accurate information regarding his education and integrity. He knows that the patrons who are most critical are nearly always the ones who are least capable of intelligent criticism. He can usually say truthfully: "Show me my critic and I will tell you how much he owes me." He is well aware that consultations, as a rule, are fraught with deception, hypocrisy, efforts to gain undue professional prestige, and actual disadvantage to the patient instead of benefit, and frequently he should withdraw from the case rather than be a suspect, even, of such dishonesty. Our experience has taught us that there are people in every community so wise that if God Almighty, with His infinite ability should choose to practice medicine in their own town, some other physician would be selected by them when overtaken by illness. An honest physician will treat such people with due consideration. An honest physician will not restrict the definition of the term honesty to actual words of deceit. Dishonesty consists in the decep"tion, not in the methods of bringing it about. I am sorry to say that honesty, as a rule, is not a paying proposition. An honest physician must not expect to acquire wealth, walk on thornless paths, or sleep on downy beds of ease. He must not even expect to receive general credit for being honest, and, as a rule, his word will not be as convincing as the egotistical brag of a bombast. It is very unfortunate that in this world honesty does not carry with it the certainty of adequate reward, but such is the fact. Nevertheless, we all bow our heads with heartfelt respect when we meet an honest man. But we do not have to injure our anatomy by many motions of that kind. The importance of honesty in a physician can not be overestimated. If the merchant is dishonest, you may lose a few cents in a deal. If an office-holder is dishonest, you are not at all surprised. If a minister of the gospel is dishonest, it does no practical harm until he is found out, but if a physician is dishonest, the vista of his pathway looking backward shows life-wreckage, horrible to behold. Untimely deaths, broken hearts in despair, undeserved sorrow, unexpected want, blighted prospects, wrinkles from unnecessary suffering, and destroyed confidence in humanity, form the record of his contact with his fellowmen. And the prospects of the future are equally terrible to contemplate. Who can estimate the true worth of an honest physician?

REWARDING DOCTORS.

The question of the recommendation of certain proprietary articles by doctors, the proprietors of which pay a fixed sum to a medical provident society for each bottle sold, is engaging the attention of pharmacists in general, and particularly in the South. M. Labussière states that for each bottle of Vin de Kordia sold, Is. is handed by Blanc Bernard Plaisance & Cie. to the doctors, and that the Grains de Vals, Afflogol, Somine and other preparations are pushed on the same basis.-The Chemist and Druggist, June, 1908.

ANATOMICAL MEMORANDA FROM BYRON ROBINSON'S NOTE

BOOK.

[Written for the MEDICAL BRIEF.]

1. The proximal mesenteric artery is subject to arterio-sclerosis which diminishes its lumen, and consequently diminishes the quantity of blood transported. The sclerosis hypertrophies the parietes of the vessel, and consequently function (sensation, peristalsis, absorption, secretion) is interfered with, deranged.

2. The jejunal artery, or the trunk of the proximal mesenteric artery, is of interest, (a) from its association with gastro-duodenal dilatation, (b) from its association with the duodenal jejunal angle, (c) from its spirality or torsioned state. The spirality of the proximal mesenteric artery may be an exciting factor; in enteronic volvulus it constitutes ten per cent of volvulus of the tractus intestinalis.

3. "Visceral drainage" is a rational base for therapeutics.

4. The old medical monks called the apex of the renal pyramid the cerebrum benedictum-the blessed sieve, because they thought if the renal pyramidal apex, which consists of some forty apertures, should close, the subject would die. Hence, the blessed sieve-cerebrum benedictum-saved life by sifting the urine through it.

5. When a marble-sized nodule develops in the peripheral margin of a mammary gland, remember it is perhaps an adeno-fibroma, and should be extirpated.

6. The percentage of pulmonary tuberculosis of the tractus intestinalis is difficult to diagnose. However, the last two autopsies which I attended. showed primary pulmonary tuberculosis.

7. The "ileo-colic circle" is formed by the bifurcation of the trunk of the jejunal artery into the ileo-colic artery and the ileal artery and their distal anastomosis. The "ileo-colic circle" is a constant structure with a constant location.

8. The ileo-colic circle is a typical inosculation circle, which consists of an arc, automatic peripheral ganglia and a peripheral viscus. The object of an inosculation circle is to congest its peripheral viscus.

PARAFFIN SPLINTS IN PROLAPSE OF THE RECTUM IN CHILDREN.

Dr. Kephallinos (Jahrbuch f. kinderheilkunde, March, No. 3) advises use of injections of paraffin after the prolapse of the rectum is reduced. Inject on each side, drawing out the needle as the paraffin is injected, leaving a long strip of paraffin in the tissues, forming as it solidifies two straight sticks or splints in the pararectal tissue.

CORRESPONDENCE.

TO THE EDITOR:

Opportunity to Medical Men.

I wish that some American physicians would come and settle in this part of this country, Department of Huila. There are only three practicing physicians in a population of (300,000) three hundred thousand inhabitants. Medical fees are the highest in the world; they charge from $100 to $1,400 in American gold. The Government repealed the medical law last year, and the country is full of quacks.

