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a patient's stomach with a superabundance of and to dilation of the heart with attendant highly nitrogenous food. It does sometimes evils. In no other condition with fever is exhelp toward recovery, but just as surely it ercise ever ordered. Will some one give a sometimes does harm.
rational reason for doing it with tuberculous The patient should be told about what and fever? how much is best for him. One with some
Of course there are conditions in tuberculosis temperature and a not good appetite would when some exercise is proper. When the lung better eat five or six small, easily-digested is healed, the fever gone and strength returned, meals, than to follow the usual custom of three even mountain climbing may be indulged in. meals a day. As the fever leaves and appetite The limits of this paper will not allow further and digestion improve, he can return to the discussion of the subject of rest and exercise usual three meals. Remember always that in tuberculosis ; but let me emphasize this individuals differ greatly as to the quantity of point: The patient with fever should be told to food they can take and assimilate. What is a rest; to live all possible in the open air, and surplus for one is not half enuf for another. to take as little exercise as possible. He can
Probably fewer people need advice with re- lie on a couch under a tree, on a veranda, or gard to the amount of water they drink than on in a room even, if it has a free circulation. A any other subject, and yet within the past year free circulation of air in a room requires doors I found a man who had read that it would or windows on opposit sides with a constant fatten one to drink lots of water, and he was current. This free circulation should exist in trying to drink two gallons each day! Some room or tent at night also. The bed can be do not drink enuf water. Few take the pains at one side and screens can be used to protect, to investigate as to the quality of the water if necessary, from a too strong draft. they get.
One who is quite feeble, with a weak circuThe drinking of beer, wine and distilled lation, should not dress and undress in such a liquors is greatly abused by tuberculous inva- room. There should be, in cold weather, a
One brief rule will apply with great warm adjoining room in which to prepare for benefit to forty-nine out of fifty of these cases. bed ; or the caretaker may put the patient to It is, don't touch any alcoholic drinks--not a bed before a fire with the room warm, and then drop. Many physicians still prescribe these throw open doors and windows. The room so things for their consumptiv clientele, but like opened will, during our clear winter pights, opium in this condition, alcohol has little pos- become very cold. The patient should wear a sible good for much possible harm. The harm warm night dress with plenty of light, warm is sure and positiv if the liquor is drank in any bedclothes, and a night-cap if more comfortaconsiderable amount, and no one is more prone ble with it. to drink to excess than the sick man away from To sum up regarding fresh air: The patient home. Forbid it.
should live in fresh, free air, but he should do Pure air is one of the best of things for the it with comfort; and there should be no exconsumptiv, and yet believe me, people go to posure or over-exertion to tax his vital forces. extremes in getting pure air. I do not mean The trouble about this advice is that so that it is possible to get too much of it, or that many do not know how little they can do it is possible for the air to be too pure. I without over-exerting themselves—how little mean that in what the patient fancies is neces- they can bear without taxing their vital forces. sary in order to procure pure air, he goes to Even physician patients, with the first appear. extremes in the way of exposure and fatigue. ance of returning health, will fancy their old One of the advantages of the Colorado climate vigor has returned and will work or walk beis the clear weather that makes possible so yond their strength. Other patients say they many hours of out-door life. But it is not feel better in a hotel office over a hot stove and necessary to be climbing mountains or riding will stay there unless watcht. Or they think horseback all the waking hours. It is in this it can do no harm to go into a crowded theater, that many make wreck of their chances of re- church or lecture hall, or that it will not hurt covery. And it is in this that many physicians them to go to a ball “just this once." The give bad advice. Dr. Erskine, in the May tuberculous subject should do none of these number of THE MEDICAL World, tells of physi- things. cians advising patients weakened by disease This leads to one more word of advice: and with afternoon temperature, “to ride When you have decided where to send your thirty-five or forty miles every day and to patient, select some physician at that place climb mountains and inflate that consolidated and instruct the patient to report to that physilung."
cian immediately upon arrival, and to be obeSuch advice is all wrong. Such a course dient to his instructions thruout his sojourn in is almost sure to lead to cavitation of the lung the locality. If the family doctor knows no
physician at the desired point, he can vided they can be brought to the point of disrespond with the postmaster or mayor of the believing some things taught them by their town regarding men of ability and standing, grandmothers several decades ago. Our learned or he can refer to Polk's Directory and select (?) profession must learn to act different before some one who is a member of state and na- it can hope to preach the true gospel, and then tional medical societies. It is very important it must learn to practise what it preaches. So to place the patient under the care of a good long as physicians give their testimony for, local physician. To do otherwise is like send- and often in consideration of a few sample ing a ship thru a rocky, perilous channel with- bottles of, Dr. Cureall's Elixir of Life, or Get out a pilot.
