tion is far from being satisfactory, he often has only himself to blame, or some of his brother physicians, or both. The true, up-to-date therapeutist understands that to become such it is necessary to dispense his own drugs. and thus know exactly what he is giving, watch its action and remain in touch with his drugs. He understands that the prescribing of patent medicins is a curse to the medical profession, as well as to the public, and can only be favored by such physicians whose knowledge of therapeutics is very, very limited. The prescribing of proprietary medicins or compounds is another practise to be condemned. The true therapeutist knows that it is not desirable to prescribe compounds. Drugs should be dispenst by the physician himself, given to meet the indications of the individual case. In this way the physician cures his patients, his prescriptions do not become public property as they often do otherwise, and he gets the cream of the financial part, while in prescribing the druggist often gets the cream and the physician the skimmed milk. As professional men we should, not alone for our sake, but for that of our brother physicians as well be liberal, upto-date, and business men as well. One school of medicin has as much right to exist as another; the object is, or at least should be, to heal the sick. By studying a drug in its entirety the strained feeling existing between the members of the different schools would soon

be a thing of the past. Laws are needed to protect from christian and mental scientists as well as fakirs; to prohibit the sale of patent medicin containing narcotics in any form; to require any dealer to pay liquor license to sell patent medicins containing so much alcohol so as to be justly classed as liquors.

The practise of giving services to members of fraternal societies at starvation fees is a practise that cannot be too strongly condemned. It is a disgrace to the medical profession. There are enuf to look after for physicians of all schools for their mutual benefit, instead of wasting time in antagonizing each other, to the detriment of the whole medical profession. Last but not least, be a good collector. Los Olivas, Cal. F. J. PETERSEN, M.D.

"Should Doctors Charge Clergymen ?" Editor MEDICAL WORLD:-Yours of May, 1904, has just come into my hands, and I, a Baptist preacher, have read it thru with unabated interest. The query named above has often occupied my mind and weighed upon my heart. Your heroic profession is closely allied to my vocation by the Great Preacher and Healer, as His words testify: "Preach the Gospel and heal the sick." My ministry has

been confined to South Carolina, Georgia and Alabama, and no physician has ever allowed me to pay him a dime. A reply characteristic of them all is that of Dr. A. C. Forster, Georgetown, S. C., a quotation of Hamlet's words to Ophelia: "Nymph, in thine orisons be all my sins remembered." I sympathize with "Frank," your correspondent from South Dakota. The preacher who attended the burial of his wife, etc., and charged him fifteen dollars, was (let us believe that he is dead, as he deserves to be) a mere masquerader in ministerial garb. May his tribe rapidly decrease to the vanishing point, and may a bottomless hole swallow that! Suppose the Doctor had only chosen to use his infinit resources of invectiv e.g., to cry out when the bill was presented: "You miserable mockery of a The stomach was your father, the colon your mother, and the rectum your birthplace.'

man!

A doctor can make himself a dangerous animal; yea, verily and amen! But the skilful doctor has no truer friend than the real minister, who is ever ready and generally competent to act as a trained nurse in cases of necessity and emergency. Moreover, the doctors should ponder the words of the Iron Duke who conquered Napoleon: "We lost a thousand men, in the Peninsular Campaign, for lack of ministers in the hospitals to speak constantly to the sick and wounded, the great, heartening words of the Bible." About the true minister there is ever an atmosphere elemental in faith, hope, love-and peace! And when the faithful doctor is dead and gone, his children's friend, faithful and persistent, is the "Man of God," the "Servant of Jehovah." Even in his lifetime not seldom comes a case like this: "Doctor," said his pastor one bright May morning, "if you saw a daughter of mine, just blooming into womanhood, flattered and courted and tea-ed and party-ed by one you knew to be a wicked woman, would you warn me?" "Sir," replied the doctor, in deep, hoarse tone, "at the risk of my life." "Then," said the minister softly, as he turned his head aside and brusht away a tear, "I should know that you were indeed my friend.” The doctor's eyes were opened, and Miss Jennie, his daughter, is today a happy wife and mother instead of-but we may not think of what she was fairly on the way to be. My own home was long the cherisht sheltering-place for my "family physician's" daughter, whose father had lost his thousands and his broad acres, and gone himself to the silent land. She wanted nothing in my power to supply, and her welcome in my home would have never worn out. Charge us, dear doctors, if you will, and God will enable us to pay you in

Pinopolis, S. C.

