You may not happen to know what things doctors do. Some of us do know. We know of women saved, of young men steadied, of families held together, of money given instead of received, of free calls and often material assistance. We know of operations performed in the hope of saving life when it seemed that the surgeon was ready to drop from physical exhaustion. We know of the most tender care freely bestowed upon the lowest and feeblest and most unattractive of God's creatures. The good and the wicked, the black and the white, are all one to the honest physician. The man who doesn't pay his doctor's bill and can is meaner than the man who dodges his taxes. But the physician goes on.-Peru, Ind., Journal.

NEW YORK has a population of 3,153,213, and on August 19, 1906, registered 22,165 living cases of tuberculosis. In that year the number of deaths from the disease was 10,194, and the total expense to the city for tuberculosis cases in 1906 was $1,269,400. The list of expenses included nurses, milk, eggs, medicine and sputum cups; clinic maintenance, dispensary provisions, reception hospital and expenses of hospital provision.

With a few exceptions, a gradual numerical decrease of bacilli indicates curative changes, and will usually be accompanied by corresponding improvement in appetite and weight, freedom from fever, cessation of night-sweats, etc. At the time this statement was first made by Prof. von Ziemssen, in 1887, it created a sensation. The date mentioned seems centuries ago, and yet we have not improved upon it even to-day.

A fight is progressing in Florida that dwarfs the recent Russo-Japanese conflict to small proportions. There is a movement on foot on the part of the citizens of Tampa to have the offices of the State Board of Health and laboratory removed from Jacksonville to that city. Tampa has offered the State health authorities a site for the laboratory, and offers to put up a suitable building at a reasonable rental.

The Indiana State Board of Medical Examination and Registration met August 20 and took up complaints against several physicians in various parts of the State who are charged with various offenses, including malpractice, failure to report births, practicing without license, and similar charges.

Medico-Legal.

ES M'KEE, M.D.

A Wise Coroner's Jury and Unwise Doctors.

A New York coroner's jury, in rendering a decision on a death of a Christian Scientist recently, appended the following, which, if such is the case, is a matter needing attention. "And we find that a number of medical doctors in New York City make a practice to furnish death certificates to persons who die under so-called Christian Science treatment, thus enabling Christian Science practitioners to evade the laws of New York in their so-called treatment. And we respectfully call attention of the Health Department of New York City, the prosecuting attorney of New York County, and the Medical Society of New York County to the practice of such physicians, and request them to take the necessary steps to put a stop to such practices and to punish the perpetrators thereof according to law." This very commendable action on the part of the coroner's jury was due to the very decided stand taken by coroner Acritelli, who, in his address before the coroner's jury, denounced in the most scathing terms those licensed medical practitioners who, for the sake of a little money, disgrace the profession by making out death certificates for persons whom they never attended during life.

Danger to Doctors.

It seems that the greatest danger the doctor has to contend with is not contagious disease or stress of weather, or the night highwayman, but that it is woman, designing, malicious women, either disgraced, about to be, or desiring to be. In looking over the reports of deaths among physicians, comparatively few are reported to be from contagious diseases. A reputable physician of Detroit has recently undergone an experience which makes the average doctor shudder and look about for a chaperone. Dr. E. L. Emmons was called to visit a patient whom he had never visited before. He found her in a boardinghouse complaining of the symptoms of a hard cold, for which he prescribed. He did not hear from her again till a week or so later, when he read in the papers that this woman had accused him of procuring an abortion on her.

She was a janitress and was found by another physician suffering from sepsis due to a blundering attempt to procure an abortion. Another physician was called in and the patient removed to the hospital. The prosecutor's office was notified and the assist

ant prosecutor and a stenographer hastened to the bedside to take the ante-mortem statement. The priest having administered the last sacrament, facing death and in the presence of several witnesses, she said that Dr. Emmons had performed the operation, named the time, place and fee. But she did not die. A month later the case was brought to trial and instead of the ante-mortem statement the woman herself was on the stand. On crossexamination she broke down and admitted that Dr. Emmons knew nothing at all about the case or her condition. She said she thought that she would be sent to prison herself if she did not accuse some one. Think of the fate of Dr. Emmons had she died with this awful lie upon her lips! Laws should be passed making it a crime to solicit a physician to commit an abortion as well as to offer a bribe, and the laws should be made to better protect physicians from blackmail and accusations of this kind.

