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4httr

ANNUAL ADDRESS
delivered before the
eakal iwtietg of Clinton fanta,
STATE OF INTEW -STORK:,
JUNE 6, 1860,
By F. J. D'AVIGNON, M. D.,
VI ,SAULK FORKS.
  w'ngtcn^

ffTTSBUKGH:
J. WIMPLE, BOOK & JOB printer.

      1860. 

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   Gentlemen,—The By-Laws of the Medical Society of this
county request its President to deliver a written address, an-
nually, before the members.   To-day this duty devolves on
me,  and indeed I  £cel myself incapable  of performing the
office of addressing you.  My embarrassment  is caused  by
the want of time in preparing something worthy of your at-
tention.   But the honor you have conferred on  me, is so
great and  important,  that  I consider that  energy must
prompt me in securing your  indulgence.
   Over twenty-one years ago I was admitted  as  a member
of this Society.  Our lamented friend, Doctor Stevenson, of
Chazy, had the kindness to move my admission.  Since, the
Society has met three or four times, and we have all neglect-
ed to meet again.  Then the spirit of our profession drooped.
   Eleven  years  ago, acknowledging our error, I saw that it
was  necessary to do something  in order to stimulate the
Brotherhood  and elevate our profession, I have made it my
duty to excite some interest  in this northern section.   With
this  view my  friend  Doctor Horace Nelson  and  myself
wrote, in the newspapers of Clinton and Essex counties, an
appeal to  the medical  profession, inviting them to meet ua
in Keeseville, that we might have some understanding with
respect to the union and the promotion of our interest.  We
intended to have a; journal publiihed^ and. to.be edited  by
aweral members. But unfortunately the meeting ini Reese- 
2
ville was not  duly  attended.  No physician came  from a
distance but Dr. Shumway, of Essex.   The journal was nev-
ertheless published,  and would now be in existence if it fold
not been for the absence of  its editor.  Doctor Nelson was
obliged to move to Montreal; and his departure has been a
loss to Plattsburgh  and neighborhood.  His medical attain-
ments were  such that he had no  superior in this northern
section.  A good physician ; his intimate knowledge of ana-
tomy  made him skillful in surgery.  Study, energy and
perseverance have sustained him and brought him to the
high position he held amongst us.   Montreal and other parts
of Canada have  the advantage ol possessing  his skill and
observations.
   Another member  of  the fraternity, Doctor Edward pane,
has also  left this county.  Universally esteemed in Platts-
burgh, a  good scholar, a well educated  physician, he was
desirous ol knowledge and  ready to  sympathise with the
the other medical gentlemen.
   We had, last  year,  to mourn the loss  of Doctor  J. H,
Patchin.  From  what acquaintance  I had with the doctor.
He appeared t) me to be right.  His  reputation,, as a physi-
cian, was good.   A large circle surrounded him with praise
and affection.
   The death  of our friend, Doctor  Samuel Beaumont, is-
 another blow to our society.  A member of this society, as I
 understand, since its foundation, he has contributed much to
 sustain it.  He  has also much contributed in helping his
 late brother, William Beaumont.
   As you know,  gentlemen, Doctor William Beaumont, of
 the American  Army, has added much to the medical science.
 His experiments and  observations on Alexis St. Martin are
 Known.  The accidental shot in the  lower part of the chest
 of St. Martin in  1822, then a young  Canadian of 18 years of
 age, employed in the service of the  North-West Fur Com-
 pany, has resulted  to the benefit  of the medical faculty and
 also to the benefit of the whole world. His stomach having
 Heen torn by the lead could  not be healed by either a natural 
3
©r an artificial process.  Dr. Beaumont tried to effect a cure,
in keeping St. Martin without food lor two days, without
any desired effect.   The gastric juice secreted by the mucous
membrane of the stomach would not  allow  the re-union of
the torn  walls ol that organ.   The consequence has been
natural, a fistula or opening from the stomach, so much so
that if St. Martjn does not keep a compress to the aperture,
in drinking water or swallowing any thing else, that the whole
contents of the st broach will pass out through that opening.