[A pretty good sermon.-ED.]

The Treatment of Syphilis. Editor MEDICAL WORLD:-In a general way the treatment of syphilis has been but little modified by the introduction of the activ principles. In fact with our present knowledge of the disease and materia medica, any radical change would be impossible. However, one great point has been gained: The activ principle therapeutist has finally demonstrated that the effect hitherto gained by the exhibition of mercurials can be obtained in less time and with much less mercury by giving the patient stillingin. At the same time the reparativ processes have been stimulated and the excretion of waste matter augmented by the free use of nuclein and tonic eliminants.

Apart from these features, the principles of the alkalometric treatment had already been adopted and there remained for the dosimetrist merely the substitution of more positiv and accurate preparations. The anti-syphilitics being chiefly mineral, there could be no necessity for the exclusion of waste and inert matter which the writer has so constantly urged in the case of vegetable remedies; merely attention to secure and maintain chemical purity.

Iodin, without question, remains one of the most reliable anti syphilitics, and if administered with a calcium base it may be exhibited with the usual salts of mercury without the disastrous effects upon the system which follow the ingestion of potassium iodid and some mercurials. The discovery of iodized calcium therefore marked an era in the treatment of syphilis. In this connection it should be remembered that mercury protoiodid, so often prescribed in syphilis, becomes decomposed in the presence of potassium iodid into mercuric iodid and metallic mercury. Syphilis is recognized as a specific malady affecting (after infection) the entire system. The virus may be transmitted by contact or inheritance. The progress of the disease is divided into certain well-refined and easily-recognized stages.

In the initial sore or chancre is contained the secretion which spreads the disease, and upon its appearance we know that the patient has acquired the constitutional taint. Later appear the characteristic eruptions with rheumatoid pains, head-ache, anemia, glandular enlargement, etc. These are all due to the existence in the body of the syphilitic toxina virus animatum the micro-organism of which is unknown to us.

In all well-markt cases of syphilis, however,

we

have certain cutaneous manifestations which disappear under the exhibition of mercurials. As these syphilitic growths fade and disappear, so the patient improves; and it is fairly safe to measure his progress towards recovery by this cutaneous barometer.

Mercury in small doses causes the death of syphilitic tissues of low vitality, just as toxic doses cause the death of normal tissues. Iodin promotes absorption and elimination of the waste thus produced, hence it is evident that concurrent exhibition of the two remedies is essential.

The object of the physician therefore is to ascertain exactly how much mercury the patient can take without its affecting the normal tissues and causing their necrosis; as thus he can obtain the greatest possible action against the disease, without injury to the patient. For this reason he begins with moderate doses of mercury, and cautiously increases them until the patient begins to show softening of the gums, soreness of the teeth, or some other evidence of a destructiv action upon the normal tissues. Then he lessens the dose a little until this toxic action ceases, and continues with doses just below the toxic point until the disease has been completely eradicated; for this a year or more is required.

Here we have in actual use and universally accepted the cardinal principles of activ-principle therapeutics-a specific remedy for an infection, given to saturation, to render the body uninhabitable by the specific cause, with careful watch kept to see that the effect never passes over into the toxic, and continued till the desired result has been achieved. "Dose enuf" is the object sought.

No one nowadays contents himself with simply prescribing a dose of mercury three times a day and turning the patient loose, for one to be salivated and the next to have the disease go on uncheckt because the dosage is insufficient. Or, perhaps some do; and to them are attributable the terrible results of the incautious, unskilful administration of this potent remedy.

How often have we lamented that we have not specifics for other maladies as we possess in mercury for syphilis. Quinin for malaria, citric acid for scurvy, sulfid of calcium for gonorrhea, pilocarpin for erysipelas, iodized calcium for croup, etc., but none of these is so universally admitted as is mercury for syphilis.

