To contributors of Original Articles, a liberal number of copies of the Herald will be given (or mailed free of expense if addresses are furnished), and the publishers will furnish reprints at cost, application for same to be made when copy is forwarded. Original Articles, Clinical Reports, Society Proceedings, Correspondence and News invited. Illustrations will be furnished free for all articles requiring same, if drawings are furnished. Address all articles for publication, books for review and exchanges to the Editor. Address all correspondence relating to subscriptions and advertising to Medical Herald Co., Sixth and Charles Streets. FOR SALE.-A physician desiring a location, can secure one by purchasing office furniture. For particulars address, with a stamp, Lock Box 8, Highland, Kas. INSTRUMENTS AT COST.-Physicians desiring a battery or a good nebulizer at a bargain can learn price by addressing "Bargain" care Medical Herald Co. LOCATION.-Anyone desiring a good location in which to practice the the specialties, eye, ear, nose and throat, address DR. HUGH T. MILLER, Clinton, Mo. NEW ORLEANS POLYCLINIC. Seventeenth annual session opens November 2d, 1903, and closes May 28, 1904. Physicians will find the Polyclinic an excellent means for posting themselves upon modern progress in all branches of medicine and surgery. The specialties are fully taught, including laboratory work. For further information, address, New Orleans Polyclinic, Postoffice box 797, New Orleans, La. SANDER & SONS EUCALPTOL (pure volatile Eucalypti Extract) In an article on inhalations of Eucalpytus in Diphtheria, by Prof. D. Mosler, Director of the Medical Clinic of the University at Griefswald (Berlin, Klin. Wochenschrift) it is stated: "The ol.eucalpyti e folies I employed in my tests I received through Holzle & Chelius, Frankfurt, it must not be mistaken for the more frequently offered ol. eucaly-pti australe, which is obtained from the eucalyptus tree. This latter is used for mechanical purposes only, and has a far cheaper price; it is however, no longer employed as an internal medicament." In a direct communication Dr. Mosler says: "At your special request I gladly certify that the ol. eucalypti e folies with which I experimented in 1878 and 1879 was taken from the stock maintained by the firm of SANDER & Sons, Bendyo, Australia, with Holzle & Chelius of Frankfort. It has ever since rendered me the most excellent services." Samples and literature of Sander's Eucalyptol gratis through Meyer Bros. Drug Co., St. Louis, Mo., sole agents. Pharmaceutical preparations that have been advertised for years in the medical press certainly have merit, or physicians would not continue to prescribe them. Substitutes are usually unknown quantities, and should be avoided. There are thousands of conscientious, upright, honorable pharmacists who would no more think of substituting than they would of trying to pass a counterfeit bill. Some of these are located in your city. Patronize them exclusively. ST. JOSEPH, MO., DECEMBER, 1903. Contributed Articles T THE MECHANICAL PROBLEMS OF INTUBATION. B. F. Gillmor, M. D, Creston, Ia. HIS paper will embrace only such questions as refer to the mechanical problems of intubation. Other questions referring to the subject we must pass over, for the time. Pathology, diagnosis and therapeutics are inseparable portions of every surgical subject, when considered in its entirety, and knowledge of these is wholly vital to the fullest success in any surgical undertaking and to the dignity and majesty of the surgeon's calling. But, on the other hand, we must not scorn the purely mechanical and manual end of our calling; for the surgeon must be not only a scientist, an observer and a logician, but a mechanic, for art is the point of application of his science and the vindication of his ideas rests with his manual dexterity. After years of patient education of his reflexes, and by the most complex of mechanical feats, the musician voices the profundity of his soul: But neither the musician nor the surgeon may adopt the theological method and, like a medieval monk, double up, gaze fixedly at his own navel and await the coming of the divine afflatus. The practical is but the ideal in action; and the true surgeon brings to bear upon his practical acts the best thought and purest ambitions of his mind; for to him, his daily tasks are but the achievement of his fairest hopes and he loves his knives, not as bits of plated steel, but as instruments for the attainment of lofty ends. And while he cultivates with industry the science of his mission, yet he is not above studying the eccentricities of his tools. He knows the temper of each blade and chisel, knows the stiff joint here and the loose one there, the fit of each handle in his palm, and familiarizes himself in pantomime with his instruments with the same laudable assiduity that the soldier fights the mimic battle in preparation for war, for he knows that such familiarity is essential to the success of his great undertakings. He studies with painstaking care the smallest detail of his work and while mastering the scientific aspects of his vocation applies himself to the acquisition of the manual dexterity essential to the performance of good work. Nowhere is mechanical dexterity of more importance than in the performance of intubation; for the anatomical parts involved are sensitive, are hidden from view, the landmarks are small and are often disguised to the touch by processes of the disease for which the operation is undertaken, the larynx is movable and active, the patient is usually conscious and the operation must involve but a few seconds of time. Anyone, with a small knowledge of the local anatomy, and with sufficient ignorance of his responsibilities, may drive a tube home-perhaps successfully, one or more times-but this is not intubation! Except for the momentary sense of suffocation, the operation is in no wise brutal when done with the proper celerity, gentleness and precision; and it is only by practice upon the manikin or cadaver, and by familiarity with the instruments that this celerity, gentleness and precision may be acquired. Of course, one may perform the operation without this acquaintance with larynx and instrument, but such lack would be inexcusable amid such abundance of opportunity for practice, and less credit would reflect upon the operator than upon the industry of the teachers who had beaten through his lazy calvarium the small anatomical knowledge that enabled him to do at all a very poor job. It is not poor work that has placed intubation in eminence as a lifesaving operation; it is fidelity to detail-even to the last mechanical detail. Such men as O'Dwyer and Waxham were not above practicing upon manikin and cadaver and the large percentages of recoveries in the experience of these two skillful operators speak volumes for the efficacy of taking pains: while the low percentages in other lists reflect less upon the operation of intubation than upon the poor work of the men responsible for the figures encumbering statistics. It is so in many another department of medical science; men sit with folded hands, try, fail, and return again to contemplation of the navel. A practice manikin may be purchased for a small sum from any dealer in nose and throat instruments, or, better still, one may be constructed by one's self from materials at hand about the office. A board, a few nails, some bandage material, some rubber strips and a fair degree of mechanical skill will suffice for the construction of a manikin suitable for practice with the instruments. My associate, Dr. Sampson, constructed a very serviceable manikin from a discarded rubber shoe, which, when coated with soap-suds, presented to the finger the most life-like feel of any artificial imitation of the human larynx that I have ever practiced with. Since the larynx is found by the finger at quite different levels and depths in different individuals and at different ages, it will be well to construct manikins of different sizes and demanding different and various reach for the fictitious epiglottis and rima for the fullest education by these means of the guiding finger and instrument hand. After acquiring all skill possible by these means, it will be well for the beginner to practice upon the cadaver before attempting intubation of the living subject; but, while practice upon the cadaver is most serviceable and while no other condition than death affords opportunity for leisurely exploration of these parts by the finger, yet practice upon the dead person is by no means vitally essential to the education of an intubationist. The manikin affords abundant opportunity for practice in manipulation of the instruments; while neither manikin nor cadaver in any manner duplicates the behavior of the live larynx undergoing the operation. the cadaver presents only the principal advantage over the manikin in per |