HENRY WALDO COE, M. D. Editor The Officers of The State Medical Societies of Oregon, Washington G. S. Armstrong, M. D., Spokane (For Roster see adv page 10) C. S. Baldwin, M.L., Salt Lake City George M. Horton, M D., Seattle F. M. Shaw, M.D., Ashland Ed. E. Maxey, M. D., Boise Jessie M. McGavin, M.D., Portland Address all communications regarding papers, subscriptions, advertising or business mat ters to the MEDICAL SENTINEL, Marquam Building, Portland, Oregon A MEDICAL LAW FOR ALASKA Efforts will be made at the next session of Congress to secure the passage of a measure, providing for a medical law for Alaska. At present there is no law whatever regulating the practice of medicine in our great northwestern territory. Dr. S. H. Moore, who has been chosen. as a delegate from Alaska to the American Medical Association convention, will bring the matter before that body, and seek to have a resolution passed endorsing the proposition, and urging Congress to enact such a law. The people of Alaska are entitled to such protection as a good medical law will furnish them-just as much entitled to it as any of the States of the Union. There is no reason why a charlatan, with no education or experience, should be allowed to go there among our fellow citizens and practice medicine, and risk the lives and health of the people, any more than it should be allowed in the other territories or States of the Union. WHERE SHALL THE YOUNG DOCTOR LOCATE? It is safe to say that the editorial office of every medical journal is in receipt of frequent requests from aspiring young doctors as to the prospects of the young man who locates within the immediate territory of the editor. At this time of year, there is a large number of medical students sent forth into the world. They have passed through their medical colleges, taken their degrees, and are ready to help in the noble work of preventing disease and curing humanity of its ills. But where to locate is the question that bothers more than half these young and deserving doctors. They have been advised very properly that to be successful in the practice of medicine they must have a solid foundation for practical work, must be earnest of purpose, devoted to their calling, must exercise integrity, and must observe the golden rule. While this advice is of the very best, many of them will earnestly strive to observe all these directions, and still not succeed, as the world regards success. Others will be deficient in many particulars as to following these general rules, and yet will appear to be successful, and will be pointed out as examples for others to follow. It is not ncessary for The Sentinel to give any advice to the young men who write to it, as to the general rules that a practitioner should follow. It is a poor commencement exercise in which all the advice necessary to last a young man a life-time, on these questions, is not given. But yet the question is presented to us, after all the advice given by the valedictorian, or the learned and experienced gentlemen who addressed the graduating class,-Where shall the graduates locate? Shall they come to the Pacific Coast from the Eastern States? Sometimes, when in conversation with a lawyer or a doctor, one will hear the remark made that if the speaker were to start all over again he would go to New York City. Of course such a remark bespeaks a full measure of self-confidence-an excellent quality to possess. The speaker means that in his opinion his attainments and capabilities under the stimulation of the intense life that prevails in the largest city of the nation, are such that they would bring him into the front rank. Yet, New York is not for most men, even though they be young. Their place is elsewhere, but just where is that place to be? Many a young man, who may be absolutely lost in a large city, might attain considerable success and be extremely useful in a smaller, growing place. The country is not to be despised, even for a doctor. George Eliot makes one of her characters in Middlemarch-Celia-deplore the fact that Dorothea was going to marry Ladislaw, who was so poor. Now the couple "would have to live in a street"—one of the most undesirable things that poor Celia could think of. To her the country was the only fit place to live. The young doctor who would be sure of making progress can select a growing town, at present not overcrowded with physicians, and there make himself useful. Many of our most successful city physicians have graduated from the country town, and they never regret their country experience. Whether to come to Oregon, Washington, Idaho or some other Western State-this is the question that is urgently pressed upon us by some of our correspondents, looking for advice. In reply let us state that the colleges of these States are exceedingly busy, and many a doctor who will make his mark in the far West has recently been graduated from our nearby colleges. Whether a young man who has received his education in a Middle or Eastern State should start out on his career on the Pacific slope or not is a question harder to answer than to ask. It depends so much upon the person, and the conditions that exist in the locality where he proposes to locate. No general and infallible advice can be given. If you have personal friends here who know your capabilities, and who also know the needs of a particular community, and advise the step, then the move can safely be made, provided their judgment can be regarded as being good. At the same time, personal investigation is worth more than anything else. This summer, rates to Portland will be cheaper than ever before, and cheaper than they will be again for some time. There is much to see here that will delight anybody. The young doctor, aspiring to improve his position, and engage in the work where his capabilities and talents can the best be utilized, cannot do better than to take a look over the ground for himself. This, after all, is about as definite advice on the subject as The Sentinel can give. THE CRUSADE AGAINST TUBERCULOSIS The crusade against tuberculosis, which has received its greatest impulse from the medical fraternity, is accomplishing great things all over the country. Boards of Health, impelled to their duty by the doctors, have done their share of the good work of educating the public, and the result is highly gratifying. The establishment in different parts of the country of open air sanitariums for the special treatment of sufferers, has done much in individual cases, but the secondary good has been enormous, by calling public attention to the fact, hitherto not properly appreciated, that taken at a certain stage, there is hope for the sufferer. In many cities throughout the country, rules and regulations, enforced by the law authorities, prohibit spitting on sidewalks and in street cars and other public places. Portland has not yet progressed as far as it ought in this regard, but there are hopes for this city. The