stroke plates; serum agar stroke plates; bouillon tubes; litmus milk tubes from anerobic cultures by Wright's method; glucose agar for anerobic cultures. In addition, cover-slip preparations were made, two being stained with Loeffler's stain and two with Gram's stain.

With regard to the value of the intra-uterine culture as an aid to diagnosis, these two observers think that it is valuable in a routine study of infected cases, at least in institutions which have the advantage of a well-equipped laboratory of bacteriology. They do not desire to be understood, however, as taking the stand that the method is, as was formerly thought, a sovereign means of diagnosticating the presence or absence of infection in all cases. They feel satisfied, however, in making this statement as a result of their investigations: if both blood and uterine cultures are negative, the temperature in a given case is due to some intercurrent condition; if the intra-uterine condition is positive, but the blood culture negative, the infection ought to be considered local in its manifestations; and thirdly, if the intra-uterine culture is negative but the blood culture is positive-a very unusual condition-one should be justified in concluding that the case is one of general infection, the local endometrial condition having been made sterile either from the first or having become so gradually after the general infection developed.

On the whole, they consider that their observations and bacteriological tests warrant them in believing that the uterine lochia in normal cases is sterile throughout the puerperium, and that streptococci are never present in the cavum uteri without causing symptoms. This is a most important observation, and seems to be firmly backed up by the exactness of the scientific research made by Nicholson and Evans. They admit that in a few cases non-pathogenic germs may be found in cultures in afebrile. cases, but there is every reason to believe that their presence is really the result either of contamination during the extraction of the lochia or of their introduction during obstetric manipulation. It also seems firmly established as a result of these tests that ascendance of the gonococcus is an event of comparative rarity, though the frequency of this organism would of itself give reason 'to expect otherwise.

While it is true that a study of the bacterial content of the puerperal uterus is of great importance as a subsidiary means of diagnosing septic infection following delivery, the writers issue a note of warning against the indiscriminate culturing of the uterus because infection of the endometrium is an ever-present danger in culturing within a few days of delivery. This is to be borne in mind in so far as the overly-enthusiastic scientist may be led to take up this bacteriological work to the detriment of the health of the patient. Extreme caution should be exercised, therefore, in this regard. Possibly, now that this exhaustive investigation seems so conclusively to have given the profession the exact status of the

bacterial content of the puerperal uterus, future work may be reserved. entirely for diagnostic purposes and not for mere scientific investigation.

THE CONSEQUENCES OF EXTREME MEDICAL LEGISLATION.

In an editorial in our August issue, criticising the A. M. A. leaders. for their political activity and for their efforts to secure extreme and unreasonable medical legislation, we said that their conduct in this respect would ultimately engender a general distrust in the minds of the public against physicians as a class, and that the people, holding the entire medical profession responsible for the arrogance of a few, would compel the enactment of legislation of so reactionary a nature as to make even just and salutary medical regulation an impossibility, if, indeed, it did not lead to the repeal of all such laws as are at present on the statute books, leaving the profession with no protection at all.

We had forgotten, when we wrote the editorial in question, that a consummation exactly such as we described had actually come to pass in Germany. That country, as everyone knows, has gone far ahead of any other civilized nation in its efforts at state regulation. The physicians, taking advantage of this paternalistic spirit, gradually secured very restrictive medical laws. Most of this legislation was probably just such as ought to have been passed for the benefit of the profession and the protection of the public; but the physicians there eventually became so filled with the spirit of caste and were so arrogant in their demands for further privileges, that the German people, accustomed though they are to obey implicitly the mandates of a government upon which they look as occupying almost a parental attitude toward them, arose in vehement protest, with the result that, finally, all laws of every description protecting the practice of medicine were wiped from the statute books.

The conditions consequent upon this radical policy are described in an article published in the British Medical Journal of July 18, entitled "Quackery in Germany." From that article we quote as follows:

"The repeal of the old laws which prohibited the practice of medicine by any other than regularly educated practitioners has been followed in Germany by an enormous development of the most barefaced and ignorant quackery, and we have drawn attention to the dangers and difficulties which have resulted from this retrograde legislation on several occasions. (See Journal, 1903, Vol. II, p. 163, and 1906, Vol. I, pp. 1348, 1410, 1470 and 1538). It is well known that the influence which led to the alteration of the law was the success of hydropaths, like Priessnitz, who was a simple peasant, and of other founders of socalled "Natural" system of curing diseases, who were equally destitute of any claim to regular medical or scientific training. They secured so large an amount of popular support, and it is fair to say their methods were on the whole productive of so much benefit to the sick, that the attempt to enforce the law was abandoned, and although in Austria, the home of hydropathy, its letter remains the same, in North Germany repeal was the only logical result of the popular determination to en

courage the development of therapeutic means which had arisen inde-
pendently of the regular practitioners of medicine. While there is
probably no intention, and certainly little hope, of reverting to the
former state of things, a large and influential party in Germany is
agitating for such a modification of the law as will afford some check
to quackery in its more pernicious forms, and protect the ignorant
against the machinations of swindlers. A practical point arises in con-
nection with the enforcement of legislation for the medical inspection of
school children, who, if suffering from some ailments requiring proper
medical treatment, are often taken by their parents to quacks. The
inspectors endeavor to prevent this by serving the parents with notices
to take the child to a doctor (arzt), but a correspondent tells us that
in Holstein there is a notorious example of quackery in the case of an
old shepherd who cures persons at the rate of five marks a head simply
by placing his hands on their chests, and who 'treats' persons at a dis-
tance on receipt of a few hairs cut from their heads."