This  opening is about three-fourths of an inch wide and one
and a half inch in length.   Through this opening comes out
a small part of the  stomach, i. e., the inner coat, which shows
its different appearances, thick and swollen  when  under the
work of digestion and thinner when  the digestion is over.
   Much can be written on this subject,  the  most important
in physiology.  For good reason, no animal can live without
stomach better than  without  heart.  Therefore this living
man, the only one on record, is a subject of great interest.
   I was very  fortunate in 1856  to become acquainted with
St. Martin.   He came often to my  office.   I examined him
several times, and indeed my satisfaction was complete.  I
wish that you, gentlemen, could see St. Martin, and see for
yourselves the very man.  He is still  alive at  St. Thomas,
District of Montreal, Lower Canada.  H^is  56 years of age,
healthy, sound in mind and body, lively.
   Medical men should spare no  trouble, must' spare neither
time or money to get an  opportunity to witness a sight of
St. Martin.   Those who are pursuing the study of medicine,
those who have added by their labor to the science, those who
are still adding, will be happy to examine the man.
   From such  an examination, and by further experiments
on the gastric  juice, which  can  be  extracted  from the
stomach,  valuable results will be known, and valuable knowl-
edge  will be obtained.
   I introduced St. Martin to Dr. Bnnring, who took him for
a few months  and vieited the principal cities of the United 
                           4
States.  Newspapers have reported  their travels  and the
great interest felt by the American Medical Profession.
  Another member of this Society, who has gone to the land
of spirits, three years ago, Doctor Newell S. Fisk, of Chazy
—one of the most  humane, charitable and. well disposed.  I
knew him well;  we both, in 1832, attended  the lectures  of
the learned Anatomist Lincoln, of Burlington, in Vermont.
At the same time we enjoyed the privilege of listening to the
rich instruction of  Professor Sweetser.
  Doctor Fisk was esteemed by all hi* class-mates—studi-
ous, punctual to the lectures, he had reaped a large amount
of  knowledge.  His unremitting application  to  medical
tcienca has rendered him an efficient member of  the profes-
sion.  As a  practitioner he was successful.   Many patients
he has treated.   Many patients he has relieved.   His ameni-
ty gave confidence  to the sick.   The  sufferer was certain  to
receive help at his  hands.  His character was mild and even.
His proneness to do good was the motor of his conduct, and
indeed was the cause of his death.  In helping  a neighbor,
in a conflagration,  he fell from the building  he was so eager
to save ; which  accident disabled him from any more toil.
He departed, regretted by all who knew him.
   Gentlemen,—It  has been my  fortune to attend the State
Medical Convention at Albany last  February.  Composed
mostly of the most celebrated physicians of the State, their
transactions could  not be otherwise  but interesting.   Few
hours brough't forward the cream of the experience of many
physicians,  who, for years,  have worked, observed and re-
flected on different subjects of medicine, who, at divers times,
and repeatedly, have applied their  knowledge to  practice ;
and, who, by study and energy, have improved our profession.
   The chair was well sustainel by one of our most talented
men, Doctor B. Fordyce Barker, formerly of the New York
Medical College.   He acted beautifully his  part.  And  his
presiding qualities are so eminent that I do believe that he
has added much to the  interest of the Convention—I could
name several members of the Convention who  are eminent 
'S
in different branches of medicine.  Yc a will remark in the
transactions, published, all I could say about them.
  Our fellow citizen, Doctor Samuel  Shumway, was there ;
and his presence was greeted by all who knew him—I  wasr
for my part, happy to meet him, and his company made me
feel more at home.
   Though Dr. Shumway was  lately  afflicted, under the rod
of grief, after \vhe loss of an amiable companion, the choice
of his youth,—his  duty, as a  scientific man, prompted him
to come to the medical council.  Nothing is in his  way,
when he can be useful to the honor of his  profession.
   The Convention  was entertained to a festival by  Profess
sors March and  Armsby.  They were, as usual, courteous
and gentlemanly.   Men who have done much, not only for
medical science, but have improved and have added to the
pillars of useful  institutions of the  capital of the  Empire
State.  May they live long for our profession.
   Gentlemen,—You will see in the last transactions of the
 State Society,  valuable papers.  I would  draw  your atten-
tion especially to a paper, written by Doctor Percy, on cer-
tain vegetable medicines examined with the microscope. The
study has been intense and shows a great  perseverance.
