sota is simply complying with the law as interpreted to them by the attorney general. Let us. then, ask, Is the law right? Are two colleges of the high standing of Rush and the P. & S. doing right in their apparent opposition to our law? The answer to each is simple. If a four-year course as a requirement to admission to practice is justified, surely such course should be taken either under medical men or under their supervision, and this can safely be done only in the medical college. Rush and the P. & S. should refrain from doing anything which, though in itself and in their hands is all right, is capable of great abuse in the hands of other colleges.

THE LANCET would not take so serious a view of this matter were we not aware of great abuses that can be practiced, if indeed they are not already practiced, under this power to grant advanced standing for work done outside of the medical college.

We commend the course pursued by our State Board of Medical Examiners, and we feel confident that their efforts to raise the standard of the men coming into the state will bear rich fruitage.

WHAT MAKES A CITY?

Answer this question as you will, the ultimate cause is found in the "push" of the men who shape the policy of the various trades and proiessions of the hamlet, the village, the city; but enterprise will never increase trade and population unless it be felt, and to be felt it must be known. Here is the opportunity for the trade and profession journal. Minneapolis has 120 such periodicals, the largest of which has a circulation of 300,000.

Daily, weekly, and monthly these journals go to all parts of the world as heralds of the opportunities Minneapolis offers to enterprising men and women; and the result is so manifest that the most optimistic wonder at the city's growth, and this wonder was never greater than at the end of the year just closed.

But we started out to say a word about one of these journals, The Northwestern Miller. Its holiday number contains 256 pages double the size of the ordinary magazine page. More than a score of its illustrations are full page in size; and in beauty of design and printing they are unsurpassed by the handsomest work of our

great monthlies, which are to-day the wonder of the world.

The text of this issue is in keeping with this wealth of illustration, and together they make a journal well worth the selling price, $2.00 a

copy.

Can anyone compute the value of The Northwestern Miller to Minneapolis? Can any advertiser in such a journal say his advertisement does not pay? Perhaps he can if the estimate be in the amount of mail-orders received, but great enterprises are not built up in that way.

We may well feel proud of The Northwestern Miller, but we should recall, once a year at least, that it is not self-made: it has an editor, William C. Edgar.

Due credit is all the credit needed by the makers of the Minneapolis trade and professional journals.

IMPORTANCE OF VACCINATION

The recent outbreak of smallpox in Montana, and the inability of the health officers to control or suppress the epidemic, is the strongest evidence for protection by vaccination. Dr. H. M. Bracken, in a paper on the "Control of Smallpox," urges physicians to educate the people anew on the subject of vaccination. Until the public understand that vaccination is more protection than isolation the responsibility of epidemics must rest upon the people themselves. The history of epidemics and their control by vaccination is familiar to physicians, but the laity still are inclined to skepticism. The faddists who try to think they believe that vaccination does more harm than good, are not so boisterous as they were a few years ago. Many of them have been removed by smallpox, many have become alarmed for their own safety, and a few have been converted by valuable object lessons. A large number remain who obstinately adhere to their delusions, and who are capable of delaying the only true means of protection from smallpox.

The present methods of preparing vaccine are so comparatively free from harm that every physician should demand the vaccination of every infant or child when there is a suspicious case in the vicinity. The immunity that follows successful vaccination in childhood is the best safeguard against epidemics, and, as Dr. Bracken

says, the danger from isolated or occasional cases is reduced to the minimum. The necessities for quarantine are lessened with early vaccination among the young. If vaccination were made legally compulsory there would be no epidemics, and smallpox would be stamped out in a few years, certainly within two decades.

From a commercial point of view compulsory vaccination would pay, for business would not be interrupted and expensive methods of quarantine would be needless. The carelessness displayed during mild epidemics by the public means great expense when epidemics are serious. No one can foretell how severe an epidemic may become.

From 1899 to October 1, 1904, Minnesota had about 25,000 cases of smallpox with nearly 200 deaths. The large number of cases was the outcome of lax vaccination methods and the mildness of the epidemic. Some day the epidemic will spread with rapidity and furor, the people will hasten to the physician for protection, and the lesson will make an impression-for a time.

Until the public thoroughly understand the dangers of smallpox, and the safety of vaccination, the physician must continue the campaign of education. Compulsory vaccination is neither a hardship nor a danger, but an epidemic of smallpox is both.

