Professor of Diseases of Children in the Baltimore Polyclinic,
Baltimore, Md.
It is said of Baltimore that socially it is different from other large
cities in the _freedom_ as well as the cordiality with which it extends
its hospitality. The business men and their clerks are polite and
attentive. They do not display the trait, so common in the metropolis,
of incognizance—even to rudeness—if one chances to be on a tour of
inspection instead of purchase. The impression is at once made, and very
forcibly, that a Baltimorean has plenty of time, that he is not hurried.
He will stop on the street and direct a discomfited stranger, and has
been frequently known to turn aside from his duties and accompany the
lost one to where he could take care of himself. This is a natural
element in the entire populace, and is very prominent in the medical
profession. A stranger is welcomed so heartily that he feels at home
immediately, and can settle down among friends.
It occurs to me that this easy-going feeling has had much to do in
keeping our city from occupying the prominent position in education and
authorship that her opportunities, and conditions in general, would lead
us to expect. I am glad to say that she is arousing from her lethargy,
and recently her pen has been busy. Several works have emanated from the
profession here which have attracted much attention, and have been quite
extensively read. Notably among them is a 'Text-book of Hygiene,' by Dr.
Rohe, and 'The Physician Himself,' by Dr. Cathell, which has reached a
fifth edition and a sale of over fifteen thousand copies. I should like
to say, concerning these two works, that no physician, especially if he
be under thirty-five years of age, should be without them. Two other
works, 'A Manual on Nervous Diseases,' by Dr. A. B. Arnold, an old,
experienced and able teacher, and one on 'Practical Chemistry,' by Dr.
Simon, have been much studied and commented upon. They are limited to
special subjects and will not naturally obtain a large class of readers.
These, like the long-delayed blade of corn, which pushes its emerald tip
heavenward and bears upon its face the sparkling matin dew, give promise
of a fertile soil and of abundant fruitage.
At the last meeting of the Medical and Surgical Society—which we had the
pleasure of attending—there was an interesting discussion on cerebral
troubles of syphilitic origin. A number of cases were related. The
various symptoms of these maladies are familiar to your readers. The
treatment which was successful in all but one of the cases here
reported, was mercury and iodide of potassium. The plan preferred for
the administration of mercury is by inunction. All the debaters insisted
upon the full constitutional effects of the drugs. As one gentleman put
it, “the system must be saturated before a cure is assured.”
I might mention among the symptoms, that those manifested by the eye
were not regarded as reliable. In one case the only manifestation was a
persistent and severe supra-orbital and occipital neuralgia, and for
some time the man was in consequence wrongly treated.
One physician noted _insomnia_ as a distinct and always present symptom.
Also as a point of differential diagnosis between the convulsions of
epilepsy and those of local lesion of the brain, that in the former
there is no _consciousness_ of having a convulsion, while in the latter
such consciousness is very clear, at least at the beginning of the
spasm.
A case of pelvic peritonitis of the chronic form, reported by the
president of the society, elicited much discussion, especially upon the
subject of exploratory abdominal incision as a means of diagnosis. He
noticed that the younger surgeons favored the operation, but the older
ones were more conservative.
A member reported one of those peculiarly (excruciatingly, I ought to
say) interesting cases of labor, in which, by _great_ exertion on his
part, and the assistance of two physicians and three (I think is the
number) midwifes or old ladies, he managed “to save the old man,” though
the other parties concerned passed on into the mysterious future. (The
society is expected to laugh a good deal just here, and of course we
expect the readers to do the same.)
At a recent meeting of the Baltimore Medical Association a member
related the following experience: In a family of three children, the
oldest, who had scarlatina four years ago, contracted diphtheria; in a
few days a younger one became ill with the same disease, but accompanied
in forty-eight hours with a distinct eruption of scarlatina. A few days
later the youngest was stricken with scarlatina, but had no symptom of
the diphtheritic trouble.
The report brought out the thought of most of the members present. The
two questions of “the identity of pseudomembranous croup and
diphtheria,” and of “diphtheria a local or a constitutional disease”
were again argued, and, as usual, no opinions were changed. Like the
Scotchman, each was willing to be convinced, but he could not find any
one able to convince him. Two points were fully agreed upon, namely,
that the presence of membrane in the fauces, and of sequellæ, are not of
importance in diagnosis; also that nearly all of the cases in which the
posterior nares becomes seriously implicated are fatal. One gentleman
advanced the opinion, supported by “statistics” (as accommodating a
friend as “facts”), that when the submaxillary glands were enlarged in
this disease recovery took place; when they were _not_ enlarged, death
occurred. The doctor did not say that death occurred at once or within a
few days, so we shall be charitable and suppose that he meant sometime
during the succeeding hundred years.
Notes of two very interesting cases of myelitis, followed by spastic
paraplegia, were read and discussed. The author made special mention of
the exaggerated tendon-reflex being always present in disease of the
lateral tract of the cord, and that this symptom is diagnostic—if
hysteria be first excluded. He also noted in these cases that the
condition of the muscles of the posterior portion of the legs (lower)
was very tense, producing an impression on grasping them similar to that
noticed on grasping a piece of iron. Neither of these men were able to
place the heel upon the floor when standing erect. No amount of effort
on their part could enable them to accomplish it. Neither of them were
improved by the use of the iodides.