., New York. 




PHILLIPS’ 

MILK OF MAGNESIA 

( Nig H'2 O 2 ) // 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the Gastrointestinal irritations of Infant, Child and Adult Life. 

THE CHAS. H. PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV. DECEMBER 1909, No. 8. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGA1S OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES, 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., YI CKSBCRG , MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


PANOPEPTON 

Considered Clinically 

Continued clinical experience with Panopepton shows a net gain 
from its use far beyond the original anticipations which were so 
thoroughly well justified by the nature of the food itself. 

There are records to show that in cases of extreme intolerance of 
food, Panopepton is often retained after every other form of nourish- 
ment has been rejected : 

In persistent nausea, it renders truly remarkable service in allay- 
ing irritation and preventing exhaustion. And under all conditions 
where such a food is indicated, it acts promptly as a restorative, not 
only by providing nutrition without taxing energy, but by the directly 
stimulating effects of its savory and nitrogenous constituents. 

Panopepton is a wholly absorbable food ; leaves no debris to 
cause complications due to putrefactive changes, and herein the 
patient derives benefits, obvious and potential, that are beyond chemi- 
cal and caloric estimation. 

FAIRCHILD BROS. & FOSTER > 

New York 


4 


BKSfl 


Cys togen-JEi th i a 

Effervescent Tablets of { SSto tartSS” grains 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

- Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate. ) 


C L 4 


SURGICAL ’ 

AND i 

RECTAL DISEASES 

Dr, B. G. Henning, Dr. Max Henning, 


Quiz Master Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Rec- 
tum, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Professor Theory and Practice of Medicine, 

Memphis Hospital Medical College. 

Clinical Instructor in Diseases of the Reotum, 

Memphis Hospital Medical College. 

Consulting Physician, St. Joseph's Hospital. 

Surgeon to Rectal Dept., St. Joseph's Hospital. 

Surgeon to L: & N. R. R. 

Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

tWDurlng the session of the Memphis Hospital Medical College from November to April, 
all charier cates of Surgical or Rectal Diseases will be treated Free of Charge— the patient 
paying his board, 810.00 per week. 



m. 


v- ,-Y> 









! 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, tully-equipped operating 
rooms. X-Ray Department. Hydrotherapby, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician's charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. A A 


FUNCTIONAL 
NERVOUS DISEASES] 

A l arge proportion of all nervous disorders can be traced toTaulty 1 
nutrition.. To effect Jheir prompt and permanent relief^ 


Jis of exceptional therapeutic vadue: Thls powerful tonic stimulates v 
functional activity throughout the body and substantially aids the abl 
sorption and assimilation of nutriment Nervous affections of 
functional origin usually disappear as the normal nutri- 
tional index is re-established. Samples on. request. 

THE PURDUE FREDERICK .CO. 

288 Broadway. New Yorl| 


3 

* 




For Upwards of Forty 
Years the Use of 


ihi 

j-i 




* 











THE BEST RECONSTRUCTIVE; 

PHILLIPS’ 

PHOSPHO-MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE GHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol. XIV. JANUARY 1910. No. 9. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES, 

