I find protargol and albargin the best, with preference for protargol, although I think a more ideal preparation for the treatment of gonorrhea will yet be discovered. I am forced to say that protargol is the most efficient and rational drug in gonorrheal therapy. Before going further, a word as to potassium permanganate. When Janet introduced his method of flushing the urethra with potassium permanganate, he mentioned particularly that potassium permanganate did not have the power of killing the gonococci, but that it thoroughly saturated its abiding places and made it an unfavorable soil for their development; in other words, it rendered the urethra a poor culture medium for their segmentation. Christian says that the value of potassium. permanganate depends upon its action as a general cleansing agent rather than upon any specific destructive action upon the gonococcus. It was Neisser who advised an early and complete annihilation of the gonococci in all their attainable seats of localization. Finger, notwithstanding his early policy of awaiting the subsidence of the acute symptoms, was eventually forced to admit that the sooner the pure antiseptics were used the much better the results. Frank, likewise, says that prompt and energetic treatment should be directed immediately against the gonococci, otherwise we are committing an unpardonable sin toward our patients. Under the caption of "Successful Treatment of Gonorrhea," it is surprising to encounter statements of this character: "It is not wise to irrigate the first two or three days on account of the extreme sensitiveness of the urethra, for it is a common occurrence to have the patient faint." If we revert to the pathology we learn that the gonococci penetrate rapidly between the epithelial cells and lodge in the submucous tissue. We must dislodge the gonococci, and each day wasted gives the gonococci the opportunity of multiplying their families and making their abode more secure.

2. Termination of the Inflammatory Process.—On discovery by microscopic examination of the disappearance of gonococci, which usually occurs in from four to five days, the next indication is the use of astringents. Mistakes are made here by most practitioners, who continue the use of the silver preparations which induce a secretion. Were a microscopic examination made at this time, the secretion

would be found free from gonococci. During this stage the patient is instructed to use the silver and astringent preparations each twice a day, reducing the protargol injection to once a day, and then to discard it altogether. About this time I give a provocative test of 1 to 2,000 silver nitrate solution as an injection and examine the morning secretion. Should there be any gonococci (latent as they sometimes are), I immediately return to the protargol solution and carry out the same plan as outlined above.

3. Restoration of the Integrity of the Urethra.-Nitrate of silver, by its stimulating action, causes the absorption of the submucous exudate, and by its astringent action, has a powerful effect on the relaxed and catarrhal mucous membrane, producing a new and healthy epithelium. When applied through the endoscope, or by Ultzmann's pencilling apparatus, it is very efficient. In this way, granulations and erosions are touched up. Soft infiltrations are absorbed by gentle and gradual dilatation by means of Oberlander and Kollman's dilators and sounds. Secondary Infection. At times secondary infection occurs during the course of the disease, usually toward the end, the cause of which should be sought and eradicated. For injection I use a 1 to 10,000 bichloride of mercury, or what is still better, oxycyanide of mercury (much less irritating than the bichloride), in solutions of 1 to 5,000.

For the patient's general condition a tonic is prescribed, especially in anemic cases, the urine is examined for oxalates as well as uric acid, and should these substances be found in excess, proper treatment must be instituted. I also have a printed blank for routine directions, which is given each patient; it dwells on the avoidance of sexual relations, abstinence from alcohol, avoidance of constipation, regulation of diet, insistence on the use of the suspensory bandage as well as moderation in exercise.

So far I have only dwelt on anterior gonorrhea; for posterior involvement of a mild form, the posterior urethra and bladder are irrigated with a solution of protargol (of 1 per cent). When the inflammation is severe in character, I order hot sitz baths, rectal suppositories of opium, belladonna and hyoscyamus, and discontinue all injections until the hyperacute symptoms have disappeared.

I rarely use instillations of nitrate of silver into the posterior urethra.

A word as to the use of microscope in treatment. The microscope is as necessary an aid in following the course of a gonorrhea, informing us of the time to change our treatment, as quinine is in malaria, and the medical man is not in a position to treat a gonorrhea scientifically who does not possess it and use it throughout the disease.

As to the length of time for a cure by the above treatment. From a study of my cases I find the period to be from nine days as a minimum to six weeks as a maximum, with three weeks as the average. How do I know my patients are cured? Before discharging my patients I give a provocative test with nitrate of silver as an injection in the strength of 1 to 1,000 to 1 to 2,000, sexual congress with the use of a condom and the beer test, and should an examination of the secretion bring forth no gonococci and the patient be absolutely free from secretion, then and only then, do I claim my gonorrheal cases are cured.

