From the wide extent of diplobacillus catarrh in our neighborhood it is evident that complications of the same with other external diseases of the eye must be frequent. Peters and Hoffman have thrice and Axenfeld twice clearly demonstrated diplobacilli in follicular formations of the conjunctiva. Seven times have we found the same combination, and agree with them that there is not a common cause for both, but that it is an accidental combination. Similarly we have 19 times observed diplobacilli in conjunction with all forms of conjunctivitis granulosa, though more frequent in the cicatricial stage. It was never possible to observe that the pathologic process of this disease was influenced by the presence of the diplobacilli. In most of these cases the blepharitis characteristic of diplobacillus catarrh was well pronounced so that a probable diagnosis could be made despite the complications. The same is true of the cases complicated with conjunctivitis phlyctenulosa. Of these we have had 22 cases. Generally the phlyctenules were present when the patient was first seen, but sometimes they developed later. That diplobacilli predispose the conjunctiva to the formation of phlyctenules is likely. In the same way it is quite likely that the presence of phlyctenules renders the conjunctiva more susceptible to the attack of the diplobacilli. It is seldom that a direct etiologic union can be established. Rather are these cases to be regarded simply as accidental complications. (Continued.) A REMEDY PORPOSED FOR THE EVIL OF SUBSTITUTION. By J. D. WILLIAMS, M. D, New York. There can be no subject of more importance to physicians than the violation of their confidence on the part of a dishonest dispensing druggist. Law will not make a dishonest man honest, but the right law properly executed will prevent a criminal's further infliction of injury upon society. The requirement of a license to all druggists who dispense drugs or medicines, revokable upon the licensee's being convicted of substituting any ingredient, drug or medicine other than, and in lieu or instead of, that specified in the prescription, order or request in writing, of any physician, would go a long way to aid in the matter of honestly filling prescriptions. Let the medical societies induce their respective state legislatures to enact a law requiring such a license, with a simple and practical procedure for establishing the guilt and enforcing the penalty against infraction, and the practice of substitution would soon cease. Let procedings for revocation of license be before the court, board or officer empowered to issue the license, and be set in motion at the relation of either the board of health, a local medical society, or the purchaser upon whom the fraud and imposition had been done, or of the physician by whom the prescripiton or order was issued or given, or of any person, firm or corporation for whose brand or make of drug or medicine the substitution had been perpetrated. Let the licensing board, court, or officer be empowered to issue citations, subpoenas for witnesses, to administer oaths, and be given all other requisite powers for duly trying the issues and revoking the license of the guilty.Exchange. THE KANSAS CITY MEDICAL INDEX - LANCET. --BY JOHN PUNTON, M. D., EDITOR AND Publisher. SECRETARY AND PROFESSOR OF NERVOUS AND MENTAL DISEASES, UNIVERSITY MEDICAL COLLEGE PUBLICATION OFFICE: 532 ALTMAN BUILDING. C. F. WAINBRIGHT, M. D. O. L. McKILLIP, BUSINESS MANAGER. ASSOCIATE EDITORS. B. C. HYDE, A. M., M. D. HONORARY CONTRIBUTORS. H.T. PATRICK, M. D., Chicago, Ill. TERMS $1.00 PER YEAR IN ADVANCE. Foreign Subscription Terms: HERMAN E. PEARSE, M. D., F. W. LANGDON, M. D., Cincinnati, Ohio. SINGLE COPIES 10 CENTS. France, 6 Francs; Germany, 5 Marks; England, 5 Shillings; Eastern Representative: John Guy Monihan, St. Paul Building, 220 Broadway, New York City. EDITORIAL. PROGNOSIS OF NERVOUS DISEASES. The Bradshaw lecture delivered before the Royal College of Physicians, London, November 5, 1901, by Judson S. Bury, M. D., F. R. C. P., was a masterly effort. The subject which he selected, viz., "Prognosis of Nervous Diseases," is one full of interest to every medical practitioner, and the manner in which he handled it proved him to be master of his art. It is generally admitted that of all problems in practical medicine the prognosis of nervous diseases is perhaps the most difficult. To forecast and fortell the ultimate result of any nervous affection is no easy task, and Dr. Bury at the outset reminds us against the fallacy of dividing nervous diseases into those that are curable and those that are incurable. He then points out by actual practical illustrations that many so-called curable diseases may, and often do, leave behind them organic changes and alterations, with persistent of permanent impairment of health, while other currently regarded as incurable may be arrested or become apparently completely cured. The common classification of diseases of the nervous system into functional and organic by no means coincides with the