ADDRESS OF THE PRESIDENT OF THE 
SECTION ON NEUROLOGY AND 
PYSCHIATRY OF THE FIRST 
PAN-AMERICAN MEDICAL 
CONGRESS. [Reprint from Thk Alienist and Neurologist, St. Louis, Oct. 1893.] 
Address of the President of the Section on 
Neurology and Psychiatry of the First 
Pan-American Medical Congress.* 
By C. H. Hughes, M. D., St. Louis, Mo. 
/COLLEAGUES of the Continent • I bid you cor- 
dial welcome. For the first time in the history of 
the world the medical profession of all the Americas 
meets fraternally for mutual work and words of counsel 
for the welfare of the North and South American medi- 
cal profession and people. 
In this Neurologic and Psychiatric Section, brothers, 
we also, for the first time, grasp the hand of fellowship. 
We heartily clasp hands with you and in our hearts we 
embrace you, with the prayer that nothing shall ever dis- 
sever the friendship between the Northern and Southern 
American profession now so auspiciously consummated. 
May the final hand-shake between the profession of the 
North and South American States never be permitted to 
take place. We want your friendship forever. So long 
as “ earth grows a plant or sea rolls a wave,” we pray 
that it may endure, growing closer and closer in ties of 
inseparable fraternity. 
In our special departments of medical research and 
labor we have a common interest, and in every depart- 
ment of medical investigation and advance, our interests 
are likewise mutual. The sanitary welfare of all of the 
American States is alike. The same hygienic, therapeutic 
and pathologic problems press upon us all for solution ; 
the medical discoveries of each one of these States 
redounds to the welfare of all the others. 
To this end, therefore, we salute and welcome you, 
wishing you health and happiness, through a mutually 
* Washington, D. C., September 5, 6, 7 and 8, 1893. 4 
C. H. Hughes. 
advanced and glorified medical profession, and in behalf 
of the Neurological Section of this great congress, I join 
you in the sentiment, “ America laudamus—viva Amer- 
icana ! ” 
Before proceeding to the work before us, it may prove 
a source of pleasure and profit, and it certainly is flattering 
to our professional pride to note some of the neuro- 
logical advances of our day and especially the contribu- 
tions of neurology to general medicine and the consequent 
welfare of the world. 
None of the many victories in the onward march of 
American medicine during the century now nearing its 
close, have contributed, or are destined yet to contribute, 
more to the happiness of mankind than the light which 
has been thrown by our researches on the nature and 
treatment of inebriety, dipsomania and chronic alco- 
holism and their neural sequelae, especially multiple 
neuritis. 
To a distinguished American physician, signer of that 
Declaration which gave a nation birth, Surgeon-General 
of the Continental Army and teacher of the Practice of 
Medicine in the first medical university founded in 
America, Dr. Benjamin Rush, the scientific world is 
indebted for having taught that inebriety is a disease. 
His followers, living in the Pan-American States, taking 
their cue from this distinguished pioneer medical savant, 
have pursued the study until the therapeutics of inebriety 
has become as successful as that of any other grave 
nervous disorder and its pathology as well understood, 
while medical philanthropy, following his advice,* has 
erected hospitals for the cure and care of its unfortunate 
victims, though, as yet, no monumental shaft memen- 
toes, as it should, a nation’s grateful memory of Benja- 
min Rush’s noble work. 
We record, also, with satisfaction scarcely exceeded 
by that we enjoy from contemplating the salvation of the 
inebriate, the successful cure of the opium habit and 
* “ Diseases of the Mind,” 1812. Pan-American Medical Congress. 
5 
other kindred forms of baneful drug enslavement. Yet it 
has not been long since that once brilliant litterateur, De 
Quincy, himself enthralled, proclaimed in despair the 
“ pangs of opium ” and the “ Illiad of woes ” its enslaved 
victims hopelessly endured. 
The opium fiend, as he is with cruel facetiousness so 
often called, need not be longer regarded as a hopeless 
wreck if the hand of charity will only conduct him within 
the pale of professional resource. This and alcoholism 
and all similar forms of nervous derangement are now 
treated successfully much like certain forms of mental 
aberration are—by change of environment, by therapeutic 
repression, including hypnotic support and reconstruction 
of the damaged and aberrantly-acting neuropsychic cen- 
ters. This is another jewel medicine offers for the crown 
of modern progress. 
Notwithstanding the illustrious names which, in our 
own day, the world beyond our geographical boundaries 
has given to medical science, our American States have 
likewise their great physicians whose offerings on the 
altar of that science whose special care is the welfare of 
man, are worthy of exalted place beside the Old World’s 
gods. For the Virchows, Charcots and Lombrosos, Mar- 
aglianos and Kowalewskys, Gulls and Horsleys, of world- 
wide fame beyond our shores, we have given to the 
world our Brown-Sequard, who went from America to 
cosmopolitan fame, our Hammond, another pioneer Amer- 
ican neurologist whose books have been translated into 
all the languages of civilization, our Seguin likewise, and 
our Pepper, President of this Congress and the peer of 
Sir William Gull, of Great Britain, and Ferran, whose 
preventive inoculations against cholera Asiatica called the 
medical world’s attention anew to the grandeur of Spanish 
medicine. If Wigan could conjecture the duality of the 
mind from theoretical considerations and the general 
division of the brain into hemispheres, Brown-Sequard 
later, and at the time an American, proved it, and even 
my own feeble contribution on the “ Duality of Action 6 
C. H. Hughes. 
and Vicarious Functions of the Cerebral Lobes and 
Hemispheres,” * in 1873, might count for something, even 
though it emanated from a lunatic asylum in the valley 
of the Mississippi. If Hitzig, a German, and Ferrier, an 
Englishman, demonstrated and located motor centers in 
the cerebrums of the lower animals, Bartholow, an Amer- 
ican, established by satisfactory physiological experiment 
their correspondence in the human brain.f If Victor 
Horsley and others first clinically applied the discovery 
of cerebral localization to surgical therapeutics for brain 
diseases, Professor William Fuller, a Canadian anatomist 
and surgeon, first trephined the skull in a case of idiocy, 
an operation which has recently been heralded from abroad 
as a new surgical procedure. 
The author of this operation, now residing in this 
country, in Grand Rapids, Mich., is the designer from 
life of a series of brain sections and sectional casts, 
photographs and models, some of which I now show you, 
which have not been excelled in Europe. 
Now that this operation of Dr. Fuller has come back 
to America with European approval as a European pro- 
cedure, it is interesting to note the reception, a part at 
least, of the medical press of England, gave the novel 
surgical procedure at its inception on this continent. 
The following extract from The London Doctor, a 
monthly Review of British and Foreign Medical Practice 
and Literature, No. 1, Vol. VIIII., page 5, Jan. 1, 1878, 
is appended as evidence that the case reported in this 
paper, received at the time a wide publication : 
Dr. Fuller, of Montreal, has, says the Canada Lancet, conceived the 
novel idea of trephining out portions of the skull of an idiot child of 
two years old, so as to allow the expansion of the brain. The idea is 
certainly novel, so far as we know, no surgeon having previously ven- 
tured to remove portions of the skull cap, so as to allow the brain to 
expand. We sincerely hope this brilliant (!) experiment will not be 
repeated. How does Dr. Fuller propose to protect the exposed portions 
of brain, should the brain protrude through the apertures he has made ? 
* American Journal of Intanity, Vol. XXXII., 1875. 
f American Journal of the Medical Sciencee. Pan-American Medical Congress. 
7 
According to latest advices, Dr. Fuller contemplates removing another 
piece. We hope not. 
Under the name of linear craniotomy, this operation 
has recently found decided approval both at home and 
abroad. Engel speaks enthusiastically of it even for 
dementia epileptica. 
