follow powder wounds than other lesions of like severity; and this should prompt thoro eradication and cleansing. There is the certainty that if they are not removed at this time that there will be an annoying disfigurement, and the knowledge that the attempted removal at a later time will be difficult, impossible, or disappointing. Such knowledge on the part of the physician should impel him to insist upon the patient submitting to a thoro removal at the first dressing, even in the face of all the objections commonly made about "increasing the soreness." The fact is that the soreness is not increast by this cleansing and removal, but that such proper dressing hastens healing; and removing the foreign bodies lessens the irritation and inflammation consequent upon the wounding of the tissues.

It is not possible, except perhaps in cases where only a very few grains are imbedded, to make a satisfactory dressing unless the patient is completely anesthetized. Local anesthesia may be used, but the time required to induce a satisfactory degree of anesthesia is an item, and many patients will object to the vigorous scrubbing of the lesion, even tho it does not cause severe pain, if they are conscious. General anesthesia in such cases is more commonly satisfactory in the end. In portions of the body normally covered with clothing one may accede to the pleas of a patient to finish the dressing as quickly and as easily as possible, but if the face or hands are involved one may be sure that however hard the victim begs at the time, he will always after cherish resentment towards the physician "soft" enuf to yield to his importunities, and who leaves the disfiguring marks a testimony to his lack of skill and mastery.

The powder speedily softens after it is imbedded in the skin, and it is practically impossible to remove it by "picking out' each individual particle. It is quickest and easiest done by scrubbing the area involved with a stiff brush, dipt in some antiseptic and vigorously wielded. The wound is aggravated by this abrasion caused by the bristles, but this soon disappears, and no permanent scar remains at all commensurate with the disfigurement the powder grains would cause if left alone. The after dressing is merely that customary for abrasions or similar lesions.

The oldest method of mechanical removal after the pigment has disintegrated

and the stain has become permanent is to use a small dermal "punch," incising, by a rotary motion, the skin to a depth sufficient to include the stained area. This small "button" of superficial skin is withdrawn with the punch, and brings with it the discolored area. The circular area removed is very small and the wound not deep, so that healing is rapid and the scar insignificant. The incisions may be filled with boric acid powder to act as an antiseptic dressing. If the disk of skin fails to loosen from the underlying tissues it will project above the level of the surrounding skin, and may be snipt off with fine scissors.

The application of full strength of peroxid of hydrogen has proven a success in a number of instances. The skin involved is kept frequently wetted with it until a white zone appears about each discolored area, when "bubbling" begins. The application is continued till the effervescence has ceast, after which the discolored areas may be "pickt out" with any fine-pointed instrument like an iris knife. If the peroxid of hydrogen does not cause inflammation of the skin, it may be applied on lint, and the lint in such a case is kept saturated till the desired effect is induced. This method is most successful in cases where the discoloration is very superficial.

Another method of treatment is by the use of electrolysis, the needle being applied similarly to the method in use in the removal of superfluous hairs. The needle is inserted in a slanting direction until its point reaches just to the lowest or deepest edge of the discoloration, when the current is applied. The complete technic is found in all books on electrical therapeutics. It is very simple, and may be applied by any one. The current may be modified from the commercial wires by a specially devised instrument, or cells of a storage battery will furnish sufficient power. The method is quite painful in most instances, altho some operators claim that great skillfulness acquired by long practise enables them to almost abolish pain. It is very tedious, since only one discolored area, however small, can be removed by a set of punctures, and it is not practical to treat more than ten of the areas at a single sitting. It should be stated that in the removal of the powder stain the needle must be inserted several times, in a circular line about the stain, so

that the tissues will be destroyed which are involved, as they then separate as a small eschar, leaving a small white scar.

Another plan of treatment is that similar to the tattoo treatment of tattoo marks. A saturated solution of tannin is prepared and spread over the surface involved; this is tattooed into the skin thoroly by the use of a tattoo needle, or by the use of a number of needles fastened into a small bundle. Following this a stick of silver nitrate is vigorously rubbed over the tattooed surface until it is well blackened. Within a few days a crust forms, which separates in the course of about two weeks, leaving the skin healed with only a pinkish discoloration remaining, and this gradually fades until in a couple of months it is hardly visible.

Brault has devised a similar method of treatment, except that he prefers to use a solution of chlorid of zinc, 30 parts of zinc salt to 40 parts of water. The surface is tattooed with this solution, and after the tattooing the surface is covered with the solution. Inflammatory action is set up, followed by a crust and separation similar to that induced by the silver and tannin, with a resultant scar and later fading quite like the tannin method.

Ohmann Dumesnil devised a method of tattooing in which he uses the glycerole of papoid or caroid. He anesthetizes the skin by the use of a spray of chlorid of ethyl, and then uses the needles with just sufficient force to draw a very little blood. The glycerole of papoid is then poured on the surface treated, and it is covered with gauze.

