thought, may be induced to become constant readers of this publication.

AMERICAN MEDICO - PSYCHOLOGICAL ASSOCIATION.-The American MedicoPsychological Association, having become affiliated with the Congress of American Physicians and Surgeons, it is obligatory under the constitution and by-laws of the Congress that the Association hold its meeting in 1903, and every third year in Washington. The Council has therefore instructed the Secretary to issue this notice, changing the place of meeting from Providence to Washington, and fixing the dates, May 12, 13, 14 and 15, 1903.

THE date of meeting of the Illinois State Medical Society has been changed from May 19-20-21 to April 29-30, May 1-2, 1903, in Chicago. This change was made necessary to anticipate the earlier meeting of the American Medical Association at New Orleans.

FOR SALE - Superior location in central Ohio. Fine schools, church, etc. Town of 1,000. rich surrounding country. Practice averages $2 000 per year. For further particulars address DR. F. A. VIGOR, Marysville, Ohio.

RATIONAL TREATMENT OF GOUT.-Referring to the diagnosis of gout, the following symptoms are worth mentioning: Gastritis, enteritis, hemorrhoids, migraine, neuralgias, sciatica, lumbago, ocular inflammations, varicose veins, nephritis, gravel, and we may add pulmonary catarrh in the aged. As can be readily understood, gout is in the main an affection of the stomach, liver, pancreas and kidneys. Hence the necessity of instituting at once a treatment regulating the functions of digestion and assimilation. This is readily accomplished through the persistent and systematic administration of Kutnow's Powder once or twice a day, an hour before meals. This preparation corrects the acidity of the stomach, and regulates the liver, while acting on the kidneys. We may keep in mind, also, that the timely administration of Kutnow's powder is an admirable preventive. When prescribing Kutnow's powder in suitable cases, doctors may desire to test the acidity or alkalinity of the urine. Kutnow Brothers, Ltd, 853 Broadway, New York, will send to every physician two boxes of the very best litmus papers obtainable, put up in a specially convenient form, each box containing sufficient amount for one hundred tests. Whenever the supply is exhausted they will renew the boxes, if the physician will drop them a postal.

Correspondence.

NASAL CATARRH. KNOXVILLE, TENN., January 18, 1903. Editor LANCET CLINIC:

Having myself for years been a great sufferer from nasal catarrh, and finding no relief from routine treatment of like troubles, such as actual cautery, sprays, etc., I experimented on myself with different remedies till now, after three years' trial, I am confident I can, offer the profession a remedy in the shape of a snuff that is almost a specific in nasal catarrh, both acute and chronic.

Again, if used freely at the beginning of an ordinary cold in the head-as soon as sneezing sets in-it will prevent it from developing, and will stop a full-blown

cold in the head in twelve hours. I use the term freely advisedly, because to do good-especially in severe cases-it must be used every few minutes.

We all know what it is to feel bad, when an incipient coryza requires us to constantly attend to the condition of our nose; when the nose may literally be said to run water, and take the skin off where it touches, too.

This is the time to use the snuff "freely." You will be surprised and gratified at the relief to the pain and burning in the nose, and how quickly the discharge stops. Again, in the declining stage of a cold in the head, it has a happy effect, in that the patient who uses the snuff freely will never discharge pus from the nose, and I fancy will lessen the liability to ethmoid disease and empyema of the frontal sinus, also middle-ear disease.

Another feature of the snuff is that it contains nothing injurious to the nasal passages, hence may be used ad libitum; nor does it hurt the system. The ingredients of the snuff meet all the indications for an antiseptic, an astringent, an analgesic, and a protection to the inflamed mucosa against the cold air, which causes that peculiar burning sensation in acute nasal catarrh.

This is the proportion of the formula:

I would urge every physician prescribing this snuff to insist that the druggist put up the snuff in a small vial, because, unless the snuff be kept well protected from the air, it will deteriorate, and then the patient can carry it in his vest pocket and use at pleasure.

Again, the physician should never fail to teach the patient how to use the snuff. This is absolutely necessary to get the full benefit from it. For example, suppose you want to introduce the snuff into the right nostril. Place the palmar surfaces of the thumb, index and middle fingers of the right hand together so as to form a cone, in the apex of which cone will be a natural fossa to hold a bit of the snuff (which you pour from the bottle with the left hand the size of a grain of wheat). a grain of wheat). Then place the cone formed by the fingers holding the snuff against the right nostril, close the left nostril with the left hand, toss the head slghtly back and draw the snuff up into the nose with a strong inspiration. Repeat the process on the other side. In this way one gets the good effects of the snuff and don't spill it over one's face and clothes. Only in attention to these details will the physician succeed in having a cure effected.