Rich Quick & Co.'s Specific, we may expect Safety for the phthisical patient, his restora- the less enlightened laity to follow our lead, tion to health, depends upon careful painstak- and be led to ruin in many cases by consuming ing management of every detail of his daily the various proprietary nostrums containing life ; and the greater the care and pains taken, alcohol, morphin, cocain, etc., in disguise. the greater will be the success.
Altho we may differ widely in religion and Boulder, Colo. L. P. BARBOUR, M.D. politics with some degree of consistency, I see
absolutely no reason why the great majority Is $5. Per Capita Per Year a Reasonable of medical men cannot agree upon truths too Average for Medical Attendance ?
apparent to admit of doubt, and of vital imEditor MEDICAL WORLD :-Inclosed find portance to the profession. one dollar to pay for your valuable journal for If seventy-five percent of the physicians in 1904. Pardon delay in remitting, and be as- the United States would do their whole duty sured it is not due to lack of appreciation of to themselves and their profession there would your efforts in behalf of the profession. Your not be a secret nostrum for sale in this country crusade against proprietary medicin journals, two years from today; and instead of living whose existence is made possible by the pa- from hand to mouth, receiving less pay than tronage of the profession they seek to rob, the man with the trowel, or saw and square, or places THE WORLD in a class almost alone, in even pick and shovel, as the great majority of the work it is doing, and should win for its physicians do, we could live in ease and comEditor a place high among the benefactors of fort, as the doctor must to do his best. I don't the world.
think I am getting the cart before the horse I used to be a subscriber to the Medical when I say as a rule, almost without exception, Brief, but becoming disgusted with its editorial the best paid doctor is the best doctor ; in endorsement of every proprietary nostrum ad- other words, professional success depends very vertised in it from cover to cover, I dropt it largely upon the doctor's income. like a “ hot tater ;' but now and then I receive The profession is over-crowded with quacks, a sample copy which reminds me that I once secret nostrum vendors and free dispensaries; aided and abetted in propagating a professional eliminate these and compel all who are able, to stench by sending the Brief a few of my hard- pay physicians even as well as they do groceryearned dollars. If it is true that this unholy men, etc., and there will be room for all who thing is now being offered for sale to the laity are qualified and have a legal and moral right by newsdealers or others, it is not fit to occupy to practise medicin. a place in any physician's office, even in the The law of the survival of the fittest does waste basket. But thanks to such men as the not hold good in the practise of medicin ; the Editor of THE WORLD and a few lay magazines shrewd quack with his catching advertisements and papers, the dawn of a better day is ap- can put a scientific physician out of business, proaching, and let us hope the time is not far and pocket more good money in a month than distant when secret nostrums will no longer be the former would in a year. Is it right to alused by profession or laity.
low these sharks to go about over the country, I have just received a sample copy of taking sick people's money and at the same Everybody's Magazine, publisht by the Ridg- time robbing them of the few days or weeks way-Thayer Co., of New York. This maga- when their disease was in its incipiency and zine, The Ladies' Home Journal, and a few might have been cured by one qualified and others of the better class, not only decline equipt to render the very best service? I consecret medicin advs., but they are doing a good tend that a physician whose armamentarium conwork in teaching medical common sense. In sists only of an office desk, medicin case and the June number of Everybody's Magazine is prescription book is necessarily to a consideraan article on consumption worth many times ble extent practising quack methods, tho it is the subscription price of the magazine, and I nearly always the case that one so poorly am acquainted with several doctors who would equipt is giving his patrons considerably more profit by reading this kind of literature, pro- than they are paying for.
