Showing papers in "Yale Journal of Biology and Medicine in 1934"

Crime and Personality.

Abstract: In some social groups the acquisition of property is called theft. This may be a perfectly obvious proposition to those who have no property, but is not an appealing one to most of those who have acquired or have inherited property in what is or has been considered an honest way. In most societies people who possess property are generally not brought to trial as alleged thieves or criminals. There was a time when the slave-trade was not generally regarded as criminal. Later it became a crime, and today is looked upon as such-at least, officially-in most societies. There was a law in the State of Connecticut which stated that a person under 16 years of age might be put to death for disobeying his mother. In war, and in revolution, killing and even massacre are not only legal but may be most highly regarded by the very standard-bearers of ethics. In times of peace one sometimes sees considerable fuss made in courts, although more often outside of them, about a situation in which one person called another a bad name, or a pauper took some potatoes without paying for them. By th-ese examples, the point is made that at different times different things are considered crimes, that different people and different groups of society, even different contemporary ones, may consider the same thing a crime or not a crime, according to their social or economic Weltanschauung. One may say that in any society one group, usually a minority, develops and sets up a moral code. Eventually a legal code is evolved. With this code the rest of that society falls in line for a longer or shorter time. Under such circumstances how can the psychiatrist who, after all, does not live apart from his contemporary society or, at least, should not do so, define crime? The best the psychiatrist can do is not to offer any ready-made legal or quasi-legal definition; rather he should adopt a definition given by the established mouthpiece of society on legal matters, i.e., the lawmakers. Of course, they should belong to contemporary society. It seems that the lawmakers of

A Method for the Remote Control of Electrical Stimulation of the Nervous System

Abstract: ImagesFig. 16Fig. 13Fig. 14

The Relationship of Age to Immunological Reactions

Abstract: The relations of heredity and environment to biological reactions have occupied a large place in most branches of biology and medicine, but it is only within comparatively recent years that they have been seriously considered in immunological studies. All elementary text-books contain statements regarding the effect of environmental or hereditary factors-racial, species, and individual immunities are postulated, and factors responsible for natural resistance are enumerated, but the subject has usually been disposed of in a few pages without any attempt at adequate explanation. It has most generally been supposed that the individual will react in a regular and almost predictable manner to a given stimulus, and that the immunologist may determine the nature of the response. But in more recent years, as the focus of attention, first directed by Pasteur upon the bacterium, swings back to that equally important factor, the host, new emphases are evident. The experimental epidemiological studies of Topley in England, of Neufeld in Germany, and of the Rockefeller group in America have proved the importance of an hereditary factor in racial resistance. The newer knowledge of nutrition has brought much interest in the effect of diet. Zingher's exhaustive diphtheria studies have thrown side-lights upon the effects of social and economic environment, and the studies of Huntington have proved that a climatic factor is of importance in general resistance. The relation of the age of a subject to any one of his biological reactions is obviously of considerable interest. Yet in immunology, until recently, little has been done experimentally save to note the incidence of susceptibility to a given organism in various age groups.t Studies of this kind have revealed the well-known Schick and Dick susceptibility curves. The fact of a changing resistance with age is

Bronchopneumonia in Adolescence.

Abstract: ImagesFig. VFig. VFig. VIFig. VIFig. IIIFig. IIIFig. IVFig. IV

Social Insurance and Economic Security

Abstract: Social legislation is the popular topic of the day. If he realizes it the Forgotten Man must be mildly annoyed by being so well remembered. While the noisy protagonists of the various styles of social insurance are making their stirring pleas it is only right that the opponents have their day in court. Dr. Ochsner ably presents the case. His long and active career as a student in the Health Insurance Clinics in Germany and as a practicing physician and member of Welfare Commissions in America eminently qualifies him to form opinions of his own and to comment authoritatively upon the opinions of others. The book is written in a vigorous, rather dogmatic style. It is unfortunate that the author relies so frequently on the fable and anecdote method of proof which is not always convincing, but in spite of that there is never any uncertainty in the reader's mind as to where Dr. Ochsner stands; each page brings out a sound denial of some favorite assertion of the Social Insurance enthusiasts. In passing he takes unerring potshots at the earnest reformer who has one starry eye on the payroll , the ever-busy executive secretary of the uplifters, and the professional survey-maker who obligingly unearths the wrongs that his philanthropic sponsor surmised. It is regretted that he overlooked the beaming target presented by the politico who appreciates the powerful vote-getting mechanism of social legislation. One after another are wise observations concerning the cost of social insurance, the inadequacy of the service rendered, the undermining of Independence, Industry, and Integrity, and finally he quite wrecks the prevalent opinion that there is some mystical hocus-pocus in government that can fix up anything. The most telling conclusion that the author develops is in one of the early chapters where he establishes that Unemployment and Sickness Insurance are not only misnamed, but are so-called with a deliberate motive of deception to make the people think they are getting insurance when in reality they are receiving alms. He supports this conclusion with such important technical evidence that denial is difficult. Dr. Ochsner is especially concerned with compulsory Health Insurance, and rightly so. He is convinced that no such system can solve the problem of poverty for which these schemes are originated, nor will it supply adequate and efficient medical services for the citizens of any nation. Moreover, he believes that physicians under Compulsory Insurance will …

Diabetes Insipidus Associated with Pinealoma Transplant in the Tuber Cinereum.

