citis. Failures were so frequent and so much valuable time lost to the patient that surgeons soon began to discredit the claims of the laboratory, and latterly have practically discarded this method for the more accurate clinical knowledge obtained from operative experience. The laboratory man, however, has pursued the even tenor of his way, and with untiring patience and improved methods. of blood examination has again favored us with some observations which are highly interesting, almost convincing, and which, let us hope, will bear fruit in the near future.

Dr. Wile, in a continued article (American Jornal of Surgery, September, October, November), reports the blood findings of malignant disease in the November issue of this journal:

"The hematological conditions due to any malignant tumor vary according to the nature, location, extent, duration, rapidity of growth and virulence ot the neoplasm."

The previous state of health, hemorrhage and the presence of toxins are determining factors in the blood picture.

One of the first changes is a diminution in number and size of the red corpuscles, the hemoglobin is slightly reduced, and as these progress anemia more or less pronounced ensues, which bears a direct ratio to the cachexia. The blood index is usually lower than 1.0, normoblasts appear early, and in the absence of marked anemia, megaloblasts accompany the cachexia, but never equal in number the normoblasts.

Leucocytosis, simulating leukemia in intensity, manifests itself in the presence of a rapidly developing malignant neoplasm, and is a differential point, in the absence of hemorrhage or suppuration, favoring malignancy.

There is a relative and absolute increase in the polynuclear neutrophiles, and much importance attaches to this relative leucocytosis if the total count is normal or slightly increased.

Obstructive effects of the tumor may impair nutrition and find expression in its effect upon leucoblastic tissue, hence the accompanying leucytosis would not necessarily indicate the true pathology of the growth.

The specific gravity is lowered in keeping with the per cent. of hemoglobin, and in the absence of sloughing and hemorrhage the coagulation time is lengthened. This accounts for the marked tendency to secondary hemorrhage in post-operative malignant cases.

The percentage of hemoglobin rarely falls. below 50. In carcinoma involving peripheral structures-breast, lip, etc.-less deleterious effects are shown than when the growth

appears in some internal organ-stomach, uterus, etc.

Some light is thrown upon the future of the case by the rapidity with which hemoglobin regenerates after operation. There is a delay of an entire week in this regeneration as compared with an ordinary hemorrhage, and although the patient may gain weight post-operatively the percentage of hemoglobin will remain below the ante-operative reading.

The following classification of carcinoma, based upon the blood findings, has been formulated:

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1. Cases presenting normal blood.

2. "Cases presenting reduced hemoglobin, with the number of red corpuscles normal or slightly decreased.

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3. Cases presenting low hemoglobin, with the number of red corpuscles reduced.

Cases in the first and second class are most amenable to operative procedure, whereas, when the disease has progressed so far as to reduce the number of reds and the percentage of hemoglobin to a state resembling pernicious anemia, little hope from operation is offered.

Normoblasts, megaloblasts, microcytes, megalocytes, poikilocytes and various types of degeneration are encountered in the course of the disease. Those cases of malignancy in which metastases are present show greatest blood changes, and this fact enables one to judge of the status of the case after operation with reference to reeurrence that is to say, the sudden appearance of a leucocytosis after operation would, in the absence of hemorrhage and suppuration, imply recurrence of the growth.

The Treatment of Toothache.

Country doctors are still called on to treat this painful affliction, and city doctors still suffer from it at times. A shamefully large number of physicians still relieve toothache by extracting the tooth. It is easier to extract than to spend time in giving medicine or advice. The average layman does not know how great is the value of a tooth and how hard it is to properly replace it when gone. The following formula will relieve any tooth ache which will succumb to medicines: Creosote, chloroform, oil of cloves, aa, 10.00; camphor, 7.00; phenol, 3.00. Apply.

E. S. S.

"Not in the clamor or the crowded street,
Not in tfie shouts and plaudits of the throng,
But in ourselves, are triumph and defeat.'
Longfellow.

"Human improvement is from within outwards." - Froude.

THE

The Academy of Medicine two weeks. ago passed a resolution asking the State Legislature to amend the law so as to provide for Cincinnati a real Board of Health. It is high time that such a movement was inaugurated.

The history of the legislation in regard to the Board of Health furnishes a most interesting example of the influence of machine politics on our municipal government.

