Blackwell Family Emily Blackwell Biographical Material MiscellanyPlease return WOMAN's MEDICAL JOURNAL A Monthly Journal Published in the Interests of Women Physicians Volume number XX.9. SEPTEMBER, 1910 $2.00 PER YEAR IN ADVANCE SINGLE COPIES, 20 CENTS EDITORS. ELIZA M. MOSHER, M.D., BROOKLYN, N.Y. MARGARET A. CLEAVES, M.D., NEW YORK, N.Y. GRACE PECKHAM MURRAY, M.D., NEW YORK, N.Y. MARION CRAIG POTTER, M.D., ROCHESTER, N.Y. MARTHA WOLLSTEIN, M.D., NEW YORK, N.Y. COLLABORATORS. Bertha Van Hoosen, M.D., Chicago, Ill. Emily Lewi, M.D., New York Laura L. Branson, M.D., Iowa City, Ia. Ida E. Wilson, M.D., Columbus, O. Laura E. Liebhardt, M.D., Denver, Col. Julia M. Carpenter, M.D., Cincinatti, O. Avis Smith, M.S., M.D., Kansas City, Mo. Mary Ryerson Butin, M.D., Madera, Cal. Marian K. Bowles, M.D., Joliet, Ill. Helen MacMurchy, M.D., Toronto, Can. Evangeline W. Young, M.D., Boston, Mass. Elsie Berwig, M.D., Berlin, Germany Anne Burnet, M.D., Mt. Pleasant, Iowa. Ellen Heise, M.D., Canton, Ill. Lillian C. Towslee, M.D., Cleveland, O. May Michaels, M.D., Chicago, Ill. Bethena Coone, M.D., Chicago, Ill. MARGARET HACKEDORN ROCKHILL, MANAGING EDITOR, CINCINNATI, OHIO To whom all business communications should be addressed THE WOMAN's MEDICAL JOURNAL, Publishers COPYRIGHT SECURED CINCINNATI, OHIO. Entered as Second-Class Matter at the Post-Office at Cincinnati, O. CONTENTS ORIGINAL. Diabetes Mellitus, by Lois L. Gannett, M.D., Adams, N.Y. 179 Athletics in Our Schools and Colleges, by Dr. Augusta Camp, White Plains, N.Y. 181 Prenatal Influences, by Dr. Jennie Gray Wildman, Toronto, Canada 183 Adrenalin Therapy of Malignant Tumors 185 A Ruling Against Osteopathy 185 EDITORIAL. The Passing of Dr. Emily Blackwell 186 Babies 187 The Pathology of Hepatic Cirrhosis 187 Dr. Elizabeth Blackwell by Dr. Eliza M. Mosher, Brooklyn, N.Y. 188 (Contents Continued on Tenth Ad Page.) UNDER THE PURE FOOD LAW. We guarantee Pa-pay-ans Bell to be composed of papain, charcoal, soda, flavoring and nothing else. We deliver, gratis, to physicians any- where, enough Pa-pay-ans Bell to prove that it removes Indigestion. Bell & Co. (Inc.) Mfg. Chemists, Orangeburg, New York, U.S.A Pa-pay-ans Bell is advertised to physicians only. 11 The Woman's Medical Journal September, 1910 Lactopeptine is a combination -- acts like a combination -- secures results only to be obtained from a combination Digestive -Enzymogenic-Activating (Counteracts Digestive disorders - Gastric or Intestinal) The N.Y. Pharmacal Assn Yonkers, N.Y. A Pure Hypnotic Not a Narcotic NEURONIDIA Agreeable in taste, prompt in action, producing natural, refreshing sleep, and exceptionally free from unpleasant sequelae. FOR NERVOUS INSOMNIA. In its varied forms Neuronidia is highly recommended, as well as in the sleeplessness attending acute and chronic diseases in general, if unassociated with pain. Schieffelin & Co., New York Send for Literature and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL iii LISTERINE is a powerful, non-toxic antiseptic. It is a saturated solution of boric acid, reinforced by the antiseptic properties of ozoniferous oils. It is unirritating, even when applied to the most delicate tissue. It does not coagulate serous albumen. It is particularly useful in the treatment of abnormal conditions of the mucosa, and admirably suited for a wash, gargle or douche in catarrhal conditions of the nose and throat. There is no possibility of poisonous effect through the absorption of Listerine. Listerine Dermatic Soap is a bland, unirritating and remarkably efficient soap. The important function which the skin performs in the maintenance of the personal health may easily be impaired by the use of an impure soap, or by one containing insoluble matter which tends to close the pores of the skin, and thus defeats the object of the emunctories; indeed, skin diseases may be induced, and existing disease greatly aggravated by the use of an impure or irritating soap. When it is to be used in cleansing a cutaneous surface affected by disease, it is doubly important that a pure soap be selected, hence Listerine Dermatic Soap will prove an effective adjuvant in the general treatment prescribed for the relief of various cutaneous diseases. "The Inhibitory Action of Listerine," a 128-page pamphlet descriptive of the antiseptic, and indicating its utility in medical, surgical and dental practice, may be had upon application to the manufacturers, Lambert Pharmacal Co., St. Louis, Missouri, but the best advertisement of Listerine is ------------- LISTERINEiv The Woman's Medical Journal September, 1910 Tannismuth Bi-Tannate of Bismuth Intestinal astringent Very efficient in acute and chronic diarrhoea The astringent action sets in at once and extends over the entire length of the Alimentary Canal. Dosage: 7 1/2 grains --- 3 to 5 times daily. (May also be given in 7 1/2 grain tablets.) Carbosant Carbonic Acid Eater of Santalol (containing 94% of Santalol). Absolutely unirritating, odorless and tasteless preparation possessing in the full the therapeautic value of Sandal Wood Oil without any of its disagreeable effects. No gastric distress need be anticipated. Its administration is followed by diminution of pain, absence of complications and clearing of urine. Dose - 10 to 15 minims three times a day. Supplied in bulk or 5 and 10 minim capsules. Samples and Literature gladly sent to Physicians. The Heyden Chemical Works 135 William Street New York Medinal Monosodium-Diethyl-Barbituric Acid A freely soluble hypnotic for use by mouth, by rectum and subcutaneously. Being readily absorbed and rapidly excreted, it is distinguished by prompt and reliable soporific effect Freedom from cumulative toxic actions Superior to the sparingly soluble diethyl-barbituric acid of Mering. Advantageously replaces chloral in threatening delirium tremens; useful in the treatment of morphinism. Dose: 5 to 15 grains (1 to 3 tablets) Brovalol Brom-Isovaleric-Acid-Borneolester Combines the action of valerian with that of bromine, but is readily taken and well borne, causing no eructation or other untoward symptoms. Exhibits vigorous sedative and nervine effect Innocuous even in large doses Decidedly effective in neurasthenic and hysterical conditions, obviating subjective difficulties - mental and physical fatigue, headache, nervousness, insomnia, etc. Dose: 1 to 3 pearls several times daily Literature from Schering & Glatz New York Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL Incontrovertible Facts That a remedy to be of therapeutic value must produce unquestionable satisfactory results. That a product established upon its proven utility and scientifically prepared with the object of maintaining its reputation, must be superior to any imitation carelessly compounded with only the maker's "Just as Good" as evidence. That Antiphlogistine (Trade Mark) (the originat clay dressing) has unquestionably demonstrated its dependable value in all inflammatory conditions, is reflected by the confidence reposed in it by thousands of successful practitioners and its ever increasing sales. A few doctors may not be familiar with the wide range of conditions in which Antiphlogistine is particularly serviceable, in that instance, literature will be cheerfully sent upon request. The Denver Chemical Manufacturing Co. New York Send for Samples and Mention this Journal.V1 THE WOMAN'S MEDICAL JOURNAL September, 1910 The prudent practitioner, being guided by the dictates of experience, relieves himself from disquieting uncertainty of results by safeguarding himself against imposition when prescribing ERGOAPIOL (Smith) The widespread employment of the preparation in the treatment of anomalies of the menstrual function rests on the unqualified indorsement of physicians whose superior knowledge of the relative value of agents of this class stands unimpeached. By virtue of its impressive analgesic and antispasmodic action on the female reproductive system and its property of promoting functional activity of the uterus and its appendages, Ergoapiol (Smith) is of extraordinary service in the treatment of AMENORRHEA, DYSMENORRHEA MENORRHAGIA, METRORRHAGIA ERGOAPIOL (Smith) is supplied only in packages containing twenty capsules. DOSE: One to two capsules three to four times a day. ' ' ' Samples and literature sent on request. MARTIN H. SMITH COMPANY, New York, N. Y., U. S. A. Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL vii The Heart in Pneumonia 'a haunting concern.' You have been seriously conscious of it more than once, we dare say. As to its management--"I pin my faith on digitalis," declares a physician of wide experience. And there are many others who do likewise. "In treating pneumonia," wrote a prominent clinician in the Medical Record of May 4, 1907, "when we cannot afford to wait for the sometimes slow action of the infusion of digitalis, we now have a rapidly acting preparation in Cloetta's soluble digitoxin (Digalen), a prepared solution of which may be given by mouth or hypodermically. This is reliable and prompt in its effect." You can depend upon DIGALEN far more than upon the tincture, infusion, extract or dialysate, because (1) its dosage is exact--no guesswork; (2) it is the least irritative to the stomach; (3) it is non-cumulative within the limits of physiological dosage; (4) it is prompt, precise and constant in its action--can be given intravenously with almost instant effect. Dosage: 1/2 to 1 c.c. (8 to 16 m.) Send for Sample and Clinical Reports. The Hoffmann-La Roche Chemical Works, 65 Fulton Street, New York A DELIGHTFUL REVELATION The value of senna as a laxative is well known to the medical profession, but to the physician accustomed to the ordinary senna preparations, the gentle yet efficient action of the pure laxative principles correctly obtained and scientifically combined with a pleasant aromatic syrup of Californian figs is a delightful revelation and in order that the name of the laxative combination may be more fully descriptive of it, we have added to the name Syrup of Figs "and Elixir of Senna," so that its full title now is "Syrup of Figs and Elixir of Senna." It is the same pleasant, gentle laxative, however, which for many years past physicians have entrusted to domestic use because of its non-irritant and non-debilitating character, its wide range of usefulness and its freedom from every objectionable quality. It is well and generally known that the component parts of Syrup of Figs and Elixir of Senna are as follows: Syrup of California Figs.................................................75 parts Aromatic Elixir of Senna, manufactured by our original method, known to the California Fig Syrup Co only................................25 parts Its production satisfied the demand of the profession for an elegant pharmaceutical laxative of agreeable quality and high standard and it is, therefore, a scientific accomplishment of value, as our method ensures that perfect purity and uniformity of product required by the careful physician. It is a laxative which physicians may sanction for family use because its constituents are known to the profession and the remedy itself proven to be prompt and reliable in its action acceptable to the taste and never followed by the slightest debilitation. ITS ETHICAL CHARACTER Syrup of Figs and Elixir of Senna is an ethical proprietary remedy and has been mentioned favorably as a laxative, in the medical literature of the age, by some of the most eminent living authorities. The method of manufacture is known to us only, but we have always informed the profession fully as to its component parts. It is therefore not a secret remedy, and we make no empirical claims for it. The value of senna as a laxative is too well known to physicians to call for any special comment, but in this scientific age it is important to get it in its best and most acceptable form and of the choicest quality, which we are enabled to offer in Syrup of Figs and Elixir of Senna, as our facilities and equipment are exceptional and our best efforts devoted to the one purpose. CALIFORNIA FIG SYRUP CO. Addresses: San Francisco, Cal., Louisville, Ky., New York, N. Y., U. S. A. London, Englandviii THE WOMAN'S MEDICAL JOURNAL September, 1910 The Treatment of CHRONIC CONSTIPATION with bland, neutral non-assimilable oil, in the form of AROMATIC LIQUID ALBOLENE is proving most successful. The Albolene acts mechanically, is excreted in toto and does not need to be given in increasing doses. The treatment is superior in every way to the use of cathartics. COMPLETE LITERATURE ON APPLICATION McKESSON & ROBBINS . . . NEW YORK "God Bless the Duke of ARGYLL" Don't Prescribe a Stone Post Long years ago, when half the men of Scotland carried about itching backs, the Duke of Argyll had stone posts set up at intervals beside the highway as a convenient place for the passerby to scratch. So much were the moments of relief appreciated that each man, as he scratched, was sure to say "God bless the Duke of Argyll." But stone post treatment will not do today. During these summer months countless thousands of persons will go to their doctors for relief from some maddening skin infection the heated weather makes intolerable, more especially catarrhs and itching inflammation of the genito-urinary and rectal organs of both male and female, as well as the treatment of infantile and other diarrhoeas. This is no time for the physician to experiment, no time to offer stone post remedies--his patient wants something that sooths while it heals, and does both rapidly. A good remedy is not enough. It must be the best. From the torture of burning, swollen feet, hives, mosquito bites, prickly heat, sun burn, offensive perspiration, etc.--in short from all the many torments of the heated season--science has been able to guarantee, and practice been able to prove, but one prompt and positive relief and cure--TYREE'S ANTISEPTIC POWDER. A sample with literature descriptive of its composition, application, etc., furnished the profession free upon application. Washington, D. C. J. S. TYREE, Chemist Send for Sample and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL ix Welch's Grape Juice embodies all the dietetic and medicinal qualities of fully ripened Concord Grapes. The juice is pressed where the grapes grow, so they can be left to store their utmost of sugar, nitrogenous elements and delicate acids before they are gathered. Transferring the juice form the clusters to the bottle is but a matter of a few hours. Grape Juice made under these conditions is bound to be of a quality which physicians feel safe in prescribing. Welch's Grape Juice is sold by leading druggists everywhere. Three-ounce bottle, by mail, six cents. Pint bottle, express prepaid east of Omaha, 25 cents. You will be interested in our booklet, "The Food Value of the Grape." Sent free to physicians. The Welch Grape Juice Company, Westfield, N. Y. THOSE FRAGILE CHILDREN Who have little or no appetite, who are markedly affected by every temperature variation, who lose time from school, will respond splendidly to the administration of CORD. EXT. OL. MORRHUAE COMP. (HAGEE) Given throughout the cold season, three times a day, it will add to the child's weight and increase its resistance to cold and disease. --A further desideratum is that it will not interfere with the gastric functions. EACH FLUID OUNCE OF HAGEE'S CORDIAL OF THE EXTRACT OF COD LIVER OIL COMPOUND REPRESENTS THE EXTRACT OBTAINABLE FROM ONE-THIRD FLUID OUNCE OF COD LIVER OIL (THE FATTY PORTION BEING ELIMINATED) 6 GRAINS CALCIUM HYPOPHOSPHITE, 3 GRAINS SODIUM HYPOPHOSPITE, WITH GLYCERIN AND AROMATICS. Supplied in sixteen ounce bottles only. --Dispensed by all druggists. Katharmon Chemical Co., St. Louis, Mo. Send for Samples and Mention this Journal.x THE WOMAN'S MEDICAL JOURNAL September, 1910 A CHAIN IS NO STRONGER THAN ITS WEAKEST LINK. A MAN IS NO STRONGER THAN HIS STOMACH. IT IS NOT ENOUGH TO DO THE DIGESTING FOR THE STOMACH, WE SHOULD PROPERLY FEED the DIGESTIVE CELLS in order that THEY MAY DO their OWN WORK. The NUCLEO-ENZYMES FEED THE CELLS and as found in PEPTENZYME MAKES IT DIFFERENT from ALL other DIGESTIVES. SEE THAT YOUR PRESCRIPTION READS PEPTENZYME ACCEPT NO SUBSTITUTE IF INTERESTED SEND FOR SAMPLES & LITERATURE REED & CARNRICK 42-46 GERMANIA AVE JERSETY CITY N. J. CONTENTS. ITEMS OF INTEREST-- Epidemic Poliomyelitis........................................................................190 Race Suicide in Hawaii.........................................................................190 Bureau of Health Speakers.................................................................190 Aid for Japan............................................................................................190 Red Cross Hospital................................................................................190 A Bequest to the New York Academy of Medicine..................190 Fourth of July Victims...........................................................................190 Books for Hospital Patients................................................................191 Protection Against Cholera................................................................191 ABSTRACTS-- Myogenous Leucocytosis...................................................................191 The Clinical Aspect of Arteriosclerosis...........................................191 Recent Surgery of Pulmonary Tuberculosis.................................191 Cats as Plague Preventers...................................................................191 Hereditary Syphilis and the Wasserman Reaction.....................192 Acute Anterior Poliomyelitis...............................................................192 Treatment of Syphilis with Ehrlich-Hata's New Preparation of Arsenic......................................................................192 Does an Attack of Epidemic Poliomyelitis That is Recovered From Afford Immunity to Reinfection?................192 Pancreas Intoxication..............................................................................192 Treatment of Sciatica with Epidural Injections..............................193 Tumors of the Abdominal Wall...........................................................193 Diagnosis in Malignant Diseases........................................................193 Suppository for Inflamed Rectum......................................................193 Heat in Treatment of Erysipelas..........................................................193 Prevention of Constipation in the Young.......................................193 Availability of the Desmoid Reaction in General Practice........193 Causes of Bromine Retention and Chorine Displacement in the Blood Serum.............................................................................193 Syringomyelia in Mother and Daughter..........................................193 BOOK REVIEWS.........................................................................................194 PUBLISHER'S DEPARTMENT.................................................................195 Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xi Dear Doctor We come with no new or startling message, we simply remind you of one of the reasonable certainties of medicine - Pepto-Mangan (Gude) During its twenty years of continuous service as blood constructor and general tonic it has firmly intrenched itself in the professional favor No preparation has been as extensively taken by the physician himself as Pepto-Mangan None has been as extensively prescribed for members of the physician's family and household No product has been marketed in more strict accordance with the true ethics of the profession These facts count for something and mean something They are urged as legitimate reasons for your continued favor and preference Yours Respectfully M. G. Breitenbach Company, U. S. A. Send for Samples and Mention this Journal.xii THE WOMAN'S MEDICAL JOURNAL September, 1910 GASTROGEN TABLETS A NEUTRALIZING DIGESTIVE Used in connection with Sal Hepatica in the treatment of Dyspepsia and Indigestion. Each tablet contains one grain Purified Pepsin, (digestive power 1 to 9000), one-fourth grain Pancreatin, U. S. P., one-fourth grain Purified Papain, seven grains Calcium Carbonate, and one-half grain Calcium Phosphate, combined with aromatics. These tablets present the proteolytic ferments, Pepsin and Papain, in an exceedingly active form and in combination with a compatible antacid. The pepsin is made by the Webber process and is capable of digesting nine thousand times its weight in egg-albumen, or three times the quantity required by the U. S. P. It is an exceedingly permanent form of this ferment in that it is free from the peptone contamination which causes commercial pepsins in general to readily undergo putrefactive changes upon exposure, with a development of a disagreeable odor--a sure sign of deterioration. The antacid used in Gastrogen Tablets does not destroy the digestive action of pepsin, while the amount contained in a single Gastrogen Tablet is equivalent to twelve grains of sodium bicarbonate in neutralizing power. Papain, the remarkable ferment obtained from the papaw (Carica Papaya), is specially serviceable in the digestion of meat, and is present in its most active obtainable form. Gastrogen Tablets are, therefore, indicated in apeptic dyspepsia, caused by a deficiency of the gastric fluid, and will also be found very efficient in relieving gastric distress arising from fermentative causes. For intestinal indigestion, flatulence, etc., take one to two tables immediately before meals. Repeat the dose in an hour if needed for sour stomach or heartburn. For gastric distress, weak stomach and dyspepsia, take one or two tablets after eating, repeating in half an hour if necessary. Samples mailed to Physicians only, upon request. BRISTOL-MYERS CO. 277-279 Greene Ave., Brooklyn, New York, U. S. A. CELLASIN (Metabolic Ferment Derived from Fungi) A dependable influencer of Nutrition Clinically efficient in Malnutrition as is nothing else. Produces These Important Effects In Early Tuberculosis. Unmistakably Increases the Blood Count. Enables the System to Metabolize Carbohydrates and Fats. Increases Appetite and Weight. Chemistry and Scientific Rationale on Request. MEAD JOHNSON & CO. Jersey City, N. J. Send for Sample and Mention this Journal. The Woman's Medical Journal. A Monthly Journal Published in the Interests of Women Physicians VOLUME XX NUMBER 9 September, 1910 $2 per year in advance Single Copies, 20 cents Original Articles. DIABETES MELLITUS.* BY LOIS L. GANNETT, M. D., ADAMS, N. Y. Fellow-Workers in the Medical Profession: This subject is so large in scope and intricate in its various manifestations, that I realize my inability to deal with it from any other standpoint than that of personal study of cases with a few references to such well-known authorities as a country doctor can command. I beg not more for your attention than for your helpful, open criticism and discussion. Austin Flint, in his lectures published in 1873, says: "Glycosuria and melituria are names applied to the affection characterized by diuresis and saccharine urine and they are to be preferred to diabetes mellitus. The term Glycohemia, denoting a saccharine condition of the blood, is to be preferred to either. The affection is far from being of frequent occurrence. Yet it is not so rare but that a case occasionally arises under the observation of any physician." In reading the above I wondered how much it meant to a teacher like Austin Flint when the world went by on the other side and did not use his favorite term "Glycohemia." Regarding the frequency of the disease, I have not found it of rare occurrence. Less than four years of practice in a country village has brought to me eight cases of true diabetes mellitus and several cases of glycosuria so severe as to simulate diabetes over variable periods of time. Concerning the cause of this disease, Dr. John Watson, of London, England, writing fifty-five years ago, Dr. Austin Flint, of Philadelphia, some fifteen or twenty years later, and Dr. Wm. Osler, always of Baltimore, in more recent writing, agree that the cause is unknown. Certain ways of living, certain family traits may seem to predispose to the disease. But even on this point we have the wide divergence between luxurious living, with much eating and drinking as a predisposing factor, and again we are told that malnutrition, lack of food, scanty, unvaried diet makes the liver throw off the sugar from its storehouses from the sheer lack of any other way to get it for the uses of the body. Yet believing as we do that assimilation rather than ingestion controls the health of the body, it is not as hard to reconcile these apparent extremes as, at first glance, it appears to be. At various times and by various authors other causes, as cold, fright, exposure, etc., have been advanced, but these seem all to have been relegated to the list of possible exciting causes in persons already predisposed to the disease, or possibly already suffering from an unrecognized diabetes. * Read at meeting of Zeta Phi. By others, different little spots in our anatomy have been held responsible for all our trouble. The pituitary body was accused at one time, but when tried was found to be not always guilty. The islands of Langerhans were said to be always diseased, but autopsies revealing pancreas destroyed by carcinoma without causing diabetes threw a doubt on this theory. Now Sajous tells us of a disturbed condition of the adrenal bodies always found in diabetes--the obese form being due to a super-activity of the glands and requiring arsenic as a depressant, and the poorly nourished diabetic due to an under-activity of the adrenal bodies and curable by thyroid extract. Doubtless this theory, like the others, will be found true in some cases. In the eight cases I have observed I have been able to trace no common cause. Not one has ever been cold or exposed or frightened. Not one has ever gone hungry for any length of time and only one was ever addicted to the use of intoxicating liquors. Like our friend of fifty years ago, the cause of diabetes is to me unknown. Not so however my cases of transient glycosuria. The cause of that condition has been easily traced, in each case, to either the candy habit or a nervous anemic condition easily controlled by tonics. Authorities agree that young patients do not endure the disease as well as older ones, also that corpulent persons succumb more easily than spare persons. In my cases six of the eight were over fifty, one forty and one twenty-three years of age. Of course it is impossible for me to say just how old they were when the disease began. In six of the cases I was the first to diagnosticate the condition. The other two cases had been treated for some time and came to me only to try the new doctor. Only one of my cases has been spare and three of them are excessively fat persons. The lean one was the one addicted to the use of alcoholic beverages. Six of my patients have been women. The influence of heredity in the development of diabetes is an interesting study, as is also the question of possible contagion or transmission of the disease. In a work entitled "Health and Disease in Relation to Marriage and the Married State," edited by Senator and Kaminer, of Berlin. Senator devotes considerable space to these questions His conclusions are briefly as follows: A diabetic should be advised not to marry before the age of thirty or thirty-five; the pathological manifestations of diabetes are likely not to be improved and may become worse through marriage; pregnancy in a diabetic woman is a serious condition; and, diabetes in either parent is a source of danger to the offspring. Watson believed that he had positive evidence of inherited diabetes. Acting on his theory Lorand fed a test meal consisting of 250 grammes of carbohydrates to ten healthy persons who were descendants of diabetics. Twenty-four hours later a distinct sugar reaction was noted in the urine of eight of these ten persons. To prove180 The Woman's Medical Journal September, 1910 the value of this test it would be necessary to repeat it several times and to carry out a similar proceeding with ten other persons who have no family history of diabetes. The only evidence I have been able to obtain in my own practice is one case who reports three own cousins suffering from this disease and one case of conjugal diabetes. The husband was the man who died of apoplexy. His wife is in fair health at present but shows varying amounts of sugar always in the urine. Beal, of New York, teaches that "children of a diabetic parent or parents, whether healthy or not, should partake only of a diabetic diet. A non-diabetic person should not sleep with a diabetic. A non-diabetic person who if the husband or wife of a diabetic should use a diabetic diet. Those who are subject to a temporary glycosuria after taking 100 grammes of grape sugar should partake only of a diabetic diet." Without disrespect to Dr. Beal I would like to know how many persons, husbands, wives, or offspring he has found who will carry out a prophylactic treatment for diabetes. I should also like to know the mental effect of constant self-watchfulness as a prophylaxis against diabetes in a person who has no diabetes. I should expect at least a nervous glycosuria in the whole family if I put one person under such a regimen. The symptoms noted by various observers are almost as varied as the possible causes of this disease. In my cases some form of pruritus has been the most common and marked feature. In one man the itching of the whole surface of the body was most distressing. Once or twice each night he would get out of bed and rub himself with a long brush til he was sore and stinging with the irritation produced. Four of the six women have had pronounced pruritus vulvar especially disturbing at night. Muscular weakness is a symptom noted in nearly every case I have studied. This has been especially noticeable in the cases accompanied by obesity. Even when the pulse has been good the patient has complained of being very tired. Polyuria has been present in 50 per cent of my cases. Constipation was very marked in one case and noted in some degree in about one-half of those observed. One condition reported by two patients, which I do not find mentioned in the authorities at my command, is an uncertain poise or balance of the body. Not like the tabetic patient who keeps his balance by looking at some fixed object, but a sensation of uncertainty that the balance will be kept, a fear of brushing rudely against any one who may be walking beside him which makes the patient prefer to walk alone and after dark. In neither case was this symptom reported as constant but the patient seemed to realize when it was present and so to avoid walking with any one at that time. Dimness of vision is complained of by both the younger patients although good oculists have reported no defect in the vision of either case. Excessive thirst and inordinate appetite have not been among the symptoms noted in my cases although the patients have been able to eat and drink in sufficient quantity and with apparent relish. From a long list of possible complications of diabetes I have observed onychia and rheumatism in one case, extensive eczema in two cases and boils in two cases. Of the three fatal cases one died suddenly from apoplexy after a day