Abstract: ImagesFig. 1Fig. 2Fig. 3Fig. 4

The Properties and Significance of the Reticulocyte.

Abstract: The discovery of the efficacy of liver and other tissue preparations in the treatment of pernicious anemia, has brought into prominence the vital-staining erythrocyte, the reticulocyte. A knowledge of fluctuations of these cells in the blood of pernicious anemia patients has proved invaluable as an index to the success of the treatment of this malady. Likewise, the diagnostic and prognostic value of the information obtained from reticulocyte determinations in certain other blood disorders is well known. The growing importance of the reticulocyte in modern medicine justifies a discussion of the properties and significance of this blood constituent as well as of the conditions influencing its normal and abnormal variations in the organism.

Postures and Practices During Labor Among Primitive Peoples

Abstract: 189 The author wisely devotes a considerable space to differential diagnosis, especially of cervical lymphadenitis. The various therapeutic agents are discussed separately as to their individual merits, and again reviewed as they are indicated by variations in the local type of the disease. The author takes a middle ground in deciding between conservative and surgical treatment of infected nodes, but since he believes that involved nodes are a potential source of later spread in tuberculosis, he inclines to practise early surgical excision. The technic of the cervical dissections is described in excellent detail. Pulmonary hilar tuberculosis and abdominal mesenteric lymph node involvement are the, subjects of two separate chapters. Each chapter of the book concludes with a very extensive bibliography which should prove useful to students of the disease. The anatomy of the lymphatic system is satisfactorily illustrated, but we feel that the usefulness of the book as a whole would be enhanced by more profuse illustrations. The author speaks with the authority of wide clinical experience, and his book should prove a serviceable addition to any medical library. No physiologic function which affects mankind is as dramatic as that which perpetuates life itself. It is obvious, therefore, that the greatest number of superstitions and fancies which the race has accumulated should center around the process of childbirth. That some of these still persist in a measure among presumably intellectual people is a fact well known to obstetricians. The study of the customs and taboos of primitive people concerning childbirth becomes therefore a fascinating subject to all who are interested in the history of mankind. The present book, although unusually brief, brings together in a striking way many of the most outstanding of these superstitions and customs. The text and illustrations are exceptionally well done and the book itself is a good example of the modern bookmaker's art. Dr. Jarcho is to be praised for bringing to the attention of English readers a subject which has received too little attention since the noteworthy contribution of Engelmann.

Wilhelm Conrad Röntgen and the Early History of the Roentgen Rays.

Abstract: The most fascinating and informative biography that has recently come to my attention is that of William Conrad Rontgen by Dr. Otto Glasser of Cleveland, which includes a chapter of \"Personal Reminiscences\" by Margret Boveri of Berlin. The preliminary part of the book deals with the dramatic chapter in science, the discovery of the roentgen rays, with a reprinting of Rontgen's first article \"On a New Kind of Rays,\" and the report of H. J. W. Dam in McClure's Magazine for April, 1896, a lay article which still remains one of the best of the early reports of the discovery. The author emphasizes that the greatness of R6ntgen lies in the fact that he grasped the significance of an unknown phenomenon and developed scientific methods of investigation which culminated in accurate knowledge of the roentgen rays. From a view-point of biographical interest the best chapters are undoubtedly those which deal with Rontgen the scientist and man, in which Glasser shows his skill as a biographer, and that of the personal reminiscences by Margret Boveri. Interesting too are the chapters on roentgen rays in medical diagnosis and in therapy; while the development of roentgen tubes and apparatus, and the practical use of roentgen rays for non-medical purposes reveal information which is not available in medical literature. The author devotes a chapter to the pioneer roentgenologists and their work, and it is evident that America may claim a generous share in the early work which followed the discovery. The book is not without delectable touches of humor, as seen in a chapter devoted to R6ntgen's discovery in contemporary humor. Among the amazing things we learn here is the advertisement of a firm in London which purported to sell \"X-ray proof underclothing\" and also of the introduction in February, 1896, of a bill in the New Jersey legislature \"prohibiting the use of X-rays in opera-glasses in theatres.\" Appended to the volume is an admirable bibliography of 1044 articles concerning Rontgen. It is inconceivable that medical men and workers in roentgenology will not be interested in this volume in which the very fundamentals of this science are so admirably set forth. HERBERT THOMS.