division into curable and incurable. Functional diseases resist all attempts to detect their actual pathological lesion, and are often as hopelessly incurable as those associated with known coarse structural changes. It would seem, therefore, that the time has not yet come for formulating prognostic rules based upon diagnosis and pathology, but Dr. Bury directs our attention to the greater value of symptoms and the need of more careful clinical study of them as guides to the course, progress and ultimate termination of nervous diseases. According to Dr. Bury, prognosis depends less uopn our knowledge of pathology than upon the accuracy of our experience with regard to symptomatology, and he discusses in his lecture the significance of certain symptoms and their relation to certain nervous diseases, as well as their unreliable character as an aid in prognosis. Improved methods of treatment will undoubtedly bring with them, if not better methods of prognosis, at least a better prognostic outlook, but this must vary with our knowledge of the proper treatment for the elimination of the poisons and of the effects produced by them. Dr. Bury is a firm believer in toxemia as the chief cause of nervous diseases and the nature of the toxins, together with the discovery of specific antitoxins, form, in his judgment, a sufficient stimulus to the rising generation of physicians to continue those labors in the department of diseases of the nervous system which have made the better half of the nineteenth century so fruitful in results. Altogether, Dr. Bury is to be congratulated for his valuable contribution to this department of medicine, and his lecture is well worthy the careful consideration it richly deserves. VACCINATION VS. POLITICS. The recent tetanus fatalities following vaccination at Camden, Atlantic City, Brooklyn, Cleveland and other cities have been watched very closely by the medical profession as well as the laity, and one point to which we wish to have the profession call to mind is that not a single case of tetanus has succeeded the employment of the vaccine virus manufactured by either Park, Davis & Co., or H. K. Mulford Co. This is very gratifying to us since both firms are advertising their products in our columns, and while we could not stand responsible for the mistakes of any advertiser, it is nevertheless a great satisfaction to us to be able to testify to the superior quality of the product advertised. We would not be understood as condemning the products of any reputable pharmaceutical manufacturer, but we cannot refrain from calling attention to the fact that too much care cannot be exercised in the selection of a virus. The experiences through which the various cities are passing certainly demonstrate that medicine and politics are two separate and distinct callings. STATISTICS OF SUICIDES. Two peculiarities are shown in the recently published figures of suicides in American cities-the recession of natives of Germany from the head of the list, which they long held, and an increase in the number of suicides among colored people. In the last published report on the subject in this city, all boroughs, it was seen for the first time that there were more suicides by natives of the United States than by those of Germany, though the disparity was very small. The change is explained in part by the fact that while the number of German men who commit suicide is larger than that of male suicides of any other country, suicide by German women is comparatively rare, and gets rarer each year. The suicides of colored people have been more conspicuously observed in the large cities of the South than in Northern cities, where the colored population is small and is not increasing, and the explanation of it is found in a single phrase, city life. Colored residents of farms or small towns seldom commit or attempt suicide; it is in the large cities, where the struggle for existence is under conditions most unfavorable to colored men, that a few of them overcome their repugnance to such an act of violence. In proportion to the total population, suicides among Englishmen residing in the United States are very much more frequent than among residents of Irish birth. Among male natives of France and Switzerland in the United States, the rate of suicides is high; among women from France or Switzerland there is practically none at all. In respect to the total number of suicides compared with the population, Chicago and San Francisco rank highest among American cities. Baltimore and Richmond are low on the list. In New York City the ratio of suicides is higher in Queens than in the Bronx. OBITUARY. JOHN STARK. M. D. John Stark, M. D., died at his home in Kansas City, December 17th, after a short illness. Dr. Stark was a native of Scotland. He entered the Universtiy of Glascow early and graduated from the medical department in 1863. Believing that America offered the most attractive field for his calling, he sailed from Scotland the same year he was graduated ,and saw five years' service, from 1863 to 1865, as