In 1902, when the new municipal code was passed, the law provided for a Board of Health made up of five members and the Mayor as president. The members were to be appointed by the Mayor for a term of five years, and to serve without compensation. The first appointees were to serve for one, two, three, four and five years respectively, and thereafter one member was to be appointed every year for five years.

It was very evident that the Legislature desired a Board of Health that should, so far as was possible under our system, be removed from political influence. This is to be seen in the fact that a majority of the board would always hold over from one municipal administration to the other, since the Mayor was elected for but two years.

Under the law, the Mayor of Cincinnati at that time appointed the men, who happened to be members of the Board of Public Service. By 1904 the politicians saw an

It

might happen that a member of the Board of Public Service who had ceased to be useful to them, and whom they did not intend to renominate and re-elect, might, if he chose, make trouble by holding on to his job as a member of the Board of Health, to which he had been appointed for an indefinite term. They therefore went to the Legislature in 1904 and had their illegal practice made legal by the enactment of an amendment to the law governing the Board of Health. This amendment provided "that whenever the council of any city shall declare by ordinance that it will be for the best interests of said city that the Board of Public Service act as a Board of Health for the city, then upon the passage of said ordinance the Board of Public Service of said city shall be the duly authorized Board of Health thereof," etc.

Thus was this "iniquity enacted into law." In order that this state of affairs may be ended, the Academy has appointed a committee to wait upon the members of the Legislature and to urge upon them the desirability of repealing the law of April, 1904, and re-enacting the original law, providing for a separate Board of Health appointed by the Mayor.

In asking this let it be remembered that we are but asking for what every city in Ohio already has, except Toledo and Cincinnati. These are the only cities that have availed themselves of this iniquitous amendment. The original law was wise and liberal, and its defeat in the manner described above is an example of the insidious influence of the pinheaded machine politician against the best interests of the community.

The committee of the Academy calls upon the entire profession for help in this matter. It has already obtained a very respectful hearing from the Hamilton County delegation to the General Assembly, and a promise of some of its members to help the project.

S. P. K.

The City Home, Richmond, Va., is to have a regular staff of physicians and surgeons instead of only one medical attendant. The faculty of the Medical College of Virginia and other physicians have voluneered their services.

t

THE HYGIENE OF UNDERCLOTHES. Habits of good hygiene are of slow growth, for the world is at heart conservative, and men are prone to think that what was good enough for their fathers is good enough for them. Again, there are many habits to which nobody gives thought, and it comes as a disagreeable surprise to be told that they are not sanitary.

Take the matter of underclothing, for example. A few years ago it was not unusual to find persons, even those of good breeding and culture, who would have resented in perfect good faith the intimation that their habits were uncleanly, although they systematically wore the same underclothes at night that they wore during the day.

There may have been some reform in this matter, but the habit still remains with us to a considerable extent, although nobody professes to believe that the wearing of daytime underclothes when in bed is a hygienic custom. Persons who require excessive protection during the night ought to have a special set of underclothes for night wear. The ordinary individual needs nothing more than a flannel nightshirt.

As a matter of fact, we are still far from perfect in the hygiene of clothing.

Many persons wear a set of underclothes each day for a week; a few individuals have a complete change every day, and others change twice during the week. The last named practice is, perhaps, in the present state of hygienic intelligence, the best that can be looked for, and it is really satisfactory, provided the wearer takes a daily bath.

There is, however, a way in which underclothes can be made more cleanly without adding to the laundry bill. The average individual wearing two sets of underclothes a week usually changes his garments in the middle of the week, but it would be far better if the two sets were used during the entire week upon alternate days. When underclothes are discarded at the middle of the week, those in actual use during the day are only aired for a few hours out of twentyfour-the eight or nine hours during which the owner is in bed-and they are never

exposed to the purifying process of a sun bath.

A better plan is to wear one set of garments one day and the other on the following day. The underclothes which are not in use should be hung up where they can receive the direct rays of the sun for some hours of each morning. They should not be kept in a dark closet, for every physician knows that light, and especially direct sunlight, is a powerful opponent of microbic invasion. The alternating plan of wearing undergarments will keep each set almost as fresh and sweet for a week as if they had been washed each day after use, and the common weakening of the system shown by a marked susceptibility to take "cold," which is often described as inexplicable, but which is probably, due to a reabsorption of the animal secretions from insufficiently aired underclothes, will be averted.

