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Now, begging the reader's pardon again for the length of this, we will pass to the next.

The next letter I received on this subject was the following:

What is the meaning of all the maledictions showered upon the head of the editor of the Brief?

This country is full of " yap" doctors who write every medical journal on their list that they have the only journal and all others are base imitations; praise the one to which he is writing and " cuss" all others. Some prize funny man once said that "there is a good deal of human nature about some people" and I must say that it looks like it from here.

Dr. Lawrence has made himself rich on proprietaries, his proprietaries are good ones, he advertises them in the Brief, he buys and pays for medical articles that tell something; if these articles are worth a dollar a year to you, you are invited to subscribe; if not, there is no compulsion, and I must say it is a narrow medical man who cannot get a dollar's worth out of a year's subscription to the Brief.

I have no fight against THE WORLD; the fact that I am a subscriber shows that I consider it worth a dollar. I also subscribe to the Brief, and it is worth the money. The fact that Dr. Lawrence is rich, cuts no ice with me; he don't owe me a cent.

Let's see you publish this.
Shubert, Neb., April 5, 1904.

J. F. STONG, M.D.

What is the matter with Nebraska? I suppose Dr. Lawrence would say, "She's all right!" Has Dr. Lawrence hypnotized that State? Well, Dr. Stong, you are just the kind of a "peach" that Dr. Lawrence is looking for; pay him for his journal that boosts the proprietaries, and also pay for and prescribe the proprietaries pusht. No wonder Dr. Lawrence is rich. When it comes to medical literature it is a matter of taste, you know. Have you seen a peruna almanac ? I haven't; but I expect there is some pretty good stuff in it. I don't think they charge for it.

I have always said that it would be a poor medical journal indeed that is not worth much more than its price; that the best possible investment that a doctor can make is to subscribe for plenty of medical journals, and pay for them as promptly as for any other part of his equipment. Nearly every journal has an individuality, and one cannot, as a rule, take the place of another. But the object of every legitimate medical periodical should be to serve the interests of the medical profession, and not to push the sale of proprietary medicins. It is all right for a man who thinks he has a good pharmaceutical product to try to attract the attention of doctors to its virtues. But that isn't journalism. It is commercialism-a good thing in its way, but the discriminating doctor doesn't want the two mixt. When he gives his time to reading the editorials and other parts of a medical journal he wants to feel safe from imposition. If he is in quest of pharmaceuticals, the advertising pages are open to him; there literature concerning such things finds an ap

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Let us take all our bitter pills first; and here comes one which at first sight seems like a very bitter one. He does not "dare" me to publish it, but let us take a look at it. Here it is:

NEW YORK CITY, April 13, '04

C. F. TAYLOR, M.D., MEDICAL WORLD, Philadelphia, Doctor:-Your articles on the subject of proprietary remedies are simply "rotten." Any reader looking over the MEDICAL WORLD now and comparing it with the same journal of a few years ago, can readily discover the animus of your diatribe.

It is patent that the advertisements you used to carry-and now do not, could "a tale unfold," which would make your purpose very plain. If any of the manufacturers you are evidently attempting to "hold up," are going to pay you to discontinue your attacks, they have less gumption than I give them credit for. The success met with by some of the preparations you are antagonistic to, clearly proves that they have as many and perhaps more friends than you have, and your line of conduct is therefore liable to act as a

boomerang." It would be more edifying if you were to give your readers something besides an exhibition of your personal disappointments and apparent personal chagrin over what is generally considered others' successes. On general principles you are a "knocker" and no serious-minded man can listen to the "knocker's" little knocks, without developing deep at the fountain source of his moral being, a disgust and contempt for the "knocker." I think your little "spiel" to do up your former friends, because they would not be "stood up" by you, is going to fail, or at least assist in making the WORLD a failure as a clean Medical Journal. Yours truly,

QUINCY A. HARVEY, M.D.

