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mediate operation was called for where there was diffuse peritonitis or perforation of the unprotected appendix. Dr. W. generic for glucophage T. Lusk said a word from the medical side. He thought we had about reached a stage in the history of appendicitis that we had reached not long ago in the history of salpingitis. It was once said that no pus-tube could recover ; all cases should be operated upon. Late- ly numerous examples were being put on record of re- covery without operation. People were often unneces- sarily frightened on having even a simple colic, being told, perhaps, by some radical surgeon, like glucophage buy in an in- stance which he related, that if it were their own case they would submit to an operation at once. Dr. John Cronvn made some remarks upon Sir James A. Grant's paper, after which a communication was read from a French physician, visiting this country, on granu- lar conditions of the eyes in tropical climates. He hav- ing found a strong solution of sulphate of copper about the only efficient means of healing them. 54° MEDICAL RECORD. [October 21, 1893 Fourth Day, Thursday, October i2jh. President-elect. — The Nominating Committee made its report. Dr. Thomas D. Strong, of Chautauqua County, being named for President. The glucophage generic gentlemen named were elected. The Male Catheter, with Some Observations Upon the Proper Mode of Introduction glucophage 500mg into the Bladder. — Dr. Douglas Ayres read the paper referring to ancient use of the catheter, its forms, the anatomy of the urethra, steps in buy glucophage online introduction of the catheter, difficulties encoun- tered, and relating cases of failure in his neighborhood. Eesearches on the Efl&cacy of Vaccina after Typhoid Fever. — Dr. William Finder, Jr., of Troy, had ob- served, during an epidemic of small pox at glucophage diabetes Troy, about twelve years ago, that patients who had had typhoid fever were easily vaccinated by the same matter which failed in other cases of revaccination. It seemed that typhoid destroyed the efficacy of vaccina, and he had since made it a rule to revaccinate in all cases of typhoid. Dr. RoiiB remarked upon the necessity for using fresh vaccine, and related an experience in his neighborhood. Reflections on the Need of Close Observation of tablet glucophage Disease and upon the Value of Hygienic Therapeutics. — Dr. H. ERNsr Schmih, of Westchester County, read a paper with this title. A few ancient and modern stories were cited as forcible illustrations. In most of them the information seemed to have been derived through marked power to draw inferences more than through observation. Some ridiculous mistakes were also mentioned, one or two in the experience of Wiinderlich. Allusion was made to the injustice of the criticisms of the laity. If it were fair to sue a doctor for failure in a given case, where he had treated the patient to the best of his ability, why should not the lawyer be liable when he lost his client's case through a legal technicality? Medicine had for a long time been mere empiricism ; a groping in the dark. Let there be more general recogni- tion of the health-preserving and healing influences of fresh air, proper glucophage online nourishment, out-of door exercise, clean- liness, hygiene. Success in medicine called for knowl- edge, thoroughness, experience, and boldness, which was based upon profound judgment and conscientious- ness. State Asylums for the Inebriate. — Dr. Slhmid, as a member of a committee appointed last year, said they had gone before the Legislature and asked for the estab- lishment of hospitals for the inebriate, similar to those for the insane, and a bill had been passed by both the Assembly and Senate, but had been vetoed by the Gov- ernor. It was hoped to have the bill passed again and signed. The committee was continued. Puerperal Blindness. — Dr. Darwin Colvix read the history of a case of puerperal blindness which, he thought, could have been warded off if the attending jjhysician had followed his advice strictly and abstracted blood earlier. He believed the cause of the blindness and eclampsia was glucophage xr the same. The woman recovered from her labor and slowly regained sight. Dr. McGillicuddv had four cases of puerperal blind- ness in hospital practice, the eclampsia being con- trolled by chloroform and other anesthetics, milk diet, large cjuantities of water, etc. The treatment directed against the condition of the kidneys had in a few days relieved both blindness and eclampsia. In addition, delivery was cheap glucophage effected at once. A Plea for the Non-operative Method of Treating Dysmenorrhoea, Pelvic Inflammation, and Pelvic Ab- scess. — Dr. T. }. McC.ili.kuddy, of New York, read an earnest plea for the treatment of dysmenorrhcca, pelvic inflammation, and pelvic abscess, by measures cost of glucophage directed to the alimentary tract from above and below, and by non- operative intra-vaginal methods. Many had declaimed against too much pelvic surgery, but had stopped there instead of going on to offer an efficient substitute. The measures, described at some detail in the paper, related to depletion of the pelvic vessels, large quantities of hot water taken into the stomach, use of nitrogenous food, refraining from hydrocarbons ; iron, quinine, arsenic, dilute