   The papers of Doctors Squibs and Parker are equally full
of interest, and show the result of a well educated mind.
   The report  of cases on hypodermic  operation  by Dr.
Sturdevant, of Rome, in Oneida County,  is also interesting
and instructive.  As  you know, this manner of operating
was brought forward by Doctor Trousseau, of Paris.  It has
been already extensively used  on this continent.  Indeed,
the effects produced are so prompt and reliable that it has
become a valuable  mode of treatment.  I have  used it sev-
eral times, with  decided relief.  In  one  case of Sub-Acute
Rheumatism (ischiatic), George Prindle,  of Palmer Hill, a
Californian for several years, had returned, last fall, in good
health.  But winter being too cold,  and especially too varir
able for him, he was led into the above mentioned disease.
Re was fQr.two .nights and one day in. April .lastj  without 
6
 sleep.   I introduced in his leg, in the adipose membrane,
 about  one grain of Sulphate  of Morphine.  In  less than
 three quarters of a minute, he  exclaimed  that  he could
 straighten his leg.  He said that  he had  no pain.  He got
 up, standing erect, entirely free of pains.   Soon he went to
 sleep for an hour.  Then was sick at stomach, vomited and
 felt better.  For few days afterwards the pains occurred less
 often, but were severe.  The instrument  has been used oc-
 casionally with perfect  relief.  Of course it was not perman-
 ent, but prevented the stiffness of the tendons and  took
 away so much of the intensity of the disease that, finally, he
 was restored to a tolerable state of health.
   Another case, Mrs. Brouille had hurt  the inside of her
 foot on  a stick, which  accident  caused her much  pain, ex-
 cruciating pains, verging to tetanus.   I relieved her in  two
 minutes with the solution of Sulphate of  Morphine.   Next
 day,  she had no pain, but her head felt bad, just with simi-
 lar effect as if she had  taken a large dose of opium.  Two
 days after she went to her usual avocation.
   It is customary in the annual address of the chairman of
 a medical society to give a bird's eye view  of the diseases in
 the localities where such society is  established.
   I would remark here that, without  speaking of  common
 diseases  which we  have to  encounter  most  every  year  we
 have to notice particularly three  sorts—Scarlatina, Diph-
 therite and slow nervous, bilious remittent fever.
   Scarlatina has been raging  very much.  It has  been un-
 commonly severe.   The different phenomena, attending usu-
 ally this disease have been, this last  year, different.  They
 have  been mingling  with certain  characters, well demon-
 strated by  French and  English  physicians, and also lately
 tmown in the  able paper on diphtherite in Albany by my
 friend, Dr. S.  D. Willard, which you can peruse with inter-
 est in the State Medical Transactions of 1859.  I will report
 briefly a  case of diphtherite in my practice.
  Russell French,  a )oung man  of Franklin, with  good
habitS) on the 17th of April' last,  going home from a short 
journey felt his throat sore, almost similar to the pains ex-
perienced by those who are affected with quinzy.  That same
evening, I was called, at his  father's  house, to see two chil-
dren under the influence of scarlatina, and as I was ready to
leave, he addressed  me  and  said:  Doctor,  I am sick too.
What is the matter with you? said  I.  I think a cold,  sir.
1 feel  headache and some sore throat,, and  that  since few
days.    Dull  pains  all  over  me.  Tired  and  sick at  my
stomach.   My  month  feels  bad.  My throat feels dry and
sore.  I gave him an emetic followed with  cathartic pills.
On leaving I advised him that if he  was no  better in a day
or two to not neglect but send for a  physician.  The emetic
operated well.  The cathartic did the same.   Both brought
out a  large quantity of bilious  matter.   He felt some re-
lieved but soon the throat became more affected.  I was sent
for on the 18th at 11 o'clock at night.  I sent  two doses of
 calomel and dover's powder,  with the direction to give him a
 dose, and should he vomit it, give the other one immediate-
 ly.  So it happened.  I ordered a blister on  each side of the
 neck, to be followed with yeast poultice ; that  I would be,
 next day, with him.