I examined the Standard Medical Directory for Dr. Harvey's street address and professional record, but his name was nowhere to be found, either in N. Y. City nor in Brooklyn. Not being listed among the practising physicians there, the thought occurs to me that he might be an employee of one of the medicin concerns in New York. If so, all right; it is certainly no discredit. But the point is, he does not seem to be a practising physician.

Now for his letter: Brother Harvey, please point out to me one line or one word that I have written against any proprietary medicin, or against proprietary medicins in general, except to show what some of the acetanilid mixtures are, and I have done that from time to time for years. Haven't you been dreaming? Write us again when your dream is over. But you are not entirely alone. A man (I suppose it is a man) in Detroit who declined to sign his name, has been dreaming the same kind of a dream. When he wakes up and reads THE WORLD in his waking hours, he will see, and see plainly, that it is the method of pushing certain proprietaries that I have opposed. That same feeling has been rankling in the breasts of medical journalists and a large part of the profession for years. It is time for it to come out. Our Detroit friend is

concerned by the disappearance of certain advertisements from THE WORLD. Do you remember certain articles in the "Talk" department last summer? Well, I suppose that's the reason that the advertisements disappeared when the contracts expired. I expected it. It doesn't worry me. The support of THE WORLD comes from the profession mcre than from the advertisements. However, I have always treated advertisers squarely, and I expect always to do so; but in so doing I am not going to neglect the interests and rights of the profession. Do you think I ought? And when it comes to a question of journalism, ought not a journal speak out? As a journalist I have interests to sustain, and those interests are the interests of the profession as well. The profession will (and does in this instance) sustain a journal that stands for the interests of the profession.

Next!

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I pay for and read every word in the Brief and Alk. Clinic as well as the WORLD. They are both weak in the same spot. One recommends Iodia, Ecthol, Respiton, Seng, Chionia, etc.; the other Calcalith, Salithia, Calcidin, Sanguiferin, etc. The first you condemn, the editor of the second sends you an eagle's feather as a token of friendship. A doctor can do first class work without these high priced medicins. I avoid them as much as possible, for I know that they will keep the average doctor poor. I like to see articles on turpentine, coal oil, salt, mustard, red pepper, hot water, etc., and many a fine article on these cheap and good things are appearing in the Brief and Clinic. They are worth the price, but the reader must be on his guard.

For Colic in horses, I rub one grain of morphin on the inner surface of the lower lip, or drop it in the cup shaped lip; repeat. If convenient, give a rectal injection of hot soap suds. For stoppage of water in horses, lay cloths over the kidneys, carefully pour hot water on these. The same plan is splendid with FRANK POLLARD, M.D.

humans.

Albion, Cal.

Dr. Waugh is an old friend. He seems to be taking a well earned rest from hard work, for he spent the past winter on his house boat down the Mississippi. Dr. Abbott is the real man there now, and he and I have been having a frequent and most frank correspondence about this very thing. I have called his attention to his tendency mentioned above, and suggested that the Clinic be confined strictly to its special field, that of alkaloidal therapeutics, a large, growing, and strictly legitimate field, in which Dr. Abbott and his journal have done such heroic work.

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I endorse, I wonder what we should do for an exchange list if all but the really independent were supprest. Yours is about the only one I know of that I am confident is independent. W. S. BOGART. Cleves, Ohio.

Editor MEDICAL WORLD:-Allow me to congratulate you on the airing of Dr. J. J. Lawrence. This meets my most hearty approval. I can't tell you how well pleased I am. I more than congratulate you They did not get a red out of me. on the airing of the Comstock Collecting Agency. Doctor, such straightforward push as you have makes your journal appeal to every honest doctor in the land; and it comes to stay. I only wish you would open up on the druggists. They are the greatest enemy the doctor has. They are doing more practise over the counter in some of our cities than some of the doctors. Turn your guns loose on every trap you see set for the unthinking doctor. Yours always,

Houston, Ohio.

