the subject or has had similar opportunities for observation, do most earnestly protest against the inauguration of any system looking to a provision for insane criminals in any one of the existing State hospitals, or upon any part of the grounds of these institutions, as impolitic, unnecessary, and detrimental to the best interests of the insane. Feb. 19, 1874. THOS. S. KIRKBRIDE, M.D., JOHN CURWEN, M.D., S. S. SCHULTZ, M.D. REPORT OF CENSORS ON APPEAL OF DR. WM. R. FINDLEY. THE Board of Censors of the third and fourth Districts met at the Crawford House, Williamsport, Pa., July 24, 1873, on a call from Dr. J. S. Crawford, President of the Board: Drs. J. S. Crawford, E. B. Brandt, and D. P. Miller, present. Dr. Crawford called the Board to order. On motion of Dr. Brandt, D. P. Miller was elected Secretary. The several appeals of Dr. Wm. R. Findley from the action of the Blair County Medical Society were presented to the Board by Dr. Crawford. Dr. Findley was present. The records and minutes of the Blair County Medical Society were placed in the possession of the Board by the Secretary of the Society. The appeals were taken up in their order by the Board as follows, viz.: April 18, 1873. 1st. At a meeting of the Blair County Medical Society held Jan. 28, 1873, when the minutes of the preceding meeting were read, a motion was made and carried, that the Society will not entertain, or allow to appear on the minutes or to be tried, the charge preferred by Dr. W. R. Findley against Dr. Rowan Clarke at the last meeting of this Society in October, 1872. From this action I most respectfully appeal. WM. R. FINDLEY. April 18, 1873. 2d. At a meeting of the Blair County Medical Society held Jan. 28, 1873, I was tried upon a charge preferred against me by Dr. C. Irwin, found guilty, and expelled. From this action I respectfully appeal. WM. R. FINDLEY. April 18, 1873. 3d. At a meeting of the Blair County Medical Society held Jan. 28, 1873, the Society refused to take up and try the charges preferred by me, at the last meeting in October 1872, against Drs. Calderwood, Gemmill, Sr., and Fay. From this action I respectfully appeal. WM. R. FINDLEY. April 18, 1873. 4th. At a meeting of the Blair County Medical Society held Jan. 28, 1873, after the vote to expel me, I gave notice in writing to the Secretary that I appealed from that action. Notwithstanding my appeal, a motion was made and carried, that the Secretary be directed to strike my name from the roll of members of the Society, and that the Secretary be directed to notify the Secretary of the State Medical Society also to strike my name from the roll of members of that body. I replied to this that my appeal held all such action, and all or any penal consequences of their vote of expulsion in abeyance till the appeal would be issued. From the action directing my name to be stricken off, etc. etc., I respectfully appeal. WM. R. FINDLEY. The Board, after thoroughly and carefully investigating all the appeals, hearing patiently all the evidence in the cases, would respectfully offer the following report, viz. : 1st. That they approve the action of the Blair County Medical Society in the disposition made by the Society of the charge preferred against Dr. Rowan Clarke, and therefore dismiss the appeal, Dr. Crawford dissenting from the majority of the Board. 2d. That they further approve the action of the said Society in finding Dr. W. R. Findley guilty of the charge preferred against him by Dr. C. Irwin, and therefore do not sanction the appeal. Dr. Crawford would recommend suspension for six months instead of expulsion. 3d. The appeal not sustained, because the case referred to was not disposed of when up for trial for want of time, and was never called up at a subsequent meeting. 4th. Appeal sustained by the entire Board. The majority of the Board would notice that the Secretary of the Blair County Medical Society was not authorized, as is stated in Dr. Findley's appeal, to request the Secretary of the State Medical Society to strike the name of Dr. W. R. Findley from its roll.-See Transactions of State Medical Society of Penna. for 1873, page 19. All of which is respectfully submitted. E. B. BRANDT, M.D., D. P. MILLER, M.D., Censors. ADDRESS IN SURGERY. BY THOMAS M. DRYSDALE, M.D., OF PHILADELPHIA. AT the last meeting of the State Medical Society I had the honor of being appointed by the President to deliver the "Address in Surgery" for this year. Appreciating the importance of the subject, I have given it careful consideration, and, aiming at usefulness, I have ventured to disregard the letter of the resolution under which the appointment was made and to address you upon a matter of practical importance rather than give a necessarily incomplete review of the progress of surgery. I do this with greater freedom since I but follow the course pursued by a former lecturer who was fully endorsed by the Society. The subject I have chosen is tracheotomy, which is equally important to the surgeon and the general practitioner "since it brings back to life one who is suffocating and is at the point of death." It may, perhaps, be urged as an objection to this subject that it is an old one and supposed to be understood by all members of the profession. That the operation is ancient I admit, but that there are many members who are not familiar enough with it to undertake its performance is a well-known fact, in proof of which assertion I could offer more than one sad instance. This neglect of a subject of such vital interest should not exist in any medical practitioner, and I hold it to be the duty of every physician to be as ready to perform tracheotomy in cases requiring it, as to bleed in those diseases demanding the prompt use of the lancet to save life, for the cases are generally urgent, and the time required to send for a surgeon is frequently insufficient, so that if the attending physician is incapable of operating, the sufferer may expire before assistance reaches him. That many physicians are to be found who practically know nothing of this operation is not strange, nor are they entirely to be blamed for it, for the opportunities to familiarize themselves with tracheotomy do not present themselves. In private practice the operation is usually performed hurriedly with but few assistants, and these, in the excitement of the moment, can follow but imperfectly the various steps of the operation. In hospital practice the emergency arises and the surgeon in charge cannot delay, as in other cases, in order to present the patient to his class. The cadaver then is the only subject in which they see the operation performed, and the professor, in urging on his hearers the importance and difficulty of the operation, unfortunately too often succeeds in frightening his class from its performance. Believing that there are but few men practising medicine who have not been or will not be called to cases requiring tracheotomy, I have considered it a proper subject to bring before you. The operation is an ancient one, having been, according to Galen, first performed by Asclepiades; but without considering its history, which would indeed be foreign to my purpose, I will at once glance at the principal diseases and accidents which may require its performance. These may be considered under six heads: 1st. Inflammation of the larynx and trachea and its results; 2d. Spasm of the larynx; 3d. Abnormal growths in the larynx; 4th. Paralysis of the larynx; 5th. Pressure from tumors, aneurisms, or abscesses; 6th. Foreign bodies in the windpipe. Besides these, it has been recommended and used in hydrophobia, epilepsy, asphyxia 'from drowning, etc. 1st. Under the first head we have: (a) Simple laryngitis, which is the commonest disease of this organ, being produced by many different causes, such as colds, inhaling steam from boiling water, or even drawing the hot water into the windpipe; from breathing irritating gases, or from external violence, such as garroting or wounds, and may be acute or chronic. (b) Inflammation of the larynx also occasionally occurs in measles and scarlatina when, according to Wood, it is usually of the pseudomembranous form, and in smallpox it sometimes happens that the eruption and attending inflammation extend to the larynx and trachea. We may also meet with cases of erysipelatous inflammation of the windpipe, which is an exceedingly dangerous affection. The disease commencing in the fauces spreads to the larynx, giving rise to œdematous infiltration of the mucous membrane and submucous cellular tissue, obstructs the rima glottidis, and strangles the patient. From this special tendency to oedema the disease has been termed, by some writers, cedematous laryngitis, although we may have dematous laryngitis independent of erysipelas. |