   On my arrival  I  found that the medicines,  calomel  and
 blisters had acted well; but the throat was worse, swollen—
 the fauces dark and seemed covered with a dark yellow scum
 or membrane.  I took  a probang armed with sponge, wet
 with a  strong  solution of nitrate of silver.  I swabed the
 throat thoroughly and several times, which had the effect of
 breaking this  kind  of false membrane.   So  the young man
 exclaimed, after* this operation : I feel a little better.  I feel
 now as  if there was a passage for my breath, on the left side
 especially.
   I left him some snake root and squills, with direction to
 make a decoction, to use ad libitum, in order to expectorate
 and  prevent, if possible, the  disease from  raging into the
 bronchial tubes.  A gargle of one table spoonful of chloride
 of soda with a cup of boiling water  to dissolve it and a tea
 cupful of common vinegar, to be used occasionally, to detach 
8
such matter from forming  in  the throat; I  left him few
dover's  powders in order to relieve  pains  he had in his
stomach and bowels.  He still complained of sickness at
stomach, showing by this undoubtedly the existence of false
membrane in the intestinal canal.
  On the 21st I again visited him.  His throat felt  some-
what easier—same treatment.   The bowels were  sore  and
griped.
  On the 24th, the throat nearly the same—but considera-
ble gripings and diarrhea, resembling dysentery.   Pieces of
skins passed through his bowels which demonstrated that a
false membrane, similar to that in the  throat,  had been also
formed  in  and over the surface of the intestinal mucous
membrane, and which  had been destroyed by the treatment
above mentioned.   The  mucous membrane then  appeared
very red, shiny and  tender.   In order to alleviate  this ail-
ment I gave a weak  solution of nitrate of silver which did
well.
   Finding that he was weak, I prepared for him few powders
of sulph of quinine, with  the addition  of brandy and water
   Three days after I exchanged these powders for the solu-
tion of quinine with  few drops  of sulphuric acid, which
treatment gave him some strength, and he recovered in a few
days.
   I will repeat the saying of several eminent physicians of
 Europe and of. this  continent,  that  the treatment is to
evacuate the stomach and bowels.   Then break up this false
membrane and prevent its formation.  Use freely blisters on
 the neck.   And as 60on as the  patient feels weak  order
 stimulants—brandy, quinine, with some mineral acids, either
 sulphuric or nitric.
   The third kind of diseases mentioned is bilious  remittent
 fever.
  : For  two or three years we have been, at  Ausable Forks,
 visited by this mean disease.  In general the disease has not
 been fatal.  Few have died.   The disease has been insiduous
 in  ii#  beginning. ..Lassitude,  headache, some sickness.at 
                            9
stomach, bowels often costive.   The bowels with tympanites
—urine often scanty ; in general  we might resume and re-
peat the symptoms of such disease, described by the pathol-
ogists. .
  The patient usually, during the sickness, felt as though he
was not sick, but  still did not feel  well.  He felt " out of
sorts."  At certain period, daily,  he  would find himself with
a little fever—would remark  that he  did not perceive the
fever coming—knew that he had fever only when he was
fairly in its power, but would leave  him more suddenly ; in
this malady, as you  know, quite the reverse of intermittents.
  Now the question has been often asked :  What  is the
cause of so many  cases  of fever  at Ausable Forks ?  The
place appears as a very healthy place.
  The  reasons  assigned  to these fevers by nosologists are
effluvia from miasmatic regions.
  In a  conversation, last spring, with  my  friend,  Doctor
Samuel Haynes, of  Saranac, on  the  prevalence of bilious
remittent  fever at Ausable Forks, he made me the  remark
that, in Vermont, a village was similarly visited by the same
fever.   And few days ago, as I was preparing notes to ad-
dress you, I wrote to the Doctor, in order to know the name
of the place in question.   Very kindly the Doctor answered
promptly to my enquiries.   His  letter was a very able dis-
sertation, and gave me the history of the place, relating to
the origin, progress  and failure of the disease.
