WESTERN MEDICAL REVIEW A JOURNAL OF MEDICINE AND SURGERY Publshed Monthly by Western Medical Review Company, Omaha, Nebr. Per Annum, $2.00 The Western Medical Review is the journal of the Nebraska State Medical Association and is sent by order of the Association to each of its members. Entered as second-class matter at the Postoffice of Omaha, Nebraska, under the act of Congress of March 3, 1879. The deplorable effects upon the optic nerve of atoxyl and other arsenical compounds introduced about the same time led Ehrlich on first recommending salvarsan to the profession to warn against its use in cases which were complicated with eye symptoms. But so many cases of eye symptoms, including optic neuritis, were soon observed to be benefited by its use that the feeling rapidly gained ground that salvarsan had no especial affinity for the optic nerve, and that no bad effects on the eyesight were to be feared from its use. Then cases of optic neuritis, either immediately or some time after salvarsan injections, began to be reported, and this with the fact that in other cases damage to the acoustic and chorda-tympani nerves was apparently due to salvarsan, led some men, notably Finger of Vienna, to the conclusion that the drug was decidedly neurotropic and hence dangerous. Regarding the cases of optic neuritis, it should be said that a number of them have healed promptly on a repetition of the salvarsan treatment, thus indicating that the neuritis was in the nature of a Herxheimer reaction (from the sudden decomposition of dead spirochaetes) rather than a direct poisoning of the nerve. After observing a case in his own practice in which oculo-motor paralysis and optic neuritis appeared some months after two salvarsan injections, Goerlitz (Klin. Monatsblatter fur Augenheilk., Nov., 1911), reviews the literature of the subject and concludes that while there can be little doubt that inflammation of the optic nerves in syphilis occurs earlier and more frequently under salvarsan treatment than it did before the latter came into use, it responds readily either to continued salvarsan or the mercury and iodide, and hence is not specially dangerous. On the other hand, since salvarsan, on the whole, is little if at all more efficient in the ocular symptoms of syphilis than the older forms of treatment, and since it is conceivable that an existing optic neuritis might be made enough worse by the salarvan so make a serious difference in the sight, it would be safer not to use it in optic neuritis except possibly when the sight is rapidly getting worse in spite of the ordinary treatment. As to the real nature of these cases of salvarsan neuritis, i. e., whether any of them are really due to a direct toxic influence on the nerve, it can only be told after long observation of many cases treated with salvarsan alone, as compared with similar cases treated with mercury and iodide. Gifford (Omaha). Malpractice-Medico-Legal Defense. The National Fidelity and Casualty Company of Omaha. Elsewhere in the advertising pages of this issue of the Western Medical Review will be found a notice from the above mentioned Company, of their offered co-operation with the Medico-Legal Defense Committee of the Nebraska State Medical Association. Every physician, who has interested himself in this subject, has read the annual report of the Committee to the Association for the year 1910-1911 and he knows the splendid results accomplished. And we doubt not that regard for his own welfare prompts him to avail himself of this great service by the payment of the small sum ($1.00 per year) for the expenses of the committee. Most, if not all of the Indemnity Companies, which for the payment of about fifteen (15) dollars agree to defend physicians against one to three malpractice suits a year, cease their responsibility when judgment is rendered, letting the defendant doctor pay the piper, if he loses his suit. Their interest seldom extends beyond the furnishing of an attorney, who, very often is illy equipped for medico-legal work. Not so, with the National Fidelity and Casualty Company of Omaha. This absolutely reliable concern agrees not only to defend the suit, but will pay any judgment up to five thousand ($5,000) if the case goes against the Doctor. They further agree to defend any number of such suits during the life of the policy (one year) and pay the judgment in ever instance up to a total Fifteen Thousand Dollars. They hereby furnish a vital interest for themselves to use every honorable means to carry such suits to their successful issue; or what is still more important to both Doctor and Company, they will make every effort, compatible with dignity and dencency to have the case dismissed by the plaintiff before it comes to trial, or settled outside of the court room with satisfaction to themselves and their client, the Doctor. This company early acquired the knowledge of the importance of the help of medical men in these cases; they had read the report of the Medico-Legal Defense Committee to the Nebraska State Medical Association. A conference quickly brought these equally important forces for the defense of malpractice suits together and both readily agreed to join their powers for good. Namely: the Committee gladly agreed to give all the help they are capable of in all cases insured by this company, who are also members of the Medico-Legal Defense Fund. The expenses of the members will not be increased one cent by this membership in the National Fidelity and Casualty Company and the MedicoLegal Defense Fund of the Nebraska State Medical Association. A. S. VON MANSFELDE, (Ashland.) Senator Owen Amends His Bill. Objections to Senator Owen's bill for a national department of health (Senate Bill No. 1) have come largely from followers of various sects and cults who feared that their business of treating the sick might be interfered with. Many of the more sincere opponents of this much-needed law are evidently too ignorant to understand that congress can exercise only those powers which have been delegated to it by the states, that the regulation of the practice of medicine stands on the same basis as the regulation of other occupations and trades, which is not a function of congress, and that any federal law attempting to regulate the practice of medicine in the states would be void. Repeated explanations have been made that congress has no authority to regulate the practice of medicine or any other profession or calling in any state and that the object of the Owen bill was the prevention and not the treatment of disease. Apparently, these explanations have not been convincing-perhaps some people have never heard of them. To reassure those who are honestly opposing the Owen bill on account of such a misconception Senator Owen last week introduced the following amendment to his bill: "That the department of health established by this act shall have no power to regulate the practice of medicine or the practice of healing, or to interfere with the right of a citizen to employ the practitioner of his choice, within any state of the Union, and all appointments within the department shall be made without discrimination against any school of medicine or of healing.” It is to be hoped that this amendment will be retained as a part of the bill, although it is entirely unnecessary from a legal standpoint, since it declares that it is not the purpose of congress to do what it has no right to do. This fact is undoubted ly recognized by Senator Owen, so that the amendment must be intended to remove any possibility of honest objection to the bill. This amendment will doubtless quiet the fears of honest but misguided opponents of the measure, since, after the incorporation of this statement, the only persons who can oppose the measure will be those who have a selfish and mercenary objection to its passage.-J. A. M. A. Still After Dr. Wiley. We are still flooded with magazine articles, newspaper clippings and typewritten notices concerning the alleged incompetency of Dr. Wiley and his alleged dishonesty in connection with his rulings and testimony concerning the pure food and drugs question. One would have to be very blind in order not to recognize the animus which inspires these attacks, for without a single exception the articles emanate from those whose dishonesty has been proved, and who have been forced to be reasonably good as a result of prosecution under the pure food and drugs act. Those who howl the loudest are the patent medicine manufacturers, and it will be strange indeed if they do not, as a result of their enormous expenditures in advertising and promotion work, succeed in creating the popular impression that Dr. Wiley and all that he represents is all wrong. The patent medicine business is a menace to public health, but the enormous profits obtained by the promoters of this nefarious business are not going to be surrendered without a struggle, and the fight against Dr., Wiley is only one of the many ways in which an effort is to be made to keep the business going. Ex. According to the Prescriber, the following prescription has a marvelous effect in cutting short a "cold in the head": Sodium salicylate Compound tincture of cinchona. Aromatic spirit of ammonia. Camphorated tincture of opium. Tincture of ginger. 3i .3ii .3ii ..3ii ..3ii .ad-oz. vi Chloroform water... M. et Sig. One tablespoonful in water three or four times daily between meals.--Ex. |