..zxz~-~ biisovoo NLM 05147671 G sun m mw /V~t <^oW' (Wrg^ ARMY MEDICAL LIBRARY FOUNDED 1836 WASHINGTON, DC f e> -•- .. A- THE BOOK OF THE DORCHESTER^ ^MEDICAL CLUB lj i S> f* rt f'i V ! SURGEON Gr.strrALS Of FiC: | ■*V*' ^$ ^ * F t >"* s 5 * ■ '* :" PRIVATELY PRINTED, 1898 WB the heintzemann press BOSTON r .^s>,j»«'-ft< s\ WM '<&■ r / i "U. £ W i~UA/ Oj^M 4*AkA zu£ rfotuU> (ytAt ■\ Ifcxs; ip. DEDICATION To Dr. CHARLES ELLERY STEDMAN FOUNDER AND PROMOTER OF THE CLUB; FIRST SECRETARY, ARTIST, AND FRIEND OF ALL ITS MEMBERS REMINISCENCES OF THE Dorchester Medical Club AN ADDRESS READ BY DR. EVERETT AT THE MEETING OF OCTOBER ip, iSpj, WITH EXTRACTS FROM THE CLUB RECORDS AND COPIES OF SOME OF ITS PICTURES. OMEBODY has suggested that possibly The Dorchester Medical Club might spend one evening — sometime, when in reminiscent mood — as pleasantly, if not as profitably, in reviewing some of the incidents of its early history, as in listening to someone's narration of his encoun- ter with a lacerated perineum, or hypertrophied cervix, or his conclusions drawn from investi- gations and analyses of the morning conbutritions to the various chamber conveniences of the neighborhood wherein his peculiar talent is exercised. It has come to pass that it has fallen to the reader's lot to undertake this work of calling your attention to the things that you — and those who have left us — have said, and forgotten, and would hardly believe that they had been said except that the unerring pen of the secretary has caught them, and transcribed them as they fell from the speaker's lips. And none of us has the temerity to question the accuracy of the secretary's written page. It would be a congenial task if time might be devoted to it, to go over these records slowly and carefully, noting faithfully each memory as the work went on, revelling in the delight inspired in dwelling upon the sparkling wit and brilliant scintillations of genius with which 6 DORCHESTER MEDICAL CLUB. they are bristling on every page, and noting as well the devotion to the science that has been the work of the members' lives. Nothing in the whole range of literary labor could have been more charming, and nothing could have offered a more alluring employment. As it is, such as I have been able to bring together from the first fifteen years of the life of our Club I bring you now. I shall not attempt a scientific paper, but if you can be interested in recurring once more to events long gone by and perhaps forgot- ten, till recalled to your memory here, you may not regard the time spent in listening as a wasted hour. The field is rich in material, and the gleaner in this vineyard will find much to repay his search. Old memories come back to us as we open every page. Old times reappear. Words, expressions of countenance, actions, movements, all come back again, all the more vividly, because the allusions of these pages reassure us that they do not originate in my imaginative brain. These records mean much to us who were participants in the transactions to which they refer. Their perusal must needs start some reflections that have their sentimental side. Many things have hap- pened since those days. Our hair was not white when these pages were written, and our heads were not bald. Our steps were then firm and elastic, and our sight was not then dim. Weariness and fatigue were terms that did not come into our vocabulary, and hope and am- bition were then the guiding principles of our lives. Now all is changed. For us the shadows have long been lengthening from the westward, and the pinnacle of life has long since been reached. More than one generation is already behind us, and our children are either gone be- fore us, or are standing in about the same places that we were then, and the places that we have occupied, in the nature of things, must soon be theirs. Thirty years do not come and go in a lifetime and leave us where we were when they began. We have followed those whom we have honored and respected to their final resting-places, and words that they have spoken are among our treasured memories now We shall be reminded of them often as we go on, for our early records are hlled with their sayings. But their places are taken by men who are mT 1 ST^nr6 ^^ ^^ thCy inauSurated> ™* The Dorchester Medical Club still hves. The interest in it has not abated/and the love DORCHESTER MEDICAL CLUB. 7 for it has never failed. Many years of usefulness are yet before it, and if the exigencies of the times or the requirements of progressive thought shall at any time demand new or different adaptations, there can cer- tainly be no better or safer counsellor to control or direct its manage- ment, than the experience it has gathered in all these many and har- monious years. Long may it live and prosper! May no harm happen to it; may no evil befall it, and when we, who have been with it, and have been a part of it from the beginning, shall come no more to its gatherings, shall have no longer voice or vote in controlling its management or its purposes, we ask no more of the survivors than that they shall fill our places with men who will prize it as we have prized it, and keep it as profitable and as enjoyable as it has ever been. The Dorchester Medical Club came into existence on the 25th day of July, 1866. On the evening of that day there was a meeting at the house of Dr. Stedman—then living in Downer Court—as the records say, "to consider the feasibility of establishing and maintaining a Medical Society in this town." At that meeting there were present beside the host, Drs. Edward Jarvis, E. D. Miller, Henry Blanchard, Benjamin Cushing, W. C. B. Fifield, James S. Greene and —last and least of all—W. S. Everett. Messages of regret for enforced absence, and of approval of the object of the meeting were received from Drs. J. P. Spooner, Jonathan Ware and C. C. Holmes. Eleven men therefore were represented at that ini- tial meeting in 1866. Of that eleven, five are living still. Six have ceased from their labors and are gone where the weary rest. This number does not include all who have died, but the others were not of the original members. A sumptuous banquet had been prepared for us, of which,—in the light of our subsequent history—it is much to be regretted that the records contain no report. They have recorded neither how much we enjoyed the dinner, nor how pleasant an evening was passed. The omis- sion on the part of the secretary is one that we can scarcely forgive. He never failed to compliment