REPORTS OF SOCIETIES

HENNEPIN

COUNTY MEDICAL SO-
CIETY

F. A. KNIGHTS, M. D., SECRETARY.
The annual meeting of the Hennepin County
Medical Society was held January 9, Dr. C.
H. Hunter, president, in the chair.

The application of Dr. A. E. Johnson, Hamline, 1903, 2408 Central Ave., was read and referred to the Censors.

The Censors reported favorably upon the names of Dr. C. E. Henry and Dr. H. C. Arey for membership, and Dr. P. M. Hall for reinstatement, and upon ballots they were declared elected to membership. The applications of Dr. M. A. Kiefer, U. of Minn., '04; Dr. Geo. H. Coffin, Hamline, '04; Dr. Arnt E. Ofstad, Hamline, '04; Dr. L. Joseph Coria, U. of Minn., '04, and

Dr. Geo. D. Crossette, U. of Minn., '04, all hospital internes, for associate membership were read and referred to the Censors.

The Secretary-Treasurer moved that the Board of Censors be instructed not to consider, hereafter, any applications for membership not accompanied by the initiation fee of three dollars.

Dr. C. H. Hunter then delivered the annual address, the subject being "Some Suggested Functions of the Hennepin County Medical Society."

The election of officers then took place, and the following named gentlemen were declared elected: President, Dr. D. O. Thomas; vicepresident, Dr. A. B. Cates; librarian, Dr. S. M. White; executive committee, Dr. C. H. Bradley, Dr. J. W. Bell, Dr. Geo. G. Eitel; board of censors, Dr. R. J. Hill, Dr. W. B. Pineo, Dr. J. C. Litzenberg, Dr. Geo. D. Head, Dr. J. D. Simpson; trustees, Dr. H. H. Kimball, Dr. Edwin Phillips, Dr. W. A. Hall, Dr. G. C. Barton, Dr. R. J. Hill; delegates to state association, Dr. A. W. Abbott, Dr. F. A. Dunsmoor, Dr. G. G. Eitel, Dr. D. O. Thomas, Dr. A. B. Cates; alternates, Dr. J. W. Little, Dr. L. A. Nippert, Dr. C. G. Weston, Dr. H. B. Sweetser, Dr. A. J. Murdock.

Dr. Hunter then resigned the chair to Dr. D. O. Thomas, who made a brief speech of accept

ance.

Dr. Thomas, in accepting the nomination, said in substance:

I cannot take the chair without expressing my appreciation of the honor you have conferred upon me. Since your action did not originate in any aspiration or candidacy on my part, and since I possess no special fitness for the position, I am more gratified by the unanimity of your action than by the wisdom of your choice.

As a rule we are more deeply touched by the manner a favor is extended than by the distinction involved. In social life the true flavor of culture and urbanity fills the occasion with only sweet thoughts more by the way a tribute is expressed than by the consideration bestowed. And even in our own profession the technique often elicits more admiration than the result. At this juncture I could wish that the subject of your choice were more worthy of your technique. While your unanimity of choice doubtless was

due largely to my membership in the society of nearly twenty years, and some social affiliations, it is natural for me to see in your kind feeling an intention to recognize my honest endeavor to stand shoulder to shoulder with the profession. And while I know myself too well to believe that your tribute implies more than that I am in the procession with my face in the right direction, the harmoniousness of your action is very gratifying as it enables me to count you all as my friends.

While I appreciate all friends, and esteem the opinion of all good men, there are no friends whose good opinion I value so highly as those of the medical fraternity, and my loyalty to the profession has made me ever ready to sustain an honorable practitioner, even if I have to sacrifice my most intimate friend in lay circles.

I have always tried to be loyal to the Hennepin County Medical Society, and have regarded it of more value to me by far than any other society to which I belong. Its excellent contributions and able discussions cannot fail to have an educational value, consequently it affords me great pleasure to have the honor to serve the Society during this, the most prosperous, time in its history. I shall do my utmost to maintain its hight tide of prosperity, and to promote the spirit of good fellowship in the profession.

I shall confide that the generosity which prompted you to confer this honor upon me will also leniently regard all my shortcomings. Even if I am not equal to some in mental alertness I shall endeavor by a slower pace to arrive at unbiased and just decisions, and shall do my utmost to prove myself worthy of the honor you have bestowed upon me.

The society then adjourned.

NEWS ITEMS

Dr. Arthur Kahala, who has been associated with Dr. Quinn, of St. Paul, has located at Men

tor.

Dr. J. B. McGaughey, of Winona, has been. reappointed a member of the State Board of Health.