of feeling unusually well and going down to his business. One died after weeks of suffering and exhaustion but in the care of another physician so I do not know the immediate cause of death. The third case was feeling somewhat tired for several weeks when she was suddenly attacked with colicky pains in the upper abdomen requiring morphia hypodermically to give any relief. Other attacks followed and within a week she died during one of them. I signed her death certificate giving gastralgia as the immediate and diabetes mellitus as the underlying cause of death. I have since wondered if the case was one of pancreatic calculi. If there is among you an enthusiast, and I hope we have more than one present, who thinks I should have examined that case post mortem before I signed the death certificate, let me offer an explanation. I was once an enthusiast. I have done my share of condemning careless conclusions and I have done one autopsy. It was in the dark, cool parlor of a farm house. Permission to have an autopsy was granted willingly enough, especially if I would work alone. Not a more quiet, holy, peaceful spot have I ever seen than that parlor. The carpet was spotless, the linen around the corpse was spotless, the family wandered in and out, telling tender reminiscences of the deceased and keeping an eye on the doctor that no mutilation took place. I was five miles from home, a day's work awaited me and it was nearly noon. My enthusiasm for autopsy work in a country practice died a natural death and still awaits its resurrection. Dr. Watson says that three objects are to be kept in view in the treatment of diabetes. First: To restore the defective power of the digestive apparatus. Second: To cut off or restrict as much as possible the supply of saccharine matters from without. Third: To mitigate or remove the distressing symptoms. I find nothing in later text-books that excels this advice. First, aid digestion: with that end in view relieve acidity with soda bi-carbonate or sodium salicylate. Unload the bowels, using cathartics, enemeta and massage separately or combined as necessary to accomplish the result. Second, cut off the saccharine matters from without. In other words, regulate the diet. I find nearly everyone reasonable about diet for a time, but with improvement you may expect carelessness in eating. I consider saccharin tablets and gluten flour as our most valuable aids in a diabetic diet. One patient has shown marked improvement on a diet consisting of an orange and a glass of milk at breakfast, three small slices of gluten bread and a moderate slice of steak at dinner, a soft-boiled egg, two slices of gluten bread and a cup of tea at supper. A decided reduction of flesh, a decrease in the amount of urine passed, a decrease in percentage of sugar excreted, with marked relief from weakness followed within a few days. No medicine was used during this treatment. The case is still under observation. Third, relief of distressing symptoms. In this work each case is a law unto itself. I have yet to see any good results in diabetes from the use of codia in either the large or small doses. Wider experience may bring different results. In the case of intense general pruritus everything has been tried and nothing short of a large dose of morphia Vol. XX, No.9 The Woman's Medical Journal 181 gave any relief. A neighbor told him to get a cake of Packer's tar soap and anoint his body with a thick lather on going to bed. The effect was magical at first but soon failed to control. I feel bound to confess, however, that the remedy gave as much relief as anything he could use. The first case of diabetes that I ever treated had been "twice cured" of a vulvar eczema by the violet rays of a high-frequency apparatus. One week on a diabetic diet left her berating me for a useless crank. The second week made her think I knew a little something. At the end the third week she was a fine adherent to the woman doctor. Although she died of diabetes three years later the eczema never returned. In other cases of diabetic pruritus I have found pilocarpine nitrate grammes 1-60 every night and morning to be of benefit. The effect of the drug in that quantity being to produce slight moisture of the skin without any ill effects on the heart even though used continuously for several weeks. A little tablet containing the arsenates of iron, quinine, and strychnine has been very helpful in cases in requiring tonic treatment. An ointment containing 10 per cent bismuth sub-iodide is my favorite prescription for the outward application in eczema or pruritus. From my study of diabetes mellitus I have reached these conclusions: Diabetes mellitus is a disorder of nutrition, the cause and pathological results of which are still imperfectly known. Careful urinalysis will prove diabetic conditions to be much more common than they are now supposed to be. Each case must be studied and treated with as much regard to the idiosyncrasies of the patient as to the features of the disease. Polyuria, excessive thirst and inordinate appetite may be, but are not necessarily, the accompaniments of diabetes. For general rules of treatment we have none better than those taught fifty-five years ago by John Watson, i. e., to aid digestion, control ingestion of saccharine material and to relieve the distressing features of each case. Athletics in Our Schools and Colleges By Dr. Augusta Camp, White Plains, N. Y. During this past year, the country has been appalled at the useless waste of life in the football field, and the question confronts us, as physicians. Shall these games be allowed to go on, year after year, killing annually a number of young men, and injuring scores of others. Letters from all over the country appear in protest- letters from men of high rank in the collegiate world, and letters from parents who would prevent the dreaded calamity from entering their own immediate circle. Rules are made and altered from time to time, in an effort to minimize the dangers, but the reports of this year's games show no abatement of the horrors. Where danger and suffering are to be faced, for the accomplishment of some good end, either national or personal, one can feel only admiration and give applause; but when such motives are lacking, it is with shuddering disgust that one reads of the loss of useful lives and of the maimed bodies of the devotees of football. A father said to me the other day: "Can't you doctors stop it? My boy has gone crazy on the subject and it is a source of constant anxiety to me. I expect daily to hear of some accident" I answered "You are this boy's father, why can you not stop it. Why not forbid it in the case of your own son, at least" and he replied "I don't want to make my boy seem different from his friends. The authorities of the colleges and preparatory schools, should stop it." And so the responsibility is tossed back and forth and the annual slaughter goes on. If this condition of affairs obtains among boys and young men, what shall we say about the strenuous athletic games for young women. True there is no such yearly list of fatalities among our girls, but never the less there are many sufferers annually. Basket-ball, the favorite game, as played by girls in many places, is far and away too violent a game to be either helpful or even harmless. The rules followed in many preparatory and high schools are those intended for boys only and are utterly unsuited to girls. Under proper supervision and restraint basket-ball is capable of being a fine game for girls, developing grace and agility self-restraint and good comradeship, but when these attributes are thrown to the winds, and brute force and slugging appear and rough manners and indelicacy are developed, what can be more deplorable. The holding of "test games" or one school playing against another, or games between rival classes, I hope to see entirely abolished. Girls are so constituted that rivalry is easily aroused and soon becomes an overwhelming passion. As soon as a game is played to win at any price it becomes a danger. When restrained within the bounds of an agreeable pastime and exhilarating exercise, basket-ball is a valuable help in physical development. Any one with the slightest knowledge of the anatomy and physiology of a girl, must know that at times, violent exercise is best avoided and also that it would be an impossibility for eighteen girls (the game is often played with nine on a side, although a smaller number can play) to be in constant practice for even one week, when it might not be detrimental to a number of them. There are usually substitutes who are supposed to be called upon, but every one who has been brought into contact with the teams of various schools and colleges, knows that when a game of special interest is in immediate prospect the girls go in for hard and steady daily practice. Unfortunately, many girls, under this stress, see their duty with an unnatural bias, and many many girls have confessed to me, sometimes years afterwards, "I knew I should not have played at that time, but I felt I owed it to the class, or I owed it to the girls and I have been paying for it ever since." Unlike the accidents happening to boys in football, which usually are of such a nature that they are at once recognized; the injuries to girls are often not immediately evident, and develop gradually from strains and displacements of delicate internal organs causing years of suffering and invalidism. I could cite many instances of these things, but a doctor's office should be as sacred as the confessional.182 The Woman's Medical Journal September, 1910 A broken bone or sprained knee or ankle is a small matter compared to internal injuries which may affect not the girl alone, through her entire life, but also have an influence possibly on the next generation. Brisk walking, in fine air and in proper clothing, is as good exercise as can ever be invented. Riding on a well trained horse is admirable, especially astride. Dancing and skating, tennis, golf, hockey and basket-ball are all good in moderation but the strain of any contest games for girls is an evil to be avoided. In most colleges the girls play only on their own grounds, but I regret to say some teams have played in public, with the tickets on sale, and any one who has the price of admission may enter. Even if the proceeds are for some charitable purpose, it seems to me objectionable that our girls should play before a mixed crowd. Athletics have done much for our girls; I pray that the harm may not outweigh it. A game of basket-ball should not be permitted except in the presence of one in charge of a gymnasium. No rough play should be allowed and a persistent "slugger" should be absolutely debarred. A game with the girls sprawling all over the floor, tumbling on top of each other and pounding or grabbing is undignified and vulgar. It should be skill and grace, not weight and muscle that win the day and self-control always, in every position. In suitable weather and on good grounds basket-ball is best played outdoors, but one advantage of this game is that it may be played in a gymnasium during the winter, when most outdoor sports are impossible. It should never be played except in a regular gymnasium costume and no single game should last over twenty minutes, without a rest. The modified rules as arranged for the Smith College girls so away with much that is objectionable in the game, but the regular Y.M.C.A. rules are not suitable for girls at all. No girl should play basket-ball until she has had a thorough physical examination made by a physician competent to do such work. On entering college, girls usually have such an examination and it is then decided whether they are suitable candidates for full athletic work or not. Often it has been discovered then, for the first time that their hearts have been overtaxed and are not in a condition to endure the unusual strain of vigorous activities. The cry is often "oh! but I have always been very active and have done just as my brother shave," or "I have played basket-ball all through high school and was on the regular team." Frequently these are the very reasons for the overwrought condition of the heart and why a halt must be made. I remember one case where the girl came to be examined and as she was an expert basket-ball player, much disappointment was expressed when told she could not play at all for a year. "Why," she said, I have been at the seaside all summer and have been able to swim longer and faster than most of the men and could dive and stay under water for longer than any one." The weakened heart with its imperfect valvular action showed the result of all this over exertion and to one in a position to judge, were danger signals of utmost importance. In this case, I am happy to say, a return to normal conditions resulted in simply cutting out all athletics for one year. The overworked heart of the athlete is no new subject, and girls, more often than boys, perhaps, are in danger in this direction. They are spurred on to keep pace with fathers and brothers and dislike to own themselves vanquished. There was a time when one often met a "bicycle heart," but now that is a thing of the past, and one rarely hears "I can ride so many miles up hill and keep pace with my brothers." Frequently I have received letters from family physicians, questioning my decision as to the necessity of Elizabeth or Margaret being excluded from athletic sports, and upon investigation have found that these same physicians have never made an examination of heart or lungs of the girls in question. They have taken it for granted that the girl was all right, because she had not had a serious illness in a number of years, and seemed very active. This very activity carried to excess, is frequently the cause of serious heart strain or some form of uterine trouble. This is one point I want to emphasize. No physician should give an opinion as the the advisability of a girls's taking active part in athletics, without first making a careful physical examination and understanding all the circumstances. In colleges, there is as a rule enforced, but not so in many high schools. Here girls often play without the presence of a qualified director and frequently in their ordinary dresses and shoes, decidedly increasing the chances of harm resulting. I should be glad to see the day when every preparatory school and academy as well as the colleges, when athletics are part of the system, shall have a regularly appointed woman physician for the girls and a man physician for the boys, to give a complete and thorough physical examination to each pupil, not once only, but several times in the year, and that such records be kept that it would be possible to note any danger signals of over physical exertion. After ten years of experience in the largest college for women in the world, I can truthfully say it is the rarest exception where a girl is overtaxed by her studies but too many social activities and too strenuous a life in athletics often wreck a useful and happy career. To recapitulate: Athletics are in my opinion a valuable means of development as well as recreation and have done much to improve the health and vigor of our young people, but to avoid the possible harm, overbalancing the good, I would beg the medical profession and particularly the women in the profession to do all in their power to protect the young people from their own eager excitability. This may be done by enforcing a system of physical examinations by competent selected doctors, in all schools where athletics are allowed, and strictly debarring all those who show any evidence of strain, for a time at least, if not altogether. I would abolish all contest games for girls and young women. In my opinion all games should be played for relaxation and pleasure and not on a spirit of rivalry. As soon as that spirit develops and a fierce determination to win at any price, just to beat the other side and have the glory of it exists, danger follows. Some of the men's colleges have this year abolished foot-ball entirely. All games played in a sense of pastime are useful, but I earnestly hope to see the day when all the so-called "great games" are entirely done away with, and certainly all contest games for girls a thing of the past. Vol. XX, No. 9 The Woman's Medical Journal 183 Prenatal Influences.* By Dr. Jennie Gray Wildman, Toronto, Canada. When asked to write a paper for this Association meeting, the subject, "Prenatal Influences," at once came to my mind, together with the thought of the tremendous power and influence for good invested in the woman physician, who is fully informed on this and kindred subjects. It is an important subject, because of the ignorance- because of the fatal and awful results of ignorance or willful violation of known laws, by those who know little and care less for responsible acts- the results of which the world has to bear, though the individual may suffer most keenly. First, it appears to me the highest patriotism to spend time and effort on this matter. This fair land of America- United States and Canada- has been blessed for 300 years with freedom of speech and religion, and with constitutional government. That this freedom has not resulted as yet in all-round good may be judged by the writings of Prince A. Morrow, of New York; Robt. N. Willson, of Philadelphia; J. Tabor Johnson, of Washington; Krafts, in his Psychopathy Sexualis; and Dr. Winfield S. Hall, of Chicago, and Dr. L. Barker, of Johns Hopkins. It is evident that all the wonder working discoveries of science and medicine- all the increase in general knowledge and intelligence, has not as yet stayed the increase of diseases that destroy children, make invalids of men and woomen, breaks up homes, and wrecks nations. Note the immense amount of time, money and skill expended in devising ways and means for the treatment of gonorrhea, syphilis, and their after-coming results. Science sought and found the cause of African fever, yellow fever, typhoid, pneumonia, tuberculosis, and many other diseases, and, having found the cause, at once went to work to find means to remove or overcome it. The cause of gonorrhea and of syphilis is known. What scientific, definite systematic means has been used to prevent the wholesale devastation wrought by these evils? It is an anomaly. It is just one thing of a kind. We isolate scarlet fever, measles, small-pox, etc. We are teaching consumptives how to live so as to not infect others. We guard people from septicemia and erysipelas. We muzzle the dogs to prevent the spread of rabies. We warn, we guard, we teach, we talk, and it is all good, but there are two diseases which, according to Dr. P. A. Morrow, produce- first, 42 per cent. of all abortions; second, kills 60 per cent. to 80 per cent. of all children affected with it before birth, or shortly after; while the other 20 per cent. to 40 per cent. are subjects of degeneration, and susceptible of transmitting it to the third generation; third, causes 80 per cent. of deaths from diseases peculiar to women; fourth, makes 50 per cent. of women affected sterile; fifth, causes 10 to 30 per cent. of all blindness. Dr. J. F. Johnson, of Boston, declares that 75 per cent. of men are subjects of venereal disease; and we all know what this means in the production of sickness, death, and sterility. Science has been applied for the production of better cattle, better horses, better sheep. Hens have been made *Read before the Women's New York Medical Society, March 11, 1910 more productive. The breeding of dogs is scientifically and systematically studied. Almost every state has an experimental farm, belonging to the government, cared for and directed by trained men whose work is to find out ways and means of improving grain, fruit or flowers that grow in that state. For example, science has changed the common little chrysanthemum that we find in the woods into all the varied forms of beauty that we find in our flower shows. We have out Bells, Edisons, Marconis, Astors, Kellys, Mayos, and each has brought his quota of good and given it to the world. But what lesson does each teach as he wins from nature her treasures and turns them to account by the magic of his intellect? N. N. Riddill says: "It is a noticeable thing in the ruling and guiding of this world, there is absolutely nothing done by chance." Everything is subjected to a system, and anything that is not scientific is thought not worth consideration. Great systems of railroads form a network for communication through the countries. Automobiles and flying machines almost annihilate space. Floating palaces make ocean voyages short pleasure trips. But what about scientific child-culture? Is it not true to apply the common well-known laws governing the production of new life in all the world around us, to the production of new child life? Is it true, this question of child culture, with its prenatal and postnatal training, is now written about and spoken of today in a manner and to a degree that could not have been conceived of five years ago? So there is advancement. But are we, as physicians and physical instructors, scientists in this matter? Are we, in our high and most responsible position, as scientific and trustworthy as advisors as your gardener and veterinary are in theirs? Some of us know that there are the few who have grasped the thought, that to procreate a human being in love and purity, give it its first rights, is the greatest and best gift that any one may bequeath to the world; but the great mass of the people is in the deepest ignorance concerning these things, and their children are fit products of this ignorance. The following reports bear out only too graphically this fact: In the United States, idiots, blind, deaf mutes and insane have increased nearly five times as fast as the population in the past forty years. In 1850 there was one criminal for every 3,400 of population. In 1900 there was one for every 560 persons. Crimes are nearly five times as numerous as forty years ago. Homicide and suicide are alarmingly on the increase. In the United Kingdom (England, Ireland and Scotland) crime and evil are also on the increase, and it costs $165,000,000 each year for the up-keep of its defectives. Statistics are such dry reading, we are apt to pass over the fact that the sum is made up of individual units, each helping to swell the number for or against. Now, let us look at some other facts: The large majority of children are born because of selfish or thoughtless indulgence of desire, either in ignorance or in defiance of nature's laws on the part of one or both of those concerned. The mental, spiritual or physical fitness for this function has not been considered, though a human being, with all which that means, may be the result of the act.184 THE WOMAN'S MEDICAL JOURNAL September, 1910 Undesired Children. The first three months of prenatal life is the time when the foetus is most susceptible of impression, both physical, mental and spiritual. The brain and nervous system take precedence in the order of development. Anger, fear, disgust, sorrow, all create poisons in the blood which more or less affect the growth and development of the new life. These are sufficient at times to produce the death of the foetus. Drugs used to produce abortion also more or less injure or destroy the foetus. What a heritage for the thousands of unwelcome little strangers. Prof. Elmer Gates (Lab. of Psychology and Allied Art at Chevy Chase, Md.), as reported in 1879, showed the breath of a patient condensed and precipitated by Rhodopsin gave various results according to the state of the patient. He concludes, "emotions generate in the system compounds that are injurious or nutritious, according to their nature." We know that anger so poisons the system as to produce extreme depression or even death. Joy, love and happiness give a stimulant and nutritive that is capable of producing remarkable endurance, viz: sick child and mother. The health and vitality of the child are injured if the mother be over-worked - first, before conception; second, during gestation; third, during lactation. Is it any wonder so many children are failures in life? And the pity is, the mothers do not know what they are doing. Most people want to be fair to their children. The only remedy for this condition manifestly is to teach the laws governing procreation and prenatal influences. First, let us consider that all the father is able to give as his part in the new life is what he has been previous to conception, with the strong impress of what he is physically, mentally and spiritually at the time of conception. Second, alcohol and tobacco are both poisons. Dr. Rentoul says: "In any case, it cannot be denied that alcohol is a brain poison." Dr. Elam says: "When duty was removed from spirits in Norway, idiocy increased 150 per cent and insanity 50 per cent." Howe found 50 per cent, of parents of idiots were drunkards. As to tobacco, Riddell says: "The hereditary effects of tobacco are unlike those of chronic alcoholism. The tendency towards its use is transmitted from one generation to another. Its effects on the brain and nervous system may be well studied in the reports of those who examine applicants for the army. Cigarette smokers are found not to be desirable in business, and are not employed in the best establishments. The Law of Continence. Perhaps the most important law for right development is that of continence during gestation. It is also probably the one most often broken. What the breaking of this law before conception and during gestation means to the individual and to the state is absolutely beyond computation. Dr. Cowan says: "Do you know why a son, while yet a boy, practices self-abuse? Do you know why a son, before even he has reached manhood, seeks, through prostitution and seduction, to foul, blot, weaken his soul and body?" Then he goes on to show it is because of incontinence on the part of the parents before and during the prenatal life of the child that these things are so. Inquire in your own clientile - as I have done - and you will verify these statements. You are physicians. You know how general is this practice, even among the religious, sober and otherwise good citizens. Prof. Gates has shown in his experiments on puppies that repeated use of certain facilities increases the number of brain cells in that region of the brain that presides over the part controlling that function, and makes them of a higher grade of development. This fact alone will account for the abnormal development of the sexual nature in a large part of the human race. We have this far looked at the dark side of the picture. Let us turn now to the consideration of what may be, ought to be, and in a few years will largely be, when humanity has evolved and wakened up to the fact that the science of child culture is, of all the ologies, the greatest and most productive of good. Dr. Rentoul this describes a child's birthright: "The right to be healthy and to be happy. The right to be useful citizens and the healthy begetters of a strong race." The child is given what the parents have attained to by their previous life. If the child is to have its first right - health - and that in its first degree, no man or woman should become a parent until he can bequeath that most previous gift. This would also mean that a possible conception must not be thought of except under the most favorable mental and spiritual conditions. If sorrow and anger create poisons, joy, love, happiness and peace produce a stimulating tonic generally helpful to the organism. Children born under these favorable conditions will be better specimens of humanity than their parents. Dr. Cowan, in his chapter on Genius, gives the laws to be followed in order to produce children with - first, a strong physique; and secondly, any special line of genius that may be desired. This is done constantly with flowers, fruits and animals. Why not with children? If it be possible at all for ordinary men and women to so live as to be assured of good, talented, healthy children that will grow up to be a blessing, a joy to all, and a success in the world, isn't it worth study and work and planning for ten to twenty months? What is that in a lifetime? I have personally noted the enduring powers of both classes and believe Dr. Cowan to be right. The Jewish race is an example of what obedience to the laws of health will do in preserving a people. They are a wonder to the world. If they disobeyed the Jewish laws and followed the rest of the world with regard to sex life, would their history differ from that of the ancient Romans, Greeks and Egyptians? The whole secret is in obedience to nature's law. Now let me sum up: First, there is no doubt about the evil conditions; second, the cause without question is the world thought, that the organs of generation are for the gratification of the individual, whereas is it as clear by analogy that these are only for the individual to use for the good of the race, as is clearly understood in the world of flowers and fruit as well as among lower animals; third, reproduction in all departments of nature has its well defined laws, the breaking of which produces chaos - in a greater or less degree, according to the extent of the departure from the normal; fourth, by obedience to known rules, Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL 185 children, beautiful, honest, talented and physically strong, are assured. Can you conceive of a greater service to the world than to spread abroad every hit of real light on this subject! Is it not cruel and unpatriotic and destructive to allow any one in this fair land to remain in ignorance of these truths? Think of the absolute ignorance and unpreparedness of those who undertake to people our countries. Is it not time to awake out of sleep? No one is more fully aware of the magnitude of this question, and of the difficulties attending it, and after much thought, if asked for an all-round working rule for the governing of conduct in these matters. I have found this beautiful, old-fashioned and long-tried one, "Love worketh no ill to his neighbor." ADRENALIN THERAPY OF MALIGNANT TUMORS. Berlin savants, at least those connected with the Imperial Institute for Cancer Research and Prof. Pier's University Surgical Clinic, continue to show plainly their belief in the possibility of finding at last a medical remedy for cancerous growths and malignomata in general. This is an encouraging sign, for surgical resources hold out no hope for attaining a permanent solution of the problem; so that no one should belittle earnest efforts to find new therapeutic adjuvants in the domains of physicotherapy and biochemistry. Certainly no one should fail to keep himself posted as to the work of von Leyden, Bier, and their numerous lieutenants. For if the problem of curing cancer still seems as far off as ever, knowledge has been greatly multiplied; and it is probable that the ultimate solution will rest on knowledge thus acquired rather than on the “accidental discoveries’ which some laymen are prone to credit for radical advances in medicine. In the Deutsche medizinische Wochenschrift for July ‘21st, Reicher, of the Berlin Cancer Research Institute demonstrates that mouse-cancer (adeno- carcinoma) responds to all the tests for human cancer, save that it is much more amenable to treatment, He explains this tentatively by the naturally short life of the mouse, which may imply a greatly lessened resistance of its tissue cells to remedial agents. Among the substances which may be made to cause the complete disappearance of mouse-cancer is adrenalin, when injected into the tissues surrounding the growth. The morbid tissue undergoes necrosis as the result of the injections. One’s first impression would naturally be that adrenalin therapy represents a starvation treatment through the characteristic action of the drug on the blood vessels. The author, however, does not allude to this possibility, and, in fact, his vain endeavors to immunize animals against inoculation-cancer by preventive injections of the drug show a belief in a specific property of the latter. To transfer the adrenalin possibility from the mouse to man, in view of certain alarming consequences sometimes attributed to systematic injections of the drug, is to assume some responsibility. Adrenalin has been pronounced contraindicated in a variety of degenerative diseases and certain other disorders, because of its action on the blood pressure. It is true that it would be injected for its local effect—and in the trifling amounts employed for local anesthesia unpleasant consequences are not feared; but if employed systematically for weeks at a time, enough might be absorbed to affect the blood pressure unpleasantly. This could in part be offset by physiological antidotes. Reicher announces, moreover, that he has already tested adrenalin on human cancer with encouraging results. His forthcoming report will be awaited with interest.