   This place  is Westford Centre,  located on both banks of
Brown's river, in the town of Westford, and county of Chit-
tenden.   Doctor Haynes  says, " That Brown's river passes
through  Brown's River  Valley—a  hilly and mountainous
region of country.  It is winding in its course, and is bound-
ed  upon either side by a rich loamy soil with a preponderance
of  clay, which, in many  places, is subject to inundation after
heavy thaws or rains, in a few hours  depositing an  alluvial
soil or matter, which upon the subsiding of the  water, gives
rise to miasmatic  vapors, which gives rise to fevers of a bil-
ious and typhoid type, &c." 
10
  The doctor remarks, in his letter, that a dam  had  been
erected there twice, and twice it had been demolished.  When
this  dam existed, the  locality caused cases of fever; and
when the dam did not exist, there was no fever.  This local-
ity in question," says the  doctor, " is not more than a half.
dozen acres in extent, located some twenty-five rods below a
mill pond, the water of which carries a saw mill on the right
bank, a grist mill and small woolen factory on the left bank.
Sawyers engaged at times  in  the saw mill, with their fami-
lies, generally occupied the  house and land above ;  family
after family would suffer  from remittent  and intermittent
fevers.   Other families than sawyers occupied these premises
and suffered likewise."
  Similarly situated as Westford, Ausable Forks is a  manu-
facturing place, at sixteen  miles from Port Kent,  several
hundred feet above the  level of Lake Champlain.   It is
surrounded with high hills, filled up with iron ore.
  Twenty, and even ten years ago, the surrounding country
was covered with forests of pine—which forests kept the soil
damp and moist.   It prevented the water from running into
the river.  But now what water is left in the soil, adjoining.
the stream of the Ausable, after heavy rains, is absorbed and
leaves the  ground in some  spots dry, and in # others damp.
The  stream  becomes  small, shallow,  and discovers  a great
quantity of wood, roots,  saw dust, chips, which  have been
soaked a great while, which become so many ingredients for
fermentation, and so many germs for miasmatic effluvia.
  Few years  ago as I said, the  neighborhood ol Ausable
Forks was a  continued forest, and so  thick that one  was
liable to get astray without a compass, or without a  map to
show the numerous log roads, through which were drawn so
many thousands of logs every winter, and which  afforded to
our cities so large piles of fine lumber.
  Twenty-one years ago,  last winter and  last   spring, the
first patient I went to  see on Finch Ore Bed, five  miles from
my place, I loBt my right direction and went to the village of 
11
Clintonville.   It was not without the help of a guide that I
could go and see my patient.
  Another time, returning from Black Brook, four miles dis-
tant, in the middle of  a dark night, my horse took a road
which led me to Wilmington, where I had never been before,
I came to a house near the mouth of the Black Brook st:eam;
I hallooed and  a man came to the  door ; I  enquired the
name of the  place.  " Black Brook," said he.  I  replied,
" Black Brook!   I just came from Black Brook; it cannot
be possible."  " Yes,"  says he, "this place is  the limits  of
Black Brook.   You have to return back and take your right
hand road and surely you will reach the Forks." .
  In those times the  snow fell generally  in November and
December; it did not  disappear before March.   The ground
was covered  with snow, or  else it was kept  frozen during
winter.   It was for good effect, health and comfort.  The
summers were splendid, mild, temperate and charming; water
freely in the natural channels, roaring and sliding to increase
the sheet of the majestic Lake Champlain.
   Perhaps it  will not  be out of place here to lay before you
incidents in my practice, such as have occurred to you some-
t'mes, and which incidents  in the life of a physician will
puzzle him.
   I will remark that nothing of  that kind could puzzle the
late Doctor  Samuel McClellan, of Rensselaer County.  I
was amused in  reading the able  biographical sketch of the
same Dr. McClellan,  by  Doctor  Thomas W.  Blachford,  of
Troy, in  the transactions of the State Medical Society  of
1857, page 58.  I must copy one of the Doctor's anecdotes
verbatim, in order to show the case so beautifully described:
   " He was called on  a very hot day in July to visit a lady
residing  an a  neighboring village, in  consultation  with her
physician.  The  lady was of a highly excitable disposition,
and strongly marked nervous temperament.  She had been
the subject of powerful excitement, and during this she had
a dream  which  made a very deep impression  on her  mind
already bordering on mono-mania.   The case was represent- 
12
ed to be hopeless.  She dreamed that she was converted, that
all her sins were forgiven, and  that she had gone to heaven.
