66

Why Treat Syphilis Before Secondary Symptoms?" By DR. A. P. WOODWARD, San Francisco. [Read by title.] "Decapsulation of Kidney for Bright's Disease," by DR. GEO. GOODFELLOW, San Francisco. [Read by title.]

Surgery in Its Relation to the Restriction of Crime," by DR. C. N. ELLINWOOD, of San Francisco.

An argument for the therapeutic use of vasectomy in certain mental diseases, and as a means of diminishing crime and the number of criminals. Advantages are betterment of the individual, protection to his fellows, protection to society from vicious hereditary tendencies. Some are erotic, sexual perverts, leading to mania to kill and destroy.

Case.-Boy at puberty showed maniacal tendencies under sexual excitement; sent to reformatory; no change in several years; submitted to vasectomy; reports great improvement mentally, maniacal tendency gone; learns at school; patient is grateful. Practical results are yet to be shown by many cases, but enough has been shown to commend it to trial. Discussion by DRS. ROSENSTIRN, HOISHOLT, DOIG, LUCAS, PAULDING and WITHERBY.

Hygiene, Sanitation and Climatology.

A Comparative Study of the Climates of Southern California and Other Health Resorts, with Special Reference to Personal Observations Regarding the Climate of Santa Barbara," by C. M. RICHTER, M. D., of San Francisco.

This discussion was illustrated by charts showing the results of a comparative study of the climates of Santa Barbara, Pine Crest, Los Angeles and San Diego, relative to clear days, temperature, humidity, wind, etc., in which comparison Santa Barbara appeared to good advantage. In respect to fog, Los Angeles had 57 foggy days, San Diego 14, and Santa Barbara 5 foggy days in the year. Besides there is a difference in fogs relative to cause; free evaporation cools the air and fog comes from the sea, this is clean and nonirritating. The land fog is impure and more irritating. Santa Barbara leads with 250 clear days, yet is, in summer, nearly as cool as San Francisco.

Discussion opened by ALEXANDER G. MCADIE, Forecast Official U. S. Weather Bureau, San Francisco, who said: It is my duty to uphold the reputation of California against Dr. Richter. It would be good for patient, better for

physician, and better still for climatologist if there were more Dr. Richters. The verses of the poet accomplished more in advertisement of the Alps than the carefully founded and scientific opinion of the engineer. Climatology is determined by sea and mountains and the interaction of these on each other, and general air movements due to state of pressure. The movements of air here are not rapid; Santa Barbara may be described as like San Francisco with all the objectionable features removed, the influx of sea air is not so great. We owe Dr. Richter a great debt for his five year records at Pine Crest.

DR. FLINT: I should cordially advise bronchial cases to secure residence near the foothills. I have had opportunity to observe in Europe, but I must admit I would give this preference.

DR. CHARLES ANDERSON: The humidity is greater at the coast than on the hills, but at the latter the winds are severe from 7 P. M. to 4 A. M., not continuous but intermittent; they are stimulating, but dispose to nervousness in women; in the daytime they abate. The day temperature is higher by 7° to 8° at an altitude of 350 feet, while the night temperature, owing to the winds, is about the same as the coast.

DR. LINDLEY: I know this peculiar thing about the relative humidity at Idylwild, and that is that during the night it falls, and is less than during the day, due to influx of desert air.

MR. MCADIE: That question of the fall of night humidity is one that interests the climatologist, and we will in a year or so know whether or not it is a true condition.

"The Relation of the Physician to Preventive Medicine, a Study of the Health of University Girls," by DR. MARY B. RITTER, of Berkeley.

My observations for thirteen years, cause me to believe that the average boy and girl improve in health during the college course. Of course exceptions exist, but it is not uncommon to gain twelve to fifteen pounds the first year in college. Yet where so much smoke is, some flame exists. I find causes of later collapse exist at entrance and date back to previous illness. Previously the medical profession alone have been trained in hygiene and sanitation; has the family doctor done his duty in warning against