Laboratory Manual of Biological Chemistry

Abstract: This new edition of Folin's Manual follows the same general plan of topics treated as that which characterized the earlier editions. The first chapter treats of such fundamental topics as acidimetry, alkalimetry, calibration of apparatus, and nitrogen determination. Some commentators might be disposed to criticize this on the ground that such matters should be considered prerequisite for entrance to a course in biological chemistry. In defense the reviewer suggests that details of entrance requirements cannot always be decided by one instructor, but depend on numerous factors beyond his control, and the first edition of this manual which sets the pattern of the present book, was the result of actual experience in Professor Folin's laboratory over a period of years. Furthermore, in developing the subject of biological chemistry in accordance with the viewpoint of Folin, which conceives as the ideal the treatment of both qualitative and quantitative aspects of the subject without definite separation, it is logical to begin as he has done. Incidentally, it may be added, this first chapter is as condensed and clear a presentation of these fundamental essentials as may be found anywhere, if it is not indeed the best. The importance of acidimetry is emphasized to the student and related in a practical way by titrations of the gastric contents, a presentation which reveals the deep pedagogical insight of the author. This edition differs from the previous ones largely in that it describes newer quantitative methods applicable to blood analysis. The supplement, which is devoted to quantitative methods useful with blood and urine, covers 163 pages as compared with 201 pages for the previous part of the book and constitutes a valuable compendium of the methods developed and in use in the Harvard laboratories. The style of presentation of the material in the first chapter is quite different from that of the later chapters which read more like conventional laboratory manual notes. In the reviewer's opinion, the later sections would be improved by inclusion of informative comments and descriptive matter similar to that presented in the first chapter. However, it might be argued, against this view, that such material belongs more properly to a textbook ; also, that this additional material should be given by the instructor. One of the useful features of the earlier editions has been retained, namely, the use of blank left-hand pages as a place for the student to record important data. …

The Brain and Its Mechanism

Abstract: SIR CHARLES SHERRINGTON'S Rede lecture delivered at Cambridg last December, and now published, is an amazing compendium of conclusions covering the whole range of scientific inquiry in that field of Nature hich has excited man's intensest curiosity.The Brain and its Mechanism.By Sir Charles Sherrington. The Rede Lecture delivered before the University of Cambridge, 5 December 1933. Pp. 36. (Cambridge: At the University Press, 1933.) 1s. 6d. net.

A Roentgenographic Study of the Thoraces of New-Born Infants.

Abstract: ImagesFig. 5Fig. 6Fig. 7AFig. 7BFig. 1Fig. 2Fig. 3Fig. 4

Psychology in Relation to Medicine.

Abstract: New updated! The latest book from a very famous author finally comes out. Book of psychology in relation to medicine, as an amazing reference becomes what you need to get. What's for is this book? Are you still thinking for what the book is? Well, this is what you probably will get. You should have made proper choices for your better life. Book, as a source that may involve the facts, opinion, literature, religion, and many others are the great friends to join with.

End-Results in the Treatment of Carcinoma of the Colon.