In conclusion I will say that: First-The pathology of the disease must be understood in order to treat it scientifically. Second-The gonococcus must be destroyed in its abiding places, which is in the submucous tissue. ThirdIn order to reach these localities, one of the silver salts must be used. Fourth-The most efficient silver salt, in my experience, is protargol. Fifth-If, by microscopical examination, the gonococci have disappeared, we should change to an astringent. Sixth-That the urethral mucous membrane 's damaged by the inflammation, and treatment should be directed toward this altered condition. Seventh -Constant microscopical examination is indispensable in following the course of a gonorrhea. Eighth-Treatment should be instituted as soon as the diagnosis is made. Ninth-Before our patients are permitted to leave our care we should use provocative tests.

369 Sutter Street.

THE San Jose Board of Health has elected Dr. J. J. Miller, President; Dr. Gerlach, Secretary and Health Officer, and Mr. J. C. Corcoran, Assistant Secretary and Plumbing Inspector. The salary of the Health Officer is $100 per month.

THE MEDICAL PROFESSION; ITS POLITICS AND POLITICIANS.

By B. M. JACKS ON, A. M., M. D., LL. B., Omaha, Neb.

"Silence does not always mark wisdom."-Coleridge.

The number of weaknesses and shortcomings harboring within the confines of mortal beings are illimitable, but the more pronounced are mental in their character, and are commonly known as Hypocrisy, Selfishness, Egotism, Prejudice and Intolerance. In our relations with fellow men we often have occasion to learn that those who possess these weaknesses are not representatives of true manhood, because their mental afflictions are inconsistent with honesty, integrity and wisdom. And how dearly many of us have paid for carrying on relations with men lacking in moral principles! And yet our sorrowful experiences do not seem to guard us against repetitions.

This in spite of the fact that we know, and are ever wont to say, "experience is the best teacher." But, in truth, how many of us do profit by experience? How many of us do care for history from which we could learn the experiences of our ancestors and profit, at least, by their mistakes? Very few. Hence, mankind travel constantly upon the same paths, always revolve within the same circle of experience, and ever find themselves upon the same axis of existence. And what sorrowful spectacle we behold! Ever and anon, the masses as subjects and slaves; and the words Freedom and Independence only mockeries and sport for autocrats and oligarchies. Would-be leaders and politicians of noisy and banner-parading propensities are ever leading the masses into goals that they may more readily exploit them; and the masses follow blindly. Intellectual giants have from time immemorial warned mankind to read history and profit by the mistakes of their ancestors, but the would-be leaders and politicians only have to shrug their shoulders and say, "Oh, they are 'soreheads,'' cranks,' or what-nots," and these are sufficient "arguments" with the masses; hence, they ignore the warnings of the former and always follow the latter. Only when the masses actually find themselves in deep abysses, their flesh and souls tormented, and with chains around their necks well fettered, do they attempt to revolt. But

alas! too late. The goals are strongly barricaded hence they cannot escape, and their physical condition is too weak to resist.

Why is it that the masses are subjects and slaves instead of free and independent even in countries where the fundamental laws thereof guarantee them liberties? BecauseI am sorry to say it-they do not appreciate them and deliberately throw them away. Yes! The priceless jewels to which man is by natural and divine law entitled, man himself casts away.

Paradoxical as the answer may seem in view of, we might say, recent history, and the fresh graves from which echo the words, Freedom and Independence, for which their lifeless tenants have given up their precious lives, yet it is true. And we need not go very far to prove our statement, but shall do it right at home, so to speak, in the medical profession.

Prior to the enactment of the present medical laws, one who graduated from a medical college could practice medicine wherever he pleased within the confines of this country. No one asked him to contribute a sum of money towards the support of a few politicians, no one asked him to prove how much he knew about medicine, in short, no one molested him. He was "as free as a bird." Physicians regarded one another as gentlemen, they treated each other with the utmost courtesy, and the people in turn treated physicians with the greatest respect and accorded them full honors, as becomes men of a noble profession. Physicians, too, minded their own business, and never did they stoop to persecution or prosecution. And last but not least, physicians were well paid for their services, and all of them earned more than a livelihood from the practice of medicine.

Have physicians been satisfied with this freedom and independence and happy condition? Not at all. They have allowed themselves to be persuaded that if they should consent to the enactment of the present laws they will be benefited. Is it not strange that they failed to reflect how laws could benefit them when their very enactment would rob them of the most precious jewels-Freedom and Liberty? The fact is they failed to reflect and have deliberately cast the jewels away. What do we witness in conse