Vol. IX No. I January 1939 "You can't have a panic if you pay as you qo," -IRVING FISHER. BULLETIN of the Mahoning . County Medical Society YOU [AN GIVE SALI[YLATES IN AllEOUATE DOSES Gastric Disturbance Held to a Minimum TODAY the trend is toward massive doses of salicy lates in treating influenza, the common cold, rheu matic and arthritic conditions. Tolerance, then, becomes a most urgent consideration, for salicylates so often produce gastric disturbance when given in ade quate doses. AL YCIN-MERRELL assures maximum tolerance, for only Alycin combines these two elements: 1. Natural Salicylates-preferred for over 60 years for reliable salicylization with less gastric distress. 2. Balanced Alkaline Base-selected alka line salts in proper proportion to act as a buffer against gastric irritation. ELIXIR ALY[IN (MERRELL) One average teaspoonful Elixir Alycin contains approximately 5 gr. Natural Sodium Salicy late and 10 gr. alkaline salts (potassium bicarbonate, sodium citrate) in aromatized elixir containing 10 per cent alcohol. Supplied in four-ounce and sixteen ounce bottles. Alycin Powder and Alycin Effer vescent Tablets are also available at the prescription pharmacy. Write for literature and sample. THE WM. S. MERRELL [OMPANY Establislzed 1828 CINCINNATI, U.S.A. THE Mfl.HONJNG COUNTY "WINTER COM related There is an accepted C4 and some of the "summe1 the difficult summer pe physicians prescribe Sirr babies are well nourished intestinal upsets. e But isn't it true that as respiratory infections) I ing-being less frequent nourished? e When your Similac-fe ing summer period so we to prescribe Similac - c Similac's nutritional balan tor are still of undiminishE SI A food mother's milk {cal lactose, ! ble and Similac i! and no d trade pac M & R DIETETIC LABORATORIEl 1939 IVE SA.Lil:YLA.TES OUA.TE DOSES ance Held to a Minimum 1 toward massive doses of salicy uenza, the common cold, rheu conditions. Tolerance, then, 1t consideration, for salicylates so disturbance when given in ade- , assures maximum tolerance, for · these two elements: cylates-preferred for over reliable salicylization with istress. faline Base-selected alka Droper proportion to act as • 0 0 0 0 nst gastnc 1rntatwn. R ALYl:IN MERRELL) Eul Elixir Alycin contains :-ratural Sodium Salicy ~line salts (potassium ttrate) in aromatized per cent alcohol. 1 1Ce and sixteen- Alycin Effer .lso available I armacy. d sample. . S. MERRELL l:OMPA.NY Established 1828 INCINNATI, U.S.A. THE MAHONING COUNTY MEDICAL SOCIETY "WINTER COMPLAINTS" related t 0 feeding? There is an accepted causal relation between feeding and some of the "summer complaints" of infancy. During the difficult summer period an increasing number of physicians prescribe Similac . . • Because Similac-fed babies are well nourished and notably free from gastro intestinal upsets. e But isn't it true that "winter complaints" too, (such as respiratory infections) have a definite relation to feed ing-being less frequent and less serious among the well nourished? e When your Similac-fed infants come through the try ing summer period so well nourished, why not continue to prescribe Similac -during the winter months when Similac's nutritional balance and excellent digestive fac• tor are still of undiminished importance? SIMI LAC A food for infants deprived of mother's milk. Made from fresh skim milk (casein modified) with added lactose, salts, milk fat, and vegeta ble and cod-liver oils. Similac is not advertised to the laity and no directions appear on or in the trade package. M & R DIETETIC LABORATORIES, INC., COLUMBUS, 0. 1939 2 BUL L ETIN ADVERTISERS' LIST Patronize them-they make the "Bulletin" possible Baker Laboratories .. ............. . Blair Dry Cleaning ..... . . . .... . .. . Central Square Garage .. ......... . Cross Drug Stores .... . ......... . . . Defiance Milk Products Co. . ...... . Denver Chemical Mfg. Co .. . ...... . Dobson's ..... . .... . . . . .. . . .... . . . Fair Oaks Villa .... . . ............. . Francis, John P., Agency .. .. . . ... . . Giering's ...... . .. .. .... . . . . . ... . . Golden Age Gingerale .... . .. . .... . 14 20 22 14 23 12 22 4 20 22 20 Heberding's . . . . . . . . . . . . . . . . . . . . . . 18 Hockstadt, R. L. . . . . . . . . . . . . . . . . . . 32 Humphrey Drug Co., Inc. . . . . . . . . . . 18 lsaly's . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 James & Weaver.. . . . ..... . .... . .. 18 Jones Pharmacy . . . . . . . . . . . . . . . . . . 20 Lyons Physician Supply Co .. . . . .. .. 10- 24 McKelveys . . . . . . . . . . . . . . . . . . . . . . . 2 Mead Johnson & Co ......... . ..... Cover Mercer Sanitarium . . . . . . . . . . . . . . . . 22 Merrell, Wm. S., Co ... • . ....... .. Cover Renner's . . . . . . . . . . . . . . . . . . . . . . . . . 26 Schmidt, Paul . . . . . . . . . . . . . . . . . . . . 20 Scott Company . . . . . . . . . . . . . . . . . . . 10 Similac .... . ........... . ..... . •.. Strouss-Hirshberg's . . . . . . . . . . . . . . . . 8 Thornton's . . . . . . . . . . . . . . . . . . . . . . . 24 Treudley, H. H. , & Co .... : . . . . . . . . . 20 White Drug Co. . . . . . . . . . . . . . . . . . . . 8 Youngstown Printing Co . . ....... . . Cover Youngstown Sanitary Milk...... . .. . 26 Zemmer Co. . . . . . . . . . . . . . . . • . . . . . . 24 I. WhyisanArrow Handkerchief like a point after touchdown? When you fold a fresh, color· ful Arrow handkerchief into your breast pocket you give yourself an extra something, a final touch, that makes for a winning appearance. Stop in today and take your pick of our perfectly swell new pat terns. 25c: up. Also a Complete Line ARROW Shirts & Ties McKELVEY'S (Men's Store- Street Floor) January THE MAHONING CO UNT BULLETIN MAHONING COUNTY A Component Society of the Oh Published me 787 Wick Avenue, y, Annual Subscri WM. M. SKIPP, M. D., President R. B. POLI NG, M. D., President-Elect H. E. PATRICK, RADIO~ Jan. 6- Asking the Doctor Questiom Jan. 13- Measles Jan. 20- Feeding Your Baby - Jan. 27- Lock-iaw Feb. !- Emergency Aid - Feb. 11- First Aid - MEDICAL Cl January, 1939- Annua l Ba nquet-Dr. of the State Medical Journa l. St: February- Loca l Program-Tubercul March- Dr. Curtis, Surgeon. Ohio ~ Vol. IX-No. 1 ADVERTISERS' LIST PRESIDENT 'S PAGE CONTE ANNUAL MEETING SCLEROSING OF VARICOSE V AND ONE MASSIVE INJEC RICINOLEATE ANNUAL BANQUET SECRETARY'S REPORT NEWS MEDICAL CRIER COUNCIL, OFFICERS AND CO:tv ROSTER OF THE SOCIETY PRESIDENT'S BIRTHDAY CELEE 1939 ULLETIN """" 1e 14 20 22 14 23 12 22 4 20 22 20 18 32 18 6 18 20 -24 2 ver 22 t ver 26 20 10 1 8 24 20 8 1ver 26 24 Why is an Arrow Handkerchief ~~ ·like a point after touchdown? When you fold a fresh, color• ful Arrow handkerchief into your breast pocket you give yourself an extra something, a final touch, that makes for a winning appearance. Stop in today and take your pick of our perfectly swell new pat· terns. 25e up. Also a Complete Line ARROW Shirts & Ties McKELVEY'S (Men's Store-Street Floor) January • • THE MAHONING COUNTY MEDICAL SOCIETY BULLETIN OF THE MAHONING COUNTY MEDICAL SOCIETY A Component Society of the Ohio Stale Medical Ass:lcialbn. Published monthly at 787 Wick Avenue, Youngstown, Ohio. Annual Subscription, $2.00. WM. M. SKIPP, M. D., President JOHN NOLL, M. D., Secretary 3 R. B. POLING, M. D., President-Elect ELMER H. NAGEL, M. D., Treasurer H. E. PATRICK, M. D., Editor RADIO TALKS Jan. 6-Asking the Doctor Questions ----Dr. Morris Rosenblum Jan. 13-Measles ------------Dr. P. J. McOwen Jan. 20-Feeding Your Baby ---------Dr. C. C. Wales Jan. 27-Lock-Jaw ----------Dr. Gordon G. Nelson Feb. !-Emergency Aid -----------Dr. P. L. Boyle Feb. 11-First Aid -------------Dr. S. R. Cafaro MEDICAL CALENDAR January, 1939-Annual Banquet-Dr. Jonathan Forman, Editor-in-Chief of the State Medical Journal. Subject: Socialized Medicine. February-Local Program-Tuberculosis. March-Dr. Curtis, Surgeon. Ohio State University Medical College. Vol. IX-No. 1 CONTENTS January, 1939 ADVERTISERS' LIST PRESIDENT'S PAGE ANNUAL MEETING SCLEROSING OF VARICOSE VEINS BY LIGATION AND ONE MASSIVE INJECTION OF SODIUM RICINOLEATE ANNUAL BANQUET SECRETARY'S REPORT NEWS MEDICAL CRIER . COUNCIL, OFFICERS AND COMMITTEES ROSTER OF THE SOCIETY PRESIDENT'S BIRTHDAY CELEBRATION 1939 2 4 7 9-28 16-17 28 28 29 30 31-32 32 ~nee 1894 View of "Brownstone" House/ FAIR OAKS VIlLA G. D. TIPTON, M. D. Medical Director A. B. BOSMA, M. D. Assistant Physician R. E. PINKERTON, M. D. Consultant E. D. McGOWAN, President E. A. PAISLEY, Business Mgr. c£auifatium CUYAHOGA FALLS, 0. A MODERN INSTITUTION FOR THE TREATMENT AND CARE OF NERVOUS AND MENTAL PATIENTS ALCOHOL AND DRUG ADDICTION The homelike atmosphere of Fair Oaks Villa is afforded by the pleas ant rooms, by the eight and one-half acres of attractive lawns, picturesque landscaping, and restful surround ings. Fair Oaks Sanitarium is a member cf the American Hospital Association and the Central Neuropsychiatric Hospital Association. Phone WALBRIDGE 2131 January • II JPJQJESJIDJE ~1 May I wish each and every mt Medical Society a happy and very su It is my sincere wish that our S ful year. :May we witness progress i Society be of more service to its rr have been instituted in 1938 will b certain new ideas and plans in vi involved. The Society cannot go forward committees alone; it requires the w members. Cooperation will have to have to act as a unit if we are to mo which to date are very much against to cooperate with our State and N a reasons, we should have an executive This does not mean, however, that wt larly elected secretary, whci must be quired supervision of the duties of th Publicity must be continued. L , now than ever before. Scientific adv, for any of these. They all must prog our self respect and our place as a n• The government has decided t• going to tell us how and when we shal or modify this we will have to be on < Along these lines let me inform gress will have a special message frorr the National Health Program. This Miss Josephine Roche, Chairman of t sion on Health and Welfare of the I Look out for compulsory health pearing all o\·er the country proposin~ is well organized propaganda, and wi Lay Education Committee and State· As the Federal Government ha has indicted us for violation of the Sl out for legislative actions coming fror will take plenty of calm, cool, Ievel-I: our members, to keep straight and a which is right. We must keep our give advice and receive the same. If you can give us any help, let u your light under a bushel. If things they should, let us hear about it. 1939 lKS VIlLA c£auifatium CUYAHOGA FALLS, 0. A MODERN INSTITUTION FOR THE TREATMENT AND CARE OF NERVOUS AND MENTAL PATIENTS ALCOHOL AND DRUG ADDICTION The homelike atmosphere of Fair Oaks Villa is afforded by the pleas ant rooms. by the eight and one-half acres of attractive lawns. picturesque landscaping, and restful surround ings. Fair Oaks Sanitarium is a member cf the American Hospital Association and the Central Neuropsychiatric Hospital Association. Phone WALBRIDGE 2131 January • • JP1QJIESIUDIEN1r 9 8 lPA\tC~JE May I wish each and every member of the Mahoning County Medical Society a happy and very successful year. It is my sincere wish that our Society shall have a very success ful year. lVIay we witness progress in all our activities and may the Society be of more service to its members. Some activities which have been instituted in 1938 will be carried over into 1939, with certain new ideas and plans in view for the betterment of all involved. The Society cannot go forward by the work of its officers or committees alone; it requires the "·hole-hearted support of all the members. Cooperation will have to be our "·atchword. We will have to act as a unit if we are to mould the happenings of the times which to date are very much against us. It will be necessary for us to cooperate with our State and National