Again, be careful to caution against using too great amount of the snuff at each séance, because, unless you do, the patient may have a fit of sneezing, and be loth to try it again. Tell the patient if he should sneeze after the snuff to blow his nose and use it again.

The sensation on using the snuff, especially if in the height of a cold, is a momentary burning or stinging, which soon gives way to a pleasant, cool feeling as the nasal passages open up.

I hope my brother practitioners who may see this letter will give the snuff a fair trial and tell others of it, because I never see or hear of anyone suffering with a "cold in the head" that I don't feel as if I would like to do something for the unfortunate. Yours faithfully,

BENJAMIN B. CATES, M. D., Professor of Surgery in the Tennessee Medical College; Visiting Surgeon Knoxville General Hospital.

METHYLENE BLUE.

CHAMBERLAIN, S. D., January 21, 1903. Some time ago I had occasion to prescribe methylene blue to a married gentle

man, who tells the following story on himself:

After taking a capsule he retired, but during the night had occasion to use the chamber. In the morning, while in his library, he heard his wife call his eldest daughter, who is six years old, into the bedroom, and heard her say: "Daughter, why did you spill ink in this chamber?" And before the child could explain she received a spanking, and amidst sobs declared her innocence. "Well, then, it was your younger sister;" and that child received a spanking, after which the father recalled what he had taken, and an explanation and reconciliation followed.

Mr. T., thinking it a good joke, induced a friend of his to take one, telling him it was the very thing to take after an evening of dissipation. This gentleman, too, used the chamber during the night, in common with his good wife. The next morning she called him into the bedroom and said: "Harry, what under the sun ails you?" Harry replied that he was all right, but asked: "What's the matter with you? It's your bladder, not mine, that's off." Harmony has since been restored, the effect of the fray having disappeared. F. TREON, M.D.

Treatment of Hemorrhage in Typhoid Fever.

Curtin, of Philadephia (Medicine), makes the following recommendations as to the treatment of hemorrhage in typhoid fever. If caused by leakage from the mucous membrane, ergot hypodermically or by mouth. Turpentine, internally or externally, is useful when the hemorrhage is associated with tympanites. Externally applied it should be sprinkled on a flannel cloth. Opium should be used if the bowels are loose. Oil of erigeron is useful if the stomach will bear it. It should be given in capsule. Ice externally, applied in an ice bag, or pieces of pounded ice passed into the bowel may be efficacious. Suprarenal entract, and, in some cases, thyroid extract are useful. Ligatures about the limbs, applied tight enough to obstruct the venous return of blood should be used in extreme cases. The foot of the bed should be elevated.

Dr. Curtin's records show that since the introduction of the cold-water treatment the percentage of hemorrhagic cases and the mortality of these cases has increased.

Current Literature.

Chloride of Calcium.

Dr. Bertignon (Medical Press, November 26, 1902) furnishes a series of cases in which chloride of calcium proved to be an excellent hemostatic. It succeeded where perchloride of iron, antipyrin, ergotin, and hot injections failed. It is indicated. in hemorrhages of every kind, and in all maladies presenting hemorrhagic complications. Hematemesis, hematuria, enterorrhagia, are arrested by CaCl. Bertignon cites the case of a patient suffering from acute general purpura cured by this remedy, where ergotin, perchloride of iron, citric acie, lemonade, etc., were tried without success.

Bertignon says that of all the coagulating solutions known, chloride of calcium was the most easily borne by the stomach. In more than one instance at the hospital had he seen it succeed when prescribed for grave hematemesis.

For intestinal hemorrhage complicating a case of typhoid fever, enemas of a drachm of the salt, and half a drachm given by the mouth, with a little opium, have yielded very good results. It is especially indicated in hemophilia.

The best formula, according to Dr. Bertignon, is chloride of calcium (crystallized), zj; syrup of opium, ziij; water, 3iv. To be taken every twenty-hours, and renewed as long as the hemorrhage lasts.-Med. Age.