others for their generous entertainment, but he neglected to make a record of the fact that he established the standard himself. g DORCHESTER MEDICAL CLUB. There the situation was talked over, and it was decided that "The Dorchester Medical Club" should be formed. It came about in this way: Dr. Jarvis presided with becoming gravity and dignity over that solemn conclave, and " after discussion, on motion of Dr. Miller, it was voted to form : An Association to be called The Dorchester Medical Club, for social," — Dr. Miller, it is remembered, was particular to have the social come first — " for social enjoyment and professional improvement." The preliminary arrangements for its organization, in the manner that has been perpetuated to the present time, were then and there completed by the appointment of committees charged with the duties of setting the machinery in motion. The proceedings of these committees were rati- fied at the next meeting, which was held at Dr. Miller's on the 8th of August. The officers and committees immediately assumed their different functions, and the thing was under way, and from that day to this the Dorchester Medical Club has been a factor of no mean significance in the local medical history of its time. It has always been very harmo- nious and very happy in all its relations, but it has never been, and it is not now, a society devoted exclusively to mutual admiration. Once in a while, some mild and attenuated criticism of opinions, methods, minds and men is indulged and tolerated, till it has come to be pretty well un- derstood among members that if there be a vulnerable spot in anybody's armor, or a weak point in his argument or statement of his case, he will be very likely to have it made manifest to him before the evening is through. This fact has had the effect to subdue any inclination we may have to overrate our own importance, or indulge in self-adulation now. But the simple truth may be told. It is not every community, oc- cupying an area of only the few square miles of territory that comprises the section of Norfolk County that has been the field of operations for the members of the Club, that can summon to its succor, in the emergencies of life and death, such an array of skill, experience, trained judgment, knowl- edge of disease and its manifestations, as has been and is yet to be found within the circle of our Dorchester Medical Club. It is not every gather- ing of twelve or thirteen individuals that can boast of such as we now de- light to honor and meet as fellows among the living, nor such as Morison and Miller and Burgess, Holmes and Cushing, among the dead. And though far less intimate in our relations and for a much shorter time we must DORCHESTER MEDICAL CLUB. 9 not in reviewing our past history forget as well-wishers and promoters of our Club and its interests in our early days, others, most of whom have been sometime members, and all have been entertainers, and have, with per- haps a single exception, read papers before it, and have had the good of the Club at heart, but who have long ago gone forward with the silent majority. And we must pause long enough in our review to give respectful mention to the names of Spooner and Jarvis and Read and Ware. One of the marked features in the history of the Club has been the firm, rigid, unyielding adherence that has ever been maintained to the in- tellectual and scientific purposes for which the Club was instituted. Wit, and mirth and jollity and goodfellowship have always been encouraged, and have always reigned in our gatherings to a degree that would have been dan- gerous in a club composed of different, perhaps, also, of greater numbers of men. But they have never been allowed to reign supreme. They have never usurped the place of devoted, thoughtful, patient attention to the busi- ness of the hour. They have only been allowed to be used as sidelights to throw a more brilliant illumination by their enlivening influence over the sterner work that was in hand. The social element may have had first place, as Dr. Miller wished it should, but it has been kept in its place, and has never appropriated more than was its own. So that now, after twenty- eight years existence, the Club is not merely disappointed, but feels itself snubbed and slighted, not to say insulted, if a member fails to bring to it some thoughtful and appropriate preparation for his appointed work. There are two other considerations that render this Club unique and remarkable in its character. The first is the confidential character of its transactions. Its business does not leak. Its communications are as sacred as those made at the family altar, which they closely resemble in this re- spect. Second, its wit has no bitterness; its jests leave no sting. The papers that have been read in the Club have been of different de- grees of excellence, but they have never been mean or low. The discus- sions that have been held upon them have brought out stores of knowledge, the result of wide research and deep study, with an experience that would seem to have pretty nearly covered the whole range of medical science. The amazing fullness and faithfulness with which these records have 10 DORCHESTER MEDICAL CLUB. caught and preserved these topics, and the discussions upon them, will jus- tify this statement. Yet a vein of lightheartedness, amounting almost to juvenile merriment, is found pervading the whole. There are many things brought out in these records that are worthy of a much wider circulation than they are ever likely to attain. There are evenings when the discussions take on such a character that it almost seems as though some inspiration had pervaded the whole atmos- phere, and lifted the whole subject of the disgusting diseases of dying mor- tality, into the plane of elevating and ennobling thought. There are other evenings when it seems, after the restraints of routine business are removed, as though the ambition to tell some questionable story in the smoothest language, or the biggest narrative within the limit of probability, became the animating spirit of the hour, and fulfilled the highest ideal of that hilarious crowd, for that occasion. The third meeting of the Club was held at Dr. Cushing's, September i 3. Five members besides the host are recorded as being present. At this meeting the annual assessment of five dollars was established. And it is on record that " Dr. Fifield related an interesting medico-legal case, illustrat- ing the inefficiency of the coroner's