thorough consideration of and an earnest appeal to the higher purposes and the ultimate aim of the medical profession in its relation. ship to the people, along educational lines, as regards the nostrum evil and quack medical practice, as sustained by the daily and weekly press of this country, through the advertising columns. He adequately expressed condemnation of the commercial spirit of the press, which regardless of its responsibility to its patrons, accepted and displayed advertisements which authoritative investigators have shown to be vile, unreliable and essentially productive of evil throughout the trail of the serpent, which unfortunately, was to be found everywhere. Again, he commented. with no uncertain sound upon the effect upon the youth of our fair country, of the advertisements of so-called specialists, dealing with sexual disorders. The supreme necessity of a law controlling the appearance of such "ads" in the daily press and distributed through the mails, was enforced. Dr. Lewis.

in his sociological observations has had opportunities to see the train of evil which is so universal, and his words should and will be respected by those in authority. And we dare say, good will come out of his able and fearless address, a synopsis of which appears in this issue.

The address in Surgery by Dr. W. D. Hag gard, of Nashville, Tenn., was an able review of the present status of Surgery of the Stomach. We hope to have the honor of printing

this in full later.

The address in Medicine was not read owing to the illness of the orator, Dr. Arthur R. Edwards, of Chicago.

The sections presented good programs and a very fair average of papers present and read. Unfortuately this association, like most large organizations, grows top-heavy with surgery. The surgical section can and does command an audience when the medical section can scarcely muster a baker's dozen. This is due to the fact that the general practitioner is not considerate enough of his own abilities to contribute to this section, whereas if he only knew it he has a fund of experi. ence which should be contributed to his fellows.

We believe this section can be developed and it should be the aim of the society to make one of the vice-presidents the responsible officer of this section to co-operate with the secretary in securing and arranging a program of equal interest with that of the surgical section.

The display by the exhibitors was good and appreciated by all. The social features of the meeting were pleasant and entertaining.

The election of officers resulted as follows: President, J. Henry Carstens, Detroit; first

vice-president Joseph R. Eastman, Indianapolis; second vice-president H. H. Grant, Louisville; secretary, Henry E. Tuley, Louisville; treasurer, S. C. Stanton, Chicago. Next annual meeting will be held in Hot Springs, Ark.

general consent, on the medical profession, of IN conformity with the custom, devolving by

Some

Unrecognized Responsibilities of Press and State in Conserving Health.*

looking after the hy
gienic welfare of the
people, Dr. Lewis sug-
gested that there were
questions and problems
now presenting them-
selves that equalled in
importance
any yet
solved; and took up for
consideration two of

them, viz., the quack and patent medicine advertising evils in the newspapers and magazines.

While it was the general policy of the state to protect its people against frauds of various kinds, and of the public press to lend its assistance, this policy was not pursued in the instance under discussion: The state ignored the subject, and the press stood an active partner in the fraudulent practices, dividing the spoils of such swindles in the shape of advertising fees. Of the two parties of this blame, since it assumed the attitude of warr alliance, the press was deserving of most ing against error and crime, in general; while nothing was to be expected of the quack, whose nature and calling led inevitably to false-pretence; whose only thought, on being caught and punished for crime, is that he "should have been more careful" about its commission.

A number of self-evident fraudulent advertisements, now running in the newspapers, were quoted, and the rank injustice done the While the peopeople by them was shown. ple might the more quickly appreciate the monetary injury done, the medical profession knows that that is the least serious aspect of the subject; that far greater damage is done to the health and mentality of youth, who read the alluring and misleading advertisements, are fed on bug-a-boos of "lostmanhood," varicoceles, spermatorrheas, etc., and are both rendered melancholic by the assurance that they were suffering from such disorders, aud drained of as much of their salaries for as long as possible; while, as a matter of fact, they were well and healthy all of the time. It was simply bare-faced fraud

Subject of the President's Address to the Mississippi Valley Medical Association at Indianapolis, October, 10th, 1995; by Dr. Bransford Lewis, St. Louis.

-ignored by state, and suppressed by the

press.

While, under such circumstances, relief from oppressive conditions is sought through legislative enactment, the author did not consider such a mode adequate to the requirements, and called attention to the fact that ordinances already existed in the Municipal Code of St. Louis forbidding under severe penalties, such advertisements in public prints, but they had been systematically ignored.

The proper remedy, he thought, lay in a widespread campaign of education, reaching through not only the limits of medical influence, but also through all channels of education, of the ministry, of the legal fraternity, and of philanthropy; by which youth might receive the instruction that would serve to protect it against the wiles of such malefactors. Such a movement had already been begun in the more respectable of newspapers and magazines: Collier's Weekly had done splendid service in that line, through the writings and exposures of Norman Hapgood and Samuel H. Adams: The Ladies Home Journal was active in a similar way; and some daily newspapers, among them, the Emporia (Kansas) Gazette, the Boston Herald, and the Minneapolis Journal, were pursuing a similar trend. So that the time was ripe for furthering the movement from every standpoint.