organizations. For these reasons, we should have an· executive secretary with a central office. This does not mean, however, that we should dispense with our regu larly elected secretary, who must be continued in office for the re quired supervision of the duties of the hired secretary. Publicity must be continued. Lay education is more important now than ever before. Scientific advancement cannot be sidetracked for any of these. They all must progress together if we are to keep our self respect and our place as a noble profession. The government has decided to curtail our activities and is going to tell us how and when we shall practice medicine; to ward off or modify this we will have to be on our toes. Along these lines let me inform you that the forthcoming Con gress will have a speciai message from President Roosevelt regarding the National Health Program. This legislation is being proposed by 11iss Josephine Roche, Chairman of the Interdepartmental Commis sion on Health and Welfare of the Federal Government. Look out for compulsory health insurance. Editorials are ap pearing all o\·er the country proposing this form of insurance, which is well organized propaganda, and will have to be combated by our Lay Education Committee and State-sponsored publicity. As the Federal Government has decided we are a trust and has indicted us for violation of the Sherman Anti-Trust Lmn, look out for legislative actions coming from all law-making bodies. This will take plenty of calm, cool, level-headed thinking on the part of our members, to keep straight and at the same time do only that which is right. \¥ e must keep our feet on the ground; we must give advice and receive the same. If you can give us any help, let us hear from you. Do not keep your light under a bushel. If things do not go the way you think they should, let us hear about it. Wl\1. M. SKIPP, M. D. 7939 ALL ISAL Y MILK BOTTLES ARE NOW "RENTSCHLERIZED" with the Ultra-Violet Rays of STERILAMPS Always alert to give its patrons the advantages of every advanced idea for the improvement or protection of its products. Isaly's is the first in this locality to adopt "RENTSCHLERIZING." This is a new sterilizing agent using Ultra-Violet Radiation to destroy bacteria. All Isaly Milk Bottles. after being scoured, are subjected to these bacteria killing rays as the bottles pass, on a traveling belt, beneath STERILAMPS, on their way to automatic bottling machines. This is the "last word" in bottle sterilization, and is avail able in this locality with Isaly products only. Enjoy this added protection for lsaly's Milk and the good health of your family. JIB llU Jll Jll JIE 1/L ]/[ _N Mahoning County JANUARY OUR ANNUAL The Society held its annual Busi ness Meeting and Election of Officers at the Youngstown Club, Tuesday evening, January 20th. After calling the meeting to order, the President, Dr. Claude B. Norris, said, in part: "Once more the ceaseless movement of time has brought to an end another year in the course of our lives and in the history of our Society-and with it the beginning of a new year. The infinite Spinner has added an other thread, and that same infinite Spinner, as the Master Weaver, has woven that thread into the tapestry that is our lives. In that important phase of our lives contemplated when we speak of the work of our Society, we have done all we could to make that thread strong, and we wanted it to be not only strong but also beauti ful. For the degree of its strength is the measure of its utility and the extent of its beauty is the test by which we may gauge its spiritual satisfactions. "In many ways the year now clos ing has been the most discouraging, even the most outrageous year, within the history of our civilization. Mil lions have felt the scourge of intoler ance and beastly cruelty. "Tonight we hold a democratic election to choose for ourselves those who are to conduct our affairs during the coming year. Of course, we covet the approval of all men, but in carry ing out our duties here, we shall not ask the leave of Mr. Roosevelt, Mr. Hoover, nor any other man or group of men. We acknO\dedge no master, save and except one-our individual conscience. In few other places than in this blessed land, the United States 1939 c t I' p r e I g ft t: A t: a' Sl a] "' p S! St p C( H '"' as di a I a I Vt In RENTSCHLERIZED" 1let Rays of STERILAMPS patrons the advantages of every improvement or protection of its 1 first in this locality to adopt tis is a new sterilizing agent using destroy bacteria. All lsaly Milk ed. are subjected to these bacteria l pass. on a traveling belt. beneath ay to automatic bottling machines. in bottle sterilization. and is avail h Isaly products only. Enjoy this : ly's Milk and the good health of ·our family. 7 liB lllJ Jll Jll JIE 11L Jl[ No= r t=he == Mahoning County Medical Soci~ty JANUARY 1 9 3 9 OUR ANNUAL MEETING The Society held its annual Busi ness Meeting and Election of Officers at the Youngstown Club, Tuesday evening, January 20th. After calling the meeting to order, the President, Dr. Claude B. Norris, said, in part: "Once more the ceaseless movement of time has brought to an end another year in the course of our lives and in the history of our Society-and with it the beginning of a new year. The infinite Spinner has added an other thread, and that same infinite Spinner, as the Master Weaver, has woven that thread into the tapestry that is our lives. In that important phase of our lives contemplated when we speak of the \York of our Society, we have done all we could to make that thread strong, and we wanted it to be not only strong but also beauti ful. For the degree of its strength is the measure of its utility and the extent of its beauty is the test by which we may gauge its spiritual satisfactions. "In many ways the year now clos ing has been the most discouraging, even the most outrageous year, within the history of our civilization. Mil lions have felt the scourge of intoler ance and beastly cruelty. "Tonight we hold a democratic election to choose for ourselves those who are to conduct our affairs during the coming year. Of course, we covet the approval of all men, but in carry ing out our duties here, we shall not ask the leave of Mr. Roosevelt, Mr. Hoover, nor any other man or group of men. vVe acknowledge no master, save and except one-our individual conscience. In fe"· other places than in this blessed land, the United States 1939 of America, is this true-and for this liberty we should offer our grat itude to Almighty God, and should pledge our lives to its preservation regardless of the cost to ourselves." The election resulted as follows : Dr. Robert B. Poling, Pres.-Elect; Dr. John Noll, Secretary; Dr. Elmer Nagel, Treasurer; Dr. Walter K. Stewart, Delegate; Dr. Ivan C. Smith, Alternate Del- egate; Dr. Edward C. Reilly, Alternate Delegate; Dr. Dean Nesbit, Alternate Dele gate; Dr. H. E. Patrick, Society Rep. to the Asso. Hospital Service, Inc. Dr. Poling was promoted after four years of efficiency as our Secre tary. The Treasurer, Delegate, and Alternate Delegates, and the Hospi tal Representative were all reelected -testimony of the Society's appreci ation of their good work. This same spirit of appreciation was responsible, also, for the promotion of Dr. Noll, whose service as chairman of the Program Committee for the past two years was signally successful. Bidding the new President God speed Dr. Norris duly installed his successor, Dr. Wm. M. Skipp as President. Dr. Skipp pleaded for the continued cooperation of the Society. He ma\' be assured that the Societv will do. all possible to make his yea-r as President a successful one. By a new voting device, the te diousness of balloting was eliminated, and the election consumed less than an hour. In the words of a faithful veteran, "It was a hel-a-va good meet ing." 8 * BULLETIN DIASTASE is capable of converting 2000 times its weight into Maltose or Malt-sugar. PUL VIS SIPPY Improved contains Diastase in addition to the usual light and heavy Carbonates found in ANT ACID powders. - FOR GASTRIC ACIDITY - Contains: Bismuth Subcarbonate-Magnesii Carbonate Calcii Carbonate- Sodii Carbonate- Diastasa Cone. - 01. Menth Pip. Dose: On teaspoonful p.c. Dispensed in 4 oz. bottles. DRUG STORES Dependable Prescription Druggists PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN Semi-Annual Sale of Men's '1f~SHOES Unrestricted Choice From Stock Regularly $10 to $15 $8 95 Others • $9.95 to $11.95 Even Nettleton's patented Algonquin and Spring models are included. Ex clusive with us in Youngs· town. Men's Shoe Shop____:,Phelps St. Annex STROUSS - HIRSHBERG'S * January • • THE Mfl.HONING COUN'Ii SCLEROSING OF VARICOSE ONE MASSIVE INJECTION 0 By SAMUEL H. SEDWITZ. M. D .. an1 Youngs low; Reprinted from The American j To the best of our knowledge, the e veins were made by Provatz 1 in 1851. cessful, but there were many reactions DeLore 2 , in 189+, first demonstrated th1 literation in the veins. Since the beginr varicose veins many types of solutions l of success. The action of sclerosing agents hi experimentation and biopsy. These obse formation of an adherent fibrotic clot 1 destruction of the intima of the vein. Tl firm deposit of fibrin and blood platelets, clot extending into the smaller vein whi Figs. 1 to 4, photomicrographs of t: rabbit, show the effect of a 2 per cent sol at intervals of fifteen minutes to twen1 photomicrographs that the clotting of tl to coagulation of the red cells and that the lining of the vein. This clotting is the usual course of an ordinary, slowly Within an hour after the injection of desquamation of the lining endothelium there is complete destruction of the intim; changes taking place in the surrounding of the material out of the venules into tl The chief danger encountered in thi vein sclerosis. This, we believe, is dimini patient immediately after the injection s As soon as the wound is closed, the patie series there has been no obliteration of t. the fact that we make our patients beco a dilute solution. This is further diluted damage to the intima of the vein thereaf The sclerosing solution used in ou1 sodium ricinoleate prepared in accordance drug in this solution is approximately 9, with small amounts of sodium oleate and distinct advantage in the use of sodium known, stable compound, the composition very narrow limits. The 2 per cent solu justed to 8.0. Froehlich and Henrickson 4 report the in the treatment of varicose veins in 300 *From the Peripheral Vascular Clinic of t pita! Association. Received for publication January 7, 1938. 