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the physician of former times attacht an undue excluded. Severe lacerations of the cervix are importance to the value of these three series of perhaps the next most frequent causativ factor. phenomena, on which his diagnosis and prog- Another class of cases often presents this feanosis—and, of course, his treatment-were in- ture: Those where the mother or father, or evitably based. For him the tongue was the both, are in a poor state of health—where the mirror of the stomach. Its mucous membrane vital forces of both are at a low ebb at the being an essential and a specially sympathetic time of conception and subsequent to such portion of the lining of the digestiv tube, its conception; and, also, where there is an uncondition unfailingly indicated that of the questionably “strumous" diathesis. In the latter-more particularly of the stomach, to latter case no better proof of the actual causawhich was attacht the leading role in the proc
tiv factor could be desired than the therapeuess of digestion. If the tongue was heavily tical test; i. e., a thoro course of “anti-strufurred, the gastric surface was also loaded with mous" medicin. This generally produces a detritus, and an activ emetic was required to complete absence of the accident if the attack free it of its objectionable coating. This often has been energetic enuf and properly managed. gave considerable relief, but when it failed to In the syphilitic cases it may be noted that the do so, as frequently happened, the process was tendency is toward a spontaneous relief from repeated again and again, sometimes with grue- the misfortune. After a number of abortions, some consequences. In a recent communica- it will be noted that the product of conception tion (Gazette des Hôpitaux, September, 1903), is allowed to remain longer in the uterus before Drs. Mathieu and Roux have critically exam- the expulsiv efforts are set up, however more ined the value of lingual diagnosis, and clearly deplorable may be the physical condition of pointed out the reasons of its frequent failure. the later fetus. In the strumous type the age They point out, following Laségue, that the of the fetus becomes progressivly less at each tongue is really a muscular mass, covered by abortion, unless some radical treatment lookmucous membrane. And they further proceeding toward the upbuilding of the health of the to indicate the important fact that the invest- parents is undertaken. in the syphilitic type, ment of this organ is really a false mucous the abortions are usually accomplisht with difmembrane, derived from an invaginated proc. ficulty or with some such complication as an ess of the external layer of the blastoderm, adherent placenta,obstinate hemorrhage, failure and not, like that of the gastro-intestinal sur- of contractil power in the uterus, etc.; in the face, from the inner layer of that structure. strumous type the abortions are easy and quickly Accordingly, in pathologic processes, it com- completed as a rule. ports itself more like a portion of skin than of In recurrent abortions the possibility of memucous membrane. On this account, the chanical interference is always to be thought of physician must be guarded against attaching whenever the causes enumerated can be exclutoo much importance to the information ded. Many women will repeatedly induce yielded by the time honored examination of abortion on themselves, even when they have the tongue.
The general conclusions at which begun to feel the baleful effects of such pracDrs. Mathieu and Roux have arrived are: (1) tises upon their weakened constitutions, rather The lingual mucous membrane is really a pro- than undergo the throes of labor or think of cess of the cutaneous investment of modified “sacrificing themselves" (?) to maternal cares. structure ; (2) its furred condition is the result A properly stern demeanor on the part of the of an “ excessiv abundance" of filiform papil. physician will often bring these cases to a las, which form a dense thicket over its sur- prompt confession when warnings of the evils face; (3) its (raw or) desquamated condition to come would have no effect. If they are is usually the result of a form of superficial allowed to see that the physician suspects that dermatitis.
they have been guilty of producing the repeated
abortions and of deceiving him as to the cause, Habitual Abortion : A Misnomer. an accusing conscience will oft-times work an Habitual abortion, as a medical term, should amazing change of heart. be allowed to drop out of use. It represents In those cases which will not in any measure a theory which is no longer tenable; i. e., that conform to any of the classes given above, and the uterus falls into a “ habit” of emptying it- in many of them which fall in direct line with self at a certain period of gestation. The term such classes, ten grain doses of chlorate of “ recurrent abortion," as suggested by Taylor, potash, three times daily, continued from the is much better. There is always a cause for third month of pregnancy until its termination, recurrent abortion, and it is generally a cause is declared by Taylor to be efficient in checkamenable to a remedy. Syphilis is the great ing the “habit." and most frequent cause, yet many of us see
Calcium chlorid, 30 grains to the ounce, is one of many cases where syphilis can be absolutely our most efficient local applications in hemorrhage.
· grs. ivss
A Common Fault.
