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attention, you will have patients who will into the dark ages, if that would help him to furnish the work.

push his proprietaries, and perhaps it would. Many practicians are too dignified (?) to act And he can hire medical college professors as beautifiers. The best paying work of the and foreign hospital men to help him do it, as specialist is generally “cosmetic" in char- is plainly evidenced by the last two issues, I tho acter. We would rather be less ignorantly the most of the contributions by these disdignified ; would prefer to know more, earn tinguisht men are not of much interest or money, and benefit humanity. The patient of value to the busy family doctor, an unduly average intelligence will have more appreci- large proportion of these articles being on eye ation of the value of your services if you can diseases, and similar subjects outside the genremove a mole skilfully, than he would if he eral field. But the object being to get the knew you could remove the lime from athero- name, and supposedly the influence, of promimatous arteries. But this is not the greatest nent medical men to bolster up a proprietary feature. It is often possible to permanently medicin almanac, any kind of an article will remove an epithelioma when it first appears by do. application of caustic; where, if the case be We thought that “Old Docwould, for treated expectantly or neglected, it may once, just for the sake of appearances, give his ghoulishly disfigure the person of the victim, characteristic “Well, boys,” without boosting or even destroy life itself.

any of Dr. Lawrence's proprietaries; but he

don't. Neurilla and chionia come in for his The Brief.

favors this time. I don't receive the Brief any more. The Beginning on page 489 is a thinly veiled WORLD has evidently been cut off the Brief's trap for morphin victims, winding up with a exchange list. But I happened to see it boost for celerina, which, in Dr. Lawrence's prominently exposed for sale to the general family of proprietaries, might be styled as the public at a news-stand on Chestnut street, so I oldest daughter-a nice, respectable girl, the bought a copy of June number. I learned only objectionable feature about her being the from the newsdealer that he handles the Brief way her father boosts her in the reading colevery month, and I see in the magazine called umns, and she cannot be blamed for that. the Bookseller, Newsdealer and Stationer that The “Brief Talks," which according to the the Medical Brief is in the list of “ returnable evidence that comes to this office cost Dr. publications,” which means that any news- Lawrence $5.00 each, are beginning to be indealer can return any unsold copies of the vaded boosters; for example, there are three Brief, thereby taking no risk of loss in hand- boosts in the first column of page 492. ling it. Is the Brief leaving the doctors for Beginning on page 507 is a two page write the general public?

up for papine. was predicted, the editorials in the June We thought that this ventilation would number do not push proprietaries by individual clear the answers to queries of proprietary name as freely as the editorials of a few months boosts, but they still continue—and how long ago did; only one editorial in June issue is will you continue to read them? Seng, celeguilty of this, sanmetto and neurilla getting a rina, chionia, sanmetto, neurilla, iodia, ecthol, boost on page 437; but proprietaries in gen- etc., all get boosts. eral are boosted freely and repeatedly. The How can we, without taking too much space, first editoral, entitled Organizations” is give you an idea of the contents of the big pile decidedly anarchistic. The opening sentence of letters touching on the Brief, that have been is this: “ Organizations have always been an saved out from the subscription department, obstruction to progress and enlightenment." as per our ipstructions, during the past few Is not such a sentiment surprising in these weeks ? We will pick out a few typical ones, enlightened times? The argument goes on as representativ of all the rest, and we will and winds up with a defense of “independent ask you if you don't feel inspired to help clear medical journals." Can the almanac organ medical journalism of the incubus of comof half a dozen or more proprietary medicin mercialism? companies, all owned or controled by the editor, be considered an “independent medi- C. F. Taylor, M.D., Dear Doctor :- I take pleascal journal ?" This and other editorials try to

ure in enclosing my check for $3.00 for THE MEDICAL

WORLD for the next four years, and will add a word of make anarchists of all the doctors who can be commendation for your course in the exposing of thus influenced; the effort is to make every

fakes in medicin and journalism, as well as in the doctor a free booter, not only indifferent to,

various swindles that are made plausible to the busy

physician by slick tongued promoters or circulars that but opposed to his local medical society and fail to find words enuf to express the return of fabuall other medical societies! It seems that the

lous wealth to the investor.