—Medical Record. A RULING AGAINST OSTEOPATHY. .Justice Putnam of the Brooklyn Supreme Court, on August 26th, handed down a decision in the case of Charles F. Bandel, an osteopath who applied for a mandamus to compel the Board of Health of New York to grant a burial permit on a death certificate signed by him. Justice Putnam upholds the demurrer of the Corporation Counsel, and sustains the action of the Board. In a memorandum accompanying the decision Justice Putnam says- “While the State has wisely allowed the practice of osteopathy, it does not follow that it thereby holds out one, without any practice in surgery or experience in prescribing drugs, as fully qualified to certify the cause of death. Indeed it. is not certain that a board of health would be compelled to take the certificate of death of all licensed physicians in the event of an epidemic or the spread of some new and mysterious disease. Granted that the theoretical education of the osteopath is of a standard equal to that of a doctor of medicine, after he enters on his profession his practice is restricted, so that it does not appear that he can make the tests by examination of blood and tissues by which alone many diseases can be certainly detected. The sanitary code is discriminatory, but the discrimination is not personal and arbitrary. It is based on a limitation which the osteopath may be said to make for himself, and deprives him of no rights which he ought to exercise consistent with the public safety. The Extreme Span of Human Life. Somewhere between 100 and 110 years according to the Census Bureau. A chapter concerning reported centenarians is contained in the Census Bureau's latest annual mortality statistics report prepared by Chief Statistician, Dr. Cressy L. Wilbur, of the Division of Vital Statistics. The report affirms that it is undoubtedly true that the age of 100 years is occasionally attained. It suggests that it Is perhaps doubtful whether, as shown by incontrovertible evidence, the age of 110 has ever been reached or exceeded. This would, it is stated, set the possible longevity of man or the extreme span of human life somewhere between 100 and 110 years. Dr. Wilbur declares that it would be a fact of vast interest to humanity if it were true that a human being could live 150 or 140 or 130 years, or even 120 or 110 years, as established by exact observation. The capability of the bodily mechanism would be tested, and it might be inferred that, with better hygiene, superior eugenics, and proper methods of living the extreme limit of life might more frequently be attained, and that after many generations the average age of humanity might perhaps approximate to this limit.186 The Woman's Medical Journal September, 1910 The Woman's Medical Journal A Monthly Journal Published in the Interests of Women Physicians Published by The Woman's Medical Journal 3437 Mooney Ave., Hyde Park Cincinnati, Ohio Subscription, Two Dollars Per Year. Remittances should be made by check, draft, registered letter, money, or express order. A subscriber should notify the publishers promptly of any removal, giving Old and New address, that there may be no break in the service of the Journal. In order to discontinue a subscription, notice must be sent direct to The Journal and all arrears paid in full to date. The Editors and publishers are not responsible for the views of contributors. Contributions and books to be reviewed, and all business communications should be addressed to Margaret Hackedorn Rockhill, Managing Editor, Cincinnati, O. The Passing of Dr. Emily Blackwell Dr. Emily Blackwell, for many years Dean of the New York Infirmary for Women and Children, passed away at New York Cliffs, Me., her summer home, on the afternoon of September 7th, aged 84 years, within three months of the death of her beloved sister and co-worker, Dr. Elizabeth Blackwell. Emily Blackwell, born October 8, 1826, was the daughter of Samuel Blackwell and Hannah Lane, the sixth in a family of nine children. Her early girlhood was spent in Cincinnati. Emily, at 18, determined to make an independent life for herself and to help in opening the doors for other women. At that time there was hardly any occupation open to women, except teaching or sewing at very low wages. It was marriage or starvation. She entered the Medical College at Cleveland, O., and graduated with honors in 1854, the only woman in her class. In America in those days medical education even for men was very superficial. Nominally, a doctor must have studied for three years; but two of these might be spent in private study with any doctor, the student seeing what he could of the older man's practice. Then, after attending lectures for two terms of four months each, he could take his medical degree without ever having practiced, and without even having seen a confinement case. In the cities, where there were hospitals, the best doctors, of course, got much for training. The Blackwell sisters always stood for thorough and scientific training for medical women. Dr. Emily studied in Edinburgh under Dr. (afterwards Sir) James Simpson, in London with Dr. Jenner at the Children's Hospital and at St. Bartholomew's, and in Paris at the Hospital Beaujeu under Huguier, and at other Paris hospitals. Here she also took the full course in midwifery at the Maternité. In 1865, by advice of some of the leading New York physicians, the sisters secured a charter from the Legislature and opened the Women's Medical College of the New York Infirmary. The new college stood above all for full and thorough preparation. They started out with the intention of making the course three years, but at the end of the first year all the students said that they would go to the Woman's Medical College of Philadelphia for the second year, and graduate at the end of it, if the New York College did not shorten its course. So the faculty of the New York college were obliged in the beginning to make the three years' course optional. When Harvard lengthened its medical course to three years, they did the same. When Cornell University opened its medical school to women, the trustees of the Women's Medical College of the New York Infirmary felt that it was no longer necessary in view of the larger opportunities offered by Cornell. It was therefore closed: but the Infirmary is still continued, and, after half a century, is still the only place in New York City, except one small homeopathic hospital, where poor women can be treated by physicians of their own sec. It now occupies more commodious quarters at No. 5 Livingston Place. Dr. Blackwell was an honorary vice-president of the New Jersey W. S. A., and had been chosen honorary president of the New York Women's Medical Association at its last meeting, in place of Dr. Elizabeth Blackwell. Her health had been remarkable good during the past few months. She had spent several weeks at Chilmark, Martha's Vineyard, at the summer home of her adopted daughter, and had taken great pleasure in the society of the four beautiful little boys, her "grandchildren," of whom she was exceedingly fond. She loved the ocean, and used to sit on a seat at the top of a cliff looking out over the water, and talk with one of her nieces about the problems of life and death. She said one day, only a few weeks ago, "How I wonder what becomes of all the energy that is arranyed in behalf of reform in any age of the world- of all that great force, for instance, represented by Josephine Butler and her co-workers!" She often referred to her brother, who died a year before her, and said, "I wonder what he is doing now!" Her own intellect remained unimpaired to the last; she said, near the end of her life, that she felt that her mind was not only as good as ever, but that it was still growing; she was still able to add to her stock of knowledge. She was a woman of high character and great integrity, of wide reading and information, and with osthetic sensibilities that delighted in the beautiful. She had a warm and tender heart, though it was hidden under a reserved manner which made her rather awe-inspiring to strangers. She herself said that she thought this was due in part to the extreme unpopularity attaching to women physicians in her early days. A disposition naturally intensified in those days by an unwillingness to put herself forward where she thought she was not wanted. But to those whom she loved, she was not only a true friend but a delightful companion. Soon after her return from Chilmark to her summer home at York Cliffs, Me., she was taken ill with enterocolitis, and died after a short illness, which she bore with her usual patience and courage. Her adopted daughter, her only surviving brother, Mr. George W. Blackwell, of Cambridge, Mass., and her former partner and devoted friend, Dr. E. M. Cushier, were with her when she passed away. Vol. XX, No. 9 The Woman's Medical Journal 187 RABIES The Public Health and Marine Hospital Service has recently issued a most valuable brochure entitled Facts and Problems of Rabies, prepared by Past Assistant Surgeon A. M. Stimson, of the Division of Pathology and Bacteriology of the Hygienic Laboratory. Strange as it must always seem, there are a few capable physicians who deny the very existence of this dreadful disease, just as there are those who assert that vaccination and the use of diphtheria antitoxine are of no service. Of such individuals Dr Stimson says: "If they are fairminded and possess an average amount of intelligence, a visit to a laboratory where scientific work in this direction is being done will suffice to dispel their objections even if their faith in human nature is so slight that they are able to regard those investigators who have devoted years of disinterested study to the subjects as untruthful or very badly mistaken." Dr Stimson gives a useful definition of "fixed" virus (the virus fixe of the French). It is a modification of the "street" virus (the virus of the casual disease) produced by passing it through a long series of rabbits. "In this way," he says, "its virulence becomes greater for these animals, so that they finally take the disease after a constant 'fixed' period of incubation". "No amount of passage," he adds, "can reduce the incubation period below this point, so the virulence is said to be fixed." Inasmuch as rabies is contagious before the characteristic symptoms have declared themselves, there is great danger from a dog which is in the period of incubation. It is quite common for such an animal to show a sudden change of temper, and the change may take the form of increased affection and an unusual longing to be petted. The dog insists on licking its master, and thus trifling abrasions may readily become infected. So, too, the paralytic form of the disease, which is not uncommon in dogs, is peculiarly dangerous to man, for the fury of the ordinary form is lacking and "the owner or sympathetic bystander endeavors to remove an imaginary bone from the throat and becomes bitten or scratched." The symptoms and course of the disease, in the dog and in the human subject, are graphically described by Dr. Stimson. The clinical diagnosis is unusually easy, he says, but observation of the animal that did the biting should never be omitted, and inoculation experiments must by all means be carried out. As regards the post mortem diagnosis, the Negri bodies are conclusive when they are present, as they generally are, but their absence does not exclude the disease. Recovery on the part of the biting dog must not be interpreted as proof that its disease was not really rabies, for dogs known to be rabietic do occasionally recover. Other animals bitten by such a dog should be kept under observation. It is reasonable to admit that a human being may recover from rabies, but cases of alleged recovery are not of unquestionable authenticity. As regards treatment, cauterization of the wound is of some value, for it tends to prolong the period of incubation and thus affords a better chance for the Pasteur treatment. Nitric acid is the best caustic for the purpose, made to penetrate every recess of the wound. In view of the enormous reduction of mortality achieved by the employment of the Pasteur inoculations, they should always be resorted to, though they sometimes fail and even, in rare instances, accelerate the fatal issue. The procedure calls for improvement, but it is not easy to establish it in the present state of our knowledge. The continued prevalence of rabies, even to the present moderate extent, is viewed by Dr. Stimson as a reproach to our civilization, and so it doubtless is. Great Britain, he remarks, being an island, has of late years succeeded in suppressing the disease within her borders, and certain peninsular countries have come near to extinguishing it, but the problem is more difficult on great continents. In the American Union systematic actions should be taken by the various States, by uniform legislation so far as practicable. All vagrant dogs should be destroyed, and in time of an outbreak all dogs should be muzzled when they are allowed to run at large. The Pathology of Hepatic Cirrhosis For many years there has been some difference of opinion as to the nature of the process known as cirrhosis of the liver. On one side have been arrayed the pathologists who believe that the primary process is a perilobular increase of connective tissue, with a secondary degeneration of the parenchyma due to pressure or inanition, while on the other are those who hold that a primary destruction of liver tissue is compensated for by a secondary growth of scar tissue. In recent years the latter view has been held by most pathologists. In the Deutsche medizinische Wochenschrift for May 12, 1910, however, Warschauer reports a case which leads him to believe that, in certain cases at least, the older view may be the correct one. The patient died during the early stages of hepatic cirrhosis. The liver was somewhat enlarged and hard, but showed no other macroscopic changes. Under the low power of the microscope the acini were seen to be intact; in the middle of each acinus was the central vein, without pathological changes; the parenchyma cells were arranged in regular radiations; the capillaries were somewhat dilated; around the interlobular vein, for a distance equal to about five times its diameter, mere patches of fibrous tissue with small cell infiltration, and grouped around these were liver parenchyma cells between which the capillaries were not visible. On high power magnification, no signs of degeneration could be seen inside the ancini. The cells were normally arranged, the nuclei were well stained, and there was no trace of connective tissue growth within the acini. The appearance, on the other hand, of the interacinous periportal connective tissue was greatly altered. Here were found all the signs of active tissue proliferation; small cell infiltration, fibroblasts, young connective tissue cells, and formed fibrous tissue. Such a picture Warschauer maintains, with some reason, could be produced only by a primary interstitial hepatitis.188 THE WOMAN’S MEDICAL JOURNAL. September, 1910 DR. ELIZABETH BLACKWELL. BY DR. ELIZA. M. MOSHER. BROOKLYN, N. Y. (Continued from August.) The early years of a physician's life are not easy ones at best. In addition to the ordinary difficulties to be met, Dr. Elizabeth Blackwell had public opinion to disarm. Single-handed, she stepped into the medical field in New York City, and for seven years plodded steadily on, winter and summer, up the difficult path to success. She had no medical companionship, for the medical profession stood aloof, and society was distrustful of the innovation. Insolent letters occasionally came by post, and her pecuniary condition was a source of constant anxiety. Soon after settling down in University Place, where she had chosen good rooms, she made application for admission to the woman’s department of a large city dispensary, but was refused, During the long wait for patients she occupied herself by writing some lectures on the "Physical Education of Girls,” which she delivered in a basement Sunday school room the spring after her return (1852). Of these she writes. "The social and professional connections which resulted from these lectures gave me my first start in practical medical life. They were attended by a small but very intelligent audience of ladies, and among them were some members of the Society of Friends whose warm and personal interest was soon enlisted. Indeed, my practice during those early years became very much a Quaker Practice, and the institutions which sprang up later owed their foundation to the active support of this valuable section of the community.” An influential family belonging to that society was the first to engage her as their family physician The first use she had opportunity to make of the skill she had acquired at the Maternity in Paris was at the birth of a grand-daughter to this delightful family, and it is an interesting fact that this child when she became a woman studied medicine. Dr. Elizabeth Blackwell’s "first consultation with a physician” was in a severe case of pneumonia in an elderly lady. The doctor she called was one who had lived in Cincinnati and was in attendance in her father’s fatal illness. After seeing the patient she and the consultant returned to the parlor, when he became very much agitated, and walked about the room exclaiming, "a most extraordinary case. Such a one never happened to me before. I really do not know what to do." Dr. Blackwell finally discovered that his perplexity was not about the patient, but related to her, and the propriety of his consulting with a woman physician." She assured him it need not be considered in the light of an ordinary consultation but a friendly talk, whereupon he gave her his best advice. Never afterward did she experience any difficulty in obtaining a necessary consultation from any member of the profession During the summer she published the lectures she had given, under the title, "The Laws of Life in Reference to the Physical Education of Girls." The little book was favorably regarded by physicians and it drew forth an appreciative letter from the Dean of her college at Geneva, which was, of course, a great source of gratification to her. It also fell under Mr. Ruskin's notice, and received his valuable commendation. Unable to gain admission to any city dispensary, Dr. Elizabeth Blackwell determined to open one herself, and in 1853, with the aid of friends, a small room was engaged in a poor quarter of the city, and a dispensary fitted up and opened on three afternoons each week. This little dispensary was welcomed by the poor so warmly that Dr. Blackwell’s circle of friends, which by this time (1854) had widened considerably, helped her to obtain an act of incorporation for an institution where women physicians could be available for the poor. A few well-known citizens consented to act as trustees. Dr. Blackwell’s work now began to enlarge and make itself more widely felt. The difficulties and trials which she encountered at this time were still, however, very great. Ill-natured gossip assailed her. Of it she writes as follows: "These malicious stories are painful to me, for I am a woman as well as a physician, and both natures are wounded by these falsehoods. Ah, I am glad I and not another have to bear this pioneer's work. I understand now why this life has never been lived before. It is hard with no support but a high purpose to live against every species of social opposition. I should like to have a little fun now and then. Life is altogether too sober.’’ The utter loneliness of her life became so intense that in 1854 she took a little orphan girl to live with her, and finally, finding her most congenial, she adopted her. The wisdom of this step will become manifest as the history of this wonderful woman proceeds. Emily Blackwell, a young sister of Elizabeth, had also taken up the study of medicine, gaining admittance to the Medical College of Cleveland, O., from which she graduated with honor in 1854. She then went to Edinburgh, Scotland, where she became the medical assistant of Sir James Y. Simpson, the noted specialist in diseases of women, He had an extensive practice, and was able to give her most valuable personal teaching, not only in gynaecology, but in surgery, Later she studied in London and Paris, and after two years returned to New York, where she became the able partner and co-worker of her sister, Dr. Elizabeth Blackwell. Some time before this a young German woman, Marie [Zakszewska] had come to America, hoping to study medicine. She had studied midwifery in Berlin. Her talent was so remarkable she had been made chief of the department, and had taught large classes of men and women. On her arrival in New York she was sent to Dr. Blackwell, who, recognizing her great ability, helped to make it possible for her to study medicine at the medical college at Cleveland. After her graduation she also joined the Doctors Blackwell in their work. Thus reinforced, an advance step was made in 1857 by the renting of a house, No. 64 Bleecker Street, which they fitted up as a hospital where both patients and young medical assistants could be received. This institution, under the name of "The New York Infirmary for Women and Children," was formally opened by a public meeting, in which the Rev. Henry Ward Beecher, Dr. Elder, of Philadelphia, and the Rev. Dr. Tyng, Jr., were present, and warmly supported the movement. In [Zackrzewska] Vol. XX, No. 9 THE WOMAN’S MEDICAL JOURNAL. 189 this institution Dr. Zakszewska accepted the part of resident physician, and Dr. Emily Blackwell became chiefly responsible for the surgical practice. At that date, although college instruction was being given to women in some places, no hospital was anywhere available, either for practical instruction or the exercise of the woman physician’s skill. To this step (the establishment of a hospital) a host of objections were raised, yet, through a cloud of discouragements and distrust, the little institution steadily worked its way, its few friends holding to it more firmly for the difficulties it experienced. While the practice of the infirmary, both medical and surgical, was conducted entirely by women, a board of consulting physicians, men of high standing in the profession, gave it the sanction of their names; earliest among these being Drs. Valentine Mott, .John Watson, Willard Parker, S. Kessam, Isaac E. Taylor and George Camman. For many years the pecuniary support of the infirmary was a great burden to the Drs. Blackwell in addition to the medical responsibility. Bazaars, lectures, concerts, every available means for collecting funds was resorted to by these brave pioneer sisters and their friends. In 1857 Dr. Elizabeth Blackwell, in a letter to Lady Byron, wrote: "Very few people understand the soul of this work or the absolute necessity which lies upon us to live out the ideal life to the utmost of our power. My work is undoubtedly for the few. It is a labor in the interlinkings of humanity, and is necessarily difficult of appreciation by the mass of people, and is very slow in gaining their esteem. It has been a most toilsome task to translate my thoughts into the common language of life. I labor at this translation perpetually, and still remain too often incomprehensible. I will not degrade the central thought of this work, but I seek in every way to accommodate it wisely to the practical commonsense feeling of the people. My sister is a noble helper, and we shall stand, I trust, shoulder to shoulder through many years of active service.'’ In ten years the new departure in medical work had gained a firm footing in the United States. Medical work by women was being carried on successfully in Boston and Philadelphia, where hospitals for women and children had been founded—the one in Boston by Dr.[ Zaskrzewska], who had been such an able helper in the early days of the infirmary. It seemed important now to the Drs. Blackwell to use their influence in England to bring about the medical education of women; so Dr. Elizabeth paid a visit with that purpose in mind. In order to present the subject forcefully, she prepared three addresses to be delivered in England on the following subjects: (1) “The Value of Physiological Knowledge to Women,” (2) “The Value of Medical Knowledge to Women ” (3) “The Practical Aspect of Medical Work by Women as established in America and its adaptability to England.” These addresses were first given in Marylebone Hall, London, to very intelligent and appreciative audiences, whose interest was warmly enlisted. The most important listener was Miss Elizabeth Garrett, to whom came the inspiration to study medicine as she listened to Dr. Blackwell’s presentation of her subject; she afterwards became the [Zackrzewska] pioneer of the medical movement in England. Dr. Blackwell later delivered the same lectures in Manchester, Birmingham and Liverpool. Writing to her sister, Dr. Emily, at this time, she said: "The more I see of work in England the more I like it. From the Queen downward I see the signs of favor. The way in which the cause is regarded, both by the laity and doctors, is most respectful. There is an immense chance in this fresh field where solid English heads receive the highest view of truth, where generosity and largeness of life meet you at every turn.” To Lady Byron she wrote while in London: “From Leeds, Nottingham and Edinburgh came earnest invitations to lecture. A student from Cambridge told me the young men were warmly in our favor. But this sympathy is necessarily intellectual only; practical receptiveness and familiarity with the new position of women must necessarily be of slow growth. It must be, in fact, a life work. The children of the present generation will grow up accustomed to women doctors, respecting and trusting them; but the large majority of the adults will only hold a half faith, and this will be a gradual growth." It was during this visit to England that the important step was taken of placing a woman’s name for the first time on the authorized medical register of Great Britain. Influential friends of Dr. Blackwell presented the various testimonials of English and continental study given by distinguished physicians and credentials of American practice to the medical council, of which Sir Benjamin Brodie was president, and other old friends of the St. Bartholomew’s days were members. The subject was very carefully considered, and after mature deliberation this just and important concession to qualified women was authorized; and Dr. Blackwell says of it.: “I had the satisfaction of being enrolled as a recognized physician of my native land in the medical register of January 1, 1859 (London).” It had again been a strong hope of the English friends of Dr. Blackwell that she would remain and practice medicine in London, but she still felt that her work in America was not completed. She wrote to a friend as follows: “In America, as here, it is a life work. I shall go back to create the institutions of which we have planted only the little germ.” She returned to New York City in August. 1859, to find the fund for the new hospital prospering. The spacious house at No. 120 Second Avenue was soon after purchased and adapted to the use of hospital and dispensary, with accommodations for several students. At this juncture the Civil War swept over our country, put- ting a stop to further development of the work. The noble band of women already organized for it, however, turned to the more important one of supplying the want of trained nurses, so widely felt after the first battles. A meeting was called in the parlors of the new infirmary, which were crowded, quite to the surprise of the little group of managers. A letter was drafted, calling a public meeting at Cooper Institute, and from this grew the “Ladies’ Sanitary Aid Association,” which did such phenomenal service during the entire course of the war. When the great national rebellion was ended the next forward step was taken. The infirmary needed more well graduated women in medicine to carry on its work than could be ob-190 THE WOMAN’S MEDICAL JOURNAL September, 1910 tained; so in 1865 the trustees of the infirmary, finding that the institution was established in public favor, applied to the Legislature for a charter, conferring college powers upon it. They took this step by the strong advice of some leading physicians of New York interested in the infirmary, who urged that the medical education of women should not be allowed to pass into the hands of the irresponsible persons who were at that time seeking to establish a woman’s college in New York. Dr. Blackwell says: “We took this step with hesitation, for our own feeling was adverse to the formation of an entirely separate school for women.” The first women physicians connected with the infirmary, having all been educated in the ordinary medical schools, all felt very strongly the advantage of admission to the large organized system of public education already existing for men, and also the benefits arising from association with men as instructors and companions in the early years of medical study. They renewed their efforts, therefore, to induce some good recognized New York school to admit, under suitable arrangements, a class of students guaranteed by the infirmary, rather than add another to the list of colleges already existing exclusively for women. Finding such arrangements could not be then made, the trustees followed the advice of their consulting staff—obtained a college charter, and opened a subscription for a college fund. A full course of college instructions was gradually organized, with the important improvement of making the subject of hygiene one of the principal chairs and all obligatory study. Dr. Elizabeth Blackwell filled this chair. A sanitary visitor to the homes of the poor had been a member of the infirmary staff from its inception. The work of this physician was also superintended by Dr. Blackwell, who believed that the first and constant aim of the family physician should be to diffuse the sanitary knowledge which should enable parents to bring up healthy children. When the New York Infirmary and Medical School were well established our great pioneer felt that her work for women in medicine in America was done. Her sister, Dr. Emily Blackwell, and the able corps of professors, both men and women, were quite competent to carry on the work of college and infirmary. This was in 1869. During the twenty years which followed Dr. Blackwell’s graduation at Geneva, New York, public recognition of the justice and advantage of such a measure had steadily grown throughout the Northern States; the free and equal entrance of women into the profession of medicine was assured. Medical schools for women were established in Boston and Philadelphia as well as in New York, and in some long established colleges women were received in the ordinary classes. A pioneer work similar to that which had gone on in America was under way in London, and Dr. Elizabeth Blackwell turned her face toward that work and the friends who had stood by her so faithfully through all her years of struggle. (Concluded in October) Items of Interest. Epidemic Poliomyelitis.