But while the principles of Burggraeve had been adopted in the treatment of syphilis before his day, there is yet room for an improvement in the agents employed as well as in the completeness of the method itself. The universal preference today is for some form of mercury, and iodid of potassium as an adju

vant, a substitute or an alternant. We can do better. Here is our prescription: Mercury biniodid, gr. ; arsenic iodid, gr. ; iodoform, gr. 2; phytolaccin, gr. 2. This to be given before each meal and at bedtime and a dose daily added every third day till evidences of toxic action are manifest; then one daily dose to be dropt and the remedy continued as usual.

Mercury biniodid is as good a mercurial as can be selected, and the iodin aids the mercury in antagonizing the disease, in inducing elimination, and in carrying the metal out of the system and preventing salivation.

Arsenic iodid is the most activ of all preparations of iodin, and hence of special value when hurry is requisit, as in cerebral syphilis; it also aids in elimination.

Iodoform is an activ iodic agent, and soothes the stomach, so that the foregoing remedies may be administered with it for greater lengths of time; it is analgesic also, especially effectiv for the nocturnal pains.

Phytolaccin strongly stimulates glandular elimination, and aids in carrying the debris out of the system. By relieving mercury of

this task it frees the latter to devote its entire energies against the specific poison. To this may well be added tonic doses of strychnin, iron and quinin. A good formula, sometimes called "triple arsenates with nuclein," is as follows:

These combinations have been employed by the writer and his friends for years, in the various forms of specific disease presenting, and have proved their worth as far superior to the old combination of mercury and iodid of potassium. Especially in cases demanding haste (cerebral, ocular and nasal), where it is essential to save the vitality of the threatened tissues, has its speedy effect from the first been manifest. Given persistently and wisely for a year (often less) there are very few cases of syphilis that will show any further evidences of the disease. It is believed that by this tonic eliminativ and yet reconstructiv method the infection may be eradicated in less time than by any other.

We do not advocate prescription by formulas. The whole trend of activ-principle medication opposes polypharmacy, as it teaches the careful study of drug-action, and dosage prest until the drug effect is manifest; but for each of the agents suggested there is a distinct indication, a separate role to be fulfilled.. Mercury may be too slow; iodin lacks permanency; together they supplement each other. Potassium is a protoplasmic poison and increases the destructiv effect of mercury and iodin on the normal cells without adding to their control over the syphilitic poison, hence should be omitted.

I am aware that this method of treatment will be lookt upon with disfavor by such of my readers as are fixt in the old way; but if they will treat two series of cases side by side they will soon be convinced. Elimination, with systemic and intestinal antisepsis, enters largely into the success of the method suggested; and their lack accounts for much of the dissatisfaction from the old; and with all, good common sense should be liberally mixt, remembering that the patient is the battle-ground, and that if it is devastated your otherwise readily victorious army will fail for want of foragefand supplies. Chicago, Ill. W. C. ABBOTT.

My Medical Creed.

I. I believe the sons of physicians make the best physicians.

2. I believe the schoolmaster, provided he has reacht the age of sound judgment and is recognized as a suitable judge, should be able to notice in the pupil such virtues as are essential for the medical profession.

3. I believe that an early age should be selected, provided the pupil evince an adaptability or genius for our art. He should possess markt discernment, a sound judgment, a character of mildness, boldness, and full of sympathy, studious, patient, inventiv and resourceful.

4. I believe the student should have thoro training in the Latin, Greek, and English classics, in fact, should not be allowed to matriculate in medicin except he possess the B.A. or B.S. degree, or proceed in his medical course unless he combine an arts or science course with medicin, and obtain either of the degrees when he graduates as M.D.

5. I believe that each province or state should have its university, and it alone be allowed to grant degrees.

6. I believe that if four hundred of the universities in the U. S. would cease to exist, the remaining number, eighty-four, would be more honored, and higher education and university degrees more prized. (Think of the U. S. having three hundred more universities than the rest of the world!)

7. I believe our medical colleges should not admit the sons of saloon keepers, whiskey sellers, fakirs, licentious or immoral persons, however rich; and that the sons of esteemed and regularly graduated practicians should be allowed free tuition and every encouragement.

8. I believe every graduate at graduation, should be made to sign papers, agreeing under penalties not to practise quackery, and to conform his practise to the principles of medical ethics.

