The president, Dr. Mitchell of Mansfield, called the meeting to order, and owing to the number of papers to be presented and the brief time for the session, ordered the omission of reading of minutes of last meeting and all miscellaneous business. E. H. Hyatt of Delaware, was first called, and excused on the ground that he could not do justice to his subject, “The Use and Abuse of Alcohol from a Professional Standpoint,” in so short a time.

Dr. R. Harvey Reed of Mansfield, the appointed lecturer, read a paper on AnÆsthetics, in which he gave a brief review of the different general and local anÆsthetics in use and the different compounds of the same.

He referred to the elaborate experiments of Dr. Watson of Jersey City, which showed the following mortality on rabbits:

And on dogs:

In these experiments the doctor found it necessary to resort to artificial respiration on dogs as follows:

The author referred to a number of experiments he had made on frogs, in which vivisection was made, and the heart exposed and chloroform applied direct, from which they died in from ten to twenty minutes, and when bromide of ethyl was used in fifteen to thirty minutes, but when ether was used, and even much freer than either of the others, they did not die at all.

In repeated experiments, he said, he had found the use of electricity unreliable in resuscitating the heart under these circumstances.

After referring to the mortality reports which showed 405 deaths from chloroform against seventeen from ether, he said: “I feel that every time I use chloroform as an anÆsthetic I am trifling with a dangerous compound, and that it will only require time and perseverance in its use until I will share the fate of many others, whose misfortunes ought to be a timely warning to us against its dangerous effects; and if not heeded an accident will be all the more inexcusable.”

He condemned the use of so-called “vitalized air” as being an uncertain and unstable compound: being one of the nitro-oxygen series mixed with chloroform, its effects were uncertain and often very injurious, which, he said, “should be reason enough to deter any conscientious physician from using it or even recommending it.”

For administering anÆsthetics the author recommended a clean folded towel as being more preferable than anything else, as it was just as efficient and decidedly better from a sanitary standpoint.

He recommended watching the pulse closely while administering chloroform, and the respirations when ether was administered, lest in the former the cardiac ganglia become affected and suddenly arrest the heart's action, or in the latter the nerve cells of the medulla from its toxic effects abruptly interfere with the breathing.

In closing the author said: “From the brief review of the anÆsthetics most familiar to the profession from a practical standpoint we have arrived at the following conclusions:”

First—Of all general anÆsthetics known pure sulphuric ether stands at the head for safety, efficiency and every day practical use.

Second—Hydrochlorate of cocaine stands at the head of all known local anÆsthetics.

Third—Ethidene promises to rival ether and merits a more general and extended trial.

Fourth—No surgeon should give any anÆsthetics without being prepared to resuscitate the patient on the shortest possible notice if necessary, among which preparations nitrite of amyl stands preËminent.

Fifth—No person should be entrusted with the administration of any anÆsthetic who is not thoroughly familiar with its physiological action and practical administration.

Sixth—The indiscriminate use of anÆsthetics should be strenuously guarded against, and especially the practice of leaving such dangerous compounds in the hands of the laity to be given ad libitum whenever they may deem it necessary.

Seventh—The judicious use of anÆsthetics under all necessary circumstances should never be omitted, for when properly used by skilled hands they are a glorious haven of peace in the midst of a stormy sea.

Dr. J. Campbell of Galion reported a case of embolism, in which the diagnosis was uncertain, the symptoms grave and the disturbance of the circulation extremely severe, distinguished physicians differing widely as to the pathological conditions, and the autopsy revealed adhesions of the right lung and of the pericardum. Left lung compressed, left heart hypetrophied and stenosis of aortic orifice. On motion the case was referred to the committee on publication, and Drs. Hackendorn, Ridgway and Mitchell, who had seen the patient, were requested to give their views.

Dr. N. B. Ridgway reported a case of laceration of perinÆum with operation within an hour, with complete success, on which remarks were made by Drs. Reed, Larimore and Kelley.

Dr. Kelley presented a clinical case of blindness in right eye of a girl, from the concussion of a snow ball striking the arch of the orbit.