Abstract: s of Postoperative Deaths Case 1: C. P. No. 100243. Age 76. Male. This patient entered the hospital on January 14, 1931. He had previously had a cecpstomy for intestinal obstruction in another hospital. The cecostomy had been done on December 31, and while he had improved considerably, there was still some evidence of obstruction. It had been previously demonstrated by X-ray that he had obstruction of the sigmoid colon. At operation a tumor of the sigmoid colon was found. This was resected, and an end-to-end anastomosis performed. Following operation there was considerable drainage of brownish-red fluid from the peritoneal cavity. The course was steadily down-hill and he died on the second postoperative day. It was stated in the operative note that there was some soiling at operation. No post-mortem examination was permitted. It was not known whether the patient developed a peritonitis as the result of the soiling or whether the suture line broke down. In any event, it would seem that the death must be attributed directly to the operative procedure. Case 2: T. M. No. 4033. Age 54. Male. This patient was admitted to the medical service January 8, 1922, complaining of gas and pain beneath the umbilicus. The present illness began in June, 1921, when he first noticed pain in the umbilicus. This gradually became worse and he was treated for chronic constipation. Two months before admission he had severe diarrhea with blood in the stools. Physical examination showed an acutely ill, emaciated individual with a markedly distended abdomen and visible peristalsis. At operation a large tumor of the cecum was found, and in view of the patient's critical condition, a first stage Mikulicz procedure was done. Two days later the tumor was removed by dividing the terminal ileum and ascending colon. The obstruction was not entirely relieved, probably due to a kink in the ileum. The patient died on the fourth postoperative 437 YALE JOURNAL OF BIOLOGY AND MEDICINE day. There was considerable drainage from the peritoneum. Although no post-mortem examination was made it was thought likely that this patient had a peritonitis. Whether this resulted from soiling at the second stage Mikulicz operation when the tumor was removed could not be determined. Comment: While the late diagnosis and the extremely poor condition of the patient at operation are contributory factors it seems likely that the technic of the Mikulicz operation should be held responsible for the death, probably due to peritonitis. Case 3: K. G. No. 22002. Age 46. Female. This patient entered the hospital on June 20, 1923, complaining of pain in the abdomen. The present illness began three months before admission when she developed severe pain in the upper part of the abdomen. Since that time she had had repeated attacks of sharp abdominal pain accompanied by nausea and vomiting. Physical examination showed a moderately well-nourished woman with a mass 6 cm. in diameter just to the right of the midline and below the costal margin. At operation a carcinoma of the transverse colon was found and a resection and end-to-end suture of the large intestine was done. On the third postoperative day the patient suddenly developed signs of perforation and died on the next day. Post-mortem examination showed that the suture line had given away and diffuse peritonitis had resulted in death from Streptococcus hemolyticus and B. coli. It was found that when the anastomosis had been done a rather large diaphragm had been turned in. The opening was patent but on the proximal side a flap of the diaphragm had turned upward and covered the opening so that there was a complete obstruction. This obstruction led to undue tension on the sutures and a perforation of the suture line had occurred anteriorly with resulting peritonitis. Comment: A tube drainage near the site of anastomosis would probably have saved this patient. Case 4: G. S. No. 70578. Age 66. Male. This patient entered the hospital on June 25, 1928, complaining of \"stomach trouble\". The present illness began at least two years before admission. There were attacks of upper abdominal pain not relieved by food but relieved by pressure. Four months before admission he began to vomit, and four weeks before admission he developed severe lower abdominal cramps accompanied by obstipation and blood in the stools. Throughout this period there had been increasing weakness, loss of weight and anemia. Physical examination showed the patient to be chronically ill with evidence of severe loss of weight. There was moderate abdominal distension, and an anemia of 2,500,000 r.b.c. Following transfusion, operation was performed and a large carcinoma was found at the hepatic flexure. The ascending and half of the transverse colon were resected and a side-to-side anastomosis performed between the ileum and the transverse colon. No drainage tube was placed in the bowel. The first day after operation the patient had a chill. There was considerable drainage 438 CARCINOMA OF THE COLON from the Penrose drain which had been inserted. By the sixth postoperative day it was obvious that the patient had a fecal fistula. On the tenth postoperative day he developed pneumonia and died twelve days after operation. Comment. The late diagnosis and the poor condition of the patient, together with his severe anemia, undoubtedly contributed to the outcome. However, it is obvious that there was a breakdown of the suture line at the site of anastomosis. It is likely that a tube should have been used to prevent pressure at the suture line, but whether or not it would have changed the course of events cannot be stated. Case 5: J. W. No. 81028. Age 69. Female. This patient entered the hospital on the medical service on September 19, 1929, complaining of gas and abdominal discomfort. The present illness began with a backache 22 days before admission. She was confined to bed for three days, at which time she had loss of appetite and a temperature of 1010 F. After this episode she had some constipation and anorexia, and entered the hospital for study. Physical examination showed marked arteriosclerosis and hypertension. The ascending and descending colon could readily be palpated. Barium enema disclosed a narrowing of the lumen of the upper two-thirds of the sigmoid, associated with slight spasm in the upper portion. There was no evidence of infiltration of the wall of the colon. After cleansing the colon the patient had no complaints. She was discharged with a diagnosis of intestinal adhesions and chronic colitis. The remainder of the laboratory work was negative and there was no blood in the stools. This was a third attack of a similar nature that this patient had experienced, having promptly recovered from each of the others. The patient then remained symptom-free and went to Europe. On January 28, 1930, she had a chill, backache and abdominal discomfort. At intervals she had a slight fever and remained in a hospital in Rome until April 24, 1930, when she sailed for America. At this time she also had some frequency and dysuria. She again entered the New Haven Hospital on May 9, 1930, for study. On admission she had no complaints and felt as well as ever. Stool examinations were again negative, as was the other laboratory work, and the barium enema disclosed the same picture as on the previous examination. The patient was discharged from the hospital without treatment. She continued well until August 6, 1930, when she was suddenly taken ill with vague abdominal discomfort and distension. Distension increased, and she was taken to the New Bedford Hospital in Massachusetts, where she was treated for four days in an unsuccessful attempt to reduce the distension. Following this, an ileostomy was established. She steadily improved, and on October 21 she again entered the New Haven Hospital for closure of the ileostomy. Laboratory work was again negative, but it now seemed obvious that an exploration was indicated. At operation a dense mass was found fixed to the uterus and 439 YALE JOURNAL OF BIOLOGY AND MEDICINE sacrum and the upper sigmoid. This mass had resulted from a perforation of a carcinoma of the upper sigmoid, and involved two loops of ileum and a part of the transverse colon. The sigmoid, including the mass, was resected, and an end-to-end anastomosis was performed. In order to accomplish this, it was also necessary to divide the ileum involved in the mass, which was later anastomosed by a side-to-side anastomosis. The patient seemed to stand the operative procedure fairly well, but on the second postoperative day her temperature became elevated, and on the next day her pulse became irregular. She died on the fourth postoperative day. Comment: No post-mortem examination was obtained, but it seemed likely from the symptoms that this patient died as a result of peritonitis following a very extensive operative procedure. Failure to make an early diagnosis was a contributory factor, and it is possible that if an exploration had been carried out when she first entered the hospital a more favorable condition might have been encountered. It was probably unwise to attempt a radical operation on this patient. Case 6: H. D. No. 15846. Age 70. Female. This patient entered the hospital on February 28, 1923, complaining of \"gas on the stomach\". The present illness began four days before admission to the hospital following \"a strain on the right side\". At this time the patient noticed a dull pain in the right lower quadrant. The following day there was generalized abdominal pain, gas and vomiting. The pain increased, was colicky in nature, and was relieved by belching. She had a bowel movement following the ingestion of castor oil. The patient had had indigestion for years, but no attacks similar to the present one. She had also been troubled with chronic constipation. There was no history of blood in the stools. Physical examination revealed an obese woman with a moderately distende