The Partially Insane.

It has been said that the sane majority put the insane minority in insane asylums just as in politics the majority puts the minority out of office. It has been surmised that as the insane minority is increasing rapidly they will, in time, constitute the majority and put the sane minority in the asylums for acting queer, just as in politics when the minority grows until it becomes the majority, and puts the former majority in seclusion. We have, however, a very large class of half-crazy people who in politics would be designated as on the fence." In view of this semi-psychic weakness the community in which these semiunfortunates live owes to them the necessary care and treatment, and to itself measures to protect itself from their misdeeds. Here we find ourselves right in the midst of the question of partial responsibility. It is unjust to punish the partially insane as though he were entirely sane, and it is quite as unfair to restrain him as though he were actually insane. Grassat, of Montpellier, in a very suggestive monograph entitled "Demi Fous et Demiresponsibles" (Bibliotheque de philosophie contemporaire), suggests as a partial solution of the problem that institutions or special asylums be established by the State in which it could take proper care of or punish individuals of partially defective mentality, or the half-crazy people, and that the courts should take proper cognizance of this important and numerous class of people and treat them properly. Grassat considers the born criminal of Lombroso as semi-insane. We find in this group of the semi-insane that the saying that one must have

The season of 1907 has not given us anything specially new in the treatment of the rhus radicans or three-leaved ivy poisoning. It is estimated that three thousand Californians are constantly suffering from poisonous plants, and they and all their friends swear by the fluid extract of grindelia robusta, applied locally. Pfaff's discovery that the poison, toxicodendrol, is an alcohol soluble fat, is still the key to the situation. Remove the poison with equal parts of alcoho! and water and cure with a saturated solution of acetate of lead in the same strength of alcohol. Those individuals who claim that they cannot go near poison ivy without being poisoned are probably slightly mistaken. If not, they would probably be suffering most of the time. Inquiry develops the fact that they are poisoned in this way mostly in May or June, and, as Dr. Carl Schwalbe claims, that the small hairs which cover the leaves, especially the under side, contain poison, and that these become detached and are carried by the wind. This may account for the poisoning without contact. Human urine is highly recommended as a cure. If it is curative it must probably be alkaline. The prolonged application of water, as hot as can be borne, is also highly recommended. While alcohol dissolves and removes the poison, alkaline solutions act differently by the excess of alkalies forming an insoluble compound.

Cataplasma Kaolini.

The variability of the kaolin furnishes a source of annoyance in the preparation of this remedy. In making this up in lots of about four pounds pharmacists can produce it at a cost of about eight cents per pound. This cost takes no note of the strenuous exercise, which is good for pharmacists. It will in about one year's time turn slightly darker and the glycerine will begin to separate slightly, which spoils its appearance some, but not its real value. If made in quantities larger than four pounds the pharmacist would require a hand or motor power machine to

Coal-Tar Products Valued Lightly.

Dr. H. C. Wood, Jr., of Philadelphia, in a recent discussion before the Theraputic Society, said that he thought that very few useful drugs had been put out by the manufacturing chemists, and that we would have been better off if Perkins had never discov

ered the coal-tar products. The aniline dyes were cheap and gaudy, and did not last, and the coal-tar drugs were in the same class. He believed that the good coal-tar products had done was neutralized by the harm.

This makes a good, thick mixture, which is not unpleasant to take. Physicians who wish to carry their medicines will find it more convenient to substitute the powder of ginger for the syrup. If syrup be objectionable substitute for it tincture of ginger with water, mucilage of acacia.

Hay Fever Treated by Way of the Antrum.

Schadel, in the Medical Record, relates treating ninety-two cases of hay fever by washing out and medicating the antrum of Highmore, with which treatment he obtained the best results in all but one case. Most of the patients were entirely cured in from one to three weeks, and remained so. The affection does not occur in persons in whom the ostium maxillare is of the normal small size, but in those in whom the disease, malformation or injury has made the antrum opening of sufficient size to admit germs to the interior of the cavity.