9. I believe that those who have acquired great wealth in the disposal of sour beer, pork, or oil, or by lucky ventures in stocks or mines, and wishing to

"honor" their name in educational interests, would endow a hall or college in connection with the state university. They would not less honor their names, and it would advance the interests of education much better than to establish a "John Q. Smith's university."

Io. I believe it advisable that a thoro set of addresses relating to medical ethics, medical fees, collection agencies, stock speculations, the obligations and duties of court witnesses, medical journalism, quackery, etc., should be given during the last year at college to medical students.

II. I do not believe it advisable, but rather condemnable, except in a very few instances, that we advise any young man to study medicin.

12. I do believe that medical men have more power for good, and really do more good, than the resident preachers. I believe, also, that if "these leaders of faithful souls and guides of those who travel to the skies" (i. e. the preachers), were better educated and not so many of them the possessors of purchast degrees from Central University (?), Indianapolis, or National University, Chicago, we would respect them better, and they would better advance every progressiv movement-even religion.

13. I believe that the "Hon." title which many assume, and which wrongfully it seems is given to many, would look better if not attacht to names recommending "Swamp Vine Tonic,' ""Peruna," etc., in our newspapers. The name of Admiral Schley (!) in public print announcing the virtues of peruna, is a sad reflection on medical education in the U. S. I hope no British admiral or officer will ever so disgrace himself or his country by such insults.

"These are thoughts of things which thoughts but slenderly touch "-and the last very sorrowfully mentioned. JAMES S. SPRAGUE, M.D.,

Examiner College Phys. and Surgs., Ontario.

Stirling, Ontario, Canada.

Reply to Dr. Cottew.

""

Editor MEDICAL WORLD:-Replying to Arthur A. Cottew, M.D.'s article in September WORLD, “Questions for Homeopaths," I will say that if the Doctor will read Hahnemann's "Organon of the Art of Healing," he will find his questions answered and much light thrown on many things he cannot see thru at present. The man he calls a most successful homeopathic physician" might go by the title of a homeopath, but his works prove him otherwise. The Doctor says that "such wonderful cures could be accomplisht by ferrum phos. 3x and fluoric acid 6x, seems to me bordering on the impossible." Here is a test the Doctor can make on himself: Procure one ounce of the 6x dilution of heloderma horid. (prepared by Boericke & Tafel) and take ten drops every six hours for twenty-one days (taking no other medicin during the time), then report his experience in THE MEDICAL WORLD. GEO. WIGG, M.D.

Portland, Oregon.

Reply to "Shockt."

Editor MEDICAL WORLD:-"Shockt," in October WORLD, says "the liquor traffic is the greatest question before the American people." Many men of many minds." I can easily call his attention to another question compared with which the liquor question is as a mole-hill to the Himalaya Mountains. I would not, however, by any means underrate the evils of the liquor traffic. But all the prohibitionists I have ever known appear to strike at the branches of the tree, leaving the roots to grow and flourish as tho their efforts were a needful process of pruning, rather than one of extirpation.

All political power resides primarily in the people; and the only question to solve is the one of so enlightening them that they will come forward and secure to themselves the right to vote on all measures proposed for their government. Instead of doing this, however, they send representativs to do the voting for them; and these representativs, a sufficient number at least, are bought, cajoled, or influenced" in some way to

vote against the people every time. And thus the thwarting of the will of the people goes merrily on, and will continue to do so to the end of time unless the people arouse and secure what is called "direct legislatlon."

All the sumptuary legislation in the world, by lawmakers as they are known today, will not change the traffic other than by substituting one form of foolish tyranny for another without in the slightest degree bettering the condition.

But when laws are enacted and referred back to the people for the stamp of their approval or rejection, then, presto! there is a change! You then have solved the greatest question of this or any other age, or of this or any other country; and without which we shall still go on floundering in "a sea of troubles" while the countless ages roll! So come, good Brother "Shockt," and join us in our effort to secure direct legislation, and then the liquor question and all others affecting the welfare of the world can be settled.

As to the ladies and their taste in the matter of dress, you may as well join the good old Dame Partington in her effort to hurl back the incoming tide of the Atlantic Ocean with her little broom! "La! bless you, yes!" R. H. BAYLOR, M.D. Erin, Tenn.