laws." The fourth meeting was at Dr. Spooner's. At this meeting the much talked of Fee Table came to the front. In November the fifth meeting was held at Dr. Holmes'. Here the Fee Table seems to have been given considerable attention, for no other general business is reported, and the subject assigned at Dr. Spooner's meeting for discussion at this meeting, — Obstruction of bowels — was postponed. Then the Club went to supper, which was understood to be simple. And knowing Dr. Holmes as we came to know him, it is to be presumed that it was simple. At any rate, the best the secretary could do, was to record that " no practical illustration of the proposed subject for dis- cussion" occurred in consequence so far as he ever knew. The record of the December meeting is worth listening to entire. The page under date of December 27 reads as follows: — (It is transcribed bodily from the secretary's notes.) "This Club should have met on the Thurs- day preceding this date, but owing to the stupidity and neglect of the secretary, who was incompetent to ascertain the phases of the moon, the notifications were not sent out. DORCHESTER MEDICAL CLUB. n "The consequence was, that on the evening when the Club convened, it didn't. It was, perhaps, the poorest style of weather that was ever noticed;—the meanest wheeling; the vilest walking, and no sleighing. In spite of the floods of rain, however, it is to be recorded that our friend Greene, equipped in much caoutchouc braved the elements and walked to Dr. Blanchard's, where he met his host and an obscure practitioner from the northern part of the town. Having compared notes on the weather G. and the O. P. returned home." The illustration showing Greene plodding along his way home is something astonishing, but it cannot be reproduced.* The Annual Meeting appointed for January 17, 1867, turned out not better. It was to be held at Dr. Greene's, but owing to the worst snow- storm of the period, if the records are reliable, and this is the only instance in which they have ever been open to suspicion, — not an individual put in an appearance—a remarkable fact to record of a company of men who never allow any weather complications to interfere with their engagements. The illustrations of this meeting, representing Greene, with his hands in his trousers, peering out of the window into the darkness, and congratulat- ing himself on the fact that "those beggars surely can't come to-night;" and also sitting at the table, attended by some half dozen or so waiting- maids of different degrees of youth and attractiveness; proving equal to the emergency of devouring, single-handed and alone, the banquet that had been prepared for twelve persons, is something not to be forgotten when once seen. February 14, 1867. Meeting held at Dr. Jarvis'. After the banquet, which is alluded to in complimentary terms, some general business of no special interest at this date was transacted, and the Club reached the topic for discussion, appointed away back in November, — "Obstruction of the bowels." This seems to have been one of the nights for big stories and incredi- ble facts. Wonderful things happen to people with obstructed bowels, un- less the veracity of these narrators can be impeached. Here we have a case of obstructed bowels, reported by Dr Cushing that would not yield to cathartics till opium had been given to the amount of six grains, which had the effect of making the cathartic operate. One * Its reproduction has been attempted, see photograph. 12 DORCHESTER MEDICAL CLUB. would think the opium might have killed the patient, if the obstruction failed to accomplish it. Dr. Miller discovered his case of obstruction to be due to the impac- tion of walnut shells in the rectum. Dr. Blanchard had a case of impaction from huckleberries, and Dr. Stedman rattled the pipe of his syringe against some obstacle in giving a girl of nine an opiate injection for colic, and this obstruction proved to be a pint of cherry stones. Dr. Miller quoted Dr. J. C. Warren's saying, that, "good-natured people are always regular in their bowels;" and also repeated the story of his, Dr. Warren's father, a good-natured gentleman, going a journey of twenty-one days without a movement till his return, although his habit was regular to two movements a day. Dr. Holmes had a case where twenty grains of Bromide Potassa produced immediate and smart purga- tion. Dr. Cushing had a case where he seems to have been faithful in resorting to remedies for obstruction known to science—cathartics, till voming ensued, opium, enemata, baths, etc., — but the obstruction was ob- stinate and would not yield for ten days, when Dr. Hay ward in consulation recommended a blister. That did the business. Dr. Cushing also referred to the fact of pure liquid being found in autopsies of such cases above the seat of such obstruction. Dr. Holmes finished the discussion on this topic by giving a case of obstruction with peritonitis and tympany, yielding to insufflation of air, and another case of the successful use of pumpkin seed in a case of tenia. After this topic was exhausted Dr. Spooner read a paper on pneu- monia, on which some discussion ensued, in course of which the Dr. said, "that pneumonia in children gave him little anxiety, as though he some- times lost a little patient from bronchitis, those with pneumonia —single or double —almost always got well!" Would that it could come to us all! March 21, 1867. Meeting at Dr. Cushing's. Weather fair. Doc- tors Ware, Jarvis, Spooner, Miller, Blanchard, Holmes, Everett and Sted- man, are reported as being present. Dr. Hayes, of Hyde Park, was elected a member of the Club. He was the first member admitted by election Oral communications took the direction of proper management of dys- pepsia and indigestion, and must have taken a pretty wide range Dr Ware never had anything disagree with his stomach, and told of a gentle- man, who could eat nothing without a pain, cured on a diet of baked apples DORCHESTER MEDICAL CLUB. 13 and milk. Dr. Jarvis had a case in Louisville cured on corned beef and bacon; also a child who got well on a solution of rock candy. Dr. Blanch- ard had a case of erysipelas, that insisted on getting well on cold potatoes and vinegar,—and did it. Dr. Cushing got off into a case of placenta previa that had occurred to him since the last meeting. Recovery of mother,—child dead. Dr. Ware had used powdered ergot as snuff, success- fully, to increase labor pains, and intimated that powdered borax would accom- plish