PUBLISHED MONTHLY AT 714 S. CHEERY ST., VICKSBllltG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 

~~~~ U^U—'IU ! !-'!. — — 1-' ■' ’ — v, 

MAKING HISTORY 

The development of tbe“ Fairchild” preparations is apart of ibe bis- 
tory of tbe digestive ferments in medical practice during the past thirty years 


I N 1879, the enzymes of the fresh gastric juice, in their natural 
association, were first presented in an active and agreeable form 
in Essence of Pepsine, Fairchild; in 1881, the first efficient 
pancreatic extract, Extradhim Pancreatis, was offered by Fairchild. 

In 1882, Fairchild introduced Peptonising Tubes, containing the 
proteolytic enzyme of the pancreas, for preparing peptonised milk and other 
foods for the sick ; Peptogenic Milk Powder, for preparing milk for 
infants, followed in 1884; Panopepton, a peptonised, standardised, 
“balanced” food for the sick, in 1893. 

Diazyme— Essence and Glycerole— first presented the diastase of the 
pancreas in a practically isolated form; in 1905, Holadin was offered as 
an extract of the entire pancreas gland, peculiarly potent in trypsin, amylop- 
sin and lipase. 

In Enzymol, obtained from the fresh gastric cells, the gastric juice 
is made available for external application. 

The pancreas ferments were first utilised as “surgical solvents,” and 
) first proved to be capable of hypodermatic use, by means of the “Fairchild ” 
if, products. 

FAIRCHILD BROS & FOSTER : : New York 






Cijstogen-d.it/iia 

Effervescent Tablets nf { ®2TJ.?t?£"§ jtal „ 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSB — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Litbia is of advantage; 
WTiere LitEiia is prescribed, Cy$togen is indicated. 

ladScattons— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Ctstogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 


C L 4 


it 




SURGICAL 

AND 

RECTAL DISEASES 

Dr, B. G, Henning , Dr, Max Henning, 


Professor Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Clinical Instructor In Diseases of the Rectum, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Rectal Dept., St. Joseph’s Hospital. 
Surgeon to L. & N. R. R. 


Quiz Master Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos. 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. C. and MAX HENNING, 


Long Distance Telephone 478. 


13 S. Main St., MEMPHIS, TENN. 


.^-During the session of the Memphis Hoe pital Medical College from November to April, 
all ehnrifv ca.es of Surgical or Rectal Diseases will be treated Free of Charge— the patient 
paying his board, S10.00 per week. 



TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, lully-equipped optraniig 
rooms. X-Ray Department. Hydrotherapby, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautilul 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room -for outside patients. All private rooms and wards situated in the 
new building. Rates, §2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. X, X 


FUNCTIONAL 

NERVOUS DISEASES 

A la rge proportion of all nervous disorders can be traced to faulty" 
^ nutrition.. To effect their prompt and permanent relief' 

Graf is Glycerine Tonic Comp. 

W is of exceptional therapeutic value: This powerful tonic stimulates 
w Junctional activity throughout the body and substantially aids the abl 
sorption and assimilation of nutriment Nervous affections of 
Junctional origin usually disappear as the normal nutri- 
tio nal i ndex is re-established. Samples on request. 

THE PURDUE FREDERICK, CO. 

298 Broadway, New York 


Notes 



For Upwards of Forty 
Years the Use of 


has been recommended by the 

Leading Medical Specialists 
in all Countries 


■Worthless Substitutes 
Preparations “Just as Good 



PHILLIPS’ 

MILK OF MAGNESIA 

( Mg H 2 0 2 ) 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the Gastro-lntestinal Irritations of Infant, Child and Adult Life. 

THE CHAS. H. PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV, FEBRUARY 1910. No. 10. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES , 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mall Matter. 


MAKING HISTORY 

