BIBLIOGRAPHICAL NOTICES.
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Transactions of the American Medical Association, instituted
1847. Vol. III. Philadelphia, 1850. pp. 499.
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The third volume of “ Transactions of the American Medical
Association,” although less voluminous than its predecessor of
the last year, is in no way inferior to it in the interest and cha-
racter of its contents.
The meeting of 1850 was indeed in some respects, more encour-
aging and more fruitful in its results than either of the preceding
ones. The number of delegates appointed by the different medical
Societies, amounted to between six and seven hundred, from
twenty-seven States of the Union, and although the larger num-
ber of these were not present, yet the fact of their appointment,
shows the deep and wide spread interest which this new move-
ment has inspired throughout the medical profession of the United
States. It is believed that no body of physicians of equal number
and respectability, has ever been assembled at one time, in any
part of the world, and although its proceedings may as yet be in-
ferior in point of scientific importance to the doings of many smaller
bodies in other countries, yet the power and influence which it is
destined to exert upon medical science in America, if held together
by the ties of fraternal feeling, and managed with discretion and
wisdom, can scarcely be estimated.
Based upon the representative system, and throwing open its
portals to all the regularly educated members of the profession, in
good standing with their brethren at home, without distinction of
talent, wealth or position, the Association may be regarded as a
great democratic medical assembly, in which all the members
stand upon the same platform, and act in the true republican
spirit.
Here the Professor, whose teachings and writings have rendered
him eminent at home and abroad, and whose position gives him a
deserved influence over the minds, both of his pupils and his con-
temporaries, places himself on the same level with the more ob-
scure and humble private physician, whose name and whose med-
ical skill may not be known beyond his immediate circle.
It is true that one element exists in the organization of the As-
sociation not strictly republican, viz., that which confers upon
medical colleges the right of appointing delegates, irrespective of
the medical societies of states and counties. The disturbing in-
fluence of this arrangement, has already been the cause of conflict
between opposing interests, which has tended in some degree to
mar the harmonious action of the Association, and has even induced
a fear in some minds that a radical change will have to be made
in this respect, before its full benefits can be realized. This,
however, is a question upon which there is a variety of views,
which it would be premature to discuss at this time.
The volume of Transactions before us, is as usual, chiefly occu-
pied with the reports of the standing committees of the Association
upon the several subjects Committed to them. These reports with
some exceptions, appear to us highly creditable to the talents and
industry of the committees wrho framed them. In one respect, seve-
ral of them are superior to the reports upon the same subjects
in former years, inasmuch as they are strictly American, and con-
tain altogether the original observations of our own men. While
this curtails their length, it imparts to them freshness and origi-
nality, and brings them within the design contemplated' by the
Association. Such reports must tend to elevate our national
character, and if continued in the same spirit, and improved from
year to year, by the additional materials which American Physi-
cians are continually furnishing, wre shall soon evince to the
world, that there are laborers in the field of Science here, whoj as
original thinkers, discoverers, and men of genius, have not their su-
periors in the older nations of Europe.
The first Report on Medical Sciences covering about 50 pages
of the Transactions, and embracing a review of the several depart-
ments of Anatomy, Physiology, General Pathology, and Therapeu-
tics, with other branches of natural, science, bearing directly on
the condition and .progress of medical knowledge in America, is
particularly rich and interesting. It would be impossible in our
narrow limits to do more than glance at its general features, with-
out specifying particular points.
An .article on the arrangement of the cancelli in human bones,
exhibits a novel and ingenious view of the mechanical uses of the
interior structure of bone, which manifests in a striking manner,
that admirable adaptation of means to ends,, which prevails
throughout all the works of nature. Dr. Wyman, the author, a
distinguished Anatomist of Boston, deserves great credit for his
curious investigations into this subject,
Under the same head are detailed the results of Dr. Morton’s in- .
vestigations, into the “ capacity of crania in different .races of
man,” anew and interesting subject, which is just beginning to
attract attention. Dr. John Neill, and Dr. Joseph Leidy, both
of Philadelphia, and amongst the most acute and industrious la-
borers in the field of Anatomy and Physiology, have also added
their portion to this department in several interesting communi-
cations. The article on “Parasitic Life” by the latter gentleman,
is particularly valuable, as well as the observations on the para-
sites which infest the human teeth, by Dr. H. J. Bowditch, of Bos-
ton. The fact that the number of parasites which are found on
the teeth, is in proportion to the degree of cleanliness observed;
and that the various detergent tooth washes do not impair their
vitality, while soap destroys them instantly, if it should be con-
firmed by future observations, would possess great practical
value.
The department of Pathology in the report, treats of the propa-
gation of epidemic and contagious diseases, in which the views re-
cently propounded on this subject by Drs. J. K. Mitchell, J. Knight,
and S. IL. Dickson, are briefly detailed. The progress of cholera
is traced, and the interesting report of the post-mortem appear-
ances in this disease, presented to the College of Physicians'of
Philadelphia, by a committee appointed to investigate the subject,
is briefly sketched.
