does not pretend to be a specialist in insanity cases, and who has not made the care and treatment of the insane a special study, nor followed it for any length of time whatever as a special vocation. The policy of the provision under consideration is entirely a matter for legislative determination.

"As the respondent was entitled to hold the office until a qualified successor should be legally elected to take his place, there was no ground for a judgment that he wrongfully usurps, bolds, occupies, etc., the said cffice, therefore there is no error in any part of the judgment rendered by the court below. Respondent contends that the managers of the hospital had no power to legally elect the appellant even if he had been qualified to hold the office.

"The insanity law nowhere expressly provides that the managers may appoint a successor to a medical superintendent after his term of four years has expired and, indeed, it does not provide for any term of office of the medical superintendent whatever. It merely provides that they may appoint a medical superintendent and certain other named officerg as often as vacancies occur therein.

"Respondent contends that the insanity law was intended to be and is a revision of the whole subject of the management of the insane, and it therefore takes the place of all former laws upon the subject and repeals all such laws; that under judicial decisions vacancy in an office does not occur when there is a person in the office presently entitled to hold the same, and occurs only when by death or resignation or removal, the office is entirely unoccupied; and that as the managers are given no power to appoint a successor there is no vacancy which they are entitled to fill.

"This contention has certainly great plausibility, for the insanity law with respect to this matter is certainly very loose and indefinite; but we are not called upon in this case to pass upon the merits of the contention, and it is to be hoped that the legislature will amend the law so as to clear up these difficulties and thus make a judicial determination of the question thus raised unnecessary. With respect to the contention of appellant that the insanity law is unconstitutional, first, because it is special legislation and does not have a uniform operation, and second, that it embraces subjects not expressed in its title, it is sufficient to say that the contention is not maintainable upon

either of the grounds specified. The judgment appealed from is affirmed."

FEES IN THE UNITED STATES.

"The West London Medical Journal says: 'Some attention was recently directed in an American medical journal to the professional fees paid to 'physicians' in the States, and the curious fact was pointed out that a fee of $500 was quite exceptionally netted. In the land where millionaires abound as well as men of large wealth, this certainly seems a surprising thing. A surgeon not long ago operated successfully for appendicitis in San Francisco, and his millionaire patient voluntarily handed him a draft for $30,000. This fee must eclipse any record we have in this country. If anything, however, there are signs everywhere that 'operation stock' is a falling market. That is to say, the fees for operations are not what they used to be. Many causes, no doubt, are contributing to this doleful state of affairs, but perhaps the most active of all is the increasing number of those in whose hands the public find that their surgical needs can be placed. Thus, by competition combined with efficiency, the operation stock market is being depressed."". Med. Record, N. Y.

[No surgeon ever received $30,000 for an operation in San Francisco, although, no doubt, in many cases, he was entitled to it for saving human life.—ED ]

TO BE CONGRATULATED.

The enterprising house of Clinton E. Worden & Co., is to be congratulated on its splendid success. The house is ably managed by Mr. Clinton E. Worden, who has with him a superior staff of pharmaceutical and manufacturing chemists. Worden's products are known to be accurate and reliable. The Cascoroma is an excellent tonic laxative. The Duc-Peptonate as a ferruginous tonic is equal to any in the market. The PalmoSantal compound has proven an excellent remedy in catarrhal diseases of the genitc-urinary tract. We commend the house to the medical practitioners on the Coast, feeling assured that every article furnished by Clinton E. Worden & Co. is absclutely reliable.

Correspondence.

Censorship Established by "Vote" in the San Francisco County Medical Society.

The promptness with which your old and valuable journal has responded to the real needs of the profession (regardless of personal interests) prompts me to ask for space once more, in order to fully expose and criticize the peculiar methods whereby certain members who have managed to gain control of the County Society, are depriving reputable members in good standing (persona non grata) of the free exercise of membership rights within such Society. During the past two years or more, charges of "clique, censorship, indecorum and general lawless. ness" within the Society, have been so pronounced by "mouth and press" that the Society has become a "by-word and reproach" among the profession and laity alike, at home and abroad.

The gentlemen responsible for this deplorable condition of affairs have, in order to justify their acts, resorted to cajolery and sophism, such as: Appeal to nativity, patriotism, alma mater, to prejudice against foreigners, exclusion of quackery, overcrowding of programme, etc., and, strange to say, have found "willing ears and votes" to assist in carrying out prearranged unlawful programmes at the meetings of the Society.