Hoff's Prescription for Consumption. There is a habit common among the profes- We have met the gentleman who made the sion which is a relic of the darker days of med- first “batch” of this preparation in this icin. We refer to the habit of prescribing such country. When he saw the article on page drugs as we know will derange digestion and 246, June WORLD he said, “ Give it to those assimilation, without having fully considered fellows; they are frauds.” When he saw the whether the exigencies of the case demand such prescription on the above mentioned page he harmfully meddlesome procedures. In the
said, “ The prescripton is all right. Dr. Hoff times when knowledge of physiology, of the lives in Vienna, and that accounts for the diffirules governing digestion, of the manner in culty of an American deciphering the prescripwhich drugs really acted when ingested was tion as written." Here is the prescription in very limited-in short, in the days of
plain English as he gave it to us. Turn to the piricism, the physician was not expected to above mentioned page and compare with the think of these things. His entire duty ceast following: when he had made an attempt at diagnosis, and had prescribed his crude drugs in sufficient
Arsenious acid .
· grs. iij quantity. But it is not so now. With our in- Cinnamic acid. creast knowledge our responsibility has in- Distilled water
m. lxxv creast. Now the thinking man realizes that Boil until a perfect solution is obtained, and add drug giving, without full consideration of the
. m. xxxviij ultimate effect of such drugs on the various pro- Aqueous ext. of opium cesses of the body, is often a very injurious
Mix and filter. plan. We know that study of the dietetics, physiology, and the hygienic considerations Of course this is not made in separate preinfluencing a given case, is frequently of greater scriptions as above, but it is made in large importance than the mere giving of drugs. quantities, keeping the above proportions, After diagnosis has been made, and remedies bottles being filled by the dozen or gross from prescribed, it is yet necessary to consider what the tank, and sold like any “patent." The effect the " indicated” remedies will have special feature is the cinnamic acid. The genbeside that of relieving or masking the symp
tleman referred to above gave as the cost of toms. The thoughtless practician who pre- each bottle, about two cents; retail price $1.00 scribes opium in every case of diarrhea, while -worse in this respect than the copyrighted he may often succeed in checking the diarrhea,
acetanilid mixtures. will often fail ignominiously, and will often have a much sicker patient after the medicin has been taken than before. A little bit of
Speculations Again. thought would have suggested that, inasmuch Did you ever know of a single instance as this case of diarrhea is due to intestinal in- where anyone who took “a flyer" in any of digestion, very probably accompanied by the numerous speculativ schemes that are advermasses of undigested food and putrefying feces tised in circulars sent to doctors, in which the within the intestinal canal, the logical proced
oo small investor" did not lose his money? ure would have been to give a flushing purga- In short, did you ever know of a single instance tion. In certain acute cases of rheumatism we that succeeded according to promises? Did admit that it is necessary to give salicylic acid you ever know of a single instance in which in enormous quantities, for it is then a question the investor even got his money back? Did of saving the heart before the rheumatic poison you ever know of an instance that was not a has permanently destroyed it; in malignant total loss ? Yet some people think it is malarial infection enormous doses of quinin “smart” to “ dabble in stocks,” and “take a must be given; in a few other instances seem- flyer" occasionally! Isn't it a supremely ingly reckless therapeutics is justifiable, but the foolish thing to do? instances are rare.
I must quote here a sentence in a letter from We plead for a more rational practise along one of our subscribers: “A pen made from a such lines We have all been taught that “if quill pluckt from the wing of an angel and doubtful of being able to do good, make certain dipt in the colors of the rainbow, could not of doing no harm.''
induce me to part with another $."
And this from another subscriber. “MinIf you are afraid of the forceps because you do not
ing stocks are generally more worthless, and know how to employ them, you will fail to “fill the
even more fraudulent, than lottery promises." bill” in many cases. If you fear them because you But here is something rich. Among the know what they have done in inexperienced hands, and yet can use them when necessary, your patients are
many things sent to me is a large, four-page fortunate.