The Physical Status of Underprivileged Boys of New Haven.

Abstract: During the winter and spring of 1933 609 boys, ranging in age from 7 to 21 years (mean 12.66) were examined* at the Boys' Club of New Haven, which draws its membership from the poorest economic groups in the city. As far as we are aware no studies of a comparable group of boys have been published,-a surprising fact since in recent years this economic level has received the most attention from charitable organizations. The boys were weighed and examined, while stripped, by one of five physicians. When abnormalities, such as cardiac murmurs,

Tuberculous Choroiditis in an Infant of Thirteen Months.

Abstract: A review of the literature of recent years dealing with tuberculous choroiditis, discloses very few reports on the subject. Robin and Dickey' reported a case and stated that it was the only one seen in their clinic. Apparently there is little interest in this lesion; tuberculous choroiditis is not frequent or is overlooked. At a clinico-pathological conference in which the case of a young girl who had died of disseminated tuberculosis, and had lesions in the eye, was under discussion, Cabot' remarked, \"I suppose somebody was speculating as to whether these refractile areas [seen on ophthalmological examination] in the retina could be miliary tuberdes, which we have all read about but most of us have never seen.\" The incidence of choroid tuberdes in wide-spread tuberculosis varies greatly according to the various discussions of the subject. Thirteen cases of tuberculous meningitis, all having choroidal miliary tubercles, were described by Marple5 in 1912 (i.e., 100 per cent in 13 cases). Carpenter and Stephenson2 could not discover tuberculous involvement of the eye in more than 50 per cent of the cases reported by them. On the other hand Heinzl4, in an examination of 41 cases of tuberculous meningitis, was unable to detect any choroidal tubercles. This last report was published in 1875, when the means of examining the fundi were crude. Had the refinements in ophthalmoscopy of later years been available then, it is probable that pathological changes would have been brought to light. In his review of 73 cases of tuberculous meningitis, Tooke7 found only seven cases of miliary tuberculosis of the choroid. This divergence of opinion in the incidence of this complication is further explained by the fact that frequent examinations are required, since in the early stages of tuberculosis of the miliary type, choroid tubercles may not be present. Tooke said that tubercles were not seen earlier than three days before death. Marple recites an incident where an examination was done at 6 P. M. with no disclosure of choroid tubercles, but four hours later he was called by the house officer, who informed him that a tubercle had been found.

The Beginnings of Medical Practice in New Haven Colony.

Abstract: From the standpoint of present-day medical knowledge the story of medicine in the early colonial period is not an attractive one. The ridiculous treatment and the absurd remedies accorded the sick in that day seem valueless now. Nevertheless, the meager accounts that tell us of the medical life of that period are inspiring. One reads of the endeavors and contentions of these earnest medical pioneers with an admiration that is akin to reverence. The incessant physical struggles that their environment demanded and their firm spiritual contention for righteous living, produced in them a fortitude of body and mind that we, their descendants, may properly revere. It is my purpose to consider the beginnings of medical practice in New Haven Colony, to deal with our first physicians and to review the medical life of their time. Of necessity I shall limit my inquiry to the period from the establishment of the Colony in 1639 to the beginning of the next century. When we consider the changes in medical practice in our own time, changes brought about not only by newer and more effectual methods of treatment, but also by such agencies as the telephone, the automobile, and the development of the modern hospital, it is difficult for us to form an accurate picture of medical life even half a century ago. Scientific discovery and invention are making such tremendous changes in our entire life today, that the wonders of yesterday become commonplace, and each new complexity further obscures our vision of those who have gone before. How extremely difficult it is for us to think of the tiny settlement on the Quinnipiac meadows with its one hundred and thirty families, and how hard to picture the seventeenth-century physician making his daily rounds. The settlement of New Haven from its inception was a compact, thriving community. It comprised among its inhabitants people who were wealthy and educated. Although Bacon in Atwater's History says that \"New Haven Colony managed to be born and pass some years of its life without the help of any doctor of its own.