The development of tbe“ Fairchild” preparations is apartoftbe his- 
tory of the digestive ferments in medical practice during the past thirty years 


I N 1879, the enzymes of the fresh gastric juice, in their natural 
association, were first presented in an active and agreeable form 
in Essence of Pepsine, Fairchild; in 1881, the first efficient 
pancreatic extract, Extradtum Pancreatis, was offered by Fairchild. 

In 1882, Fairchild introduced Peptonising Tubes, containing the 
proteolytic enzyme of the pancreas, for preparing peptonised milk and other 
foods for the sick ; Peptogenic Milk Powder, for preparing milk for 
infants, followed in 1 884 ; Panopepton, a peptonised, standardised, 
“balanced” food for the sick, in 1893. 

Diazyme— Essence and Glycerole— first presented the diastase of the 
pancreas in a practically isolated form ; in 1 905, Holadin was offered as 
an extract of the entire pancreas gland, peculiarly potent in trypsin, amylop- 
sin and lipase. 

In Enzymol, obtained from the fresh gastric cells, the gastric juice 
is made available for external application. 

The pancreas ferments were first utilised as “surgical solvents,” and 
first proved to be capable of hypodermatic use, by means of the “Fairchild ” 
products. 

FAIRCHILD BROS & FOSTER : : New York 



Cystogen- JCithia 


Effervescent T,b.ets ef {SSSSTSASS'S freln. 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE— One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Litbia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate. ) 


C L 4 


SURGICAL 

AND 

RECTAL 

Dr, B, G, Henning, 

Professor Theory and Practice of Medicine, 

Memphis Hospital Medical College. 

Cllnloal Instructor in Disease* of the Rectum, 

Memphis Hospital Medical College. 

Consulting Physician, St. Joseph’s Hospital. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to L. & N. R. R. 

Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. G. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

^-During the session of the Memphis Hospital Medical College from November to April, 
all charity cases of Surgical or Rectal Diseases will be treated Free of Charge— the patient 
paying his board, 810.00 per week. 


DISEASES 

Dr, Max Henning, 

Quiz Master Theory and Practice of Mediolne, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Rec- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 15 8. X X 





usually disappear as the general bodily nu- 
trition and vitality improve. This is why 


Gray’s Glycerine Tonic Comp. 






For Upwards of Forty 

Years the Use of 







has been recommended by the 

Leading Medical Specialists 
in all Countries 




Worthless Substitutes 
' ^^Preparations “Just as Good” 


THE BEST RECONSTRUCTIVE 

PHILLIPS’ 

PHOSPHO MURIATE OF QUININE 

( Soluble Phosphates with Muriate of Quinine, Iron and Strychnia. ) 


THE CHAS. H. PHILLIPS CHEMICAL CO., New York and London. 


Vol. XIV. MARCH 1910. No. 11. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Offloe at Vicksburg as Second Class Mall Matter, 


MAKING HISTORY 

The development of tbe t( Fairchild” preparations is apartoftbe bis- 
tory of tbe digestive ferments in medical practice during the past thirty years 


I N 1879, the enzymes of the fresh gastric juice, in their natural 
association, were first presented in an active and agreeable form 
in Essence of Pepsine, Fairchild ; in 1881, the first efficient 
pancreatic extract, Extradtum Pancreatis, was offered by Fairchild. 

In 1882, Fairchild introduced Peptonising Tubes, containing the 
proteolytic enzyme of the pancreas, for preparing peptonised milk and other 
foods for the sick ; Peptogenic Milk Powder, for preparing milk for 
infants, followed in 1884; Panopepton, a peptonised, standardised, 
“balanced” food for the sick, in 1893. 

Diazyme— Essence and Glycerole— first presented the diastase of the 
pancreas in a practically isolated form ; in 1 905, Holadin was offered as 
an extract of the entire pancreas gland, peculiarly potent in trypsin, amylop- 
sin and lipase. 

In Enzymol, obtained from the fresh gastric cells, the gastric juice 
is made available for external application. 

