PACIFIC MEDICAL JOURNAL WINSLOW ANDERSON, A. M., M. D., M. R. C. P. LOND., etc. W. F. SOUTHARD, A. M., M. D., Managing Editor. COLLABORATORS. C. F. BUCKLEY, B.A., M.D., L.R.C.P.Edin., etc. P. C. REMONDINO, M.D. GEO. C. MACDONALD, M.D., F.R C.S, Ed. W. E. TAYLOR, M D. W L. ADAMS, M.D. CARL C. HANSEN, M.D. GEORGE H. POWERS, A.M., M.D. C. A. RUGGLES, M.D. FRANK HOWARD PAYNE, M,D. A. W. MORTON, A.B., M.D. CHAS. E. JONES, A.B., M.D. F. F. KNORP, M.D. WM. J. JACKSON, Ph.G., M.D. F. W. HARRIS, M.D. WM. A. BRYANT, M.D., D.D.S, WALTER F. LEWIS, D.D.S. A. SCHLOSS, M.D. FRED. W. LUX, M.D. H. N. ROWELL, M.D. CLARK L. ABBOTT, M.D. SOPHIE B. KOBICKE, M. D. LOLITA B DAY, M.D. ROBERT E. O'CONNELL, D.D.S. CHAS W. MILLS, A B, M D., D.D.S. B. F. WILLIAMS M.D. WILLIAM BURFIEND, D.D.S. JOHN M. STOWELL, M.D. BERTHA WAGNER-STARK, M.D. J. H. SEYMOUR, M.D. CALVIN W. KNOWLES, D.D.S., M.D. CORYDON B. Roor, M.D., D.D.S. J. LORAN PEASE, D.D.S. J. C. HENNESSEY, D.D.S. A. F. MERRIMAN, JR., D.D.S. S. L. STRICKLAND, D.D.S. The Editors are not responsible for the views of contributors. All matters relating to the editorial and business departments should be addressed to the PACIFIC MEDICAL JOURNAL, 1025 Sutter St., San Francisco. The following editorial from the Medical News of May 30th, is so timely and so appropriate to existing conditions. that we quote it in full. One of the questions criticized, "What is Hanot's Cirrhosis," was asked by the California State Board of Medical Examiners. A few other questions, such as "What is Cryoscopy," and define "Pollakiuria," asked by the same Board, could have been fittingly quoted: "This is the season of the year when the medical licensing boards of the various States are preparing the questions for the June examinations. As it is at the examinations at this season of the year that by far the greater majority of the medical graduates apply for licenses, it seems a fitting occasion to say another word with regard to the character of the questions that have been asked in the past with the hope of bringing about an improvement in this important matter. There is no doubt that in spite of the numerous protests that have been made by some of the most prominent medical teachers, and even the faculties of medical colleges, there are still entirely too many unsuitable questions, often mere 'catch" questions included among the examining boards' lists each year. 64 "The President of the National Confederation of State Medical Examining and Licensing Boards, in the course of his official address at the thirteenth annual meeting of this assoc ation, held at New Orleans May 4, 1902, gave a list of some questions which he considered had been answered very ludi. crously by medical students in recent years in his own experience. We hope that those who listened and laughed at the presumedly ridiculous answers to these questions were not entirely in sympathy with the character of the interro gatories as stated. Practically all of the questions over which the worthy president was so hilarious were of the kind which to our thinking should not be found at all among the list of questions to be asked either of the graduate medical student or the physician of many years' standing with an idea of determining his practical fitness for the exercise of the profession medicine. "In the MEDICAL NEWS for May 9, 1903, p. 897, will be found some of the questions that were answered ridiculously. One of them is, "What is Morbus Cærule us?" Since the New Orleans meeting we have asked three medical editors, all of them actively engaged in the reading and criticism of medical articles for publication, and all of them have hesitated as to the answer they would make to this question. Now, medical editors may not know the practice of mecicine. There are those who ungenerously insist that it is better for a medical editor not to know too much about the practice of medicine, since this is almost sure to spoil his faith in medical theory and hurt his power to write confident editorial opinions with regard to practical application of remedial measures. Medical editors do, however, know the meaning of words. They must necessarily, if the columns of their journals are not to be disfigured by verbal errors. Morbus Cæruleus, as the name for congenital cyanosis, due to congenital malformation of the heart, is not a commonly employed term, and besides it is not a commendable designation. The affection is not a disease entity to which the name morbus would properly apply. Morbus has etymologically the sense of an acquired pathological condition, and does not well represent a permanent state due to an enduring anatomical anomaly. When the familiar "blue baby" becomes metamorphosed into the subject suffering from morbus cæruleus, it is a little difficult of recognition, even by those who might be quite familiar with the condition by actual experience. Unless one has heard the term employed in just that sense, one is at sea as to what is intended by it. Other questions suggested by the President of the National Confederation of State Medical Examining and Licensing Boards, as ludicrously answered, are, to our mind, quite as unjustifiable examples of this tendency, unconscious though it may be, to ask catch questions. For instance, Cheyne-Stokes breathing is really of too little clinical importance to make a question with regard to it count for one-tenth in the examination of a medical student's knowledge of practical medicine. Unless he is a physician engaged in very active hospital practice in large cities, the practitioner may not see a case of Cheyne-Stokes breathing in many years. What is more, when he does see it, his recognition of the symptom complex will usually not be of any material help to him in the treatment of his patient, since sufferers are commonly doomed to speedy dissolution. The question, What is podagra? seems scarcely a suitable one to ask of would-be-practitioners in America. We have learned quite recently that gout is more frequent in this country than we were accustomed to think, but this knowledge has only come to the teachers of medicine within the last year or two. While the word podagra is familiar enough in England, it is very seldom used in this country. Besides, it is not a complete descriptive term for gout, since gout affects other parts of the body, notably the fingers and ears, quite as frequently as the feet. Why not have asked the question simply, What is gout? We sympathize