If European surgery first exsects a stomach or a kid- 
ney, or cuts down upon and removes a stone from 
the bladder or gall cyst; American surgery, repre- 
sented in the person of Ephraim McDowell, with a 
temerity that startles the conservatism of Europe, first 
cuts into that surgical terra incognito, the abdominal cavity 
and saves an imperiled human life by successfully remov- 
ing an abdominal tumor, a feat common enough now, 
alas, all too frequently performed by novices with the knife; 
lacking in mature surgical judgment. He and Battey, 
another American, led the way for the successful ovari- 
otomies of Lawson Tait and his followers, and Marion- 
Sims, God bless his gentle precious memory, lays the 
foundation, by a peerless procedure on the female per- 
ineum, for the rescue of womanhood from untold misery. 
Marion-Sims, who, when asked to unsex a woman, 
in whom there was other possibility of salvation, could 
say to Weir Mitchell, “ Let us give her a reprieve; I never 
unsex a woman without a pang,” and the woman got 
well as you and I know hundreds of others would, if 
permitted to do, without oophorectomy. God bless 
Marion Sims. 
As we are justly appreciative of the part which 
American skill has performed in the world’s surgical 
advancement; as the recalling of the names and deeds 
of our Motts, Brainards, Popes and Stones and Physics’, 
Gross’and Hodgens, gives us pleasure; if we revere our 
Rushs and Woods as England does her Hunters, Syd- 
enhams and Gulls, so of our own American alienists and 
neurologists and their achievements, we are justly proud. 
The accomplished Isaac Ray and the gifted Amariah 
Brigham, Pliny Earle and Tyler, now no longer among 8 
C. H. Hughes. 
us, and Van Dusen, the son of Michigan and a Kalamazoo 
Asylum Superintendent, whose essay on “Neurasthenia” 
preceded that of the classical work of Beard on “ Nerv- 
ous Exhaustion ”—Beard who gave to the world a new 
disease, and gave it a new name, although the term 
“ Neurasthenia ” was borrowed unknowingly from Van 
Dusen (vide Alienist and Neurologist, Vol. I., No. 4, 
1880). Since these contributions appeared the subject of 
nervous exhaustion has become too common in the liter- 
ature of this country and Europe to need further mention 
here. 
There are three works of Dr. Hammond which have 
had much influence on Neurology and Medicine generally 
and these were accomplished during his service as Surgeon- 
General on the active list of the United States Army. 
1st. The establishment of the Hospital for Injuries and 
Diseases of the Nervous System in Philadelphia, where the 
foundation of Dr. Weir Mitchell’s most original work, 
“ Wounds and Injuries of Nerves,” was laid, Dr. Mitchell 
having been placed in charge by Surgeon-General Ham- 
mond. 
2nd. The establishment of the Army Medical Museum 
in Washington. 
3rd. The origination of the “ Medical and Surgical 
History of the Rebellion.” 
These three things give our colleague just claim to dis- 
tinction. I think the Hospital for Nervous Diseases was 
the first of its kind ever established in the world. 
Besides, our colleague wrote the first systematic “ Trea- 
tise on Diseases of the Nervous System ” in the English 
language, if not in any language. 
If we look for new discovery and classification of 
disease, America has not been entirely wanting. For a 
long time Beard’s claim was controverted abroad, after- 
ward Neurasthenia was called “ The American Disease,” 
then “American Nervousness,” till finally foreign writers 
recorded it among their people, even away oft in far-off 
Russia, where Kowalewsky has written his classic book on Pan-American Medical Congress. 
9 
the subject and given us due credit for our discovery. So 
in regard to Hammond’s discovery of athetosis and myso- 
phobia, and the coinage of these terms ; and in regard to 
neurasthenia, I believe it is even now conceded that the 
original American claim* of general functional neurotrophia 
as the foundation of nervous exhaustion is universally 
admitted. 
Seguin, in his clinical lectures in 1890, first suggested 
the substitution of a mixture of chloral and bromide for 
simple bromide, in the treatment of idiopathic epilepsy, 
when certain indications are present, chloral being 
indicated when the bromides alone produce undue stu- 
por and extremely severe acne; also in cases where 
psychic disorder follows the stoppage of the bromides. 
This practice has now become general. He first attempted 
to subdivide the symptomology of “ cerebral hyperaemia ” 
(of Hammond and others) into several new groups 
according to etiology, e. g., cases due to lithaemia, to 
feeble or diseased heart, and (a large group) to eye- 
strain, etc. He also attempted to give the distinguishing 
clinical signs (N. Y. Med. Jour., Dec., 1892), between 
cases of cerebral paraesthesia due to insufficiency of the 
interni and those due to insufficiency of the externi, and 
recommended the use of nux vomica and strychinia for 
weakness of the interni and of belladonna, cannabis indica 
and other mydriatics for weakness of the externi. These 
drugs to be user) as tests for diagnosis, and also for 
continuous treatment. He contributed by autopsies and 
clinical cases to confirm the doctrine of cortical localiza- 
tion of functions, in respect to the visual center (cuneus 
in 1880, I think), the speech center (1868) and in subse- 
quent years, the facial, brachial and pedal, or crural, 
centers, and gave absolute post-mortem evidence in sup- 
port of the idea that such centers exist. 
Besides Bartholow’s communication, the whole subject 
of cerebral localization has received additional light from 
the contributions of our Charles K. Mills, of M. Allen 
* Vide, Alienist and Neurologist, Yol. III., No. 3,1882. 10 
C. H. Hughes. 
Starr, Eskridge, Spitzka, myself ?nd nearly every American 
neurologist, while the contributions of Spitzka to cerebral 
pathology, as those of Isaac Ott to cerebral physiology, 
have been justly acknowledged abroad. 
Seguin and Hammond early advocated, before any- 
one else abroad, I think, the use of large doses of potas- 
sium iodide in syphilitic or non-syphilitic diseases of the 
nervous system, giving historical proof of its American 
origin (New York) and called it the “American method.” 
Attempts have been lately made in Europe to ignore our 
great priority in this. Seguin, S. and H., say they learned 
it from Van Buren and Draper in 1865-7. I adopted this 
practice at the Insane Hospital at Fulton in 1867-8. 
It falls to the lot of but very few men to discover 
a really important thing and to cause a great forward 
step to be made in medical science. Most of us must 
be content with helping the good work of adding new 
facts of secondary importance, and trying to apply scien- 
tific methods to the treatment of disease. I think that in 
this sphere of secondary scientific usefulness, American 
neurologists have made and are making good records. 
The clinical relation of absent patellar reflex to loco- 
motor ataxia, though first shown by Westphal and Erb, 
was extensively studied by Seguin, Gray, myself and others, 
and its relation to other diseases and the possibility of 
the knee-jerk being naturally nil in some persons, was first 
shown in this country and acknowledged abroad,* so that 
the knee-jerk criteria of tabes dorsalis is a lost reflex, 
and an exaggerated jerk in lateral sclerosis and other 
states. I myself offered the first proof many years ago 
that it need not be present in apparently healthy indi- 
viduals. One of those persons still lives and is free from 
any spinal or other nervous disease to this day. What 
is true as to elucidation of this reflex is equally true of 
the cremasteric and other reflexes, vide writings of Weir 
Mitchell and others. The bulbo-cavernous reflex and the 
* “ Diagnostic Significance of Absent Patellar Reflex.”—Alienist and Neu- 
rologist, January, 1880; St. Loui* Medical and Surgical Journal, February, 1879. Pari-American Medical Congress. 
11 
virile reflex, practically the same thing, were discovered 
and clinically elucidated about the same time in Europe 
and America. 
The value of the cremasteric reflex has been studied 
by Weir Mitchell with the same thoroughness of elucida- 
tion as that he has given to lesions of the peripheral 
nervous system generally; and Dr. John Ferguson, of 
Toronto, Canada, has also thrown new light upon the 
patellar reflex {vide “ Remarks on Some Cases of Hemi- 
plegia,” Alienist and Neurologist, January, 1892.) This 
subject has also lately been enriched in this country by 
Dr. F. X. Dercum, in a paper on “ Optic Neuritis, Blind- 
ness and the Knee-Jerk in Cerebellar Disease,” read 
before the American Neurological Society, July, 25th. 
