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Published Monthly by WESTERN MEDICAL REVIEW COMPANY, Omaha, Nebr. Annum, $2.00. The WESTERN MEDICAL REVIEW is the Journal of the Wyoming State Medical Society and is sent by order of the Society to each of its members.

OFFICERS:

Dr. A. G. HAMILTON, Thermopolis, President

DR. W. H. ROBERTS, Cheyenne, Secretary

DR. NEIL DAVID NELSON, Shoshoni, Treasurer

All matter for publication in this section should be sent to

FRED W. PHIFER, M. D., Editor, Wheatland, Wyo.

COLLABORATORS-SUBJECT TO REVISION.
WYOMING SECTION.

Pestal, Joseph. Douglas; Keith, M. C.; Casper; Marshall, T. E., Sheridan; Nelsen, N. D.; Shoshoni; Wicks, J. L., Evanston; Wiseman, Letitia, Cheyenne; Young, J. H., Rock Springs.

Vol. XVII.

CHEYENNE, WYO., MAY, 1912.

ABSTRACTS.

The "Blue Sky" Law and Medical Frauds.

No. 5

According to estimates by credit-rating concerns and the postoffice authorities, the people of the United States lose more than one hundred million dollars a year through fake and wildcat securities. Kansas is the only state, so far as we know, that has attempted to protect its people against this class of swindling. That state has a law which is popularly known as the "blue sky" law. It is estimated to save Kansas investors two million dollars a year. But it simply covers one line of business, that of stock-selling in its broad sense; it does not cover the multitude of other fake schemes such as those of the swindling "patent" medicine fakers. It protects only people who have money to invest and who might be considered well-to-do or even rich. Commendable as it is, it does not protect the people who need protection most-those who are sick, or think they are sick, and who are more likely to be influenced by misrepresentation than any other class of people. The admirable Kansas law should be extended to protect people from the most vicious form of swindling. If the people of the United States are swindled out of a hundred million dollars annually by stock jobbers and si milar concerns, it would not be a reckless statement to make that they are swindled out of twice that sum by those who prey on the sick the "patent-medicine" swindlers and quacks, es

pecially if the mail-order fakes are included. Should the people not be protected also against this more damnable and dangerous form of swindling?

Wayward Girls.

The study of wayward girls made in New York by the Episcopal Church Mission of Help, has added more proof to what has been known since long before Lombroso so conclusively showed that they were the female counterpart of the male criminal. Each class comes from respectable families as a rule and as each is more or less mentally lacking, the problem is essentially a medical one to find out why they depart from parental type. The causes are mostly pre-natal, but the environment after birth has a great deal to do with it. The reformatories have proved a thousand times over that the young criminal who through sheer weakness has bent to the evil influences of his environment can be straightened up if properly managed soon enough, and that he will keep straight, as a rule, when he is given this new strength, though of course there is no cure for his lack of mental development. The workers in the female field report equal success with wayward girls who are nearest the normal, but the worst are incorrigible.-American Medicine.

The Treatment of Nocturnal Enuresis In Children.

Ruhrah (American Journal of the Medical Sciences, February, 1912) has had remarkable results in a certain class of cases of enuresis, through the administration of thyroid extract. These cases have been described by Williams as follows: The children have a subnormal temperature, the usual range being from 96.2° to 97.2° F. (in some cases even lower); they complain of being cold, even when somewhat overclothed, and they have what is spoken of as "dead fingers"-one or more fingers becoming blanched and very cold when the child is exposed to cold, and often at other times; they feel cold even in summer, and suffer more at night than during the day. They are undersized and under weight. About one half have adenoids, but nasal respiration is free. The high arched palate is present in all these cases, and Williams believes that these things together indicate thyroid insufficiency.

To these children between two and six years of age, one half grain of dried thyroid is given twice daily, and this amount may be increased somewhat for older children. The increase in dose should be made slowly, as directly opposite results are oc

casionally induced by overdoses. In every instance of favorable result, a marked difference was noticed after giving one or two doses, and in all cases within a week. It has not been found necessary to continue the thyroid over long periods of time.

The Term "Rheumatism."

No term in medicine is more loosely, not to say more recklessly, applied than "rheumatism." As still used, it covers a multitude of erroneous diagnoses. To some medical minds every painful or swollen joint represents a manifestations of rheumatism--this in spite of the fact that the etiology may be entirely different. Many of these conditions are no doubt of bacterial origin, especially the more acute forms, while in the chronic types disorders of metabolism, trophic disturbances, or autointoxications seems to play a prominent part.

