A New Rubber Substitute. From a shrub called yule, growing wild in Central Mexico,.a new substitute for india rubber has lately been produced, says the Carolina Medical Journal. The bark and wood are ground and the gum, resembling crude rubber, extracted by maceration with gasoline, oil of turpentine, naphtha or other hydrocarbon. The shrub yields 40 per cent. by weight of gum.

Appendicitis During Scarlet Fever.-An interesting example of suppurative appendicitis, occurring on the fourth or fifth day of a scarlatinal attack, is reported by Dr. J. S. Price in the September Texas Medical Journal. The author thinks we should be on the alert for appendicitis as a sequel of scarlet fever, since it is very likely to result from the catarrhal disturbances of the gastro-intestinal tract.

Grand Army of the Republic.-The founder of the G. A. R. (Medical Standard) was a physician named Benjamin F. Stephenson, who served for three years as surgeon of the Fourteenth Illinois Infantry. He organized the first Grand Army Post April 6, 1866, at Decatur, Ill., with a charter membership of twelve. The idea spread so rapidly that by autumn of the same year there were organizations in thirteen states.

Thinness. To make thin people thicker Le Roy (Medical Record) advises to avoid condiments, acids, sour fruits, salads, cabbage, coffee, turnips, sour wines, hot drinks and tobacco; to take fatty meats and foods, crust of bread, pastry, beans, peas, nuts, sugars, honey, water; to reside in the country and secure rest of mind as well as body, and to take Fowler's solution in gradually increasing dose up to 20 drops.

Amenorrhea. In primary amenorrhea, L. H. Dunning (Indiana Medical Journal) considers the intrauterine application of the faradic current an efficient means when the trouble is due to retarded development of the sexual organs. The prolonged administration of small doses of iron, or the iron and aloes pills, will often be of service. Mild emmenagogues, such as potassium permanganate, in 1 or 2 grain doses, are frequently beneficial.

For Red Nose. Many of the victims of a red nose suffer also with cold feet. H. S. Purdon (quoted in Medical Record) advises convallaria internally as a circulatory regulator, calisthenic exercises with arms, bending body, and making intermittent pressure with the hands over the epigastric region; a mustard foot-bath at night for ten or fifteen minutes, followed by brisk friction; and in winter, a hot water bottle in bed. In the way of local treatment a sulphur and calamine lotion rubbed into the nose aids in restoring a natural appearance to this organ.

Pyocyanic Infection. -The editor of the Medical Review of Reviews emphasizes the importance of the bacillus pyocyaneus as a necrosis-producing agent. This micro-organism, he states, has been recognized as the essential factor in a whole group of destructive lesions in young children, variously designated as varicella gangrenos, ecthyma terebranae, etc. A child with lesions of this description had better be isolated and treated with special care.

Post-Apoplectic Temperature. The fever commonly observed after an apoplectic "stroke" is attributed by Henry Lyle Winter (Medical News, Sept. 15) in part to absorption of septic material from the alimentory canal, as shown by rapid reduction of temperature with dram doses each of hydrogen peroxide and pure glycerin every hour. The decline was most marked in the axilla of the paralyzed side, which as usual exhibited the higher grade of temperature.

After-Pains From Extraction of Teeth.--This common condition, says Charles B. Isaacson (Medical Record, Aug. 11) may be due to any one of the following causes: Retention of pyogenic membrane; expansion of osseous walls; fracture of alveolus; sundering of maxillary process and alveolus, together with laceration of tissues; retention of root and spiculae; necrosis of wall and septum of nonantagonized teeth; perforation of alveolus from invasion of pus. The treatment in general is the removal, under local anesthesia, of foreign substances with curet or burr and the local use of sedative antiseptics.

Rocky Mountain Inter-State Medical Association.-The next meeting will be held in Denver and will no doubt be larger and better than any preceding conventions. The officers for the ensuing year are as follows: President, Dr. C. K. Fleming, Denver; First VicePresident, Dr. H. D. Niles, Salt Lake City; Second Vice-President, Dr. F. W. McCrimmon, Butte; Treasurer, Dr. Charles J. Plummer, Salt Lake City; Recording Secretary, Dr. E. P. Hershey, Denver; Corresponding Secretary, Dr. S. D. Hopkins, Denver; Board of Trustees, Dr. T. J. Murray, Montana; Dr. James Carter, Wyoming; Dr. W. R. Pike, Utah; Dr. Charles H. Jones, Arizona; Dr. J. H. Bean, Idaho; Dr. A. M. Holmes, Colorado,

Fatal Lead Poisoning.-Two cases of this class in children of the same family are reported by Allen Baines in September Archives of Pediatrics. The symptoms in the first child resembled basilar meningitis so closely that it was treated for this disease until its death. The urine of the second child contained one milligram of lead per ounce, and the course of the malady was almost identical with that of his brother. The mother also developed lead colic and other classical symptoms. The manner of absorption was through cooking with the staves of old barrels which had contained white lead. The writer calls attention to a very pronounced dark blue circle about the anus as a valuable diagnostic sign.

In considering the elements which should enter into the annual address of the President of this Association, it has been difficult to decide how to proceed.