sequelæ, faulty posture, food, etc.? I wish to enter a plea for more careful instruction about pertussis and rheumatism, which is often called "growing pains" but results in endocarditis. It is fair to assume that the girls of California are of average physique. The examination on entrance includes physical examination, history, etc. Of 660 Freshmen, 176 were subject to headache, 86 to indigestion, 3 to tuberculosis, 7 goiter, 57 anemia, 105 abnormal hearts, 193 back-ache, 443 menstrual disorders, 10 broken down, 149 free from all ailments. The seed for most of the ills are sown in childhood, and mostly preventable by wisdom. of mother. My experience teaches that the mother is as unwise as the daughter. I feel that the future will show an improvement. Statistics show infant mortality with college mothers decreased. Gymnasium work secures careful supervision, and a gain is made despite strain of college life. Most all ailments are traceable to diseases of childhood or to anemia. Dr. Adelaide Brown, some years. ago, showed that the errors of grammar school led to anemia; of 1,300 children none went to bed before 10 o'clock. With regular sleep, rest, exercise, and proper food there is little danger from mental application. In watching school children it is impressed on me that their disorders are also due to faulty position; looking at this pelvis, you see that in standing normally a plumb line from the sternum falls anterior to the pubes, hence the weight of the abdominal viscera is not upon the pelvic organs. The ordinary faulty posture is with relaxed knees, pelvis tilted back, lessened lumbar curve, increased dorsal curve, so that plumb line from sternum falls behind pelvis instead of two to four inches anterior to pubes. This seems to me one of the chief causes of menstrual disorders, especially when we add the weight of skirts, etc. When erect the weight falls in front of uterus, but when the pelvis is tilted back the weight falls on the fundus; this posture is so common that there must be a deep seated cause; the mothers must wage the battle with the children. Shoulder straps is putting the cart before the horse. The military position with knees locked is fatiguing, but with the head erect the shoulders must become erect. My opinion of the cause is that there is an inherent hereditary tendency due to effort of assuming the erect position during the develop

ment of man; the apes stand so stooped that the hand touches the ground, and must be used as an aid in standing. Only in man are the posterior muscles of limbs so developed. In evolution the medical man is one specialization and preventive medicine is another; they are more or less antagonistic, but the role of the physician who strives to prevent is no less noble than the more spectacular work of the surgeon. The twentieth century practice predicts that young people on marriage will select a physician to keep them well, which is ideal. The college education does not cause disease, the seeds of subsequent break down are sowed at home and preparatory school by causes which are avoidable. More careful supervision of the child by physicians, more careful teaching of sanitary laws and hygiene, and the prevention of disease would avoid many subsequent complications and break downs.

DR. KRONE: I have always held that mental application need not in itself injure health, for we are made to think. I assure you if the demonstrations made here to-day were made in every high school once in six months it would be of great benefit.

DR. REINHARDT: My work is among the men, and while knowing much was being done on the other side I did not know how much. I had observed the improvement of young women during their first year in college, and think it is largely due to Dr. Ritter's lectures every week upon hygiene, and I have thought it accounted for our superior results when compared with institutions where such provision is not made.

DRS. ALLEN and FALLANSBEE spoke and DR. PRIOR moved that the paper of DR. RITTER be published in the Western Journal of Education so that it will reach all Superintendents of Public Instruction.

"The Proposed National Bureau of Medicine and Foods," by DR. PHILIP MILLS JONES, San Francisco.

Resumé-Review of increase in proprietary medicinesU. S. P. means but little; some houses put out three grades of U. S. P. Conditions with chemicals is worse than medicines, e. g., some boric acid contains three times its weight of borax. Distinction between proprietary and patent medicines, the latter are known because the formula is

registered at the Patent Office, while proprietary remedies may be varied at pleasure of manufacturer.

Plan of proposed Bureau: Manufacturers will register formula and it will be published-it is proposed to form a membership corporation without thought of profit. The Board of Directors will be one-half elected by the American Medical Association and the other half by Pharmacy Association, one of each changing office annually. The idea is to bring into association manufacturers whose objects are honest. Funds can be secured by a light assessment on valuation of concerns represented. The legal status is assured by legal counsel.

The problem of antitoxin has been a subject of difficulty to the Pharmacy Association for years, for the moment the package is opened the product is destroyed-this would be certified by the seal of the proposed association.

Discussion by DR. GARDNER.

"The Physiology of the Cell in Its Relation to Therapy," by DR. CARL R. KRONE, Oakland: All cells require food, and in addition some special pabulum to enable activity, e. g., the red cell requires oxygen, a frog's muscle thrown into Ca Cl, solution goes into tetanic contraction. The second function of the red cell is to part with oxygen easily under a minus pressure, hemoglobin does not concern itself with any other product of anabolism. Solutions of manganese and iron have influence on this action; but other substances have affinity for hemoglobic also which explains influence of poisons. In the regulation of the specific functions of cells we may have explanation of specific remedies. Impaired activity of one cell must involve all others of same group. Only highly differentiated cells have special function, e. g., adrenalin has selective action on unstriped muscle of arterioles.

The clinical observation of a case of hemorrhage in the intestine showed it caused fall of temperature and failure of pulse and respiration-used adrenaline solution in

ii 3vss in five days; results were improvement in pulse, temperature and respiration; this proves that adrenalin is indicated in hemorrhage and shock, give gr. 1-300 at once, or 1 to 167,000 parts of blood, 0.006 of 1 per cent solution. Normal adrenal secretion is used up by cellular activity, it is necessary to life, found in blood of adrenal vein; whether