1939 ULLETIN DIASTASE !able of converting 2000 times its : into Maltose or Malt-sugar. JL VIS SIPPY Improved contains se in addition to the usual light and Carbonates found in ANT ACID ;rs. -FOR GASTRIC ACIDITY - )Carbonate-Magnesii Carbonate Carbonate-Diastass Cone. -Ol. p.c. tles. >RUG STORES Prescription Druggists SERS AND MENTION THE BULLETIN I Sale of Men's on SHOES - rom $15 ~ed ing Ex lgs· Annex HIRSHBERG'S * January ' THE Mfl.HONING COUNTY MEDICAL SOCIETY 9 SCLEROSING OF VARICOSE VEINS BY LIGATION AND ONE MASSIVE INJECTION OF SODIUM RICINOLEATE~ By SAMUEL H. SEDWITZ. M. D .. and MYRON H. STEINBERG, M. D. Y ounqstown. Ohio Reprinted from The American Heart Journal, June, 193 8. To the best of our knowledge, the earliest attempts to obliterate varicose veins were made by Provatz 1 in 1851. These attempts were somewhat suc cessful, but there were many reactions and infections, and some fatalities. DeLore 2 , in 189+, first demonstrated the action of drugs which produce ob literation in the veins. Since the beginning of this method of treatment of varicose veins many types of solutions have been used with varying degrees of success. The action of sclerosing agents has been carefully studied by animal experimentation and biopsy. These observations indicate that following the formation of an adherent fibrotic clot there is sufficient irritation to cause destruction of the intima of the vein. This is followed by the formation of a firm deposit of fibrin and blood platelets, resulting in the formation of a dense clot extending into the smaller vein which leads into the varicosity. Figs. 1 to +, photomicrographs of the cross section of the ear vein of a rabbit, show the effect of a 2 per cent solution of sodium ricinoleate (soricin) at intervals of fifteen minutes to twenty-four hours. It appears from the photomicrographs that the clotting of the blood is an immediate effect due to coagulation of the red cells and that it precedes the injurious effects on the lining of the vein. This clotting is a sudden event and does not follow the usual course of an ordinary, slowly developing ante-mortem thrombus. Within an hour after the injection of sodium ricinoleate, destruction and desquamation of the lining endothelium occur. Within twenty-four hours there is complete destruction of the intima of the vein, with some degenerative changes taking place in the surrounding tissue, probably due to an extension of the material out of the venules into the tissue spaces. The chief danger encountered in this procedure is the possibility of deep vein sclerosis. This, we believe, is diminished by changing the posture of the patient immediately after the injection so that the foot becomes dependent. As soon as the wound is closed, the patient gets up and walks about. In our series there has been no obliteration of the deep veins. We attribute this to the fact that we make our patients become active at once and that we use a dilute solution. This is further diluted by the blood and cannot cause much damage to the intima of the vein thereafter. The sclerosing solution used in our work is a 2 per cent solution of sodium ricinoleate prepared in accordance with the directions of Rider. 3 The drug in this solution is approximately 98 per cent pure sodium ricinoleate, "·ith small amounts of sodium oleate and sodium linoleate. We feel that one distinct advantage in the use of sodium ricinoleate is the fact that it is a known, stable compound, the composition of which can be controlled within very narrow limits. The 2 per cent solution has a pH which has been ad justed to 8.0. Froehlich and Henrickson 4 report the use of 5 per cent sodium ricinoleate in the treatment of varicose veins in 300 patients. Their method was to give *From the Peripheral Vascular Clinic of the North Side Unit. Youngstown Hos pital Association. Received for publication January 7, 1938. 1939 10 * FOR REAL FOOT COMFORT WEAR BULLETIN InterwoYen Sox These nationally-famous sox excel all others for style perfect fit and extra long wear. We have an excellent selection of plain color silk or lisle -fancy patterns in wool and the wonderful 6x3 English Rib- prices from 50¢ up. The Scott Company 32 ?V.._orth Phelps Street PATRONIZE OUR ADVERTISERS AND MENTION THE BULlETIN DIRECTOIRE SUITE Mr. Fred Lyons of the Lyons Physician Supply Co .. recently installed the above Allison furniture in the office of a local physician. It is without doubt the most L beautJful suite brought to the city. We are local Allison Distributors. * lanum:y THE Mfl.HONING COUN a preliminary injection of 1 c.c. into a sr mine whether or not the patient was s sensitivity was evidenced, a 5 c.c. dose injections (averaging three to four in m Fig. 1. Fig. 3. Fig. I.-Cross section of ear vein of rabbit ricinoleate. Fig. 2. Cross section of ear vein of rabbit onE Fig. 3. Cross section of ear vein of rabbit six Fig. 4.-Cross section of ear vein of rabbit t ricinoleate. 1939 LLETIN 'OYen Sox 3 sox excel all others for style ear. election of plain color silk or lisle :i the wonderful 6x3 English Rib- from 50¢ up. tt Company n 'Phelps Street ERS AND MENTION THE BULI;ETIN * TOIRE SUITE s>c>an Supply Co .• recently installed the above local phys>cian. It is without doubt the most We are local Allison Distributors. lanum:y I THE MfiHONING COUNTY MEDICAL SOCIETY 11 a preliminary injection of 1 c.c. into a small loop of the vein as a test to deter mine whether or not the patient was sensitive to sodium ricinoleate. If no sensitivity was evidenced, a 5 c.c. dose was used in a sufficient number of injections (averaging three to four in number) until all veins were sclerosed. Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 1.-Cross section of ear vein of rabbit fifteen minutes after injection of sodium ricinoleate. Fig. 2. Cross section of ear vein of rabbit one hour after injection of sodium ricinoleate. Fig. 3.-Cross section of ear vein of rabbit six hours after injection of sodium ricinoleate. Fig. 4.-Cross section of ear vein of rabbit twenty-four hours after injection of sodium ricinoleate. 1939 As a supporting measure in all cases of pneumonia, Antiphlogistine is a great help, no matter what other means of therapy is employed. Sample on request THE DENVER CHEMICAL MANUFACTURING COMPANY 163 VARICK STREET NEW YORK CITY THE MAHONING COUNT Postlethwaite" employed a 2 per cen only small amounts of the solution and entire vein became sclerosed. Riddle 6 reported the use of 10 pe that it was effective even when 10 per ct had failed. McPheeter 7 states that 5 per cent sc morrhuate but that it is a little strange this reason he is now using 2 per cent ~ and 0.5 per cent in the superficial vein Johnston 8 reports the use-of a solu1 with ligation of the great saphenous v opening. He stresses the importance of li renee and canalization. We believe tha blockage are present, they c~ntraindicate because the wound does not heal readil destruction of the lymphatics by dissectic of edema which persists for a long time vein, should this be necessary. J ohnston 8 the arterial circulation, with which we 2 In the treatment of varicose veins, fractional injection of small quantities disadvantages of this method of treatmen discomfort, lasting from four to seven d: tiplicity of injections requiring from tl numerous periods of disability and discor ment. There is also to be considered the at the site of the injection. Because of these disadvantages, we procedure in selected patients who have delenburg and Perthes tests, and have als arterial system, including oscillometric re and Callens-Wilensky and Buerger tests In the Trendelenburg test the patient is extremity is raised to empty the veins. A to patient then stands. Quick filling of the vei1 communicating vein valves are incompetent a veins into the supercilia! ones. When the tou fills rapidly from above as soon as the patier at the saphenofemoral junction are incompeten test. A combination of the two is a Trendele The Perthes test shows whether or not patient standing a tourniquet is placed abov( the superficial venous return. The patient th If the deep venous return is not adequate, p< the leg. If the deep veins are open, the dilat no pain will be produced. The collapse of th blood by muscular contraction. The blood is into the femoral system and then up through The Buerger test is performed by having elevate the legs, and flex and extend the an blanching, and any pain or cramp in the calf The Callens-Wilensky test is performed the foot is elevated until the superficial veins I owe red over the side of the bed and the time dorsum of the foot is noted. The normal fil 1939 M®~Lt~ cases of pneumonia, Antiphlogistine other means of therapy is employed. re on request MANUFACTURING COMPANY f · NEW YORK CITY • THE MAHONING COUNTY MEDICAL SOCIETY 13 Postlethwaite:; employed a 2 per cent solution of sodium ricinoleate, using on!) small amounts of the solution and making repeated injections until the entire vein became sclerosed. Riddle" reported the use of 10 per cent sodium ricinoleate and found that it was effective even when 10 per cent sodium morrhuate or invert sugar had failed. McPheeter 7 states that 5 per cent sodium ricinoleate is as good as sodium morrhuate but that it is a little stronger and gives more of a reaction. For this reason he is now using 2 per cent sodium ricinoleate in the larger veins and 0.5 per cent in the superficial vein ruptures. J ohnston 8 reports the use of a solution of 5 per cent sodium ricinoleate with ligation of the great saphenous vein and its branches at the femoral opening. He stresses the importance of ligating the branches to prevent recur rence and canalization. We believe that, if marked adhesions or lymphatic blockage are present, they contraindicate wide dissection to ligate the branches because the wound does not heal readily and marked seepage results. The destruction of the lymphatics by dissection results in the increased production of edema which persists for a long time and prevents further injection of the vein, should this be necessary. Johnston 8 also stresses the importance of testing the arterial circulation, with which we are in accord. In the treatment of varicose veins, we have not been satisfied with the fractional injection of small quantities at the site of the varicosities. The disadvantages of this method of treatment consist of a period of disability and discomfort, lasting from four to seven days after each treatment, and a mul tiplicity of injections requiring from three to six months, accompanied by numerous periods of disability and discomfort scattered throughout the treat ment. There is also to be considered the danger of the development of sloughs at the site of the injection. Because of these disadvantages, we have adopted a somewhat different procedure in selected patients who have reacted satisfactorily to the Tren delenburg and Perthes tests, and have also had a thorough examination of the arterial system, including oscillometric readings, surface temperature readings, and Collens-Wilensky and Buerger tests. In the Trendelenburg test the patient is placed in the decubitus position and the extremity is raised to empty the veins. A tourniquet is placed above the knee. The patient then stands. Quick filling of the veins from below upwards means that thz communicating vein valves are incompetent and that there is overflow from the deep veins into the supercifial ones. When the tourniquet is released, if the saphenous vein fills rapidly from above as soon as the patient stands up, it indicates that the valves at the saphenofemoral junction are incompetent. The latter is a positive Trendelenburg test. A combination of the two is a Trendelenburg double test. The Perthes test shows whether or not the femoral vein is patent. With the patient standing a tourniquet is placed above the knee just tight enough to cut off the superficial venous return. The patient then walks about the room several times. If the deep venous return is not adequate, pain will soon be experienced throughout the leg. If the deep veins are open, the dilated superficial veins tend to collapse and no pain will be produced. The collapse of the veins is due to the sucking out of the blood by muscular contraction. The blood is drawn through the communicating veins into the femoral system and then up through the femoral vein. The Buerger test is performed by having the patient assume the supine position. elevate the legs, and flex and extend the ankle rapidly. The foot is observed for blanching, and any pain or cramp in the calf is noted. The Callens-Wilensky test is performed as follows: The patient lies down and the foot is elevated until the superficial veins are collapsed. Then the foot is quickly lowered over the side of the bed and the time for filling of the superficial veins on the dorsum of the foot is noted. The normal filling time is from five to seven seconds. 