The society adjourned to meet in Mansfield March 25, 1886.

THE AMERICAN PUBLIC HEALTH ASSOCIATION.

In the summer of 1873 a few gentlemen met at Long Branch, New Jersey, and organized as the “American Public Health Association.” At that time there were but few state boards of health, and local boards were not generally efficient; and it was one of the chief objects of the American Public Health Association to aid in the establishment of health and sanitary organizations throughout the country. Prominent among the original members of the association were gentlemen from the Mississippi valley. For a long time the cities and towns of that valley had suffered from visitations of yellow fever, and men had become somewhat enlightened by the good results obtained from the course pursued by certain officers during the war. Especially was this true in New Orleans, and the question was fairly raised whether local conditions were not responsible for the disastrous outbreaks which had occurred so frequently.

From 1873 to the present time, there have been annual meetings of the association, with a greatly enlarged membership. A large result of the efforts of the association and its members is seen in the national, state and local boards of health, and other sanitary organizations throughout the country. But three of the states are now without state organizations. The recent meeting in Washington was its “thirteenth annual,” and was as well attended and its members as enthusiastic as at any. The members were “welcomed” on behalf the medical fraternity of Washington by the venerable Dr. J. M. Toner, and by the district authorities through the President of the Board of Commissioners, Judge Edmonds. These remarks were followed by the usual address by the president of the association, Dr. Reeves of West Virginia.

The chief point, perhaps, of Dr. Reeves' address, and the one calling out most expressions of approval, was the arraignment of Congress for its failure to provide means for the support of the National Board of Health. He cited the liberality shown to care for domestic animals, the fisheries, the Indians, and, indeed, almost every conceivable object, but Congress was unwilling to grant even a sum sufficient for gathering and publishing the reports from local boards. He expressed a strong feeling against the attempt to have the work for which the National Board was created to perform, done by the Marine Hospital Service.

A large part of the time of the meetings was taken up in hearing reports from committees appointed at the meeting in St. Louis, 1884. Among these reports were some of great interest. Prof. Sargent, of Harvard, gave a report upon “School Hygiene in American Schools and Colleges,” and this was enlarged by a paper from Dr. Hartwell, of John Hopkins University, on “The German System of Physical Education.” At this meeting prizes were to be awarded, in accordance with the wish of Mr. Lomb, of Baush & Lomb, Rochester. The subjects were:

1. “Healthy homes and food for the working classes.”

2. “The sanitary conditions and necessities of school-houses and school life.”

3. On “Disinfection and individual prophylaxis against infectious diseases.”

4. On “Preventable causes of disease, injury, and death in American manufactories and workshops, and the best means and appliances for preventing and avoiding them.”

These prizes were in cash, and amounted to five hundred dollars each, the decision resting with a separate committee for each. Without taking more space, it may be said that these meetings are usually attended by about three hundred members, from all parts of the country. Canada sends representatives, and the meeting in 1886 is to be held in Toronto. Very diverse opinions are developed, and sharp discussions are the order. All shades of medical and lay topics and views are brought out, but all meet on the common ground of desire for improvement in health. The medical officers of the army and navy are always well represented by such men as Drs. Billings, Sternberg, Gihon, Turner and others, while Hon. Erastus Brooks of New York is a layman whose views have been and still are relied upon as representing a philanthropic sentiment which can be found in all communities.

CUYAHOGA COUNTY MEDICAL SOCIETY—ADJOURNED MEETING, OCTOBER 15^TH.

REPORTED BY L. B. TUCKERMAN, COR. SEC.

Dr. Himes presided.

Dr. Powell gave a verbal report on the progress of obstetrics and diseases of children as follows:

OBSTETRICS.

In the department of obstetric literature, 'Barnes' Obstetrics' had just been published by Lea. It was encyclopÆdic in its character. Lusk had issued a new edition with several chapters added. Parvin's book was now in press, and is also issued by Lea. In the department of diseases of children, Eustace Smith's work is invaluable as regards symptomatology and clinical history, but is not so good in therapeutics. Goodhart's work, edited by Starr, is also of value.