Why can we not lay aside professional. jeal- and if they did, so many would not be able to ousy and by mutual agreement present a Solid pay their $5. quota. However, if the wealth front to our enemies, the quack, secret medicin of this great country were distributed on a vendor, and, worse than all, the dead beat who more just basis than it is, $5. per capita for goes from one physician to another, year after medical services could well be afforded, and it year, never paying a cent for services faithfully would be a good investment; but when we rendered? There is a remedy for this rodent think of the great wealth of the few, and the ulcer which is gnawing at the very vitals of our poverty of the many, and that poor people are professional existence, and if we fail to apply even more liable to get sick than those proit, a very large percent of physicians now vided with every comfort, we see the difficulty living are destined to fill paupers' graves; while of establishing such a high average, with any $165,000,000 are spent annually for secret prospect of getting it. This would be an innostrums, dead beats are robbing the profes- teresting question for discussion.-ED.) sion of uncounted millions. Take for example the county in which I live, with a population Packing the Auditory Canal.- Collection of a little more than 25,000 people and 25
Agencies. physicians in activ practise. If equally divided, Editor MEDICAL WORLD :-Your criticism of each physician in the county would have a my paper publisht in the June WORLD, page clientele of 1,000. Now confine the drug
Now confine the drug 233, is duly appreciated; but I do not think stores to their legitimate business, and compel the point is well taken. Packing the external all who are able to pay their medical accounts, auditory canal indiscriminately would indeed and the average would not be less than $5. for be very bad practise, and no well-informed each individual per annum, or an annual in- man would do so; but to pack the ear with a come of $5,000 for each physician in the soothing remedy such as I recommended for county. But let us see what we have. There the relief of pain, before there is any discharge is but one doctor in this county who claims an to “dam back" certainly can do no harm, annual income of $5,000 from his practise ; and often affords a great amount of relief to the others get from $500 to $2,000, We will the poor sufferer. It was, if you and the say 24 of the 25 average $1,500 each, or a total readers of THE WORLD and Dr. Gleason will of $36,000 a year; add $5,000 to this and we note carefully, only at this stage, before there have a grand total of $41,000 paid to the is any discharge, that the measure is recomphysicians of this county annually, whereas, at mended. The pain almost always ceases as $5. each, as it should be, the 25 doctors would soon as the discharge appears, and then, of receive an average of $5,000 each, or a total of course, the remedy would be discontinued. $125,000. In other words, we are losing Anent the question of collecting agencies, I $84,000 every year of money that we are justly thought perhaps my experience might be worth entitled to. Where does it go, and whose relating. My first time to “monkey” with fault is it that we fail to get what is justly due any of them was about fifteen years ago. A us? Think, brother.
friend suggested that I send some bad accounts For the encouragement of the Editor I must I had to R. G. Dun & Co. I wrote them for say I endorse his political views. I am a demo- terms, etc. They required fifty cents in adcrat, but not to the extent of “following dem- vance, to cover the cost of correspondence. I agogs to perdition.” J. L. EDWARDS, M.D. sent it and a list of accounts. After some Brownsville, Tenn.