Your course toward the Brief is that which should editor would like to see the profession put back be endorsed by every thinking medical man. When


the Brief reaches my office, which it has done for years supposed everyone could see it. You are doing a good without a request on my part, it is transferred without work, and I am glad you have the courage to show it opening to the waste-basket, for I cannot understand up to the profession. how any one can waste time by reading it, or any other The Christian Hospital” scheme was so trans. of those fake publications that laud proprietary arti- parent that I fired their literature into the waste basket cles. Let the good work go on, Doctor. Right pre- and thought no more about it, until I saw your article vails always, and you will have every successful physi- showing up their whole plan. cian at your back

H. W. HITZROT, M.D. I do not expect you to publish this, but I wisht to McKeesport, Pa.

show my approbation of your work along this line. Sincerely yours,

JOHN J. ORTON. Editor MEDICAL WORLD : Inclosed find postal Randolph, O. money order for $3.00 for four years' subscription to one of the best “all-round” medical journals publisht. [If all members of the A. M. A. would take I admire your loyalty to the profession. You are such a stand for the profession, it would be to right. Show up Dock" Lawrence and all of his kind to the rank and file of the profession. The Brief

their credit. But many, particularly the colwith its noxious "gas” comes regularly to my desk lege professors, cannot muster up sufficient (its "gas." makes fine kindling). We need more of your kind of journalism. Yours, in the interest of the

courage to return a check. The honor of the profession,

W. B. HOOSER. profession is maintained chiefly by the rank Fairfield, Mo.

and file. It is a shame that so many of the I admire the stand The World always takes against leaders of the profession will talk like angels to medical as well as political fraud. I have observed their students, but will forget it all when a check your“ Monthly Talks" ever since you started them. is offered.-ED.] They are "0. K.,' every one of them. Your attack on the methods of the Medical Brief is just in line with the idea I have sustained for years. Doctors are look

DR. C. F. TAYLOR, Dear Doctor :-Inclosed please ing for true, impartial facts, and not material, every

find $1.00 in payment of subscription for MEDICAL word of which is molded to the interests of adver

WORLD for 1904. I have so many journals to read, tisers. Keep right along in the path you have mapt out. regular, homeopathic and eclectic, that I have thought Stonington, Maine. B. L. Noyes, PH.G., M.D.

several times to drop THE WORLD and one other old

school journal, but the stand you have taken against DEAR EDITOR :-I inclose $3.00 for four years' sub

unethical journalism, and your evident sincere desire scription to THE WORLD. Your fight against the

to aid in every way possible the medical profession,

has decided me to stick to THE WORLD if I have to Brief merits the approval of every physician worthy the name.


drop all the other journals. Your political opinions Fort Ransam, N. Dak.

are in strict accord with my own. Am pleased to observe that you are not afraid to attack the methods

of the “Brief,” because it is rich and powerful; you Editor MEDICAL WORLD :-Find inclosed check for will find that it is not quite as powerful as the whole $5.00 for my subscription. I am enjoying your expose medical profession, so adhere to the admirable policy of the proprietary medicin pushers and hope you will you have adopted and we will give you our support. keep on being a "knocker." If it is necessary to help Brockton, Mass.

F. E. LADD. you out, I'll double my subscription, and undoubtedly many others would do the same. I don't know how [That is true. “The Brief is not as strong as the far the $5.00 will carry me, but let me know when there whole medical profession." Dr. Lawrence got his is more due. Only be sure and don't shut me off ; and

financial strength from the medical profession, but if I should die before my subscription expires, you can

what has he ever done for the profession?. His adversend it free to some other brother. Yours for honestytising pages frequently contain fakes and frauds, but and square dealing,


it seems that he cares only for the money that comes Collinsville, Conn.

his way, however much the profession may be cheated; and the reading columns of the Brief-well, the pro

fession is getting "onto" them. Have taken the Brief for more than 20 years, but I'm But maybe the Brief is going to leave the medical done.-DR. J. M. CARLTON, Wet Glaize, Mo.