1939 14 * BULLETIN Other Baker Products M E L C 0 S E- a completely modified liquid milk. Very economical. A single can costs 15c and dilutes to a full quart. MELODEX- Maltose and dextrin, an easily assimilated carbohydrate espe cially prepared to modify cow's milk. Price 49c. Baker's MODIFIED MILK has a high protein content To compensate for the lower bio logical value of cow's milk protein as a tissue builder in lnfants, Baker's MODIFIED MILK provides approximately 40% more protein than human milk. The usual re sult is a solid, muscular baby; not the fat, flabby type. Available in both powder and liquid forms. Adoertised only to Physicians The Baker Laboratories, Cleveland PATRONIZE OUR .ADVERTISERS .AND MENTION THE BULLETIN Youngstown Owned and Operated CROSS DRUGS 6 EAST FEDERAL STREET In the Stambaugh Bldg. 1 WEST FEDERAL STREET In Central Tower Bldg . • WE INVITE YOU TO VISIT OUR PRESCRIPTION DEPARTMENTS Five Pharmacists to Serve You. Prescriptions Delivered to Your Patient. * January t THE MAHONING COUNTJ Comparison of Metho The treatment consisted in Group in Group 2 of ligation of the great saphe by multiple injections of 2 per cent sodiu patients who were treated by ligation o branches, together with massive injection ricinoleate into the distal portion of the ' sider to be the most satisfactory method Group I.-This group comprised ; chemical thrombophlebitis at the site of multiple injections of various solutions: n averaging 207 c.c.-13 cases; sodium mo quinine hydrochloride and urethane, aver no ligations of the great saphenous vein i1 ization after two years occurred in 38 y; Group 2.-This group consisted oJ ligation of the great saphenous vein and of 2 per cent sodium ricinoleate, averagi1 nor canalization after one and one-half y Group 3.-This group consisted oJ ligation of the great saphenous vein and jection of 2 per cent sodium ricinoleate recurrence or canalization after one year. Fig. 5. Fig .. 6. Fig. 5.-F. W., aged 52 years, a tailor. Va ligation of great saphenous vein and injection of ricinoleate. Fig. 6.-F. W. Disability for one week. Ma phlebitis. Mecholyl by iontophoresis, and Callens ning forty-eight hours after injection and ligatiOJ Fig. 7.-F. W., six weeks later. (Continued on : 1939 .LETIN Baker's I MODIFIED MILK has a high protein content o compensate for the lower bio ::Jgical value of cow's milk protein 1s a tissue builder in infants, Iaker's MODIFIED MILK provides 1pproximately 40% more protein nan human milk. The usual re ,ult is a solid, muscular baby; tot the fat, flabby type. ~ vailable in both powder md liquid forms. Advertised only to Physicians rhe Baker Laboratories, Cleveland tS AND MENTION THE BULLETIN * Nned and Operated DRUGS >ERAL STREET 1mbaugh Bldg. DERAL STREET I Tower Bldg . • )U TO VISIT OUR ~DEPARTMENTS ists to Serve You. tered to Your Patient. January l THE MAHONING COUNTY MEDICAL SOCIETY ~~ Comparison of Methods of Treatment The treatment consisted in Group 1 of injections of various drugs and in Group 2 of ligation of the great saphenous vein and its branches, follO\nd b) multiple injections of 2 per cent sodium ricinoleate. Group 3 consisted of patients who were treated by ligation of the great saphenous vein and its branches, together with massive injections of a 2 per cent solution of sodium ricinoleate into the distal portion of the vein. This constitutes what we con sider to be the most satisfactory method thus far described. Group ].-This group comprised 26 patients, all of whom showed a chemical thrombophlebitis at the site of injection. They were treated with multiple injections of various solutions: namely, sodium salicylate 30 per cent, a\·eraging 207 c.c.-13 cases; sodium morrhuate, averaging 76 c.c.-9 cases; quinine hydrochloride and urethane, averaging 17 c.c.-+ cases. There were no ligations of the great saphenous vein in this group. Recurrence and canal ization after two years occurred in 38 0 per cent of the cases. Group 2.-This group consisted of 78 patients who were treated by ligation of the great saphenous vein and its branches and multiple injections of 2 per cent sodium ricinoleate, averaging +8 c.c. There was no recurrence nor canalization after one and one-half years. Group 3.-This group consisted of 31 patients who were treated by ligation of the great saphenous vein and its branches, when feasible, and in jection of 2 per cent sodium ricinoleate, averaging 17 c.c. There was no recurrence or canalization after one year. In addition, iontophoresis of acetyl- Fig. 5. Fig. 6. Fig. 7. Fig. 5.-F. W., aged 52 years, a tailor. Varicose veins for fifteen years. Treated by ligation of great saphenous vein and injection of 27 c.c. of a 2 per cent solution of sodium ricinoleate. Fig. 6. F. W. Disability for one week. Marked induration and periphlebitis, chemical phlebitis. Mecholyl by iontophoresis, and Callens· Wilensky cuff, daily for one week, begin ning forty.eight hours after injection and ligation. Fig. 7.-F. W., six weeks later. (Continued on Page 19) 1939 16 BULLETIN ANNUAL BANQUET Tuesday Evening. January 17. 6:30 P. M. YOUNGSTOWN CLUB Subject "UNCLE SAM. M. D." • BIOGRAPHY Dr. Jonathan Forman, Columbus, Editor of The Ohio State Medical Journal, has practiced medicine in Columbus for 25 years. He is a graduate of Starling-Ohio Medical College, now Ohio State University College of Medicine. For several years he was assistant professor of pathology at Ohio State and is at present clinical instructor in allergy, the field of medicine in which he specializes. Dr. Forman has made many con tributions to medical literature. Between 1913 and 1920, he published over 40 papers on anatomy and pathology and collaborated in the publication of a text book on surgical pathology. He also has published many articles on diseases of the gastro-intestinal tract and on allergy and allied subjects. Much interested in medical history, Dr. Forman in 19 2 8 wrote a 200-page historv of the Univer sity of Michigan Medical School and in 1 9 3 4 edited a 56 7 -page history of the College of Medicine of Ohio State Uni versity. Prior to his appointment as Editor of The Ohio State Medical Jour nal two years ago, he conducted "The Historian's Notebook," a feature of that Dr. Jonathan Forman publication. For many years Dr. Forman was editor of the Journal of Phi Rho Sigma, a medical fraternity , of which he is now grand historian and a member of the executive council. D u ring the World War, he was .director of laboratories at the naval base hospital at Hampton Roads, Va. A past-president of the Columbus Academy of Medicine. Dr. Forman is also a member of the Ohio State Medical Association; Fellow of the American Medical Association; member of Sigma Xi, honorary scientific fr3ternity; member of the American Association of Anatomists; Ohio So ciety of Clinical' Laboratory Diagnosis; American Board of Internal Medicine and the American Association for the Study of Allergy. January THE MflHONING COUN' C!Annual l of tl MAHONING COUNTY • Spea] DR. JONATHJ. • Subje UNCLE SA • Tuesday Evening, Janu YOUNGSTOV 1939 ULLETJN L BANQUET r. January 17. 6:30 P. M. ~STOWN CLUB Subject ~ SAM. M. D." • IOGRAPHY 1mbus, Editor of The Ohio State Medical Columbus for 25 years. He is a graduate '· now Ohio State University College of as assistant professor of pathology at Ohio tstructor 1 which 1y con Between >Ver 40 •gy and a text also has •ases of allergy 'sted in I J928 Univer and in of the te Uni lent as tl Jour ! "The of that Dr. Jonathan Forman Forman Rho Sigma. a medical fraternity, of which member of the executive council. During of laboratories at the naval base hospital tmbus Academy of Medicine. Dr. Forman )tate Medical Association; Fellow of the nember of Sigma Xi, honorary scientific :an Association of Anatomists; Ohio So osis; American Board of Internal Medicine the Study of Allergy. January • THE Mfi.HONING COUNTY MEDICAL SOCIETY 17 cAnnual CJJanquet of the MAHONING COUNTY MEDICAL SOCIETY • Speaker DR. JONATHAN FORMAN • Subject UNCLE· SAM, M. D. • Tuesday Evening, January 17, 6:30 P. M . YOUNGSTOWN CLUB 1939 18 * BULLETIN I just saw the Doctor leave your house. Now ~he INDIAN CREEK FARM MILKMAN will be leavmg an extra bottle of Heberding's Milk. He always d 't It's clean! Phone 2-2344. recommen s 1 • PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN Attention All Doctors When you really need absorption of Calcium incor porated with Oil, prescribe KAOMUL as other Doctors do. 23 years of Professional Service. Humphrey Drug Co., Inc. 31 Central Square BENJ. FRANKLIN KELLEY. PH. C. Mana ger·Sec'y. ERENST E. GEYER. PH. C. We are distributors for ABBOTTS AMPOULES. available at all times. II 11 1 ~ I I OFFICE FURNITURE Venetian Blinds James & Weaver "Office Outfitters" 4·4427 W. Wood * January THE MAHONING COUNTY (Continued from beta-methylcholine chloride ( mecholyl) an venous compression cuff ( Collens-Wilensl In Group 3, the new procedure was criteria for the selection of which will foi: The results are shown graphically in Group 1.-There " ·ere 9 ulcers ( 3 bi of treatment employed did not lead to hea postinjection pain was never accomplishe1 per cent of the cases disappearance of pen \l·eeks after completion of treatment. Group 2.-There were 22 ulcers in t within t\relve weeks ( 6 per cent of cases the patients were relieved of pain within 01 the periphlebitis disappeared within one '' Group 3.-There were 7 ulcers in tt within nine weeks; 87 per cent of the pa one week. In 8+ per cent of the cases p( one week, averaging four days. Fig. 8. Fig. 8.- C. R., aged 48 years, a laborer. Vari• four years. Treated by ligation of great saphenous v solution of sodium ricinoleate. Mecholyl by ionto]J for two weeks, beginning forty-eight hours after inje lasted four days. Fig. 9.- G. R., anterior view. 1939 "LETIN leave your house. Now the MILKMAN will be leaving )erding's Milk. He always lan! Phone 2-2344. RS AND MENTION THE BULLETIN J ~ OFFICE FURNITURE Venetian Blinds James & Weaver "Office Outfitters" 4-4427 W. Wood * January THE MAHONING COUNTY MEDICAL SOCIETY 19 (Continued from Page 15) beta-methylcholine chloride (mecholyl) and the application of the intermittent venous compression cuff (Callens-Wilensky) were used. In Group 3, the new procedure was adopted only in selected cases, the criteria for the selection of which will follo"·- The results are sho\Yn graphically in Charts 1, 2, and 3. Group 1.-There were 9 ulcers ( 3 bilateral) in this group. The method of treatment employed did not lead to healing after one year's time. Relief of postinjection pain was never accomplished in less than two weeks. In 110 per cent of the cases disappeara_nce of periphlebitis was evidenced within two weeks after completion of treatment. Group 2.-There were 22 ulcers in this group in which healing occurred "·ithin twelve weeks (6 per cent of cases). Eight and one-half per cent of the patients were relieved of pain within one week. In 2+ per cent of the cases the periphlebitis disappeared within one week. Group 3.-There were 7 ulcers in this group, all of which were healed within nine weeks; 87 per cent of the patients were relieved of pain within one week. In 8+ per cent of the cases periphlebitis disappeared in less than one week, averaging four days. Fig. 8. F;g, 9. Fig. 8.-C. R., aged 48 years, a laborer. Varicose veins for twelve years, ulceration for four years. Treated by ligation of great saphenous vein and injection of 22 c.c. of a 2 per cent solution of sodium ricinoleate. Mecholyl by iontophoresis, and Callens-Wilensky cuff, daily for two weeks, beginning forty-eight hours after injection and ligation. Ulcer healed. Disability lasted four days. Fig. 9.