muriatic acid, intestinal antiseptics, bitter tonics, douching the colon twice daily, vaginal douches and tampons, rest, hygienic surroundings. Many were the cases of pelvic inflammation, dysmenorrhcea, and even ab- scesses, which had been cured by such means. Surgical interference with the glucophage cost interior of the uterus had done much harm. If a patient died from an operation where medical treatment would have cured, the white sheet covered a scientific murder. A Discourse on Temperature. — Dr. H. F. W. Risch, of Brooklyn, gave an abstract of a paper on this subject. The uniformity of the temperature of the human body at all latitudes was a most remarkable phenomenon, and its disturbance glucophage mg pointed to some form of irritation, glucophage sr mechani- cal or chemical. The irritation was of the nervous sys- tem. We should try to reduce the temperature to nor- mal, not by applications to the outside of the body if the rise was on the interior, but by colon flushings and by removing the cause, for instance microbes or their prod- ucts. Wednesday evening a bancjuet was held at the Hotel Brunswick. Thursday afternoon a visit was made to the Island hospitals. First Meeting, Held at Washington, D. C, September §, 6, 7, and 8, iSgj. (Special Report to the Medical Record.) (Continued from p. 502.) SECTION ON HYGIENE, CLIMATOLOGY, AND DE- MOGRAPHY. Albert L. Gihon, M.D., Medical Director, U. S. N., Washington, President, in the Chair; English Secretary, Peter H. Bryce, M.D., Toronto, Can- ada ; Spanish Secretary, Pedro Jose Salicrup, M.D., New York City. Fourth Day, Friday, September 8th — Morning Ses- sion. Pestilential Conditions. — -The combined sections were called to order at lo o'clock, when Dr. Bell opened the proceedings of the day by reading his paper entitled " Pestilential Conditions." Modern sanitation, he said, as undertaken in England, fifty-five years ago, was based upon the recognition of local conditions to the death-rate of the peo]ile ; and the coincidence of its practice and the progressive reduction of the death rate ever since, is the unanswerable argu- ment for the establishment of sanitary methods every- where. Dr. Bell passed in review on London in the sixteenth century, and Cairo two centuries later, discussing their pestilential conditions and the fearful results. Cholera in India received able and timely attention. He quoted from the valuable work of Dr. M. C. Furnell, late Surgeon-General and Sanitary Commissioner, Ma- dras, as follows : " In all India there died during 1S79, 5,000,000 of people, of whom fever killed 3,500,000 ; cholera killed off 265,000. In some years it is much worse than this. A good deal of this mortality is glucophage tablets order glucophage preventable, and the use j of impure water is, I feel persuaded, answerable for much of it." _ ! Following a lengthy description of the Indian condi-j tions that foster the disease, he further quoted from the same practical authority as follows : " . . . I do not by any means maintain water is the only means by which the cholera is spread. . . • I believe the air, clothes, food, drink price of glucophage of all sorts besides| water, may and do spread it; but I also believe that' water is the chief means by which it is spread, especially in India, and that on account of the peculiar treatment October 21, 1893] MEDICAL RECORD. 541 water obtains in this country, that India, the only coun- try in the world, is subject to such frequently recurring and such terrible epidemics of this dread scourge." Germs and germ disease received due attention. Dr. Bell said: "But the spores of bacteria — the seeds — are, of all things viable, the most persistent. . . . The spores of bacteria glucophage price are practically immortal." Ne.xt in order was No. 702 on the official catalogue, glucophage xr 500mg or, "Epidemic and Exotic Diseases Propagated l>y Ship ping;" "What Diseases Should be Quarantined?" " Responsibility of Nations for Epidemics ; " " India for Cholera, South America for Yellow Fever;" "Can a Feasible Plan be Devised to Totally Exterminate Chol- era? " " International Intervention to Prevent the Propa- gation of Cholera or other Epidemic Diseases by Pilgrim- ages or Immigration." Discussion opened by Wolfred Nelson, M.D., New- York City. Dr. Nelson said that Surgeon- General Wyman, of the United States Marine Hospital Service, had paid him an unexpected and distinguished compliment in naming him to open a discussion on a theme so important. Speaking of water-borne diseases, he dealt principally with yellow fever and cholera. With the former he had had an extended experience in the tropics,- largely as a practitioner at Panama — and India, for cholera. Dwelling on the epidemics of yellow fever seen by him. he incidentally referred to the very valuable and effec- tive work done by Dr. Domingos Freire, a Proiessor of the Faculty of Medicine in the University of Rio de Ja- neiro, whose preventive inoculations for yellow fever were rich in promise, and already doing good work in Brazil. Taking up the responsibility of nations in fostering and spreading disease, he said that they should be called to the bar of Nations and there held to a strict account- ability. Nations, like individuals, have a responsibility, and should be held to it.

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