the same result. Why would not common yellow snuff do as well ? Dr. Holmes mentioned a case where an injection of warm water was administered for uterine colic, with the effect of the immediate expulsion of a foetus at full term ; at which one of those present remarked that he had seen woodchucks drowned out of their holes, but he didn't know that babies were caught that way. At ten o'clock supper was announced. May 16. Meeting at Dr. Stedman's. This time a leading topic of conversation was the collection of fees. It was also suggested that the time had come for advancing rates to correspond with city charges. It ended in talk. Dr. Fifield gave an interesting condensation of Dr. Fraser's paper on parecentesis thoracis for empyena. We find something to dwell upon at every page, — but we must hasten on. July 11, 1867. Club met at Dr. Holmes'. Dr. Edes, of Hing- ham, so the record reads, and Dr. Burgess, of Dedham, were elected mem- bers of the Club. The records also say that Dr. Stedman read a stupid paper about a man that died of schirrus of the liver. Dr Holmes had this time got his dose of Bromide down to five grains for cathartic effect. On three different occasions he had produced violent catharsis in this way. The preceding week he had given this quantity to a lady, aged sixty, who had found herself afloat up to the armpits, in bed, from the brisk purgation the medicine had induced. He had given eighty grains in his practice with no such effect. Dr. Holmes also showed an instrument of villanous design, used by the abortionists to induce labor, consisting of an India-rubber bag attached to a hollow needle, through which water was thrown into the uterus. He also detailed a case where a man, having reasons for not desiring a family, was advised to abstain from intercourse between the first and fifteen days. Though he went strictly by schedule time, he was disgusted to find that his precautions didn't work. 14 DORCHESTER MEDICAL CLUB. August 15. Club met with Dr. Greene. Weather bad as ever. At this meeting a paper was read by Dr. Burgess, entitled,—"What did my patient die of?" And the Club couldn't tell. No autopsy was allowed because a short time before one had been held at the next house, and some doctor had disgusted everybody by leaving pieces of his patient lying around "loose and promiscuous" on the floor, and requesting the woman in attendance to sweep them up in a dust-pan. Dr. Burgess reported the case of a woman who died in convulsions one week before expected con- finement. Dr. Cushing reported a similar experience. Dr. Burgess quoted Dr. Hodges of Boston as saying that he never knew a case where labor ought to be induced for nausea. Dr. Cushing had known two cases of the kind. Dr. Spooner had known of two deaths from the vomiting of pregnancy. Dr. Miller had known one such case. Dr. Jarvis inquired how far displacements of the uterus and inability of conception were due to costume. Dr. Miller said slight deviations are no impediment. Dr. Cushing said the reason women didn't conceive was because they didn't want to. Dr. Holmes said our grandmothers were ashamed to talk about conception. They had their big families and said nothing about it. Dr. Burgess said people who tried to prevent conception often found when they wanted children that they had lost the power. At this meeting Dr. Holmes reported the case of his predecessor, Dr. Holbrook, who was found at the autopsy to have one hundred and twenty-two robin shot in his vermiform appendix, without ever having done him any harm. January 9, 1868. Time of meeting established to be on Thursday nearest the full of the moon. The talk got round to obstetrics, and Dr. Cushing said he had never had a ruptured perineum in his life, and had given up supporting it many years ago. February 8, 1868. Club met at Dr. Cushing's. At this meeting the doctor was obliged to go back on his statement at the last meeting about a lacerated perineum, and acknowledge that his luck had deserted him. A week after the last meeting he had his first case. Dr. Ware had never used obstetric forceps in his life. Dr. Fifield wanted to know the experience of members as to how long after suspicious connection urethral inflammation may show itself. Just at this sadly inopportune moment, Dr. Cushing peremptorily called the Club to supper, and the opportunity* was DORCHESTER MEDICAL CLUB. 15 lost forever of ascertaining what had been the experiences of members with their urethras after these performances, and Dr. Fifield never told us how soon after exposure it came on in his case. We come now to May 7, 1868. Club met at Dr. Miller's. Dr. Holmes led off when the story-tell- ing period was reached, according to the record, with the story of a woman who ate her supper all right on Saturday night and went to bed. On Sun- day morning she was in collapse, and died in the afternoon. Autopsy showed ruptured abscess in ovary, and the doctor closes his case with the statement that it culminated during connection with her husband. Dr. Fifield follows with the statement that most of the cases of strangulated hernia are brought to the London Hospital on Sunday morning. Not to be outdone in this direction, Dr. Miller told of the impending dissolution which a man of sixty feared was coming to him at his last family exercise with his wife. The doctor judiciously and cautiously explained to him the danger of the practice, but his advice seems to have been unavailing. He subsequently died—as the record states it—"insitu." How the ge- nial doctor got at his facts, as to the termination, the records have preserved no transcription, if he told. The doctor closed his narrative with the state- ment that Napoleon and some other old fellow, whose name is represented upon the records by a dash, used to have epileptic fits on such gay and fes- tive occasions. At this meeting on call for corrections to the records, one gentleman excepted to the secretary's record of a case of measles as ele- phantasis. Another gentleman suggested that there must be a trifling inaccuracy in the record of his case of clergyman's sore throat ; it was re- ported as a case of orchitis. Again there was a slight error in the report of the autopsy. The patient didn't die, and was yet alive. July, 1868. When the Club met with Dr. Edes at Hingham, has ever been memorable in the history of the Club, for the delightful trip that it afforded, and for the pleasant time that was enjoyed. The business that was transacted is of no special interest now. October, 