This dressing is to be removed

at the end of two or three days, when the stains present but a hazy appearance. A crust now forms, which later drops off and and carries with it the stains. This method has not proven completely satisfactory in the hands of some observers, and it is asserted that the results are simply those of irritation, as in the methods previously given.

If reasonable aseptic precautions are taken, there is no reason to fear infection, tho some suppuration occasionally occurs underneath the crust. If secondary infection is prevented by reasonable care, no serious results follow, since the skin is tolerant of the organisms to which it is continually exposed and in contact with.

If a complete result is not obtained with any of these methods, the process may be repeated at a later time. We hope that

no physician will give an absolutely unfavorable opinion when consulted regarding the possibility of removal of a disfigurement by powder stains. At the same time it is necessary to warn the patient that it is possible that he may be disappointed in the results, since some skins are very susceptible to the formation of scar tissue, and if such be the case, the scar from any of these methods may exceed the dimensions which the patient had pictured in his own mind.

Business Talks to Doctors.

But

As I sat down to write this Talk in midAugust, I thought there was not much to say at this season, as August is a bad time to float schemes and catch suckers. just then I received a communication from Dr. A. J. Garrison, of Buckley, Ill., containing a bunch of those Christian Hospital circulars. I was surprised, for I had heard two or three years ago that the "president," "N. News Wood, A.M., M.D.," was dead; and I supposed this "hospital appointment" scheme dead long before that and it was quiescent. I had also heard that Wood had considerable money lockt up in printed circulars stored away, and maybe somebody has gotten them and is sending them out "on a venture." The circulars bear no date—that helps to make the above supposition probable. course the "appointment" offered is a fake-sold for a price, including a certificate, the price ranging from $8 to $12.50, according as the certificate is "Heavy Royal Linen," "Imitation of Parchment,' or "Genuin Sheepskin." I hope that no WORLD reader is so green as to invest; and if he has already done so, he should be ashamed to show the certificate-he should destroy it. We exposed this thoroly, years ago.

Of

There is another matter that I must mention this month, even if it is in the heat of mid-August. Please see June WORLD, page 235, bottom half of first column. The attorney of the Mexico International Land Co., of Kansas City, there mentioned, has threatened me twice about this, the second time very savagely; so I must explain more fully, and if they press, I must give the full correspondence of all concerned, with explanatory comments. The complaining WORLD subscriber is Dr. E. B. Griffin, of Almena, Kan. In my correspondence with him I told him that he should not have included

I

his expenses among his "losses," for a trip to Mexico is presumably worth its cost. would so consider it if I had the time to take such a trip. His statement that he "spent two dollars to save one" is the only thing in the printed statement that I can see is unjust to the company, and in the very same sentence I stated that this included expenses, and in a subsequent letter I told him that he should not have included traveling expenses in his "losses"; and I now publicly state this fact.

But this is far from being the whole story, which I will give far more fully if the company continues to insist. I also told Dr. Griffin very frankly in my correspondence with him that he was induced to sign his name far too easily. Agents want the signatures of responsible people to contracts or orders; and a verbal promise of an agent, "you don't need to take it if you don't want to," or money back if not satisfied," seldom means anything some companies will not honor such promises on the part of their agents. Therefore, be very careful about signing anything.

A favorit trick with many companies selling on the installment plan is for the company or its agents to sell the land, stock, or whatever they offer, and collect the first installment; and then turn the notes or other obligations over to another company for collection-and this other company is usually organized for the purpose mentioned, by the parties in the original company- a wheel within a wheel. The purpose is plain; the second company can say that it has nothing to do with the promises of the first company; its business is to collect the notes or other obligations which have been turned over to it. Do you see the plan? It usually works well, but it is not a compliment to any company using it. It looks as tho a company using this plan does it to avoid meeting its patrons after they have a chance to see that they are victims.

Also a word about land schemes in new or foreign countries: We all know that people give value to land. Suppose all the people would move out of Philadelphia. Of what value would real estate be-supposing, of course, that the people would never return. The values would sink to zero as soon as the last man got out; for you could get no rent for property in a deserted city. Don't you suppose that real estate values tumbled with the

buildings when the earthquake occurred at Messina some months ago? And the prospect of returning values depends entirely upon the prospect for re-inhabiting the city and its surroundings. So it has been everywhere since the earth began, and so will it always be. Land values are made by people. Mineral values, and harbor or shipping site values, may be said to be somewhat special; but mines must be accessible and have people to work them in order to be valuable, and harbors and shipping sites must have the business in order to be of any value at all. Manhattan Island had no value for centuries until its magnificent shipping facilities and its grand harbor were used; and as the population of New York City has increast these values, and all other real estate values in and about Manhattan Island, have increast. Other magnificent harbors with excellent shipping sites exist in parts of the world without inhabitants, hence without value.