Dr. Frank W. Cottom, a recent graduate of Jefferson Medical College, of Philadelphia, has located at Nassau.

Dr. M. A. Heffelfinger, of Washburn, N. D., has become associated in practice with Dr. F. R. Smyth, of Bismarck.

Dr. Harry Crawford, of Brookings, S. D., was married last month to Miss Mary E. Madden, of Castlewood, S. D.

Dr. H. H. Healy, of Grand Forks, N. D., has been appointed superintendent of the North Dakota State Board of Health.

Dr. Thomas A. Pierce, a homeopathic physician of Winona, and one of the oldest practitioners in the state, died last month.

Dr. Augusta F. True has moved from Lismore to West Concord. Dr. True graduated from the State University in '94.

Dr. H. C. Leonard, a homeopathic physician, who has been farming at Pine Knoll, has resumed practice and located in Duluth.

Dr. Ovide Martel, formerly of St. Paul, is conducting a hospital at Young America, of which he is making a marked success.

Dr. C. W. Wilkowske, who graduated from the homeopathic department of the State University, last summer, has located in Faribault.

The Mennonites in the vicinity of Mountain Lake have formed a corporation with a capital of $25,000 for the purpose of building a hos

Dr. S. O. Kron, of Enderlin, S. D., has sold his business to Dr. Gerrish of that place, and will move to California. Dr. Kron is a graduate of Hamline.

Dr. Garrett Murphy, who has practiced for a number of years at Garden City, committed suicide at Pine River last month, where he had recently located.

Dr. G. M. F. Rogers, of Buffalo, was operated upon at St. Barnabas last month by Dr. G. C. Barton. He is much improved and will soon resume his practice.

Dr. H. O. Schaleben, a graduate of the State university, now practicing at Lake Benton, was married last month to Miss Gertrude Ramsland, of Sacred Heart.

The local paper of Leonard, S. D., says a physician is needed at that place, and adds that the country surrounding Leonard will give a good practice to a good man.

Dr. I. M. Burnside, of Highmore, S. D., was married last month to Miss Jessie May McDonald, who has been prominent in educational circles of South Dakota and Wisconsin.

Dr. E. L. Cheeney, of Duluth, has been appointed acting assistant surgeon in the public health and marine hospital service, in place of Dr. S. H. Olson, who has left Duluth.

Dr. F. D. Brandenburg, of Faribault, who formerly practiced in Mankato, has decided to return to the latter city. He will be on the surgical staff of the new Lutheran hospital.

Dr. A. J. Stone, of St. Paul, is surgeon-general on the staff of Governor Johnson, and he will fill the position admirably, having had experience in this position on Governor Lind's staff.

Dr. G. J. Hanley has returned to Cass Lake to resume a very successful practice. He has had an extended course at Johns Hopkins and other eastern hospitals, and spent six months in Berlin.

It took a jury five minutes to acquit and completely exonerate Dr. R. T. Germain, of Barnesville, Minn., who was charged with administering poison to a confirmed inebriate who died under his care.

Dr. A. E. Spalding, of Luverne, is at the head of an organization to build a hospital in that place. The plans for a two-story building have been drawn, and work will soon be begun on the structure.

Dr. Christopher Graham, of Rochester, has been appointed a member of the State Board of Health, in place of Dr. Charles H. Mayo, who declined reappointment because of lack of time to serve on the board.

Dr. W. H. Young, who has been an interne for the past six months at St. Mary's Hospital, Rochester, has located at Munich, S. D. Dr. Young is a graduate of the Physicians and Surgeons' College of Chicago.

Dr. N. S. Tefft, of Plainview, died on Jan. 21, at the age of 74. Dr. Tefft was the oldest physician in Wabasha county, and had practiced in Plainview since 1856. He graduated from the Electric Medical Institute of Cincinnati in 1852.

The Morrison County Medical Society met last month in annual session at Little Falls, and the following were elected officers for the current year: President, Dr. O. C. Trace; vicepresident, Dr. C. F. Holst; treasurer, Dr. N. W. Chance, all of Little Falls.

The Washington County Medical Society met last month at Stillwater and elected the following officers for the current year: President, Dr. T. C. Clark; vice-president, Dr. G. N. Watier ; secretary and treasurer, Dr. F. G. Landeen, all of Stillwater.