Dr. Austin Flint’s observations on Serous Effusion, within the
arachnoid cavity, receive a due share of attention, and are well,
worthy of examination, as are the facts on Etherization in Insan-
ity communicated by Dr. Luther V. Bell and Dr. Ray.
A curious case of spontaneous Hydrophobia, reported to the
Philadelphia College of Physicians by Dr. Condie, finds a place in
this connection, as amongst the medical curiosities of the year.
Some interesting observations made in the same body by Drs. Con-
die and Riofrey, on the causes of Pulmonary Consumption, are
worthy of note—as also the abstract of an instructive paper on
- Intestinal Auscultation, by Dr. C. Hooker of Yale College.
This department of the report closes with a section- on the form-
ation and composition of Urinary Calculi, in which is recorded
the results of analysis of the calculi in the large collection of Tran-
sylvania University by Professor Peter, as originally published
in the Western Lancet—and also of the collection in the Museum
of the Boston Society for Medical Improvement. The connection
of different urinary deposits with the geological character of the
earth, is appropriately urged by the committee as an inquiry well
worthy of the investigation of physicians in the different parts of
our country.
Dr. G. Emerson of Philadelphia, a member of the committee, has
communicated a valuable section on “ Vital Statistics/’ pointing
out some of the 'causes of mortality in children of the two sexes.
It appears from his inquiries that the preponderance of male over
female births, which is known Io exist, is soon lost by reason of
the greater mortality of males, “ so that the numbers of the two
sexes living at the age of ten years, are very nearly equal, and at
the fifteenth year, the living females outnumber the males, about
as much as the males did the females at birth.” Dr. E. supposes
that .the excess of mortality amongst male children, arises from the
greater prevalence amongst them of the inflammatory affections of
the organs of respiration, circulation and nutrition, but more espe-
cially inflammation of the brain and its appendages;—while “ the
principal diseases of which females die, are hooping cough, small
pox, scarlet fever, measles, thrush and consumption.” The diseases
of the males being allied to the sthenic, and of the females to the
asthentic class.	•	.
Dr. E. also presents some very curious enquiries upon the “ In- •
fluences operating to change the number of births, and also the
proportion of the sexes at birth.” The seasons, the quantity and
quality of the food, purity of the air, ov6r-working, and whatever
tends to exalt or impair the vital energies of the people, are enu-
merated as so many agencies which influence these results. Dur-
ing fatal epidemics which alarm the public mind, Dr. E. believes
that the conceptions of female children will preponderate over the
males, and he adduces the births in Philadelphia and Paris, which
occurred nine months after the prevalence of cholera in those
cities, as an illustration of his views. The close attention which
Dr. Emerson has given to the subject of vital statistics, impart
great interest to these observations. Under the head of Toxicology
and Miscellaneous matters, we find a brief section on the “ mode
of actions of poisons” by Professor James Blake, of the St. Louis
University, intended to prove that the most rapidly fatal poisons
act only by being absorbed into the blood—a doctrine which this
gentleman endeavored to sustain by a series of experiments, an
account of which was published some years ago, and which has
since been controverted by Christison and Taylor, in the Edinburgh
Medical and Surgical Journal. Dr. Blake has .followed up the
subject by more recent experiments, which have tended to confirm
his original views.
The comparative effects of anaesthetics receive some attention
in this department, as well as the effect of these agents on what
are called sensitive plants.
A short abstract of a paper of Professor Horsford presented at
the meeting of the American Association for the advancement of
science, on “ moisture, ammonia, and organic matter in the atmos-
phere,” is well worthy of study, and may tend to throw some light
upon the causes of epidemics and other diseases, believed to depend
upon certain states of the atmosphere.
The existence of ozone in the air, and its supposed connection
with cholera, are succinctly discussed by the committee, and the
conclusion that “the ozone theory of cholera, on the whole, is not
sustained” appears to be adopted by them.
The report closes with some eloquent remarks on the future
prospects of American Medicine, and upon the vast benefits which
the Association is destined to confer upon its rising fame.
The report on Practical Medicine and Epidemics from the pen of
Dr. J. K. Mitchell, is chiefly occupied with an admirable history
of the introduction of cholera into the United States in the year
1849, with the statistics of the various cholera hospitals in Phila-
delphia, the proportional mortality in the hospitals of Philadel-
phia, New York and Boston, the different plans of treating cholera
and their results so far as statistics furnish them, the effects of cer-
tain articles in relieving certain symptoms of cholera, with a lucid
exposition of the arguments in favor of the portability, and against
the contagiousness of the disease.