There is every reason to believe that acute articular rheinatism is of microbic character, probably a streptococcic infection, and it would be well if the term "rheumatism" were restricted to this disease alone. Other forms of acute inflammations of the joints can be advantageously designated as arthritis, qualified according to the causative agent, whether it be the tubercle bacillus, the gonococcus, the bacillus typhosus, the influenza bacillus the spirocheta, etc. Such a classification is not only very desirable from a diagnostic but also from a therapeutic standpoint. To speak of a case as "gonorrheal rheumatism" is apt to divert attention from the cause and lead to undue attention being given to the affected joint and little, if any, to the focus of infection in the urethra, prostate, and seminal vesicles. Under this mistaken notion these patients are often deluged with antirheumatics, which, though they may relieve pain, exert but slight influence upon the pathological process.

Even greater errors are committed in calssifying chronic affections of the joints as rheumatic. Some physicians evidently are not yet sufficiently impressed with the fact that acute articular rheumatism is rarely, if ever, followed by chronic manifestations, and that the existence of chronic rheumatism per se is strongly doubted or even denied by many authorities. Such names as rheumatoid or gouty arthritis are equally misleading, to say the least; for though they may be consoling to the patient, they tend to foster slipshod therapeutics based upon their supposed origin. In fact, progress in the treatment of these cases is greatly hampered by cut-and-dried diagnoses of this kind. Thus, for instance, to treat patients suffering with osteo- arthri

tis or arthritis deformans as rheumatics is to ignore the fact that many of them require tonic and reconstructive medication and the use of remedies that will arrest auto-intoxication, intestinal or otherwise in addition to appropriate local measures (massage, electricity, hydrotherapy, dry hot-air, etc.). It is not too much to say that the persistent use of the salicylates in alrge doses in these cases may act unfavorably through their depressing effect.

Hence it will be seen that looked at from whatever point we may, there is abundant room for reform in our terminology of the conditions still so commonly grouped under the general name of "rheumatism."-International Journal of Surgery.

Venereal Disease.

White and Melville continue their discussion of the present and future of these diseases in the London Lancet for December, 1911. After placing the incidence of venereal disease in the great cities of the world at about one twenty-fifth of the total population of each and the occurrence in the smaller cities. and towns and in the rural districts at proportionately smaller figures, conclude that there are on conservative estimate at least a half a million in Great Britain alone who are infected annually. The question then of what is to be done to reduce these appalling numbers which seem to be on the increase becomes a very pertinent one. The authors are of the opinion that from whatever point of view, whether individual or national, moral or physical, of theory or of practice, all evidence is against the state regulation of vice. It has failed after a century of trial. Legislation cannot rid us of prostitution. They hold that the ideas of disease being retributive and of fear a deterrent are radical errors, though plausible and popular. They believe that the diseases must be attacked directly in addition to the use of other means of moral improvement. There must be adequate hospital provision for these cases just as much as for tuberculosis. The stigma associated with the treatment of these ailments must be removed and physicians and victims alike must be taught to strive for early and complete cure. Prophylaxis must be urged upon those who are capable of transmitting the disease. All these means, together with education and elevation of the general moral standards and the encouragement of temperance, would soon bring the Scourge within control.

New Move In War On Tuberculosis.

The New York Association for the Improvement of the Condition of the Poor has undertaken an experiment to demonstrate if it is possible to wipe out centers of tuberculosis infection in tenement districts of New York. An entire section of the Vanderbilt tenements, recently built as homes for families having members afflicted with tuberculosis, has been leased for a period of three years and has been converted into a home hospital. Into each of the twenty-four apartments a family, which has become dependent because of tuberculosis in one of its members, has been moved, and for the next three years an effort will be made to determine whether the spread of tuberculosis can be checked and cures effected under medical direction, aided by competent nursing, adequate relief, freedom from worry, fresh air and sunshine. Equal attention will be paid to the social and medical phases of the question and all patients will be forbidden to work before recovery. Where cures are effected, the families will be moved into suitable homes and the supervision continued until the cure has been demonstrated to be permanent. Dr. Linsly R. Williams is chairman of the committee in charge of this work and it is thought that the experiment will be one of national importance.

Moving Picture Shows.

No one, be he highly cultured or abjectly illiterate, is free from the influence of pictures. The great illustrated periodicals have an immense circulation, and the desire for pictorial representation makes of the Sunday paper an orgy of nonsense. The astonishing possibilities of the moving picture shows, patronized daily by eight million persons in this country alone, are scarcely realized sufficiently by men and women of light and leading, or they would have, ere this, exerted themselves more in their regulation. As the Woman's Home Companion says, "the moving picture, developed along proper lines, combining educational and amusement features, would raise the standard of living, promote municipal and domestic sanitation and stamp out disease." In addition, think of the lessons which eight million persons can be taught in civic duties, in economics, in art, in ethics, in humanitarianism, by easy stages and in most attractive forms. The minstrels of the middle ages taught dozens where the moving picture shows teach millions, and yet the former helped to change the map of Europe. Newspapers have at once taken a secondary position in the diffusion of intelligence.