1868, Dr. Hazelton was elected a member and remained with us till his removal to Wellesley Hills. Vacancies in the Club have been rare. Men who once gained ad- mission into it, have prized its membership too highly to surrender its priv- ileges and advantages on any trivial grounds. Dr. Jarvis and Dr. Hayes it; DORCHESTER MEDICAL CLUB resigned for no reason that is known, except their own personal choice. Dr. Hayes' name does not appear after January, 1870, and Dr. Jarvis' let- ter of resignation was received at the same date. Dr. Jarvis was one of the original members, and was president at the first meeting that was ever held. His membership was four and one-half years. Dr. Spooner retired from active membership when increasing years came to make it inexpedient to hazard unnecessary fatigue. He was made an honorary member, and in this relation he died. Dr. Fifield has recently handed in his resignation and has been made an honorary member. The enforced absence of Dr. Blanchard from our later meetings is not at all in the nature of a withdrawal from the Club. He is altogether too highly respected, and too much beloved, and has been quite too valuable a member to have his place declared vacant because the infirmities of advanc- ing years have interfered somewhat with his active membership. His heart is still with us, and his place will never be vacant, so long as he shall live. August 18, 1869. Club met at Dr. Stedman's. Devoted largely to discussion concerning maternal marks. November 25, 1869, voted that after January 1, 1870, the Boston Fee Table be adopted by Dorchester Physicians. Drs. Blanchard and Cushing exhibited a specimen which con- sisted of a portion of abdominal aorta with pancreas and left kidney attached. December, 1869. Dr. Morrison of Quincy elected to membership. September, 1870. Dr. Gilbert was elected to membership. January 25, 1872. Annual meeting at Dr. Fifield's. Dr. Holmes in chair. Dr. Gilbert was reader. He reported the case of a maiden found pregnant, and whose paramour denied having had fruitful connection. Dr. Gilbert was requested to examine and report on the existence of pregnancy. The hymen was found entire, and the man said there had been no entrance^ the maiden said she had made suitable resistance, but the doctor thought he was sure of his diagnosis, and the decision that the girl was pregnant was made. It then appeared that perfect connection had never taken place semen having been deposited outside the hymen, and they undertook to persuade Dr. Gilbert that but one attempt had been made. However the boy arrived two hundred and fifty-two days after this acknowledged at- -pt at coition, which took place one day after menstruation Dr Gil tern DORCHESTER MEDICAL CLUB. 17 bert called attention to these points. First, incomplete coition, one day after menstruation. Second, the birth of the child two hundred and fifty- two days afterward. Third, the product was a male. Dr. Gilbert said breed- ers considered heifers more likely to come when the bull was allowed to run free with the cows. Dr. Fifield said that pregnancy with an entire hymen was commonly understood to be practicable, and cited several instances. He had seen one case. Dr. Miller had seen one case. Somebody else had seen one. The records at this point state that " Dr. Spooner related the case of an acepalous fcetus which was considered to be due to untimely interruption at the time of its propagation." Correct so far as it goes, this brief state- ment does not do Dr. Spooner justice. The story as it was told, and as it is remembered, is one of the brightest that has ever been told in the Club, and is worth repeating, for the memory of it is sufficiently vivid to secure accuracy in its details. It seems to have escaped the fate of so many that we have laughed at so many times and that seem to come round in revolv- ing cycles like the changes of the moon, and perhaps nobody will object to its being told over again. Those who heard it can perhaps stand its repetition. If there are any to whom it is new it ought not to be lost. The tone, manner and spirit of the late lamented and venerable narrator cannot be reproduced, and are beyond description or imitation, but the story went on in this way. In the early days of his professional life—before his own marriage — a young couple among his early associates and intimate friends were married, and he attended the wedding. After a suitable interval, he felt it incumbent upon him to pay his respects to the young couple by making his wedding call. It must be that the modern custom of issuing "at home " cards in such cases, is an outgrowth of a later civilization, for he went unheralded and unannounced on an evening when there was no spe- cial reason why callers should be expected. He was ushered into a vacant room, where he was left in silent and meditative loneliness for so long a time that the situation began to be embarrassing, when finally the bride- groom, and still later, the bride, made their appearance, but with a manner so constrained and embarrassed that after a short time—the shortest that he thought proper — even for a wedding call, during which time all par- i8 DORCHESTER MEDICAL CLUB. ties were uncomfortable and ill at ease, he took his departure with the feel- ing that life was a failure, and friendship a disappointment. Altogether his wedding call, from which he had anticipated so much pleasure, — for the parties had been very dear and intimate friends of his, — was not a pronounced success. The cordial greeting that he had expected was not forthcoming, and he wended his way homeward with the feeling that all in this world is vanity. Some months afterward, however, he was called to attend the lady who had been taken suddenly and alarmingly ill. He responded to the call with due alacrity and promptness, notwithstanding the yet unhealed laceration that was still sending out its lancinating twinges from some spot in the neighborhood of his heart. The result of the illness was that the woman gave birth to an acephalous foetus, as the record states; and the doctor closed his narrative by saying — with a merry twinkle in his eye and a mirthful ring in his voice, that told how much satisfaction he found in the conclusion to which he had arrived —that after making as careful computation as he could make, — and he had laid himself out upon it, — he had always considered that his unfortunate wedding call had been so ill- timed as to have disturbed the loving couple in the midst of their