profession and go to the laity, like antikamnia. A few days ago I received a letter from a man in New York,

asking for employment, saying as follows: Editor MediCAL WORLD:-I will venture two opin- "I understand the Medical Brief is placing their ions relating to the present fight The World is mak- journal on the news-stands, and I thought you might ing against almanac” medical journals: First, the use a man in the same capacity." Editor will come out of it with more professional I did not answer the letter. THE WORLD belongs friends and consequently more subscribers than he to the profession, and not to the laity; and it is deentered with. Second, that THE WORLD has more voted to the interests of the profession. long-time subscribers than any other medical journal Query : Will the medical college professors and publisht. Honesty and consistency are jewels most other “high-up" members of the profession continue people recognize on sight, even tho scarce. It is in- to write for the Brief, even if it goes to the laity? Yes; sulting the intelligence of the profession to ask its for unfortunately some of the biggest "grafters" are members to pay $1.00 per year to a journal teeming, in the upper ranks of not only our profession, but of from end to end with puffs (slightly disguised) of every other profession. They talk the loudest of high proprietary articles owned by the editor. I believe, ethical standards, and are the first to violate them all. Mr. Editor, the profession will stand by you in your The nice talk is meant for the students; but there is attack on this form of swindle the same as it has in the a wide difference between their preaching and pracpast on get-rich-quick investment schemes. In the lat- tise. Of course this does not apply to all the profester you did the profession a service, the value of which sors and other eminent men in the profession, but that no one can estimate.

9. M. MANN, M.D. kind of men can easily be found in this class. Grafton, Iowa.

The moral stamina of the profession exists in the

ranks more largely than in any other class; it is with DR. C. F. TAYLOR, Dear Doctor :-Inclosed find a this class that we cast our lot and plight our faith. letter from the editor of the Medical Brief, which ex

-ED.] plains itself. I promptly returned the check with thanks, saying that, as I am a member of the A. M. A., I could not accept the offer.

There are many other excellent letters that we The real object of the Brief is so apparent that I would like to quote from, but space bids us call a halt. Several more letters have been received from Dr. so evidently they have chosen the wiser course, B. M. Jackson, of Omaha, Neb.-you know upon what subject, for I never knew him to write on any but one

and have concluded to “ quit," at least for the şubject. We cannot give space to these letters. This present. But after “resting on their oars" is not only my judgment, but it is also the earnestly

awhile, they will think that the effect of our exprest wish of a number of our readers. There is one point, however, in a letter from him dated May 19, exposé has “blown over," and they will begin which I must recognize and meet. His letter starts putting out their lines again, and try to sell out this way :

their 65 cent “ certificates," decorated plentiSir: I am informed that you graduated from a medical college which organized less than one year, prior there-to. Is this correct? fully with tinsel and blue ribbon, and gotten After you graduated, did any one hold you up for an examination or a $60 fee?

up to look like diplomas, for from $15 to

$25, to the foolish or vicious hangers-on to There are four pages of this letter, but the above is the point that I want to meet, and meet it squarely.

the medical profession, with which to deceive Yes, the statement is true. It was my final course. I the public. This kind of business can't go on had' attended medical college before, at Louisville, Ky. Before going there I had read medicin about

in the medical profession as long as the present three years, under preceptors, as was the custom at

Editor lives and controls THE MEDICAL WORLD. that time. After the course at Louisville I did about If any WORLD reader receives literature from a year and a half of practical work, and then came up for a final course and graduation at Indianapolis.

the “Christian Hospital," he is requested to The college chosen was the Central College of Physi- send it here immediately. We have stopt this cians and Surgeons, then newly organized. I was nefarious certificate selling game, and we will attracted to that institution by the able Professor of Practice, my friend the now lamented Dr. G. C.

keep it stopt. If you know any doctor, or Smythe, of Greencastle Ind., and by the distinguisht pretending doctor, who has bought one of these surgeon, Dr. Joseph Eastman, who only last year passed to the silent majority. But the college, like

certificates, make him so ashamed of it that he John Brown's soul, “goes marching on," and has

will be glad to burn it up. made a record that every graduate may be proud of.

