a m. a. m. 7 Oct. 21, '95. 5 Oct. 4, '95..Oct. 6, '95 Oct. 6, 95.. N. Y. Pasteur Inst 1500 1 injection.... 1 injection..... Oct. 22, 95. N. Y. Pasteur Inst. 1500 1 injection... 1 injection.. a. m. a. m. 1520 1 injection............. 12 Nov. 8, '95. Nov. 12, '95 Nov. 12, 95 N. Y. Pasteur Inst. 1500 13 Jan. 9, 96.. Jan. 9, '96.. Jan. 10, '96 N. Y. Pasteur Inst. 14 Nov. 8, 95. Nov. 9. '95. Nov. 12, '95 Behring's 15 Nov 11, '95 Nov. 12, '95 Nov. 12 '95 Behring's 1 injection.. 1 Sept. 16, '95 Sept. 17, '95 Sept. 17, '95 N. Y. Pasteur Inst 2 Sept 24, '95 Sept. 26, '95 Sept. 26. '95 Mulford's. 3 Sept. 24, 95 Sept. 26, '95 Sept. 26, '95 Behring's....... Girl, aet. 7 yrs... None .... None. Trace. None..Tonsils and uvula.... Rapid recovery. 4 Oct. 2, 95..Oct. 3, '95.. Oct. 3, '95.. N. Y. Pasteur Inst. 1500 p. m. a. m. p. m. 9 Oct. 29, 95 a. m. Oct. 31, '95. Oct. 31, 95. Behring's Nov. 12, '95 Nov. 12, '9 Behring's..... ....... 2, 10-3-95 and 10-4-95.. Boy, aet. 3 yrs.. Slight.... None..Trace.. None..Tonsils and palate.... Prompt recovery. Boy, aet. 3 yrs.. None None..Trace.. None. Tonsils. 2, 11-12-95 and 11-13-85 Girl, aet. 5 yrs... Moderate Severe Trace.. Slight.. Entire pharynx...... Boy, aet. 7 yrs.. Severe... Severe. Trace.. Great.. Nose, pharynx and larynx. a. m. 1500 1 injection..... a m. 1500 1 injection.... 18 Sept. 20, 95 Sept. 22, '95 Sept. 22, '95 Behring's....... 19 Dec. 16, '95. Dec. 18, 95. Dec. 18, '95. N. Y. Pasteur Inst p. m. 1500 1 injection..... 1 injection..... .... a. m. 1503 1 injection.. 1500 1 injection.. .... Boy, aet. 2 yrs.. Severe... None..Trace Slight. Post-wall of pharynx. Prompt recovery. .... None Trace.. None.. Pharynx and larynx.. Prompt recovery. None. Trace.. None. None..None. None .... None. Trace. None..Entire pharynx....... Prompt recovery. None..Trace.. None Pharynx and larynx. Average recovery. A tablespoonful every hour or half hour, according to symptoms. Tincture of viburnum prunifolium has a sedative action upon the excitomotor centers of the spinal cord, especially upon those localized in the utero-ovarian region. For one suppository. Use one every night, beginning five days before the period. Metorrhagia of the Menopause.-50 centigrammes of sulphate of quinine, daily, by the rectum. Three injections of warm water, per vaginam, daily, by the physician or a trained nurse, if possible. Thirty to forty drops of alcholate of hydrastis canadensis in doses of five drops every two hours. If the hemorrhage persists, dilate and curette. Dysmenorrhea and Enemata of Ergotine (Rheimtater).—When ergotine is not tolerated by the mouth it may be given in an enema, by the rectum, a coffeespoonful of the following solution, being added to three tablespoonfuls of warm water: Correspondence. WASHINGTON LETTER. [SPECIAL CORRESPONDENCE OF THE MEDICAL FORTNIGHTLY.] THE MEDICAL PROFESSION AND THE TARIFF. WASHINGTON, D. C., May 19th, 1897. There has been a greater degree of secrecy about the construction of the pending tariff than has characterized any previous measure in Congress. The committees of both House and Senate having the work in hand have bridled their tongues unprecedently, and as a consequence the press correspondents feeling compelled to cover the progress made, have drawn largely upon a reserve force of fact and fancy. The result is that there is a great amount of popular ignorance as to the actual measure and the real prospects for this or that schedule becoming a law. The full text of the hearings before Congress have only just now been officially published, and, as usual, they are so voluminous that it involves a good deal of time and labor to "dig out" the special portions that interest the respective trades. From among the hearings that concern the medical profession, the following is of interest: PETITION OF THE MEDICAL PROFESSION OF THE UNITED STATES. The following resolution was adopted at a meeting of the New York County Medical Association, held on May 19, 1890: Resolved, That the New York County Medical Association, a representative body composed of five hundred practicing physicians in the city of New York, believing that it is for the best interests of the people of the United States, that all foreign natural mineral waters should be imported free of duty, respectfully urges upon the National Senate and House of Representatives that the provisions now in force relating to foreign natural mineral waters, and to the bottles in which they are imported, should be re-enacted in any tariff which is sanctioned by them. To the Honorable, the Senate and House of Representatives of the United States of America in Congress, assembled: Your memoralists, members of the medical profession in various cities. of this country, respectfully present this their petition, and pray that the same may be considered at an early day. The provisions of the tariff bill now under the consideration of your honorable Houses are designed to inflict duties upon natural mineral waters, which will prevent their importation. The proposed tariff provisions are such that all natural mineral waters. which contain free carbonic acid gas, and which, therefore, may be described in popular language as "effervescent" in various degrees, will be subject to prohibitive duties. Under present enactments all such waters are for reasons of public utility, and because of their great value to public health as beverages and as medicines, expressly admitted free, except in respect to a reasonable duty. on the bottles in which thay are inclosed. The carbonic acid gas which such mineral waters contain, and in virtue of which they are necessarily more or less effervescent is one of the main elements in their constitution, It has the effect of preserving their valuable natural ingredients and solution, and without such free carbonic acid gas they would inevitably suffer change and deterioration, which would alter their constitution and destroy their properties and good effects. They would undergo decomposition, and