six months or more, I received a letter from [The Doctor's figures are interesting. Apply an attorney in my county site asking for some the same basis of calculation to our total popu- information concerning some of the claims, lation of 80,000,000, and the annual income and saying that he had been employed to of the medical profession would be $400,000,- collect them. That has been more than fourooo. In "The Physician as
an Economic teen years ago. I have never heard any more Factor,'' March World, 1902, page 128, I from the matter in any way. So I sent good estimated the total annual income to the profes- money after bad, and it never brought any sion to be $217,000,000. When we think of all back. the poor people, and particularly of the poor Next, the United_Protectiv Association, negroes in Dr. Edwards' own county (they with headquarters at Topeka, Kansas, got my must have been in his count), $5. per capita name and wrote me, wanting to “ collect my every year for medical services seems to me outlawed notes and accounts." The terms on pretty high. True, all the protracted cases, which they proposed to do so were that I should surgery, obstetrics, chronics, etc., go to sign a contract to pay them $15 membership help make up the total and determin the av- fee, to be paid out of the first money collected erage, but still it seems high. So many indi- from the claims sent to them, and after this I viduals need no service at all, year after year; was to pay them a certain small percent of all amounts collected on these claims. I was Recently I undertook to take a grain of only to send them a statement of the claim. corn from the nose of a child whose parents I held possession of my notes, and all money had tried in vain to dislodge it. They had collected was to be paid to me, and I was to pusht it so high and so firmly fastened it that remit their fee. They further agreed that if the blowing process would not move it. The they had not collected ten times the amount best I could do was to push it back into the of the membership fee in twelve months, they pharynx, where it was swallowed and troubled would continue their efforts free of charge the little one no more. until they had done so. I signed the contract Foreign objects may be best taken from the and sent it to them with a good number of ear by syringing with warm water. But since claims. That has been ten years ago, and I living in this cattle country in Southwest have never received a penny thru their service, Texas, I have had a unique experience in the and have not heard from them for several case of an old man who came to me with pain years. So I am not out anything except a few and roaring in his ear. After using the syringe postage stamps and a little of my very precious he continued to complain. I introduced a time; nor have I received anything in return pair of forceps and in making careful exploraexcept a little experience.
tion came upon what seemed to be a foreign A few months ago, after the assault on such substance. Taking hold of it and pulling frauds by THE WORLD, I saw a very flowing slightly met resistance. But so sure was I that advertisement of the Sprague Mercantile this was the offender, I pulled slightly harder Agency of Chicago, praising themselves at a and out came a regular West Texas cow tick. wonderful rate, claiming unequaled ability and The tick had taken hold of the tympanic facility for collecting oultawed claims. I
membrane. An antiseptic, emollient dressing wrote for terms, and soon as Uncle Sam could finisht the case. go to Chicago and back he brought me a Some years ago, while practising in Madiletter, and a large lot of testimonials as to sonville, Texas, I was called by one of the the wonders that had been accomplisht for resident physicians to treat him for a rectal others, and a note for $50 payable in six trouble. Just above the lower sphincter my months, for me to sign and return to them as finger impinged upon a foreign object embeda retainer; also a stampt envelope for reply. ded in the tissues. Improvising a speculum I simply wrote a postal card saying to them out of two fingers of my left hand and taking “the whole thing is off with me." About hold with forceps of the free upper end of the every week since I have received something foreign body, I pusht it up until the lower end from them, but have answered nothing. They was disengaged, then easily withdrew it. kept sending stampt envelopes until, perhaps, About a week previously he remembered to they furnisht me with a dozen stamps. Then have had some difficulty in swallowing a bolus they quit putting on the stamp, but sent the of food, and inadvertently had taken into the envelope. Now I refuse to take them out of the stomach an inch long leg bone of a small postoffice, and am wondering how much longer chicken. After entering the esophagus and they will continue to send them and have them passing into the stomach it gave the counterreturned markt “refused."
sign and was allowed to pass into the duodenum, My object in writing this article is to give thence to jejunum, the ileum and the colon. my conclusion. It is that if one of my cus- But failing to give the proper password its pastomers is in my reach, that I can come nearer sage thru the rectum was challenged, and reaching a satisfactory settlement of my claim thus the trouble was set up, and thus it was against him than any other man or set of men ended. can, and that it is foolish to fool with any of But the singular case which has prompted these collecting agencies. Any practician who the chronicling of these bits of hitherto unwill adopt and carry out a business method will written history is the following: Only two have very few claims that he will wish to submit nights ago I was aroused from slumber by an to a collector. D. C. SUMMERS, M.D. anxious voice at my door. The visitor proved Elm Springs, Ark.
to be an old man long addicted to the use of
the catheter. He had broken off the rubber Orificial Surgery.-A Few Cases. instrument half way the body of the penis. Editor MEDICAL WORLD :-During the first He told me it seemed to be glued in. So I year of my practise I was called to extract a filled a pipet with glycerin, had him lie on his bean from the nose of a child. Failing with back, and holding the organ erect, introduced the forceps, I introduced a small scoop, and the glycerin allowing it to gravitate downward pressing the convex side close to the nostril, while I proceeded to select an available exsucceeded in getting it above the bean and tractor. With one blade of the instrument in drew it out quite easily.