Of course, all phenomena have an underlying cause, and the "nigger in the fence," or underlying cause in this case may be briefly stated thus: About five years ago I took up the cudgel against the various evils that contribute towards lowering the medical power of the State, or the earning capacity of the profession, from its legitimate value of about $15,000,000 to about $2,500,000 per annum.

This caused a certain number of those who depend on such evils for their present social and professional standing, to unite in an effort to prevent exposure and abolition of the "unethical concerns" through which they ply their nefarious practices, to the great detriment of the profession as a whole.

That my labors in this field come legitimately within the scope of the County Society, will be seen by quoting the objects of the Society, which are plainly set forth in Art. II of the Con

stitution, to wit: "The objects of said Society shall be (1) the cultivation and advancement of medical science; (2) to promote and protect the interests of the profession."*

Proverbial apathy on the part of reputable members, and union on the part of the opposition, have thus far prevented the adoption of direct measures by the Society for curing the evils referred to, although nearly every county in this and other States, has taken energetic action in the matter. As long as the opposition confined itself to voting down resolutions appertaining to the matter, no one could, "on the principle that the maority rules," complain; but, when the opposition takes advantage of the apathy above noted, and a slight defect in a single by-law (Art. III), and resorts to actual "rowdyism" to render inoperative the "spirit and letter," of the constitution, by-laws and rules of order governing the free exercise of membership rights, then the matter assumes an aspect that calls for severe censure and condemnation, especially so, when such opposition is composed almost entirely of so-called professors, who ought to take the lead in all matters that tend to uphold the dignity and prosperity of the profession.

It would be needless repetition to allude to proofs of the foregoing charges, as the details of the outrageous manner in which the opposition prevented me from reading a certain paper before the Society last April, appeared in this journal at that time, and have been challenged by no one thus far.

Queries.-Who will deny that the censorship thus established is un-American, and more in line with the practices of the Inquisition?

The "quantity and quality" of the programme of the Society soon showed that fair-minded, independent, scientific members resented the censorship thus inaugurated.

Queries -Who will contradict the assertion that 95 per cent of the programme has, during the past three years or more, appertained solely to one out of the twenty or more departments of medicine, and that it has been a "threshing of old straws," without the production of a single original idea ?

Perceiving that an amendment to Art. III of the by-laws, making it the duty of the Secretary to announce "the titles of * NOTE.—Paragraph 2 of this Article was introduced by me in November, and unanimously adopted December 10, 1894. (See Proceedings, PACIFIC MEDICAL JOURNAL and Occidental Medical Times, January, 1895.)

all communications on the meeting notices in the order the same were submitted to him," would cure the evil, an amendment thus worded was accordingly introduced by me at the January meeting, and, as might be expected, rejected, at the following meeting when it came up for action.*

Queries. Who can successfully dispute the uniformity, fairness and urgency of such amendment? What medical gentleman will doubt that such amendment would have been unanimously adopted by any medical society outside of the City and County of San Francisco?

The following "hoodlum" methods were resorted to by the opposition to defeat the amendment:

1. Uncontrolled deafening tumult by standing gesticulating members at the time such amendment was read and introduced by me in the Society.

2. Refusal (contrary to custom) by the President and Secretary to print, circulate, and make such amendment part of the minutes of the Society.

3. Withholding of the minutes of the Society from the medical press.

4. The action of the Secretary in contemptuously referr.ng to the preamble as a "rigmarole."

5. The arbitrary rulings of the President in refusing to allow the preamble to be read by the Secretary, and in limiting the discussion on such amendment to five minutes.

6. Uncontrolled, malicious and idiotic laughter and rowdyism during the five minutes allotted me in which to discuss the measure, to such extent that calling on the President several times to preserve order was of no avail.

The amendment was opposed in argument by a single member who thought that the programme of the evening was good enough, and that for that reason the amendment should be defeated. That the programme especially got up for that evening (which, in looking backwards, reminds me of the old adage: "When the Devil was sick," etc.) was especially good for, and served the purpose of the opposition-to tire out and drive away apathetic members—was evidenced by the fact that over one-half of the members in attendance left before the drawn out papers and discussions were concluded. The only subject be

*NOTE.—The preamble, amendments and certain remarks appeared in the February issue of this journal.