The important subject of rheumatism affecting the 
nervous system was embodied in the recent address of 
Dr. Henry M. Lyman, before the American Neurological 
Association, and attention called to important clinical facts, 
especially affections of the sensory nervous system, not 
commonly recognized as associated with this disease. 
The gastralgias, enteralgias, cutaneous irritations, 
sensitive feet and arthritic and cutaneous neuritides of 
rheumatism, have often attracted my attention and 
have been to me an interesting clinical study, and much 
more is yet to be written on this important subject. 
In the therapeutics of the nervous diseases, as well 
as in clinical description and pathology, to America 
belongs much credit for originality and efficiency of 
discovery and suggestion. Was it not in this country 
that the great Brown-Sequard first conceived and prom- 
ulgated his famous treatment for epilepsia, which has 
done more than all preceding or subsequent therapeu- 
tics suggested for the alleviation of this grave malady ? 
All the now acknowledged virtues of phytolacca 
decandra, or poke root, except the property of phyto- 
line to reduce corpulency, were brought to my attention 
through the thesis of a student candidate for graduation 
of the St. Louis Medical College, in 1859; and Dr. 12 
C. H. Hughes. 
Bealle, an ingenious fellow-graduate from Texas, that same 
year, told in a thesis, which he entitled “ Ups and 
Downs of a Texas Doctor,” how he made a satisfactory 
flexible bougie out of green slippery elm bark, how he 
employed a smooth green wheat straw for a catheter 
and the crushed potato bug mixed with lard as a satis- 
factory vessicant in lieu of Spanish cantharides,—practices 
which I imitated myself while doing a general country 
practice in Missouri in 1859 and ’60, when I could do 
no better, and there is nothing much better for gentle 
dilatation in certain surgical emergencies than a smooth 
slippery elm bougie. I could relate other instances of 
Western American surgical genius in the use of thera- 
peutic expedients in pressing emergencies of practice 
were they strictly germane to our subject. 
It would require the space ©f many hours to detail the 
remedial virtues of our South American flora, beginning 
with our well-known cinchona. Vide paper on this subject 
by Dr. J. B. DeLacerda, a colleague of the present Congress. 
I suggested and used chloral hydrate per rectum in the 
treatment of convulsive affections, a method based on the 
West Riding Asylum practice in epilepsy, and used by me 
for arresting the convulsions of children and of the puerperal 
state. 
Leonard Coming’s method of local anaesthesia is 
original, and we justly claim the discovery and thera- 
peutic application of general anaesthesia as American, 
Sir. James Y. Simpson, to the contrary notwithstand- 
ing. Copious ether douching for cephalo-spinal pain 
was practiced by myself thirty years ago. I was the 
first to employ capsicum, hot coffee and ammonia 
enemata to resuscitate from profound opium narcosis 
{vide Appendix), after failing with a battery. Kiernan 
was the next to follow the practice. 
In the department of electrotherapy, especially in dis- 
eases of the nervous system, America stands well forward 
in therapeutic suggestion and resource. Beard and Rock- 
well and their followers in this country have done much Pan-American Medical Congress. 
13 
in this line. It has been fully thirty years since I first 
employed the constant current for cerebral and other 
congestive states, not excepting ovaries and pelvis, and 
recommended it in gynecology, based on a prior recom- 
mendation of Legros and Onimus that it would reduce 
interpelvic sanguineous fluxes. It has been more than 
twenty years since I began the systematic employment 
of constant cephalic galvanizations for the cure of insom- 
nia and the treatment of epilepsia, under the conviction 
that the prominent symptomatology of both of these 
affections were dependent upon disorder of vasomotor 
control, which cephalic galvanizations tend to restore as 
the bromides do. 
Dr. J. B. de Lacerda, of Rio de Janeiro, has offered 
to this Section a paper on “The Condition of Hyper- 
excitability of the Phrenic Nerve in Beri-Beri,” which is 
a real addition to the subject. 
In this connection I may properly mention Dr. Henry 
M. Lyman’s book on tl Artificial Anaesthesia and Anaesthet- 
ics, Insomnia and other Disorders of Sleep,” as a valuable 
American contribution to these subjects. 
We have done no markedly original work in hypno- 
tism, but have some imitators of Charcot and others, 
as Charcot and his followers have with professionah 
applause followed Braid, the professionally tabooed Man- 
chester follower of Mesmer, the mountebank original. 
Cataphoresis in neurotherapy has been considerably 
advanced in America by Corning, Peterson and others,, 
and likewise the hypodermic use of arsenic by Moyer;, 
also the employment of antipyrine, acetanilide and other 
coal tar derivatives, by the last named and many others,. 
(Vide Appendix.) 
The therapeutics, as well as semiology, of insanity, 
has been enriched by Jewell and Moyer in this country 
by treatment directed to the colon. (Vide Appendix.) 
Nitroglycerine, or glonoine, was first suggested to the 
regular profession in 1876 and ’78, by Allen McLane 
Hamilton, before Murrell or others abroad had used it, 14 
C. H. Hughes. 
for anaemic cerebral states and cerebral arteriole spasm. 
It was on this recommendation and the recommendation of 
nitrite of amyl for a similar purpose that I first employed 
the latter for the differential diagnosis of supposed 
hyperaemic from anaemic intracranial states (vide Editorial 
in Alienist and Neurologist, October, 1880.) 
A decidedly original and successful procedure in 
American surgical neurotherapy is that of pudic neurec- 
tomy as a remedy for masturbation, reported by Dr. J. 
S. Eastman in the Medical News of August 12th, of this 
year. The nerve being more sensitive on this side. Dr. 
Eastman cut down upon the left pudic nerve, which he 
found hypertrophied, and removed three inches of it. 
The patient gained weight and was freed from this vice, 
which had existed from the sixth to the twenty-sixth 
year. She had been previously sutured in the labia, 
cauterized, oophorectomized and clitoridectomized with- 
out benefit. 
Veratrum viride, one of the very best remedies I know 
of for sthenic states of high cerebral and pulmonary 
congestion with full, bounding pulse and violent cardiac sys- 
tole, that is better than the lancet in high grade apoplexy 
and pneumonia, as it is fatal to opposite asthenic states 
of pulmonary inflammation and cerebral congestion, is a 
distinctly American remedy, and the practice of using it, 
as well as abusing its use, is of American origin. It may 
sometimes well substitute the bromides in certain phases 
of neurotherapy. I have so employed it. But we must 
not further dwell specially on American original contri- 
butions to neurotherapy. We could not complete the 
subject in the limits of an ordinary duodecimo volume, 
while another volume of equal size would not record the 
real practical progress and unequaled elegance of Amer- 
ican pharmacy as applied to our therapeutics. 
In the direction of neurological originality and advance 
the work of our own distinguished Spanish-speaking 
Secretary, Dr. M. G. Echeverria must not be overlooked. 
Though his modesty has prevented him from publicly Pan-American Medical Congress. 
15 
claiming his due reward of merit, his claims have not 
been overlooked by foreign sources of appreciation. 
His English publications, notably his great book on 
“ Epilepsy,” although scarcely noticed by American 
authors, is much and favorably quoted by neurologists in 
Germany, England and France. On their merit he was 
elected Honorary Member of the Medico-Psychological 
Society, of Paris, and of Great Britain and Ireland; also 
Vice-President to the first Congres International de Mede- 
cine Mentale, held in Paris in 1878, when he was called 
upon to preside on motion of the late Professor Lasegue, 
after the sudden illness of Dr. Baillarger, Chairman of 
the Congress. So far as I know, Dr. Echeverria was the 
first physician in this country who, as “ Professor of 
Nervous and Mental Diseases,” delivered didactic courses 
of lectures on this subject. This was in 1861, in the 
University Medical College of New York, while Sequin 
followed at the College of Physicians and Surgeons, in 
1873. On his removal to New York from the National 
Hospital for the Paralyzed and Epileptic, in London, 
where he had occupied the position of resident assistant 
physician with Drs, Brown-Sequard and Ramskill as 
visiting physicians, he induced the Commissioners of 
Public Charities and Correction to establish the Hospital 
for Epileptics and Paralytics on Blackwell’s Island, New 
York, under his chiel direction, and to found a school 
for idiots in Randall’s Island, and Dr. E. Seguin, pere, 
Drs. Kerlin and Wilmarth, of Elwyn, and their literary 
and practical works as revealed in the pages of the 
Alienist and Neurologist (vide Appendix). They and 
Dr. Brown, of Barre, Mass., and the Wilburs have 
certainly done much creditable pioneer work with this 
class of defectives. 