exer- cises,—just at a sadly inopportune moment, when the last finishing stroke was necessary that should complete the performance and develop into the perfect man. As it was, the process was only partially completed, and there was an imperfect result. Somebody in the Club who had been lis- tening to the story, after it was ended, capped the climax in making the situation appear ridiculous, by suggesting in the slang phrase of that day, that " he didn't have time to put a head on him." But realizing as well as an unmarried man could realize, not only how tantalizing, but how dif- ficult it must be for a man, or a woman either, to feel obliged to pretend to feel pleasantly in such circumstances, his heart softened toward them in forgiving and pitying kindness, and he buried his resentment from that hour. February 6, 1873. Club met at Dr. Cushing's. Voted that the number of members in this Club be limited to fourteen. November 6, 1873, Dr- Bolles was elected a member. February, 1875. Club met with Dr. Gilbert. Dr. Miller read a paper in place of Dr. Holmes, on uterine displacements and inflammations, DORCHESTER MEDICAL CLUB. l9 criticising Grady Hewitt's views. But as he buttoned it up in his breast- pocket and would not let the secretary have it, after he had read it, it was with many drawbacks and reservations that the secretary could conscien- tiously bring himself to acknowledge that it was a good one. Dr. Bolles was confounded, when he commenced his career, by the unexpected places in which the os uteri appeared. Just what kind of a "career" it was on which the doctor was starting in, when his efforts were so strangely baffled, he left for us to conjecture, and where he had expected to find it, and where he had been in the habit of looking for it, and in what localities it finally turned up when he did find it, have never been explained to this day. Dr. Miller said abrasions of the os are seldom found in single women. The diagnosis must be made by touch, which is often best when the spec- ulum fails. There are very few cases in which it is necessary to rupture the hymen, except for extreme sensitiveness. He often used the nitrate on the os as a tonic with a quick touch. Irregular menstruation, pain in back, and leucorrhoea were symptoms demanding examination. He had seldom seen post mortem evidence of uterine inflammation. Mere induration is no sign of schirrhus. Never had an application from a young girl for an examination of her own volition. In a young lady, plump, and of healthy looks he found tenderness in the cul de sac, and absence of hymen, and was obliged to ask if she had been indiscreet, to which she answered — No ! At his next examination he found the hymen restored, and Dr. Miller did not explain by what process this result had been wrought out — and what a pity! Had he but imparted to us the secret, and taught us to work it successfully, what a legacy he would have left to the physicians of future times. Mending broken mirrors would be nothing in comparison. We honored him while he was living and we grieved for him when he died. We acknowledge our debt of gratitude for his many kindnesses, and for his many instructive words. We revere his memory and lay wreathes of immortelles and roses upon his grave. But a lingering regret still re- mains, that one secret was buried with him. December 16,1875. Club met at Dr. Bolles. Dr. Edes read a paper on hysteria, which seems to have been the subject of quite extended com- ment. Dr. Ingalls who was present as guest, remarked on the number of cases set down as hysteria because we know no better. Dr. Holmes related the history of an annoying cough, that was cured by getting the patient 20 DORCHESTER MEDICAL CLUB. angry, and afterwards getting angry himself. Dr. Miller thought he had seen a' case of genuine hysteria in a male. Cases of mimicry can be cured by the physician as in the case of a patient who had not walked for nine months, starting off at once, without trouble. One patient had passed no urine for several days, had no dejection for two weeks, no catamenia for three months—herself being reporter. Tongue was clean, pulse normal, — catheter brought half an ounce of urine. She was watched, and stained napkin was found in watercloset. Dr. Miller also related a case of snake in patient's stomach, — relieved by painting tincture iodine over patient's epigas- trium. His father had a patient who swallowed a pin, which pricked her for ten years. She described it, so he procured one like it, cut with a scal- pel over the spot, concealed the pin in his forceps and finally, when the right moment came, extracted it, very skillfully and successfully, and the patient was cured. Patient hoped the world would now believe it — now they saw it. Dr. Ingalls had a patient who had a snake in her stomach — knew she had. How it terminated was not reported. February 10, 1876. Dr. Spooner was made an honorary member of the Club by unanimous vote. March 9, 1876. Club met at Dr. Cushing's. Dr. Rogers elected to membership. May 4, 1876. Club met at Dr. Edes. Dr. Holmes read a paper on diphtheria, taking the ground that diphtheria and croup are not identical. May 23, 1877. Club met at Dr. Stedman's ; Dr. Gilbert read a paper on " Constitutional Treatment of Uterine Fibroids." He referred to three cases treated with internal administration muriate of ammonia in fifteen grain doses. One case did not promise well. In one case the tumor was disappearing, and in one case the woman was apparently cured. September 27, 1877. Club was at Dr. Morison's. Dr. Holmes read letter of committee appointed by Club to communicate its sympathy with family of Dr. Burgess, who had died abroad. Dr. Burgess had been a much loved and highly valued member of the Club, and his had been the first in active membership in the history of the Club. October 18, 1877. Club met at Dr. Roger's. Hysteria again came in for its share of attention. Dr. Bolles related case of a young man who had symptoms of meningitis, but which proved to be due to DORCHESTER MEDICAL CLUB. 21 the suppression of the finer emotions, and recovery immediately followed when the presence of the loved one was secured. Dr. Rogers had known symptoms that looked badly turn out to be hysterical. Dr. Blanchard had known hysterical symptoms to affect pulse, so that it could not be detected, and patient was thought to be dead. Dr. Miller pointed out that a feather run up the nostril would usually bring a hysterical patient to. March 14, 1878. Club met at Dr. Bolles. In