The report is accompanied by two charts, one exhibiting the
relative position on the ocean of the packet-ship New York, and
the ship Swanton, when the cholera broke out upon them, on their
way, the one to New York, the other to New Orleans ; the other
shows the date and place of occurrence of the first twenty-three cases
of cholera reported to the Board of Health of Philadelphia, marked
out on an outline map of the city and districts.
Some interesting facts illustrative of “ the effect of special con-
ditions upon the power of the progression of cholera,” are also re-
corded, together with numerous examples of its non-extension from
infected points and localities.
Our space will not permit more than a passing notice of this
interesting paper, but we cannot refrain from a remark or two upon
the question of the portability and non-contagiousness of cholera
as presented by Dr. Mitchell.
While it is, we think, clearly shown by the facts collected with
great care by the committee that cholera was introduced at the
New York Quarantine Station, and at New Orleans, by the ships
New York and Swanton, and that these vessels became infected
with the disease while on the ocean 1000 miles apart, within a
day of each other, we are still in the dark as to the means
whereby it was introduced into Philadelphia and other infected
cities, several months after its appeaeance at the localities stated.
It first occurred in Philadelphia on the 30th of May, at two op-
posite points of the city three and a quarter miles apart, and then
appeared in different sections : for the first seventeen days no two
cases occurring within a square of each- other. If the disease is
portable, how was it brought to Philadelphia, and why did it pursue
so tortuous a course ?
No evidence is furnished upon these points, except that the*
eleventh case which occurred on the 12th day of the epidemic
visitation, had recently visited the infected city of New York.
Dr. Mitchell concludes from the facts stated, that the disease
was not propagated by contagion, but that “ the atmosphere of
the whole city had become slightly epidemical, not being sufficient-
ly poisonous to produce its specific effects unless aided by person-
al imprudence or a deleterious locality.” It would seem therefore
from this statement, that in the opinion of Dr. Mitchell, though
cholera is portable, yet it may become epidemic without being
first carried to the place where it spreads, or, in other words, that
it is both portable and epidemic, but not contagious.
Now we cannot see the utility of introducing the portable theory
into this discussion, in contra-distinction to the theory of conta-
gion.
It appears to us .just as easy to explain the. introduction of
cholera into the hospitals on Staten Island, and at New Orleans,
from the two vessels arriving with cases on board, by the old idea
of contagion, as by the doctrine of portability. The first cases on the
landing of both of these vessels could be traced to them. One case
was taken directly from the ship Swanton to the Charity Hospital at
New Orleans, just as the vessel arrived; the ship New York had
cases on board on her arrival at Quarantine, and the first case which
appeared on shore, was in a person who had been on the ship forty-
eight hours before. It must be remembered also, that the disease
was confined in this latter locality to a small space, that a
rigid quarantine was established between the Island and New
York city, and that not a single case occurred in the city
during its prevalence on the island.
We cannot see, therefore, that the introduction of tlie wordywr-
table, has any tendency to clear up the obscurity in which this sub-
ject is involved, and we are disposed to believe in the absence of
farther proof, that cholera, like typhus fever, scarlet fever, and
other kindred affections, is both epidemic and contagious, being
greatly influenced -in its progress, by those special conditions,
which are known to fayor the attacks of malignant disease. This
view is at least as satisfactory to our mind, as that which excludes
the idea of contagion, and embraces that of portability.
The committee make some brief remarks upon the occurrence of
yellow fever within the past year at Charleston and Rio Janeiro.
Its appearance in the latter place, being unprecedented, induced
the committee to seek the aid of the Naval Bureau, in investiga-
ting this singular fact ; and they have been assured of the
hearty co-operation of the medical officers of the Navy in present-
ing the enquiry.
Scarlatina, variola, and typhoid fever, are said to have been
unusually prevalent in different parts of the United States within
the past year. <
In tracing out the latter disease, the committee complain of the
Usual difficulty of deciding from the descriptions given by physi-
cians “ whether the typhoid of Louis, or a typhus state of some
of the malarious fevers of the country is to be understood.” With a
view of rendering information more accurate upon this and other
topics, they propose a distribution of subjects to special commit-
tees, to report from year to year. The committee remark, “one ad-
vantage of the distribution of subjects to special committees, would
be the issue by each of an interrogative formulary, so that socie-
ties and individuals, might know how to give, the information
upon which such reports could be founded^ _ The knowledge now
concealed in modest retreats, must thus be concentrated in the As-
sociation,- to be, by its authority, diffused over the world.”
This suggestion appears to us well worthy of the consideration
of members of the Association, and will, we trust, demand special
attention at an early date.
As appendices to the report, are subjoined two interesting papers
one by Dr. Pancoast of Philadelphia, on the treatment of Aphonia,
and the other by Dr. Reynolds of Gloucester, Massachusetts, on
Epidemic Fever and Dysentery, but our limits will not permit a
tice of their contents.
(To be continued.5