As a new organization, the Rocky Mountain Inter-State Medical Association has much cause for self-congratulation, and the present meeting seems auspicious of a future of enlarged influence and usefulness in its chosen field.

It is a pleasant circumstance that this, the second annual meeting, should be so well attended, when it is considered how sparsely populated are most of the districts in the various states from which our membership is derived.

At the same time it is a matter of serious regret that certain of the states are not better represented in point of numbers. In this connection I may be excused for taking the liberty of urging upon all whose names are on our roster, the need of continued and earnest effort in behalf of the society.

These efforts should not be limited to securing an increased membership, but quite as much to the guarding of our portals against the unworthy.

Let us at the outset create, and, as time goes on, carefully maintain a standard which shall prove a factor in support of the best ideals in medical ethics in the New West-a standard which shall at the same time be a menace to the disreputable, and a comfort to every reputable element in medical practice.

The suggestion is respectfully made that this association, as soon as practicable, place itself in position for positive, effective

*Read at the Rocky Mountain Inter-State Medical Association, Butte, Mont., Aug., 1900.

effort, along certain lines looking to a general betterment of conditions vitally affecting the relation of the medical profession to the laity.

EDUCATION.

Medical education, considered from the present status, necessarily involves a fairly liberal collegiate course, as a basis for the study of medicine. The time has passed when the dullard boy whose mental endowments prohibit him from entering the other liberal professions, may be pushed into the study of medicine as a dernier ressort with any hope of success. The young man who cannot or will not possess himself of a good primary education should be discouraged from beginning the study of medicine.

During my own medical student days the curriculum of study, as well as the methods employed, were very meagre compared with the requirements of to-day. These changes in methods and requirements have been brought about through a sentiment inspired by the active practitioners themselves, and this sentiment has been cultivated and voiced through societies like this, aided by the medical press of the country.

The fad of starting medical colleges and journals in every ambitious young Western city should be discountenanced and aid given only to such institutions as exist on a sound basis, with conditions and facilities for work, which appeal to our judgment and guarantee satisfactory results to the conscientious student.

Habitual post graduate study is a sine qua non to success. Discriminate reading of carefully selected journals; careful analytical study of individual cases as they present themselves; systematic recording of history, diagnosis, treatment, and results for subsequent use; occasional visits to the great medical centers for purposes of study; regular attendance upon and participation in the proceedings of medical societies; these are some of the characteristics of the intelligent, painstaking and ultimately successful physician, and mark an epoch in medical education of recent years-in striking contradistinction to our forefathers whose opportunities were less than ours.

HOSPITAL WORK.

It is gratifying to note a growing tendency in the West to make use of hospital facilities and graduate nurses in caring for patients. The average hospital of a quarter of a century ago was as unlike the average hospital of to-day as was the kind, motherly "natural nurse" (with an intuitive disregard of dirt) of that period, compared with the bright, wide-awake, up-to-date aseptic nurse, who seems so essential an adjunct to the modern practitioner. Heretofore the country general practitioner has been satisfied to give his patients such attention as he could under adverse conditions, or send them to the

city specialist, who had hospital facilities and trained nurses at his disposal. Nowadays nearly every county seat has a public or private hospital with skilled nurses in attendance, where all but the more formidable and intricate cases may be well cared for.

These remarks are not intended to decry the value of specialism, but rather to emphasize a modern innovation which is a direct result of more frequent intercourse and exchange of thought in the various medical organizations, not only in the West, but throughout the country.

COMMERCIALISM AND CHARLATANISM.

Time will not permit of more than a brief allusion to what is a constant and growing danger in our profession. In almost every community may be found physicians who are considered at least semirespectable-many of whom are in affiliation with medical societieswho in the stress of competition, and their eagerness to make money, are willing to prostitute their calling by undignified and disreputable methods. Abortionists, under the guise of specialists, men who are not averse to personally soliciting business, and those who have paid agents and "heelers," as well as those who for the sake of business accept half fees, are exceedingly common in most communities. Contracting by the month or year at nominal rates, for family practice, giving and accepting commissions for cases sent or received, commissions from druggists, false statements to patients and their friends for the sake of personal gain, the various phases of advertising one's superior skill, and the want of ability of a competitor, consorting with Christian Scientists, Osteopaths, Faith Curists, etc., for the sake of popularity with a class or sect, claiming to practice homeopathy, allopathy or eclecticism as individual patients desire these and other similar attributes mark the quack and deserve the condemnation of honest physicians and should be frowned upon by medical associations such as this..

MEDICAL LEGISLATION AND EXAMINING BOARDS.

Some of the new Western states have been pioneers in enacting excellent medical laws, which, under existing conditions, are standing the test. The standard of requirements in Colorado, Utah, Idaho and Montana is on a footing with such states as Illinois, New York, Pennsylvania and Ohio, and the state examining boards are similarly organized. The crying need in this connection is for interchangeable state certificates in states where the lgeal requirements are practically the same. To accomplish this, federal legislation is necessary, and in the opinion of many who have given the subject attention, such legislation should be in connection with the establishment of a national board of health.