Some of her weak, but well meaning friends viewed it as a
premonition, and presumed that her departure was at  hand.
They gathered  in crowds around  her, and  several of  them
praying all together, apparently vieing with each other who
could  pray the loudest, for her immediate entrance into
heaven.  At this stage  of  the Babel  confusion the doctor
arrived.  He was amazed beyond measure at the scene before
him, and for a moment  scarcely knew what to do.   He en-
tered the room with a quiet noiseless step, almost unobserved
by any one but the patient herself.  Carefully avoiding I he
legs of those who  were  prostrate in prayer, he reached the
bed-side;  the eyes of the patient were riveted upon his.  He
felt her pulse  carefully, and in a  low whisper said to her,
" Let me  see  your tongue."  She immediately complied;
after satisfying himself of the  purely  nervous character  of
her complaints, and the  absolute necessity of perfect quiet,
he suddenly turned around to a  little man kneeling by the
bed, and who seemed to  be taking the lead, and as if he had
been a child, quietly took him up  under his arms, walked
h:m carefully  out of the room, allowing  him  not  the least
opportunity to remonstrate, and giving him a gentle  push,
said, " Friend, you go home, this lady will not go to heaven
to-day."   The  room was soon cleared, strict  directions for
perfect quiet with nourishing  food, and very little if any
medicine,  soon restored the lady to perfect health."
  Last March I had been treating for sometime Mrs. M. for
a bilious difficulty and derangement of the uterus.   One day
she was better, and I thought  she would continue  so.  On
leaving her, I  prescribed and told  her that I would visit her
in about a week,  unless she felt  worse.   In this  case she
must send.  Before the  time expired, she being worse, f was
sent for.   Arriving at  the door, a  man  told  me  that my
patient was so much worse that she was dying.   I went in
the house—found the husband in tears—the children lament-
ing, crying—one of the  largest daughters and a female  neigh- 
13
bor were over the head of the patient, lamenting her loss for
this world, and she, the sick woman, was talking calmly of
the approach of death.  She was dying happy, and going to
heaven.  I approached as near as I could, being prevented by
the crowd of friends around the bed.  I saw that the eyes of
the woman did not appear to me as those of a dying person.
Then.I crowded myself.  "Let me see," said I.   "Let me
see.  I cannot believe she is dying."  I felt her pulse.   It
was weak, but excited;  her  hands cold; the head natural;
no profused perspiration ; no contraction of features.
   The attendants  remarked to me that it was too bad to lose
her—that she was going—that her hands were already cold.
" No," said I ;  "I do not think her dying just yet;  that it
was nervous."  Then she looked at  me and  said : " Am I
not dying ?"  " No, said I ;  " you canfiot die now."   I
found, on enquiry, that she  had flowed considerably the day
before, which made her weak, and a long protracted sickness
was just the very  thing to make her nervous.
   I ordered  counter irritants to the feet and warm bricks.
Then gave her sweet spirit of niter, in repeated doses.  About
an hour and a half after, I  came and sat down on the edge
of the bed.   " Madam, how do you feel ?"  " A little bet-
ter,"  she replied.  " Now you see that I can make you either
better or worse ?"  " Yes," she said.  " Well,  you must
take  courage and  everything will come right.  You will do
well,  and get well."   So it  ended.
   On the 2d June, 1859, Miss Mary G., 17 years of age next
 julv—light and fair complexion—nervous temperament—in
January was taken with lame side ;  could not lift anything,
or even could not move  the left arm; it  was painful and
appeared swollen, unable to bear any application.   Such
feelings increased  in intensity until it occasionally  made her
breathing difficult and produced faintness—and though there
was but a little palpitation occasionally, she expressed her-
self in saying that her  heart was pressed ;  complained that
her heart was beating in her throat, and at times seemed to
be stopped.   It lasted about two weeks, when she though* 
14
 that something must have broken internally.   But nothing
 came up  at that  time.  In  the  beginning of the month of
 March, she had symptoms much similar  to  those felt in
 January.   First day  of April, same recurrence.   In the
 middle of May same symptoms and feelings, but more severe
 than the former attacks, because the cheeks, lips  and nails
 were purple—more  difficult  in breathing, headache, faint-
 tiess, &c.  This spell  was  about a week lasting.  The last
 thirty-six  hours very  bad ;  the  last twelve hours in the
 afternoon, took her bed ; next morning she raised her head
 from her pillow, her mouth being then empty, but after being
 raised, her  mouth fiHed up  with bloody matter—such as
 comes from a boil.   This evacuation lasted four days.   Trifle
 after the first commencement.