We may here remark, as facts of historical interest, 
that Dr. Echeverria was the first in America to perform, 
in 1865, assisted by Dr. J. H. Douglas, excision of a 
large portion (two inches) of the ulnar nerve at the 
elbow for the radical cure of epilepsy following upon 16 
C. H. Hughes. 
traumatic injury. In 1869, in the presence of Prof. 
Boeck, of Christiania, and other physicians and students, 
he removed at the hospital in Blackwell’s Island, the 
largest sanguineous clot (one and three-fourth inches 
long by three-fourths of an inch wide) ever extracted, to 
that time, from the base of the second parietal convolu- 
tion of an epileptic lad, another operation lately origi- 
nated abroad. The conical fibrinous clot was deeply 
imbedded in the cerebral substance, and the patient 
directly recovered his lost intellectual faculties upon the 
successful operation. The case is reported in his “ Clin- 
ical and Anatomopathological Researches on Epilepsy,” 
and in a subsequent paper published in Paris in 1878 
(Lesigue's Archives Generate), with the records of five similar 
cases from Dr. Echeverria’s own practice, and one hundred 
and forty, mostly by American and English Surgeons. 
This paper was written mainly to show how unwarranted 
was the risk of this procedure then ascribed to it by 
French surgeons. 
This distinguished neurologist, one of our colleagues, 
to-day, and those I have named before him, will not be 
overlooked when a candid world enumerates in history 
of America’s neurological benefactors. 
Worthy of special mention with the foregoing is our 
indefatigable co-worker and colleague, Prof. Chas. K. 
Mills, whom the University of Pennsylvania has so lately 
honored with its Chair of Mental and Medico-legal 
Medicine. His recent studies in “ Lesions of the Supe- 
rior Temporal Convolution,” accurately locating the 
auditory center, his presentation of the subject of 
aphasia and other affections of speech in their medico- 
legal relations, and lesions of the cauda equina, are real 
advances that must be universally acknowledged, as are 
likewise the complications of multiple neuritis, and other 
papers which we present in the Appendix. 
And now I name another star which shines in the 
neurological firmament of New York—a star emphatically 
spelled by his far-seeing parents with a double “ r.” Pan-American Medical Congress. 
17 
Among numerous recent contributions, besides his 
book on “ Brain Surgery ” (Published by William Wood 
& Co., N. Y.), he has given us a special study of 
“Local Anaesthesia as a means of Diagnosis of Lesions 
of the Lower Spinal Cord ” (American Journal of Medical 
Science, July, 1892); “The Cerebral Atrophies of 
Childhood, with Special Reference to Imbecility, Epilepsia 
and Paralysis (N. Y Med. Record, Jan., 1892); “ Trephining 
for Hemorrhage of the Brain Producing Aphasia.— 
Recovery” {Brain, 1892); “ Hemi-Analgesia Alternans ” 
(W. Y Med. Record, Feb. nth, 1893, and has thrown 
some new light on the subject of “ Syringo-myelia ” 
{vide American Journal of Medical Sciences, May, 1888). 
His book, “ Familiar Forms of Nervous Disease,” is a 
credit to any country. Other bright neurological stars 
are shining and many have shone longer in the same 
scientific and humanitarian sky. 
It is my impression that Ord’s discovery of “ Myxoe- 
dema,” received its first clinical confirmation in this 
country, and McLane Hamilton, I think, furnished five 
of the earliest clinical proofs of its verity as a distinct 
disease. 
Hamilton first pointed out the neuro-genesis of cer- 
tain meningeal inflammations, and I have maintained 
and do yet maintain that haemophilia is a vasomotor 
neurosis. 
The Alienist and Neurologist (April, 1884, et seq.) 
early maintained that oophorectomy was too often per- 
formed upon the mistaken assumption that the ovary 
originated nervous disease, whereas the reverse is the most 
common clinical fact. This is not only an original American 
claim, but it is now becoming a generally admitted fact 
both abroad’and at home, and the latest and best article 
on this subject is by Dr. Hamilton, in a late number of 
the N. Y. Med. Jour. 
Another rising luminary of this field is Dr. Frederick 
Peterson, a reference to whose late contributions {vide 
the Appendix) will interest you and show some good 18 
C. H. Hughes. 
spokes, at least, in the wheel of neurological progress. 
His recent papers on “ Cataphoresis,” his physiological 
experiments with magnetism at the Edison laboratory, 
and his joint papers with Sachs on “ The Cerebral 
Palsies of Early Life” {Jour, of Nervous and Mental 
Diseases, May, 1890), and other papers to be found in 
Appendix, are all valuable. 
But the stars of this firmament are too many to be 
counted. Should we dwell long enough to attempt it, 
we should not during our hour get round the circle. 
There remains Sachs who has translated Maynert’s 
“ Psychiatry ” for us; Bert Wilder, The Brain Builder 
of Ithaca; A. Jacobi, The Universal Genius; Corn- 
ing, already mentioned, whose book on “ Brain Exhaus- 
tion ” is standard. There is also Dana, to whom we 
have already alluded, with Carter Gray, whose respec- 
tive books are abreast of all neurological advance, and 
in every way creditable to American neurological science; 
besides E. N. Brill, Graeme M. Hammond and Brown 
of the Journal of Nervous and Mental Diseases, also 
Ambrose L. Ranney and his standard text-books on 
“ Nervous Diseases and Neurological Anatomy,” and Geo. 
I. Stevens with his Belgian Academy prize essays on 
the ” Occulo-Neural Reflexes, and the Relation of 
Eye-Strain to Nervous Diseases,” whose first article on 
this subject appeared in the earlier numbers of my 
journal. Too many stars to classify and minutely describe, 
but they make a brilliant constellation. 
If*we look back to Philadelphia we discover another 
neurological star that has escaped our gaze, Wm. C. 
Wood, whose treatise stands high, and yet another, Dr. 
A. H. P. Leuff, of neuro-anatomical fame, also Harri- 
son Allen, and there is Wormly, too, of Philadelphia, who 
is not altogether without the pale, and James Hendrie 
Lloyd. 
Far to the Southward are Joseph Jones and Sanford 
Chaille, of New Orleans, and Buckley, of the Occidental 
metropolis. Pan-American Medical Congress: 
19 
And now, casting our eye to Baltimore, our vision 
falls on three luminaries, Miles, Osier and Hurd, whose 
light has not shone in vain. There also shine Conrod, Reed, 
Berkley, Welch and Halstead of Johns Hopkins Hos- 
pital. 
Skirting the sky Northward we come to the Hartford 
Constellation, Stearns and Crothers. The book of the 
former is devoted to practical psychiatry, the contri- 
butions of the latter to that important branch of psy- 
chiatry, which through Kerr, Mason, Wright, Crothers and 
others, has made such rapid forward strides in American, 
as well as in English, study of inebriety. 
The subject of alcoholic trance has been almost 
exclusively an American neurological study, and Dr. 
Crothers has contributed more than any other Ameri- 
can, perhaps, to make it plain. In the Appendix appears 
further evidences of American advance in this direc- 
tion. 
I had almost omitted to note the excellent series of 
articles by Dr. Frank G. Baker, Professor of Anatomy in 
the Medical Department of Georgetown University, on 
‘‘ Recent Discoveries in the Nervous System,” which have 
appeared in the Neiv York Medical Journal during the 
current year, and which have been copied into my own 
journal, from which it appears, in the language of the 
writer, that all the ideas we have had concerning the 
development and inter-relation of these structures must 
be revised. The entire nervous system must be re-exam- 
ined, the history of every ganglionic center must be 
traced. 