sincerely with the medical student who mistook podagra for the equally unfamiliar pellagra, and answered that it was poisoning due to the ingestion of rye bread that bad been affected by dis ase. While we have picked out the flagrant examples cited at New Orleans, because the failure to answer them on the part of the mecical student was a subject for merriment on the part of examiners assembled, and was supposed to indicate a lack of proper training at medical schools, we would not wish to be considered as thinking that any one man is more responsible than many others for the frequent peculiar questions that find their way into the examination papers of State licensing boards all over the country. In the last few years such questions have been asked as, What is Laennec's cirrhosis of the liver? What is Hanot's cirrhosis of the liver? and, in spite of the priority of the English observer in the matter, describe Basedow's disease, instead of the better Graves' disease, if a man's name has to be used or the descriptive title exophthalmic goiter. We realize, of course, that it is not easy to pick out suitable questions and yet avoid repeating questions that have been asked in recent years, and have for that reason been specially "boned up" by those who are studying only to pass, and with regard to whom Huxley once said, "They study to pass and not to know, and outraged nature takes her revenge-they do pass and do not know." Medical examiners are well paid for their services, and so should be expected to accomplish this difficult task with satisfaction. "We have spoken only of the questions asked in the practice of medicine, because surely in this department at least there is no need to look for farfetched questions. If there are abuses here, how much more likely are they to occur in the theoretic sections. There is need for the most zealous care on the part of examining boards to prevent abuses creeping in in these matters that distinctly lessen the prestige of the medical licensing system. Legislators are only 100 glad to have an excuse to refuse the extension of protection to the medical profession, and complaints of this kind made by medical teachers are apt to have an effect beyond the sphere of the matter actually involved." Two Large Journals are Amalgamated. The New York Medical Journal and the Philadelphia Medical Journal became consolidated, with Frank P. Foster, M. D., as editor, and Kenneth W. Millican, M. R. C. S., associate editor. The two journals are now one, and will be published by A. R. Elliott, the enterprising publisher. Both have enjoyed for many years a very large share of patronage. They have ranked among the first in the land. Now that they are united they will undoubtedly become stronger than ever, as in union there is strength. We wish the enterprise every success. BRITISH LOSING IN PHYSIQUE. Condition Steadily Deteriorating in Spite of the Advance of Sanitary and Medical Science. In the May Nineteenth Century Mr. George F. Shee makes out an unpleasantly strong case against the physical condition of the British people, which, he maintains, is steadily deteriorating, in spite of the advance of sanitary and medical science and the "superficially" reassuring reduction of the death rate. He bases his argument mainly upon the army's recruiting and medical reports and annual general returns. Here are a few samples of the figures he gives: Proportion of men in the army under five feet five inches: Recruits passed for service under 120 pounds in weight: 1871. 1872. 159.4 per 1,000 1898 174 4 per 1,000 1900 .269 per 1,000 301 per 1,000 A highly unsatisfactory comparison is drawn between the health of the British army and that of Germany, the figures given being those for 1900, and no account being taken of the South African war. The figures are per 1,000: Meanwhile the percentage of rejections for unfitness in the German army and of admissions to hospital is falling every year, and the average size of the Frenchman is actually improving. Outside the army Mr. Shee calls attention to the drop in the birth rate from 36.3 per 1,000 in 1876 to 29.4 in 1898; the increase in deaths of children under 12 months from 149 per 1,000 in 1871-80 to 163 in 1898; and great increases in infants' deaths from congenital defects, in female children born, and in deaths from premature childbirth. His conclusion is that England requires universal military or naval training to arrest this physical deterioration.—Ex. The American Urological Association. American Urological Association meets first Wednesday of each month, except July, August and September. Annual meetings: The last day of the American Medical Association's meeting and the day following. This year's meeting was at New Orleans, May 8th and 9th. President, Ramon Guiteras, M. D. Secretary, Fred. C. Valentine, M. D., 31 West 61st street, New York. Typhoid Antitoxin. Lord Lister has communicated to the Royal Society a paper by Dr. Allan Macfadyen, Director of the Jenner Institute of Preventive Medicine, setting forth an efficient prophylactic and curative treatment for typhoid fever. Dr. Macfadyen found that by crushing the microscopic cells of the typhoid bacillus in liquid air, the intercellular juices can be obtained apart from their living organism, and that these juices are highly toxic. By injecting them in small, repeated doses into a living animal its blood serum is rendered powerfully anti-toxic and bactericidal; that is to say, it becomes an antidote alike to living typhoid bacteria, and to the poison that may be extracted therefrom. Dr. Macfadyen explains the application of the serum to animals, and details his various experiments, which showed that the serum is a curative of typhoid as well as a protective against infection. It may be contended that what is true in the case of one pathogenic bacterium is also true in the others, but Dr. Macfadyen is not satisfied to accept this hypothesis without experimental verifications, and the Jenner Institute is now investigating the juices of other bacteria. A Liberal Offer and a Good Anatomico Physiological Chart. The PACIFIC MEDICAL JOURNAL will be sent free of charge to all purchasers of Eales & Taber's Anatomical and Physiological Encyclopedic Chart of the Human Body. See advertisement on page 38. Stab Wound of the Heart Successfully Sutured. Surgeon Furnivall, of the London Hospital, successfully sutured a stab in the left ventricle. The patient recovered. |