become undrinkable and useless. We respectfully submit that it would be contrary to public policy to deprive the many thousands of persons of the benefit which they now derive from these natural mineral waters, whether as dietetic beverages or as medicines. Such deprivation would take out of the hands of the medical profession these important resources of hygiene and of medicine, and would be serious injury to the people. The combined effects of the heavy and prohibitive tax which is now proposed to levy on bottles containing mineral water, and the yet heavier prohibitive impost proposed on effervescent natural mineral waters, would altogether rob the public and the medical profession of the inestimable boon which under the present and all preceding tariffs they have enjoyed by the provisions expressly inserted in such tariffs in favor of these waters, on the ground of health a public utility, and we submit that on these grounds, the provisions now in force relating to foreign natural mineral waters, and to the bottles in which they are imported, should be re-enacted in any tariff which is sanctioned by your honorable Houses. We respectfully and earnestly pray that our petition may be considered at an early date. FORDYCE BARKER, M. D., and 900 others. Presented in the Senate and referred to the Committee on Finance. Reciprocity in Medical Licensure.-Dr. William Warren Potter, of Buffalo, president of the National Confederation of State Medical Examining and Licensing Boards, chose this for the subject of his annual address at the seventh annual meeting of that body held at Philadelphia, at May 31, 1897. He first paid tribute to the memory of Dr. Perry H. Millard, of St. Paul, then in an introduction reviewed some of the essential points of progress that had been made in State control of medical practice, and finally considered his subject. The Problem.-The most important question now to be discussed pertains to the interstate exchange of licenses, and every friend of State control is interested in establishing this principle. It is one of the objects this confederation is laboring to accomplish, but a most difficult problem for solution. A national registration bureau is desirable where legally qualified and reputable physicians may be recorded-physicians whose names appear on this register to be allowed to pass from State to State in the enjoyment of all privileges pertaining to the practice of medicine. Those chiefly agitating the question of reciprocity, however, are specialists who desire to spend profitable vacations at summer resorts, and who do not relish the idea of taking State examinations in the localities chosen for their holiday practice. Another class of men, compelled by circumstances to change. residence, is more deserving of sympathy; they take the examinations uncomplainingly. Shall a State require of its own citizens a compliance with its practice laws while granting to thrifty summer specialists exemption from their operation? As the State laws forbid discrimination against the inhabitants of each, there is both a legal and a moral bar to such exemptions. Obstacles to Reciprocity.-Equality of standards for admission to the study and practice of medicine is the only enduring basis on which recip rocity can be established. When the several States adopt a uniform level of preliminaries; a uniform period of collegiate training, including uniformity of methods of teaching; and finally, an absolute similarity in the methods of conducting State examinations and granting licenses, then reciprocity will be equitably and permanently established. It is important for the State medical examiners to come to an agreement on these several points that they may act with intelligence on a common platform. The State imposes a post-graduate examination, and none should be admitted to it who are not holders of diplomas legally obtained from registered and recognized colleges. It is understood, of course, that there must be established a uniform system of recognizing and registering medical schools in the several States. The Solution-Legislative Enactments.-The remedies lie in legislative enactments. Those who most loudly and persistently demand interstate indorsment aim their criticisms at examining boards; whereas these have nothing to do with the question. The statutes in States that have established licensure prohibit interstate exchange, except between such as have equality of standards. The demands of the restless and migratory doctors must be taken to the State legislative halls. Meanwhile the members of this Confederation may assist in bringing the matter to a more speedy conclusion by acquainting their legislatures with the difficulties to be overcome, and by urgently recommending the adoption of such amendments to existing laws as will meet and remove the present defects. Great care must be exercised, however, in the preparation of amendments; the State laws are for the public weal, reciprocity is only for the few. Amendments to existing statutes should be proposed only through state medical examining boards or state medical societies; they are familiar with defects, and best know the remedies needed. When legislatures can be persuaded to turn a deaf ear to all amendments that are proposed outside of official sources it will be a happy day for the friends of State license. The object of this discussion is to divert further criticism of the delay of reciprocity into the proper channel. If legislators could be made to appreciate the fact that public health interests are involved in the question of State license; that every blow at public sanitation; and that attempt to weaken the principle is higher standards of medical education mean better health for the people, then perhaps it would be easier to obtain and maintain the necessary laws to protect the commonwealth against that kind of ignorance, superstition or super-refinement that always lurks in the environment of quackery. 1 |