The pancreas ferments were first utilised as “surgical solvents,” and 
first proved to be capable of hypodermatic use, by means of the “Fairchild ” 
products. 

FAIRCHILD BROS & FOSTER : : New York 




Cys togen-JEi th i a 

' ™>'“» p.Uu, 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE— One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cystogen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cystogen is indicated. 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON RBQUEST. with Sodium Phosphate.) 

C L 4 


SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 


Professor Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Cllnloal Instructor In Diseases of the Rectum, 
Memphis Hospital Medical College. 
Consulting Physician, St. Joseph’s Hospital. 
Surgeon to Rectal Dept., St. Joseph’s Hospital. 
Surgeon to L. & N. R. R. . 


Quiz Master Theory and Practioe of Medlolne, 
Memphis Hospital Medloal College. 

Ass’t. Clinical Instructor Diseases of the Rec- 
tum, Memphis Hospital Medical College. 

Clinical Instructor in Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Rectal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. G. and MAX HENNING, 

Long Distance Telephone 478. 13 S. Main St., MEMPHIS, TENN. 

^-During the session of the Memphis Hospital Medical College from November to April, 
all rhori.y cases of Surgical or Rectal Diseases will be treated Free of Charge — the patient 
paying his board, 810.00 per week. 



usually disappear as the general bodily nu- 
trition and vitality improve. This is why 


linical 


TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotlieraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

Ajl reputable physicians are invited to avail themselves of the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 15 8. X X 


Gray’s Glycerine Tonic Comp. 

accomplishes such surprising results in many a 
serious, intractable case of bronchitis or other 
respiratory disease, when other remedies fail 
completely. Its use stimulates the appetite, 
promotes digestion, increases assimilation, 
and raises the whole vital index. The 
benefits, therefore, are permanent— 
not transitory. 

THE PURDUE FREDERICK CO. J* J . 

298 Broadway, New York Imf Of 1 Pi? 


m 


■ 








n • j ^"Worthless Substitutes 
t ^^Preparations “Just as Good 



»! 





For Upwards of Forty 
IlC Years the Use of mil 

| fellows Syrup of | 
| Ijypopbospbites I 

g has been recommended by the 

B Leading Medical Specialists SJ 
in all Countries 


% 










m 






PHILLIPS’ 

MILK OF MAGNESIA 

( Mg H 2 0 2 ) 

AN EFFICIENT ANTACID AND CORRECTIVE. 

Useful in the Gastro-lntestinal Irritations of infant, Child and Adult Life. 

THE CHAS. It: PHILLIPS CHEMICAL CO. 

NEW YORK AND LONDON. 


Vol. XIV. APRIL 1910, No. 12. 

MISSISSIPPI MEDICAL MONTHLY 

OFFICIAL ORGAN OF 

THE MISSISSIPPI STATE MEDICAL ASSOCIATION 
AND ITS COMPONENT SOCIETIES. 

PUBLISHED MONTHLY AT 714 S. CHERRY ST., VICKSBURG, MISS. 

Entered at the Post Office at Vicksburg as Second Class Mail Matter. 


PANOPEPTON 

A Complete Food and Completely Available 

Panopepton gives practical expression to the idea that in order to be of 
the widest utility a food for the sick should contain all the elements of the 
ordinary complex diet, should present in an available form the nitrogenous, 
carbohydrate and inorganic constituents essential to complete nutrition. 

Panopepton also expresses the belief that a “balanced” ration is just 
as important for the sick as the well, and this food is rigidly standardised to 
a certain definite ratio of protein to carbohydrate. Of its 22% soluble solids, 
6.30% is protein and 13% cereal carbohydrate, in genuine fortified Spanish 
Sherry wine. 

Panopepton is derived from prime lean beef and whole wheat by 
physiological conversion, by the action of the natural digestive enzymes under 
conditions approximating as closely as possible to those of normal digestion, 
and presents in a form ready for immediate appropriation all the constituents 
that contribute to the repair and support of the body. It is a matter of daily 