Medical Societies, Past and Present.

Abstract: I feel very much as though I were breaking into a family party tonight. The doctors of Connecticut have assembled to celebrate the 150th anniversary of the founding of the New Haven County Medical Association. All the relatives from near and far come together to extend congratulations to the child whose birthday is being celebrated today, a very grown-up child indeed. To do it honor are gathered here representatives of the administration, the church, the university, and many medical societies. Whenever a birthday party is held, it is customary for one of the worthiest members of the family to rise and express the feelings of all. And certainly no worthier member could have been selected than Dr. Harvey Cushing, himself a Yale graduate, now on the faculty of Yale, offspring of a distinguished line of physicians, pioneer doctors in New England, and later in Ohio, one of the great figures in American medicine, who conquered a new field for surgery and always succeeded in preserving the humanistic spirit which is typical of all the really great doctors. I am sure that we all deeply regret that illness prevented Dr. Cushing from being with us, and I feel that I am speaking as a mere substitute, and that my task will not be easy. When your invitation was extended to me, I felt greatly honored. I accepted it after some hesitation, and I did so for several reasons. Being an historian of medicine, I am naturally interested in all medico-historical events, and being in charge of the first Institute of the History of Medicine to be established in this country, I am eager to increase my knowledge of American medicine. And I felt that, after all, we medical men, no matter what our origin, belong to one great family. Wherever we are, whatever our specialty, we are fighting the same enemy and serving the same ideal. And, finally, it occurred to me that coming from the outside, I might be able to tell you things that modesty would prevent you, yourselves, from saying. In undertaking to prepare this address, I asked myself, \"What is the meaning, what the significance of such a celebration?\" Today we survey three thousand years of medicine, and from the point of

The Founding of the Medical Institution of Yale College.

Abstract: Two tributary streams of interest and endeavor united to form one of the outstanding developments arising from that union of brave men who, in 1784, banded themselves together in one of the oldest medical associations in the country. One of these tributaries was fed from the spring of deep dissatisfaction with the conditions of practice in the Colony and in the subsequent State. The other had its origin in the deep-rooted aspirations of the people for a wider and deeper culture. The eighteenth century saw a profound alteration in the conditions of living in Connecticut. In the early decades the population was scanty and largely confined to coast and river front. Means of communication were slow and arduous so that each little community tended to become a more or less isolated unit. These small congregations were self-supporting and self-sufficient, finding within their own borders the means of livelihood, and through the Divines of the period, education and spiritual and temporal guidance. In spite of this autonomy, a constant sense of comradeship in a joint enterprise kept the stalwarts in slow but sure communication with each other and with whatever central government existed. Toward the end of the century the population increased to something over 200,000, so evenly distributed over the territory that only two municipalities , New Haven and Hartford, called themselves cities, each with between 3000 and 4000 people. Nearly every man tilled the soil, turning his hands to that wide variety of handicraft requisite for the adequate maintenance of a well-regulated farm. Each family helped to produce the necessities for ordinary comforts of the household and but little was produced in excess of the needs. As a result, there was almost no accumulation of wealth, either private or public, and even less time was left over for the cultivation of the mind and spirit. The rigorous laws concerning behavior on Sunday were quite as much a defense against the encroachments of mere existence as they were a hope of future salvation. Only the children of the more successful could be freed from the household tasks to gain a rudimentary education at the hands of the local clergyman.