In Part II of the address, Dr. Lewis took up for consideration, the almost universal prevalence and the disastrous influences of the so-called venereal diseases, and the means best calculated to limit them. He called attention to the large extent to which they existed as non-venereal, though contagious diseases; explained the innumerable modes in which they were transmitted from one person to another, or to numerous others, by absolutely innocent and non-venereal media; the inexhaustible array of damaging effects to which they gave rise; the predominant bearing they had on "race-suicide, "(the fact being alluded to that 20,000 children die in France every year from hereditary syphilis, alone; while gonorrhea was far more potent, even that this, in its influence for preventing conception). Such were these contagious diseases, ignored by the public, neglected by state and authorities, accepted and concealed by society, tabooed by the press, except in their nauseous advertisements of fake remedies and worse doctors; decried and loaded down under the designation, "venereal," until one hardly dared mention them even in a medical society, because of the habitual odium attached to them. The question arose, was it sensible, was it manly, humane, or

right to refrain thus from promulgating facts and figures that mean so much to humanity? Shall we, custodians of this knowledge, idly wait for the awakening of the people to a realization of their error? Shall we hold the tastes and habits of society so sacred that we tremble lest we disturb its serenity? Lest, by saying unpleasant things, we cast a ripple over the surface of the foul pool? Away with such complaisance and such fears. Let us tell the truth and shame the devil!

This was the cue to the proper remedy: Education of the people, and more especially of the youthful part of the public. This would accomplish more than anything else toward freedom from the thraldom of such conditions. And, as previously mentioned, educational channels of all sorts should be engaged in the work of enlightenment, reaching all ages and classes. Youth was entirely able to consider such subjects seriously and judiciously, when presented properly; and it was only fair and right that it should have the opportunity of being placed right with regard to them.

Dr. Lewis has given voice to some very important living questions in his able address; questions which should deeply interest every physician, minister, lawyer and teacher in the land. It is certainly high time that action be had in the direction of educating our youth along the lines of vital truth, and we hope to see much good as a result of the wide publicity which should and no doubt will be given this burning topic.

"The commission decided to concentrate attention first upon the bacteriological and clinical aspects of lobar pneumonia. As a preliminary to subsequent work of a seemingly more practical nature, it was thought necessary to determine, for the identification of the species, the character of the pneumococcus was found in cases of lobar pneumonia and also was found in the secretion in the mouth and throat of healthy individuals, including such a study of streptococci as would suffice to differentiate them from the pneumococcus. Among the studies bearing on these points which it was decided to pursue were the following: (1) study of the occur. rence and virulence of the pneumococcus and organisms relating to or resembling this, in the human mouth in health and disease; (2) the evidence of variation in virulence of the pneumococcus; (3) the occurrence of the pneumococcus in children's hospital, homes and asylum, with a study of the bacteria. of mouths before and after outbreaks of pneumonia; (4) the vitality of the pneumococcus under various conditions; (5) a study of mouth disinfection. The method

adopted as stated in the introductory note to these reports, was, first, to secure the co-operation of bacteriologists in various places, who should make independent study along the lines suggested; and, second, to establish a central laboratory or "clearing house" to which ultimately cultures from various independent workers should be sent for comparative study under a single observer. hoped that by the establishment of this central laboratory with its large number of available cultures, light might be thrown upon atypical forms, variations, etc., and greater precision achieved in determining the characters relied upon for identification.

It was

There are nine separate contributions to the report, most of them being the work of two or more investigators-twenty-one in all. We confess to a slight feeling of disappoint. ment that the labors of so many skilled laboratory workers, extending over the greater part of a year, should have resulted in little more than a reaffirmation of what has long been known regarding the pneumococcus and its distribution. The various contributors found the pneumococcus frequently present in the secretions of the mouth and throat in apparently healthy persons, and determined that the organism taken from these parts was virulent for rabbits and mice, though Park and Williams found it seemingly somewhat less virulent than the organism obtained from a person with pneumonia. A larger proprotion of atypical pneumococci was obtained from healthy persons than from those suffering from pneumonia. A rather interesting

fact developed in this inquiry was that discovered by Norris and Pappenheimer, who found pneumococci present, not only in the secretions of the mouth and throat, but actually in the lungs in practically all autopsies-and this, whether the lungs were normal or were the seat of lesions of various kinds. But the significance of the discovery was considerably weakened by control experiments which made it probable that the organism was carried into the lungs in the fluids collecting in the mouth of the dying person and flowing down the air passages during the transfer of the body from the hospital ward to the morgue.

"In the course of a comparative study of pneumococci and streptococci, made by Longcope and Fox, attention was directed to Rosenow's statement that acid is formed in considerable amount in cultures of pneumococci in pneumonia serum, but not when serum from normal individuals is used. Longcope found that this phenomenon is dependent upon the appearance in the blood serum, under certain conditions, of a substance from which the pneumococcus is capable of forming large quantities of acid. This substance is almost constantly present in the serum during an attack of pneumonia, but disappears after the crisis; what it is and what ocasions its presence in the blood during the pneumonic process Longcope was not able to determine satisfactorily. What the practical significance of its presence is in the blood is not clearly apparent, but it is probably protective in intention, since acid is inimical to the growth of the pneumococcus. The subject is one that invites to further investigation, and is perhaps the most important as well as novel of all those dealt with in this report.