—Dr. Simon Flexner, of the Rockefeller Institute has issued a request for specimens of the nervous system from fatal cases of epidemic poliomyelitis, which is widely prevalent throughout the United States and Canada at the present time. The specimens should consist of portions of the spinal cord, preferably of the lumbar or cervical enlargement, removed as soon after death as possible, and preserved in plenty of pure glycerin. The specimens are to be used for experimental purposes, and may be sent by mail or by express collect to Dr. Flexner at the Rockefeller Institute, Sixty-sixth Street and Avenue A, New York. Race Suicide in Hawaii.—According to a report made recently by Governor Frear of the Hawaiian Islands, the birth rate of Hawaii is decreasing in proportion to the population, while the death rate is increasing. Last year the deaths numbered sixty-one more than the year before, whereas the births numbered 600 less. Bureau of Health Speakers.—The State Board of Health is about to establish a bureau of speakers on health. These speakers will accompany the tuberculosis exhibits which are to be sent to school houses, and will speak to the school children on how to live and how to prevent disease. The lectures will be illustrated, and photographs of correct living and sleeping apartments and other methods of sanitation will be shown. Aid for Japan.—The American Red Cross Society, through the State Department, has telegraphed $5,000 to Japan, for the relief of the sufferers from the flood in that country. The money will be distributed by the American Embassy. Dr. Anita Newcomb McGee has been appointed Chairman of the Health Department of the California Federation of Womens Clubs. Dr. McGee is well known for her work during the Spanish-American and Russo-Japanese wars. Red Cross Hospital.—After a conference with the Forestry Service officials, which was held on September 2d, the officers of the American National Red Cross announced that it would pay the hospital expenses of the Government employes injured in fighting the forest fires in the Northwest. It is estimated that the expenses will amount to about $1,000, which will be paid out of the contingent relief fund of the Red Cross. Had it not been for this decision on the part of the Red Cross, the employes would not only have lost their wages during the time of their confinement in the hospitals, but would have been required to pay their own hospital expenses, as no Government funds were available for those purposes. A Bequest to the New York Academy of Medicine.— The will of Mrs. Margaret E. Gray, who died two weeks ago, provides a bequest of $50,000 to the New York Academy of Medicine, to establish the Landon Carter Gray Memorial Fund, in memory of her husband, who was a well-known neurologist at the time of his death ten years ago. Mrs. Gray directs that the income be used from time to time to purchase books for the academy library, and requires that all books so purchased shall have inserted a book plate which she had designed for the purpose and left in a safe deposit box. She directs that if her estate should not be sufficient to pay all bequests that this fund be set aside first. The will also leaves $5,000 to Dr. William B. Pritchard, at whose home Mrs. Gray lived much of the time after her husband’s death, and $3,000 to Dr. John J. McPhee. Fourth of July Victims.—The carefully compiled statistics of the American Medical Association show that the agitation for a sane Fourth has had some effect, a decrease in the number of victims being particularly notable in those communities which have passed restrictive legislation. The summary shows that this year 2,923 persons were injured, of whom 131 died, In 1903 the injured numbered 4,219, of whom 466 died. Vol. XX, No. 9 THE WOMAN’S MEDICAL JOURNAL 191 The total for the eight years is 37,526 persons injured in Fourth of July celebrations, with 1,662 deaths resulting directly from the injuries and from tetanus following the wounding. The eyesight was destroyed in 122 cases; 551 persons lost the use of one eye, and 432 were crippled by the loss of arms, hands, or legs, and 1,541 by the loss of fingers. The greatest reform was accomplished this year in Massachusetts, where the injuries were only one-seventh of the number for the previous year. Missouri, New Jersey and New York reduced their injuries to one-third, while the totals in Indiana, Iowa and Wisconsin were larger than those of a year ago. Books for Hospital Patients—As a memorial to Hon. Patrick A. Collins, the sum of $2,321 has been set aside for the purpose of supplying the patients at the Boston City Hospital with reading matter. It will be known as the Collines Memorial Library. This money was left from the Collins Memorial Fund, and the committee having the fund in hand was desirous that it be used for this purpose, stipulating, however, that $1,800 be spent for books and bookcases, and $500 be deposited with the city treasurer and invested, the interest to be spent annually for the purchase of new books for the patients. Pellagra in Philadelphia. - According to reports published in the daily press, twelve well developed cases of pellagra have been discovered among the inmates of the Philadelphia Hospital for the Insane, and there are sixteen others under observation. Women Physicians for City Hospital.—Women practitioners in St. Louis city and county have been invited by the Hospital Board under the new hospital law to apply for positions on the visiting staffs of the City Hospital and other municipal institutions. Pittsburg's Floating Hospital for Infants.—The Women's Club of Pittsburgh has chartered the steamer "Sunshine” to be used as a floating hospital for infants. The steamer went into commission on September 14th. Protection Against Cholera. Orders have been given through the Public Health and Marine Hospital Service to the American consuls at Marseilles, Havre, Cherbourg, Genoa, Palermo, Naples, and Messina to detain steerage passengers from all parts of Russia and their baggage for five days for disinfection and observation before they are allowed to take ships for the United States. The guard at ports of entry in the United States is being doubled. Officers of the service have been dispatched to New York and Boston to consult with the quarantine officers there for special measures. Special instructions for the examination of vessels from ports suspected of infection or carrying passengers from infected districts have been sent to every quarantine officer in the service. It has been reported from Naples that the cholera situation there is growing more serious. There were twelve new cases and eight deaths from the disease in that city on September 12th. Abstracts. Deutsche medizinische Wochenschrift, July 21 and 28, 1910. Myogenous Leucocytosis.—Grawitz sums up an article on leucocytosis of muscular origin as follows: Increased muscular exertion causes an increase in the leucocyte content of the blood in a ratio of from 1:2 to 1:4. This leucocytosis follows promptly upon the exertion, and is produced apparently by the compression of the lymph spaces by the contracting muscles. The object of the increased production of leucocytes must be the disposal of the metabolic products of muscular activity. Hence under tranquil circumstances we may assume that a normal property of the leucocytes is the taking up and transportation of katabolic substances. This is borne out by the fact that after prolonged muscular repose—as on waking in the morning leucopenia is present. The first manifestation of myogenous leucocytosis is a marked lymphocytosis, which is succeeded by a neutrophile leucocytosis. The lymphocytes, produced in proportion to muscular activity, no doubt constitute a reserve fund for the leucocytosis being themselves incapable of function. They enter the blood as the latter is becoming surcharged with the chemical products of muscular activity; and as many as are needed become true leucocytes for taking up the latter. The transformation takes place in consequence very rapidly. The author does not believe that myelocytes are to be found participating in this leucocytosis. Boston Medical Surgical Journal, August 11, 1910. The Clinical Aspects of Arteriosclerosis— Henry Jackson says that pathologically the changes in the intima are the most prominent features, representing a conservative process, a protective cement, so to speak, to guard against injury of the arterial wall because of the disease in the media; the primary process is found either as a degenerative or as an inflammatory change in the media, or perhaps some defect or strain of the elastic fibers. Councilman makes three divisions: (1) The nodular form, which does not give rise to clinical symptoms; (2) The senile type, with many symptoms probably directly referable to the condition of the arteries, rather local disturbances in the circulation than disease which affects the body as a whole. The arteries feel like broken pipe-stems. The heart is extremely intermittent and irregular, yet does not show the results of heart failure. (3) Diffuse arteriosclerosis, which is a disease found especially in individuals otherwise healthy, most common in those of advanced age. In this form of the disease we find the largest hearts. From clinical and experimental observations it seems probable that we must attach greater importance to the role of varying toxic processes associated with acute infectious diseases in the etiology of arteriosclerosis. Yet the chief cause probably lies in overeating and consequent gastrointestinal disturbances. From a clinical standpoint the symptoms may be divided into localized symptoms and general symptoms. Of the former probably the most important are those associated with disease of the vessels of the heart. In many cases of sclerosis of the arch of the aorta we find an extension of the process to the valves of the heart resulting in sclerotic changes of the aortic valves. An important local condition of the heart is found in diseases of the coronary arteries. Again, the heart muscle may be seriously affected by localized disease of the arteries. Among the most important symptoms of localized arteriosclerosis are the disturbances of the nervous system, central and peripheral. The heart and kidneys are the most important organs secondarily diseased. One drug he considers of value as a preventive measure, and, perhaps in some cases, as a curative measure, iodide of potash. In recent years there has accumulated evidence that permanent good is accomplished by the high frequency current. Recent Surgery of Pulmonary Tuberculosis.- Samson, in a joint review of recent literature, concludes that artificial pneumothorax gives good results in advanced and even in desperate cases, provided the disease is confined to one side of the chest and the subject has no other tuberculous lesions. Extensive extrapleural thoracoplastic may he indicated where the preceding intervention cannot be carried out, as when extensive pleural adhesions are present. Freund’s operation of dividing the prematurely ossified cartilage of the first rib may be carried out in individual cases, but its theoretical soundness is not yet sufficiently established to warrant it being made a procedure of routine. British Medical Journal. August 6, 1910. Cats as Plague Preventers.-Andrew Buchanan states that some three years ago he prophesied that "a few years hence we shall look on the neglect of the cat as one of the most extraordinary things in the whole history of our inquiries into the plague and its prevention." and that this prophecy is beginning to come true. While the author does not claim that direct infection never occurs, he holds that there is every reason to believe that plague is mainly due to rats. Poison and traps are ineffectual in disposing of the rats, which are sure to return. The theory that the plague is dying out is not sufficiently well founded to warrant any reliance being placed on that hope. In discussing the192 THE WOMAN’S MEDICAL JOURNAL September, 1910 comparative value of cats and inoculation, the writer points out that the inoculation of the immense population of India every year or every time the plague threatens would be an impossible task at the present time. Although a knowledge of the value of keeping cats is spreading, there are many parts of India in which this is not fully understood, and the interval between epidemics should be utilized to impress the people with the fact that no other means of ridding a locality of rats compares with the rat destroyer provided by Nature—the cat. Hereditary Syphilis and the Wassermann Reaction.— Mulzer and W. Michaels sum up their own findings with those of others as follows: Mothers of syphilitic nurslings and newly born invariably give positive reaction, and women who have borne syphilitic children within four years are to be regarded as latent syphilitics. When newly-born infants present no symptoms of the disease they may react negatively soon after birth, but within the first three weeks post partum the reaction changes to positive, usually coincident with the period of eruption. Nurslings with manifest lues react in general in the percentage of adults in the secondary stage (96 per cent, positive). Children over one year old react like nurslings. Latent syphilitic children react in the proportion of adults with early latent syphilis. It seems more difficult to cause the disappearance of the Wassermann reaction through treatment than is the case with adults. Mothers of syphilitic children give a high percentage of positive results (83 per cent.). When syphilitic parents have several chil- dren in succession, one is finally born with negative reaction, corresponding to absence of symptoms. (Intercol. Med. Jour, of Austral., April 20. 1909). (Brit. Jour. Chil. Dis.) Acute Anterior Poliomyelitis.—Green gives details of two fatal cases of this disease during an epidemic at Bendigo. In a boy, aged five years, the disease commenced with symptoms of intense meningitis; after the fall of temperature there was gradual extension of paralysis involving the Intercostal muscles. In a baby aged six months there occurred in the seventh day dulness of the light lung with tubular sounds of the upper third, indicating either an invasion by the same organism or a secondary infection. Death occurred on the day following the lung infection. In this case there was a gradual extension of the paralysis after the disease appeared to be at an end. Bacteriological examination of the cerebro-spinal fluid—four specimens of the cerebro-spinal fluid were obtained from this case. When withdrawn the fluid looked quite clear, but, after standing a little while, grayish sediment collected which, on microscopical examination proved to consist of lymphocytes. After centrifugalizing the fluid, a further examination showed that these deposits consisted entirely of mononclear cells, and that there were no polymorphonuclear leucocytes to be seen, and, in this respect, the writers point out that their results resemble those obtained by Geirsvold in twelve cases taken from an epidemic of acute poliomyelitis which occurred in Norway in 1905. In most of the cover-glass preparations, made from the two earlier specimens of fluid, a few widely scattered diplococci could be distinguished. In a few instances two pairs were grouped as tetrads. There was some indication of a capsule, but this was not so distinct as it was with the diplococci which were found in the cerebro-spinal fluid of rabbits. The diplococci were always found free in the fluid: no intracellular forms occurred. No culture of this diplococcus on artificial media could he obtained; media of every description were inoculated with the fluid, and incubated both aerobically and anaerobically, but in no instance was growth of any kind obtained. Rabbits were inoculated intracranially with the fluid, and, in three instances, the diplocoocus was found in the cerebro-spinal fluid on the 22d, 50th and 53d days alter Injection, and. in two of these instances, the rabbits became partially paralyzed on the 52d and 49th days after inoculation. Unfortunately no complete histological examination of the cords of these paralyzed rabbits was made. In summing up the evidence concerning the infective nature of acute poliomyelitis, these authors consider that Geirsvold’s investigations show that a specific disease exists, of which acute poliomyelitis is a frequent and prominent, though not essential, feature, and they consider that the instance they have recorded represents a sporadic case of the disease of which Gersvold observed an epidemic. Does an attack of Epidemic Poliomyelitis That is Recovered From Afford Immunity to Reinfection ? --The authors, Flexner and Lewis in Archives of Pediatrics, state that experimental polimyelitis in monkeys is a very severe disease, and, in our series, it has produced death in fully 40 per cent, of the inoculated animals that have developed paralysis. When recovery occurs, residues of paralysis persist; and when death occurs, or where the animals are killed some weeks later, atrophy of the gray matter of the spinal cord, corresponding to the paralyzed limbs, is present. We have reinoculated several of the recovered monkeys, and have noted in some instances failure of the virus to act while causing paralysis in the control monkeys. A single example will be given. Monkey 45 was inoculated into the brain on November 6, 1909. November 13th, tremulous and sick; November 15th. left leg weak; next day the leg is paralyzed; November 24th, general health good, but paralysis persists; November 30th. health excellent except for paralysis. On this day reinoculated together with two controls, Both of the latter became paralyzed, but the reinoculated animal has remained well. Lancet. Treatment of Syphilis with Ehrlich-Hata’s New Preparation of Arsenic.— Hoffmann says that the development of this new method of treatment is based on the results obtained with atoxyl. Ehrlich first replaced the dangerous atoxyl with arsacetin, replaced this with arsenophenylglycin, and finally this with dioxydiamidoarsenobenzol. or 606, which has a remarkably quick eliminating effect on human syphilis even after a single injection, according to several authors. He doubts whether a single injection heals the disease, but admits that in a number of his cases he was unable to find spirochaetae three days after injection. He noticed clinically that anginae, mucous patches, and papules often disappeared without any local treatment, as well as indurated glands and the initial lesion. In one case of malignant syphilis and in one of a tertiary, ulcerating syphilide of the face he met with a strong reaction the day after the injection. The four cases he reports are so remarkable as to deserve mention. Case I. Congenital syphilis with syphilitic ozaena in a boy. fifteen years old. The symptoms presented were severe headache. unbearable foetor, exophthalmos, and paresis of the abducens. Injection July 7th, of 0.3 gramme of 606. The symptoms disappeared almost immediately, and there was a great subjective and objective improvement, but the strong Wassermann reaction was unchanged on July 23d. Case II. Female, 34 years old. Tertiary liberating syphilide of face involving nose, right cheek, upper and lower lips. Wassermann reaction strongly positive on July 12th, injection of 0.3 gramme of 606 with a very strong local reaction on the following morning. August 1st, perfect healing with the exception of the infiltrated border. Wassermann's reaction mildly positive on July 28th. Case III. Female, 34 years old. Secondary syphilis; universal papular exanthema, involving even the palms and the soles, proliferating papules on the genitals and patches in the mouth and on the tonsils. Injection of 0.3 gramme of 606 in acid solution May 24th, followed by fever for four days. On June 6th, exanthema just visible, papules and patches gone. Case IV. Male. 40 years of age. Ulcerating gummata of tongue and scrotum, ulcers in the left angle of the mouth for four years. Injection of 0.3 gramme of 606 followed by a high fever and pleurisy due to an embolic central pneumonia. Finally, this author considers this new remedy very valuable in eases of mercury and iodine Idiosyncrasy and as a preventive. Munchener medizinische Wochenschrift, August 9, 1910. Pancreas Intoxication.—Bergmann and Guleke have investigated the subject of systematic autointoxication from the pancreas, which has apparently been suggested in part from the fact that in aseptic autolysis of this gland certain toxins are formed; but more particularly from the pathological finding that in destructive Vol. XX, No. 9 THE WOMAN’S MEDICAL JOURNAL 193 disease of the organ certain fatal toxic phenomena are produced. The toxic action noted in any case is somewhat of the nature of trypsin poisoning, and may he antagonized in experiment by previous immunization with trypsin. Yet these toxic effects cannot be set down necessarily either to trypsin or any other individual enzyme when acting alone; that is to say, the picture differs in some respects from that produced by the injection of commercial trypsin into the blood. Another toxin is present, and this is believed in some quarters to be the digestive product of the pancreatic lipase. The role of this element in the intoxication is somewhat complex and is believed to represent a displacement in the blood of its calcium ions as a result of formation and absorption of the very soluble sodium soaps, which are formed from lipase digestion. While experimental trypsin death is said to represent a paralysis of the respiratory center, soap poisoning, when carried out experimentally, represents an acute cardiac death. In pancreas intoxication, however Interpreted, we thus have two quite different lethal factors which act in conjunction. So many disease phenomena are nowadays explained by some sort of interference with soluble calcium ions that the refusal of the authors to commit themselves to any definite conclusions need occasion no surprise. Treatment of Sciatica with Epidural Injections — Blum refers by the term epidural injection to the anesthetization of the sacral nerve roots after they have left the cord, a resource for local analgesia discovered simultaneously by Cathelin and Sicard. When applied merely to relieve the pain of neuralgia, the method does not differ radically from perineural injections in the continuity of nerves. The author's paper is essentially a comparison of the two methods. The older of the latter is somewhat more readily carried out, but this drawback is more than offset by several points of disadvantage. The epidural injections, for example, affect a wider nerve distribution, and are less provocative of present and after pains. Blum has used the epidural method in over a thousand cases with a much smaller incidence of unpleasant consequences and sequelae than has been shown by perineural injections. Paralysis of the peroneus has been noted occasionally under both methods. Nevertheless the conclusion of the author that the epidural method is the best routine procedure seems to be doubtfully asserted. Lancet. August. 1910. Tumors of the Abdominal Wall.—Lockwood says that the treatment of fibroma, sarcoma, and fibromyoma of the abdominal wall depends upon their pathological characters. An encapsulated tumor may be removed from its capsule, especially when we know that the tumor consists of fibrous tissue. But if there is no capsule and if the tumor is growing along one of the abdominal muscles then the removal becomes a matter of greater difficulty. The ideal method of removing a sarcoma of muscle would be to take away the whole muscle from beginning to end, but this is not possible In the case of abdominal muscles. Nevertheless, the wider the margin we give these sarcomata the better. Diagnosis in Malignant Diseases.— Royle observes that in cases of cancer the uric acid is usually higher than is found in healthy cases under similar conditions; the output of phosphates in the urine is in the majority of cases of cancer decreased when compared with healthy individuals; the ratio of phosphates to uric acid is almost Invariably reduced in malignant disease below that found in health, any ratio below 4 being suggestive, especially if it remains low on several occasions, and any ratio below 3 is almost diagnostic of malignant disease or a blood disease, unless, indeed, further work shall prove that the same is found in other conditions. Therapie der Gegenwart. Berlin July. LI. No. 6. pp. 241-288 Suppository for Inflamed Rectum. Unna commends the use of large suppositories of cocoa butter, fully 8 cm. long by 1 or 2 cm. wide, medicated or not. They lubricate the feces and permit painless and non-irritating defecation in proctitis. The addition of a little cholic acid is said to stimulate peristalsis. Heat in Treatment of Erysipelas.—Ritter's views were recently summarized in these columns, page 176. He commends a hot flat iron as a convenient means of applying heat to erysipelatous patches, especially on the face, repealing the application for ten or fifteen minutes three times a day. He found mention of this method of treatment in a letter to Mme. de Sevigne dated 1694, it having been applied for an acute rheumatic shoulder trouble. Prevention of Constipation in the Young— Budberg writes from China to call attention to the constant absence of constipation among the children in the Orient, He ascribes this to the regular habits in respect to defecation impressed on the children from birth. When it wakes in the morning even the new-born infant is trained to defecate at once. The mother takes the rump of the infant between her hands and holds the child up. its back toward her pressing its thighs against its abdomen while her thumbs push on its back, or she presses its back against her knee or breast. This position impels the infant to strain, and the mother talks soothingly to it to facilitate its yielding to this impulse. In China and Japan, consequently, he says, the infant of even two months keeps clean and dry while all the ills of constipation in infants and children are thus averted by these regular habits. Availability of the Desmoid Reaction in General Practice.—This communication from the medical clinic at Kiel in charge of Luthje relates experiences with 145 cases of various stomach affections in which the functioning of the stomach was investigated by Sahli’s desmoid test; that is, ingestion of a stain wrapped in a square of fine rubber tissue, tied with catgut. With normal digestion the catgut is speedily dissolved and the stain passes into the urine or saliva. In over 70 per cent, of the cases the reaction paralleled the findings in the stomach content, removed with a tube; in only 6 per cent, were the findings contradictory, and these might be explained by defective technic. The test realizes in practice, he declares, all that Sahli claims for it. It is a reliable means for determining the conditions in the stomach in regard to digestion and differentiating malignant from non-malignant disturbances. It is important to make the desmoid bag one’s self, and fresh each time, the little bags not keeping well; another point is to test their weight, as they must he heavy enough to sink to the bottom of a basin of water and not permit any of the stain to diffuse before the catgut is loosened. (It has been suggested that an ether pearl might he used in the little bag instead of a stain, the patient perceiving at once by the eructation when the ether escapes from the bag.) Deutsche medizinsche Wochenschrift. August 18, 1910. Causes of Bromine Retention and. Chlorine Displacement in the Blood Serum.—Frey, assistant to Prof. Kionka. of Jena, explains this phenomenon briefly by stating that these bodies—salts of chlorine and bromine —appear in the urine in the reciprocal relation in which they exist in the blood. The urine makes no distinction in their elimination. Hence, if there is poverty of chlorides, as in a salt free diet, flooding with bromides leads to a strong accumulation of the latter, which acts more rapidly than with a diet normal in salt. Conversely, when a patient has become bromized, and the remedy is stopped, the exhibition of chlorides hastens bromine elimination. Ten per cent, of the quantity of combined halogen injected is eliminated by the kidneys, so that if a single ordinary dose of sodium bromide is ingested much more chloride will be eliminated. Syringomyelia in Mother and Daughter.