-G. R., anterior view. 1939 20 * BULLETIN GOLDEN AGE GINGER ALE Manufactured in One of America's Finest Beverage Plants COLDEN ACE CINCER ALE CO. Distributors Kingsbury-Schlitz-Miller's Hi-Life and Tivoli Beers PHONES: 3-3333 4-4107 MALPRACTICE LIABILITY More Coverage for less money. Phone for Sample Policy. THE JOHN P. FRANCIS AGENCY 1403 Central Tower Bldg. Phone 64269 H. H. TREUDLEY & CO. INC. 123 E. COMMERCE STREET OFFICE SUPPLIES ACCOUNT BOOKS STEEL & WOOD OFFICE FURNITURE For Prompt Service Call 3-0612 PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN FLOWERS For Funerals -Weddings Sick Room Bouquets PAUL SCHMIDT Florist 3121 Market St. Phone 2-4212 Youngstown, Ohio Doctor! Phone your R direct to us-we will deliver . • 2-2483 2-1048 JONES PHARMACY 2702 Market St. ONLY ONE SERVICE Blair's have only one stand ard of service and it is com plete - including texturizing and style control. Be sure that your suits re ceive the best of care by sending them to Blair's. Phone 44227 Responsible Dry Cleaning * January THE MflHONING COUW In the treatment of superficial vei per cent to 0.5 per cent solution of sodi c.c., and we have found that the sclerosi " :as_ experienced with any other solutior 1 hrs good cosmetic effect is especiall) patients. Selection of Cases an Patients with varicosities which ex varicose ulcers were selected for ligati• have adequate deep venous circulation , In selecting the cases in Group 3 ,, the :-rery _obese, high-strung nervous p;ti ~ensrv~, mfected ulcers. All subjects w mfectwn by checking leucocyte counts ar n~ann te~ts and complete urinalyses we drabetes rs a contraindication unless it is syphilis, antisyphilitic treatment is push• shows healing, the treatment is conserv· injection. . . This group does not include thos mvolvement of the great saphenous veir Fig. 10. F!g. 10.- C. R .• posterior view two months Iat F1g. 11.- C. R .• anterior view made at same t 1939 JLLETIN ~ MALPRACTICE LIABILITY More Coverage for less money. Phone for Sample Policy. THE JOHN P. FRANCIS AGENCY 1403 Central Tower Bldg. Phone 64269 H. H. TREUDLEY & CO. INC. 123 E. COMMERCE STREET OFFICE SUPPLIES ACCOUNT BOOKS STEEL & WOOD OFFICE FURNITURE For Prompt Service Call 3-0612 SERS AND MENTION THE BULLETIN * ; I I I B ONLY ONE SERVICE Blair's have only one stand ard of service and it is com plete-including texturizing and style control. Be sure that your suits re ceive the best of care by sending them to Blair's. Phone 44227 c/3/u;;a Responsible Dry Cleaning January THE MflHONING COUNTY MEDICAL SOCIETY 21 In the treatment of superficial vein ruptures \\"e h·ave employed a 0.25 per cent to 0.5 per cent solution of sodium ricinoleate in doses of 0.25 to 0.5 c.c., and we have found that the sclerosing effects leave less discoloration than \\·as experienced with any other solution. McPheeter 7 reports similar results. This good cosmetic effect is especially appreciated by the younger female patients. Selection of Cases and Contraindicalions Patients with varicosities which extended above the knee and those with ,·aricose ulcers were selected for ligation. These patients were required to have adequate deep venous circulation as shown by the Perthes test. In selecting the cases in Group 3, we excluded the aged (past 60 years), the very obese, high-strung nervous patients, and those with very chronic ex tensive, infected ulcers. All subjects were tested for the presence of latent infection by checking leucocyte counts and blood sedimentation time. Wasser mann tests and complete urinalyses were made routinely. The presence of diabetes is a contraindication unless it is well under control. In patients with syphilis, antisyphilitic treatment is pushed energetically, and, when the ulcer shows healing, the treatment is conservative, namely, ligation and fractional injection. This group does not include those patients who had, in addition to involvement of the great saphenous vein, varicosities of the lesser saphenous Fig. 10. Fig. 11. Fig. 10. C. R., posterior view two months later Fig. 11.-C. R .• anterior view made at same time as Fig. 10. 1939 22 * BULLETIN THE MERCER SANITARIUM MERCER, PENNSYLVANIA For Nervous and Mild Mental Disorders. Located at Mercer, Pennsylvania, thirty miles from Youngstown. Farm of one hundred acres with registered, tuberculin-tested herd. Re-educational measures emphasized, especially arts and crafts and outdoor pursuits. Modern laboratory facilities. Address: W. W. RICHARDSON, M . D ., Medical Director THE MAHONING COUNT vein. These patients were placed in Grot to ligation of the great saphenous vein a, Technic . The technique was similar to that of Fa: cuttmg the great saphenous vein near its entr< cuttmg such branches as present themselves, , encountered are_ the sup~rficial external pud 1 the superficial cucumtlex 1hac the internal su ficial femoral veins. ' · o;O I WK 2 \YK . Bo 6o 50 40 3o 20 10 Formerly Chief Physician, State Hospital for Insane, Norristown, Pa. Chart I.-Relief PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN * Tell " The Little Girl" that you park at the Central Square Garage and she wi II agree that you are WISE! OIL GAS WASH LUBRICATION Central Square Garage Wick & Commerce Phone 35167 24-HOUR SERVICE YOU WRITE IT- WE FILL IT CORRECTLY. Phone 27744 DOBSON'S PHARMACY 100 E. Midlothian We Deliver Drink Pepsi Cola Bottled & Distributed by The J. F. Giering Bottling Co. Youngstown. Ohio Phone 6·2212 January % Bo 7• 60 so 4 0 30 zo 10 ' WK 2 WK . 3 WK. Gi?OU P GROUP GROUP I Chart 2.- Disappearance Sw.._ _ 6w"'-. 7w~. 8W!ERS AND MENTION THE BULLETIN * YOU WRITE IT- WE FILL IT CORRECTLY. Phone 27744 DOBSON'S PHARMACY 100 E. Midlothian We Deliver Drink Pepsi Cola Bottled & Distributed by The J. F. Giering Bottling Co. Youngstown, Ohio Phone 6-2212 January THE MAHONING COUNTY MEDICAL SOCIETY 23 vein_ These patients were placed in Group 2, inasmuch as they were subjected to ligation of the great saphenous vein and subsequent multiple injections_ Technique The technique was similar to that of Faxon° and Johnston, 8 namely, ligating and cutting the great saphenous vein near its entrance to the femoral and also ligating and cutting such branches as present themselves, avoiding undue dissection. The branches encountered are the superficial external pudental, the superficial external epigastric, the superficial circumflex iliac, the internal superficial femoral, and the external super ficial femoral veins. V"o I Wfl. ZWI<.. 3WK. IMO 2 MO. 3 l"lO s~/ 1/ l1 GRO~D '3 8~"1. INOHS GROUP:2 8.5%1NOHfWK. Go' -, , , G ROU D I 0 IN ONE WK.I 50 40 3o 20 :,.~ . • ~~~~~~~~~ Chart 1.-Relief of pain. % IWK .2WK 3WK. IMO 2.MO. 3MO. so I 3 84% IN ONE WK 7o Z 24% IN ONE WK 60 I 0 IN ON£ YIK. 5'0 40 30 Chart 2.-Disappearance of periphlebitis. CY""o J~,K. 4-\,1-.. 51\ .... 6W"-. 7WII.. 8 .... 1\. 9WK. 12WI\. I~Wifl. l8WK. 30""'-. SZ ..... 'li, Chart 3.-Healing of ulcers. Group 1, recurrence of varicose veins and canalization, 38.5% (two years) ; Group 2, recurrence oi varicose veins and canalization. 0 (one and one-half years) ; Group 3, recurrence of varicose veins and canalization, 0 (one year). 1939 24 * BULLETIN MATERNITY GARMENTS PTOSIS, SACRO ILIAC, KIDNEY, POST OPERATIVE AND ABDOMINAL BELTS TRUSSES ELASTIC HOSIERY PRIVATE FITTING PARLORS LADY AND ME T FITTERS LYONS PHYSICIAN SUPPLY CO. MANUFACTURING PHARMACISTS 26 Fifth Avenue Phone 4-0131 Youngstown, Ohio PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN 1)octon! Feel fully dressed-Shirts laundered at 7¢ each with every $1.00 worth of dry cleaning. THORNTON LAUNDRY AND DRY CLEANING COMPANY Phone 40155 ALWAYS DEPENDABLE PRODUCTS Girard 139 Prescribe or Dispense ZEMMER Pharmaceuticals ... Tablets, Lozenges, Ampoules, Capsules, Ointments, etc. Guaranteed reliable potency. Our products are laboratory controlled. Write for catalog. Chemists to the Medical Profession. THE ZEMMER COMPANY, Oakland Station, PITTSBURGH, PA. * January THE MflHONING COl A syringe filled with the desired ar ricinoleate is fitted with a fairly large bore distal to the first ligature. The suture p is tied over the needle but is not tightene< needle withdrawn. The amount of sodiu: The vein is then ligated and severed bet"~< proximal segment of the vein is doubly li This method of treatment was empl obliteration of all varicosities of the great A new method adopted after the tion: Before the distal portion of the (sizes 6-10) was inserted in the vein pressure. In these selected cases it ger with the estimated amount of solutiot jected to the extent of the amount b the knee, and then gradually withdr. rest of the soricin was injected. After of the technic was the same as formal This technic was adopted accord York Postgraduate Vascular Clinic. · \ras because we noted with the insert injection of the soricin there often occ1 defied further injection. This is overo the catheter keeps the luminin of the of the soricin. Aftereffects a When the primary burning disap jection, patients may get up. They us1 feeling of the extremities. They claim 1 \Vithin twelve hours, a brawny indu \Vithin twenty-four hours, the skin o the periphlebitis (due to penetration of spaces) is quite painful. Within fort) pears. Treatment of these two developr intermittent venous compression cuff phoresis of acetyl-beta-methylcholine c pain and edema last from two to four abled and continues at his work. Altertret The day following injection, the ceives a treatment by iontophoresis. Th that, when patients with severe periph were subjected to this treatment, follo without ligation, they responded with induration of the parts involved. On 1 compression cuff ( Collens and Wilensky of one hour or more depending upon th whether the edema increases. This trea as long as there is periphlebitis and swel The treatment of the ulcer al> chloride 11 by iontophoresis, the ulcer an After treatment, the ulcer is covered w carbonamidine ( azochloramide) in oil. 1939 LLETIN • R N ITY • tMENTS 0 ILIAC, KIDNEY, !:RATIVE AND INAL BELTS ~USSES C HOSIERY TTING PARLORS AND MEN TTERS ClAN SUPPLY CO. liNG PHARMACISTS Phone 4-0 131 rstown, Ohio ERS AND MENTION THE BULLETIN lhirts laundered at 7¢ each lh of dry cleaning. >N LAUNDRY AND DRY CLEANING COMPANY Girard 139 scribe or Dispense ZEMMER rmaceuticals ... Tablets, Lozenges, ~oules, Capsules, Ointments, etc. Hanteed reliable potency. Our :lucts are laboratory controlled. Write for catalog. Chemists to the Medical Profession. Oakland Station, PITTSBURGH. PA. * January THE M.AHONING COUNTY MEDIC.AL SOCIETY 25 A syringe filled with the desired amount of a 2 per cent solution of sodium ricinoleate is fitted with a fairly large bore needle (20 gauge), and the needle is inserted distal to the first ligature. The suture placed around the distal portion of the vein is tied over the needle but is not tightened until after the solution is injected and the needle withdrawn. The amount of sodium ricinoleate used varied from 6 to 30 c.c. The vein is then ligated and severed between the distal and proximal ligatures. The proximal segment of the vein is doubly ligated as an added safeguard. This method of treatment was employed in 31 patients and produced complete obliteration of all varicosities of the great saphenous tree. A new method adopted after these first cases consisted of this modifica tion: Before the distal portion of the ligated vein was tied a urate! catheter (sizes 6-10) was inserted in the vein as fa:r as it would go without undue pressure. In these selected cases it generally went below the knee. A syringe "·ith the estimated amount of solution was attached and the soricin was in jected to the extent of the amount believed required for the varices below the knee, and then gradually withdraw, as we withdrew the catheter, the rest of the soricin was injected. After the withdrawal of the catheter the rest of the technic was the same as formally employed. This technic was adopted according to the procedure used at the New York Postgraduate Vascular Clinic. The reason we adopted this procedure "·as because we noted with the· insertion of the needle in the vein and the injection of the soricin there often occurred a severe spasm of the vein which defied further injection. This is overcome by the use of the catheter, in that the catheter keeps the luminin of the vein open and permits the installation of the soricin. Aftereffects and Reactions When the primary burning disappears, within a few minutes after in jection, patients may get up. They usually complain of a "leaden," "heavy" feeling of the extremities. They claim that the legs feel "drawn" and "tight." Within twelve hours, a brawny induration of the entire extremity ensues. \Vithin twenty-four hours, the skin over the vein becomes ecchymotic and the periphlebitis (due to penetration of the solution into the venules and tissue spaces) is quite painful. Within forty-eight hours some edema usually ap pears. Treatment of these two developments has consisted of application of the intermittent venous compression cuff (Collens and Wilensk/ 0 ) and ionto phoresis of acetyl-beta-methylcholine chloride (mecholyl) . 