No, I was not " held up” for a State examination, Do You Want to Buy a Degree ? nor an examination fee, as that was not the law at that time. If it had been I would have obeyed the law as

A correspondent sends to Amer. Med. a I have always tried to do. My associations and incli- letter from a socalled college in Detroit, nations have always led me to be patriotic in my pub- which is self explanatory. lic relations, and true to the profession and its highest ideals, in my professional relations. Not that I believe Doctor, Being Fin. Sec., of above, from March ist I in passivly lying down” and have no independent desire to inform you we are just now Issuing Honay opinions. I think my record shows that I believe in Degrees to some of our best V. S. &c. Prof. and men independent criticism in order to advance healthy up in standing. Knowing of your medical standing progress; but I believe in patriotism first.

and profession if you are of the Desire and looking for As to being“ held up" for a $50 fee, I here append LL. D., in Harness, write me Early when I will send

i the examination fees required by the different States :

Rekord of data" for filling out for the board EXAMINATION FEE.

EXAMINATION FEB. to pass on, the only expence $10 for Issue of Same. Alabama......

$10 00

New Mexico ........... $25 co Waiting a kind reply I am Dear Doctor
New York

Yours Very Respectfully
Arkansas ................** TO O
North Carolina.............. 10 00

E. M. LL. D. California

Fin Sec Colorado

The Board may, in

Fourth of July Injuries.

its discretion, dispense District Columbia......... 10 OO with the examination in

In treating contusions and lacerations caused Florida

case of a physician Georgia

duly authorized to

by 4th of July explosivs, be sure to open the Idaho........................... 25 00

practise in ancther

wound freely, and allow free drainage. Illinois

State; in which event Indiana ....................... 25 00

the license fee is $50, shock of the explosion frequently causes disIowa

accompanied by cer. Kansas.

tificate or license issued

turbances not visible on the surface, far from the Ky. (registration fee)....

by such other State.

visible seat of injury; particularly is this true Louisiana

Oklahoma............. $ 5 00

of injuries of the hand, the most frequent part Maryland ..... Pennsylvania....

injured, the shock following the sheaths of Massachusetts.

Rhode Island
South Carolina

tendons. These deep injuries, and possibly Minnesota

South Dakota..... Mississippi .............. 10 25

deep implantations of gun powder, are very Missouri


15 00 likely to cause tetanus if not freely and comMontana.

...... 15 00

Utah Nebraska (graduates of

pletely opened. Nebraska College $10,

Virginia all other applicants Washington,

In June WORLD, page 231, second column, $25.)

West Virginia Nevada .......

29th line from the top (about the middle of New Hampshire............ 10 00 New Jersey............. 25.00 Wyoming

the column), by some slip the word aristol got in in place of aspirin in some of the earliest

copies printed. If you have one of these, take Traffic in Tinsel.

a pencil and cross out aristol and write aspirin Please refer to the remarkable letter from N. in the margin. News Wood, on page 243, June WORLD, and our reply on the following page. No suit has been The itching of eczema may be relieved by painting entered, and no more vi Christian Hospital

the affected part with three percent aqueous solution of literature has been received from our readers ; lesion.

potassium permanganate and allowing it to dry on the

you a



25 00

20 00

North Dakota....

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15 00

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........................... 15 00 Vermont

5 00 ................. 10 00

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Wisconsin-must not ex-

20 00
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***..... 25 00





ORIGINAL COMMUNICATIONS hypertrophy, a normal sized gland or even

atrophy. Prolonged obstruction, complete or Sbort articles of practical help to the profession are solicited for

partial, results ultimately in relaxation and enthis department.

feebleness of the bladder itself, progressivly Articles accepted must be contributed to this journal only. The less expulsiv power, and less ability to resist or editors are not responsible for views expressed by contributors.