—Goldbladt finds this coincidence of interest both as a contribution to recorded cases and as throwing some possible light on the disease. The cases themselves are interesting, because right-sided exophthalmus, a very rare symptom, was present in the daughter (but one prior observation is on record). Enophthalmus is fairly common. The exophthalmus was transitory, recurrent and doubtless connected with some fault of innervation in the sympathetic of reflex origin. About seven instances of familial syringomyelia were all that could be found in literature, the author's cases making eight. While the author believes that some necessary connection underlies the syringomyelia and exophthalmus, he goes no further194 THE WOMAN'S MEDICAL JOURNAL September, 1910 that the intimation that the pathology of the sympathetic needs revision. Clinical and experimental findings do not agree. If we assume that the syringomyelia irritate the core centers with which the sympathetic is connected, the symptoms should have been different. There should have been certain pupillary symptoms. On the other hand, atrophy of the facial muscles of the right side seemed to point to a paretic condition of the sympathetic. Book Reviews. The Sexual Life of Woman. By E. HEINRICH KISCH, M.D., Professor of the German Medical Faculty of the University of Prague; Physician to the Hospital and Spa of Marienbad' Member of the Board of Health, etc. Translated into the English Language from the German by M. Eden Paul, M.D., Illustrated. Rebman Company. New York. Price $5 net. The author presents us with a very carefully prepared treatise on a highly important subject. He treats his topic thoroughly, viewing every phase, and giving his views and those of others in an eminently broad-minded and frank manner. There is no question but that we need in this country more of such literature, which quite the opposite is prurient, candidly discussed subjects, which even physicians are too apt to consider tabooed. Many of the evils mentioned by Prof. Kisch are the result of the habit of cloaking with mystery and concealing many physiological functions and requirements, and a broader attitude and plainer treatment of these subjects by physician would help, we believe, in the solutions of questions physical and moral of wide-reaching results. The author of the above volume divides his time into three periods of life, and enters into detailed description of the anatomy, physiology and pathology of each. He does not confine himself to the pelvic organs, but even to the remote organs which may be in any way connected reflexly, physiologically and pathologically with the natural, unnatural functions or disturbances of the former. By natural processes broader questions are introduced and discussed impartially. A great number of references are given, giving the views of a large number of investigators of all nationalities, adding considerably to the general interest. This book is of value to the practitioner, enabling him to better treat a large class of his patients. The book is warmly recommended by those interested. A Text Book of the Practice of Medicine. By JAMES M. ANSWERS, M.D., Ph. D., L.L. D., Professor of the Theory of Medicine and of Clinical Medicine, Medico-Chirurgical College, Philadelphia. Ninth revised edition. Octavo of 1326 pages, fully illustrated. Philadelphia and London. W.B. Saunders Company, 1909. Cloth, $5.50 net; half morocco, $7 net. Previous edition of Anders' "Practice of Medicine" have been reviewed in these columns, and the work is so favorably known as a general text book that there is little more to say, save that this new edition has been revised with characteristic care by the author and brought quite up to date by the addition of the newer developments. While, of course, the main parts of the book are but slightly altered, it is surprising in reading carefully to see how many changes may be noted; many minor, to be sure, but also many of considerable importance, such as Flexner's serum, the various tuberculin tests (including the ophthalmic test, we regret to say, a number of new signs and symptoms in diagnosis, etc. The diseases of the nervous system also have received especial attention in this revision. Without doubt this new edition will continue the well deserved popularity of the work as a text book. BOOKS RECEIVED. Pocket Therapeutics and Dose Book. By MORSE STEWART, Jr., B.A., M.D. Fourth edition, re-written. Small 32-mo of 263 pages. Philadelphia and London. W.B. Saunders Company, 1910. Cloth, $1 net. Essentials of Gynecology Arranged in the form of questions and answers. Prepared especially for students of medicine by EDWIN B. CRAGIN, M.D., Professor of Obstetrics and Gynecology, College of Physicians and Surgeons, New York; Attending Physician to the Sloane Maternity Hospital; Consulting Gynecologist to the New York Infirmary for Women and Children; Consulting Obstetric Surgeon, City Maternity Hospital, the Sydenham Hospital, and the New York Infant Asylum; Consulting Gynecologist and Obstetrician to the Lincoln Hospital and Home. Seventh edition. Thoroughly revised by FRANK S. MATHEWS, M.D., Instructor in Gynecology, College of Physicians and Surgeons, New York; Associate Surgeon to the General Memorial Hospital; Attending Gynecologist, Roosevelt Hospital, Out-Patient Department. With 59 illustrations. Philadelphia and London. W.B. Saunders Company, 1909. Juvenile Courts and the Study of the Juvenile Delinquents. One of the salutary results of the establishment of children's court in metropolises should be a more intelligent study of the juvenile delinquent. The normal delinquent youth differs necessarily from the offender of defective makeup or degenerate stock. The boy criminal differs radically from the girl offender. Youthful offenders differ from adults of the same class. The children also differ, as to the relative frequency of certain offenses, according as they dwell in agricultural, manufacturing, or commercial communities. Much interesting information along these lines is brought out by State Attorney Rupprecht, a practitioner in the children's courts at Munich (Munchener medizinische Wochenschrift, July 26th). In that city the children's court takes cognizance of all offenders between the ages of 13 and 18, inclusive. The lad or girl of healthy stock must at this period be regarded as potentially a criminal, because character and will are undeveloped, and experience - that best of teachers - has not yet had its innings. Desires are strong, over-powering; and inhibition is weak. Hence many offenders, absolutely free from taint, are merely the product of their environment. Such must not be confounded with defectives. Munich, as a city of superior educational facilities for the masses, and without certain drawbacks native to mill towns, has but a small contingent of youthful criminals. Naturally petty offenses - such as begging - multiply this total five-fold, but with these we are not concerned. Theft is the great offense of youth. It overshadows all others so far that the latter appear almost freakish. Thus, but two boys were arrested in a given year for torturing animals; while the convictions for violence against the person, rape, pederasty and subsisting on prostitutes were hardly more numerous. There were but few arrests for drunkenness. When we consider that the offenders in such cases are likely to be either defectives or boys near the superior age limit, these may almost be eliminated from the ranks of juvenile offenders proper. To return to offenses against property - in this case confined chiefly to theft: It appears that the boy steals in an unpremeditated fashion, while the girl has a plan. Boys tend to steal junk - not, it appears, to sell, but as raw material for making playthings. Girls tend to appropriate cosmetic articles. We have heard much in the United States as to the dangers of moving picture shows in tempting boys to pattern after burglars and highwaymen. This theoretical position may be quite offset by the actual knowledge that in Munich boys steal in order to be able to visit these entertainments (which, for all we know, may be highly moral). The temptation to visit these Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL 195 attractions is so strong that even a "good" boy may not only forego his dinner, but pilfer the price of the entertainment. In regard to shoplifting and pilfering by girls it is moving to note that they sometimes steal in order to make a present to a favorite school teacher. One took the flowers off a grave for this purpose. When caught in the act of a theft, a boy usually confesses, repents and refuses to betray his associates. A girl, Rupprecht says, lies until the last minute, and then endeavors to throw the blame on someone else. But boys almost always rob in bands, while girls usually act alone. A boy seldom robs his employer, but some outsider; the reverse is the case with girls, who, since they pilfer cosmetics, adornments, etc., must almost necessarily rob their mistresses. Of much less interest are the crimes of degenerates and defectives, who form a class by themselves. The chief value of Rupprecht's study is that it deals in the main with normal subjects, the policies advisable in dealing with whom have hitherto received comparatively little attention. Publisher's Department. Toxemic Anemia. It is now generally recognized by both pathologists and clinicians that an auto-toxemia, resulting from the systematic absorption of the products of intestinal putrefaction, will, if sufficiently long continued, induce a general devitalizaton of the circulating fluid. Such a condition is by no means uncommon, although often unrecognized. Under such circumstances it is, of course, quite idle to attack the anemic blood condition primarily, or until the toxic cause of same has been measurably corrected by proper attention to the gastrointestinal tract. The causative factor being one removed or materially modified, restorative ad hematinic measures are distinctly indicated. It is especially desirable in such cases to avoid the administration of drugs that tend to derange the digestion, and the ordinary, inorganic, metallic salts of iron should not be given as they frequently prove irritant, astringent and constipating. Pepto-Magan (Gude) is the ideal hematinic in any condition in which the integrity of the digestive functions must be conserved and maintained, as the necessary iron and manganese are promptly absorbed without irritating the gastric mucosa or inducing a constipated habit. Because of its distinct palatability children always take it readily. A Contribution to the Treatment of Hay Fever - By GEORGE A. LEITNER, M.D., Surgeon Nyack Hospital; Attending Physician St. Agnes' Orphan Asylum, Sparkill, N.Y.; Attending Physician St. Joseph's Orphan Asylum, Blauvelt, N.Y.; Surgeon Erie Railroad. Although much has been written on the subject of hay fever and numerous methods have been suggested for its treatment, none of these can be regarded in the light of specifics. This is not at all surprising when it is considered that in hay fever we are not dealing with a distinct pathological entity, but rather with a complex of symptoms having many sources of origin. In view of the diversity of factors concerned in the etiology of hay fever it is apparent that each case is a law unto itself and must be treated individually, ascertaining if possible the underlying cause. When my attention was called to the possible value of a special culture of the bacillus of Massol in this condition, through an article by Dr. H. Holbrook Curtis (Merck's Archives, January, 1909), I decided to give it a trial. Dr. Curtis in this article stated that the active solution of this culture had a pronounced effect upon the vaso-motor system of the nose, so that turgescent hypertrophies seemed to disappear and edematous conditions resulting from hay fever subsided. It may be mentioned here that the preparation of lactic acid bacili employed in Dr. Curtis' experiments has since been introduced under the name of Masolin. The results so far obtained by us have been most interesting and encouraging. We found that in those cases in which there were distinct pathological conditions in the nasal cavities, such as hypertrophic rhinitis, nasal spurs, polyps and sinus troubles, the use of this culture proved it to be almost a specific. In those cases where the underlying cause was undoubtedly a neurosis there was not the slightest evidence of any benefit. The series of cases under consideration were all chronic, dating back in the most recent case eight years. All had been subjected to various operations or the usual treatment with adrenalins, oils, cocaine, etc., without relief. CASE 1. Mr. M., an unusually well developed and robust athlete, suffered for nine years with prostrating attacks of hay fever, the irritant in his case unquestionably being the pollen of golden rod. He had chronic nasal trouble, including nasal spurs, hypertrophied turbinates and a peculiarly sensitive mucosa. He had been under treatment for several weeks with various sprays and douches, and had submitted to operative treatment during previous years. At the time the Massolin treatment was begun he was absolutely incapacitated and unable to undertake any physical exertion. Spraying with Massolin was commenced in the afternoon, three applications being made before bedtime. This resulted in the first night's good sleep since the commencement of the attack. At the end of forty-eight hours all symptoms had subsided. CASE 2. Sister D. had been a victim for over eight years of most pronounced hay fever symptoms in which the irritant was undoubtedly the blossom of hay. Her history for some eight years back had been one of the most pronounced incapacitating attacks during the blossoming of day. She had been confined to her room for some days when treatment with Massolin was established, beginning on a Saturday afternoon. When visited on Sunday morning the change in the facial expression, especially in connection with the eye disturbance, was most marked, and by Monday she was entirely free from all symptoms. CASE 3. Mrs. W. presented the usual train of symptoms, the exciting cause being undetermined. She had suffered for years and had submitted to various operations for the relief of this trouble. She was under the care of a conscientious and competent physician who, after trying practically all of the known remedies, as a last resort, put her on Masolin applied by spray. The results in this case were immediate, though it was necessary to continue treatment on and off throughout the season. In addition to these, we have knowledge of quite a number of other cases in which the treatment was most beneficial, but of whose subsequent history we are without knowledge. As to the method of use the nasal tract should be washed out with warm normal salt solution, cleaning it thoroughly, and then by means of a spray, swab or canula, repeating the application two or three times per day till the symptoms subside. Berliner klinische Wochenschrift, May 16, 1910. Hemolytic Free Fatty Acids in the Liver of Acute Yellow Atrophy and Phosphorus Poisoning. - Joanno vics and Pick have made a study of the extraction of hemolytic substances from the liver of a man who died of acute yellow atrophy, of a man who died of phosphorus poisoning, and of dogs and rabbits which were killed by phosphorus. They summarize their results as follows: (1) Hemolysins of exceptional activity may be obtained from the liver in acute yellow atrophy and phosphorus poisoning in both man and animals. (2) These hemolytic substances are soluble in ethyl ad methyl alcohol, ether, and acetone, and are made up almost entirely of fatty acids; the lipoids insoluble in acetone are practically without hemolytic action. (3) In experimental phosphorus poisoning this hemolysin is present in the blood in large quantities. (4) The subcutaneous fat in phosphorus poisoning does not contain this hemolytic substance. (5) The presence of such an intensely active hemolysin in the liver is valuable for the demonstration of free fatty acids. (6) The fatty acids which come in consideration in hemolysis in organic extraction, appear from the manner of their hemolytic action to belong to the higher unsaturated fatty acids. (7) In acute yellow atrophy and phosphorus poisoning it would appear that these unsaturated fatty acids, which normally are combined in lecithin, are set free by the destruction of the latter.196 THE WOMAN'S MEDICAL JOURNAL September, 1910 Painless Epilation. In a recent article on the subject of painless epilation, Dr. May Cushman Rice, of Chicago, states as follows: "To secure anaesthesia, a high degree of concentration of current is necessary. A special anaesthetizer allowing an unusually large amount of current for the size of the electrode is required. Such a one has been constructed for this purpose. This anaesthetizer is invaluable, not only for cataphoric anaesthesia for this work, but also for the anaesthetizing of any small area to be treated cataphorically, fissures and ulcers for example. It consists of solid block tin, surrounded by a hard rubber rim, which projects one-fourth inch beyond the metal. This forms a shallow cup to be filled with cotton or flat pieces of lintine saturated with the solution. The metal disc is surmounted on a metal stem, terminating in a socket for the cord tip. The stem is insulated with hard rubber, so that it can be held firmly either by the operator or patient as desired. The size adapted to all parts of the face except the lip is one inch in diameter; that to the lip is one inch long and half an inch wide. Keep a bottle of cocaine hydrochlorate, 10 per cent., and one of adrenalin chloride, one to one thousand, on hand. Before using mix in a dram bottle, in the proportion of three parts cocaine to one part adrenalin, sufficient to wet the cotton in the anaesthetizer. * * * After thoroughly cleansing the hands, prepare the field of operation by washing with liquid soap and water, and then applying alcohol, either in full strength or diluted, if the skin be especially sensitive. Wash off the alcohol with boiled water before anaesthetizing. Put a layer of cotton or lintine upon the anaesthetizing and wet thoroughly with the anaesthetic solution. Apply this, after connecting with the positive pole, to the part of the face to be treated. Use ten milliamperes of current for five minutes, gradually turn the current off, and reverse the two poles, connecting the needle holder with the negative and the indifferent pad with the positive pole. In consequence of the adrenalin carried into the tissue, the anaesthetized area will be definitely outlined as a white patch. Anaesthesia will be only partial at the border, but perfect in the central portion of this patch." Full information regarding Dr. Rice's technique, as well as a description of the special anaesthetizing electrodes described by her, may be had by addressing the McIntosh Battery & Optical Co., Chicago, Ill. The Untoward Effects of Bromide. A reason for the absence of symptoms of bromism, during the administration of Peacock's Bromides, is the fact that the mixed bromides of which it consists are much less liable to cause this condition than potassium salt, which is particularly apt to give rise to the toxic sequelae of this class of remedies. In other words, instead of depending upon a single number of the bromide group, as is commonly the case, the physician who employs Peacock's Bromides has at his command a logical and dependable combination of the five important bromides, each of which, while contributing to the therapeutic activity of the others, at the same time diminishes the possibility of untoward effects." Hagee's Cod Liver Oil Clinical experience with Hagee's Cordial of the Extract of Cod Liver Oil Compound justifies the assertion that its therapeutic indications are precisely those which belong to cod liver oil in its natural condition. The fatty element (and this alone) is indeed completely eliminated, and while the nutritional value of that factor is undoubted, as is the case with most of the other varieties of animal and vegetable oils, it must not be forgotten that oil in any form will not be tolerated by the gastric mucous membrane in many of the cases for which cod liver oil is indicated. Hagee's Cordial is free from the taste and smell of oil, and is acceptable to the most fastidious taste. An Important Utero-Ovarian Sedative, Anodyne and Tonic. While it is unquestionably true that many cases of pelvic diseases in women are amenable only to surgical treatment, it is quite evident that there are not a few in which, for some reason or other, operative measures are out of the question. Among these may be included the many cases of dysmenorrhea and ovarian hyperesthesia, for the relief of which recourse is too frequently had by the patients to alcohol, the narcotics, or some of the much-vaunted nostrums on the market. It has been shown to be a mistake to suppose that substantial and lasting benefit cannot be obtained in these ailments by the internal administration of therapeutic agents, a number of which have been thoroughly tried, with results often satisfactory, sometimes brilliant. An agent of undoubted value in such cases is Liquor Sedans, a preparation introduced to the medical profession many years ago by Messrs. Parke, Davis & Co., and esteemed and prescribed by physicians to an extent, it is believed, not equalled by any similar compound. Liquor Sedans is composed of three of the most important sedatives, anodynes and tonics to the female reproductive tract-namely, black haw, hydastis and Jamaica dogwood-so combined with aromatics as to constitute a very acceptable preparation, being in this respect unlike some other agents of a similar nature which are in the treatment of functional dysmenorrhea, menorrhagia, ovarian irritability, menstrual irregularity, etc. Parke, Davis & Co. also manufacture Liquor Sedans Rx 2 (without sugar), which is precisely like the older formula but for the omission noted, and which is available for use in cases in which sugar is contraindicated; also Liquor Sedans with Cascara, which is of the same composition as Liquor Sedans except that each fluid ounce contains 40 minims of the fluid extract of cascara sagrada, giving to the formula an important tonic-laxative value. God Bless the Duke of Argyll Is the title of a most interesting little booklet dealing with the philanthropical feature of this benevolent Scotch Duke's life. The author's handling of this subject and his manner of associating it with the medical profession, is the most clever piece of commercial literature we have ever seen, and if read and observed carefully, it cannot fail to prove both profitable and interesting to the medical profession. Dissecting this little booklet from the standpoint of a medical editor, is like making a new robe out of old material. The finished product is so bright, so radient, and so refreshing, that one wishes he had more of it; if for nothing else than to disinfect the contagious imagination of medical, surgical and chemical theories. It is the mingling of the primitive past with the positiveness of the present. It drives the skeleton, which is the doubt as to the wisdom of modern principles of medical practice, from the brain of man. Its commercial references are admirably blended with truthful deductions. The little booklet is written and published by J. S. Tyree, at Washington, D. C., and is for free distribution. Moist Heat. Thermotherapy in inflammatory conditions seems to prove most effective when applied in the form of moist heat. The relaxation of pressure by infiltrated and swollen tissues upon nerve endings, as experienced by the relief of pain, specifically proves this. The advantages of moist heat where indicated is generally acknowledged. The method of its application from professional preferment seems to be in the form of Antiphlogistine. By this method, a high temperature can be maintained in contact with the affected part for hours without exposure to the patient for redressing. The superior advantages of Antiphlogistine over other forms of moist dressings, such as poultices, hot packs, etc., are that it is easily applied, retains its heat for hours, is antiseptic in action, and above all produces satisfactory therapeutic results. To facilitate easy childbirth some physicians prescribe sanmetto, beginning about six weeks before confinement, with good results in every case. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xiii Mulford's Antitoxin and the New Syringe Metal Plunger Finger-rests Sterile Rubber Plug Flexible Joint Every dose furnished in this Perfected Syringe Advantages of New Syringe: ASEPSIS, contamination impossible. Positive Working: The metal plunger screws into the rubber plug, adjusting pressure and making action positive. Metal finger-rest with rubber guard at top of syringe prevents any possibility of syringe breaking or injuring operator's hand. Needle attached with flexible rubber joint permits motion of patient without danger of tearing the skin--a great advantage in administering to children. Our new adjustable rubber packing possesses great advantages; it is readily sterilized, does not harden, shred, absorb serum or become pulpy. Simplicity and accuracy--no parts to get out of order Mulford's Antitoxin is Accepted Everywhere as THE STANDARD The higher potency enables us to use much smaller syringes. Minimum bulk--maximum therapeutic results Brochures and Working Bulletins sent upon request H. K. MULFORD CO., Philadelphia New York Chicago St. Louis Minneapolis San Franciscoxiv THE WOMAN'S MEDICAL JOURNAL September, 1910 K & O. DOUCHE FOR THE APPLICATION OF GLYCO-THYMOLINE TO THE NASAL CAVITIES GLYCO= THYMOLINE FOR CATARRHAL CONDITIONS Nasal, Throat Intestinal Stomach, Rectal and Utero=Vaginal KRESS & OWEN COMPANY 210 FULTON STREET NEW YORK FORMULA--Benzo-Salicyl. Sod. 33.33; Eucalyptol .33; Thymol .17; Salycilate of Methyl. from Betula Lenta .16; Menthol .08; Pini Pumilions .17; Glycerine and solveutsq. s. 480. The Antitoxin Treatment of Diphtheria. Again are we nearing the season when the problem of diphtheria and its treatment must be met and solved. The writer of this paragraph is forcibly reminded of the fact by the receipt of a modest but important brochure of sixteen pages bearing the title, "Antidiphtheric Serum and Antidiphtheric Globulins." A second thought is that here is a little work that every general practitioner ought to send for and read. Not that the booklet is in any sense an argument for serum therapy. It is nothing of the kind. Indeed, the efficacy of the antitoxin treatment of diphtheria is no longer a debatable question, that method of procedure having long since attained the position of an established therapeutic measure. The pamphlet is noteworthy because of the timeliness of its appearance, the mass of useful information which it presents in comparatively limited compass, and the interest and freshness with which its author has been able to invest a subject that has been much writen about in the past dozen or fifteen years. Its tendency, one may as well admit, is to foster a preference for a particular brand of serum, but that fact lessens not one whit its value and authoritativeness. Here is a specimen paragraph, reprinted in this space not so much to show the scope and character of the offering as to emphasize its helpful tone and to point out the fact that its author was not actuated wholly by motives of commercialism: "Medical practitioners have learned that, inasmuch as the main problem presented in the treatment of diphtheria is the neutralization of a specific toxin, the true antitoxin cannot too soon be administered; moreover, that, antitoxin being a product of definite strength, a little too little of it may fail when a little more would have succeeded--hence larger or more frequently repeated doses are becoming more and more the rule. One more point: If the medical attendant is prompt, as he must be, and fearless, as he has a right to be, the full justification of his course will hinge upon the choice of the best and most reliable antidiphtheric serum to be had; for while there is little or no danger of harm ensuing from the use of any brand issued by a reputable house, the best results--which may mean recovery as the alternative of death--can only be hoped for from the use of the best serum." The brochure is from the press of Parke, Davis & Co., who will doubtless be pleased to send a copy to any physician upon receipt of a request addressed to them at their main offices, Detroit, Mich. ALCOHOLISM For neutralizing and overcoming the nervous and systemic sequelae of alcoholism, no remedy is so promptly effective as CELERINA One to two teaspoonfuls in water every two or three hours gives exceptional results, not only in "sobering up" a patient, but also in rapidly restoring nerve tone and general functional activity. Celerina is absolutely free from narcotics, consequently never induces a habit, and can be withdrawn as soon as it has accomplished its purpose. For further data address RIO CHEMICAL CO. 79 BARROW ST., NEW YORK Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xv Gastric Catarrh with its fermentation, nausea, pain, distress and other disagreeable symptoms, is rapidly and often permanently relieved by the use of Gray's Glycerine Tonic Comp. and this not infrequently when other remedies have proven unavailing. The reason is easily found in the general reconstructive and upbuilding influence of this effective tonic. In other words, it overcomes local conditions not only by directly promoting the functional activity of special organs and tissues, but also through substantially increasing general bodily vitality. Thus it is that the therapeutic effects from "Grays" are far reaching and permanent--not superficial and fleeting. THE PURDUE FREDERICK CO. 298 Broadway, New York Wall Plates Simplified In the McIntosh Type 12 Plate illustrated we have eliminated the complication present with other designs. With our new Dial Current Selector one turn of the knob selects any one of eleven bona-fide, distinct modalities indicated in plain lettering on the dial, preventing confusion. All currents excepting cautery controlled by the MacLagan Wire Rheostat with volt scale and may be interrupted with out practical Monomotive Rheotome operated by one motion. Other features are Cautery and Sinusoidal Transformer, large Faradic Coil and Double indicating Pole Changer. LOOK FOR THE NAME MCINTOSH THE TRADE MARK OF QUALITY Ask for our attractive booklet "Wall Plates Simplified," and special introductory offer on above. Get our complete 160 page illustrated catalogue of Wall Plates, Rectifiers, Vibrators, Transformers, Therapeutic Lamps, Electrodes, etc. McINTOSH BATTERY & OPTICAL CO. 227-229 Washington St., Chicago, Ill. CUT THIS COUPON OUT. McIntosh Battery & Optical Co., Chicago, Ill.: Gentlemen-- Kindly send me your free booklet "Wall Plates Simplified" and your special introductory offer on Type 12 Plate without obligation on my part. Also send me your complete catalogue No. 30-H. Name............................ Address.......................................................xvi THE WOMAN'S MEDICAL JOURNAL September, 1910 Hunyadi Janos Natural Laxative Water Does not produce the nausea common to mineral cathartics. Its action upon the liver is that of a true hepatic stimulant. On the intestine its action is that of a gentle saline hydragogue. Administered in doses of one-half glassful before breakfast. Bottled at the springs and always of staple composition. Clinical Results Prove Therapeutics and clinical results, reported by thousands of successful practitioners, demonstrate that Anasarcin (Oxydendron Arboreum, Sambucus Canadensis, and Urginea Scilla) Gives Relief in VALVULAR HEART TROUBLE ASCITES AND ANASARCA EXOPHTHALMIC GOITRE BRIGHT'S DISEASE CIRRHOSIS OF THE LIVER Use Anasarcin in any obstinate case and note results. Trial quantity and literature on request, to physicians only. THE ANASARCIN CHEMICAL CO. Winchester, Tenn. Messrs. Thos. Christy & Co., London Agents. ABBOTT'S TWIN SALINES Here are two effervescent salts that others have long patterned after. But they still remain the choice of the discerning doctor regardless of the substitutes repeatedly urged upon him. It is easy to say these things are just as good but mere adjectives count for little as against rigid comparisons. Both are appreciably better than the best the substitutor has ever been able to offer--in regularity of action and every other particular. The first (purified magnesium sulphate 60%) is unexcelled as an ejector of alimentary debris--the second (same with colchicine and lithium) as an expellant of uric acid. If you have not received samples we shall be pleased to send one or both just to convince you. THE ABBOTT ALKALOIDAL CO. NEW YORK TORONTO CHICAGO SEATTLE SAN FRANCISCO Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xvii WHEN PROPERLY ADMINISTERED as prescribed by the physician BORDEN'S EAGLE BRAND CONDENSED MILK HAS NO EQUAL FOR INFANT FEEDING. The individual requirements of every infant should be considered in preparing its food. Eagle Brand can be modified to suit almost any case. BORDEN'S CONDENSED MILK CO. "Leaders of Quality" Est. 1857 New York When everything fails in RHEUMATISM OR GOUT prescribe COLCHI-SAL Each capsule of 20 centigrams contains: 1/4 milligram (1-250 grain) of colchicine, 1/8 milligram active principle of cannabis indica dissolved in methyl salicylate from betula lenta, with appropriate adjuvants to ensure toleration by the stomach. Dose: From 8 to 16 capsules daily. Avoid substitutes for the original "little green capsules," by ordering original bottles of 50 or 100. E. FOUGERA & CO., New York Anglo-American Pharmaceutical Co., Ld. Croydon, London Leeming Miles Co., Ld., Montreal. L. Midy, 113 Faub'g St. Honore, Paris. Sample and Literature on Applicationxviii THE WOMAN'S MEDICAL JOURNAL September, 1910 Chicago Laboratory CLINICAL AND ANALYTICAL 126 STATE STREET CHICAGO, ILL. TELEPHONE 6239 CENERAL Ralph W. Webster, M. D., Ph. D. Director Chemical Department Thomas L. Dagg, M. D. Director Pathological Department C. Churchill Croy, M. D. Director Bacteriological Department Alys B. Croy, M. D. Assistant. WE MAKE Urine Analysis (Chemical and Microscope) for - $1.50 Tissue Examinations for - - - 5.00 Mother's Milk - - - - - - - 5.00 To preserve Urine, use Gum Camphor or Chloroform. To preserve Tissue, Formalin Solution or Alcohol. To preserve Milk, a drop of Formaldehyde. WRITE US FOR COMPLETE FEE LIST. Liquid SATYRIA Tablet The Ideal Genito-Urinary Tonic and Nerve Reconstituent A palatable combination of the active constituents of Muira-puama, Saw Palmetto, False Bitter Sweet, Phosphorus and Aromatics. Indicated in Prostatic Troubles, Cystitis, Urethritis, Sexual Debility and Impotency. DOSE--One teaspoonful or one tablet four times a day after meals. Full size bottle to physicians who will pay express charges. Satyria Chemical Co. ST. LOUIS, MO., U. S. A. Probilin Pills Obviate biliary infection and stagnation Reduce swelling and spasm of the gall-ducts Modify calculi and favor their expulsion. Arhovin Capsules Render the urine antibacterial, clear, acid Lessen gonorrheal difficulties (tenesmus) Diminish the occurrence of complications. Anusol Suppositories Relieve hemorrhoidal pain and congestion Exert a tonic action on inflamed mucosae Promote healing of the vascular structures. Literature from Schering & Glatz, New York. Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xix BOVININE IN ANEMIA OF CONVALESCENCE In convalescence from all diseases, either acute or chronic, medical or surgical, the danger of Anemia is ever imminent. Multitudes of foods and tonics have been presented to the medical profession to prevent the development of, or overcome this blood impoverishment, but most of them are inadequate. BOVININE being a nutritive tonic of highest standard, rich in organic iron, makes normal red blood, feeds the cells completely, and establishes normal cell metabolism, thereby assuring HEALTH. Write for Sample, also for one of our New Glass (sterilizable) Tongue Depressors. THE BOVININE COMPANY 75 West Houston St., New York City PRUNOIDS AN IDEAL PURGATIVE MINUS CATHARTIC INIQUITIES A real advance in the therapy of intestinal constipation. SENG A STIMULATOR OF DIGESTIVE PROCESSES Used alone or as a vehicle to augment and aid the natural functions of digestion. CACTINA PILLETS CEREUS GRANDIFLORUS IN ITS MOST EFFICIENT FORM A persuasive Heart Tonic to improve Cardiac nutrition. SAMPLES AND LITERATURE SENT TO PHYSICIANS. SULTAN DRUG CO., St. Louis. Send for Samples and Mention this Journal.xx THE WOMAN'S MEDICAL JOURNAL September, 1910 PEACOCK'S BROMIDES In Epilepsy and all cases demanding continued bromide treatment, its purity, uniformity and definite therapeutic action insures the maximum bromide results with the minimum danger of bromism or nausea. CHIONIA is a gentle but certain stimulant to the hepatic functions and overcomes suppressed biliary secretions. It is particularly indicated in the treatment of Biliousness, Jaundice, Constipation and all conditions caused by hepatic torpor. FREE SAMPLES AND LITERATURE TO THE PROFESSION, UPON REQUEST. PEACOCK CHEMICAL CO., St. Louis, Mo. PHARMACEUTICAL CHEMISTS IF THERE'S PAIN THAT'S ENOUGH THE ANTIKAMNIA CHEMICAL COMPANY - ST. LOUIS, U. S. A Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xxi CAMPHO-PHENIQUE LIQUID POWDER ACKNOWLEDGED PREMIER IN THE FIELD OF ANTISEPTICS FOR CASES OF MINOR AND MAJOR SURGERY THE SUPERIOR DRY DRESSING FOR CUTS BURNS ULCERS AND ALL SUPERFICIAL WOUNDS LIQUID IN 25c and $1.00 Containers. POWDER IN 1 oz. and 1 lb. Containers. For Samples and Literature address the CAMPHO-PHENIQUE CO., ST. LOUIS, MO. DAILY LIVING A Real Domestic Science COOK BOOK By Nellie E. Ewart Boston Cooking School Graduate, 1898 Points the Way to Judicious Buying, Choice Cooking, Proper Service and Correct Housekeeping, Introduces Food Principles and Marketing, and Furnishes Menus and Recipes for 365 Consecutive Days, With Suggestions for Invalid Cooking, Food for the Convalescent, Feeding of Children, Etc. PUBLISHED AND SOLD BY H. P. HOOD & SONS 494 Rutherford Ave., Boston, Mass. THE LARGEST INDEPENDENT DAIRY COMPANY IN NEW ENGLAND. Price, $1.50 Net. Sent Postpaid, $1.66. Also on sale at Book Stores and News Stands. Varicose Ulcers and Skin Diseases of an Inflammatory Nature respond to the scientific application of OXYNOLEUM The-original-oxygen-ointment. WHY? BECAUSE! First: It is antiseptic. Second: Relieves pain and irritation. Third: It liberates nascent oxygen. Fourth: It promotes capillary circulation. For any of the above Skin Diseases, apply OXYNOLEUM full strength; and in fresh BURNS and SCALDS, add equal parts of fresh petrolatum. We send literature and free samples to any physician desiring to prove the merits of OXYNOLEUM The-original-oxygen-ointment. BIOPLASM MANUFACTURING COMPANY 92 John St., New York, N. Y.xxii THE WOMAN'S MEDICAL JOURNAL September, 1910 OPEN LETTER No. 2. BALTIMORE, MD., U. S. A. Dear Doctor: We have at various times called your attention to Resinol products. These are skillfully made and scientifically compounded preparations. They possess medicinal qualities that are both unique and meritorious--so much so, that they have attracted the attention of medical men throughout the world, and are kept in stock by the Drug and Chemical Trade universally. There is no other article known that will allay the itching of Eczema and other eruptive skin diseases as will Resinol Ointment, and in treating this disease, in children especially, you must stop the itching or give up the case. Resinol Ointment is equally essential and effective for the relief and cure of Pruritus Ani, and if caused by incipient hemorrhoids will usually abort them. The efficacy of this remedy in this trouble alone has earned it world-wide fame and made it indeed a boon to humanity. Resinol Soap, containing in a modified form the same medication, should be used when bathing all cases. Its use for infants and children is most valuable as a prophylactic and hygienic measure. Its merit as a delightfully refreshing bath soap is recognized by discriminating persons of every nationality, especially those who appreciate a healthy Skin and complexion. Resinol Medicated Shaving Stick is also worthy of your attention and approval, and it also has had most flattering commendation from professional men. Its superior qualities are convincing, and, from a sanitary viewpoint, its utility obvious. Doctor, we hope for our mutual interests' sake that you have not ignored these preparations, and if you desire us to send you samples, we will be glad to do so on request. Thanking you in advance for the opportunity to serve you, we are, Yours very truly, RESINOL CHEMICAL CO. P. S.--In writing for samples, kindly mention this advertisement. Send for Samples and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xxiii SANMETTO FOR GENITO-URINARY DISEASES. A Scientific Blending of True Santal and Saw Palmetto with Soothing Demulcents in a Pleasant Aromatic Vehicle A Vitalizing Tonic to the Reproductive System. SPECIALLY VALUABLE IN PROSTATIC TROUBLES OF OLD MEN--IRRITABLE BLADDER, CYSTITIS--URETHRITIS--PRE-SENILITY. DOSE:--One Teaspoonful Four Times a Day. OD CHEM. CO., NEW YORK. Bleeding Hemorrhoids For the prompt and effective relief of the pain, distress and other symptoms characteristic of bleeding piles Kennedy's Pinus Canadensis--Light is of exceptional value. Applied on soft cotton or gauze pledgets in solutions varying from 25% to 30% in strength, the benefits are manifest from the first application. Bleeding is stopped at once, likewise itching and burning. In fact, in cases that are of not too long standing, it is not unusual to obtain results of surprising permanency. For further information, address: THE RIO CHEMICAL CO., 79 Barrow Street, New York NEURILLA FOR NERVE DISORDERS NEURILLA If Patient suffers from THE BLUES (Nerve Exhaustion), Nervous Insomnia, Nervous Headache, Irritability or General Nervousness, give four times a day one teaspoonful NEURILLA In nervous fretfulness of teething Children give five to twenty drops. DAD CHEMICAL COMPANY, NEW YORK AND PARIS. LEARN WIRELESS and R. R. TELEGRAPHY Shortage of fully 10,000 Operators on account of 8-hour law and extensive "wireless" developments. We operate under direct supervision of Telegraph Officials and positively place all students, when qualified. Write for catalogue. National Telegraph Inst., Cincinnati, Philadelphia, Memphis, Davenport, Ia., Columbia, S. C., Portland, Ore. Send for Samples and Mention this Journal.xxiv THE WOMAN'S MEDICAL JOURNAL September, 1910 THE "STORM" Binder and Abdominal Supporter PATENTED A Comfortable, Washable Supporter that Supports IS ADAPTED TO USE OF MEN, WOMEN, CHILDREN AND BABIES WOMAN'S BELT--FRONT VIEW The "Storm" Binder may be used as a SPECIAL support in cases of prolapsed kidney, stomach, colon and many forms of hernia, especially ventral and umbilical. As a GENERAL support in pregnancy, obesity and general relaxation; as a POST-OPERATIVE Binder after operation upon the kidney, stomach, bladder, appendix and pelvic organs, and after plastic operations and in conditions of irritable bladder to support the weight of the viscera. The use of the "Storm" Binder interferes in no way with the wearing of a corset. It is a comfortable belt for sofa or bed wear and athletic exercise. The invention which took the prize offered by the Managers of the Woman's Hospital of Philadelphia NO WHALEBONES LIGHT DURABLE FLEXIBLE NO RUBBER ELASTIC WASHABLE AS UNDERWEAR Prices Net Cash must accompany mail order P. O. Money Orders Preferred Mail Orders Filled Within Twenty-four Hours on Receipt of Price Illustrated folder giving styles and prices and partial list of physicians using "STORM" BINDER sent on request KATHERINE L. STORM, M. D 1612 DIAMOND STREET PHILADELPHIA MEN'S BELT--FRONT VIEW THE FIRST THOUGHT Haydens-Viburnum-Compound DYSMENORRHEA It relieves pain and is not a narcotic. MENORRHAGIA H. V. C. imparts tone to the uterus and its appendages and stimulates normal contraction. It is superior to Ergot without its attending dangers. OBSTETRICS H. V. C. relieves spasmodic contraction (Rigid Os), prevents miscarriage and dangerous flooding and by its calmative properties it overcomes restlessness and alarm. AMENORRHEA Whether from climatic changes or nervous condition, H. V. C. invariably afford relief. MENOPAUSE H. V. C. normalizes pelvic circulation and combined with its sedative action it assists in carrying woman over a most critical period. NOTE H. V. C. should always be administered in hot water. It is never marketed in tablet or pill form. All Such Are Substitutes. Formula, Literature and Samples upon Request. NEW YORK PHARMACEUTICAL COMPANY Bedford Springs, Bedford, Mass. HAYDEN'S URIC SOLVENT of inestimable value in Rheumatism, Gout and other conditions indicating an excess of Uric Acid. Send for Literature and Mention this Journal. Vol. XX, No. 9 THE WOMAN'S MEDICAL JOURNAL xxv Fellows' Syrup of Hypophosphites A faithfully prepared, long-tried, uniform preparation. Reject - Worthless substitutes. - Preparations "Just as Good." Send for Samples and Mention this Journal.xxvi THE WOMAN'S MEDICAL JOURNAL September, 1910 The Highest Type of Antitoxin THE MOST SATISFACTORY SYRINGE CONTAINER Antidiphtheric Serum (P. D. & Co.)- The favorite antitoxin of the medical profession for sixteen years. Antidiphtheric Globulins (P. D. & Co.)- Globulins of Antidiptheric Serum. More concentrated than the regular serum; smaller dose; same price. PARKE, DAVIS & CO.'S Antidiphtheric Serum and Globulins represent the latest and best methods of serum manufacture. Every precaution available to bacteriological science is taken to insure their purity, potency and uniformity. They are exactingly standardized, tested and retested. They are supplied in the latest improved piston-syringe container-- a syringe container embodying the highest degree of safety and convenience. 500, 1000, 2000, 3000, 4000 and 5000 units. We protect both physician and pharmacist against loss by accepting unused serum in exchange for fresh product. PARKE, DAVIS & COMPANY Laboratories: Detroit, Mich., U.S.A.; Walkerville, Ont.; Hounslow, Eng. Branches: New York, Chicago, St. Louis, Boston, Baltimore, New Orleans, Kansas City, Minneapolis, U.S.A.; London, Eng.; Montreal, Que.; Sydney, N.S.W.; St. Petersburg, Russia; Bombay, India; Tokio, Japan; Buenos Aires, Argentina. Send for Samples and Mention this Journal.In Memory of DR. ELIZABETH BLACKWELL AND DR. EMILY BLACKWELLIn Memory of DR. ELIZABETH BLACKWELL AND DR. EMILY BLACKWELL JANUARY TWENTY-FIFTH MDCCCCXI ACADEMY OF MEDICINE NEW YORKThe Knickerbocker Press, New York The Women's Medical Association of New York City Emily Lewi, M. D., President Augusta Vedin, M. D., First Vice-President Selina Bloom, M. D., Second Vice-President Isabel Macmillan, M. D., Corresponding Secretary Anna I. Von Sholly, M. D., Recording Secretary Alma Vedin, M. D., Treasurer Memorial Committee Elizabeth Mercelis, M. D., Chairman Ethel D. Brown, M. D., Secretary Mercy Baker, M. D. Helen Baldwin, M. D. Mary T. Bissell, M. D. Ethel D. Brown, M. D. Marie L. Chard, M. D. Emma B. Culbertson, M. D. Annie S. Daniel, M. D. Jessie S. Edwards, M. D. Evelyn Garrigue, M. D. Jane L. Greeley, M. D. Mary D. Hussey, M. D. Gertrude B. Kelly, M. D. Helen Kuhlmann, M. D. Emily Lewi, M. D. Sarah J. McNutt, M. D. Isabel Macmillan, M. D. Sarah R. Mead, M. D. Elizabeth Mercelis, M. D. Eliza M. Mosher, M. D. Grace Peckham-Murray, M. D. Lotta W. Myers, M. D. Angenette Parry, M. D. Martha J. Peebles, M. D. Jennie M. Richardson, M. D. Ethel Blackwell-Robinson, M. D. Mary Rushmore, M. D. Elizabeth M. Sturges, M. D. Eleanor Tomes, M. D. Alma Vedin, M. D. Mathilda K. Wallin, M. D. Anna Wilner, M. D. Anna Williams, M. D.Addresses Dr. William M. Polk Dr. Stephen Smith Miss Alice Stone Blackwell Mrs. Henry Villard Dr. William H. Welch Dr. Emma B. Culbertson Dr. Abraham Jacobi Dr. Gertrude B. KellyMusic Mlle. Ada Sassoli Harpist 1. Nordische Ballade .... Poenitz 2. a Gavotte .... Rameau b Impromptu Caprice .... Pierne c Marguerite au Rouet ) d Am Springbrunnen ) .... ZabelStephen Smith, A. M., M. D., LL. D. Introductory Remarks by the Chairman It gives us genuine happiness to welcome one who was a counsellor and friend in the early days of isolation, when such an attitude bespoke we know not what greatness of heart and breadth of vision,- Dr. Stephen Smith.A Women Student in a Medical CollegeA Woman Student in a Medical College Ladies and Gentlemen: My first course of lectures was at the Geneva Medical College, in the session 1847-48. This College was located at Geneva, New York, in a rural district, and was a continuation of the old Fairfield College. It is now the Medical Department of the Syracuse University. Its Faculty was largely constituted of reputable practitioners from the cities and at the session alluded to Prof. Frank H. Hamilton and Prof. Austin Flint, of Buffalo, gave courses of lectures. Being located in the country, the class of students was largely made up of the sons of farmers, tradesmen, and mechanics. A common saying among the people of that vicinity was,4 IN MEMORIAM that a boy who proved to be unfit for anything else must become a Doctor. And the "royal road" to a medical degree was made remarkably easy at that time. The full term of study was three years, and the fee was reduced to a minimum. Under these circumstances the class contained a large element of rude and uncouth country youths, whose love of "fun" far exceeded their love of learning. During the interval of lectures every form of athletic sport might be witnessed with occasional "fisticuff" exercises, which elicited ear- splitting shouts of the spectators. Nor did the excitement cease with the commencement of the lecture, but often continued through it to the great annoyance of those students who were attentive and studious. The rowdyism of the class may be realized when it is stated that the residents in the vicinity endeavored to have the College declared and treated as a public nuisance. One morning, early in the session, the Dean of the Faculty, an elderly, courtly, nervous IN MEMORIAM 5 gentleman, entered the class-room with a letter in his hand. He stated, with trembling voice, that the Faculty had received a very important communication from an eminent physician of Philadelphia, and he had been requested to lay the letter before the class and ask its serious and thoughtful consideration of the request which the writer made. A profound silence fell upon the class-room as he proceeded. The writer stated that he had a lady medical student who had attended a course of lectures in a college in Cincinnati; that he wished to have her attend one of the eastern city colleges and graduate, but that every one had refused her admittance; that he thought a country college like Geneva might not object to her entrance; that if refused admission she would be compelled to go to Edinburgh, Scotland, to graduate. The Dean remarked that the request was so unusual, and so vitally interested the members of the class, that the Faculty decided to submit the question of the admission of a woman student to its judgement, and had determined, that, if there6 IN MEMORIAM was one negative vote, the Faculty would deny the request. It was subsequently learned that the Faculty was unanimously opposed to the admission of a woman to the class, but did not care to take the responsibility of opposing the request of the eminent Philadelphia physician. Believing that the class would quite unanimously reject the proposal, the Faculty determined to place their denial upon the action of the students. To make the action of the class certainly negative they decided that a single vote against the request would enable the Faculty to refuse the admission. But the Faculty did not understand the tone and temper of the class. For a minute or two, after the departure of the Dean, there was a pause, then the ludicrousness of the situation seemed to seize the entire class, and a perfect Babel of talk, laughter, and cat-calls followed. Congratulations upon the new source of excitement were everywhere heard, and a demand was made for a class meeting to take action on the Faculty's communication. IN MEMORIAM 7 A meeting was accordingly called for the evening, and a more uproarious scene can scarcely be imagined. Fulsome speeches were made in favour of admitting women to all the rights and privileges of the profession, which were cheered to the echo. At length the question was put to vote, and the whole class arose and voted "Aye" with waving of handkerchiefs, throwing up of hats, and all manner of vocal demonstrations. When the tumult had subsided, the chairman called for the negative vote, in a perfectly perfunctory way, when a faint "Nay" was heard in a remote corner of the room. At the instant the class arose as one man and rushed to the corner from which the voice proceeded. Amid screams of "cuff him," "crack his skull," "throw him down stairs," a young man was dragged to the platform screaming, "Aye," "Aye," "I vote 'Aye.' " A unanimous vote in favor of the woman student had thus been obtained by the class, and the Faculty was notified of the result. A fortnight or more had passed, and the in-8 In MEMORIAM cident of the admission of the woman student had ceased to interest any one, when one morning the Dean came into the class-room, evidently in a state of unusual agitation. The class took the alarm, fearing some great calamity was about to befall the College, possibly its closure under the decree of the court that it was a public nuisance. He stated, with trembling voice, that in accordance with the vote of the class the Faculty had informed the Philadelphia physician that his female student would be admitted to the College, and that she had arrived. With this introduction, he opened the door to the reception room and a lady, on his invitation, entered, whom he formally introduced as Miss Elizabeth Blackwell. She was plainly but neatly dressed in Quaker style, and carried the usual note-book o f the medical student. A hush fell upon the class as if each member had been stricken with paralysis. A death-like stillness prevailed during the lecture, and only the newly arrived student took notes. She retired with the Professor, and thereafter came IN MEMORIAM 9 in with him and sat on the platform during the lecture. It is quite impossible to magnify the power of the personality of Miss Blackwell over the lawless elements of that class. Though there were the same disorder and disturbance in her absence, as before her admission, yet the moment that she entered upon the platform the most perfect order and quiet prevailed until the door closed behind her. This influence of her presence continued unabated during the entire session. Many of the older students stated that this was the first course of lectures in that College during which they were able to take full notes. The climax came when the Professor of Anatomy reached, in his course, the organs of reproduction. He was a rollicking, jovial, fun-loving man, who seasoned his lectures plentifully with anecdotes, nor was he very choice in the use of his language. The part of his course which he was now approaching was especially adapted to illustration by vulgar stories, and hence was looked forward to with great relish by the reckless members of the class.10 IN MEMORIAM One day he came into the lecture room without his usual companion- the female student. His flushed face and excited manner betrayed great nervous tension. After a few minutes' hesitation, he recovered himself sufficiently to state that he had a very novel situation to deal with which would involve the interests of the class to such an extent that he thought they should be apprised of all of the circumstances. Believing that the presence of a woman during the lectures on the reproductive organs would be very embarrassing to him and the class as he would be obliged to be restricted in his language and illustrations, and many students would have their natural modesty strained, he had written Miss Blackwell a note, urging these objections to her attendance, and assuring her that if she would consent to withdraw from these lectures she should have every necessary opportunity to study these organs. The Professor then read Miss Blackwell's reply; which was, in substance, that she had entered the College in good faith as a medical student, and IN MEMORIAM 11 had paid the required fee; that she was bound to have all the rights and privileges accorded to other students; that if the presence of a woman's bonnet on the platform embarrassed him she would take her seat on an upper tier of benches and remove her headdress; finally that it was a great mystery to her that a profound student of science, and especially a teacher of the wonderful mechanism of the human body, could have his mind diverted from a subject so absorbingly interesting, by the mere presence of a student in a woman's dress. The Professor expressed his keen sense of humiliation by this rebuke, and in eloquent terms declared Miss Blackwell a student of the type of Galen, who said, "The study of anatomy is a perpetual hymn to the gods"; that he was profoundly impressed with her good influence upon the class; and that the noble stand which she had now taken in the assertion of her rights as an ordinary pupil of the College entitled her to every privilege and honor which the Faculty and the class could confer.12 IN MEMORIAM The Professor then opened the door and, on entering upon the platform, Miss Blackwell received an ovation from the Professor and the class which startled the neighborhood for blocks around. The course of lectures from which she was to be excluded then proceeded in a most orderly manner to its conclusion. The Professor adhered closely to his text throughout, without having occasion to amuse the class with his usual vulgar anecdotes, and the class on its part observed the most perfect decorum. The older students declared that this was the first course of lectures on that subject, by the Professor, that they had ever been able to follow connectedly, and the Professor himself acknowledged that this was the first course in which her was thoroughly interested. Miss Blackwell graduated at the head of the class and was pronounced by the Faculty one of the best all-around graduates of that session of the College. This personal experience of the moral influence of a most unpretentious woman, upon a IN MEMORIAM 13 class of untrained and undisciplined young men, determined affirmatively, in my own mind, more than threescore years ago, the question of the propriety of the co-education of the sexes even in medical colleges. Subsequent experience in the clinics of Bellevue Hospital which were attended by the students were admitted, confirmed my early experience. The promiscuous class of cases which are brought into these clinics, male and female, and the necessary exposure of the patients in operative procedures, afforded the highest possible test of the proprieties of the occasion. There was never an instance in my observations when the women students present were treated rudely, but, on the contrary, their presence always prevented any cheering, jeering, or unseemly behavior. As an abstract proposition the co-medical education of the sexes would naturally be decided in the negative. It has been so deiced many times in this country and abroad by prominent medical educators who have had no experience. When put to a practical test, the14 IN MEMORIAM anticipated improprieties have not occurred. On one occasion a surgeon, who was greatly annoyed by the presence of women medical students at his hospital clinics, determined to drive them away by a lecture which required an indecent exposure of several male patients selected for that purpose. The result was a most ludicrous exhibition of his own embarrassment which was aggravated by the perfect propriety of the conduct of the class, and its failure to respond to the vulgar anecdotes with which he seasoned his lecture. The professional career of Dr. Elizabeth Blackwell was distinguished by intense devotion to the interests of the medical education of women in this country and England, and in works of charity. Her recent death at the advanced age of ninety years closed a life of remarkable usefulness, and the power with which that usefulness was applied was her medical education. The crowning feature of that life was the demonstration of the value of woman's influence upon men in the co-education of the sexes in medicine, and the wisdom of IN MEMORIAM 15 the fiat of the Council of Creation, "It is not good that the man should be alone." Dr. Emily Blackwell had a more limited field of work, but in that field she attained conspicuous success. The "Infirmary for Women," which was a hospital and school for the medical education for women, took rank with the best medical schools in this country, as regards the thoroughness of the methods of instruction. For upwards of a score of years I was one of the Committee of Examiners of the graduating classes, and was at the same time a professor in another college where only men were admitted. As to the qualifications of the two classes, both technical and practical, the graduating classes of the women's school generally averaged the highest. I may add that the best-qualified medical graduate whom I ever examined was a young Chinese woman educated in this school. The high average was due to the plan of teaching, with a graded course, which rigidly enforced the rule not to advance a delinquent student until she had attained the full require-16 IN MEMORIAM ments of qualification in her several studies. Scarcely a college at that time had adopted a standard of preliminary education before admission to its classes, nor had graded its curriculum of studies so that the student advanced from stage to stage throughout the course. The method of teaching at the Infirmary was largely by class recitations rather than by lectures- the old and practically worthless system of imparting instruction. In class recitations the teacher is constantly brought into immediate personal relations with the pupil, and he is thus able to adapt his teaching to the peculiar mental condition of the student. In the lecture system the student is kept at arm's length from the professor who, personally, knows nothing of his qualifications for learning, nor of his difficulties, nor of his progress. It is in some measure due to the example and success of the school of the Drs. Blackwell that the system of teaching medicine in this country is changing from the lecture to the recitation, from theoretical studies to practical work in laboratories, in hospitals, and clinics. The IN MEMORIAM 17 modern student of medicine is to be congratulated on the passing of the ancient professor, in evening dress, with well conned manuscript, from which he rarely raised his gold-rimmed spectacles, and the appearance in his place of the instructor, clad in his dissecting-room or laboratory suit, and whose hearty hand-grasp assures the student that he is to be co-laborer with his teacher in the fields of science. The recitation plan of teaching where teacher and pupil mutually question each other finds its justification in the maxim of Bacon, "He that questioneth much learneth much." Comparing the results of the life-work of Drs. Elizabeth and Emily Blackwell with that of contemporary medical men, we are justified in the assertion that they had no peers. The institutions which they established and so unostentatiously conducted have had the effect of elevating women to positions in civilized society for which they have always been peculiarly adapted. But they have heretofore required the necessary educational qualifications. Already the best managed general hospitals are18 In Memoriam entirely under the control and management of women. The most successfully conducted reformatories in this and other States are conducted by women. The law of this State provides that there shall be at least one woman medical graduate on the medical staff of every State Hospital for the Insane. This reform has been long needed and is of the utmost importance to the women inmates. It is impossible to foretell, even with the lips of an inspired prophet, the vast influence of the services of these sisters in founding, and personally managing, institutions for the medical education of women. Not only has our own country been greatly benefited by this training of women to manage public and private institutions of a charitable character, but England and the continental states are being agitated by this great reform movement. Even in Oriental countries medical women are exerting an unobtrusive but powerful influence which had already attracted the attention of the shrewd and observing statesman, Li Hung Chang. When in this country he was asked what he most In Memoriam 19 feared from Western nations. He replied, "I do not fear your armies, nor your navies, nor your diplomacy, but I do fear your medical women." His wife had been sick and the Chinese physicians had failed to cure her. A medical woman missionary was called who effected such a prompt cure that she won the confidence of her patient and a large Court circle. However the institutions immediately established by the Drs. Blackwell may be affected by the mutations of time, and change of conditions, their services will forever find an abiding place in the hearts of their graduates, and a living memorial in the labors of those who are called to build upon the foundations which they laid with so much care, skill, and sacrifice. "When all is done, human life is at the greatest and the best."Miss Alice Stone BlackwellMiss Alice Stone Blackwell Introductory Remarks by the Chairman We are very fortunate to have with us this evening a kinswoman who is entitled to speak more intimately of those whom we have met to honor and whose kinship with a wide circle of those whom all women honor, gives her presence here a deep significance, Miss Alice Stone Blackwell, of Boston. Miss Blackwell: When Dr. Smith spoke of the quieting effect that the presence of the young woman medical student had upon the class, I could well believe it, for my Aunt Elizabeth was one of the most awe-inspiring persons--at least, to my childish eyes--that I have ever known. When I was about ten years old my Aunts Elizabeth and Emily took care of me for one winter, when my parents were absent, and I remember how I trembled with awe before that very kind and harmless lady, Dr. Elizabeth. 