Further Notes on Retrobulbar Neuritis Due to Thallium Poisoning

Abstract: In a previous communication9 three examples of an unmistakable syndrome due to thallium intoxication were reported, and the damaging effect of thallium upon the optic nerves was stressed. The therapeutic uses as well as distressing toxic sequellae were reviewed, together with the history of the metal. The disorder is characterized by temporary loss of hair, peripheral neuritis, nervousness, and failure of vision after the prolonged use of small amounts of thallium. There are associated evidences of peripheral neuritis, and the optic nerves become dangerously damaged, the visual acuity falling almost to nil, the visual fields stamped with the stigmata of large central scotomata, and the nerve-heads deprived of substance. It is a rare condition. The victims have generally been young women who have been bothered with hypertrichosis for which they have unknowingly used a potent thallium-containing (thallium acetate 7.18 per cent) depilatory, Koremlu Cream.t The manufacture of this preparation was discontinued in the spring of 1932 because of a pleaded bankruptcy, but the same concern has since been manufacturing another depilatory, Croxon,4 the contents of which are as ineffective with regard to their advertised power as they are innocuous. Males have likewise been affected by exposure in the preparation of thallium salts industrially, by accidental ingestion, by malicious poisoning, and after therapeutic administration. Since the publication of the earlier paper9 other cases have come to light and those previously reported have been repeatedly observed, so the opportunity is taken for reviewing the situation and reporting the later observations upon those already studied. Through the kindness of Dr. Lillie and Dr. Stine their reported cases are presented with reproductions of the visual fields. Dr. Haft has generously extended the privilege of reporting his case to which my attention had been called while the original paper was in

The Story of Childbirth

Abstract: The recent report on maternal mortality in New York City made by the Committee on Public Health Relations of The New York Academy of Medicine clearly shows that the major attack on this problem must be one of education. Physicians and laity alike must be made aware of the difficulties associated with attempts to bring the benefits of present-day obstetrical science to all those upon whom the propagation of the race depends. There is no better medium of expressing these truths than by such books as Findley's The Story of Childbirth. The work deals not only with the history of obstetrical practices but it contains excellent chapters on such timely subjects as birth regulations, maternal mortality and the modern maternity hospital. Dr. Findley brings to the preparation of such a work the experience of a skilled clinician and a notable contributor to obstetrical science, and with unusual skill he is able to translate that experience into simple language that the layman can understand. Out of a mass of popular books on sex problems now flooding the American market, The Story of Childbirth comes with a fresh and healthy view of the truth of things as they are. Dr. Franklin and the publisher, C. C. Thomas, are to be complimented on this very beautiful and interesting resurrection of one of the classics of anatomy. Stimulated by Dr. Fulton, Dr. Franklin has presented a brief but concise picture of the environment which produced this early study of the valves of the veins. The biographical notice tells us something of the colorful career of Fabricius ab Aquapendente. This anatomist must have lived a full and fruitful life. Not only was he a successful anatomist as such, but he was a stimulating and impressive teacher. Students from all over Europe came to work with him but his chief influence seems to have been on those who gathered in Padua from Poland and Germany. England, too, shared in this interest, for the young William Harvey undertook the arduous journey to Padua to study Anatomy. The historical background of the first adequate description of the valves of the veins shows how often it is that scientists miss the crucial discoveries, skirting the outer margins but only occasionally penetrating to the heart.

Features in the Architecture of Physiological Function

Abstract: Barcroft's book has the charm which is only to be found in a personal narration by a highly informed student of physiology who has gained his facts at first hand. The style of the monograph is disarming and may well be compared with that of an informal tete-Ai-tete after dinner. Nevertheless, the facts discussed are brought forward from all that the best and latest knowledge of physiology can afford and these facts are skilfully marshalled in such a manner as to illustrate the principles they subserve. For example, Claude Bernard's famous \"La fixite du milieu interieur est la condition de la vie libre\" is amply illustrated with the many mechanisms-buffer, renal, respiratory-involved in the maintenance of the acid-base equilibrium of the body. After a discussion which includes the regulation of other factors of the internal environment-glucose, water, oxygen-the meaning of the second portion of Claude Bernard's dictum is given an unexpected turn. Instead of merely the freedom to live relatively independently of the exigencies of the external environment, a freedom shared alike by all mammals, Bar-croft shows that the relative constancy of the internal environment is necessary first of all for the function of the nervous system, because the central nervous system is the portion of the body most sensitive to changes of the \"milieu interieur\". Therefore, in man, \"la vie libre\" signifies his intellectual supremacy. In a similar manner other features of the architecture of physiological function are discussed; the storage of foods and the integrative action of the body, both of which aid in the maintenance of the constancy of the fluid matrix of the body. The function of nerve, muscle and kidney tubule in an all-or-none fashion, necessitates a mobilization of an increased number of units in order to procure a greater result. The principle of antagonistic action of opposing mechanisms permits finer control of function, and that of duplication, i.e., simultaneous nervous and chemical or hormonal regulation of the various organs also subserves the purpose of finer control. After reviewing the many other duplications of functions, i.e., of the enzymes for the digestion of the foodstuffs, the various stimuli of the respiratory centers, the rods and cones for vision, the sensory organs of the skin, Barcroft defines this principle even more clearly by calling attention to a glaring exception. He is surprised that we have but one heart. The author points out that an organ should …

Dental and Medical Relationships at Yale.