The Aberdeen District Medical Society met at Aberdeen, S. D., last month and elected the following officers for 1905: President, Dr. W. A. Kriesal, Milbank; vice-president, Dr. C. E. McCauley, Aberdeen; secretary, Dr. E. J. Clemons, Aberdeen; treasurer, Dr. E. O. Miller, Aberdeen.

The Upper Mississippi Medical Society met in Staples last month, and the following were elected officers for 1905: President, Dr. J. G. Millspaugh, Little Falls; vice-president, Dr. J. A. Thabes, Brainerd; secretary, Dr. Chas. F. Coulter, Wadena; treasurer, Dr. Paul C. Kenyon, Wadena.

At the January examination of applicants for certificates to practice in North Dakota, the folwere granted lowing successfully passed and certificates: Dr. B. E. Lord, Glenburn; Dr. William Robertson, Russell; Dr. G. A. Matthews, Dresden; Dr. C. B. Lewis, Fargo; Dr. C. J. Montgomery, Winnipeg, and Dr. J. C. Dillon, Fargo.

The Southwestern Minnesota Medical Society met at Windom last month and elected the following officers for 1905: President, Dr. F. M. Manson, Worthington; vice-president, Dr. C. C. May, Adrian; secretary-treasurer, Dr. H. D. Jenckes, Pipestone; Dr. Lou M. Gerber, of Jasper, and Dr. J. A. Schultz, of Dundee, were elected to membership.

FOR SALE.

A sixteen-plate Brunsell static machine, including fluoroscope, Crookes' tube, electric motor, cautery transformer, etc. The machine and attachments are in perfect condition and cost $300. It will be sold cheap for cash. Inquire of Dr. C. M. Oberg, 201 Globe Building, Minneapolis.

FOR SALE

A Bausch and Lomb microscope, with several objectives and oculars and other attachments and case, is offered for sale by the widow of a physician who recently died. The list price is $126.50, and the instrument is offered for $75. It is now in the possession of Prof. Thomas E. Lee, of the State University, and a full description of the instrument may be had from Prof. Lee or at the office of THE LANCET.

VOL. XXV

No. 4

Surgery of the thyroid gland dates surprisingly far back. Woelfler, who made a thorough study of its history, found that Galenus, and even Celsus, reports such operations. In the middle ages we find very few data about this subject. However, in the 17th century the aspiration of cystic goitres was done by numerous surgeons, and already two hundred years ago Johann von Muralt, a Swiss surgeon, made a successful goitre operation. In the beginning of the 19th century partial excisions began to be done here and there, and after the year 1850 were gradually taken up by some leading surgeons, such as Bruns, Billroth, Rose, etc. The operation even then was done without any sufficient knowledge of the physiology and pathology of the gland. It was suddenly commanded to halt in the years 1879 and '80, when the Swiss surgeons Reverdin and Kocher became aware of the most pitiable condition into which the patients fall, when their thyroid gland has been totally excised. Kocher described these symptoms with especial care and keen observation, and named the affection cachexia strumipriva, or thyreopriva. Modern surgery has taken advantage of these all-important facts, and avoiding these dangers has taken almost full possession of the diseases of the goitre by restricting its operations to only partial removal of the gland.

The first knowledge of the function of the gland as to its internal secretion was given us by the physiologist Schiff of Geneva, which gradually led up to Murray's discovery of the physiRead before the Hennepin County Medical Society Dec., 1905.

ological action of thyroid gland substance if taken internally. Physiology in this way assisted surgery, as the indications for goitre operations became more definite, and with the help of internal thyroid medication surgery was allowed to stretch its limits, as in malignant diseases.

In order to arrive at strict indications we must have an exact history and a detailed knowledge of the size, shape, location, consistency, and the relation of the gland to the neighboring organs in each case. This knowledge can be gotten principally from an exact palpation, which is best done with the two thumbs while the rest of the fingers steady the hands to the neck of the patient. It is furthermore necessary to put down the findings in a picture. I may mention that no goitre examination is complete without an exact laryngoscopical status. In going over the different kinds of goitres in regard to their operative indications, I will mention first the most frequent and important ones, that is the benign. forms which produce pressure symptoms. The operation is indicated in these cases on account of serious dangers of different kinds which arrive from such pressure.

We may find a compression of the trachea. from front or the side. The trachea at such a place is softened, the cartilage usually degenerated in the myxomatous sense. The danger in In such a case may come in different ways. one case we have a marked and practically constant dyspnea; in other cases there occur sudden, most frightening attacks of asphyxiation by collapse of the softened trachea, while again in a