As our vision ranges further, Boston, with its neuro- 
logical and psychological savants, comes into view— 
Philip Coombs Knapp and his book on “ Intra-Cranial 
Tumors and Other Diagnoses,” Putnam, Channing, 
Webber, Folsom, John E. Tyler, the departed alienist of 
Sommerville, and Oliver Wendell Holmes, the poet sage 
and anatomical and psychological savant of Harvard. 
The subject of “ Arterial Tension in Neurasthenia” received 20 
C. H. Hughes. 
some new light from Boston in 1888 (vide article on the 
subject by Webber, Boston Medical and Surgical Journal, 
May 3d, 1888); likewise the subject of “ Lead Paralysis 
as it Affects the Brain (vide same source, October 29th, 
1891); also the “Condition of the Blood in Certain Men- 
tal States ” (vide idem, March 24th, 1892). The same 
journal for August 29th, 1889, also contained some 
additional light on “ Paramyoclonus Multiplex,” and 
other peculiar forms of spasm, and in September of the 
same year, in same journal, page 277, this American 
writer throws additional light on the subject of “ Cere- 
bral Tumors and Their Treatment.” 
As we continue our survey of the neurological heavens, 
we come to the constellation Chicago, with such bright, 
particular, neurological stars as Lyman, with his book on 
“ Practice; ” Kiernan, the polygot, who has given us 
good papers on nearly every subject in neurology and 
who has especially enriched the subject of morbid erotism 
in its clinical aspects in the United States; Moyer, the tire- 
less ; Paoli, Sanger Brown, Brower, Clevenger, Lydston, 
and their books, and Church, sadly remembering one bright 
luminary of these heavens now blotted out, whose light 
shone for a time upon our particular sky with effulgent 
’luster—Dr. J. S. Jewell. He was a star of the first mag- 
nitude, a neurological Jewell of the first water, an inde- 
fatigable student, painstaking observer and a writer of 
the highest ability. 
He blotted out his own bright life in the prime of 
his manhood by over-zealous work in the cause he loved 
above his life. He founded and maintained, while he 
lived, the Journal of Nen>ous and Mental Diseases. And 
this reminds us that we should not omit most honorable 
■mention, in this connection, of the name of Dr. Jewell’s 
worthy and industrious co-worker, Dr. H. M. Bannister, 
among the men of might near Chicago who have contrib- 
uted to brighten her brilliant neurological sky. 
Hinde and Moyer have also contributed a paper to 
4< Clonic Rhythmical Spasm of the Pronator Radii Teres” Pan-American Medical Congress. 
21 
{Jour, of Am. Med. Association, 1887); and Moyer alone has 
contributed the following additional papers: “ Periodically 
Recurring Oculo-motor Paralysis” (The Medical Record, 
1887), being the first case described in this country. 
“ Akinesia Algeria ” (Medical Standard, 1893), being 
the sixth case reported and the second in this coun- 
try, and “ A Rare Occupation Neurosis ” (Medical News, 
1893). By his works ye shall know him (vide Appendix 
for much more than we have here noted). 
Within almost a suburban radius of Chicago is 
McBride, of Milwaukee, and his “ Review of Insanity and 
Nervous Diseases," and Bannister, of Kankakee, and till 
lately Patterson, of Batavia, now deceased. 
Modesty forbids my dwelling at length upon what St. 
Louis has done for the advancement of neurology. We 
may recover from our modesty sufficiently to appear in 
the printed Appendix ; however, I might briefly intimate 
that both Dr. Bremer and myself have within the past 
few years added something to the literature of “ Astasia- 
Abasia ; ” Fry to “ Chorea ; ” Shaw to the subject of 
“ Trephining for Brain Disease,” and Bauduy to the 
“Study of Alcoholism and its Treatment.” This is not 
all that we have done, but it were better tfyat someone 
else, non-resident, should record and comment on our work, 
and I may say again, as I have said before, vide Appendix. 
Now if we continue our survey, we find the sky of 
neuriatry and psychiatry is not dimmed as we approach 
the region of the apparently setting sun. On the con- 
trary, bright stars illuminate the Western heavens. See 
how Eskridge shines : 
He has contributed a valuable paper on “ Nervo- 
Vascular Disturbances in Unacclimated Persons in Colo- 
rado ” (The Climatologist, March, 1892), the important 
conclusion of which is for persons on going to the high 
altitudes of Colorado, especially for those who-are nerv- 
ous or who suffer from pulmonary trouble or cardiac 
weakness, to live comparatively quietly until they become 
accustomed to their changed environments 22 
C. H. Hughes. 
Likewise another on “Chorea in Relation to Climate, 
Especially the Climate of Colorado” (Climatologist, Aug., 
1891). This study of the effect of the climate of Colo- 
rado on chorea shows but little, if any, modifying influ- 
ence due to altitudes of 5,000 feet to 6,000 feet. 
Another exceedingly valuable and advance contribu 
tion to the literature is “ Retro-Anterograde Amnesia 
with Report of Two Cases” (Alienist and Neurologist, 
July, 1892). This is an exceedingly interesting subject, 
both from a psychological and medico-legal point of view. 
This is as far as we can go with Eskridge. But he 
has written much from his high stand-point in the Rocky 
Mountains, and all is in the line of advanced neurology. 
( Vide Appendix.) 
Next comes Howell T. Pershing, of Denver, who 
records five cases of Pre-ataxic Tabes Dorsalis with Optic 
Nerve Atrophy, in which there were marked atrophy of 
the optic nerves with little or no ataxia. He gives - a 
statistical study of tabes, and shows that (as Walton and 
Gowers have recently claimed) the early occurrence of 
optic atrophy is in some way associated with an arrested 
development of the spinal symptoms. 
This fact modifies the ordinary rules of diagnosis and 
prognosis. 
He also records a case of Jacksonian Epilepsy, with 
successful operation ; no recurrence of the paroxysms 
more than a year after operation. Other articles by this 
writer are : “ Language and Brain Disease ” (Popular 
Science Monthly, October, 1892), and “ Disseminated Scle- 
rosis Following Syphilis ” (International Clinics, July, 
1891). 
But we cannot go further in this manner. If we went 
hence South to the City of Mexico, thence across the 
Gulf to New Orleans, thence North to St. Paul and 
crossed the continent to San Francisco, we should find 
working neurologists contributing their quota to the 
world’s neurological and psychological progress. 
As I am about to conclude, the proceedings of the Pan-American Medical Congress. 
23 
July meeting of the American Neurological Association 
have just appeared in the weekly medical press, and 
here are its notes of American neurological progress :— 
Besides the President’s Address and Dr. Dercum’s 
paper, to which I have referred, Dr. Smith Baker’s paper 
on “Heterogeneous Personality;” Matthew Field’s, on 
“Hospital Detention;” Frederick Peterson’s, on “Tem- 
perature in General Paralysis of the Insane; ” Joseph 
Collin’s, on “ Changes in the Spinal Cord in Old Cases 
of Infantile Paralysis ; ” G. M. Hammond’s, of “ Pro- 
gressive Muscular Atrophy;” C. L. Walton’s “ New 
Method of Reducing Dislocation of the Cervical Verte- 
brae ; ” Dana’s “ Acromegaly, Gigantism and Facial 
Hemi-hypertrophy ; ” J. J. Putnam’s “ Thyroidectomy in 
the Treatment of Graves’ Disease ; ” B. Sach’s “ Tabes 
and Syphilis ; ” Krauss’ “ New Pedodynamometer ;” Drs. 
Lloyd’s and Reisman’s joint communication on “ Infec- 
tious Endocarditis with General Septicaemia and Multiple 
Neuritis ; ” C. L. Walton’s “ Tumor of the Angular 
Gyrus ; ” Dr. E. D. Fisher’s “ Autopsy and Report of 
Congenital Cerebral Hemiplegia ; ” C. K. Mills’ “ Lesion 
of the Thalamus and Internal Capsule ; ” Wharton Sink- 
ler’s “Tumor of the Optic Thalamus;” Geo. J. Pres- 
ton’s paper on the “ Localizing Value of Aphasia; ” 
Leonard Weber’s, on “Neurasthenia;” Krauss’ “Case of 
Myxoedema, with Observations ; ” Philip Koombs Knapp’s 
“Simulation in Traumatic Nervous Diseases ; ” and “The 
Microbic Origin of Chorea,” by Dr. C. L. Dana, are all 
instructive, suggestive and progressive in our department. 