tenement house, in which people are packed like sardines, is a fruitful source of disease in many cities, but fortunately the cities on the Pacific slope have not yet become victims to any great extent of the tenement house evil. There is a great deal of work to be done in combatting tuberculosis in such houses, where they exist. If fresh air is useful in curing the disease, the tenement house is surely a great medium for its development. In some Eastern cities, for the purpose of educating the public on the question, Anti-Tuberculosis Associations have been started, whose business it is to make exhibits, setting forth the salient features of the disease. Charts and statistics are provided, showing the appalling ravages of the disease, photographs of patients taking the treatment, sanitary spit-cups, models of out-door tents, literature, etc. Instructors are provided to explain the exhibit. The results are declared to be very gratifying where these exhibits have been made. People who attend them go away with a firm resolve to do their share in the fight against the disease. There is no work that can better engage the attention of medical societies than to join in the crusade against tuberculosis. Locally, we can feel proud that the Portland City and County Society has done so much to aid in the good work. TO OUR SEATTLE BRETHREN Two or three of our good friends in Seattle are not very well pleased with the remarks made in the last issue of The Sentinel, concerning the attitude of a few Seattle physicians towards the local management of the American Medical Association gathering of next month. For their displeasure we are genuinely sorry. Whatever has been said, however, forms but a ripple on the surface of the placid waters. The Portland end of the Association is taking life very easily, and is grateful for the encouragement that it has received from the fraternity, and from the business interests of this city and doctors elsewhere. The physicians of Washington have as great an interest, almost, in the welfare of the success of the meetings as Portland has. The time is not far distant when Seattle, with its push and progress, will want to make a bid itself for the annual meeting of the A. M. A., and it will find that its success in its aspirations will be largely promoted by the success and brilliancy of the entertainment that the visiting doctors will receive at the hands of Portland. It will be found that in the distant future-and yet we hope not very distant—the little ripple upon the surface, in which one or two were a little too strenuous in their objections to things being managed as they were-will be entirely forgotten. Our Seattle brethren are assured that the anticipation of the meeting of the A. M. A. is a great thing to bring together the workers in the ranks; it is a great thing to unite the business interests and is well worth the doing. May we not hope that when the Seattle fraternity take hold of the matter in the years to come, they will be able to profit by the mistakes that may have been made, and by everybody's sins of omission and commission, and be able to manage the preliminaries without ruffling the feelings of anybody? The Portland committee regrets if it ruffled anybody's feelings. There has been good deal of talk in the newspapers and elsewhere, under the caption, "The Seattle Controversy." As a matter of fact, the little riffle on the waters has not been a controversy between the Portland doctors and the Seattle doctors, but it was a manifestation of a difference of opinion as to the management of the A. M. A. between the general committee of Portland and two or three men in Seattle. The doctors of Portland, and especially the members of the general committee, have not a particle of ill will against the profession in Seattle, but, on the other hand, have the kindest feelings towards them. Outside of Dr. Sharples, who has written the committee that he proposes to give the $50 to Dr. Eagleson's Y. M. C. A. work which he had planned to contribute towards the Portland fund, we don't know of a Seattle physician who will stay away on account of this little riffle. In fact, the man who was given credit for starting the trouble has had rooms reserved so that he may attend the meetings. The Sentinel would not have returned to the subject if it had not been so extensively aired in the Philistine press, to which The Sentinel referred in its last issue. PROGRESS IN NERVOUS AND MENTAL DISEASES ABSTRACTS AND COMMENTS By WM. HOUSE, M.D. PARESIS IS IT CURABLE? Amongst recent contributions to mental science none is more startling, more opposed to preconceived ideas and experiences than a paper by C. L. Dana in the Journal of the A. M. A. of May 6, on the curability of paresis. In his preliminary remarks, Dana states: "I wish to present what to my mind is convincing evidence that paresis in its early stages-in that stage which might be called 'pre-paresis'— is a disease that sometimes can be arrested. The arrest may be permanent and attended with so little mental defect that one may call the patient practically cured." Dana considers paresis as almost always a para syphilitic disease, and apparently the syphilitic element is the important item, on which hopes of successful therapy are founded. He makes comparison with tabes, which has a similar etiology, presents many points of resemblance, and is often associated with it. Yet tabes is frequently arrested for many years, and Dana can see no reason why, arguing from analogy, paresis may not yield similar results. He calls attention to the pseudo paresis of alcohol and syphilis, insisting that his cases were not of these types. Full recognition of other possible sources of error is made and stress is laid upon the presence of Argyll-Robertson pupils and disturbances of patellar reflexes as important diagnostic signs seen in his cases. The histories of seven cases follow, most of them presenting symptoms usually recognized as belonging to paresis. All save one gave a history of syphilis. The duration of symptoms prior to the first visit varied from two months to two years, and consisted of depression, irritability, nerve palsies, sensory disturbances and ataxias. They received treatment for various periods and in every instance appeared to recover, having after several years exhibited no tendency to relapse. The treatment adopted and advised was rest, regulation of diet and habits, mercury by hypodermic injection, iodides and tonics. The discussion by A. E. MacDonald, L. Pierce Clark, Carlos MacDonald and others with enormous clinical experiences, indicates grave doubt of the possibility of curing paresis. The ease with which error might enter into the diagnosis was pointed out, especially confusion with simple exudative syphilitic lesions, and the fact of recovery under antisyphilitic treatment was assumed as evidence of this mistake having been made. Statistics taken from various sources indicate a remarkable unan |