The adoption of such a movement as that proposed by Dr. Reed and embodied in his candidacy for the Senate would, in our opinion, ultimately lead to just such a denouement as that above described. The laws that govern human events and human processes are the same everywhere. There is every reason to believe that the people of this country, impatient of governmental interference as they are, would be even quicker to resent what they would consider legislative exploitation in the interests of the medical profession than the German people have shown themselves to be; and let them once be convinced that they are being imposed upon; let the legislative policies of the A. M. A. leaders be carried to the extreme to which it is sought to carry them, and the American people will show no more discrimination than did their cousins across the sea, but will lose faith in, and punish, the whole medical profession for the overbearing and arbitrary conduct of the bureaucracy.

The experiences of their German brethren should serve as a warning to the physicians of this country not to support the A. M. A. extremists in their demands for further medical legislation, but to be satisfied with the laws as they now are, since, if properly enforced, they afford ample protection for the legitimate practice of medicine. It will not be sufficient, either, simply to withhold active support from them. They must be openly and publicly opposed. The people must be taught that these extremists do not represent the medical profession; that they have no right to speak for anybody but themselves; that the laws they are seeking are not in the interests of the public health, but simply to give themselves absolute control over the practice of medicine and to enable them to dictate the terms upon which physicians shall practice their professionindeed, to say whether they shall practice at all, or not.

No better evidence of this design on their part is needed than the proposition which was recently put forth to compel by law every physician to come up before the Board of Medical Examiners every five years and submit to a re-examination. Now, everyone knows that a requirement of the kind could serve no useful purpose, so far as the public or the sci

ence of medicine is concerned. A student, fresh from his text-books and his classes, is able to pass an examination, but he knows nothing of actual practice. After an experience of five years the text-book information may have vanished from his mind, but he will certainly know something about diagnosis and the treatment of disease. To force such a practitioner, therefore, to appear before a board and to answer to its satisfaction all such questions as its members may chose to propound, before he is permitted to continue in his profession, is as absurd as it is unjust. When it is remembered that the decisions of the Board of Examiners in these matters are absolute, and that from their conclusions there is no appeal, and when the growing arrogance of the A. M. A. clique, to which these examiners belong, is taken into consideration, we think it is but the part of caution to oppose any attempt on their part to increase their powers, and to look with suspicion upon almost anything which they may propose.

This is only one of the many extreme measures which it is proposed to enact into law for the ostensible benefit of the profession, and we mention it merely to show to what extremes these men have gone, and the dangers to which physicians as a class are threatened if they are allowed to continue unchecked in their arrogant course.

A PERVERSION OF THE JOURNALISTIC FUNCTION.

We are not interested in any personal quarrel between Dr. W. C. Abbott and the A. M. A. officials, nor, specially, in the medical products of the Abbott Alkaloidal Co. Our personal acquaintance with the former consists of one casual meeting, and we have not as yet had occasion to use his remedies. But we believe that a pamphlet he has recently issued, defending himself against the malignant assaults made on him and his house in the columns of the Journal of the A. M. A., should be placed in the hands of every physician in the land, and particularly in the hands of all members of the American Medical Association, that they may know the policies which control the conduct of the organ of the greatest medical association in the world. We do not believe that any fair-minded man, no matter how he may regard Dr. Abbott and his products, can lay this pamphlet aside without being convinced that there has been a prostitution of the journalistic function in these personal attacks, and that the editorship of a great paper like the Journal of the A. M. A. carries with it. powers and responsibilities too vast to be entrusted to the hands that now direct and control it, and that the sooner a man is placed in the position. who is above descending to personality, who has no enemies to punish, and who possesses a fair and judicial mind, the better it will be for the paper and the profession of medicine.

It is the right, aye, it is the duty, of all medical editors to expose fraud and to prevent, if possible, any imposition upon their readers. It is a duty higher even than any they can owe to their subscribers, for it resolves itself into a question of humanity. No more despicable a character can be imagined than the man who attempts to foist a fraudulent medicine upon the profession. He not only strikes at the foundations of medical science, but makes traffic in human life. But it will, we think, require something more than mere altruistic pretensions to convince unprejudiced physicians that behind the Abbott attack and some others of a similar character on American manufacturers, which have appeared in the Journal of the American Medical Association during the past two or three years, that there was no other motive or influence than a just and an intelligent regard for medical science and love of humanity. It can not be that all American manufacturers, except a few apparent pets of the organization officials, are engaged in quackery and fraud, while practically all the European medical manufacturers doing business in this country are honorable, and their products ethical. Surely, in other matters the American standard of morality is as high as that of any other nation, and we shall not believe, except upon absolute proof, that when a citizen of this country goes into the medicine business he immediately throws off all moral restraint and enters upon a career of fraud. It ought, therefore, to be plain to any one that, even if philanthropic purpose has dictated all these attacks, there must exist in the minds of those who make them so strong a European prejudice as to render it impossible for them to be fair and safe advisers of American physicians.

The Abbott case, as we have said, is only one of many attacks of this character that have been made, though it gives greater evidence of personal feeling and malignity than have appeared in any previous assault. Indeed, the reader can not fail to note how careful its authors were not to make any specific and direct charges, such as, if untrue, would furnish the basis for a libel suit, but that they indulged mainly in inuendo and insinuation, all worded in such a crafty manner that it might well be imagined that the whole article was submitted before publication to some shrewd, technical lawyer, with instructions to eliminate therefrom everything that might bring responsibility to its authors and at the same time to add point and sharpness to all aspersions and insinuations contained therein as were not actionable at law. The present assault, therefore, is less calculated to deceive the profession or to injure the victim at whom it was directed than some that have preceded it; but it is not less reprehensible on that occount, and we do not believe any censure too great to be visited upon those who are responsible for it.