Yes, very "Rank."

Editor MEDICAL WORLD:-The inclosed letter just received in this morning's mail. I cannot but believe that this fellow is what his name reads: "rank;" and if my suppositions are correct, ought to be exposed. Perhaps THE WORLD has some good subscriber in Mexico City who could look him up and set us right. Wishing you all success in your laudable efforts to uproot fake deals of all sorts, and protect the "gullible" doctor, I am very sincerely yours,

Alexander, Ia.

H. B. CRAGIN.

[The circular letter is a long one, offering secret methods of treatment for a fee of $10. The letter is written in the highest style of quack art, and well calculated to catch the unwary. Perhaps this circular letter is being sent to many doctors thruout the country. It is to be hoped that no WORLD reader will be foolish enuf to send $10 to Mexico City for this alleged "secret information." You know how to rate any doctor who has secrets from the profession, and who tries to sell them to his professional brethren. Such a man disgraces the profession. I suspect that if you were to send the $10, you would receive in response information that is of no practical value, or information that you already know. In this connection, read again the "secrets of success" in October WORLD, page 418, middle of second column.-ED.]

His Waste "Barl."

Editor MEDICAL WORLD:-Your advice about investments is good and useful. If you could see my waste barl" (for a basket would be too small)! This barl contains Medical Briefs, hundreds of proprietary medicin circulars-in fact, a regular diarrhea of these come in on every mail. I also receive many financial sharper's letters, similar to the one you printed in the September WORLD. Further examination of the contents of this waste "barl" convinces me that every mole-hill, including Spindle Top and the entire Rocky Mountain system, has been "capitalized" for several billions of dollars, and we are specially invited to get in on the ground floor at a few cents a share. You may conclude that several sharpers have me on their sucker lists. I will say that the banker and business men of this place receive about the same financial circulars that I do. I hope you will, later on, expose the "system" used by the big fellows in Wall street, by which the investors in Amalgamated Copper lost nearly $200,000,000, mentioned in Lawson's "Frenzied Finance" articles in Everybody's Magazine. Jenera, Ohio. J. L. HIGBIE, M.D. [The book entitled "The Organization and Control of Industrial Corporations," which I publisht about a year ago, proposes the only feasible remedy that I

know of for the "system." The price of this book is only twenty-five cents, and it can be had at this office. -ED.]

Correction.

Editor MEDICAL WORLD:-In your comments on my letter in the October WORLD, pages 446 and 447, you say I suggest fight to settle our industrial probĺems. I must object to that. There is no such suggestion in the letter and certainly nothing was farther from my mind. Is it possible that you jumpt to that conclusion because of that same old misconception of socialism?

Our forefathers fought to establish self rule by means of the ballot. With that in our power we can accomplish any reform when we "have sense enuf." My contention is for the principle of cooperativ self government-democracy. The reason our democracy has made so poor a showing is that it has been as yet only half way applied. We have cooperativ government as to physical protection, but in the face of the great enemies, hunger and cold, we are a mob of savages fighting each other for temporary advantage. True we are beginning to be marshalled in larger and larger armies of production, and production is being largely increast and the waste of competition eliminated just enuf to show us what might be done, but the despot who rules each combination claims the whole product.

My letter was intended as a hint that after despotism comes democracy-and there is no argument against industrial democracy-socialism-and no ridicule which might not have been applied with equal force by the primitiv savage to the Utopian dream of political democracy. A. W. VINCENT, M.D.

Union, Ore.

[Doctor, you didn't say anything about the way it should be done, but you referred to the repudiation of George III's assumed "divine right" to rule our forefathers, and that precipitated a big and long fight; and it was fair to infer that your idea was to inforce your proposed repudiation of the rights of property in the same way. However, I print your letter in order to set you right.

And I will take this occasion to say that defectiv proof reading led to a little tangle in the middle of the middle paragraph in the first column of page 447. "We should have done so, and would have done so if we had done so" doesn't make sense. Change the words following "if" to "if we had had less passion and more sense." ."-ED.]

