Did you ever sit and watch 'em on a balmy afternoon
When the year has kept a rolling to the latter part of June?

Did you ever note the symptoms as by you they did trip

Of the annual epidemic of the black Morocco grip?

No, it isn't influenza that we get along in spring,
And it isn't so contagious and all that kind of thing,
But every June you'll notice it will take another trip,
This annual epidemic of the black Morocco grip.

When the schools of medic learning they have turned the youngsters

out,

When these young, ambitious doctors they have scattered all about,
You will see them go a rushing on some fake important trip,
And they all have got the symptom of the black Morocco grip.

With a hat that's tall and shiny, and a coat that's good and long,
And with patent leather kickers, they will play the bluff so strong,
And they think the very essence of their knowledge they'd let slip
If they didn't bear the symptom of the black Morocco grip.

In the days to come I reckon they will learn a little more,
And they will not need a grip-sack for to carry tools of gore,
And with stethoscope in pocket of the briefest sort of coat,
They will plug along the roadside and they will not care to tote
That emblem of the medic on every hurry trip,

The new and shining marker of the black Morocco grip.

G. T. P.

VOL. XVI.

AUGUST, 1903.

No. 8.

EDITORIAL.

The Cheapness of Doctors.

It would seem that no other service should be held in such high value as that which saves life and protects health. It is proverbial that money, knowledge or power is of little value when one is without health. It would seem that he whose duty it is to create health and protect it should be the most valuable member of society. However the world may appreciate the services of the medical man, she is slow in paying him for the good he does and she is inclined to beat him down to the last farthing and then to pay that most grudgingly. It is hardly fair to blame the world for this. The doctor himself is to be censured for accepting the pittance for valuable labor. The fees he accepts are beneath the dignity of his calling, and his motive for accepting such fees is less dignified still. He takes the bit doled. out to him because some other fellow will take it if he does not; he takes it that he may have it and the other fellow may not get it. To

day the doctor is a cheap man. But one thing about him remains on the high plane of the past, and that, fortunately, is the character of his work. It is not surprising, however, in this day of poorly paid doctors that those things connected with the doctor should become cheap. The cheap instrument maker, the cheap pharmacist, the cheap dressing maker are already appearing in the field and are patronized because the poor doctor is compelled to take their wares on account of his slim purse. The medical journal, the medium for the expression of the doctor's thoughts and the source of most of his information, is becoming cheap, and today we are confronted with a remarkable proposition of cheapness in medical journalism, which causes us to stop and ponder. We are advised of a proposed daily medical journal to come from New York to go to the medical men of the country for one dollar per annum; over three hundred numbers for one dollar. Nor is that all. A monthly medical journal will be thrown into the bargain, and on top of that an Index Medicus. Holy saints of Bedlam! What is the day before us when the weighty lore of medicine is to be sold in magazines at considerably less than onethird of a cent per number? We are opening upon a new era of the cheapness of medicine, and heaven knows we are holding ourselves too cheaply now! G. T. P.

The Blindness of Judge Lynch.

However the psychologist may explain the wave of crime which has spread over the country, resulting in the numerous lynchings and murders by supposedly normal citizens, we know not, but there are phases of the murderous epidemic which are well worth consideration. In some sections of the country and by a limited number of people in all parts of the country, lynching, as a punishment for atrocious crimes, is held to be not beyond reason, and some have drawn the comparison of the disposition of the mad dog to the hanging of the irrational brute who perpetrates these crimes. Let us allow, for the sake of argument, that the man who wantonly rapes a defenseless woman should hang for it at once, and let us admit (which is, of course, utterly false) that the people have a right to take the matter in their own hands and deprive the courts the meting out the punishment for the crime. It must at least be admitted that only sane men should take upon themselves the judgment and punishment of the criminal. We have a press report from Indiana, regarded as a civilized state, to the effect that a negro "had acted strangely, drawing

a razor and threatening to kill all of the people in the vicinity," and for this was driven out of town by a mob. At another place he acted strangely, making the same insane threats, and the mob put him to death. Here is a case of no crime committed. Here is a case where there was no real intention of crime; merely the irrational ravings of an insane man, and these people of Indiana put a man to death because he was diseased. His crime was that he was frail mentally and that his mind had left him. It would seem that the least the lynchers of the nation could do would be to determine whether a man had been guilty of crime. To kill on account of a disease is too outrageous even for American barbarians, of whom we have far more than is good for the nation.