Seidlitz Powders Effervescing Internally.

Scoville reports that he saw many cases of headache at a food fair, brought on by overindulgence in all sorts of edibles. He found the ordinary headache powder inefficacious, so administered seidlitz powders, the two portions being dissolved separately and drank separately, the effervescence taking place in the stomach. In no case was there discomfort from the effervescence, and every case showed quick relief. He states that a seidlitz

bon dioxide at the body temperature, and it is his opinion that this gas is an effective corrective of stomach disorders.

Acetanilid as a Preservative of Hydrogen Peroxide.

The pure food and drugs act has brought out the fact that acetanilid, 1:1,000, is used to properly preserve hydrogen peroxide. The dose, however, is so very small that it has no effect whatever on the patient. Original bottles of hydrogen peroxide which do not contain acetanilid have corks wired down, or they have some special device to prevent the escape of free oxygen generated. This free oxygen is generated at the expense of the peroxide.

Thyroid Extract in Hay Fever.

Pottier reports three cases of hay fever treated by this means in the Journal de Medicine de Paris, April 7, 1907. He gave the remedy in doses of ten centigrammes, or 1 grains. One or two pills daily, till twentyfive or thirty are taken, usually suffice for a

cure.

Adrenalin and Atheroma.

Adrenalin has been shown by Pearce and Miller to cause definite changes in the walls of the arteries even after but brief administration. Atheromatous patches with definite fibrosis and patches of calcification have been repeatedly found in cases in which adrenalin preparations have been exhibited. These facts should be borne in mind by those who use

cocaine and adrenalin in treatment.

"THE stand taken by Texas on this anti-tuberculosis question seems to have come in for some sweeping condemnation in this section of the country, and it is entirely uncalled for and foolish, said Dr. George R. Tabor, of Dallas, former health officer of Texas.

"It is simply a case of self-preservation. Then, too, in reality, it applies only to those consumptives who are almost in the last stages of the disease, and to whom no climate on earth would bring relief. To others who are not marked as hopeless, Texas still extends a helping hand, as she has ever done in the past, but we do not feel that we can jeopardize our own people by allowing an overburdening influx of sick people who will in the end contaminate portions of our State. We found ourselves in such a position as Phenix, Ariz., and other health resorts, simply living in an atmosphere of consumptives. The deathrate from tuberculosis among our citizens was constantly on the increase, and only the restrictions decided on can stop it. We Texans are not at all coldblooded in this matter, but it is certain that we do not intend endangering our own health when such a sacrifice can be of no benefit to others. The way is open, however, to those who have hope."-Washington Herald.

Miscellany.

The Pharmacopeial Preparations to be Kept on Hand by General Practitioners.

The above caption was the title of the prize question offered by the New York Medical Journal. The first prize for the best answer was awarded to Dr. George A. Graham, of Kansas City, Mo., and the second to Dr. Leon G. Tedesche, of Cincinnati. On three occasions lately Cincinnati has been honored with the first prize in these contests, but this is the first time she has come out second.

Dr. Graham thought that first and foremost, for croup and diphtheria, in a class by itself, is serum anti-diphtheriticum. A package of at least 3,000 units should be within reach of every practitioner, day and night. Second, were mentioned the drugs which should go in a hypodermic case. Third, in the obstetric bag―ether, chloroform, saturated solution of boracic acid, fluid extract of ergot, bichloride of mercury tablets, subsulphate of iron, quinia sulphate and petrolatum. Fourth, for poisoning and emergencies, amyl nitris (in pearls), aqua ammonia fortior, chloralum hydratum, mustard plasters, hydroxide of iron with magnesia, lime water, carbonate of magnesia, olive oil, croton oil, permanganate of potash, aromatic spirits of ammonia, wine of ipecac and sulphate of zinc. Fourth, came a list to be kept for office use, Sixth, for urinalysis. In the seventh class was a list of twenty remedies for the pocket-case. The doctor considered the best results to be obtained in the practice of medicine not by the indiscriminate use of many drugs, but the proper use of the few well-selected to meet the requirements of each case.

Dr. Tedesche, after a few preliminary remarks, gave a very comprehensive list, first arranged and numbered pharmacologically and then alphabetically, with cross references. The compilation was certainly a very valuable

one.