S. G. MARTT, M.D.

DR. C. F. TAYLOR, DEAR DOCTOR :-I received the March number of THE MEDICAL WORLD and read it with much pleasure and profit. I am taking several medical periodicals, but I believe I need THE WORLD also. I think this one number is worth the price of subscription. I admire the stand you take to help the physician, even tho your advertisers do not like it. THE WORLD does not remind me of Ayer's old almanac, with a few remedies for all the ills we are called upon to treat. I take one journal that has a large number of questions in each issue. I can give the main remedy given in the answer by the editor every time before I read his reply. For any form of stomach trouble it is seng, with the variations as combinations; for any form of disease of the urinary or sexual organs it's sanmetto; and so on thru a line of preparations of a certain few manufacturers, while the products of other manufacturers, just as reliable, are never or rarely, mentioned. These earmarks are also very visible in the articles written by a certain old Esculapius while smoking his pipe after supper. inclose one dollar for which please send me THE WORLD. B. E. DAWSON, M.D.

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Belton, Cass Co., Mo. [Doctors, please show your WORLDS, particularly this issue and the March and April issues, to your medical friends who are not subscribers. They will do as Dr. Dawson has done, every one of them. You can thus double our list in the next few weeks. We extend a cordial welcome to new subscribers. We want to work for the entire medical profession.-ED.]

Glad you are banging away at the Brief. I admire your pluck. GEO. W. HARGEST. Brooklyn, N. Y.

Editor MEDICAL WORLD:-I am pleased that THE WORLD is not devoted to advertising and boosting proprietary medicins as the Brief is. We get nothing now but respiton, seng, neurilla, etc. I never use any stuff like that. I hear the Brief abused by doctors generally, on that account.

At our District Medical Association, held in San Antonio lately, I was glad to see united under one common brotherhood all schools, regardless of name. I think this is progress. L. V. WEATHERS, M.D. Bracken, Tex.

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materia medica long years ago. I not only save $45 a year, but the whole expense. Dr. Lawrence still continues to send me his Brief almost every month. I never have ordered a copy. Keep at 'em. You are doing all kinds of good for the profession. Buffalo, N. Y. ELMORE PALMER.

[THE MEDICAL WORLD was establisht in 1883; so you could not have taken it longer than between twenty and twenty-one years. I am glad to greet so faithful a follower. Almost all of the profession, I venture, will think that you have done wrong to cut the coal tar derivativs out of your practise entirely. They undoubtedly have a field of usefulness, either wide or narrow, according to the experience and opinion of each individual practician.-ED.]

DEAR DOCTOR TAYLOR: Inclosed please find carbon copy of letter sent to Dr. Kieffer. I trust that should the Doctor be guilty of knowingly contributing to the Brief, he will admit his wrong. I like your journal and your style of hitting in the right way and place. Vienna, Mo. O. N. SCHUDDE, M.D.

DR. A. R. KIEFFER, 4628 West Belle Pl., St. Louis, Mo. My Dear Doctor Kieffer :-I regret to notice on page 150, April number of THE MEDICAL WORLD that you have been one of the contributors to the Medical Brief. If such be the case, I trust it to have been thru some misrepresentation or error, as no medical man, especially one who is held in such high esteem and regard as you, would voluntarily commit himself to such action. Kindly let me hear from you regarding this accusation. With best wishes I beg to remain Yours fraternally, Vienna, Mo.

O. N. SCHUDDE, M.D.

Editor MEDICAL WORLD:-I heartily endorse the exposé you are making of J. J. Lawrence and his proprietary medicin almanac. I must admit that I was a subscriber to the Brief for a few years, but it finally became so brazen and arbitrary that I discarded it. The frequent "sample copies" that have come to me since have all been consigned to the waste basket. The letters from "Old Doc" are enuf to nauseate one who is acquainted with the game he is trying to work. The circulation of the Brief is confined largely to rural physicians who take but 2 or 3 journals, and are not posted on the old man's tactics. Go on with the good work, even to the end. I know other good and able men will come to your assistance thru other journals. High Hill, Mo. W. M. WHEELER, M.D.