   After these ftmr days she  was comfortable until a week
 ago last night, when she was  taken with rheumatic pains in
 her back, next day to  the right heel, then, the day after, on
 the 26th, from the right heel to the toes of left foot, and
 lasted until the 29th.  On  the 30th the pains were transfer-
 red to left knee and wrist.  That same day, and during the
 night to the 31st, had more severe pains than in the middle
 of May, with a great deal of faintness, could  not in this
 spell, as well as in the former, lie on her right side.   It seem-
 ed as if something were pulling from the side, below the left
 breast about two inches.
   In those paroxysms pulso 120, and urine high colored and
 scanty.   I think that the character of the urine was due to
 the inflammatory  rheumatism.   She has no difficulty  in
 swallowing—no sickness at stomach.  But in this last attack
 since the evening  before last,  she had eructation, in appear-
 ance not from the stomach, but from the spot  above men-
 tioned, (below the left breagt,) without any smell or taste.
   I had been called on the  31st, and I treated her only for
 inflammatory rheumatism ; and therefore I gave her the root
 of colchicum and application of tr. iodine.  About 9 o'clock
 P. M., (on the 31st,) as soon as she took a fourth powder of
colcliicum, (which hy the by all sickened her stomach), she 
15
vomited  this last  powder with the vehicle  containing the
powder, clear water.   Then yellow matter, some also whitish
matter mixed with folaments, membranes*, thick and white,
small bladders  of water,  which were not saved, and  some
harder substances  were vomited from the spot before  men-
tioned.   Then  immediately after two  mouthaful of yellow
and green fluid  substance were thrown  up,  evidently  from
the stomach.  This left her weak and exhausted.   The pain
left the wrist on the 1st June.  To-day, on the 2d June, she
feels somewhat  better, and  has a pain in her right shoulder,
pulse 80, water still turbid and scanty  ; yesterday and the
two days before she was thirsty.  The spot in question, she
Bays is tender to the touch, still it feels  sore and raw inside.
  After such description from the part  of the patient and
attendants,  I was rather at loss what to decide, but bound
to find out the  real ailment.  I carried  home some of the
ingredients of the ejection.  Before leaving,  and in my en-
quiries about cough and soreness about  the osophagus, I re-
ceived the assurance that  she had  no  cough,  no soreness
whatever, in swallowing, either before or after this myste-
rious abscess.
   In the evening in looking with a weak microscope  I saw
 curious and rather heterogenous matter  for animal  substan-
ces, having in view that the patient and her family or friends
could not mistake the trouble, having all said to  me that
when she ejected those particles, the efforts to throw  them
up were certainly similar ones as  those  for ejecting matter
from lungs, or such place, as before mentioned, that she was
threatened of choking.
   But  before I finished my  examination which was a seri-
 ous one, being  bent as a philosopher to find out some  extra-
 ordinary substance, I got hold of  one piece which  appeared
 to me something too strange  for  animal, it resembled and
 was in reality the pulp and heart of a lemon.
   I remembered then that the patient had wished for lem-
 onade, and, in drinking this lemonade, she must have  swal-
 lowed some of  the hard  substance of that fruit  without 
16
much maceration.  This want of maceration accounted  for
the choking.
  Few days after, I saw the patient; she  was  comfortable,
I told her father the result  of my  studious  examination
with the request to say nothing to the  daughter about  it,
but let her enjoy the satisfaction that she had all thrown  up
its components, to the risk of choking to death.
  Much could be written on this subject, which would  bring
the conclusion that the nervous systems is  a wonderful  ap-
paratus of the man.   When it is sound it will help to move
one of the nicest pieces of mechanism, but when out of order
by some reason, it will cause an awful trouble.