2324 In Memoriam I was not quite so much afraid of Dr. Emily— she used to give me chocolate drops. When Dr. Elizabeth made her last visit to the United States, only two years before her death, a young woman who had heard a great deal about her expressed surprise to find that she was a little lady; she had always had the impression that she must be tall. Dr. Elizabeth’s adopted daughter said, "I assure you that there are occasions when she can look at least six feet high !" It is impossible in the few minutes at my command to speak at all fully of the characteristics of those two remarkable women. It has been said that "no man is a hero to his valet," but Dr. Elizabeth was quite as much of a heroine to her maid-servants as to the outside world. They were convinced that she was abundantly worthy of any honor that could come to her. Intimate acquaintance with really noble persons increases respect rather than takes it away. There were two very marked characteristics in both of my aunts—their courage and their kindness. Besides being women of high purpose, In Memoriam 25 public spirited, upright, and honorable, they had very kind hearts. There were five sisters in the family, none of whom married, and they took, among them, five children to bring up. Aunt Elizabeth was the first to do this. During the early years of her medical studies in New York, when she was ostracized socially, and was often very lonely, she thought a little girl would be company and a comfort to her. She went with one of her sisters to the Orphan Asylum, and looked over the orphans. There were pretty children and healthy children among the forlorn group. But there was one suffering with weak ankles and weak eyes. Aunt Elizabeth's medical eye was attracted by this child, and she thought how much she could do to help her if she had her under her own care. She went around looking at the different children, but always came back to that one. "O Elizabeth," said her sister, "you don’t want to take such a child as that!" but she replied, "This child needs me more than any of the others." It was a most fortunate choice for her own happiness, for the little Irish girl26 In Memoriam proved to have great intelligence, and a heart of gold. She almost worshipped her adopted mother, and devoted her whole life to her. During those last sad years, when Dr. Elizabeth’s strong health was gradually failing, leaving her in time completely helpless, the best of daughters could not have done more. She waited upon her by inches, and, as some one said, "fitted herself into all Dr. Elizabeth’s angles like an eiderdown quilt." Both the sisters were shy and reserved, and that characteristic was intensified by the social ostracism of their early years. Dr. Emily told me she knew that in most places she was not wanted, and so she withdrew more and more into herself. But any one who ever saw her with her adopted daughter, and especially with that daughter’s children, whom Aunt Emily always regarded as her grandchildren, would have been able to see what a warm and loving heart she had. Her adopted daughter had four beautiful, fair-haired little boys, and it was a pretty sight to see the grandmother among them. Many people were afraid of her, but In Memoriam 27 those children never were afraid. They clustered around her like bees around a flower, and their faces lit up whenever she came into the room—as hers did when she saw them. It was a pleasure to see her playing with them ; and the very last smile that she gave in this world was when she heard the voice of the youngest. She had been taken ill some days before, with an illness that had made her very weak. Her adopted daughter hastened to her, and took along the youngest child. They were in the next room, and the child cried. Dr. Emily asked, "Is that Nannie’s baby ?" Dr. Cushier answered, "Yes" adding, "it is a nice, fat little thing," and the words brought the last smile to Dr. Emily’s face. The great comfort that both received from their adopted daughters was an abundant recompense for the kindness they had shown to the little fatherless and motherless children. Their kindness came out in many ways. I think every one who needed it experienced it, and the people who needed it most were apt to get the most of it. 28 In Memoriam Then a word ought to be said about their courage. The young women of to-day cannot realize what courage it took to do what they did. Many of you have heard about the experiences of their early years, so I will not go over the hard times they went through when Aunt Elizabeth was studying at Geneva, N. Y., when women at her boarding-house would not speak to her, and women passing her on the street held their skirts aside. Dr. Emily had similar experiences. When they began to practise their profession, they almost starved to death because people would not employ a woman physician. Dr. Elizabeth was compelled to buy a house, because no respectable boarding-house in New York City would take in a woman doctor. It was not only the actual proscription, but the great social disapprobation which made the struggle of the early woman physician so hard. During the last summer of her life, I asked Dr. Emily to glance over Miss Ida M. Tarbell’s History of the American Woman, which was coming out in the American Magazine. Miss In Memoriam 29 Tarbell had expressed the idea that the position of women was not quite so hard in the early days as the speakers at woman’s rights’ conventions depicted it. Aunt Emily said, "No woman whose memory does not run back sixty years can realize what an iron wall hedged in every young woman who wanted to do anything outside of the most absolutely conventional groove—any girl who wanted to support herself, to earn money, to be educated, to do any one of a hundred things which would now be an everyday matter, but then were considered altogether improper. A woman who attempted anything of that kind was simply crushed, if she had not a very strong character; and those whose characters were such that they could not be crushed without a struggle, simply had to break a way through that iron wall for themselves and for those who followed.” That courage came out in many other ways. Dr. Elizabeth stood for many reforms. She was a strong opponent of compulsory vaccination, and of the abuses of vivisection, and both the sisters were strong opponents of the state 30 In Memoriam regulation of vice. Dr. Emily was, for years, a member of the little Vigilance Committee of physicians and others who successfully headed off the many attempts made after the Civil War to introduce the European system of state regulated vice in New York. As New York’s leading medical woman, she was early called upon to help resist these efforts. At first she shrank from touching the matter; but when she had studied into the results of the system abroad, and realized, as she said, "what a hideous thing it was," she felt it her duty to join the fight against it. She knew that this would bring additional criticism upon the struggling Infirmary. She notified the Trustees of her intention. They were disturbed and doubtful, but one of them, a fine, sturdy old Quaker, said, "Thee do what thy conscience bids thee." She found it very hard to do ; but she had one of Cromwell’s Ironsides among her ancestors, and she told me that perhaps a little of his spirit came to her aid in this matter. There is a great difference in people who seem outwardly very much alike. Perhaps In Memoriam 31 some of you may be familiar with Milton Hill, near Boston. The road runs along between houses set in beautiful grounds and gardens. But the houses on one side of the street, while their immediate surroundings are just as lovely, have no outlook. The houses on the other side command a wide and wonderful view over the Neponset River and its valley, and away to the sea beyond. There is that difference between people who are equally kind and amiable and pleasant to meet; some of them have a wide outlook, others a narrow one, or none at all. My aunts—and I speak especially of Dr. Emily, because Dr. Elizabeth spent the last forty years of her life abroad and I was not so well acquainted with her—Aunt Emily had a broad outlook, not only over problems and events of present and past times, but along many different lines of thought. Whatever subject was touched upon, she knew about it, and took an intelligent interest in it. Both she and Aunt Elizabeth had great public spirit, and a strong sense of public duty.32 In Memoriam Aunt Emily was the most delightful traveling companion imaginable. Once it was my good fortune to accompany her on a trip to Europe. Wherever we went she was better than all the guide-books; she knew all the points of interest; she could tell you the ancient and modern history of every city we visited, in such a way as to make the old things live again. It was a liberal education to have known and to have loved her. Another trait of Dr. Emily was her modesty. With all the reason she might have had for self-conceit, she was absolutely free from it, unpretending and unaffected. About a year ago, she attended the funeral of my father, her brother, and we were speaking together afterwards of the beautiful address that had been made by Dr. Borden P. Bowne, who conducted the service. I said to her, "When you leave us, who will be the person to make the memorial address for you?" She answered, "There is absolutely no one." And look at the speakers on this platform, and at this meeting! Mrs. Henry Villard 33Mrs. Henry Villard. Introductory Remarks by the Chairman. It is a privilege for us to have with us to-night one who for many years has been identified with the best civic life of our city and who, among manifold activities, gave her time and interest to the Woman's Infirmary, Mrs. Villard, of the Board of Trustees. Mrs Villard: I owe the privilege that is mine to-night of being permitted to add my tribute of affection and admiration for Dr. Emily Blackwell, her sister, and their associates, to the fact that, for over thirty years, I have been a member of the Board of Managers of the New York Infirmary for Women and Children. Looking over the file of the Liberator, Mr. Garrison's paper, recently, I accidentally discovered, in the issue of November 7, 1856, the following notice, which at once attracted my attention. 3536 IN MEMORIAM "The co-operation of all friends of female Medical Education is earnestly invited to an effort which is now being made in New York for the establishment of a practical School of Medicine. "The great want which is felt at the present time by women who want to follow the profession of medicine, is the opportunity of studying by the bedside of the sick, for the hospitals are all closed to them, and yet hospital instruction is as indispensable to the student of medicine as the musical instrument to the musician. "To meet this want a number of ladies are engaged in collecting funds for the establishment of a Hospital for Women and Children, to be organized by Dr. Elizabeth Blackwell, Dr. Marie Zakzrewska, and other physicians. This hospital, while it furnishes an opportunity for the thorough training of medical students, is designed to meet another want, not supplied by hospitals, viz., an earnest religious influence on the patients. The principle on which it will be founded is that of a Christian charity for the IN MEMORIAM 37 sick poor. Scientific instruction will always be subordinate to the welfare of the patient; each individual, no matter how degraded, being regarded as a human soul, as well as body. The instrument mainly relied on to influence the patients will be a body of trained nurses, free from sectarian prejudices, but imbued with those great principles of truth which form a Christian life. "Private rooms will be reserved in the institu- tion, where ladies of limited means may be admitted for a very moderate charge. Such provision is much needed by a multitude o refined women who are suffering for the want of medical aid which they are unable to pay for. "Private rooms will be reserved in the institution, where ladies of limited means may be admitted for a very moderate charge. Such provision is much needed by a multitude of refined women who are suffering for the want of medical aid which they are unable to pay for. "New York is chosen as the seat of this institution, because it presents peculiar advantages to the organization of a fine hospital, and regarding it as the great medical centre for women, it is hoped that all parts of the country will aid in founding and supporting an institution, whose benefits will be shared by all. "The sum of $5000. will be sufficient to carry on a hospital of 40 beds for one year; at the38 IN MEMORIAM end of that time it is believed that its value will be so clearly proved as to command continued support. All friends of the movement are urgently called on to aid in the collection of the amount needed for this practical trial. "Donations in money may be sent to the following friends of the enterprise : Mrs. Pendleton, 4 W. 22d St., N. Y. City. Miss Emily Howland, 78-10th St., N.Y.City. Dr. Elizabeth Blackwell, 79 E. 15th St., N. Y. City. Stacy B. Collins, Esq., 155 Bleecker St., N. Y. City. Robert Haydock, Esq., 46 Broadway, N. Y- City. Merritt Trimble, Esq., 86 Broad St., N. Y, City. Miss Catherine M. Sedgwick, Lenox, Mass. Dr. William Elder, Philadelphia. George Willey, Esq., Cleveland, Ohio. James R. Lyle, Esq., Cincinnati, Ohio. New York, October 2, 1856.” No doubt there are many people here to-night who fully realize what difficulties had to be IN MEMORIAM 39 overcome by the brave women who determined to establish this Infirmary for the protection of women and children, and for the purpose of affording women the opportunity of acquiring a medical training which at that time was wholly denied them. Still, as a Boston-born woman brought up in the midst of the anti-slavery struggle, which early became of necessity closely affiliated with the movement to secure for women their human rights, it seems to me that my appreciation of the heroism indispensable to success in this great work is of a peculiar kind. For this generation, not even a close study of conditions of that far-away time can convey a vivid idea of the disabilities under which women labored who ran counter to public sentiment, and to such an unheard of degree as to demand the right to qualify themselves for the medical profession. To stem the tide of ridicule and opprobrium, unusual qualities of mind and heart were needed, and great powers of endurance. But what more fortunate training could Dr. Elizabeth Blackwell and Dr. Emily Blackwell have had to40 IN MEMORIAM admirably equip them for the trials in store for them than that gained in the anti-slavery movement? Together with their brother, Henry B. Blackwell, they espoused the cause of the poor slaves with single-hearted devotion, possessed, too, of that martyr-spirit so characteristic of the faithful band of abolitionists. Tried and steeled in such a school, what wonder that these exceptional women, unusually gifted mentally, and full to overflowing with tender sympathies for the sufferings of others, unhesitatingly allied themselves with the advocates of that much derided Woman’s Rights Movement, by means of which marvellous changes have been wrought in the condition of women, and which to-day, under another name, is destined by the invincible might of justice and right to still further uplift them in time to come. As compensation for such wordly sacrifices as the two sisters made, they rejoiced in the possession of that inward peace and true joy which accompanies a readiness and willingness to suffer for conscience' sake—undreamed of by those who have never had a similar experience. IN MEMORIAM 41 Thus it was of momentous importance to women—and what affects the welfare of women affects that of men—when Elizabeth Blackwell and Marie Zakzrewska, surmounting all obstacles in their path, established the New York Infirmary for Women and Children, Emily Blackwell soon uniting with them in this pioneer work. They brought to this great task a spirit of self-sacrifice and courage as noble as rare, and a medical knowledge and skill obtained under difficulties that might well have intimi- dated even the bravest of women. As Dr. Zakzrewska went to Boston in 1859—finally succeeding in establishing there the New England Hospital for Women and Children the work of the Infirmary was carried on by the two sisters, Dr. Elizabeth and Dr. Emily Blackwell, wonderfully supported by the able cooperation of Dr. Mary Putnam Jacobi, Dr. Elizabeth Cushier, and others. Dr. Elizabeth Blackwell left the Infirmary in 1869, continuing the practice of her profession thereafter on English soil. It ought never to be forgotten when we42 IN MEMORIAM honor the two sisters Blackwell, that they held a private meeting in their own rooms, at the beginning of the Civil War, for the purpose of determining in what way trained nurses could be provided for the soldiers. A notice of the meeting in the N. Y. Times resulted in a large attendance, and this was the beginning of that remarkable organization, the National Sanitary Aid Association, which did such wonderful work for the relief of our soldiers during the war. It was my good fortune to be elected to the Infirmary Board on November 12, 1880, and I was at once made a member of the Executive Committee. Mr. Samuel Willets was then President, Mr. Lucius Tuckerman, Vice-President, Mr. Jonathan T. Willets, Treasurer, and Robert Haydock, Secretary. My fellow members were excellent women, deeply in earnest, a number of them being Quakers. To this day the Quaker spirit of peace and good-will seems to pervade the meetings of the Board, and I doubt if on any Board men and women have ever shown more consideration for the opinions IN MEMORIAM 43 of others or worked in greater harmony. If time would permit, I would gladly linger over the long list of names of women members, and call attention to each one of them. I cannot fail, however, to speak of the devoted service given to the Infirmary by Mrs. Robert Haydock, especially during the ten years in which her husband filled the office of President. They were eminently conspicuous for the impetus which they gave to the work of the Infirmary, and they were ably assisted by Mrs. Thomas Hicks, Mrs. D. M. Stimson, Miss M. Collins, Miss Rachel Kennedy, Miss Grace H. Dodge, Mrs. Lucius Tuckerman, Mrs. George Haven Putnam, Mrs. O. N. Rood, Dr. Emily Anthon, Mrs. J. F. Wood, Miss Julia Gilman, Mrs. J. J. Carle, Mrs. M. G. Corbin, and others. On February 11th, 1881, Miss Julia B. de Forest was elected to the Board, but it was not given to us then to imagine what untiring devotion and remarkable initiative she was to so freely give to the furtherance of the needs and aims of the Infirmary. It goes without saying that the sinews of war must be furnished—44 IN MEMORIAM even when the warfare carried on is of that exalted kind which battles with disease and untimely death—and which strains every nerve to prevent the causes of human ills. It is safe to say that to Miss de Forest’s vigorous pleading for funds with which to meet the growing needs of the Infirmary we are largely indebted for the brilliant and successful accomplishment of humane endeavor that crowned her efforts and those of her associates. She had not only the generous co-operation of Mrs. Louis C. Tiffany, who, with members of her family, was ever ready to help enlarge the scope of usefulness of the Infirmary, but she was also able to awaken the interest of a large number of philanthropic men and women in this work, which to her was one of supreme importance, and for this alone she will ever be gratefully remembered. Dr. Emily Blackwell was for a long time one of the Board of Managers of the Infirmary, acting as such in a lay capacity which was greatly appreciated. Her advice and suggestions were sure to be admirable, and her quiet IN MEMORIAM 45 yet forceful personality gave weight to her every utterance. She is distinguished for having established a Chair of Hygiene, the first one to be found in any college. Ever in advance in all matters pertaining to the physical and moral regeneration of women and children, she early recognized the need of a broader outlook than that found in mere office practice, and the need for preventive, as well as curative, work was clearly impressed upon her thoughtful mind. It is to-day the keynote of our Social Service, which in another generation is destined to lift us out of the slough of despond and rescue the victims of untoward and cruel circumstances by means of something finer and nobler than mere charity— by persistent education as to the causes of evil conditions and untiring efforts for their overthrow. No one, I know, can really believe that this can be accomplished by men alone, however earnest their efforts to this end may be. Women, the sufferers most to be pitied of all, must act together with men to save not only women, but the human race itself, which is 46 In Memoriam necessarily dependent upon the status of its mothers. We but discharge a heavy obligation resting on us when we gather together to do honor to Dr. Emily Blackwell and that advance-guard who have so diminished the sum of human misery, and made it possible for women to obtain a medical training equal to that of men. If much still remains to be accomplished, we can look confidently to the future, sure of success if animated by that forgetfulness of self and love of humanity exemplified in the noble lives of Dr. Elizabeth and Dr. Emily Blackwell, Dr. Mary Putnam Jacobi, Julia B. de Forest, and their disinterested, whole-souled co-workers. Dr. William H. Welch. 47Dr. William H. Welch. Introductory Remarks by the Chairman. We are honored in having with us one who was fully cognizant of the part that Dr. Blackwell took in the early struggle to advance the standard of medical education for women,- the former Dean of Johns Hopkins Medical School,- that institution which gives what Dr. Blackwell always fondly hoped for, equal training to the undergraduate, and equal opportunity to the graduate men and women students -Dr. Welch. Dr Welch: I esteem it a great privilege to come here and to be permitted to pay my tribute to the lives and work of the Drs. Elizabeth and Emily Blackwell. Their lives and work have been of great historical significance, how great we hardly realize to-day to the full extent. The entrance of women into the profession of medicine is an event of importance, not only to the medical profession, 4950 IN MEMORIAM but to humanity and to society, and it will always have a place in human history, and whenever that history is written it will begin with the name of Dr. Elizabeth Blackwell, and the year made memorable will be the year 1849, when she received her degree of Doctor of Medicine. It is true, there will be an introductory chapter, because there have been women doctors, and women who have practised the profession of medicine without a degree from the earliest days. That is a curious bit of history in medical annals. In the Greek period we read of Agnodice and of other female physicians. The 13th and 14th centuries, were remarkable for the number of women who both practised and taught medicine. In the 18th century there were at least four or five women in Germany and France who received the degree of Doctor of Medicine. But these were isolated cases; they could not be said, in any sense of the word, to have opened the profession of medicine to women. That opening was accomplished by the work of Dr. Elizabeth IN MEMORIAM 51 Blackwell and her sister, and others who labored with them later. It is also of not a little interest that this entrance to the profession of medicine marked the opening of a larger sphere of interest and of work to women in general. It is somewhat curious that the entrance upon the practice of medicine should have been the first event in what is spoken of as the "woman’s movement,” for the movement for the higher education of women, and various other movements of a kindred character were subsequent to this. Therefore in a broad sense the work of Dr. Elizabeth Blackwell was pioneer work. If it had stopped there, it would have had historical significance. But not all pioneers have remained leaders, and it is remarkable that she was not only the pioneer, but, with her sister, also the leader for over fifty years in this very important movement. Everything, therefore, which relates to the beginnings of things which have become thus important, is certainly of the greatest interest. It is interesting, of course, to inquire what the particular circumstances which led52 IN MEMORIAM Miss Blackwell to study medicine; what were the circumstances of her environment, of her early life, which directed her in this path. She came of an ancestry remarkable for independence of thought, for ability, and for liberality with, perhaps, a tinge of radicalism. She had an excellent early education, far better than that of the great majority of young men who then entered upon the study of medicine. She only had to supplement her classical training by some reading of Greek before she entered upon the study of medicine. She lived in Cincinnati, a pioneer Western town, at this period, where there was a very interesting and vigorous life—where there were men and women who were thinking new thoughts—where new ideas were stirring. The environment, I think, was favorable, and when you remember that the year was 1848—or about that—and recall what the year signified in this country and in Europe—what the Germans call "the spirit of the times," —it is altogether a combination of circumstances of very great interest. Also of much interest is the consideration of IN MEMORIAM 53 the motive which led her to study medicine. It has been a matter of some discussion. Dr. Chadwick of Boston, in an interesting paper on “Women in Medicine,” has taken the position that women entered upon the study of medicine simply to meet a kind of sentimental need—not that they had any peculiar fitness; no doubt, they thought women felt the need of women doctors from motives of delicacy, fastidiousness, modesty,—and it was to supply this need that women were drawn into studying medicine. But it is a mistake to suppose that that was the sole or even the controlling reason for the entrance of Dr. Elizabeth Blackwell upon the study of medicine. It seems to me of sufficient interest, and I have extracted a few passages from her admirable autobiography called Pioneer Work in Opening the Profession of Medicine to VVomen. One regrets that it is so brief in relation to certain periods of her life, and the very first mention of her intention is in these words : I soon felt the want of a more engrossing pursuit than the study of music, German, and meta- 54 In Memoriam physics, and the ordinary interests that social life presented." That was the reason- she wanted a larger life. She wanted to escape from the trammels which bound women in those days. It was not to meet merely a sentimental need, such as that suggested by Dr. Chadwick, which led her to enter on the study of medicine. As regards the question of propriety, she has this to say: "It was at this time that the suggestion of studying medicine was first presented to me by a lady friend. This friend finally died of a painful disease, the delicate nature of which made the methods of treatment a constant suffering to her. She once said to me: 'You are fond of study, have health and leisure, why not study medicine? If I could have been treated by a lady doctor, my worst sufferings would have spared me.' But I at once repudiated the suggestion as an impossible one, saying that I hated everything connected with the body, and could not bear the sight of a medical book." She goes on to say that her favorite studies "were history and metaphysics, and the very thought of dwelling on the physical structure of the body, with its various ailments, filled me In Memoriam 55 with disgust." That is, of course, a familiar enough experience. It is a popular delusion that a repugnance, such as she had, is in any sense whatever an obstacle to the study of medicine, or that the possession of an opposite character represents any peculiar adaptability to the study of medicine. Then later she became very much interested in the opportunity open to medical women to accomplish certain social and moral reforms. These motives, however, were not conspicuous, at least at the beginning, and I do not think they are to be reckoned as the determining ones leading her to the choice of the profession of medicine. But there is one other motive which I find is expressed in these terms: "Other circumstances forced upon me the necessity of devoting myself to some absorbing occupation. I became impatient of the disturbing influence exercised by the other sex. I had always been extremely susceptible to this influence. I never remember the time from my first adoration, at seven years old, of a little boy with rosy cheeks and flaxen curls, when I had not suffered more or less from the56 In Memoriam common