The proceedings of this favorite American society are 
becoming every year more and more valuable. They are 
indispensable to neurological advance. The neurological 
world would not march on to its manifest destiny to rule 
paramount in the world’s medical thought without the 
original work of this great American society of distin- 
guished neurologists. 
There were also papers read only by title before this 
body, the names of whose authors are also adequate 24 
C. H. Hughes. 
warrantee of worth. Among them—“ The Genesis of Hallu- 
cination and Illusion,” by H. A. Tomlinson, of St. Peter, 
Minn. ; “ The Diagnosis of General Paresis,” by L. C. 
Gray, of New York; “Two Cases of Friedreich’s Dis- 
ease,” by F. R. Fry, of St. Louis; “The Metapore or 
Foramen of Majendie in Man and in the Orang-Outang,” 
by Burt G. Wilder; “The Relations of Chorea to Rheu- 
matism,” by C. Eugene Riggs, St. Paul; “ Experiences 
in the Use of Testiculine and Cerebrine,” by J. J. Put- 
nam, Boston ; “ Paralysis after Surgical Operations,” by 
V. P. Gibney, New York; “Traumatic Brachial Plexus 
Paralysis in Infants,” by Wm. Leszynsky, New York. 
If I should go on enumerating the work, present and 
recent, of American neurologists, it would develop acute 
cerebrasthenia. It would make you tired. 
I had almost forgotten to note the contributions of 
our hospitals for the insane to the pathology of mental 
diseases. I cannot now go entirely over this vast sub- 
ject. Besides what has been done at Utica, N. Y., and 
Middletown, Conn., with which you are familiar through 
the Journal of Insanity, you may not know that it has for 
a long time been the custom of Dr. J. W. Blackburn, the 
eminent pathologist of the Government Hospital for 
Insane, at Washington, to each year select a number of 
cases for special study as a pathological supplement to 
the annual reports of the Government Hospital for Insane. 
This and the making of nearly one hundred post-mortem 
examinations yearly, constitutes the work of this hospital, 
to which I also invite your attention in the Appendix. 
I had almost omitted James Hendrie Lloyd, of Philadel- 
phia, and Theodore Diller, of Pittsburgh. 
You see, America breeds and develops neurologists as 
the water breeds and develops fishes. The pabulum 
neurology feeds on is in the American people—their 
hustling, rushing habits, their business, professional, social 
and political environment, and the numerous newspapers 
they read every morning before breakfast and every 
night before they forget to say their prayers—this moral, Pan-American Medical Congress. 
25 
political, social and business atmosphere of ambition and 
bustle, tends to develop the strongly endowed, neuro- 
logically and psychologically, as it tends in the weakly 
endowed to the development of neuropathic conditions. 
It develops neurologists and psychologists to care for the 
neuropaths. It builds and it breaks the nervous system. 
It cannot yet be said that we are a neuropathic people, 
though we are tending that way; but neurology is 
advancing with equal pace with neuropathic break-down, 
and will, it is hoped, ultimately enlighten and save the 
people from their neuropathic sins. 
APPENDIX. 
Dr. M. Allen Starr.— 
“ Diagnosis and Operation for Three Tumors of the 
Brain ” (American Journal of Medical Sciences, April, 1893). 
Dr. T. D. Crothers.— 
“ Law of Periodicity in Inebriety ” {vide Alienist and 
Neurologist, July, 1892), showing a uniformity in the 
drink impulse and the laws which regulated it. 
“Some New Studies of the Opium Disease,” read 
before the Philadelphia County Medical Society, Jan., 
1892, pointing out a neurotic diathesis and various con- 
ditions favoring this disease. 
“Are Inebriates Curable?” read before the English 
Society for the Cure of Inebriety, June, 1892, proving 
the curability and the periodicity from further study in 
this direction. 
“ Sanitary Side of the Drink Problem,” read before the 
American Medical Association, June, 1892, discussing the 
sanitary dangers from neglect of control of Inebriates. 
“Medical Jurisprudence in Inebriety” (vide Interna- 
tional Magazine, February, 1893); an argument to prove 
the need of a new legislation for inebriates. 
“ American Inebriate Asylums,” read before the 26 
C. H. Hughes. 
American Medical Association, June, 1893, being a his- 
torical review of asylum treatment for inebriates. 
“ Criminal Inebriates and Treatment,” read before the 
Congress of Criminology, June, 1893. 
Dr. Frederick Peterson.— 
“Homonymous Hemiopic Hallucinations” (New York 
Medical Journal, Aug. 30th, 1890 and Jan. 31st, 1891); 
“ Disturbances of Sense of Taste After Amputations 
of Tongue ” (New York Medical Record, Aug. 30th, 
1890) and his paper on “ Gyrospasm of the Head in 
Infants ” (Phila. Med. News, Oct. 1st, 1892), are especially 
interesting. “ Three Cases of Acute Mania from Imbib- 
ing Carbon Bisulphide ” (Boston Med. and Surg. Jour., 
Oct., 1892), and upon “ Physiological Experiments with 
Magnetism at the Edison Laboratory ” (N’. Y Med. Jour., 
Dec. 31st, 1892). 
Dr. Harold N. Moyer.— 
“Relation of Insanity to Crime” (Chicago Law 
Journal, 1889); “The Hypodermic Use of Arsenic” 
{Therapeutic Gazette, January 15th, 1891); “Differential 
Diagnosis of Uraemia and Epilepsy ” (Medical Mirror, 
1891) and “ Nervous Sequelae of Influenza” (Medical Aget 
1891), this and the papers of Mills and Gowers, and my 
own contribution (Alienist and Neurologist), all pre- 
sent new features of this disease and prove it to be a 
toxic neurosis. 
Pathological Work of the Government Hospital for 
the Insane.— 
Report of 1887.—Supplement Illustrated.—“Report of 
postmortem examinations in thirty-one cases of paralytic 
dementia, or general paralysis of the insane.” 
Report of 1888.—Supplement.—“Table showing the 
post-mortem appearances of the kidneys in two hundred 
and sixty-three cases of mental disease, giving the age, 
occupation, nativity, mental disorder and co-existing 
physical disease.” Pan-American Medical Congress. 
27 
Report of 1889.—Supplement Illustrated.—“Report of 
post-mortem examinations in twenty-nine cases of mental 
disease.” Part I. “ Fifteen cases of general paralysis 
and three cases of acute organic dementia.” Part II. 
“ Eight cases of acute mania, and three cases of acute 
insanity with maniacal symptoms, dependent upon organic 
brain disease.” 
Report of 1890—Supplement Illustrated.—“Report of 
post-mortem examinations in thirty-nine cases of epileptic 
insanity.” Part I. “Twenty-two cases of chronic epilep- 
tic mania.” Part II. “ Seventeen cases of chronic 
epileptic dementia.” 
Report of 1891.—Supplement Illustrated.—“A study 
of nineteen cases of general paralysis of the insane.” 
Report of 1892.—Supplement Illustrated.—I. “ Synop- 
sis of post-mortem examinations in seventy-three cases of 
mental disease in females, with special reference to the 
condition of the organs of generation.” II. “ Condensed 
description of the tumors found in five hundred and 
forty-six autopsies in cases of mental disease in 
males.” 
Dr. H. M. Lyman.— 
“ Treatment of Neuralgia,” Western Medical Reporter, 
1889. 
“ Insanity Proceeding from the Colon,” Alienist and 
Neurologist, 1889, and Journal American Medical Asso- 
ciation. 
“ Experts and Expert Testimony,” Alienist and 
Neurologist, 1891. 
“The Neurological portion of Lyman’s Text-book on 
the Practice of Medicine.” Short papers. 