Axis traction forceps are coming more and more into favor, Lusk's modification of Sarnier's forceps being used. Simpson's axis traction forceps is also much used in this country and in Germany. The form used by Dr. Lusk's assistant and in use in Karl Braun's maternite in Vienna, with a hinge jaw where the blade joins the shaft and traction handles, allows more motion of the head and has a number of other advantages.

Electricity is coming more and more in vogue as an oxystocic. It seems to hasten labor without increasing pain. Its use to destroy the life of the foetus in fallopian pregnancy is more common in this country than in Europe.

In the past two years Lawson Tait has operated five times for ruptured foetal cyst, with four recoveries. There are no other cases on record so far as known to the reporter. The present tendency of professional opinion is to favor an immediate operation.

Intra-uterine injections are not so freely used as formerly, and are restricted to cases where there is actual retention of putrid material in the uterine cavity, with fever. Bichloride of mercury is gaining ground as the antiseptic par excellence.

Cocaine has been tried to relieve the pain during dilation of the os, but has not proved a success. It is, however, a success in relieving certain cases of obstinate vomiting of pregnancy, and also the pain of fissured nipples.

Hicks' bimanual method of treating placenta previa is gaining ground.

In connection with post partum fever, a larger number of cases of diphtheritic complications is noted than formerly.

DISEASES OF CHILDREN.

Crede claimed to be able to prevent ophthalmia neonatorum by instilling into each eye at birth two drops of a two per cent. solution of nitrate of silver.

Cassels of Berlin, after an exhaustive investigation, claims that no remedies are so reliable in pertussis as belladonna and quinia.

In the treatment of diphtheria, Tr. Ferri and Potass. Chloras seem to stand as high as ever in the opinion of the profession. Calomel, which also has its admirers, seems to have lost no ground, as well as the use of the steam atomizer.

Dr. Allen presented a dermoid cyst of the left ovary, removed that forenoon from a nullipara aged twenty-seven. Six hours after the operation the patient's temperature was 99.6° Fahr., and there had been but little vomiting.

Dr. Sihler showed a gall stone found at the autopsy of a woman forty-eight years old, whose symptoms had not been those which are usual in fatal cases of obstruction of the gall duct. There had been no jaundice, no bile in the urine and no previous attacks of pain. She complained one morning of sore throat, and was given one-eighth of a grain of morphia. In the evening there was pain in the stomach and the morphia was discontinued. This was on Saturday. By Sunday or Monday the pain had become located along the border of the liver. On Tuesday the free edge of the liver could be felt, and the temperature had risen to 102° or 103°, pain and vomiting having also become very severe. The next week pain was less and swelling less, and in two weeks all symptoms were gone. She never before had symptoms of colic. Two weeks later, after she had been asleep about three hours, she had another attack. The next day the temperature rose again, and there was a larger region of sensitiveness than before. On Tuesday the fever subsided. On Wednesday collapse and vomiting ensued, ending in death. The autopsy disclosed adhesions of the liver, omentum and colon, an effusion of bile in the tissues, and this gall stone was found in the gall bladder.

Dr. Allen mentioned a case that he had seen in Keith's Clinic in Edinburgh, where an operation was undertaken for ovarian cyst, but when on opening the abdomen the tumor was found to be the gall bladder so enlarged as to fill the whole lower part of the abdomen.

Dr. Sihler said that in his case the gall bladder was not so very much enlarged.

Dr. Tuckerman reported a case where a gall stone the size of a pigeon's egg was found post mortem, but which during life could sometimes be felt through the abdominal wall and sometimes not, and which gave rise to a bruit so distinct as to warrant a strong suspicion of aneurysm.

Dr. Vance stated that according to his observation the passage of a gall stone into the intestine by ulceration was a common cause of intestinal obstruction. He also called attention to the value of the symptom of itching as pointing to the gall bladder as the seat of the difficulty.

Dr. Linhart reported a post mortem in a case of typhoid fever where eighty-five small stones were found in the gall bladder. The bladder was but little distended.