fact this seems to have been Dr. Bolles' night. Dr. Bolles read a paper on three blind pouches, Gall-cyst, Coecum, and Vesiculae Seminalis. Dr. Bolles showed spiral fracture of tibia in a horse. Dr. Bolles showed placenta of case of triplets. Dr. Bolles showed photograph of double congenital dislocation of hips. Dr. Bolles displayed some radial splints. Dr. Bolles showed two fractured pelves. October 10, 1878. Meeting at Dr. Stedman's. Dr. Miller reported resolutions on the death of Dr. Spooner, who though he had retired from active membership, had still continued his connection with the Club as an honorary member. At this meeting it was voted that a member who failed to read a paper in his appointed time, should be asked for such paper, by the secretary, at each meeting thereafter that he might attend till he furnished one. January 9th, 1879. Club held its annual meeting at Dr. Fifield's. Dr. Stedman unconditionally declined a re-election to the office of secre- tary and Dr. Rogers was chosen to fill the vacancy. Dr. Fifield reported the death of Dr. J. B. S. Jackson, and paid an eloquent and fitting tribute to his memory. On motion of Dr. Bolles it was voted that the Club sit for pictures, cabinet size. February 6, 1879. Dr. Holmes in behalf of Club presented Dr. Stedman with vase in recognition of his services as secretary and as a token of regard and esteem from the members. October 18, 1879. Club met at Dr. Gilbert's, and, as has very rarely happened in its history, every member was present. This circumstance alone is sufficient to make the occasion a notable one.* The financial possi- bilities connected with professional labor, of bankruptcy and starvation on * Of late years this has been a very frequent occurrence. — Ed. 22 DORCHESTER MEDICAL CLUB the one hand, and plethoric purses and faring sumptuously every day, on the other, seemed to be the matter of chief interest on this occasion, and the fee-table again came to the front. Generally, the members seemed to be in a bad way financially. Dr. Stedman had been accused of charging more than his neighbors, and Dr. Bolles wanted each member to state the principle on which his charges were made. Members freed their minds quite thoroughly on the subject. Some thought there was no principle about it, and all thought highly of the city fee-table, as it seemed to have been arranged for well-filled purses and prosperous times. All charged ac- cording to the fee-table and got the fee — if, and when, they could. The charge to the well-to-do was three dollars, others were charged two dollars or one dollar, or nothing. That particular occasion must for some reason or other have been one of peculiar and great despondency, and the financial embarrassments of the times must have been more than usually depressing for, judging by the records, the tone of cheerfulness that usually pervades the meetings of the Club, had taken the wings of the morning and flown away, and its place was filled by some indescribable condition, lying some- where between compulsory resignation on the one hand, and combative- ness against some ill-defined, or at least invisible antagonist on the other. One member said one half of his patients moved to the Back Bay, and the other half had failed. Another said he charged people what he thought they ought to pay, and might pay if they would—and got it if he could —and mostly didn't get it. Dr. Miller made the joke of the evening by saying that it was well known that his charges were always low. Dr. Gilbert thought bills should be pretty nearly uniform and agree pretty nearly with the fee-table, even if discounts were made. Dr. Cush- ing thought some men could be imposed upon, and some could not, and went on to state that a patient who could lend money to any member of the Club had grumbled because he (Dr. C.) had charged him three dol- lars for a visit when Dr. Rogers had charged him but two. Dr. Rogers had just said that he always charged the last cent the patient had, or that he thought he had, though he was occasionally deceived by an old coat and hat. And so the discussion ended. March 25, 1880. Club met at Dr. Greene's. A paper was read by the writer of these notes, that brought up for discussion the comparative advantage of Caesarian section, laparo-elytrotomy and hystero-coeliotomy DORCHESTER MEDICAL CLUB. 23 and the propriety of resorting to them in any circumstance. Dr. Holmes thought premature labor should be induced in cases where these operations are required. Dr. Cushing said the practical question was of risking the life of the mother to save the child. Theological views might influence some. He had known the mother's life to be sacrificed to the Catholic dogma. His personal opinion was that it was not right to submit the mother to serious - risk to save the child. Dr. Morison said that a surgeon in San Francisco had relieved a woman by Caesarian section in consequence of inability to complete labor per vias naturales. The woman recovered and sued the surgeon, laying damages at twenty thousand dollars. The suit did not succeed. Dr. Cush- ing reported a case of removal of the uterus for malignant disease. The woman died on the table. Dr. Holmes had lately delivered a woman by forceps. The next day she had facial paralysis with chills and delirium on the fifth day. She was then doing well. He also said he had long been accustomed to give one-eightieth grain atropia as enema in irritable bladder. Dr. Gilbert spoke of a case of facial erysipelas in a woman whose time for confinement had arrived, but which fortunately was de- layed till erysipelas was nearly well and nothing happened. Up to this time the history of the Club had been one exceptional and unalloyed enjoyment, happiness, prosperity and usefulness. Friendship had been engendered and cemented, regard for each others welfare in all relations, professional, personal, social, had increased with every meeting, and had only grown stronger by time, and it is but just to say that the in- fluence of the Club had been to enlarge and broaden character, to raise the minds of members above the trifling and petty neighborhood jealousies and alienations that blight the happiness and impair the usefulness of so many professional men—and to inspire the members with an earnest desire and determination to pull all together, for the best good of every individual, and for the community as well. But we were coming upon different times. The cyclone was already gathering, and its fury soon burst. September 8, 1881. Club