But

Do you see what I am driving at? In so far as these land companies in new parts of the country or in foreign countries seek to increase the inhabitants of the sections which they are seeking to promote, may their efforts be regarded as sincere. in so far as their efforts to sell land, regardless of whether the purchaser expects to go there and settle, may their efforts be regarded as efforts to make a profit by selling wild land at fancy figures, regardless of the welfare of the individual purchaser or of the promotion as a whole. And if the management does not plan to build roads, arrange for railroad stations, boat landings, and other necessary public improvements, and if the company does not reserve a reasonable share of the land as its permanent property, into which it puts its own money in order to share in the grand prospects so positivly promist to prospectiv buyers,-if the management does not do these things, it may be regarded as certain that it is a scheme to gather in money from dupes. And efforts to make sales of land to doctors, dentists, lawyers, who do not intend to go to the new settlement, and who in the nature of things cannot do so, except in the few instances of those who wish to give up the practise of their profession and begin agricultural or other productiv pursuits in a new country—in short, efforts to make sales of land in distant, undevelopt countries to these classes of people are, to say the least, suspicious.

For example, if an entire tract of such land in Mexico were sold in blocks of say from 40 to 160 acres, to say 100, or 500, or 1,000 doctors, dentists, and lawyers, no one of whom gives up his practise to go to Mexico and improve and live on the place, that land will have no more value than it had a century ago; and it never will increase in value by any such transactions. So look with suspicion upon all efforts to sell such land to you after you have made it plain that you intend to stay where you are. They will say that some of their purchasers will go, and create value for those who do not go. Then the management should devote its efforts to sell only to prospectiv emigrants, and keep a liberal portion of the land themselves and have it grow in value for themselves. Failure to do this is, according to the principles outlined above, a suspicious circumstance.

I have made it my business to try to Hence protect the interests of doctors. the above.

A Pennsylvania brother asks for report on, and my opinion of, a number of stocks, chiefly mining stocks. I have tried to make it plain many times that I do not report upon the condition or value of individual stocks, nor do I give advice concerning specific investments. I merely try to outline safe principles, and try to keep doctors from speculating or making unsafe investments. I would advise this Penna.

brother to send $3 as a yearly subscription to the World's Work (Doubleday, Page & Co., 133 E. 16th St., N. Y. City), in my opinion the best magazine publisht, and then address such inquiries to the Financial Editor of the magazine. By doing this you will get sound and reliable information from an expert who has abundant sources of such information ready at hand.

Will there never be an end to new insurance companies? This time it is the proposed Inter-Southern Life Insurance Co., of Louisville, Ky. They want a S. C. doctor to invest in their stock. Many new insurance companies want to sell their stock to doctors. A few old companies have become very wealthy; but it is not at all certain that these numerous new ones will-in fact, it may be regarded as certain that they will not-all of them

cannot.

It seems impossible to complete one of these Business Talks without the subject

of mining coming up. Here is a voice from a mining section of the country.

66

EDITOR MEDICAL WORLD:-"Business Talks to Doctors" in your June editorials hits the spot exactly. The New York houses furnishing mailing lists of probable stock buyers classify the easy marks" as follows: First, doctors, then in turn dentists, preachers, lawyers, and so on down the line. I have spent almost five years in the Nevada mining camps, and my stock purchases amount to forty shares; and they were bought, not for investment, but simply because I would not be "blufft." I am in close touch with many of the Nevada, Utah, and California mining fraternity, and frequently get inside information; but with one or two exceptions, I know of no stocks which could be considered investments. Of course there are many opportunities offered to make money in mining stocks by taking "fliers" when the market is right, but

in order to do this one must be "on the inside" and in a position to take advantage of the market. There is more money made playing the mining stock game than is taken out of the mines themselves; but it is the insider, who makes a business of playing the market, who wins.

I am not

He

knocking" legitimate mining, and a great deal is being done; but I do find fault with the doctor who puts his money into something of which he knows little or nothing. reads the lurid prospectus and takes it for granted, seemingly. He buys a bunch of stock, invariably without asking any further questions or without investigating the property in which he is askt to invest. Being promist dividends within a few months, he wonders why they are not forthcoming, and after a year or two begins writing to some one in the neighborhood of the property asking what the conditions are. Within the past six months I have had several inquiries from doctors regarding the conditions of various promotions in the Fairview as well as other

neighboring mining districts. If the doctors would inquire first and buy after getting "the dope" they might win; but they invariably buy the "pig in a poke," and when no profits are apparent they find fault.

I have some friends who are making money in the mining game, but they are men who have made mines a life-long study, and who recognize values when they see them, When they are contemplating stock purchase for investment they pay no attention to the glittering prospectus, but take their prospect picks and make a personal investigation before risking a single penny. These men make money out of mines. Some of these make money out of stock deals, but only because they are on the inside and always know when there is to be a manipulation. One of my closest friends is one of the leading mining men of Nevada; and while he makes money both by investment and by playing the markets, he has advised me to stay out of the game unless I drop medicin and take up mining as a business.

There are, as in all lines of trade, honest men in the mining business, as well as unscrupulous ones; and it is probable that many prospects are promoted honestly, altho they may later fail to "make good;' so the promoters should be given the benefit of the doubt, and not always censured when dividends are not forth