recover from cystitis, which after several interCopy must be received on or before the twelftb of the month, for publication in the issue for the next month. We decline

mittent attacks becomes chronic. responsibility for the safety of unused manuscript. It can The inflammation extends into ureters and usually be returned if request and postage for return are

received with manuscript ; but we cannot agree to always do so. kidneys, and the patient dies of uremia, septiCertainly ül is ercellent discipline for an author to feel that he must cemia and the exhaustion from pain, and from

say all he has to say in the ferest possible words, or his reader w rure to skip them; and in the plainest possible words, or his

being deprived of rest by day and night. reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want

The indications are to remove the obstrucdosenright facts at present more than anything else.-RUSKIN. tion, retain all tissues necessary to preserve

normal functions, and drain the bladder if

there is cystitis, and there nearly always is. The Principles of Prostatic Obstruction and Early operations removed all the prostate. In its Relief.

this they exceeded the requirements and caused Editor MEDICAL WORLD:—The prostate the few post-operativ complications, incontigland lies against the outer surface of the apex nence and permanent fistula, for, as I menof the bladder, and the urethra passes thru it tioned earlier in this paper, the prostate lies as do also the seminal ducts. There are against the neck of the bladder and more than strong layers of pelvic fascia on both sides of it, half its bulk is of muscular fibers surrounding above and below, which hold it firmly from the beginning of the urethra and continuous underneath. They are part of the pelvic floor, with those of the vesical sphincter. Their which in man is very firm and unyielding. removal deprives the man of that much ability

It consists of glands, fibrous tissue, and to retain his urin directly, and indirectly still muscle in varying proportions, and has scanty more by weakening the insertion of the sphincblood supply itself, altho to reach it one has ter fibers. Also, when the whole of the prosto cut thru plexuses of veins which are just tate is removed, it is in some cases impossible outside its capsule among the layers of support- to avoid removing a strip along the floor of ing fascia. It greatly imfluences an operation the prostatic urethra, which still further weakens that three-fourths of the normal prostate is the power of retention, as that divides all muscle, which is continuous with the vesical sphincter fibers in that region. Furthermore, sphincter, and assists in controling urination. it removes the ejaculatory and seminal ducts,

The enlargement which occurs in men of which are within the prostate near the median advancing years can cause protrusion upward line and behind or below the urethra, and I and backward only, because the pubic bone is have learned that men of 65 and 75 are very in front, and below the support of pelvic unwilling to be deprived of them. fascia and levator ani muscle cannot be over- The methods of operating depending upon come. Therefore, a large prostate encroaches cauterizing grooves thru the obstruction are almost entirely into the bladder and somewhat faulty. They fail in cases that do not bulge upon the rectum. The overgrowth may be into the bladder, but obstruct by pressing general and symmetrical, and then causes very along the urethra because they do not always little obstruction or retention, but usually it is relieve and do not prevent recurrence. They in irregular lobules protruding anywhere they are dangerous from hemorrhage, shock, and can, like uterin fibroids composed of many post-operativ septicemia, and they fail to prolittle tumors. If one of these presses against vide continuous bladder drainage, an essential the urethra it causes partial or complete in the majority of cases. Supra pubic operations obstruction; if they make it crooked they do may be done upon enlargements that are entirely

Sometimes a little mass with a long within the bladder, but as no one can determin slender pedicle hangs just where it blocks the before long whether they are, they are very poor passage, and all the rest of the prostate is surgery. The perineal incision and exploranormal.

Quite often there is a thickening tion of the bladder by one finger passed thru of tissues around the beginning of the prostatic an opening in the membranous urethra is the urethra that has contracted so much as to only way by which one can know the condicause retention, and is so rigid that it cannot tion of the whole prostate. It also enables the voluntarily be relaxt. In any of these condi. operator to discover any complications within tions the catheter is required frequently, per- the bladder and remove one that is curable, haps cannot be dispenst with at all, and only such as stone or tumor. Thru the same inpart of them are hypertrophic conditions. cision in the urethra a retractor is passed by Examination by usual methods may show which the tissues are controled during opera

the same.