The third paper on the list was that of Dr. Anthony W. Lamy, of Baltimore. Fourth. Dr. Maxwell S. Simpson, Middle Valley, New York. Fifth, Dr. Abner C. Matthews, Earlville, New York; Dr. H. C. Macatee, Washington D. C., and Dr. Lucien Lofton Bellefield, Emporia, Va. The last man on the list was the briefest, and for this reason would, by many, be given the first place. Besides a short and well-selected list, he enunciated the following sensible sentence: "No man is so well armed as the one forearmed, consequently, in a restricted sense, I would suggest, first, have a place for every

thing and everything in its place." Dr. Matthews said: "We all have our hobbies. Mine is antitoxine. It should be on hand constantly and sometimes changed. With a case of diphtheria to attend to it is surely no time to go round ringing teleghone bells and consulting railroad time-tables."

Dispensing physicians have more than once been the object of legislative attack, but the universal decision has always been that the right to furnish medicines to his patients is inherent in the physician, and that it is not probable that the legislature would attempt to deprive him of it or that the court would sustain any such attempt if made. E. S. M.

An Unusual Operation.

Extra-peritoneal transplantation of ureters into the rectum, was an operation made by Dr. T. B. Armugan, Medical Officer in charge Victoria Hospital, Bangalore, and reported in the Indian Medical Gazette. The writer of this article, while not anxious for or expecting the job, has thought if he were ever called upon the get up a revised edition of the human frame, he would put the calf of the leg in front of the shin-bone and enlarge the rectum, excise the bladder and turn the ureters into the rectum, thus giving the person two or three loose stools per day, like chickens, do away with constipation and cease making a sewer of the sexual organs.

A Use for Post-Cards.

E. S. M.

Dr. Lichty, of Rockford, Ill., communicates to the Dietetic and Hygienic Gazette his discovery of a good use for the picture postcard.

A recent epidemic of scarlet fever in his city quarantined a little eight-year-old against his brothers and his mother so effectually that the physician and the nurse were the only visitors. His brothers bought picture post-cards, and wrote the patient short accounts of their doings. Upon the suggestion of the doctor others were persuaded to do likewise, and by this means the tedium of his confinement to the house was markedly reduced. The cards were, of course, promptly burned when they had accomplished their service of amusing a weary, heartsick, lonesome little boy.

A BOY in an Ohio school was told by his teacher that he must have a tablet instead of a slate. As days passed and no tablet came, the teacher told the boy he must not come to school again without one. The next day the boy reported to the teacher that his mother had no more tablets, but she had given him a pill instead.

Book Reviews.

A Text-Book of Practical Therapeutics: With Especial Reference to the Application of Remedial Measures to Disease and Their Employment from a Rational Basis. By HOBART AMORY HARE, M.D., B.Sc., Professor of Therapeutics and Materia Medica in the Jefferson Medical College of Philadelphia; Physician to the Jefferson Medical College Hospital, etc., etc. Twelfth edition, 939 pages. Lea Brothers & Co., publishers, Philadelphia and New York, 1907.

It is thoroughly gratifying to read a volume of therapeutics from the hand of an author who not only is an authority, but also has the ability to present his subject in a clear and striking manner. However, in looking over the work one is struck with the fact that the term "A Text-Book of Practical Therapeutics," as used on the title page, is largely a misnomer; the work is in reality a reference, and not a text-book. The very alphabetical arrangement of the drugs and diseases which saves so much time for the investigator does much to destroy the usefulness of the work when placed in the hands of the student, who is not only unable to study groups of drugs placed in logical sequence, but is confused and perhaps discouraged by both their number and lack of relationship one to another. It is much as if one were to place a dictionary in the hands of a child and refer to it as a text-book on spelling.

The author has divided his subject into four parts. The first, "General Therapeutic Considerations,' contains much valuable material which will well repay careful perusal; his treatment of "incompatibilities" is a peculiarly clear and concise statement of a most difficult subject. A feature worthy of especial note, and one too much disregarded by many writers, is that paragraph entitled “Idiosyncrasy.