The Treatment of Chorea with Arsenic. Louis Fabel (Paris Thesis, 1901-1902, No. 260. Gaz. Heb. de Méd. et de Chirur., July 24, 1902) says that arsenic is the medicine of choice in the treatment of chorea that is not menacing to life. Chloral is the most heroic of the sedatives; but it may be vomited or, being absorbed, it may have no action. Opium, in order to succeed, should be given in large doses; but may also fail. Tartar emetic sometimes gives excellent results, but it is contra-indicated in cases of digestive or circulatory disorders. The wet pack often succeeds very well when there is prostration. Antipyrine is the best medicine in

light and medium cases of chorea. Strychnine should be rejected completely in the therapeutics of the disease.-Philadelphia Med. Journal.

Reciprocity in Licensure Once More.

The subject of interstate reciprocity in medical license has been discussed in these columns on many occasions, and we feel that it is almost unnecessary to return to the subject until we can offer something new to our readers relating to this vexed question. The journals have been printing considerable material of late that has dealt with many features of the proposition, much of which has missed its essential points, but we find an editorial article in the Boston Medical and Surgical Fournal for December 18, 1902, which exhibits such a grasp of the subject as well as such a breadth of knowledge of all its bearings, that we feel justified in giving it in full, and we ask all interested to read it carefully, because it is a succinct statement of the real facts in the case, set forth in a

plain, straightforward manner. It is as

follows:

66

Reciprocity, or Interstate Licensure of Physicians.-The impression is more or less general among medical men that a person registered as a physician in one State should, on removing to another, be recognized by the authorities therein as a qualified practitioner and licensed to practice, without being required to take another State examination, or even to pay another State registration fee. For several years this matter has received considerable attention both in the medical press and in the discussions of medical men in many of the States.

"A few years ago a national organization was effected by the examining and licensing boards of the country, in an endeavor to bring about as nearly as possible a uniformity not only of methods of procedure but of qualifications required for licensure. It was thought by the promoters of this organization that under a uniformity of requirements by the various boards, a system of reciprocity might ultimately result, whereby a physician licensed by any recognized State board might secure a license to practice within the jurisdiction of any other board, without incurring the expense and trouble of a new examination. But in this respect,

thus far, the work of this organization has proved a disappointment. In the path of reciprocity, so to speak, many obstacles appear which perhaps at first sight do not present themselves as hindrances at all.

The examining boards in the different States are differently organized. They act under different laws, making different requirements. In a number of States, Michigan, for instance, and Colorado, Kentucky, Nebraska, Vermont and several others, a diploma from a recognized medical school is the only qualification required for licensure. In Massachusetts, New York, Pennsylvania, and various other States, the laws require that every appli cant shall be examined as to his qualifications to practice. And even in States requiring an examination of all, it is easy to see that standards of qualification may differ widely. Each State is naturally jealous of its own work and standards, especially its educational standards. The several States, so far as their internal affairs are concerned, are quite independent of each other. Each makes its own laws and cares for its own people in its own peculiar way, and exercises no more authority over or in the affairs of other States of the Union than does France in the affairs of Great Britain. Hence arise difficulties nearly, if not quite, insuperable in the way of medical reciprocity.

"The contention sometimes heard as to the desirability of a national law governing practice is utterly futile from the fact that the National Government cannot legislate at all on such matters. The Constitution, the organic law of the union of the States, does not permit such interference in State affairs.

"In a few States, notably New Jersey and Maine, the examining boards have provided for a limited interchange of registration certificates issued by certain States. But the "red tape" guarding this process of registration, taken with the fact that the fee of registration through interchange of certificates is double that required for registration by the examination process, is quite enough to render such a system of registration undesirable, if not altogether impracticable.

"It is clearly within the authority of examining boards, as usually constituted, in testing the qualifications of applicants for registration, to give weight to the credentials a practitioner may bring from

another State board or from his former peers in practice. This is the kind of reciprocity one would naturally expect and which unquestionably is regarded by all State boards. Under existing circumstances this is about as far as reciprocity is likely to go in the near future."-Buffalo Med. Journal.

Seasonal Variations in Growth of Boys.

The examinations were made at the Boys' Home in Dedham, a branch of the Boston Children's Friend Society. All the children were weighed, stripped, once a week, and heights were measured every three months, except on the third quarter, which occurred in August. Twenty out of the thirty boys in the home remained throughout the year, and these only are considered. The results of the study are as follows:

1. Variations in weight amounting in some cases to as much as five pounds were observed in most of the boys from week to week. These variations were so numerous and so marked as to suggest that any single test of an individual is liable to a plus or minus error of several pounds, and that successive weighings are necessary for accuracy.