circular, one page of which is occupied by an
imitation type-writer circular to doctors ; here want more. To show you what a good return is a part of it:
it is, suppose you try paying it awhile ; you will DEAR DOCTOR :-Some time since, while the writer
find it to be quite a burden. But the main was chatting with the business management of the
thing is safety. When you earn your money, New York Office of the U. S. I. of Boston, the local you want to get the good of it yourself. Think management, Mr. B, as he was running over a quan. tity of recent mail, remarkt “Doctor, Doctor," and
of you trudging around in the rain, mud and turning to the writer, he said: “I have more inquiries darkness earning more money, while some from men of the medical profession than any other swindler is drinking champagne on the money class of people, and I believe that they are the greatest buyers of mining stock.” Being imprest with the
that you previously saved. remark, at the first opportunity I ran thru the stock ledger of the
Mining and Commercial Company, of which company I was and still am the secre
The Removal of Skin Cancers. tary, with a view of ascertaining how the medical profession was represented in my own company, and I The general practician must continually found it as a class to have the greatest representation. Prominent among them are (a number of doctors are
strive to perfect himself in every branch of here named) and many others. The thought occurred practise, or progressivly lose prestige and see to me: Why does this class take more kindly to the his patients drift to the quack or to the spepurchase of investiv securities? I found this answer to the query–First the ratio of their earning from
cialist. Perhaps there is no simple procedure their profession rank high among the professional more generally ignored than the removal of incomes; secondly their employment and profession growths upon cutaneous surfaces. The markt gives them little time to study or look after the average business venture; thirdly, the returns from
tendency to recurrence of malignant growths, loans and real estate investments are so slight, aver- and the possibility of benign lesions assuming aging about 3 percent per year, that there is little incentiv to make such investments. For these reasons
a malignant form, seem to have so horrified the they look kindly upon stocks that are safe, offer a average practician that he is anxious to refer greater return in dividends and are accompanied with the patient to the specialist, or willing to see no personal anxiety or risk. I then askt myself the question: Why not go
them writhe in the horrors of the quack's treatwith my investment direct to that class most willing
ment. to give it consideration? (Then the letter goes on with If the real facts were known and appreciated its argument.)
by the profession, such conditions could not This gives doctors a chance to “ see them- mantain for any length of time. Moles and selves as others see them.” Look again at warts are easily removed by simple measures, those three reasons, the second one, partic- and, even epitheliomas yield gracefully to the ularly: “Their employment and profession strong caustics. Shrewd men study the tactics gives them little time to study or look after the of their enemies even more than they consider average business venture." How true! This their own, and it is the duty of every pracis why they are so “easy." A business man tician to learn all he can of the means and would look into the matter and see the bottom methods employed by both the specialist and of it, and then he wouldn't go in; and what a the quack; of the specialist that he may imbusiness man does go into, he “looks after" prove and perfect his own knowledge, and of to see that there is no cheating. That's the the quack that he may save himself loss of kind of men that the usual mining company patients and be able to explain their reckless doesn't want. They want
ones, treatment and nefarious schemes. like doctors; and it is sad to say, they get
It is along such lines that the general practhem. Are you one of them ? If not yet,
tician must do battle for existence. how soon do you think it will be before you not hope for relief in legislation or diminisht are roped in. Promises will be bright and competition. Competition will gradually grow positiv; will you “tumble"'? The chances more stern, and the struggle for supremacy are that you will, unless you keep the counsel yet more bitter, until even a modest living will of The Medical World before you all the not be within the reach of the inefficient practime, particularly at the critical moment. tician. And when will I ever get paid for saving all of The patient must always risk the results of this money to the medical profession? In treatment, and the chances are that he will heaven, I suppose ; but if the few rag-tag tail take vastly lesser chances in skilful hands than enders will pay up their subscriptions, I will be under the ministrations of the quack. The satisfied here and also if our many friends qualified specialist will handle the case scienwill influence new subscriptions for us.
tifically, and if you mantain your position, you Now look again at the third reason.
You must learn to do as well. Neither you conought to be able to lend your money in your science nor the law require more of you than community, with good real estate security, at " reasonable knowledge and skill.'' Any an interest of at least 5 or 6 percent. True, graduated physician may attain to vastly more you can't "get-rich-quick" at that rate, but it than such a degree by study, attention, and is a fair rate of interest, and you shouldn't work. If you do the studying and give due
He can see it
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, 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 Doc” would, 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, is 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 Briet.
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
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
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. As 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 instructions, 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 enut to express the return of fabuall other medical societies! It seems that the
lous wealth to the investor. editor would like to see the profession put back
Your course toward the Brief is that which should 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 transof 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.Ú. 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 word of which is molded to the interests of adver
find $1.00 in payment of subscription for MEDICAL
World for 1904. I have so many journals to read, tisers. Keep right along in the path you have mapt out. Stonington, Maine.
regular, homeopathic and eclectic, that I have thought B. L. Noves, 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, Brief merits the approval of every physician worthy
has decided me to stick to THE WORLD if I have to the name.
T. M. STIXRUD, M.D.
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 honesty tising 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.
S. 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.