11 As a rule, the pain and edema last from two to four days. The patient is usually not dis abled and continues at his work. A!tertreatment The day following injection, the patient returns to the clinic and re ceives a treatment by iontophoresis. This was instituted because it was noted that, when patients with severe periphlebitis and chemical thrombophlebitis were subjected to this treatment, following multiple injections (Group 1) "·ithout ligation, they responded with complete relief of pain, stiffness, and induration of the parts involved. On the next day, the intermittent venous compression cuff (Callens and Wilensky 10 ) is applied to the thigh for a period of one hour or more depending upon the amount of discomfort produced and whether the edema increases. This treatment is given daily and is continued as long as there is periphlebitis and swelling. The treatment of the ulcer also includes acetyl-beta-methylcholine chloride 11 by iontophoresis, the ulcer area being covered ·with vaseline gauze. After treatment, the ulcer is covered with a dressing of N :N -dichloroazodi carbonamidine ( azochloramide) in oil. Activity is encouraged, and no elastic 1939 26 * BULLETIN NOW YOU CAN GET HOMOGENIZED VITAMIN D MILK It's easier to digest: Homogeniz ing breaks up the cream-by pres sure-into tiny particles that form a soft curd in the stomach, making digestion easier, even for babies. It ha s a new flavor: Because there is cream in every drop, this milk has a grand, new taste. Chil dren love it and grown-ups enjoy milk more than ever. It contains VITAMIN D: This is the precious vitamin so necessary to develop strong bones and sound teeth. Every quart contains 400 U.S.P. units of Vitamin D. It is more nutritious: Because it digests easily, more of the food value of this milk is assimilated by the system. Every mother will welcome this milk that is creamy rich from top to bottom. Order Sealtest-Approved Homogenized Vitamin D Milk today. TELEPHONE 32161 ~~ Homogenized Vitamin D Milk PATRONIZE OUR ADVERTISERS AND MENTION THE BULLETIN ENJOY THE OLD WORLD FLAVOR of PREMIUM STRAIGHT ALE Brewed in the manner of the Old English brewers, Pre mium Straight Ale possesses the champagne tang and sparkle of a real English ale. • Product of The Renner Company Youngstown. Ohio Phone 44467 EVAPORATED Morning Glory Milk IMPROVES COOKING and BAKING "IT WHIPS" Fine for Bnbies and Invalids DEFIANCE MILK PRODUCTS CO. * January THE MAHON!NG COUNTY ?andages ~re applied. In the last three ca !nt~ an omtment which contained SO 001 fhrs seemed less irritating and did n~t n Discussi• . . After having tried various solutions Jertwn, we resorted to a 1 to 5 per cent . We have found that a 2 per cent sc SUited !or our purposes, inasmuch as adeq producmg too severe a local reaction. II cent t~ 0.5 per cent solutions were m Sclerosmg effects were produced without The local reactive symptoms encount ful thrombophlebitis, were treated at h H~mamelidis _compres~es, with encouragin vems w~s quickly relieved with acetyl-be tophores~s. P aradoxical as it may seem, 1 duced ( m twenty-four to forty-eight hot venous compression cuff ( Collens and W treatment, forty-eight hours after ligatioi soone_r because the vein has been ligated, the ligatures. The result obtained may venules were kept canalized and the ede creased v_olume of blood through them. . N otu;g. the good results obtained b vems, _we InJected the whole tree and tre2 ner With surprising and satisfactory result Summar· A method of treatment of varicose 1 of. 2 p~r c_ent sodium ricinoleate solution with ligatiOn of the saphenous vein, is pr vary from 6 to 30 c.c., depending upon tl be c_aref';lllY selected, excluding patients v tensrve, u;rfected ulcers or who are extren old) . WI_th this method, the length of tr been considerably shortened and the res those follo:ving the use of 'other sclerosi 1 proced~re m the treatment of varicose vei 1 . Smce the report of the first 31 cases With better results in that more of the sel( th_e J?assive injection due to the fact tha elimmated by the use of the catheter. ReferencE I. Levent, R.: Traitement des varices par Je Pans 100: 160, 1927. 2. DeLore, X.: Traitement des varices par . n1sme, Ass. franc;. de chir. Proc.-verb. 3. R1der, T. H.: The Purification of Sodiu 4130, 1931. 4. Froehlich, J-!:. W., and Henrikson, E. C Agent, Mtnnesota Med. 18: 594, 1935 5. Post!e~hwaite, F. M.: Treatment of Varic . Rtonoleate, J. Missouri M. A. 3 3: 34t 6. Rtddle, P.: The Diagnosis and Treatmen M. J. 22: 13, 1936. 1939 LLETIN HOMOGENIZED I N D MILK to develop strong bones and sound teeth. Every quart contains 400 U.S.P. units of Vitamin D. It is more nutritious: Because it digests easily, more of the food value of this milk is assimilated by the system. Every mother will welcome this milk that is creamy rich from top to bottom. Order Sealtest-Approved Homogenized Vitamin D Milk today. ! Vitamin D Milk O:RS AND MENTION THE BULLETIN * EVAPORATED Morning Glory Milk IMPROVES COOKING and BAKING "IT WHIPS" Fine for Bnbies and Invalids DEFIANCE MILK PRODUCTS CO. January THE MAHONING COUNTY MEDICAL SOCIETY 27 bandages are applied. In the last three cases, the azochloramide "·as made up into an ointment which contained 50,000 units of vitamin D to the ounce. This seemed less irritating and did not require vaseline protection. Discussion After having tried various solutions for sclerosing varicose veins by in jection, we resorted to a 1 to 5 per cent solution of sodium ricinoleate. We have found that a 2 per cent solution of sodium ricinoleate is best suited for our purposes, inasmuch as adequate thrombosis is obtained without producing too severe a local reaction. In superficial vein ruptures 0.25 per cent to 0.5 per cent solutions were most satisfactory in our experience. Sclerosing effects were produced without undue discoloration. The local reactive symptoms encountered, such as periphlebitis and pain ful thrombophlebitis, were treated at home by local applications of aqua Hamamelidis compresses, with encouraging results. The induration about the veins was quickly relieved with acetyl-beta-methylcholine chloride 11 by ion tophoresis. Paradoxical as it may seem, the edema produced was quickly re duced (in twenty-four to forty-eight hours) by the use of the intermittent venous compression cuff (Callens and Wilenskl 0 ) for two to six hours per treatment, forty-eight hours after ligation and injection. This is not begun sooner because the vein has been ligated, and there is danger of forcing off the ligatures. The result obtained may be explained by the facts that the venules were kept canalized and the edema was reduced by forcing an in creased volume of blood through them. Noting the good results obtained by the use of these agents in small veins, we injected the whole tree and treated the reactions in the same man ner with surprising and satisfactory results. Summary A method of treatment of varicose veins by injection of large amounts of 2 per cent sodium ricinoleate solution in the entire venous tree, together with li~ation of the saphenous vein, is presented. The amount injected mar vary from 6 to 30 c.c., depending upon the nature of the case. Cases should be carefully selected, excluding patients who have syphilis, diabetes, old, ex tensive, infected ulcers or who are extremely obese, or senile (past 60 years old). With this method, the length of treatment and time of disability have been considerably shortened, and the results appear more satisfactory than those following the use of other sclerosing solutions and other methods of procedure in the treatment of varicose veins. Since the report of the first 31 cases, we have done additional 52 cases with better results in that more of the selected cases the,-were able to receive the massive injection due to the fact that the factor ~f venous spasm was eliminated by the use of the catheter. References 1. Levent, R.: Traitement des varices par les injectiones sclerosantes, Gaz. d. hop., Paris 100: 160, 1927. 2. DeLore, X.: Traitement des varices par injection iodotannique et de son meca nisme, Ass. fran<;. de chir. Proc.-verb. (etc.), Paris 8: 417. 189+. 3. Rider, T. H.: The Purification of Sodium Ricinoleate, J. Am. Chern. Soc. 53: 4130, 1931. 4. Froehlich, H. W., and Henrikson. E. C.: Sodium Ricinoleate as a Sclerosing Agent, Minnesota Med. 18: 594, 1935. 5. Postlethwaite, F. M.: Treatment of Varicose Veins With Two Per Cent Sodium Ricinoleate. J. Missouri M. A. 33: 346. 1936. 6. Riddle. P.: The Diagnosis and Treatment of Varicose Veins and Ulcers. Dallas M. J. 22: 13, 1936. 1939 28 BULLETIN 7. McPheeter, H. 0.: Varicose Veins, With Special Reference to the Injection Treatment, ed. 4, Philadelphia, 1938, F. A. Davis Co. 8. Johnston, C. Harlan: Combined Ligation and Injection Treatment of the Varicosed Great Saphenous Vein, J. A.M. A. 109: 1359, 1937. 9. Faxon, H . H.: Treatment of Varicosities; Preliminary High Ligation of Internal Saphenous Vein With Injection of Sclerosing Solutions, Arch. Surg. 29: 794, 1934. 10. Callens, W. S., and Wilensky, N. D.: Apparatus for Production of Intermittent Venous Compression in Treatment of Peripheral VasculJr Disease, AM. HEART J. 11: 721, 1936. 11. Kovacs, Joseph: The Iontophoresis of Acetyl-beta-methylcholine Chloride in the Treatment of Chronic Arthritis and Peripheral Vascular Disease, Preliminary Report, Am. J . M. Sc. 188: 32, 1934. SECRETARY'S REPORT The Society's activities for the coming year are well under way. At the regular Council meeting held December 12th, a report on the financial standinz of the Society was presented by Mr: Wm. Fisher, C. P. A., detailing in full the year's income and expenditures. His recommenda tions and advice are valuable to the Society. Dr. Wm. Skipp was requested to make a report to Council in his ca• pacity as Councillor of the State As sociation. He stated that the Ohio State Medical Association is antici pating an increase in dues from $5 .00 to $7.00 annually. The reason for this increase is largely due to the increase in cost of the 0 hio State Medical 1 ournal. Each county society w'ill instruct their delegates to vote yes or no on raising the dues to $7.00 per year. Dr. Skipp stated that the state will be redistricted. This will bring about a realignment of the Sixth District to include Trumbull and Columbiana. Two of the far western counties will be put in an other district, thus making the Sixth more compact. Statements for dues were mailed in December and there still remain too many unpaid. D4es for 1939 are due January 1st. The Society regrets the passing of two more of its members-Dr. E. W. Coe and Dr. W. ] . Colbert. The following application for reg ular membership in the Society was acted upon favorably by Council at the December meeting: Dr. John A Welter, 19 Lincoln Avenue. Should there be any objection to the above applicant, same must be made in writing and filed with the Secretary within 15 days. As your new secretary for the year 1939, I wish you all the best of New Year's and assure you of my full co operation in the affairs of the Society. JOHN NOLL, M. D., Secretary. NEWS Dr. John Keyes delivered an ad dress on Clinical and Experimental Vascular Disease of the Retina at the Annual Graduate Assembly sponsored by the Cleveland Ophthalmological Club and The Frank E. Bunts In stitute, December 6, Cleveland, Ohio. Dr. and Mrs. 0. A Axelson are the proud parents of a baby girl, Nov. 13. Dr. M. H. Belinky is taking a postgraduate course at Seaview Hos pital, Staten Island, N . Y. Dr. C . A Gustafson spent the holidays in Chicago. FOR RENT -Dental Office. 