2. Over 90 per cent. of the total increase in weight occurred during the period from June to December. This is in essential accord with Malling-Hansen's results.

3. During the period from January to June the weight fluctuated without definite gain or loss, constituting a period of minimum growth. This seems to be made up of shorter periods of gain and loss which practically neutralize each other and are more or less variable in their occurrence and in their range in different individuals.

4. The weight fluctuations are much more marked during the period of minimum growth in weight than during the period of maximum growth. This seems to indicate that there is less resistance to external influences during this time, and that on the whole the vitality of the child is at a lower level.

5. A preliminary study of the weather conditions in connection with these curves of growth shows that rainfall, temperature and barometric pressure had slight, if any, influence. Humidity, on the other hand, seems to have had some influence

during the period of minimum growth. Malling-Hansen reported that temperature controlled growth in some degree.

6. The general form of the curve of growth in weight was found common to all the individuals studied, covering the ages seven to fourteen. The larger minor fluctuations were also found to be common to the majority of the boys, suggesting that the causes were general rather than individual, and that growth throughout this age period has the same general seasonal variation.

7. Growth in height in the majority of cases showed either a continuous increase at the same rate throughout the year or more rapid growth during the period of most rapid growth in weight. Three boys only showed correspondence with MallingHansen's conclusions, that is, more rapid growth in height during the resting period of growth in weight.-F. W. HITCHINGS, M. D., and G. W. FITZ, M. D., in Gaillard's Med. Journal.

A "Pure Food" Bill Passed.

On December 19 one of the anti-adulteration bills introduced in the United States House of Representatives was passed by that body. The bill is for preventing the adulteration, mis-branding, and imitation of foods, beverages, candies, drugs and condiments exchanged between the States and in the District of Columbia and the territories, and for regulating inter-State traffic therein.

It directs the secretary of agriculture to organize the chemical division of the department of agriculture into a bureau of chemistry, which shall be charged with the inspection of food and drug products, and shall from time to time analyze samples of foods and drugs offered for sale.

Traffic in adulterated or misbranded goods is prohibited under penalty of a fine not exceeding $200 for the first offense, and for each subsequent offense a fine not exceeding $300 or imprisonment not exceeding one year or both.

When the secretary of agriculture finds that food or drugs have been adulterated or misbranded, he is to certify the fact to the proper United States district attorney, who must prosecute. The secretary is to fix the standards of food products when advisable, and is to determine the wholesomeness or unwholesomeness of preserva

tives and other substances added to foods, and these standards may be read in evidence on the trial of any violator of the law. Any dealer who refuses to furnish samples to the department can be punished by a fine of $100, or imprisonment not exceeding one hundred days, or both.

The last section of the bill provides that any article of food or drug that is adulterated or misbranded within the meaning of this bill, and is transported, or being transported from one State to another for sale, or if it be sold in the District of Columbia or the territories, or if it be imported from a foreign country, shall be liable to confiscation by a process of libel for condemnation in the United States courts. Such goods, it is also provided, shall not be sold in any State contrary to the laws thereof. -Druggists' Circular.

"Hardening" of Children.

Dr. Hæcher (Münchener med. Wochenschrift, November 18) says that the method of hardening children by means of cold baths is not only unnecessary, but is often injurious. It increases rather than diminishes their susceptibility to "colds," thus inducing coryza, throat affections, bronchitis and pneumonia. Anemia may result, with nervousness, loss of appetite, disturbed sleep (pavor nocturnus), irritability, with a subsequent change in character, such as moodiness, violent temper and uncommunicativeness. Catarrh of the large intestine may result from it and it causes a longer duration of incident illness, especially of pertussis. Hæcher would advise instead of the cold baths, accustoming the child to the room temperature by occasional stripping and permitting him to run about naked before retiring, running barefoot, avoidance of uncovering during the night. The child should sleep near an open window only during the summer. He urges that children should be sent outof-doors at all times except when it is very stormy and especially not when there is a northeast wind. Older children should have airbaths and sunbaths in the summer and should go barefooted. The clothing should always agree with the weather with no fixed rules. Children should wear no furs and should usually have the neck uncovered. The legs should be uncovered only in the summer, and in thin children, never. As to cold water, it should be