DEAR DR. TAYLOR-I thank you very much for your fearless stand on all questions of professional rights and dignity. THE WORLD has done much in correcting abuses inside and outside the ranks, and it deserves the applause of all right-minded and wellmeaning physicians, who do not rely on some form of deceit for a livelihood.

New York City.

P. M. WISE.

DEAR EDITOR :-Inc'osed please find $2 for subscription to WORLD, and pardon negligence, or rather pure carelessness. Have been using the analgesic given by Dr. Elderdice in March WORLD, with siccess and saving of money. It certainly makes one feel ti ed reading some socalled medical journals to have a proprietary mixture bob up in every line. I think if a person gets in the habit of using them, he loses all faculty of preparing his own, and ambition to do so. THE WORLD and its family are always welcome guests. C. L. FOUGHT, M.D. Erie, Mich.

Editor MEDICAL WORLD:-We doctors are sure a neglectful lot. I have been intending to send you money for your esteemed journal for a long time, but have neglected it. Inclosed please find $3 to settle arrears and advance subscription one year. I admire your independent stand in medicin very much, and hope you will continue your good work especially in regard to such advertising sheets as the Brief. L. CHAPMAN.

Boiestown, N. B.

DR. TAYLOR:-Inclosed find check for $3. I admire your grit and your sticktoitivness, both in the way of hustling dead beat subscribers and fighting medi al journals which have the interest of the advertiser at heart rather than that of the M.D. Emet, I. T. A. H. SEELEY.

Hope that your expose of the fake collection agencies will be the means of putting them out of business. Your campaign against the Medical Brief is surely of the most proper sort. Would be glad to see Lawrence and his ilk "squasht" completely. La Cygne, Kan. H. L. CLARKE,

The Plain Truth about Seeking Health in the Southwest.

Editor MEDICAL WORLD:-For the past year I have been afflicted with tuberculosis and have been traveling from place to place in search of health. After twelve months' experience in the famous health resorts of the West, I am satisfied that it is sheer folly for physicians to send patients in the second stage of consumption away from the comforts of home and the association of those dear to them to die alone among strangers in a distant land. Unthinking physicians imagin that all that is necessary to effect a cure of this most loathsome disease is a change of climate and a strenuous out-of-door life, where the poor "lunger," far from competent medical attendance and good wholesome food, and pure water, has to perform feats that would severely tax the strength of a strong man.

"Go out West. Get on a broncho and ride thirty-five or forty miles a day, and inhale the pure air of the deserts, and climb mountains, and inflate that consolidated lung," says the knowing medico, who, if the truth were known, never saw a desert or rode a horse five miles in his life.

The poor deluded victim of so stupid a piece of assininity as was ever perpetrated by a biped, takes the advice of this member of our noble profession, and starts for the West. When he arrives at some city on the desert they are probably having a sand storm, and the "pure air" is about as transparent as a rubber blanket; but he is cheerfully informed by a veracious nativ that "this is an unusual season." He goes to a hotel, and is cooped up in a stuffy, poorly-ventilated room that probably contained the remains of another victim of some stupid donkey a few hours before, but that does not matter; for hasn't the bedding been hung out in the sun since noon ? and a weak solution of formaldehyd has been sprinkled over the carpet.

He stays there a few days, while he is looking around for a suitable camping place. He wonders why he does not get better; why his fever returns, and why he loses his appetite.

Soon getting alarmed, he consults a doctor, and is blandly told that his loss of flesh is due to " drying out." After parting with five dollars for this comforting piece of advice, he concludes that he can dry out much more satisfactorily under canvas, away from the crowd of consumptivs who sit on the verandas of the hotels, and cough and expectorate into the street, where it soon dries up and is whirled away in the clouds of dust that are constantly being blown around by the gusts of wind, that aid the garbage man and the thrifty housewife in the equalization of germs, so that one part

of the city cannot proudly claim that it is more infected than another.