Specialism; Its Evils and the Remedy. Increase of specialism is a growing evil causing a loss to the family physician and often working confusion in the management of a case by reason of incompatible lines of treatment prescribed by different specialists independently of each other. Also expensiv to patients. Yet under present conditions unavoidable, if the very best advice and treatment are to be had. The remedy must be two-fold: (1) a more prolonged and thoro medical course for all doctors, and (2) a much longer medical training and decidedly higher standard for consultants than now required, besides the enforcement of a rule that consultants shall not engage in general or family practise. Suggestion that the government of the United States should establish examination boards empowered to grant higher degrees than M.D.-say Master of Medicin and Master of Surgery, such degrees enabling their holders to practise anywhere in the United States or its dependencies.-Outline of paper by Boardman Reed, M.D., of Philadelphia.

The compound spirit of juniper is beneficial in increasing the flow of urin in the passiv congestion of the kidneys common in chronic heart disease. Camphor water used as a mouth wash and gargle is of value in fetor of the breath.

Spirit of camphor, if applied to an incipient boil several times a day for a few moments at a time, will often abort it.

QUIZ

New books as they appear, are sent to our Assistant Editor, Dr. A. L. Russell, of Midway, Washington Co., Pa., for review. As the Doctor thus has all the late books for reference, and is made familiar with them by reviewing each one carefully as it reaches him, he is unusually equipt for answering queries. Therefore it has been our custom for a long time to send queries to him for reply. In fact, the Doctor made a special request that this be done, as he enjoys this work. It now occurs to us that time will be saved if you will send directly to Dr. Russell matter intended for the Quiz Department, which has grown so much under his vigorous "treatment Please notice that our query department is not used to "boost" proprietary remedies, almanac fashion. THE MEDICAL WORLD has no interests other than to give to the medical profession the greatest amount of honest service possible. It has absolutely no interests in any proprietary preparation nor any medical supply house. Other medical editors have become, and are becoming, wealthy, by using their pages to increase the sale of preparations that they are interested in; but we prefer to render service to our subscribers that is above suspicion of personal pecuniary interest. How can a man interested in the sale of certain preparations render the best service? He is always trying to push one of his preparations in. That is commercial journalism. We prefer ethical journalism-and so does the profession, for The Medical WORLD is growing in popularity faster than ever before-and our subscribers are paying ones. They must be, for we have no medicins to "boost," nothing to sell, nothing to depend on but pure journalism; but doctors that want honest, straight journalism are willing to pay for it-they are glad of the opportunity.

Only such queries will be publisht as are likely to interest and instruct many others as well as the one asking help. No charge has ever been made, nor will any charge be made, for this service to our subscribers. However, those who wish an immediate and personal reply by mail may obtain the same by inclosing two dollars to Dr. Russell. This is really a consultation in the interest of the patient, and should be charged to the patient-two dollars being a very moderate consultation fee. The Doctor agrees to give full, careful and immediate attention to such consultations. reserve the right to publish in this department any such consultatious that may be interesting and helpful to our readers. Name and address will be withheld if requested. Come freely for help, but read up as fully as you can before coming to us.

Equipment Needed for Repair of Cervix.

We

DEAR DOCTORS AND EDITORS:-I have long lookt in vain for such directions as a general practician might wish in order to equip himself to treat all cases of laceration of the cervix. Also how to proceed in performing these operations. Directions would be more valuable if explicit as to the make of instruments, as there are so many on the market. Then as to anesthesia: Is it always necessary? How far should the cervix be drawn down? is it right to do the operation at the office and let the patient ride home and keep up, under any circumstances? Los Banos, Cal.

C. E. BOYNTON.

[For repair of laceration of the cervix you will need the following:

2 pairs double tenacula (or bullet forceps), I pair long scissors, curved on the flat,

I pair rat toothed forceps,

Silkworm gut sutures, shot, and clamps for shot,

Steril cotton for sponges,

An anesthetic is

I pair dressing forceps, 4 pairs hemostatic forceps. No speculum is necessary. always advisable, and the woman should not be moved more than necessary after the operation. Certainly the operation should be done at her own home, if no hospital is convenient; one should never consider doing such an operation in an office. It is well to prepare the patient for the operation by pricking the cysts about the lesion, applying nitrate of silver solution, and inserting a boroglycerid tampon every other day for two weeks; this will