In some towns house rent and pasture for the horse is given free of charge to the physicians. There is a place here for twenty doctors and ten dentists. Splendid house rent, with board, can be obtained from $20 to $30 per month. The full fare from New York via Panama to Barranquilla, up the Magdalena River by steamer, by railroad and mule-back to Neiva, the capital of this department, costs from $140 to $180. The Colombian's official money exchange is 10,000%, and all business transactions are done in American gold, which is the money standard of the country. Thanking you for your kindness, I am, Sincerely yours,

ANIBAL E. DUSSAN, M. D., Hato, Huila, Republic of Colombia, South America.

July 21, 1908. THE BLOOD DIAGNOSIS OF TYPHOID FEVER WITH THE AID OF BILE-AGAR.

Stefansky (Medizinische Klinik, June, 1908, Archives of Diagnosis, July, 1908,) uses a culture medium consisting of equal parts of bouillon and ox-gall, with the addition of 2% of agar, 1% of peptone, and 0.5% sodium chloride. This is put into test-tubes, 15 c.c. in each. The blood (3 c.c.), is taken from the vein of the arm with a hypodermic syringe. It is put into two test-tubes with the nutrient medium, and after shaking, it is poured into Petri dishes. This dilutes the blood five times with the nutrient medium. This gave the following results: Out of twenty-three cases examined altogether, a growth of the typhoid bacillus was obta.ned in 82%; that is, in nineteen cases, while paratyphoid was not found at all. The proportion of positive results is the higher the earlier the blood is obtained. The majority of the cases were examined in the second week, and in 87% the typhoid bacillus was found at this time. In one of three cases examined in the third week of the disease, the typhoid bacillus was found. In one of two cases of recurrent typhoid, growth was obtained. On the plates the typhoid colony appears as a black point, which assumes the form of a lentil after the fifteenth or sixteenth hour. The beginning of the growth occurs after the twelfth hour; after the sixteenth hour, the colonies are large enough to be utilized in the agglutination test. Thus a definite diagnosis of typhoid may be made in one day's time. Besides the lentiliform colonies, larger colonies are found on the plates, colonies which in two days may occupy half the space of a Petri dish. From these “giant" colonies, typhoid bacilli of extraordinary motility manifest themselves.

THE following dialogue and drawing, taken from a recent issue of the famous cartoon publication Simplicissimus, will give our readers an idea of the German funny man's conception of the advantages (?) of membership in the Krankenkasse, or what might be called in English, the fifty-cents-a-month sick benefit society, an institution yet in embryo in America, but having on its enrollment most of the middle and lower classes of citizens of Germany.

"THE EXPERIMENTAL ANIMAL."

KARL

ARNOLD

"Yes, Doctor, I consider operative interference upon such a case rather hazardous. What do you say of trying the operation first upon some member of our Sick Benefit Society (Krankenkassen-Mitglied)."

CURRENT MEDICAL LITERATURE.

Appendicitis: Extra Significance of Left-Side Pain.

John F. Erdmann (Archives of Diagnosis, Vol. I, No. 3, 1908), again calls attention to a sign in appendicitis which is met with frequently in children, not so frequently in adults, namely, pain in the left lower quadrant of the abdomen. For over five years Erdmann has been directing attention to the fact that pain in the lower quadrant, with evident tenderness, pain and resistance in the right quadrant-appendicitis, in other words-and without any marked evidence of abdominal distention, signifies free fluid in the pelvic cavity, varying in character from a serous to a sero-purulent or purulent nature, although the appendix and abscess, if present, is walled off. He states that he does not know of a single occasion of this diagnostic fact being absent, under this state of affairs, during this time. He makes this statement with the understanding that he means by fluid in excess, not the ordinary amount of peritoneal fluid that one usually finds in the pelvis, but a quantity in excess of the normal, measurable in ounces or half-pints.

This symptom, which is an early precursor of general peritonitis, aids in prognosis, and gives more definite reason for demanding emergency operative interference. This sign must not be confused with Blumberg's, in which the pain is increased on releasing the palpating hand; in this sign the pain is evidenced upon pressure.

The Dangers of Calmette's Ophthalmo-Reaction.

T. Harrison Butler (British Medica! Journal, August 8, 1908) issues a note of warning concerning the indiscriminate use of the Calmette reaction for tuberculosis. He reports a case where, on March 5th, a female child, aged four years, suffering from a supposed tuberculous disease of the ankle, had instilled into the right eye one drop of 0.5% solution of Calmette's tuberculin. No change appearing, on March 9th the instillation was repeated with a 1% solution. Profuse discharge with photophobia followed, then there appeared, early in April, an elongated phlycterule at the outer aspect of the corneo-scleral margin. This was later surrounded by a patch of interstitial keratitis, developing finally an ulcer which was obstinate, and very slowly cleared up, leaving a small central nebula. In other words, as a result of the instillation of tuberculin, a typically tuberculous process was set up in a perfectly healthy eye, and the central nebula will considerably reduce the visual acuity of that eye. Considering, moreover, that the test is at times deceptive, and is apparently