“ Tetany.” Transactions of the Association of Ameri- 
can Physicians, Vol. I. 
“ Railway Shock.” Transactions of the Chicago Med- 
ical Society. 
“Nervous Dyspepsia,” Review of Insanity and Nerv- 
ous Diseases, June, 1893. 28 
C. H. Hughes. 
Dr. C. H. Hughes.— 
“ A Clinical Inquiry into the Significance of Absent 
Patellar Tendon Reflex,” Alienist and Neurologist, 
Jan., 1880. 
“The Medico-Legal Aspect of Cerebral Localization 
and Aphasia,” Alienist and Neurologist, April and 
July, 1880. 
“ Reflex Cardiac Gangliopathy with Hereditary Dia- 
thesis,” Alienist and Neurologist, April, 1880. 
“ Notes on Neurasthenia,” Alienist and Neurologist, 
October, 1880. 
“ Impending Periodic Mania,” Alienist and Neurol- 
ogist, October, 1880. 
“ Nitrite of Amyl—Differential Diagnosis of Cerebral 
Hyperaemia and Anaemia.” Editorial, Alienist and 
Neurologist, October, 1880. 
“ Moral Insanity, Depravity and the Hypothetical 
Case,” Alienist and Neurologist, Jan., 1881. 
“ Problems in Psychiatry for the Family Physician,” 
Alienist and Neurologist, Jan., 1881. 
“ Clinical Notes Illustrative of Consciousness of Epilep- 
sia,” Alienist and Neurologist, April, 1881. 
“ Illusion, Hallucination and Delusion.—A Differential 
Study for Forensic Purposes,” Alienist and Neurolo- 
gist, July, 1881. 
“ Moral (Affective) Insanity,” Alienist and Neurol- 
ogist, Jan., 1882. 
“ The Special Therapeutic Value of Hyoscyamine in 
Psychiatry,” Alienist and Neurologist, April, 1882. 
“ Note on the Essential Psychic Signs of General 
Functional Neuratrophia or Neurasthenia,” Alienist 
and Neurologist, July, 1882. 
“ Psychical Analysis of Guiteau,” Alienist and 
Neurologist, Oct., 1882. 
“ The Therapeutic Value of Cephalic and Spinal 
Electrizations,” Alienist and Neurologist, Jan., 1883. 
“ The Simulation of Insanity by the Insane,” Alienist 
and Neurologist, July, 1883. Pa?i-American Medical Congress. 
29 
“ The Opium Psycho-Neurosis.—Chronic Meconism or 
Papaverism,” Alienist and Neurologist, Jan., 1884. 
“ Borderland Psychiatric Records—Prodromal Symp- 
toms of Psychical Impairment,” Alienist and Neurolo- 
gist, July, 1884. 
“ Migraine,” Alienist and Neurologist, April, 
1884. 
“ Moral (Affective) Insanity,” Alienist and Neurol- 
ogist, April and July, 1884. 
“ The Curability of Locomotor Ataxia and the Simu- 
lations of Posterior Spinal Sclerosis,” Alienist and 
Neurologist, July, 1884. 
“ Insanity Defined,” Alienist and Neurologist, Oct., 
1884. 
“ The Hygiene of the Nervous System and Mind,” 
Alienist and Neurologist, Jan., 1885. 
“ State Provision for the Insane,” Alienist and 
Neurologist, April, 1885. 
“ A Case of Psycho-Sensory (Affective or Moral) 
Insanity,” Alienist and Neurologist, April, 1885. 
“ An Outline Brief in the Management of Melan- 
cholia,” Alienist and Neurologist, April, 1886. 
“ Meconeuropathia,” Alienist and Neurologist, July, 
1886. 
“ The Curability of Epilepsy and Epileptoid Affec- 
tions by Galvanism and the Phosphated and Arseniated 
Bromides,” Alienist and Neurologist, Jan., 1887. 
“ Neuritis Plantaris (A Clinical Record),” Alienist 
and Neurologist, April, 1887. 
“ The Scientific Rationale of Electrotherapy,” Alienist 
and Neurologist, July, 1887. 
“ The Relation of the Nervous System to Haemophilia, 
Malarial Haematuria, etc.,” Alienist and Neurologist, 
July, 1887. 
“ A Unique Case of Bi-Lateral Athetosis,” Alienist 
and Neurologist, July, 1887. 
“ The True Nature and Definition of Insanity,” 
Alienist and Neurologist, Oct., 1887. 30 
C. H. Hughes. 
“The Neural and Psycho-Neural Factor in Gymeciac 
Disease,” Alienist and Neurologist, April, 1888. 
“Essential Infantile Paralysis,” Alienist and Neurol- 
ogist, Oct., 1888. 
“ Persistent Spasm of the Levator Anguli Scapulae 
Muscle,” Alienist and Neurologist, Jan., 1889. 
“Neurological Photographs of More or Less Unique 
Cases Hastily Taken During the Active Practice of a 
Busy Neurologist,” Alienist and Neurologist, April, 1889. 
“Over-strain and Under-power of Brain,” Alienist 
and Neurologist, Oct., 1889. 
“ Memorandum of Examination of a Case of Neuro- 
Myotonia (‘ Thomsen’s Disease ’), with Remarks on its 
Differential Diagnosis,” Alienist and Neurologist, Jan., 
1890. 
“ Notes on the Legitimate Sphere of Special Medical 
Practice,” Alienist and Neurologist, April, 1890. 
“ Note on Extra-Neural Nervous Disease,” Alienist 
and Neurologist, July, 1890. 
“ Notes on the Facial Expression of Cerebral (Multi- 
ple Cerebro-Spinal) Sclerosis,” Alienist and Neurolo- 
gist, July, 1890. 
“ The Psychopathic Sequences of Hereditary Alcoholic 
Entailment,” Alienist and Neurologist, Oct., 1890. 
“Virile Reflex,” Alienist and Neurologist, ‘Jan., 
1891. 
“Psychical or Physical?” Alienist and Neurologist, 
April, 1891. 
“ Report on Neurology and Psychiatry,” Alienist 
and Neurologist, July, 1891. 
“The Work of Medicine for the Weal of the World,” 
Alienist and Neurologist, Jan., 1892. 
“ Virile and Other Nervous Reflexes,” Alienist and 
Neurologist, Jan., 1892. 
“ Epidemic Inflammatory Neurosis; or Neurotic 
Influenza,” Alienist and Neurologist, April, 1892. 
“Medical Manhood and Methods of Professional Suc- 
cess,” Alienist and Neurologist, July, 1892. Pan-American Medical Congress. 
31 
“Note on the Hysterical Concomitants of Organic 
Nervous Disease,” Alienist and Neurologist, July, 1892. 
“ Insomnia in an Infant, with Reflections on Patholog- 
ical Sleeplessness,” Alienist and Neurologist, July, 
1892. 
“ Note on Nervous Disturbances after Removal and 
Atrophy of Testicles,” Alienist and Neurologist, Jan., 
1893. 
“ Remarks on Presentation of Diplomas to the Grad- 
uating Class of the Barnes Medical College,” Alienist 
and Neurologist, April, 1893. 
“Aphasia or Aphasic Insanity, Which? A Medico- 
Legal Study,” Journal of Insanity, Jan., 1879. 
Dr. Chas. K. Mills.— 
“Spinal Localization in its Practical Relations,” Thera- 
peutic Gazette, May and June, 1889. 
“ Lesions of the Sacral and Lumbar Plexuses,” Medi- 
ical News, June 15, 1889. 
“ Brain Specimens Chiefly Illustrating Localization,” 
University Medical Magazine, November, 1889. 
“Lesions of the Cauda Equina,” Medical News, 
March 1, 1890. 
“Hysteria” (Keating’s Cyclopedia of the Diseases of 
Children), Vol. IV., 1890. 
“ Myotonia and Athetoid Spasm,” Interiiational Clinics, 
April, 1891 ; also, “ Autopsy in a Case of Athetoid 
Spasm and Myotonia,” Journal of Nervous and Mental 
Disease, December, 1891. 
