-forming, that ever present specter of hypnotic administration is Dois Chemical Co., St. Louis Other Dios products of merit are Dioviburnia, Palpebrine and Germiletum. TUBERCULOSIS OF THE Lungs, Glands, Bones or Joints will be PROTONUCLEIN BETA Combining the nucleins of the spleen with Protonuclein Attention must be paid to the marked results obtained We have combined this action of the spleen with See that your prescription reads, I PROTONUCLEIN BETA CUBES, GR. V. No. 60 Send for Literature REED & CARNRICK 42-44-46 Germania Ave. Jersey City, N. J. THE MEDICARY SENTINEL PUBLISHED MONTHLY HENRY WALDO COE, M. D., Editor, Portland, Ore. With the Collaboration of the Officers of The State and District Medical Societies of Oregon. Washington, Idaho, Montana and Utah Entered at the Postoffice at Portland, Oregon as Second Class Mail Matter Address all communications regarding papers. subscriptions, advertising or business matters to the MEDICAL SENTINEL, 516 Selling Building, Portland, Oregon Volume 22 JANUARY, 1914 Number 1 AMATEUR LEGISLATION It has been said that legislation is a cheap panacea for evils, and our reformers as a result, with the impracticability of the average theorist often burden us with useless and foolish laws. This is especially true of Oregon's present law in regard to medical examinations of male applicants for marriage licenses. Not only in this law as it now stands ridiculous and ineffective but it is dangerous, adding to the very danger it seeks to avoid for it gives to patients with a latent gonorrhea or syphilis through the agency of a haphazard or superficial examination that pronounces them well, a false security. The physician is expected to examine such applicants for the presence of any infectious disease and he is to be paid for his service $2.50. Gonorrhea in its chronic stages is undoubtedly in its most dangerous phase for it is at this time that the patient is most apt to spread the infection and it is in this stage that the disease is most apt to be overlooked. In its active stage or where there is a frank discharge there is no trouble in making the diagnosis, and indeed the man would be a rara avis indeed who would want to marry with this condition or who would attempt to pass a medical examination with this obvious evidence present. Its chronic stage, however, especially in the absence of a discharge presents special difficulties and no examination is complete without a microscopical examination of the prostatic and seminal fluid stained by Gram's method, and where the case is still suspicious a gonorrheal complement fixation test, a test far more reliable than the Wasserman test in syphilis. Without these tests a negative diagnosis in suspicious or doubtful cases is absolutely worthless. In syphilis the same criticism holds true, and no examination is complete without a Wasserman. Not only must the physician examine for these diseases but for any other infectious disease that might be present. Granting that the average physician were competent or equipped to conduct these tests, who would do it for a beggarly two dollars and a half? How many doctors would place such a small valuation on their service and skill and would conduct such a thorough and important examination and one carrying with it such a responsibility for such a fee? Not only is the health welfare and happiness of husband and wife at stake but also their progeny. The physician who examines the applicant will give him but a cousury examination. He cannot afford to do otherwise. The applicant then pays $2.50 for a certificate that is not worth the paper it is written on. He may have a prostate reeking with Gonococci, his vesicles may be full of infectious secretion, his blood stream may harbor hordes of Spirochaetes but these conditions have necessarily been overlooked. A superficial examination reveals nothing and he is given the legal sanction to infect his wife. If the physician, suspecting an existant infection, refuses to give him a certificate all the applicant has to do is to go to another physician less skillful or less honest. Assuming that the man is honest and has hesitated about marrying through fear of an existing infection. The physician gives him a two dollar and a half examination and signs an affidavit stating that there is no evidence of disease. If such a case should marry and infect his wife, while our legal knowledge is slight, we believe both man and wife would have a good case for damages against that physician. En passant we might remark upon the gallantry and delicacy shown by the framers of this law in limiting the examinations to males only, but we refrain. We might remind them, however, that sentiment and eugenics are about as compatible as oil and water and the male is as much entitled to protection as the female. So it is evident that the physician is assuming a grave responsibility for the price of an ordinary call. Medical societies are going on record denouncing the cheap fees of the contract and lodge physician but we have heard nothing from them so far in regard to this cheap work. It is very evident that this amateurish effort at eugenics defeats its very purpose, is totally impractical, cheapens the profession and should either be repealed or radically changed. It is but another example or amateur legislation run riot, and another evidence of the tendency to put into immediate practice theories that have not yet been proven. Our country is overrun with eugenists and sex experts made over night all eager to put into practice and to try out on the public their theories and dreams while it is yet an open question as to their value or what potential harm may be wrapped in them. But that matters not. Legislation is easy, especially in Oregon. PUERPERAL ECALAMPSIA In these days when new methods and means of treatment are being continually brought forward it is rather unusual to observe any reversion toward older methods and especially regarding treatment that has been obsolete for years. Bloodletting has been relegated to the past for years but its use in puerperal eclampsia is being urged by an obstetrician of note— Dr. Paul Zweifel. A published abstract in Clinical Medicine of his original article which appears in the Monatschrift fuer Geburtshilfe, 1913, No. 37, outlines his treatment and results. Formerly the treatment was purely symptomatic, and consisted mainly in abstracting blood and applying cold to the head; while in, anemic women narcotics (opiates and chloroform) were resorted to. Later, Schroeder recommended the substitution of diaphroesis for the venesection, but continuing the narcotics. The Duerens introduced the method of operative interference by immediate emptying of the gravid womb at the first seizure, or at least upon the accoucheur's arrival. While this is the most generally accepted idea at present, Dr. Zweifel, on the ground of his experience extending over some twenty-five years, now takes a stand against the same, as well as doubting the hypothesis that the eclampsia results from toxins originating either in the fetus or the placenta. The author then adduces statistics, in disapproval of those presented by Liepmann and Freund, of the Clinic of Bumm and Franz, who advocate instant induced abortion. Thus, he finds, that during the period of 1892 to 1895 the mortality among 80 eclamptic women, after induced abortion, was 15 per cent; from 1895 to 1901 the mortality among 143 patients, under similar conditions, was 17.2 per cent; while for 400 women thus treated in the years 1901 to 1910 the death rate was 18.5 per cent. Then it became known that the blood of eclamptic pregnant women is relatively thick because of a diminished water-content, and this induced Dr. Zweifel, starting with the year 1911, to begin using bloodletting again, but in conjunction with Stroganoff's treatment; the amount of blood withdrawn mostly being about 500 Cc., or 15 to 16 fluidounces. It is pointed out, when employing this method, that instillation of medicaments into the mouth must be desisted from for fear of aspirationpneumonia; under certain circumstances, also, the stomachpump must be employed. Venesection may have to be repeated. As a result of his new procedure, only five deaths occurred |