tion. Only enuf of the prostate is removed and burning are more or less intense. The to cure the obstruction and prevent liability papules soon become pustules, their bases are to recurrence. Complete removal is un- somewhat indurated, and where the papules necessary. It is especially important to leave are close together the part is red and swollen. the prostatic urethra uninjured and preserve in The eruption lasts from five to ten days, the its normal condition that part behind and be- scabs drop off leaving a redness, which grad- . low the urethra, which contains so many ually disappears, with little or no pitting. sphincter fibers and the several ducts. This The temperature is practically normal after the conservatism constitutes the latest improve- pustules are all formed, the appetite gradually ment in methods; it perfects the operation; returns, and the patient makes rapid and uneand its elaboration is largely due to Dr. Hugh ventful recovery with practically no treatYoung, who also invented instruments to make ment. It is very evident that it could not be it easier. The bladder must not be opened, as smallpox, as one man had it who had smallpox that accident adds the danger of permanent about 12 years previous, and others had it who fistula.

had been recently successfully vacinated. It is The deformities upon which the symptoms just as improbable that it could be chickenof this condition depend are now well under- pox, and I was therefore glad to see it named, stood; so also are the indications upon which as the medical works are silent on the subject attempts at its relief are based. The princi- so far as I could learn. ples of the operation are thoroly and finally It is supposed that the soldiers returning establisht, and it is not to be expected that from Cuba and Manila brought the disease to they will ever be materially changed. In the this country, and it has been called Cuban future if any improvement is introduced it will and Manila itch, also called Dobie or Dohbie be in methods of arriving at the same results itch by others. I understand that quite a now secured by those we have.

number of ex. soldiers were employed in the Old men in great numbers are suffering mines at Tonopah, Nev., where it started, and from this condition and looking to us for cure. on account of no quarantine laws being enUntil recently they have lookt in vain, except forced it was allowed to spread to other towns those in its earlier stages.

At last we can
in this vicinity.

E. T. KREBS. assure them of relief and comfort as surely and Bridgeport, Cal. safely as anything in reparativ surgery, and secure to them freedom from physical suffering Intra-uterin Douches.-Charging Clergymen. so that their declining years may be prolonged Editor MEDICAL WORLD :- In the current in peace and conteniment as the close of life number of your journal, several cases are reshould be.

William B. JONES. ported in which high temperatures followed the Rochester, N. Y.

use of intra-uterin douches.

The reporter

draws the correct inference that, in some manPemphigus Acutus Contagiosa. ner, the douche is responsible for the rise in Editor MEDICAL WORLD :-The article on temperature. He also advances several queries pemphigus acutus contagiosa by Dr. Ross in as to the rational explanation. the May World interested me considerably, Nearly two decades ago, when I began for the reason that the very same conditions practise, intra-uterin douching, in puerperal existed in this remote section of the country as cases, had reached the high water mark of its he experienced in his section. Likewise some popularity. I frequently saw this treatment called it smallpox of a mild form, others followed by chills and high temperatures. I chickenpox, etc.

have never found but one explanation that apThe onset is more or less gradual, with peals to me as being rational. About ten malaise and general weakness for from three to years ago a writer, whose name I cannot resix days. Then headache, at first slight, be- call, publisht a short article in the Philadelphia coming more severe until the eruption appears ; Medical News on this subject. His view was also pain in the back with chills and chilliness, that the disturbance is due to the fact that the anorexia, disordered digestion with nausea and douche is usually hot. The high temperature fever between 102°and 103.5° F. These symp- of the douche causes a prompt condensation of toms last about two to five days when the erup- the uterin tissues and contracts the blood vestion appears, first on the sides of the nose and sels and lymphatics. What is the result? A the contiguous part of the cheeks, then rapidly sudden and considerable decrease in the drainappearing on the forehead, neck and all over age. The general circulation is suddenly the body, even on the palms of the hands and overloaded with septic matter, and the chill the soles of the feet and on the mucous mem- and high temperature are the necessary result. brane of the lips in severe cases. The erup- This reasoning appeared logical to me. tion is about the size of a split pea. Itching have never used a hot intra-uterin douche since

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