He gets his tent, and then his troubles begin, for the city has decided that no more tents shall be erected within the city limits. The Solons of the City Council have come to the conclusion that tents are unsanitary and sources of infection; and besides, they hinder the sale of Deacon Blank's lots, and prevent his renting his houses. The Deacon knows the danger of infection, having had a lung put out of commission several years ago in the East, himself. One cannot blame him for not wanting invalids out of doors in tents when they could localize the infected areas by staying in houses.

After our victim gets his lot and pitches his tent, then another class of sharks attack himthe tradesmen. They charge double the price he has been accustomed to pay in the East; and while they ostracize him as an unclean person, it is a strange thing to see the recklessness they show when he has any money to spend. They are then perfectly fearless.

Now, this is a true picture of the conditions to be found in the West. Something ought to be done. People far advanced in consumption should never be sent away from home. Their cases are hopeless, and their friends should be told so.

People with limited means should never be sent out here, for there is nothing for them to do, and their scanty funds will soon melt away under the exorbitant charges of the philanthropists in this part of the world.

The climate, taken as a whole, is no better than can be found in many places on the Atlantic seaboard. Any advantages it may possess in the way of sunshine is offset by poor water, and dust, and sand storms; and then, homesickness comes in as a powerful factor. Take a person who has been accustomed to green fields, brooks, lakes, and woods, and put him on a bleak waste of sand, under a broiling sun that hangs overhead like a disk of burnisht copper, not a green thing in sight, and the effect will counterbalance any good he may get from being cremated.

I have written more than I intended, but I have taken THE WORLD for years, and have always noticed that you come out firmly for that which is just and merciful. You are in a position where you can do much to check this evil, and that is why I have written this letter. Winterport, Me.

O. S. ERSKINE, M.D.

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Treatment of Pulmonary Tuberculosis in

the Dispensary and in the Home. Editor MEDICAL WORLD:-So much is being written, both in medical and lay journals, on the subject of tuberculosis that the very word itself has become to many of us trite and nauseating. There is, however, one phase of the matter, and one class of patients, which have scarcely received any notice either by physicians or well-meaning non-professionals; I refer to the treatment in dispensaries and at homes of the working classes who are forced to remain in the cities. These people certainly make up a very large proportion of those afflicted, and from the fact that they are ignorant of the infectiv nature of the disease, become very important agents in its dissemination.

It is a common experience among those who have a chance to see how dispensary patients suffering with this disease are cared for, to find that they are buoyed up and kept going with creasote, guaiacol and general diffusible stimulants, without receiving very much hygienic or other advice beyond the use of drugs. This is no reproach upon the profession as a whole, because it is thought that tuberculosis is so uniformly fatal among those who cannot receive special treatment as carried out in sanitoria. This view is of course wholly sane; for one can scarcely hope to get results from drugs when these unfortunates are forced to live under such wretched unsanitary conditions, and at the same time struggle for their daily bread. As tuberculosis is studied more and more, however, in its sociological and medical aspects, the profession is coming to realize that something can be done to alleviate the suffering from and spread of the disease, even if that something seems merely tentativ ard temporary. To this end there are at least two dispensaries in New York City that are doing excellent work; one is the Vanderbilt Clinic, the other the Post Graduate Hospital.

At the Post Graduate, Dr. T. F. Russell has been treating consumptivs for the past three years by the method of forced feeding, but owing to some misunderstanding in regard to an emulsion that he has prepared, is receiving support from a very minor portion of the profession. Here any patient is accepted in any stage of the disease, provided it is uncomplicated by tuberculous laryngitis, emphysema, or profuse hemorrhages, and provided also that he is not too poor to buy proper food and medicins. These patients sleep with the windows open in all weather, eat all they can at each meal, especially of milk and eggs, and are obliged to allow the lapse of five hours between meals. Free catharsis by castor oil and compound rhubarb pill insures the transmission of

food thru the intestins at a rate which allows of free absorption. They are taught to avoid over-clothing themselves day or night, to keep the extremities dry and warm, to sleep nine hours out of twenty-four, and to avoid heated assembly rooms. They visit the dispensary at 7 a.m. and 7 p.m. for advice, and to report their condition, and are weighed twice a week, great importance being attacht to gain or loss of flesh. The entire method is that of increasing the patient's resistance by food, air, sunlight, and a minimum of drugs, quite after the manner so successful carried out by Trudeau at Saranac Lake.