  In the Transactions of the State Medical Society of 1859,
you have undoubtedly read with pleasure the address of its
President,  Doctor Thomas C. Brinsmade.   This gentleman
has been living for many years in the city of Troy.   He  has
grown with Troy.   He  is  a man of thought and  practice.
His large practice has afforded him a large amount of  ac-
quirements, and his perseverance has caused him to do much
for the reflexion of his medical brethren.
  In the convention he is looked upon as a reliable authority.
In  his annual  address, as President of the State  Societv,
he has shown a great experience.   He has  shown  what  are
the elements of society.   He has pointed what are  the  du-
ties of mankind.  Indeed  he has brought to a focus all  the
qualities necessary to a  philanthropist.
   I say  philanthropist.  The physician must be a philan-
thropist.   He cannot be otherwise, because he must have in
his heart the desire to relieve his fellow sufferer.   Without
such a character, he is mercenary, he is  a mere machine, he
cannot be an intellectual,  a scientific man.
   The inscription put on the coat of arms of this  Republic
is E Pluribus Unum, which renders well the meaning of asso-
 ciation.   An association is necessary as well to mankind as
 to  other animal in creation.   Association  is seen  amoDgst
 beavers to work and live together.  The honey bees  sustain
 and show the most beautiful system of government  and so 
17
on with other created beings.  The man himself is by  him-
self incapable of doing  good.    But  associated  he can  do
wonders.  It is on this plan that  governments  of  nations
are established, companies of individuals work, and  explain
truly the saying, united we stand, but divided we fall.
  I have, and so you have remarked that when members of
our profession feeling themselves above others, and by selfish
views despise other members, in the  localities  where  such
members reside, the healing art is not so energetic, but more
powerless, such members are so self-confident that they  for-
get knowledge.  That they themselves are the only ones to
give the orders.  No other but themselves  are the  favored
sons of Esculapius.   With  such feelings they soon  harvest
the fruit of their conduct.   Science is at  rest,   and igno-
rance takes  the place of knowledge. But members associated
with other members will form a  society.   This  society will
unite the observations of its members.  One will be happy
to communicate anything which can adorn the Society.   In-
tercommunication will promote a mutual improvement  and
the advancement of medical science.
   The aim of medical science ought to be Progress,  Union
and Friendship.   The want of  friendly feelings  is the  very
deadly instrument to progress, to  give room to empiricism,
quackery and ignorance.
   Membres of the profession who are fond of meeting  their
brethren and communicate their experience,  their observa-
tions,  their discoveries,  their  success  or  failure  in  cer-
tain cases, will excite a discussion.  This discussion  will
bring on new ideas.   Those ideas will bring on scientific re-
searches, and  the results will be pleasant and happy.
   When  members of our profession are united,  there  is a
stimulus  which brings on noble  deeds.  Knowledge is ob-
tained.   The poor sufferers  have confidence in  their physi-
cians, because they are convinced that such a body  of men
must be scientific men,  men of probity and men of attain-
ments ;   Men who work and desire the welfare of mankind.
   Such a state  of the profession  is a bulwark  against  the 
18
creepers of quacks.   The true medical men are a formidable
legion that unqualified men cannot attack or injure.  This
legion  is marching on  and will reach the  pinnacle of the
temple of science.  On their march they are sustained by the
respect, esteem, and  good wishes of all grades  of society.
Everybody looks  upon them as their best, most  intimate
friends, and their true guardians.
  With such a conduct, gentleman, can  we  feel otherwise
than proud ?   It is a state of happiness to  know  that we
have done good, and that we are considered as such by the
community.  Such thoughts ought to encourage us in our
journey.  Our path  is arduous, our task is severe.   But,
sometimes, the gratification is great.  Conscious of having
done our duty, and receiving the gratitude of our  patients
convalescing ; this certainly will pay us fully.
  With  such laurels,  must we  stop  and  slumber ?  No.
Mankind expect more from us.   We have, as a battalion of
Chivalrous Knights,  to  press  our ranks.   We have  to
strengthen our  files  and  brush up our  arms.  The drum
must beat the sound of battle.  The whole body must charge
on empiricism and quackery, and victory is ours. 
 
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