EDITORIAL NOTES.

L. I.

IN your experience and in mine is the picture, fortunately very rarely presented, of the medical man who would appear to be kind and sympathetic without being conscious that he had nothing to give of kindness and sympathy. There are deep students of medical books, and delvers in laboratories and autopsy rooms who wonder why their ponderous knowledge brings such small pecuniary return in their practice. Like Charles Darwin, who, because of his absolute concentration upon scientific problems changed his early love for music to a positive abhorrence of it, these men have lost their sympathy for their fellow-men by dwelling exclusively in the cold realms of the intellect. The averted faces of the little children, the objections almost amounting to dislike which young people feel toward them, they cannot understand. With all their book knowledge they have failed to learn that "we communicate without speech, and above speech, and no right action of ours is quite unaffecting to our friends," to quote the sage of Concord. Such men have many lessons to learn, which adversity has in store for them.

They possess a one-sided culture. They may as well begin all over again with the essentials, which have nothing to do with intellectuality but much with the morals.

THE Phoenix Mutual Life Insurance Co. of Hartford, Conn., which had reduced its fee schedule for medical examinations, has inaugurated a change; for, it has observed that its "average policy has so far increased, that it gives us satisfaction to announce that on and after December 1, 1907, the company will pay a flat fee of $5.00 for each completed examination for $1,000 and upward." Three dollars in addition are allowed for microscopical examination of urine when required. When a great corporation like the above revises its opinion you may be sure it is the result of substantial pressure, the pressure of necessity. The fight waged by Dr. McCormack and others is bearing fruit; and every one who believes in fair pay for good service in insurance examinations will rejoice in this victory, but will continue the efforts to force other recalcitrant companies to "revise" their schedule.

"WHERE ignorance is bliss, 'tis folly to be wise," may apply ordinarily, but ignorance of sex and sex matters breeds disease and death. Dr. Zenner's article on education as a factor in prevention of venereal diseases is a timely one, and one well worth perusing. Dr. Ravogli's remarks on the value of inspection of prostitutes by city boards of health might be of interest to the incoming administration.

NEWS NOTES.

Dr. J. F. Bailey, of Waco, Texas, was appointed a member of the State Board of Medical Examiners, vice Dr. I. W. Collins, El Paso, resigned.

The Irwin County (Ga.) Medical Society caused the arrest of A. D. Bennett, a so-called magic doctor or faith healer, for practicing medicine llegally.

Iola, Kansas, as well as many other points, reports the spread of a serious epidemic of health, which is causing considerable uneasiness to the profession.

Dr. I. N. Smith, of Westerville, O., has announced his candidacy for the State Legislature from Franklin County, to fill the vacancy caused by the death of Dr. W. C. Whitney.

Dr. V. P. Armstrong, Assistant Health Officer, of Texas, will have all the doctor's of Bexar County haled before the grand jury and asked to tell why they are not making reports of births and deaths.

rence Hospital, and Clinical Lecturer on Abdominal Surgery and Diseases of Women at the Starling-Ohio Medical University. Dr. Lawrence is ex-President of Columbus Academy of Medicine, and member of Tenth District Society, Ohio State Medical Association, and American Medic Association.

MEDICAL SOCIETIES.

The Columbiana County (O.) Medical Society met December 10.

The Hancock County (Ind.) Medical Association met at Greenfield, December 5.

The Dallas County (Tex.) Medical Institute held its annual meeting December 2. The institute is considering plans for club features and a professional reading room.

The Dallas County (Tex.) Medical Association elected the following officers: Dr. J. W. Bourland, President; Dr. Albert Wilkins, Vice-President, and Dr. B. Kensell, Secretary-Treasurer.

The Muskingum County (O.) Medical Society met at Zanesville, December 11. Drs. Deuschle and T. W. Rankin, of Columbus, delivered interesting addresses, and altogether a profitable and pleasant meeting was held.

The Cabarrus Medical Society, Concord, N. C., met December 3, and elected Dr. D. G. Caldwell, President, and Dr. J. E. Smoot, Secretary. It was decided to hold a social session at the next regular meeting in January.