Part II is devoted to "Drugs, which, as has been stated, are taken up alphabetically. This is a great boon to the reader, who is thus enabled to turn at once to any drug he may wish to investigate.

This division of the work shows evidence of the most painstaking care in the preparation of the subject-matter, and much personal research on the part of the author. Thus in his able article on chloroform, in making the rather practical statement that "the cause of death from chloroform is usually vasomotor depression,' he supports his view by many experiments either performed himself or by others working under his direction. Whether or not one agrees with his conclusions, it is decidedly refreshing to read a work on therapeutics which consists of something more than a mere "rehashing" of what has been written by other authors.

The reader frequently meets with new theories or with old truths presented in concise-almost epigrammatic-form. As an example of the latter the writer, in discussing the bromides, remarks: "In a word, it may be said that bromide of potassium is to be used wherever over-excitement of protoplasm is present, but never when the nervous symptoms are due to depression." Illustrations of the former are many; thus the author maintains not only that digitalis acts directly on the cardiac muscle, and on the vaso-motor centre, but that "the slow pulse is produced by stimulation of the pneumogastric centre, and the peripheral ends of the vagus;" also that "digitalis is not only a heart stimulant, but a remedy that increases the growth of its muscular tissue as well."

In discussing ether Hare takes the ground that the drug acts as a primary stimulant to the centres governing the diaphragm, and therefore in ether nar

cosis these centres must necessarily be primarily depressed; he would therefore have the anesthetist pay as close attention to the movement of the diaphragm as the condition of the pupil and pulse. He further states "that ether is not capable in the ordinary patient of producing renal disorder of any moment unless the kidneys are already diseased or the patient is soaked with the drug.'

The action of magnesium sulphate is stated to be due not only to osmosis, but to a direct stimulation of peristalsis.

In treating syphilis the writer does not believe in the hypodermic injection of mercury as a routine treatment, but considers that the internal administra-' tion of the protoiodide gives the best results. While believing the action of calomel to be still in doubt, he is rather of the opinion that a small portion, changed into the bichloride of mercury, increases the quantity of the bile excreted, and the remainder, acting on the intestinal tract, produces the laxative effect.

Strychnine is considered to be the quickest and most powerful antidote for chloroform, and a better antidote for acute opium poisoning than atropine. In an excellent article on chronic opium poisoning the curious and interesting fact is mentioned that the new-born child of an opium-eating mother often suffers collapse on the second or third day from the lack of the drug. When referring to phenol poisoning the author makes the remarkable statement that "alcohol is useless as an antidote when phenol has been swallowed.'

Two features of this section which are especially noteworthy are the series of paragraphs devoted to "Untoward Effects" and "Administration," and the portions treating of toxicology are uniformly good.

The illustrations which endeavor to demonstrate the action of the respective drugs on the nervous system are extremely poor, and not only fail to make the subject matter clearer to the reader, but are actually confusing.

It is surprising, to say the least, to find in a work which is supposed to be scientific and thoroughly up to date such expressions as "bilious headache," "belly-wall,' nervous syphilis, "plethora,' "bilious purging, 'torpid liver," and the chemically incorrect expression carbonic acid."

66

The third part of this volume is devoted to "Remedial Measures Other Than Drugs.' This is one of the most valuable sections of the work, each subject being treated in a thorough and able manner; especially is this the case with the article on "Disinfection," which can hardly be too highly praised. In speaking of "climate" the author neglects to warn the reader against the danger of sending patients to sanatoria in the West or Southwest unless he be thoroughly acquainted with their character and standing, lest the patient fall into the hands of that class of charlatans whose only object is to prey on just such unfortunates.

"Feeding the Sick” is made a separate division of this part, and is most excellent, though all too short.

Part IV takes up the different "diseases" and their treatment; a short study of the pathology of each disease precedes their strictly therapeutic consideration, and aids much in explaining the rationale of their treatment. "Heart Disease" is discussed in a long and masterly article that can hardly be read too often. Hare takes the ground that in valvular

lesions the criterion should be the state of nutrition of the tissues and not the loudness of the murmur. "Pleurisy" is the title of another particularly good article, and in writing of typhoid the author protests vigorously against a rigid milk diet.

In producing this volume Hare has given to the profession a book which cannot fail to be of great