Abstract: That dentistry and medicine are related has been so frequently commented upon during that past decade, and is today so generally accepted, that it does not need repetition here. Although a great deal has been said on the subject, there is still a need to show how and where the two professions are connected. It is true that the tooth is a part of the human body; that dentistry has been and still is practised by physicians in some countries; and that among ancient people dental and other physical disorders were treated by the same individual. But these facts do not prove that dentistry and medicine are closely bound together today, nor do they warrant an assumption that the dentist and the physician have identical functions and should be given the same training. However, there are many problems which clearly call for the application of both medical and dental knowledge. For example, a cause and effect association between acute nephritis and an acute dental abscess has been demonstrated in some cases by clinical experience. In such cases the biological knowledge of disease which the good physician has at his command is needed, as well as is the skill of the dentist who can readily find and remove the abscess. Here we observe the fields of dentistry and medicine in a very intimate association. The knowledge which has already been gained and which might be brought to bear upon the problem is divided between two individuals who do not often speak a common language. In order to facilitate the solution of such problems it would seem advisable to combine, in a few individuals at least, the physician's general medical knowledge, the dentist's skill in handling such a case, and the biological knowledge necessary for the understanding of the local dental disease. The fact that there is a sphere in which dentistry and medicine merge does not mean that all dentistry is closely linked to medicine. In our emphasis upon investigation in that sphere in which the two fields do admittedly overlap, we have no quarrel with dentistry as a whole. One can have only the highest regard for the remarkable

The Shadowed Side of Spallanzani.

Abstract: An historical study of a man tends to emphasize certain characteristics to the exclusion of others. This, of course, enables the reader to gain more readily a mental picture, but the question arises as to whether or not a well-rounded conception can be obtained from consideration of a limited number of traits. Lazaro Spal-lanzani has been indelibly traced as a religious scientist whose force of character dominated the scientific world of his time. That is true enough, but fails in the presentation of a balanced perspective. It may be worth while, then, to dispel part of the shadows that dim his character, to portray a tricky, clever man, every bit as prone to fault as other men, one who gained his ends by craftiness when \"strong-handed\" means failed-a sly, greedy, yet likeable scientist who placed his work foremost. As a boy, Spallanzani exhibited the wiliness that he was to fall back on in later years at times when straightforward domineering met with obstacles. His father, a lawyer, set the carefree son to follow in paternal footsteps, but the young lad had other indinations, slipping outside to while away the day in skipping stones over nearby waters. The story is told that while wondering what caused the stones to skip, he pondered how he could escape an approaching life of jurisprudence. An idea occurred. He left off skipping stones to study Logic, Greek, and French. After acquiring somewhat of a background, he artfully laid his plight before the great teacher, Vallisnieri, a native of Spallanzani's birthplace, Scandiano, Italy. Oddly enough, Vallisnieri's position at Padua was later to be offered to the boy who now sought him. On behalf of the young lad, Vallisnieri pressed an interview with Spallanzani Senior so successfully that the boy was not only freed from a prospective career of studying legal documents, but was given an opportunity to study under a famous relative, Laura Bassi of Bologna. Most historians mark this as the turning-point in his life, for from this time on his favorite study of Homer and the Greeks seems to have been largely replaced by scientific interests. He soon became his teacher's favorite pupil. As proof, however, that he had not entirely deserted his early love of arts is the fact that his first teaching positions were in the successive chairs of Logic,

Tissue Reactions in Immunity: Some Clinical Implications.

Abstract: Immunology has thus far been of relatively limited help to physicians in interpreting the immunologic rOle of specific tissue reactions that accompany bacterial invasion. The immunologist has been of outstanding help in bringing to light the defensive properties of the fluids with their antibodies, and of the phagocytes. In interpreting the reactions of the fixed tissues against bacterial attack the tendency of late years has been to consider them as allergic, defining allergy as hypersusceptibility-the opposite of immunity. Considering the intimate contact and the chemical interreactivity of the tissues and fluids, it is difficult to conceive how the tissues can be hypersensitive to the same microorganisms against which the fluids are protective. The basis for the allergic interpretation of specific tissue reactions undoubtedly lies in the fact that they are inflammatory in nature. If a rabbit, for example, is injected subcutaneously with some protein solution, such as horse serum, no significant inflammatory response will be noted and in less than twenty-four hours the area of injection will appear normal. If, about two weeks later, the same rabbit is again injected with horse serum, a marked inflammatory response will be noted in the area of injection. Arthus,1 who first observed this response in 1903, assumed that he dealt with a condition of \"local anaphylaxis.\" This assumption seemed reasonable. Animals usually developed tolerance to repeated injections of many substances. But here was a condition where an animal showed no inflammatory response to a first injection and increasingly marked inflammatory responses to repeated injections given at later periods. The animal tissues must have become hypersusceptible to the protein. Thus has the view become widespread that specific tissue reactions are allergic. During the past four years, studies have been directed in this laboratory to the nature of the tissue responses in the immunized state.' Albino rabbits served as the experimental animals. The