The Ashtabula County (O.) Medical Society elected the following officers for the coming year: President, Dr. A. O. Dickson Jefferson; Vice-President, Dr. Lee Stiles, Austinburg; Secretary, Dr. F. D. Snyder, Ashtabula.

The Macon (Ga.) Medical Society elected the following officers for the ensuing term: President, Dr. R. B. Barron; Vice-President, Dr. Mary McKay; Secretary and Treasurer, Dr. Herbert Respess, Delegate, Dr. W. J. Little.

The Seneca County Medical Society met at Tiffin, O., December 2, and passed resolutions condemning the candidacy of Senator Foraker for President, and pledging the society to do all in its power to defeat Foraker should he be nominated for President.

The Valparaiso (Ind.) Medical Society met December 3. Dr. B. H. Orudoff, of Chicago, read a paper on "The Essential Function of the Tonsil." Dr. H. M. Evans, President; Dr. S. J. Young, Vice-President; Dr. P. R. Urmston, Secretary.

The Eighth Councilor District Medical Society of Ohio met at Newark, December 5. Dr. E. C. Brush, of Zanesville, presided. Mayor Henry I. Raymond, of Columbus (O.) Barracks, delivered an address on "The American and the Japanese Red Cross for War."

At the first annual meeting of the American Physio-Therapeutic Association in French Lick, Ind., Dr. Curran Pope, Louisville, Ky., was elected President for the ensuing year: Dr. Geo. D. Kahlo, Indianapolis, Ind., Vice-President; Dr. Otto Juettner, Cincinnati, Secretary-Treasurer. Honorary fellowships were conferred on four distinguished pioneers of non-medicinal therapeutic methods-Dr. Solomon Solis-Cohen, Philadelphia; Dr. Simon Baruch, New York City; Dr. Charles E. de Sajous, Philadelphia; and Dr. S. Weir Mitchell, Philadelphia. Dr. Juettner

will represent the Association at the meeting this month of the American Association for the Advancement of Science, in Chicago.

The Harrison County (W. Va.) Medical Society elected the following officers for the ensuing year: President, Dr. L. F. Kormann; Vice-President, Dr. E. H. Hill; Treasurer, Dr. B. F. Shuttleworth; Secretary, Dr. C. N. Slater. This society has adopted the post-graduate method with decided benefit.

The Jefferson County (Ala.) Medical Society was highly entertained by Dr. Chas. W. Stiles, chief of the division of Zoology in the Marine Health Service at Washington, D. C., at its regular meeting, December 2. He spoke on the economie side of hookworm disease, and the particular diseases attendant upon laboring people.

The Aiken County (S. C.) Medical Society, at its meeting December 4, adopted the following resolutions: (1) The name to be the Aiken County Hospital, organized and controlled by the Aiken County Medical Society; (2) to be established by a joint stock company, capital $5,000, with privilege of increasing, and divided into shares of $25 each; (3) the hospital to be located within the city of Aiken.

KOCH'S BACILLUS.

Columbus, O., will shortly build a hospital for tuberculous patients.

Waltham, Mass., contemplates the erection of a sanatorium for tuberculosis.

Norfolk, Va., and Charleston, W. Va., are conducting a campaign of education against tuberculosis.

An appropriation of $5,000 was made by Waterbury, Conn., to establish a hospital for the treatment of tuberculosis.

Louisville, Ky., and Richmond, Ind., through their police departments, are going to enforce their anti-spitting ordinances.

The City Dispensary for Tuberculosis in Memphis, Tenn., is sadly handicapped for lack of funds. There is even danger of its discontinuance.

An appeal in the daily press for $1,600 to carry on the work of fighting consumption at the day camp of the Boston Association was followed by an ad. telling how to cure a cold in one day.

Dr. Clarence D. Wheaton, of Chicago, delivered an address at the Indiana University School of Medicine, Indianapolis, Wednesday, December 11. Subject: "The Hygiene of Tuberculosis."

The Vermont Sanatorium, near Rutland, was opened December 10 with appropriate exercises, including an address by E. R. Baldwin, M.D., of Saranac Lake. Seven dollars a week, payable for four weeks in advance, will be charged.