DIAGNOSIS OF APOPLEXY.

P.

Dr. Hugh T. Patrick, whose interesting "Neurological Clinic" in the last number of this journal has attracted considerable attention, offered a most excellent paper on apoplexy at the meeting of the Sioux Valley Medical Society. We do not know that we have seen anything in this line which is clearer and more exact than Dr. Patrick's line of differentiation, and we believe that the following ought to be practically memorized by every practitioner:

"Cerebral apoplexy does not mean cerebral hemorrhage, but means one of three things: Hemorrhage, thrombosis or embolism. Embolism is so rare that a diagnosis is only justifiable when a source of the plug or embolus can be demonstrated.

"Thrombosis is much more common than hemorrhage, but this fact and the conditions producing thrombosis seem rather unfamiliar to the average physician.

"The prophylaxis of thrombosis is important and often successful.

"The treatment of thrombosis at the time of attack is radically different from the treatment of hemorrhage.

"The immediate cause of hemorrhage is nearly always the rupture of a miliary aneurism, which previously gave no symptoms, while thrombosis is caused by changes so gross and so extensive that previous symptoms are almost invariably present.

"Cerebral hemorrhage is generally fatal the first time, and repeated attacks of apoplexy mean thrombosis, not hemorrhage.

"The apoplexy which causes monoplegia or hemiplegia from the first, affecting one extremity or the face very much more than the rest of that half of the body, is thrombotic, not hemorrhagic.

"Syphilis very rarely causes cerebral hemorrhage, very frequently thrombosis.

"Apoplexy, after severe exertion, may be from thrombosis just as much as from hemorrhage.

"There is practically no prophylactic treatment for cerebral hemorrhage, but thrombosis may be warded off by strengthening the heart, increasing arterial tension and rapidity of circulation, dilating the arterioles and diminishing arteriosclerosis.

"In hemorrhage, elevate the head, apply cold, free catharsis, and occasionally phlebotomy may be tried. In thrombosis, lower head and give cardiac stimulants, hot fluids, nitroglycerine and light bandaging of the limbs to force large amounts of blood into the cerebral circulation."

Each case of malpractice fought to a finish and won without any compromise is of incalculable benefit to every physician in the community. This is doubly impressed upon us when we consider the frequency with which suits for malpractice occur. A prominent oculist in this city, rather than compromise for even a few hundred dollars, alowed a suit for $25,000 to go to trial. The physician had operated for capsular cataract, and the eye became infected from a gonorrheal discharge, from which the patient was suffering, and which was unknown to the oculist. It was proved conclusively that every care was taken in the operation, and, after all evidence was in, the judge instructed the jury to bring a verdict for the defendant, which they did without leaving the box. It is to be regretted that a physician, for friendship or a fee-probably a contingent one-will sell his expert testimony to aid in the downfall of a brother practitioner in any case, and more especially in one like this, when not one shred of evidence existed against the defendant. We trust the expert for the plaintiff, after his uncomfortable hour of cross examination, will not be so eager in the future to place himself in a similar position.

"If you had eaten a green apple and it did not agree with you and you wanted a doctor, what number would you call up?" asked the wag as he took a seat in a Chicago club.

"Give it up," answered the man who is always willing to bite to have the matter over with; "what number would you call up?" "Eight-one-two-Green, I should think," responded the wag, and his friend moved to the other end of the room.