surgeon in the Union army on the staff of General McClellan. After the close of the war, Dr. Stark became a surgeon for the Anchor Line Steamship Company, sailing between New York City and Europe. He located subsequently in Kansas City, where he built up a large practice. Dr. Stark was a Mason and a member of the Grand Army of the Republic. Z. T. HARVEY, M. D. After a lingering illness of two years, Dr. Zachary Taylor Harvey passed away at his home in Council Grove, Kansas, November 16th. Dr. Harvey was born in Adams County, Ill., March 16, 1847. He received his education in the district schools of Adams County and in Quincy Seminary (now Chaddock College) in Quincy, Ill. His medical education was acquired in Keokuk, Iowa, and in Chicago. He received his degree in the latter city in 1871. Soon after graduating he located at Brooklyn, Ill., where he practiced until 1881, in which year he went to Kansas and located at Junction City, and in 1882 removed to Council Grove. In December, 1879, he was united in marriage to Miss Mary Howell, of Schuyler, Ill. In 1896, he was a representative from Morris County to the state legislature, which position he filled with diligence and integrity. Dr. Harvey was prominent among fraternal orders. He was a member of the Modern Woodmen, the A. O. U. W. and the Occidental Mutual Benefit Association, of which order he was an honored member of the board of directors. He ranked high as a Mason, being a member of the Knight Templars at Council Grove. OLEAGINOUS SCIENCE. There have been many reported "strikes" in oils, and now it is asserted by some scientists that petroleum is really a distilled and fossil fish oil. Is it possible that Norway cod were really at the bottom of the Standard Oil Company? Who can say?. If science says so, one may go on downing the oil, but there is no downing science. Hagee evidently believes in science and in oil in the same breath. In any event Hagee's Ol. Morrhuae Comp. is the outcome of scientific combination and adaptation. Its formula makes it a food of the greatest value in all wasting diseases and low states. If there is anything better in the market we shall be glad to herald its virtues. The Dietetic and Hygienic Gazette. 4 SOCIETY MEETINGS. KANSAS CITY ACADEMY OF MEDICINE. Incorporated under the laws of the State of Missouri, June 28, 1890. OFFICERS SINCE ITS ORGANIZATION. B. H. Zwart, M. D., President; J. W. Gaines, M. D., Vice-President; C. B. Harden, M. D., Censor; Ralph J. Brown, M. D. Secretary; C. Lester Hall, M. D., Treasurer. Meeting of November 19.-Dr. Samuel Ayres read a paper on Carcinomata which appears on page 18 of this issue. In discussion Dr. Robinson said: I have been absorbed by this paper so ably presented this evening. I sincerely trust Dr. Ayres has found a remedy or system of treatment that will do what he thinks it will toward lowering the mortality of this most untreatable and awful form of disease. How discouraging are our operation results today! Although surgical exterpation is recognized to be the best method of treatment for carcinoma devised up to the present time yet even here only 25 per cent of the cases of cancer are operable when first seen by the surgeon and in that number- how common is recurrence even after five to ten years! The A fact which makes the disease more alarming is the statement that carcinoma is greatly on the increase. This is a difficult matter to prove. increase however, is probably more apparent than real. Additional care in collecting statistics, increased facilities, and the general adoption of more scientific methods of diagnosis. The more frequent resort to abdominal section in obscure diagnosis, and the greater frequency and care in post-mortem examinations; all have caused death from cancer to occupy a more prominent place in mortality statistics than in times past. Added to this, the increased average of human life, i. e., extension of age (for cancer is a disease of advanced life); all these facts tend at least to give the disease more prominence. However, to my mind, a discussion of the treatment of carcinoma cannot be rationally undertaken without a consideration of the cause of the disease. If we do not admit the parasitic or microbic theory of cancer, our belief in the value of serum therapy is irrational. That this method of treatment is of value in sarcoma is, I believe, everywhere admitted. True, all cases even here do not get well, but a sufficient number to prove the value of the Coley treatment. Wyeth, in a rcent review of the subject of sarcoma, in the Annals of Surgery, takes a most radical stand in support of the serum treatment. He even goes so far as to advise the deliberate inoculation with the erysipelatous streptococcus of all cases immediately after the operation or amputation for sarcoma, and states that this should be repeated every six months for a period of two years, as by this means he sees the only assurance of complete immunity from fatal recurrence. Few of us would take so bold a stand, but the argument remains, and to my mind a good one, |