met at Dr. Holmes'. The first business, after the records were read, was a motion by Dr. Cushing, that Dr. Holmes be requested to convey to Mrs. Miller, an expression of the senti- ments of respect for Dr. Miller and sorrow in his death, entertained by 24 DORCHESTER MEDICAL CLUB. the Club. Dr. Miller's death had occurred in July. It was the most seri- ous shock that the Club had received. October 6, 1881. Club met at Dr. Morison's. This seems to have been the last occasion on which the exercises of the Club preceded the dinner. From this time on no reference appears upon the records of the exercises of the Club being interrupted by a summons to the table, and so what somebody had called " the champion nuisance of the year," disappeared from our history forever. January 5, 1882. Club met at Dr. Fifield's. Dr. Gilbert read a paper upon " Ulcerative Perforation of the Vermiform Appendix," and reported a case. Diagnosis confirmed by autopsy. In the light of subsequent his- tory, this paper becomes of the very greatest interest, and of the highest importance. It should become historic. The day for operative interfer- ence in such cases, was only just dawning. The daylight had not yet appeared. That was fourteen years ago. We almost want to look at the date again, to make sure that we are not twenty years behind the times. So lately as 1882 the most skilful and competent surgeons were just beginning to discuss the question whether operative surgery might possibly afford relief in some favorable cases, or whether it was allowable or justifi- able in any event. In November, 1877, tne attention of the Club had been called to a series of cases described by Dr. Loomis, where the abdo- man had been opened by Dr. Willard Parker. Result not stated, but the operation had not been commended or encouraged, so far as known. And it seems strange now, that our own Dr. Bolles, who has since per- formed the operation successfully so many times, should be on record as having said in the discussion that followed Dr. Gilbert's paper, that they were physicians rather than surgeons who recommended opening the abdomen in cases like these, that the physician overlooked the difficulties of the operation. Dr. Gilbert asked, " Can nothing be done to save life ? " He then expressed the opinion, that, "It is justifiable, and fairly indicated, to open the abdomen and examine if the diagnosis is clearly made out"; and to Dr. Gilbert must be awarded the high honor of being among the very first—not only in this country, but in the world,—to suggest opera- tive measures in cases of this kind. He believed that if the operation had been performed in the early stage of his patient's sickness, a valuable life might have been saved — saved to his family, saved to the community DORCHESTER MEDICAL CLUB. 25 saved to his friends. There were very few precedents to guide him. He had found one case reported in "The Lancet" of June 16, 1881. The man was in extremis from a knot in the ileum. The abdomen was opened, the knot untwisted, and recovery ensued. He also quoted from a letter printed in the "Boston Medical and Surgical Journal," in which the writer had been bold enough to urge that surgeons cease to be afraid of the peri- tonum, and that when there was obstruction of the bowels or lodgement in the appendix, they should open the abdomen at once, and, if possible, relieve the condition. June 1, 1882. Another death stroke has fallen in our midst. On motion of Dr. Edes it was voted that Dr. Blanchard be requested to pre- pare a notice of the late Dr. Morison for the records of the Club. And still another. September 25, 1882. Club met at Dr. Cushing's. It was voted that Dr. Cushing be requested to express to Mrs. Holmes the sentiments of the Club on the death of Dr. Holmes. Here, then, between July, 1881 and July, 1882, three deaths had occurred of members whose loss seemed irre- parable. Even now, after the lapse of these many years memory, cannot revert to those days of deep affliction without a sigh. At this meeting Dr. Blanchard read a paper upon illegitimacy. The principal question was, what was the physician's duty in the premises. Various members had various opinions. Dr. Cushing spoke of a possible danger to the physician in aiding in the concealment of pregnancy. He had helped a young woman once, in this way, and had procured a board- ing place for the child not a great distance from where the mother resi- ded. The fact of its illegitimacy was kept private by the people where it was placed. It seemed that some spiritual agencies were invoked in solv- ing the mysterious case, and when they were interrogated as to who was the father of the child, they answered " Dr. Cushing." And though it is not a matter of record, it is worth recording, that at one of the last interviews ever held with the doctor in alluding to this incident he authorized the statement that when this answer was reported to the girl's father he said he did not think it could be so, for he did not think Dr. Cushing was a man that would bring his calves so near home to pasture. November 23, 1882. Club met at Dr. Stedman's. Dr. M. V. Pierce and Dr. H. P. Jacques, both of Milton, were elected to membership, and 26 DORCHESTER MEDICAL CLUB. in coming to the election of these members these notes have brought the history of the Club down to a time since when it is familiar, and is a part of the life history of us all except Dr. Crowell, Dr. Eldredge, and Dr. Tanner, whose memberships are a much later acquisition to our ranks. Perhaps this is as good a time as any to bring them to a close. SECRETARIES OF THE DORCHESTER MEDICAL CLUB. Dr. C. Ellery Stedman, From August 8, 1866, to January 9, 1 Dr. Orville F. Rogers, From January 9, 1879, to January 5, 1 Dr. Matthew V. Pierce, From January 5, 1888, to January 13, 1 Dr. Samuel Crowell, From January 13, 1898. MEMBERS. Names. Erasmus D. Miller Benjamin Cushing Henry Blanchard Chas. Ellery Stedman William C. B. Fifield Edward Jarvis John P. Spooner Christopher C. Holmes James S. Greene Willard S. Everett Charles C. Hayes Robert T. Edes Ebenezer P. Burgess Isaac H. Hazelton Charles H. Davis James Morison Daniel D. Gilbert William P. Bolles Orville F. Rogers Matthew V. Pierce Henry P Jaques George M. Read Samuel Crowell John A. Tanner David G. Eldridge Clarence A. Cheever Henry V. Reynolds Admitted. Aug. 8, 1866 (< <« << << n << <« << << «< «< << << << << << << << << t< << <« ft >-■ 5^ I \ \ toJuJjjjJXT> , ill :. 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