malady- falling in love. But whenever I became sufficiently intimate with any individual to be able to realize what a life association might mean, I shrank from the prospect, disappointed or repelled. I find in my journal of that time the following sentence, written during an acute attack: I felt more determined than ever to become a physician, and thus place a strong barrier between me and all ordinary marriage. I must have something to engross my thoughts, some object in life which will fill this vacuum and prevent this sad wearing away of the heart.'" Mention has been made of the great hardships and obstacles. Now, I am inclined to think that they were, in some sense, the reason why she had concluded to study medicine. She consulted physicians in various parts of the country as to this question of studying medicine. She was, for the most part, discouraged, and some said it was a good idea, but an utterly impracticable one, utterly impossible for her to find an opportunity, and she had better abandon it. This verdict, however, no matter from how great an authority, was rather an encouragement than otherwise to any young, active person who needed an absorbing occupation, In Memoriam 57 and if the idea were really a valuable one, there must be some way of realizing it. "The idea of winning a doctor's degree gradually assumed the aspect of a great moral struggle, and the moral fight possessed immense attraction for me." I think, therefore, that the obstacles themselves were, in a certain sense, an attraction, as she has indicated, and are to be reckoned among the actual motives leading her to study medicine. She has a broad vision and she realized what it signified, and that she was opening a new path to women. Now, as regards her medical education. The members of the profession were mostly ungenerous and bigoted, but there were a few in those days who were sympathetic and who helped her. I think their names should be perpetuated, and injustice to my sex I would like to rescue the names of a few. Who could have wished, in those days, a better teacher in medicine than Dr. Samuel Dickson. Anybody who knows the history of medicine in this country, knows that he was58 In Memoriam one of the best qualified and most able members of the profession, a highly trained man, author of textbooks of great value. He was one of our first practitioners. In order to earn money, after she made up her mind to study medicine, she first went to Asheville and taught in the school of which Dr. John Dickson was principal. There she read medical books and commenced her study. From there she went to Charleston where Dr. Samuel H. Dickson was professor in the Medical College and a leader in the profession. He was always sympathetic, and she received, undoubtedly, a very great stimulus and inspiration from him, and her reading was directed along the proper lines. In Philadelphia, directed by Dr. Warrington, Dr. Elder, and Dr. Allen, she had training in anatomy before she entered the School at Geneva, N.Y. The circumstances of her study at Geneva have been vividly told from personal reminiscences by Dr. Stephen Smith. We cannot say that the Faculty deserved much credit for her admission. But Dr. Webster and some of the In Memoriam 59 other professors must have been admirable teachers- she certainly had an excellent training in anatomy. The beginning of Dr. Blackwell's study in Europe, and her two years in Paris and in London, are told in a fascinating way in her autobiography. She encountered great obstacles there, but she received a really remarkable training in La Maternité in Paris, and certainly no American student of the day enjoyed greater privileges than did she in this midwife's school. She says herself she would not have changed her position for that of other medical students. When we are told that that great leader of the medical profession, Mr. [later Sir] James Paget, Dean of St. Bartholomew's Hospital, took a personal interest in Miss Blackwell, and that Mis Nightingale, Lady Byron, and others took a great interest in her, I think we must concede that she had an exceptionally excellent medical training, that there was practically no medical student of the say who had a better. She was fully and admirably equipped for the60 In Memoriam work she entered upon her practice in New York. She settled in New York in 1850, encountering the hostility of the profession, great social prejudice, and leading at first a lonely and isolated life. She early attracted the interest of an influential group of men and women, largely increased by a course of lectures which she gave in 1852 on "The Physical Education of Young Girls," and this was really the turning point in her medical work. She was led to the foundation of the Infirmary because she could find no opportunities at all for practice in the dispensaries in New York City at that time. The Infirmary was begun as a dispensary, and when her sister, Dr. Emily, returned in 1856 from her European trip, the Hospital was added. What happened in the interval? The schools which had occasionally admitted women for medical study had closed their doors to them. The State and local medical societies censured the schools which admitted women, In Memoriam 61 and practically compelled them to withdraw this privilege. It is a very unpleasant chapter in the history of medicine. Independent medical schools for women were founded first in Philadelphia, in 1850, and then in Boston. The Drs. Blackwell were not particularly sympathetic with the friends of these independent schools, as they felt that they could not furnish ample opportunities for practice and for treatment. They founded the New York Infirmary, which later became a Hospital and Infirmary, in order to enable the students of these independent schools to obtain further training. Three purposes were aimed at- namely, the practical training of women, the opportunity for women to receive treatment by doctors of their own sex, and the training of nurses. Mrs. Villard has told in a very interesting manner the history of the Infirmary. I should like to emphasize in addition to what has been said that the Drs. Blackwell, long before other hospitals conceived the idea, designed the Infirmary to be a training place for nurses,62 In Memoriam and that they fully realized the significance of the training of nurses for medical practice. We consider to-day that one of the most useful modern improvements in the work of our hospitals and dispensaries is the establishment of the so-called "social service work"- that is, the employment of men and women who visit the patients in their homes. The Infirmary played here too an important and pioneer part. It has been altogether a most useful institution for the training and care of women. It has served nobly the purposes for which it was founded. It should receive the support of the citizens of this State. It would be a great pity not to have it continued with ever-increasing success. The College attached to the Infirmary was founded in 1865 and this has been referred to as one of the most important works of the Drs Blackwell. It is interesting to note that they founded the college to meet a need which, however urgent at the time, they believed to be a temporary one. They did not believe that separate colleges for women studying In Memoriam 63 medicine could be anything more than a temporary expedient. They could only be patient and await the time when the larger institutions were thrown open to them. Dr Blackwell uses these words: "The friends who established and helped support the Infirmary and its college for women, regarded co-education as the final step in the medical education of women." The necessity for co-education in some form becomes more evident the higher the character of the education. In no form of education is this more true than in that of medicine. She cites the foundation of the Johns Hopkins Medical School, which is co-educational, as sufficient reason for the abandonment of their medical school. I might say with reference to the opening of the School of Medicine at Johns Hopkins to women, that the Faculty deserve very little credit. The conditions of our endowment are such that it must become co-educational. The money had been raised for this purpose, and we cannot, therefore, lay to ourselves great virtue for64 In Memoriam opening the doors to women. This, however, I may say- that we regard co-education as a success; those of us who were not enthusiastic about it at the beginning are now sympathetic and friendly. The embarrassments which one can conjure up have not materialized at all. The presence of women, as Dr. Smith has said, has lifted the tone not only of the students, but I may say also of the professors of the School, and our Hospital is thrown open to women graduates. One of the most successful teachers on our Faculty is a woman. When the School was closed, Dr. Emily Blackwell had this to say: "We have accomplished only the first step. We have secured for women the needed opportunities for undergraduate teaching. The next step is to secure for them the same opportunities, or similar opportunities that men have for hospital work, and that is to-day the great problem before women physicians." As medicine by advancing knowledge acquires greater power over disease, it has become apparent that its aid in the solution of In Memoriam 65 the problems of modern society is essential. Thereby the opportunities for the work of women as doctors of medicine have been very much increased. Dr. Emily Blackwell expresses this admirably in an unpublished address which has been placed at my disposal: "While the needs and interests of women are inseparable from those of men, they are by no means identical, and we must hope and believe that in all questions connected with the family life, with sanitary, moral, and social problems, they will raise the tone, widen the perceptions and the attitude of the profession, so as to make it respond more perfectly to the needs of society, and exert a higher power for good in all directions." In the newer and wider mission of the physician of the future the work of women, in my judgement, will be an absolutely essential part, and their opportunity one of ever increasing usefulness. It is already so in certain directions. The outlook, I think, is therefore in every way most hopeful. The lives and work of Drs. Elizabeth and66 In Memoriam Emily Blackwell are certainly full of lessons of inspiration. Especially are they full of inspiration to all women who have entered upon the paths which have been opened to them by their work. What patience, what practical good sense, what determination, what breadth of view, what high ideals, what boundless courage, were theirs! It must ever be a source of the utmost gratification that a great movement for a larger life and increased fields of usefulness for women- a movement too of deep significance for human society- should have been initiated and for so many years led by women of such resolute and noble character as those to whom we pay our tribute to-night. Dr. Abraham Jacobi. 67Dr. Abraham Jacobi. Introductory Remarks by the Chairman. About forty-five years ago, a group of medical students of the New York Infirmary Medical College, bent upon being quite up-to-date in medical education, might have been seen wending their way, once a week, to the Bellevue Hospital, to listen to the lectures given there by one of the professors who for some years had had the audacity to maintain that the diseases of children should receive special attention,- the Father of Pediatrics in America,- Dr. Abraham Jacobi. Dr Jacobi: Elizabeth and Emily Blackwell will long be revered by women physicians in America and Great Britain, and respected by the profession at large. They will be remembered together, though they differ in many respects. Both accomplished what nobody before them had succeeded in doing,- Emily, as a quiet modest example, so retiring indeed that for some time 6970 In Memoriam she did not even accept the offer of membership in the New York County Medical Society- three other women physicians preceded her. Elizabeth was an active worker, with purposes beyond the opening to women of the medical profession, and other forms of labor of both head and hand; a traveller from hemisphere to hemisphere; an agitator amongst the rich and poor, wonderfully successful in her achievements. Personally, I have seen her rarely. I know her best from her work and her writings. Her labors in connection with the admission of women into the medical profession have been arduous, but never too arduous for the simplicity and strength of her character. That is why she does not over-estimate in her writings, mainly in her autobiography, her difficulties. She never feigns martyrdom. When she was admitted as a student, in 1847, she was well received, and the male students- for the first time, perhaps, but ever afterward, so far as she reports- were mannerly and respectful. In 1855, she writes in a letter to her sister: "Sims is now here. Seems to be in favor of women In Memoriam 71 studying medicine. I think I shall help him in any way I can." You notice that was as early as 1855, six years after her own graduation, and four years after her entrance into New York practice. As early as that she knew she could help evens Sims. In that year she reports that eight women, though "poorly prepared in Trall's Hydropathic Institute," were admitted, by Drs. Joseph Mather Smith, Gurdon Buck, and John T. Watson, to the clinics of the New York Hospital. As early as 1856, the New York Infirmary for Women and Children- established for the sick, for students, and nurses,- then a few years old, counted amongst its consultants Mott, Parker, Sabine, J.R. Wood, and Flint,- certainly no mean showing for the generosity and good will on the part of the heads of the New York profession. At the same time, she complains that, as means of instruction, women have no library, museum, hospital, dispensary; no clinics, no endowments, nor scholarships. True, indeed, but the male students were no better off, as every one knows who is old enough to re-72 In Memoriam member, or has cared to study the strenuous and protracted efforts of the profession- not much aided by the schools- to improve means and methods. But again she reports that she "never had a difficulty in obtaining a necessary consultation from members of the profession." Thus it seems that at that time no unusual hardships were undergone, except occasional rowdyism on the part of what is frequently called a man; and when Emily, who had graduated in Cleveland in 1854, returned from Europe in 1856, I remember quite well that she, like her sister, was discussed pleasantly. I think it was in 1859, surely not later than 1860, that I requested her to charge herself with the treatment of a young lady patient. Meanwhile, Dr. Elizabeth's success was quite marked. She wrote, and wrote common sense. She acted on what she printed later, such opinions as these: "The combination of qualities necessary to the physician's duties will undoubtedly render the number of female physicians comparatively small, but women may be trained to the nurse's duties." She In Memoriam 73 admits, as the other sex admits of its own: "Not all the members are honorable"; "A novelty will attract large numbers who are not fitted." She also speaks of the "mistaken expectation of rapid pecuniary profit." This question of financial profit can not and must not be overlooked. It is at the head of the list of reasons why women should- no matter what they attain in the science- be permitted to be in the practice of medicine. When, fifteen years ago, I was asked to report on American Women in Medicine, I told the Germans, amongst other things, that the women question is no longer solved by men, no longer by women,- it is a social problem. Unfortunately, most questions have become bread questions. The development of Germany in favor of women doctors has since, as you know, been a very rapid one. Elizabeth Blackwell has established herself in history- so she should be known and appreciated, but not eulogized. There is no better eulogy for her than her autobiography, which is good, substantial, and instructive read-74 IN MEMORIAM ing—telling what she has accomplished and how. She will at once be recognized as a woman with more than one aim in life. The multitude of her interests and endeavors explains both her results and her partial failures. Among the first-fruits of her studies is the attention she pays to our manner of miseducating the young. With dismay she enumerates the subjects taught or not taught in our schools by teachers who know it all when they have an open text-book on their desks. You may not know what you were expected to know when you left your boarding-school,—I take it you went there, but hope you did not,— grammar, ancient and modern history, natural philosophy, chemistry, botany, astronomy, mental and moral philosophy, physiology, rhetoric, composition, elocution, logic, algebra, German, belles-lettres, accomplishments, French, Italian, Spanish, Latin, and Greek. Her lifelong interest in the health of the race was displayed in the attention she paid constantly to the education of the young and IN MEMORIAM 75 adolescent in sexual questions. The neglect of parents and instructors who do not teach as a warning and safeguard the dangers of self-abuse and premature sexual intercourse are castigated by her with convincing seriousness. The injury worked to our population by venereal diseases, communicated by women who mostly do not know they are diseased, and ten times more by men who always know they are diseased and dangerous, was well understood by her. She spoke of these things openly, when our hypocrisy disallowed any discussion of the subject. That was why when Noeggerath, forty years ago, pointed out with accuracy, and hardly without any exaggeration, the dangers to man, and mainly to woman, of gonorrhoeal infection, resulting in lifelong invalidism, chronic endometritis, salpingitis, sterility of American families, nobody in America wanted to publish it. That American doctor had to publish his paper—not "made in Germany," since recognized as epoch-making— in Germany. Elizabeth Blackwell would have been of76 IN MEMORIAM great help to us who are combating the Page Amendment, and trust that soon the compulsory reporting of venereal diseases will be enforced like that of other contagious ailments. Many of Elizabeth Blackwell's writings concern themselves with hygiene and kindred questions to a considerable extent. Here, however, she displays her excess of feeling and lack of sufficient knowledge. She says, as late as 1898: "Observation and rational experiment, solely for the benefit of one species of animals, may individually lead to the benefit of other races of animals. But direct experimentation on one type for the supposed benefit of another kind is unscientific. It is this error that vitiates the famous postulates of Professor Koch, through the system of "controls," the latest exemplification of this fallacy being the attempt to prove the existence of cholera in man by cultivating the bacilli in animals. The same error also produces the failure of Pasteur to prevent hydrophobia in man. It is thus seen that methods of biological research which involve cruel or destructive experimentation IN MEMORIAM 77 are both ethically unjustifiable and intellectually fallacious." It is readily seen that there is more postulation than argument in such statements. They are directed to the profession, which knows of no sex. If women, as I hope, will succeed, not merely in being considered full-fledged members of the profession, but in so considering themselves, that part of Elizabeth Blackwell’s writings will be forgotten or forgiven. But such statements have also been made by her for the use and misuse of the public at large. The Encyclopaedia Britannica and Chambers's Encyclopaedia contain teachings such as these (p. 30 of Scientific Methods, 1898) : "Destructive experimentation on helpless animals—not for their own benefit—is a demoralizing practice." Page 3: “By advanced instrumentation and post-graduate classes, the student is led on to take active part, under licensed authority, in this fascinating but morally dangerous method of study." "The practice of experimentation on animals is a great temptation to teachers of somewhat78 IN MEMORIAM shallow intellect." "Innumerable examples of atrocious cruelty are occurring in the records of medical research, as practised on the Continent and in America." "The pretence of anaesthesia served to diminish the resistance of the victims, not to annihilate pain. Yet such cruelties inevitably result from free vivisection." Such statements create great responsibilities. Great natural gifts, love of the human race, of children, refined and pure character coupled with moral strength and inexhaustible patience, the faculty of popularizing her ideas and feelings,—properties which take possession of the warm hearts and idealistic tendencies of vast numbers of men and women,—all these are not a protection against the possibility of making mistakes dictated by the predominance of feeling over judgment. I wonder whether there are people whose brains and hearts may always be found in harmony and co-operation. Firm convictions, demonstrable or not, and one-sidedness, which in the most limited natures lead to fanaticism, are sometimes rewarded with great results, with or without crucifixion. IN MEMORIAM 79 Such one-sidedness as Elizabeth Blackwell exhibited in some things has always appeared to me to amount almost to a virtue. She was always occupied, her thoughts and feelings ran in the direction of usefulness to the great many. That is why occasionally she took things for granted. She was a very religious person, and religion was not the subject of meditation to her, but merely an axiom, a faith inherited and never debated or doubted. That is why no doubt ever came to her that, when she writes a book "from the standpoint of the Christian physiologist," or proclaims that it is the special work of the "Christian physiologist to discover the higher uses of our varied human faculties," such pleading offends the methods of modern physiology. It was not for her, however, to find new roads in science, by experimentation or otherwise. Hers was its application. That explains why the same superior person who knew that medical practice was not meant for one of the sexes—of which there are only two—never asked the question whether or not medical research and physiology were the80 IN MEMORIAM work or aim of one only of the religions— of which there are a good many more. Moreover, her altruistic instincts made her look for the realization of sound principles of diet and hygiene, in preference to drugs. She lived at a period when the nihilism of Vienna— during which the patient, like General Sherman’s "dead Indian," was mostly appreciated when diagnosticated and autopsied— had not outlived itself, and experimental pharmacology and close clinical observation had not taught us to rely so much on drugs as on other preservatives and adjuvants of health. More than merely a prescribing doctor, she was a humanitarian, in the sense of Virchow who, sixty years ago, preached to all ready to hear him, that the physician was meant to be the attorney of the poor. That is what made Elizabeth Blackwell say (.Autobiography, p. 176): "Extremely sceptical in relation to the value of drugs and ordinary medical methods, my strong faith in hygiene formed the solid ground from which I gradually built up my own methods of treatment. Looking back upon a IN MEMORIAM 81 long medical life, one of my happiest recollections is of the number of mothers whom I influenced in the healthy education of their children." Such a remark is welcome in our own days, when the object of most of our endeavors is prevention, both for the adults and for the babies that have to be reared. The instruction in the most common rules of hygiene, beyond the securing of a clean and germ-free milk, is the treating of the children with pure and cool air, pure water for washing and drinking, regularity of well-prepared, cheap, and nutritious meals. I need not here say that, fortunately, the most nutritious child foods are also the cheapest. For practical purposes the simplest rules will be heeded best, the shortest lectures will be remembered best, and technical terms, when scrupulously avoided, may remain the private ornament of the doctor, and the nurse, and the dictionary. Elizabeth Blackwell would be a great power in our present New York exertions in the attempt at reducing infant mortality and fortifying infant health. She would say that there 82 In Memoriam is none of you young doctors that can not, must not, participate in this work of social improvement. We ought all of us to be prouder than we are, perhaps even vainer. I admit that at present I resent the remarks they will make about us in twenty-five or fifty years, when they will sneer at us who accomplished so little while waiting for a socialistic statesmanship to carry out the bidding of common sense and warm-hearted humanitarianism. Elizabeth and Emily Blackwell will always be honored for what they have accomplished themselves and for the impulses they have conveyed to hosts of intelligent and altruistic men and women. Dr. Gertrude B. Kelly. 83Dr. Gertrude B. Kelly. Introductory Remarks by Chairman. At the close of a campaign it was customary in earlier times to confer signal honor on the standard- bearer who had never in the heat or cold, in the camp or on the field, allowed his flag to be lowered. We have with us one who for many years had held and still holds high the colors unfurled by the two women whom we commemorate this evening,- Dr. Gertrude Kelly. Dr. Kelly: After the beautiful tributes paid by Drs. Welch and Smith to Dr. Emily Blackwell, it would seem that there was nothing left for me to do but to lay another rose on her tomb, or add another stone to her cairn. But in a sense I have been commissioned by the students of the old college, her college, and by those to whom she was in the habit of referring as her "enthusiastic band of young teachers," to tell 8586 IN MEMORIAM you a little of the meaning of the rose we would lay on her tomb, and the significance of the stone which we would add to her cairn. To us she was pre-eminently the Teacher. Above and beyond any structure which she reared, any institution which she founded, any work which she accomplished, any suffering she relieved, any contributions she made to medical teaching or to medical science—was the woman herself, her character, and her ideal. The Catechism of our childhood gave as the reason for the earthly sojourn of the Great Teacher, "to teach us by His life how to live, as He was to teach us by His death how to die." In all reverence be it said, she also taught us by her life how to live, as she taught us by her death how to die. This woman, who accomplished all you have heard of here to-night—who succeeded in wresting a college education and a hospital training from hostile authorities (and did not become soured, or embittered, or narrowed in the struggle), who earned the respect of her fellow-students to the extent testified to by Dr. Stephen Smith ; IN MEMORIAM 87 who, with the eye of a seer, foresaw what every one sees now, that medical education without hospital training is a mockery and a delusion, and so wisely planted the seeds of her hospital before planting those of her college; who built a large and flourishing college with an enthusiastic corps of teachers, men and women ; who, in the early days when older and more recognized men were not available, chose her younger men so wisely that almost without exception they rose to prominence in the medical world and the medical teaching world; who had sense enough to support the standing of the college, before her young men and women had had a chance to earn their spurs, by appointing an examining board of the older men from the different medical colleges of the city (three of whom are here to-night to testify to her worth) ; who, in times of stress, often with diminishing numbers and lessening income, never lowered the high standard of education, keeping it on a level with the best in the country ; who recognized the value of Hygiene and of Pathology in their infancy, and was 88 IN MEMORIAM among the first to establish chairs in these subjects— and felt very proud when her young women began to occupy responsible positions in the world of Preventions and Scientifics as opposed to the purely Practical work of medicine who, even in her earliest and most struggling days, succeeded by the force of her personality in attracting a body of trustees from among the best and most influential people in the city; and yet, in these days of blatant egotism, never once lost sight of the object of all these exertions, never once confused the end with the means, but was willing to give it all up and sink into obscurity again the moment wider opportunities in medicine seemed opened to women. A considerable time after the bolts and bars of Dr. Welch’s institution were drawn (I am sure with Dr. Welch’s approval), Cornell University started a medical department in the city of New York, and as, according to the charter secured by its wise and beneficial and liberal founder, there were no bolts and bars to be drawn, it seemed to Dr. Blackwell that the necessity for her IN MEMORIAM 89 institution no longer obtained, and she stepped aside with "The moment it ceases to be the best thing women can get, that moment it ceases to exist," her only regret being for her young women teachers, who would be cut off from the intellectual and moral stimulus of teaching. It has been my fortune, or misfortune, to be associated with many causes for the world's betterment—causes hopeless and hopeful, causes national, political, and social, some of them involving more momentous consequences to the world and its welfare, perhaps, than the entry of women into medicine, and it has been my great good fortune to know many large-brained, whole-souled men, and many noble, devoted women, but I have never known man or woman with a clearer brain, a saner judgment, a wider outlook, a more whole-hearted devotion than had Dr. Emily Blackwell, whose death we now mourn. She has joined the "choir invisible of those immortal dead, who live again in minds made better by their presence."90 In Memoriam President's Room Western Reserve University Adelbert College Cleveland Emily Blackwell received the degree of Doctor of Medicine from the old Western Reserve Medical School in the Class of 1854, the first woman to receive a degree from the School. She prepared the way for the other eminent graduates, Dr. Cordelia Green and Dr. Zakzrewska. Western Reserve University and its Medical School unite in sympathy with those who assemble Wednesday evening to pay a tribute of respect to the character, of honor to the achievement, and of gratitude for the great human service, of Dr. Blackwell. Chas. C. F. Thwing, President. The Women's Medical Association of New York. Twenty-fourth January, 1911. The Memorial Committee regret that Dr. Wm. M. Polk and Dr. Emma B. Culbertson were prevented from delivering addresses, as promised, at the Memorial Meeting. The letter printed is one of many received in appreciation of the lives and service of Dr. Elizabeth and Dr. Emily Blackwell.