the catheter and the other outside, I made traction and only succeeded in snipping away negroes. One man had a balance of $480 to a small bit of the brittle rubber.
his credit, and in one month had drawn it all The same procedure on the opposit side was out. Askt what he had done with it, he followed by a similar result. Then pressing "didn't know;" but he remarkt that if it the blades of the forceps as wide apart as the had been $1,000 he would have spent it all. caliber of the urethra would allow, and grasp- Now this man will draw supplies for his fainily ing both sides of the catheter and making for the year, until his next crop is marketed. steady traction outwards, the instrument was The Italians do better; and in a few years dislodged and taken from its hiding-place. own their farms, whose crops of truck soon Needless to say he went home a happier man. make them comfortably well to do.
Now Mr. Editor, with all your elisions why The publication issued by Mr. Fuqua tells not elide one syllable from each of the follow- all about the character of the lands, upland, ing words: Symptom-(at)-ology and system- alluvium, salt marsh, hard and soft wood, (at)-ize, thus adding to their respectability ? corn, rice, cotton, sugar, mineral, oil, etc. Lytle, Tex.
JOHN F. NEAL.
From this one may form an idea as to what [Your suggestions are in the direction of part of the state he cares to investigate. The simplicity in language, where all progress is Illinois Central also supplies information on tending.-Ed.]
these topics; and all the roads allow reduced
rates to home-seekers. More About Conditions in the South.-An. I do not pretend to know much about farmswers to Quizes.
ing, but there are things I failed to compreEditor MEDICAL WORLD:- Judging by the hend. Below New Orleans stretch miles of number of letters coming to me asking further salt marsh, that a Georgia cotton planter told information about the South, your circulation me was the same formation as the islands on is in no urgent need of digitalin. And the which the celebrated sea island cotton was interest seems to warrant some further remarks raised. Along the Atlantic coast such land is on the subject.
very valuable, but this is sold for twenty-five · Write to Mr. Fuqua, State Commissioner of cents an acre. I could not find whether this Immigration, Baton Rouge, La., and he will land had ever been tested for sea island cotton, send you a pamphlet describing over six mil- but concluded there must be some reason it is lion acres of land in the state for sale. Over not so utilized—but people say : “Remember two thirds of the acreage of the entire state this is the South, and very likely it has never is offered in that one booklet. Practically been tried." the entire state is for sale.
Everywhere we saw whites and negroes Why? Whenever anyone wants to sell you working side by side—if there is any prejudice something, ask yourself why he values your against a white man who seeks to earn an honmoney above his own property, and you may est living by any honest work, we did not save yourself from loss.
detect it. We were even told that in the Let me remark here that not once did I State University some of the cadets earned meet in Louisiana a single white man who money waiting on tables, etc.
If this is so, exhibited any wish to leave the state. Nativs there need be no fear of any white man "losremain there, northern men come to stay. ing caste" by manual labor. But there is a vast area of land there that the Can the white man work in that climate? owners cannot utilize.
Yes, if he is not too lazy. Sixty percent of Here is an example: A wealthy planter re- the cotton crop is now raised by white labor. siding in Clinton told me he had 6,000 acres Every northern man we met treated the idea of cotton land, one-half of which lay idle for of climatic inhibition with derision. The want of hands to cultivate it. He had applied South is the machinist's paradise—the prices at the immigrant quarters in New York, and they charge for work are something fierce. traveled thru the southern Atlantic states, During the winter we never saw alligator, gathering up all he could induce to come, and snake or mosquito; but are told that during had 100 families located on the property, and the summer, fies, mosquitos, ticks, gnats, yet it was half untilled. He made any and redbugs, and other insect pests render life all arrangements with them, hiring for wages, strenuous. The sort of people who will be taking shares of the crops, renting by the acre, turned aside from their plans by such considerselling at any desired ternis; and in all cases ations would better not go south-or north, east issuing all needed supplies until the crops were or west. gathered. This is then taken at the market Do you want any more? price, and the laborers receive the balances Indiana, page 262, should begin by investidue them. That this is a substantial sum in gating the condition of the genito-urinary many cases seems to matter but little to the apparatus, and he will surely find the cause for