“ Lesions of the Superior Temporal Convolution Accu- 
rately Locating the Auditory Center,” University Medical 
Magazine, November, 1891. [This we regard as the 
most valuable and recent advance of this important 
subject.] 
“ Aphasia and Other Affections of Speech in their 
Medico-Legal Relations,” Review of Insanity and Nerv- 
ous Disease, September and December, 1891. 
Besides Articles on Apoplexy, Brain Tumor, Spinal 32 
C. H. Hughes, 
Tumor, Meningitis, Cerebritis, and Neuritis, (Hare’s 
System of Practical Therapeutics, Vol. I., 1891.) 
“The Nervous and Mental Phenomena and Sequelae 
of Influenza,” (Transactions of the Philadelphia County 
Medical Society, January 13, 11:92.) 
“ Multiple Neuritis and Some of its Complications,” 
International Medical Magazine, February, 1892. 
“ Neuritis and Myelitis and the Forms of Paralysis 
and Pseudo-Paralysis Following Labor,” University Medi- 
cal Magazine, May, 1893. 
Dr. Peterson has contributed four papers on “ Electric 
Cataphoresis,” N. Y Med. Jour., Apr. 27, 1889, and Oct., 
15, 1890; the N. Y. Med. Record, Jan., 31st, 1891 and 
the Phila. Times and Register, March 21st, 1891. This 
subject has received special elucidation in this country 
and is receiving more. It is a growing theme. 
Dr. J. T. Eskridge.— 
“ Case of Fracture of the Twelfth Dorsal Vertebra, 
Followed by Injury to the Spinal and Sympathetic 
Nerve-Supply of the Bowel in the Region of the Ileo- 
caecal Valve: Intestinal Hemorrhage and Death on the 
Seventh Day,” Medical News, Oct. 10th and 17th, 1891. 
The interesting feature *of the above case is indicated 
by the title, and consists in the accurate localization 
of the spinal and sympathetic nerve-supply to that 
portion of the bowel in the region of the ileo-caecal 
valve. 
“ Gunshot Wound of the Left Cuneus, with Right 
Homonymous Hemianopsia” Ibid, Oct. 17th, 1891. The 
case, which was carefully studied during the life of the 
patient, and the lesion accurately examined after death, 
which occurred a few days after the receipt of the injury, 
is another proof, if one were needed, of the relation 
of the occipital lobes to vision. 
“ Myelitis in a Case of Incipient Posterior Spinal 
Sclerosis,” International Medical Magazine, April, 1892. 
This case is one of posterior spinal sclerosis, which had Pan-American Medical Congress. 
33 
run a course of several years, when typical symptoms of 
acute myelitis developed, an extremely rare complication 
of this chronic affection of the cord. 
“ Acute Myelitis Preceded by Acute Optic Neuritis,” 
Journal of Nervous and Mental Disease, Sept., 1890. In 
the report of this interesting case, the author gives a 
short abstract of a number of others somewhat similar 
to it. One curious feature of the one here reported, and 
of one of Dreschfield’s cases is, that the optic neuritis 
reached its height before the spinal symptoms became 
manifest. 
“ Poliomyelitis with Perineuritis,” N. Y. Medical Jour- 
nal, Dec. 26th, 1891. The chief interest in this case 
lies in the fact that neuritis complicates poliomyelitis, 
and is a more frequent complication than was formerly 
supposed. 
“Tumor of the Brain,” Denver Medical Times, Jan., 
1892. The main interest in this case is in the perverted 
tactile sense and abolished muscular sense early in the 
history of the disease, later in the restoration of tactile 
sense, but the muscular and localization senses remain- 
ing completely abolished. The author promises an inter- 
esting report when the case is finally put on record in 
the light of the autopsy. 
“ Some Points in the Diagnosis and Nature of Certain 
Functional and Organic Nervous Diseases,” Alienist 
and Neurologist, Jan., 1892. The first part of this paper 
is occupied with reports of cases illustrating a point in 
the differential diagnosis of organic spinal lesions from 
brain and peripheral affections, first brought to the 
attention of the medical profession by Dr. C. E. Beevor, 
of England. These cases support the claim of Dr. 
Beevor in that, by the careful study of the associated and 
isolated actions of the two parts of the great pectoral 
muscle, a spinal lesion may be diagnosticated or excluded 
in doubtful cases. 
The second part is taken up in a discussion of the 
subject of “ Uric Acidemia,” so prominently and 34 
C. H. Hughes. 
enthusiastically advocated by Dr. Haig, of * London. 
While the author is far from laying great stress upon 
this condition in the production of headaches, etc., and 
its treatment by acids and salicylates, yet he believes there 
are a number of cases, which, if well selected, much 
good results by following out Haig’s method of treat- 
ment. 
“Ataxia,” International Clinics, Jan., 1892. The sub- 
ject which forms the title of this paper is treated of in 
a systematic manner, and well illustrated by several 
cases. 
“Syringomyelia,” International Clinics, Vol. I., Second 
Series. This is an elaborate and very thorough report 
of a case of this curious disease, and in the light of the 
report of a recent case by J. Hendrie Lloyd, of Phila- 
delphia, with an autopsy, including microscopical sections 
of the cord, there can be but little doubt that the 
disease now can be positively diagnosticated during 
life. 
“ Report of Cases of Moral Imbecility, of the Opium 
Habit and of Feigning, in Which Forgery is the Offense 
Committed,” Medical News, Jan. 14th, 1893. The cases 
form an interesting medico-legal study. 
“Traumatic Myelitis,” Medical News, March 4th, 1893. 
The report of this case of traumatic myelitis illustrates 
how thoroughly the cord may be disorganized by con- 
cussion of the spine without any injury directly to bones, 
membranes or cord. The subject of spinal localization is 
considered at some length in the report. 
“ Idiopathic Muscular Atrophy,” Journal of Nervous 
and Mental Disease, April, 1893. The infrequency of 
this disease gives the report its chief interest. The diag- 
nosis is between idiopathic muscular atrophy and muscu- 
lar atrophy of spinal origin. 
“ Chronic Meningo-Myelitis,” Denver Medical Times, 
April, 1893. The case herein described illustrates the 
effect of trauma in lighting up latent syphilis.. Pan-American Medical Congress. 
35 
Dr. Wm. Fuller.— 
“ Surgical Shock ” (Med. Record), Montreal, Feb., 1877 ; 
“Physiology of Convulsions,” June, 1876; “Treatment of 
Meningitis,” Aug , 1877, and “A Case of Cerebral Tubercle,” 
Dec., 1877. The ideas advanced in these papers were not 
in accordance with the teaching of the day. In Dec., 
1878, he published a paper in the Detroit Lancet upon 
“ Exophthalmic Goitre,” referring all the symptoms to 
pressure and interference with the function of important 
peripheral nerves rather than to centric or sympathetic 
disease. “ Trephining of the Skull in a Case of Idiocy, 
with Remarks,” a paper read before the Medico-Chirur- 
gical Society of Montreal. 
Dr. Rohe.— 
Dr. Rohe, of Catonsville, Md., in inquiring into the rela- 
tions existing between pelvic, disease and psychical dis- 
turbances in women (Jour. Am. Med. Assn., Sept. 24, 1890), 
points out the frequency with which bodily conditions 
influence mental states, and shows that a “torpid condition 
of the intestines, Bright’s disease, putrefactive processes in 
the intestinal canal, etc., might give rise to melancholia 
and other disorders of the mental functions.” 
Dr. Frank R. Fry.— 
“ The Sensory Symptoms of Three Spinal Cord Cases ” 
(Alienist and Neurologist, July, 1893). 
“ The Etiology and Treatment of Chorea ” (1886). 
“An Analysis of New Cases of Chorea” (1889). 
“Chorea in the Aged” (1891). 
On “A Case of Chorea Attended with General Multiple 
Neuritis ” (1891). 
On “ The Co-Existence of Chorea and Alien Spasmodic 
Phenomena” (1892). 
On “A Second Case of Chorea Attended with Multi- 
ple Neuritis” (1893).