243 Lincoln Avenue. January THE MAHO.N!NG COUNTY lltt ~rmo 1£. llf. Olnr. May 7, 1871 The Society re gre ts the omission of the ab THE MEDICA a Page of Sidelights, News and V • Christmas story about a Doctor: Last year a local medic invested heavily in an electric railway outfit. Sometime later the salesman, relieved of his Christmas position happened in at the home while canvassing on another sales job. Wishing to be friendly he enqui red, "How did your boy like the electric train?" The doctor blushingly replied, "Oh, fine, very fine-but you see we don't have any children!" Well, he didn't need to blush. The Old Crier had a fine time, too, acting as chief whistle blower and switchman on the local Christmas Tree Line this year. • What a wonderful age this is! In 1899 DaCosta said, "Tens of thousands of marvelous inventions have abridged distance, economized time, increased production, facilitated exchange, subdivided labor and stilled pain." Yet at that time the world never dreamed of transcontinental air transports, radio, assembly lines, Diesel engines, pneumonia serum or novocain. In twenty years of prac tice we have seen the development of spinal anesthesia, insulin and its newer compounds, diathermy, fever therapy, vitamines, liver therapy and sulfanilamide. Yet "·hat a preposterous age this is! \Ve see the constituted repre sentatives of an old and honored pro- 1939 fe on us on ke pL a T l tri be de to sta w see tht w It ba< • tha bac Ye ly che red wh Of for tha '"h' hap 'ns ULLETIN reins, With Special Reference to the Injection '· 1938, F. A. Davis Co. ted Ligation and Injection Treatment of the ~in, J. A.M. A. 109: 1359, 1937. tricosities; Preliminary High Ligation of Internal ion of Sclerosing Solutions, Arch. Surg. 29: . D.: Apparatus for Production of Intermittent nent of Peripheral Vascular Disease, AM. HEART ~sis of Acetyl-beta-methylcholine Chloride in the :is and Peripheral Vascular Disease, Preliminary 32, 1934. ----<$>----- !\.RY'S REPORT the ing the ~·as P. tme da the to ca• As hio ICI- .00 for the ate ety ote .00 the vill the ull far an ~th led am are of The following application for reg ular membership in the Society was acted upon favorably by Council at the December meeting: Dr. John A. Welter, 19 Lincoln Avenue. Should there be any objection to the above applicant, same must be made in writing and filed with the Secretary within 15 days. As your new secretary for the year 1939, I wish you all the best of New Year's and assure you of my full co operation in the affairs of the Society. JOHN NOLL, M. D., Secretary. NEWS Dr. John Keyes delivered an ad dress on Clinical and Experimental Vascular Disease of the Retina at the Annual Graduate Assembly sponsored by the Cleveland Ophthalmological Club and The Frank E. Bunts In stitute, December 6, Cleveland, Ohio. Dr. and Mrs. 0. A. Axelson are the proud parents of a baby girl, Nov. 13. Dr. M. H. Belinky is taking a postgraduate course at Seaview Hos pital, Staten Island, N. Y. Dr. C. A. Gustafson spent the holidays in Chicago. E. FOR RENT -Dental Office. 2-t3 Lincoln Avenue. January THE MA.HON!NG COUNTY MEDICAL SOCIETY 29 ]n fllllrmnrium 1£. Ill. (!lor. m. m. May 7, 1871 November 16, 1938 The Society regrets the omission of the above notice in the December issue. THE MEDICAL CRIER A Page of Sidelights, News and Views in the Medical Field • Christmas story about a Doctor: Last year a local medic invested heavily in an electric railway outfit. Sometime later the salesman, relieved of his Christmas position happened in at the home while canvassing on another sales job. Wishing to be friendly he enquired, "How did your boy like the electric train?" The doctor blushingly replied, "Oh, fine, \'Cry fine-but you see we don't have any children!" Well, he didn't need to blush. The Old Crier had a fine time, too, acting as chief whistle blower and switchman on the local Christmas Tree Line this year. • What a wonderful age this is! In 1899 DaCosta said, "Tens of thousands of marvelous inventions have abridged distance, economized time, increased production, facilitated exchange, subdivided labor and stilled pain." Yet at that time the \\·orld never dreamed of transcontinental air transports, radio, assembly lines, Diesel engines, pneumonia serum or novocain. In twenty years of prac tice we have seen the development of spinal anesthesia, insulin and its newer compounds, diathermy, fever therapy, vitamines, liver therapy and sulfanilamide. Yet what a preposterous age this is! \Ve see the constituted repre sentatives of an old and honored pro- 1939 fession dragged by an irate govern ment before its courts to stand crimi nal trial accused of restraint of trade. What a ghastly operation predicated on such a shallow pretext! Having used their rightful means of discipline on their own members in order to keep practice on a high professional plane, these men are prosecuted on a tradesmen's law of commerce. Through them all doctors are on trial. Will the millions who have benefitted by their discoveries, their devotion to the care of the sick, rise to defend them? \Viii public opinion stand for this kind of persecution? Will the people stand idly by and see injustice done to the very ones they call on first in time of trouble? We think not. Let this trial go on. It will prove a boomerang to come back and strike those ,,·ho started it. • One thing about the Holidays is that they make a man so glad to get back to "·ork. I\ ow that the .:\ ew Year's revelries are over, we can real ly get dmYn to brass tacks-thump chests, open abscesses, S\Yab throats, reduce fractures and insert catheters \Yhere they \Yill do the most good. Of course, "·e all expect to knock off for the annual banquet. but after that back to \York again. For it is when a doctor is busy that he is really happy. So let this be our .:\ ew Year's wish to all-Busy J'\ C\\' Year! -J. L. F. 30 BULLETIN The Mahoning County Medical Society 1 9 3 9 COUNCIL AND OFFICERS W!>J. M. SKIPP, President R. B. POLING. President-Elect JOHN NOLL, Secretary ELMER H. NAGEL, Treasurer L. G. COE, Senior Censor PAUL J. FUZY, Censor CLAUDE B. NORRIS, Censor WALTER K. STEWART, Delegate 0. J. WALKER, Delegate GORDON G. NELSON. Delegate DEAN NESBIT, Alt. Delegate EDW. J. REILLY, Alt. Delegate !VAN C. SMITH, Alt. Delegate H. E. PATRICK, Editor Editorial H. E. Patrick, Chairman J. L. Fisher louis Deitchman Saul Tamarkin C. B. orns Program John McCann, Chairman John Noll. Jr. E. C. Baker W. M. Neidus Henry Sisek John Renner E. C. Goldcamp Public Relations & Economics W. K. Stewart, Chairman W. E. Evans E. C. Rinehart Joseph Hall P. R. McConnell Sub-Com. on Economics E. C. Rinehart. Chairman Paul Kaufman Patrick Kennedy William X. Taylor Ray Hall J. M. Benko G. B. Kramer Sub-Com. on Indigent Relief J. Hall. Chairman Walter J. Tims Stanley A. Meyers D. E. Montgomery H. Schmid Sub-Com. on Public Relations Wm. Evans. Chairman E. R. Thomas R. H. Middleton James Birch A. E. Brant Medico-Legal D. H. Smeltzer, Chairman John A. Welter G. C. Warnock E. H. Jones Postgraduate Day E. J. Reilly. Chairman Paul Fuzy COMMITTEES J. D. Brown E. H. Young A. Marinelli R. E. Odom Sam Klarman l. G. Coe Legislative 0. J. Walker. Chairman Geo. M. McKelvey John McCann J. B. Drieling A. B. Sherk H. E. McClenahan Harry E. Fusselman L. S. lowendorf R. H. Middleton J. D. Brown Dean Nesbit Ray Hall Publicity M. Rosenblum, Chairman S. J. Klarman C. C. Wales W. E. Main l. W. Weller State Correspondent C. A. Gustafson, Chairman Sam D. Goldberg J. A. Altdoerffer M. H. Hawk T. K. Golden Membership and Attendance D. M. Rothrock, Chairman Coyt H . Beight Barclay M. Brandmiller l. H. Getty C. S. lowendorf L. H. Moyer l. S. Shensa Joseph Colla G. E. DeCicco Sam Tamarkin C. M. Askue M. H. Hawk T. K. Golden J. C. Vance W. J. Tims Public Health Gordon Nelson, Chairman J. D. Brown H. E. Hathhorn P. H. Fusco J. B. Birch W. W. Ryall J. P. Harvey Social Dean Nesbit, Chairman Clarence Stefanski John A. Rogers P. R. McConnell E. J. Wenaas V. A. Nee! D. M. Rothrock W. Welsh M. E. Conti John U. Buchanan H. A. Kling Lay Education lewis K. Reed. Chairman Chas. Warnock Morris Deitchman James Herald Wm. F. Hatcher Joseph Nagle Housing and Library George McKelvey, Chairman S. W. Weaver Ray Hall B. M. Bowman J. J. Wasilko Budget (Ex-Officio) President President-Elect Secretary Treasurer Program Chairman Editor Auditing Committee lawrence Segall, Chairman M. H. Bachman M. H. Steinberg Members of the Executive Committee of Women's Field Army Against Cancer Wm. D. Collier, Chairman Walter B. Turner John Heberding C. W. Sears C. R. Clark January THE MAHONING COUN~ ROSTER OF MAHONING CC 1 9 : Alden, A. H. Allsop, W. K. Altdoerifer, J. Allan Askue, Chester M. Autenreith, W. C. Axelson, 0. A. Badal, S. S. Banninga, H. S. Bachman, M. H. Baird, Julia M. Baker, E. C. Baker, W. Z. Basile, J. M. Beight, C. H. Belinky, Morris H. Benko, J. M. Bennett, W. H. Berkson, M. I. Bierkamp. F. J. Birch, J. B. Boyle. P. L. Brandt, A. J. Brant, A. E. Brown, J. D. Brungard, 0. D. Buchanan, J. R. Buchanan, J. U. Bunn, W. H. Bowman, Brack M. Brandmiller, B. M. Campbell. C. H. Cavanaugh, J. M. Cervone. Louisa Clark, C. R. Cafaro, S. Raymond Cliffe, E. W. Coe. L. Geo. Colla. Joseph Conti, Martin E. Coy, W. D. Cukerbaum, Alfred R. Curtis, W. S. Deitchman, louis Deitchman. Morris Dilorio. Enrico Dreiling, B. J. Dulick, John F. De Cicco, Gabriel E. Elliott, Alice W. Elsaesser, Armin Epstein. Samuel Evans. W. H. Fenton, R. W. Fisher, J. L. Frye. A. E. Fussellman. H. E. Fusco. P. H. Fuzy, Paul J. Getty, l. H. Goldberg. S. D. 1939 Goldblatt, L. J. Goldcamp, E. C. Goldcamp, S. W. Golden, T. K. Goldstein, M. B. Gustafson, C. A. Hake, E. H. Hall, Joseph C. Hall. Raymond Hardman, J. E. Hartzell, S. M. Harvey, J. P. Hathhorne, H. E. Haulman. 