Some experiments of F. C. Wood, made to determine the viability of the pneumococcus after drying were of interest as confirming what is known regarding the vulnerability of this organism. The diplococcus is tenacious of life when undisturbed in moist or dried sputum kept in the dark, but exposure to sunlight rapidly kills it; oxygen is also fatal to its prolonged existence, for it was found that the organism perished in from one to four hours in powdered sputum even when kept in the dark. In coughing, sneezing, or even talking, the subject of pneumonia, just as the tuberculosis, excels many fine articles of saliva or sputum containing great numbers of the specific micro-organisms, but the dan. ger to others from this is minimized by the rapid death of the bacteria so expelled under the influence of fresh air and sunlight.

"The reports of the laboratory workers are of much scientific interest, and we would not

this series and must avail himself of the needed agency, and apply it intelligently. These things are largely a development of the time since the majority of us left college, and there is no one place where more than a single subjects can be handled in single courses at post-graduate schools; as a consequence the mastery of them depends upon reading and personal work, a post-graduate course taken in your own office, and this may be advantageously done under the direction of such attractive, instructive and practical text as Dr. Cohen has gathered for his readers. In reviewing these volumes there is a temptation to deal only in generalities, for each deserves detail, and an amount of space which is beyond our command, and it is difficult to select the features more worthy of attention. Vol. II deals with a wider range of therapy than is indicated in its title: massage and exercise, orthopedic apparatus, corrective manipulations used in orthopedic surgery, and physical methods used in ophthalmic therapeutics are a few subjects considered which indicate the real range of the work. The chapters on massage and those devoted to orthopedics are exceptionally excellent. We know of no work more practical on massage and the chapters on orthopedics are the work of masters. The subject of exercise as a therapeutic agent seems a wide one, the practical worth of these chapters is great. Dr. Gulick's contribution on Exercises, a Method of Physical Education is worthy of more than passing mention. Dr. Gulick has been for years the foremost worker in the physical department of the Y.M.C.A. and his long experience makes his views practical indeed.

Vol. VIII. This volume is largely, but not exclusively devoted to the discussion of a systematic method of treatment in which rest constitutes the central factor, and which is chiefly applicable in certain of the nervous disorders. Its satisfactory exposition has necessitated a wider consideration of etiologic, pathologic, clinical and diagnostic relations than has been necessary in the discussion of other methods of treatment.

In the consideration of the important subject of rest in its therapeutic bearing Dr. Deroum has endeavored to present the subject in a systematic manner. Simple physiologic truths and clinical facts have been placed side by side, together with logical deductions in regard to treatment. In addition to Dr. Dercum's very able discussion of rest the volume concludes with a discussion of Suggestion, which is practical and instructive.

Vol. IX. This volume is largely devoted

to water, and awakens a new and appreciation of the great benefits which come from the intelligent use of this very accessible agent. The volume is quite the equal of the others of the series, and being on a subject of general applicability assumes a place of exceptional interest. The various phases of the employment of water in therapy are practi cally considered and the technique of application detailed The subject of baths other than water, including thermic, electric and sun baths is presented and the methods of application of all are made more intelligible by profuse illustration.

DISEASES OF THE KIDNEY, DISEASES OF THE SPLEEN AND HEMORRHAGIC DISEASES By Drs. H. Senator and M. Litten, of Berlin. Edited. with additions, by James B. Herrick, M.D, Professor of Medicine in Rush Medical College, Chicago. Octavo, 816 pages, illustrated. Philadelphia and London: W. B. Saunders & Company, 19.5. (Cloth, $5.00 net; Half Morocco, $6.0) net.)

With the appearancce of this, the eleventh volume of Saunders' American edition of Nothnagel's Practice, the work nears com pletion, the final volume on the heart being now in active preparation. Like the others, this volume can be taken as the acme of knowledge on the subjects embraced. Professor Senator's clear style, systematic ar rangement of facts, and logical reasoning make his articles on the kidney indispensable to the practitioner. The editor, Dr. Herrick, has enlarged on certain points whenever necessary, especially regarding treatment, diag nosis, urinary analysis, etc., so as to increase the value of the work to the general practitioner. He has also added articles on cryoscopy and phloridzin glycosuria. The sections on the spleen and the hemorrhagic diseases were written by Professor Litten, whose pioneer work in these fields is widely known. The articles on the mosquito and its relation to malaria, on splenic anemia, on congenital icterus with splenomegaly, and on the X-rays in the treatment of leukemia have been brought down to date by the editor. Indeed, the editor's interpolations add greatly to the practical value of the volume, and we are sure such an authoritative work on these subjects has never before been published.

DIPHTHERIA AT ANAPOLIS.-The opening of the United States Naval Academy has been postponed due to an epidemic of diph theria among the fourth class men.

DISPOSAL OF DEAD.-A Cologne engineer suggest placing corpses in a simple coffin and then pouring in a quicksetting liquid cement. He also suggests using these corpse-containing concrete blocks for building gigantic mausoleums-literal cities of the dead.