one condition, chloral in another, nux in another, etc. Therefore we conclude that there are specifics, so far as our knowledge of causes and pathology go. Take a case of fever; name it lung fever, bilious fever, intermittent, remittent or typhoid. Would it not be absurd to say we have a specific for lung fever, for remittent fever or typhoid fever? Here is a case in point, and I can do no better than to give it in detail. A prescription for typhoid fever has been going the rounds purporting to come from F. Peyre Porcher, of Charleston, which is as follows: B. Potassium acetate, 3j. to 3ij.;

potassium chlorate, 3j.; spirits nitrous ether, 3ss.; solution ammonium acetate, 3j.; tincture aconite, 3ss.; camphorated tincture of opium, zij. to ziij.; water, q. s., ad. živ. M. A dessert-spoonful to be taken every two or three hours, as long as there is fever. Potassium bromide or morphine may be added if there is great restlessness or want of sleep." A glance at this prescription shows that the days of shot-gun prescriptions, and polypharmacy, have not yet passed. What a variety! "To be taken as long as there is fever!!" Enough to last a thirty days' siege. We are not told that this is a "specific"; but from the impression made one would think it a sure cure. Which agent does the work? What are the indications for these remedies thus combined? Typhoid fever. Now I affirm that this theory of lumping symptoms into a name, then lumping medicines to meet the generic term, is a most dangerous one, and a most unscientific method of dealing with disease. There is nothing that so surely tells of a physician's incompetency as a shot-gun prescription.

The prescription may do well in some cases, and certainly some of its ingredients should touch the case; but they stand as evidences only of so many guesses at the case. Seven or eight drugs are seven or eight guesses, and then some are allowed to guess again.

But take now the case of fever. What have we? We mention one thing, we have a rise of temperature. Have we any drug that will lower it? Yes; veratrum, aconite, quinia and others. Then these are specifics. If, then, the pathological changes which take place in the human body are marked by certain symptoms, and if we have certain drugs which meet those symptoms, are they not specifics? I therefore maintain, that as our knowledge of pathology, symptomology, and knowledge in the action of drugs increases, the

number of ingredients entering into our prescriptions diminish. I am persuaded, therefore, to believe that we have more specifics than we have been willing to admit, and doctors are proverbial for believing, that what they do not know, others can not know, and there is no use in others trying. The writer of the article in the Weekly Medical Review thinks that "it would be well for the day when every disease having its specifics to be long delayed, for," says he, "some enterprising party would publish a tent-cent pamphlet with a list of diseases and their accompanying specifics, and then goodbye to medicine as a means of competency." This, indeed, would be deplorable were it not for the fact that specific medication requires a life-long study-a head full of knowledge, which but few doctors may ever hope to obtain. If the profession of medicine stands on a basis which more light would sink into oblivion, then let it go, and let physicians seek other means of competency.

MEDICAL AND SURGICAL CHARITIES. Physicians, perhaps, do more charity work than any other class of individuals. Their opportunities are such that appeals to their generosity are made continually to give from their time, talents and money. Though often regarded hard-hearted, I believe they are generally humane and sympathetic, and but few turn a deaf ear to those appeals, while many deem it a pleasurable part of their duty to alleviate want and suffering without hope of compensation.

In all large cities these opportunities are in great abundance. St. Louis is not unlike other cities in this particular; it has its free clinics, dispensaries and hospitals.

Originally these institutions were founded upon the prime object of affording relief to the deserving and suffering poor. They were based on genuine charity, and the good accomplished was measured by the great amount of relief afforded. A discrimination was made between the actually deserving of such aid, and the dishonest miser who sought to obtain a gratuitous treatment. Indeed, people then, who could pay for professional services, felt too proud and independent to be caught at these places, receiving for nothing that for which they could just as well pay.

In recent times, matters in these regards have materially changed. The original objects of these institutions have been grossly perverted.

Clinics, dispensaries and hospitals are more numerous, but their glory has departed; charity has given up to gain, and they are erected for self-glorification. The proprietors of these institutions now have other objects before them than that of charity, and in their eagerness for notoriety and for clinical majority the aristocratic, in fine carriages, drive to the doors of these places to obtain free medical and surgical treatment, while the physician within-one of the stricter sect, down on advertising-carries the peaceful air of selfgratification. Many of these places are now erected solely to gain practice and reputation by men, too, who have money-minus brains, who rain their blessings on the just and unjust until it is known that two-thirds of the patients thus treated are able to pay for what they might better receive; thus cheating the surrounding druggists and the worthy young graduate of medicine out of their living.

This picture is not overdrawn; the writer knows whereof he affirms. Hundreds of people in this city with plenty, having homes of their own and money at interest, are taken to these places and treated, as if by charity, though for other gain.

Our city institutions are not entirely exempt from these criticisms. Once we had a city dispensary where medicines were furnished the deserving poor-where any physician in good standing, by giving his services, writing his prescription and sending in the proper form to this dispensary, the unfortunate could have it filled and remain at home if he so desired. Times in this particular have changed; the doctor's prescription is not thus honored, and the sick must either do without, or put the city to greater expense by going to the hospital. Occasionally, and especially in some infectious disease, either some young and inexperienced doctor, or one wholly unskilled in medicine, may visit the private residence to fumigate or to advise the patient to be placed in other hands.

Selfish gratification, medical sectarianism, and the political air, all play their role in that which once was of pure charity--so much so that the present system is continued for individual gain; ends in hypocrisy and self-glorification; besmirches the fair fame of charity; lowers the professional standard; fosters medical pauperism; defrauds the younger practitioners, and makes these institutions a hissing and a by-word.

We have been willing at all times to lend a helping hand to the suffering poor, both from city and country, and of this we have our share; but those who are better able to pay for services than we are to lose them, we generally require them to do so.

SPLITTING THE CERVIX.

The Medical News says, that "dividing the cervix at the external, or at the internal os, or in the intervening portion, though not long since a comparatively frequent operation for dysmenorrhea or sterility, is now very rarely done. Most operators now turn to dilators for the treatment of cases where incision was formerly done; one wing of the army of gynecologists still fights under the same banner of mechanical uterine pathology, only in place of hysterrotomes, its enthusiastic soldiers use dilators. Possibly it is only a question of time when many of the dilators will be placed in the grave beside the hysterrotomes, if the teaching of men like Duncan, Schultze, and Williams prevails, and the mechanical theory of uterine disease is cast aside.

"However this may be, we have been somewhat astonished to know of the mortality which Sims had from this operation. Paget states, in a recent lecture, that he knew of at least four deaths of women upon whom Sims had performed his operation of division of the cervix, and he believes that other similar accidents happened to him. In the light of these facts, the profession is to be congratulated upon the fact that the operation has fallen into disuse."

I do not believe that many cases are benefitted by this operation. A case, to my knowledge, where Dr. Thomas performed this operation a couple of years ago, the lady has been in increased nervous irritability ever since. One in my practice, where splitting the cervix had been advised, is now free from all bad symptoms through a few paintings with the saturated ethereal solution of iodine, carbolic acid, and sal cylic acid, and wearing a Babcock supporter for a time. Another which gave me some trouble for a time-the external os was badly torn, yet unable to enter the uterus--finding a contraction of the internal os, the woman was relieved by dilatation and the wearing of an abdominal bandage.