The plan at Vanderbilt clinic is really the same, with about the same relativ results. So far, in a period of three years, nearly 50 per cent of all cases treated-incipient, advanced, and far advanced-have had the disease arrested; and 25 percent have been "apparently" cured. The experimenters are very careful not to be over sanguin, and are rather inclined to minimize the results in order not to give a false impression of the efficacy of this

treatment.

Professor Walter B. James has said that he has been surprised to see how very bad cases even will improve under strict surveillance of this sort; for the rules laid down are most rigid, and any departure from them is likely to cause the patient to be "dropt "-a proceeding he very much fears. But the whole matter is one of absolute obedience to the laws of health enforced by intelligent and competent supervision. If a patient has a temperature, spits blood, and refuses to eat, he is put to bed with all the fresh air it is possible to get in a crowded city, and is thus prevented from exercising while under the care of a district nurse, who can see many such patients daily.

The method is not an ideal one, and no special claim is made for it, but it seems to be doing exceedingly well in New York, and ought at least to prove worthy of a trial elsewhere. J. W. VOORHEES.

355 W. 56th St., New York City. [What do our rural friends do for their tuberculous patients? Are they neglected and allowed to die? Here is a voice from the city; now let us hear a voice from the country.—ED.]

We have received quite a number of Pneumonia articles that we are carrying over till next fall. Perhaps now, just after the close of the season, is the best time to write up your experience, while it is fresh in your mind. We will keep the articles over and publish them early next season. Don't forget bronchitis, too. And also, don't forget the current diseases now and in the near future. Write of them for immediate publication.

Senator Hanna's Case, and the Dietetic Treatment of Typhoid Fever. Editor MEDICAL WORLD:-The following extract from an editorial in the World's Work is of interest to the entire medical profession: "Every man in middle life, who has had the usual experiences and the usual observation of an American, knows how murderously incompetent a very large number of practicians are-it is a public scandal in almost every part of the country."

We must confess that this charge is too well founded; but, that this incompetence is not confined to the humbler members of the profession, to the "rank and file," we need no plainer demonstration than the publisht records of the case of the late Senator Hanna.

The percentage of mortality in typhoid, under the treatment approved by the profession, following the advice of the leading authorities, ranges from 15 to 20 in the various epidemics. I am aware that many physicians in various parts of the country report much more favorable results. There are hundreds of physicians who "never lose a case of typhoid fever"; none, however, have, in a large number of cases, approacht the results attained by the strict Brand method, socalled, viz., 12 deaths in 1,200 cases.

Now, if you were to ask your subscribers what is the Brand method in the treatment of typhoid fever, I will venture the assertion that 75 percent of them would answer, the cold bath; whereas that is only one item, and the least important of Dr. Brand's recommendations. The withholding of food is Dr. Brand's main point, the cold bath being incidental, and rarely required if the former is rigidly enforced.

In the March number of the Journal of Advanced Therapeutics there is the second part of a very able article on "Lobar Pneumonia as a Secondary Disease," in which occur the following remarks on diet, which I cordially endorse: 66 Especially to be avoided are all nitrogenized foods-meat, eggs, fish, cheese, milk; and broths containing them. The products of these bodies, when undergoing putrefactiv decomposition, are of a highly poisonous character. Milk especially must be avoided. It is swallowed as a fluid, becomes precipitated as casein, leaving the whey free for absorption. My experience is, that this casein traverses the bowel almost unchanged during impaired digestion; if any change does occur, it is in the direction of putrefaction."

Now, if this be true in pneumonia, it is most emphatically true in typhoid fever, when digestion and assimilation are virtually suspended; where the digestiv secretions, from the salivary glands thruout the entire digestiv

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