0. W. Hauser, C. D. Hauser, D. H. Hawk, M. H. Hayes. M. E. Heberding. John Heeley, J. H. Hinman, A. V. lpp. Herman Jones, E. H. Jones, W. l. Kaufman, P. M. Kennedy, P. H. Keres, J. E. Kirkwood, E. E. Klarman, S. J. Kocialek, M . J. Kramer. G. B. Kling, Herman Kupec, J. B. lander, T. A. lawton, 0. M. levy. David H. Leimbach, P. H. lewis. John S. lowendorf, C. S. Mahar, P. J. Mahrer, M. P. Maine. W. E. ] !I ~ !I !I !I 11 !I 11 11 ]\ ]\ ]\ r\ r\ N N N N 0 0 p, p, P: p, PI Pi P< R; R; R< R< Re Ri R< Rc Rc Rc Rc Ru Ry Ru JIA'alock. l. J. Sea Mariner, J. S. Sd Marinelli, A. Sec McCann, J. N. Sec McClenahan, H. E. Seg McConnell, P. R. Sea McElhaney, B. B. Sh; McElroy. W. D. Sh 1 McGowan, Joseph F. Ski McGregor, H. P. Sch McKelvey, G. M. S!o McNamara. F. W. She McOwen, P. J. Stei McReynolds, C. A. Sm Mermis, W. 0. Sm Merwin. F. S. Sm Meyer, N. N. Sis< Middleton, R. H. Spe ULLETIN ;ounty Medical Society 1 9 3 9 !L AND OFFICERS WALTER K. STEWART, Delegate 0. J. WALKER, Delegate GORDON G. NELSON. Delegate DEAN NESBIT, Alt. Delegate EDW. J. REILLY, Alt. Delegate !VAN C. SMITH, Alt. Delegate H. E. PATRICK, Editor MMITTEES rown 'oung nelli dom ttman oe ·e ·alker. Chairman McKelvey cCann rieling herk lcClenahan . Fusselman owendorf v!iddleton rown esbit I 'nblum, Chairman atman Tales VIa in Weller rrespondent ustafson, Chairman Goldberg tltdoerffer Hawk :Jolden !hip and Attendance lothrock, Chairman Beight M. Brandmiller )etty .owendorf !I oyer hen sa Colla )eCicco amarkin Askue Hawk ::Jolden Tance fims :ealth Nelson, Chairman \rown H. E. Hathhorn P. H. Fusco J. B. Birch W. W. Ryall J. P. Harvey Social Dean Nesbit, Chairman Clarence Stefanski John A. Rogers P. R. McConnell E. J. Wenaas V. A. Nee! D. M. Rothrock W. Welsh M. E. Conti John U. Buchanan H. A. Kling Lay Education Lewis K. Reed, Chairman Chas. Warnock Morris Deitchman James Herald Wm. F. Hatcher Joseph Nagle Housing and Library George McKelvey, Chairman S. W. Weaver Ray Hall B. M. Bowman J. J. Wasilko Budget (Ex-Officio) President President-Elect Secretary Treasurer Program Chairman Editor Auditing Committee Lawrence Segall, Chairman M. H. Bachman M. H. Steinberg Members of the Executive Committee of Women's Field Army Against Cancer Wm. D. Collier, Chairman Walter B. Turner John Heberding C. W. Sears C. R. Clark January THE MAHONING COUNTY MEDICAL SOCIETY 31 ROSTER OF MAHONING COUNTY MEDICAL SOCIETY 1 9 3 9 Alden, A. H. Allsop, W. K. Altdoerffer, J. Allan Askue, Chester M. Autenreith, W. C. Axelson, 0. A. Badal, S. S. Banninga, H. S. Bachman, M. H. Baird, Julia M. Baker, E. C. Baker, W. Z. Basile, J. M. Beight, C. H. Belinky, Morris H. Benko, J. M. Bennett, W. H. Berkson, M. I. Bierkamp, F. J. Birch. J. B. Boyle, P. L. Brandt, A. J. Brant, A. E. Brown, J. D . Brungard, 0. D. Buchanan, J. R. Buchanan, J. U. Bunn, W. H. Bowman, Brack M. Brandmiller, B. M. Campbell. C. H. Cavanaugh, J. M. Cervone. Louisa Clark, C. R. Cafaro, S. Raymond Cliffe, E. W. Coe. L. Geo. Colla, Joseph Conti, Martin E. Coy, W. D. Cukerbaum, Alfred R. Curtis, W. S. Deitchman, Louis Deitchman. Morris Diiorio, Enrico Dreiling. B. J. Dulick, John F. De Cicco, Gabriel E. Elliott, Alice W. Elsaesser, Armin Epstein. Samuel Evans, W. H. Fenton, R. W. Fisher, J. L. Frye. A. E. Fussellman. H. E. Fusco, P. H. Fuzy, Paul J. Getty, L. H. Goldberg. S. D. 1939 Goldblatt, L. J. Goldcamp, E. C. Goldcamp, S. W. Golden, T. K. Goldstein, M. B. Gustafson, C. A. Hake, E. H. Hall, Joseph C. Hall, Raymond Hardman, J. E. Hartzell, S. M. Harvey, J. P. Hathhorne, H. E. Haulman, 0. W. Hauser, C. D. Hauser, D. H. Hawk, M. H. Hayes. M. E. Heberding, John Heeley, J. H. Hinman, A. V. Ipp, Herman Jones, E. H. Jones, W. L. Kaufman, P. M. Kennedy, P. H. Keyes, J. E. Kirkwood, E. E. Klarman, S. J. Kocialek, M. J. Kramer, G. B. Kling, Herman Kupec, J. B. Lander, T. A. Lawton, 0. M. Levy. David H. Leimbach, P. H. Lewis, John S. Lowendorf, C. S. Mahar, P. J. Mahrer, M. P. Maine. W. E. Miglets, A. W. Miller, H. C. Monroe, F. F. Montgomery, D. E. Montani, A. C. Morrison, R. M. Mossman, R. G. Morrall, R R. Moyer, L. H. Mylott, E. C. Nagel, E. H. Nagle, Joseph Nardacci, N. J. Nee!, V. A. Neidus, M. W. Nelson, Gordon Nesbit, Dean Norris, Claude B. Noll, John Osborne, H. M. Odom, R. E. Parillo, Guy A. Patton, S. G. Patton, Thomas E. Patrick, H. E. Phipps, L. E. Piercy, F. F. Poling, R. B. Ranz, J. M. Ranz, W. E. Reed, L. K. Reilly, E. J. Renner, J. A. Rinehart, E. C. Rosapepe, A. R. Rosenblum, A.M. Rosenblum, Morris Rosenfeld, Joseph Rothrock, D. M. Russell, J. M. Ryall, W. W. Rummell, Russell W. Jl~alock, L. J. Scarnecchia, J. L. Mariner, J. S. Schmid. Henri Marinelli, A. Scofield, Charles McCann, J. N. Sedwitz, S. H. McClenahan, H. E. Segal, Lawrence McConnell, P. R. Sears, Clarence W. McElhaney, B. B. Shaffer, J. W. McElroy. W. D. Shensa, Lewis S. McGowan, Joseph F. Skipp, Wm. M. McGregor, H. P. Schwebel. Samuel McKelvey, G. M. Slossen, C. H. McNamara, F. W. Sherk, A. B. McOwen, P. J. Steinberg, Myron H. McReynolds, C. A. Smeltzer. D. H. Mermis, W. 0. Smith, Ivan C. Merwin. F. S. Smith, P. B. H. Meyer, N. N. Sisek, Henry Middleton, R. H. Speck, M. H. Stefanski, Clarence Stewart, C. C. Stewart, Walter K. Tamarkin, Samuel Tamarkin, Saul J. Taylor, W. X. Thomas, E. R. Tidd. A. C. Turner, W. B. Tims, W. J. Tuta, Jos. A. Vance, J. C. Wales, Craig C. Walker, 0. J. Wallace, C. R. Warnock, Chas. Warnock, G. C. Wasilko, J. J. Weaver, Samuel Wood Weidermier, Carl H. Weinberg, H. W. Weller, L. W. Welsh, W. A. Welter, John A. Wenaas, E. J. Yauman, C. F. Young, Earl H. Young, W. P. Zeve, H. S. Zervos, M. S. Zoss, Samuel Non-Resident Members Caskey, E. G. Clifford. R. V. Clark, Wm. A. Chalker, H. E. Holmes, William J. Maxwell, H. D. Pore, Joseph Robinson, J. W. Williams, D. R. Wilkinson, J. B. Williams. P>nl Youngblood, L. C. Honorary Members Arundel. Thomas J. Blott, H. E. Gibson, R. D. Lindsay. J. F. Welch, H. E. Whelan, R. E. Associate Members Class B Hatcher. W. F. McClure, R. J. Associate Members Class C Collier. Wm. D. (Cont. on Page 32) 32 BULLETIN Associate Members Class D (Cont. from Page 31) Agricola, W. R. Armbrecht, G. L. Beede, Ralph W. Fisher, A. J. Fowler, E. C. Hardman, E. F. Heitzman, P. 0. Herald, J. K. Hum!, A. P. Hutt, H. B. Lippert, A. F. Owen, M.S. Sofranic, J. J., Jr. Sovik, W. E. Litton, A. C. Parker, A. S .. Jr. Lupse, R. S. Phillips, A. K. Szucs, Merrill M. Thomas, Densmore Thomas, J. H. Wagner, C. F. Welling, A. W. Williamson, A. L. Yarmy, Milton M. McDonough, John Price, F. L. Marsico, Henry C. Raetz, Sylvester J. Miller, D. A. Redmond, J. J. Murray, Vincent J. Reese, Harold J. Myers, Stanley A. Rogers, John A. Oakes, P. W. Sauer, D. E. Ondash, S. W. Seesholtz, John R. MAHONING COUNTY CELEBRATION OF THE PRESIDENT'S BIRTHDAY Headquarters, 205 Dollar Bank Bldg. Youngstown, Ohio January 5, 1939. Doctor H. E. Patrick, 13 8 Lincoln Avenue, Youngstown, Ohio. Dear Doctor Patrick: I have again been appointed Chairman of Mahoning County for the President's Birthday Celebration. Two years ago when I served as Chairman of the Cele bration, thirty-four hundred dollars was turned over as Youngstown's share, to the Youngstown Rotary Club, to be used in the Fight against Infantile Paraly sis. At that time I suggested that some thing substantial and worthwhile be done with this money. That organization under the leadership of its President, Rev. Roland Luhman, contracted to install equipment in the Therapeutic Room of the Youngstown Hospital, South Side Unit. I believe they contributed $2,400.00. and advised me that $3 ,000.00 would be needed to finish this work. and last year where we made only $3 ,100.00 net, we turned over the needed $3.000.00 to the Youngstown Hospital Association. This check was delivered by Mr. Carl Ullman, upon my order to Mr. Byron W. Stewart, Super intendent. This year an entirely new plan is in effect whereby fifty percent of the net proceeds will remain in Youngstown, to be administered by a Chapter which I am organizing at the present time. Those who have consented thus far to serve on this Chapter are: Mr. Byron W. Stewart Sister M. Germaine Reverend Roland Luhman Reverend Joseph Trainor Clarence Strouss Sidney Collins Mrs. John Ford. There will be a few others appointed to this Chapter, and I would be glad to have your Association suggest a member to serve on this Committee. I also be lieve that a member of the younger groups, perhaps the Junior Chamber of Com merce, should be asked to serve. This year we plan to have a Ball, which will be held Saturday evening, January 28th, at the Stambaugh Audi torium, and a Lecture to be held Sunday evening, January 29th, also at the Audi torium. The speaker has not yet been chosen. The latter attraction is being planned for those who have no interest in dancing. I assure you that I appreciate your interest in this event; that any suggestions which your organization may desire to make will be welcomed. Yours very truly, JOHN F. CANTWELL, Chairman. R. L. Hockstad 268 Lincoln Avenue Phone 40107 Nothing But Prescriptions BIOLOGICALS Lederle- Sharpe & Dohme Parke-Davis-Lilly 1 anuary 1£ they co Council ~----~---w_o_u_I_.d "When ~ou see one of us c or food, it means first of thought enough of the prod it and his claims carefully critical, unbiased experts .. that this product was exami r was willing to listen to critic Council made, that he signi{ strict his advertising claims he will keep the Council i 1 changes in product or claim~ similar products as good a~ see us on a package, you k take someone' s self-interest is everything the manufactu hesitate to submit it to the THE FOLLOWING MEAD PRODUCTS ARI morphum(liquidandcapsules)· Mead'sCodL' Mead's Co d S ' xv . . mpoun yrup Oleum Percomorph (hqmd a~d capsules); Mead's Cod Liver Oil Wit! Stand~rdtzed Cod Liver Oil; Mead's Halibut I Dextn-Maltose With Vitamin B· Pablum· Me· Syrup; ~ead' s. Brewers Yeast (po~der and t~blet: Cevxt~mxc Acxd Tablets; Mead's Powdered Pr< Mead s Powdered Lactic Acid Milk Nos. 1 and . THE FOLLOWING NEW PRODUCT IS BE~ FOR ACCEPTANCE: Mead's Nicotinic Acid· C~36, Mead Johnson & Company, Evansville, Indiana fLLETIN e Members Class D . from Page 31) Owen, M.S. Parker, A. S., Jr. Phillips, A. K. Sofranic, J. J., Jr. Sovik, W. E. rt Price, F. L. Szucs, Merrill M. Thomas, Densmore Thomas, J. H. Wagner, C. F. Welling, A. W. Williamson, A. L. Yarmy, Milton M. Raetz, Sylvester J. Redmond, J. J. J. Reese, Harold J. Rogers, John A. Sauer, D. E. Seesholtz, John R. -----0-- EBRATION OF THE PRESIDENT'S RTHDAY tan lt' s tgo ,le vas to be ly le me 1ip an, the wn 1ey me ish a de the wn vas my er- Ill net to am ose on Clarence Strouss Sidney Collins Mrs. John Ford. There will be a few others appointed to this Chapter, and I would be glad to have your Association suggest a member to serve on this Committee. I also be lieve that a member of the younger groups, perhaps the Junior Chamber of Com merce, should be asked to serve. This year we plan to have a Ball. which will be held Saturday evening, January 28th, at the Stambaugh Audi torium, and a Lecture to be held Sunday evening, January 29th, also at the Audi torium. The speaker has not yet been chosen. The latter attraction is being planned for those who have no interest in dancing. I assure you that I appreciate your interest in this event; that any suggestions which your organization may desire to make will be welcomed. Yours very truly, JOHN F. CANTWELL. Chairman. R. L. Hockstad 268 Lincoln A venue Phone 40107 Nothing But Prescriptions BIOLOGICALS Lederle-Sharpe & Dohme Parke-Davis-Lilly 1 anuary If they could talk,,,'· r-P~~ Council Seals _ would say: A'---.-. "When you see one of us on a package of medicine or food, it means first of all that the manufacturer thought enough of the product to be willing to have it and his claims carefu\1':1 examined b':l a board of critical, unb'1ased experts ... We're glad to tell 'jOU that this product was examined, that the manufacturer was w'1lling to listen to criticisms and suggestions the. Council made, that he signified his willingness to re strict his advertising claims to proved ones, and that he will keep the Council informed of an':l intended changes in product or claims ... There may be other similar products as good as this one, but when you see us on a package, 'JOU know. Wh'J guess, or why take someone's self-interested word? If the product is everything the manufacturer claims, why should he hesitate to submit it to the Council, {or acceptance?" THE FOLLOWING MEAD PRODUCTS ARE COUNCIL-ACCEPTED: Oleum Perco morphum (liquid and capsules); Mead's Cod Liver Oil Fortified With Percomorph Liver Oil; Mead's Compound Syru;_J Oleum Percomorphum; Mead's Viosterol in Halibut Liver Oil (liquid and capsules); Mead's Cod Liver Oil With Viosterol; Mead's Viosterol in Oil; Mead's Standardized Cod Liver Oil; Mead's Halibut Liver Oil; Dextri-Maltose Nos. 1, 2, and 3; Dextri-Maltose With Vitamin B; Pablum; Mead's Cereal; Mead's Mineral Oil With Malt Syrup; Mead's Brewers Yeast (powder and tablets); Mead's Thiamin Chloride Tablets; Mead's Cevitamic Acid Tablets; Mead's Powdered Protein Milk; Mead's Powdered Whole Milk; Mead's Powdered Lactic Acid Milk Nos. 1 and 2; Alacta; Casec; Sobee; Cemac; Olac. THE FOLLOWING NEW PRODUCT IS BEFORE THE COUNCIL ON PHARMACY FOR ACCEPTANCE: Mead's Nicotinic Acid Tablets. Copyright 1936, Mead Johnson & Company, Evansville, Indiana, U.S.A. This publication printed by The Youngstown Printing Company - I B Vol. IX No.2 February 1939