observation by the clinician that this food proves peculiarly valuable as a 
conserver of energy and a promoter of functional activity. J 

Fairchild Bros. & Foster, New York 



iMBH a 


'ystogen-Jzithia 



Effervescent Tebl.ts o, { *r„o. 

Uric acid Solvent, alkaline urinary antiseptic. 

DOSE — One or two tablets in a glass of water, three or four times daily. 

They should be dispensed in the tubes to preserve the effervescent property. 

Where Cy$togen is indicated, Lithia is of advantage; 
Where Lithia is prescribed, Cyrtogen is indicated* 

Indications— Rheumatism, gout, urinary deposits, calculus, cystitis, prostatitis and 
gonorrhoea. A good urinary antiseptic during convalescence from typhoid and scarlet 
fever. 

CYSTOGEN CHEMICAL CO., St. Louis, U. S. A. 

Cystogen Preparations: 

Cystogen — Crystaline Powder. Cystogen-Lithia (Effervescent Tablets) 

Cystogen — 5-grain Tablets. Cystogen Aperient (Granular Effervescent Salt 

SAMPLES ON REQUEST. with Sodium Phosphate.) 

C L 4 


flBHBBBDI 


Quiz Master Theory and Practice of Medicine, 
Memphis Hospital Medical College. 

Ass’t. Clinical Instructor Diseases of the Reo- 
tum, Memphis Hospital Medical College. 

Clinical Instructor In Surgery, Memphis Hos- 
pital Medical College. 

Ass’t to Chair of Gynaecology, Memphis Hos- 
pital Medical College. 

Surgeon to Reotal Dept., St. Joseph’s Hospital. 

Surgeon to Memphis City Hospital. 


Professor Theory and Practice of Medicine, 

Memphis Hospital Medical College. 

Clinical Instructor in Diseases of the Rectum, 

Memphis Hospital Medical College. 

Consulting Physician, St. Joseph’s Hospital. 

Surgeon to Reotal Dept., St. Joseph’s Hospital. 

Surgeon to L. & N. R. R. 

Are prepared to treat all Surgical and Rectal Diseases at St. Joseph’s or City 
Hospitals, where every facility for operating and the after-treatment demanded by 
this class of patients is afforded. Physicians desiring to send cases away from home 
for treatment, may feel assured that the same will receive every necessary attention. 

For particulars address 

Drs. B. G. and MAX HENNING, 

Long Distance Telephone 478. S. Main St., MEMPHIS, TENN. 


49 -Daring the session of the Memphis Hospll 
all charity cases of Surgical or Rectal Disea: 
paying his board, S10.00 per week. 


dical College from November to April, 
.1 he treated Free of Charge — the patient 




SURGICAL 

AND 

RECTAL DISEASES 

Dr, B, G, Henning, Dr, Max Henning, 




* 




TOURO INFIRMARY 

Prytania, Foucher, Coliseum, and Aline Streets, 
NEW ORLEANS, LA. 


The Touro Infirmary has a capacity of 160 patients and is the most 
up-to-date hospital in the South. Three large, fully-equipped operating 
rooms. X-Ray Department. Hydrotheraphy, Electrotherapy and Mas- 
sage Departments. Dietetic cooking. Private ambulance. Beautiful 
private courtyard. Large House Staff. Experienced nurses. Treatment 
room for outside patients. All private rooms and wards situated in the 
new building. Rates, $2.00 per day and up, include meals, ordinary 
medicines and surgical dressings, services of House Staff and Nurses. 
The Attending Physician’s charge is extra. 

All reputable physicians are invited to avail themselves ot the 
excellent facilities and other advantages offered by this institution. 


TELEPHONES: Uptown 415; Uptown 158. JSC JSC 



THE NURSING MOTHER 



often requires that her strength be reinforced and fortified. 
For this purpose 


Gray’s Glycerine Tonic Comp. 

is of unequalled value, for it sharpens the appetite, increases 
digestive power and materially augments the whole bodily 
nutrition. <1 Thus lactation is promoted naturally, with 
not only substantial benefit to both mother and child, but 



with complete avoidance of every ill effect 



THE PURDUE FREDERICK CO. 



298 BROADWAY, NEW YORK, N. Y. 



1 L 



m 




For Upwards of Forty 
Years the Use of 


\ fellows Syrup of a 
1 ftypoplmpbitcs I 

has been recommended by the 

Leading Medical Specialists SR 
in all Countries 1] 

8 \ I 

Doioni a^’Worthlcss Substitutes 

' ^""Preparations “Just as Good” 


» 





■ 
































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