matter is this training of medical missionaries. We are inclined to believe that the average person devoting himself to this work is poorly equipped, and only succeeds in the foreign clime because of the ignorance and superstition of his competitors. Then, too, there is the almost universal belief that the average medical missionary is a low type of politician who delights in fomenting troubles requiring all the skill of diplomacy to settle. But the real facts do not justify this conclusion. The demand for a better class of men and women to devote themselves to service in foreign countries has brought forth a movement to be more careful in the selection of applicants.

THE public health planks in the platforms of the two leading political parties ought to be placed in juxtaposition, so that every physician and every layman who is interested can make an odious comparison. THE LANCET-CLINIC is non-partisan, but it cannot refrain from expressing the regret that the Republicans have failed to take advantage of an opportunity to go on record for a most important reform. Here is what the politicians of that party want the intelligent voters to applaud and swallow: "We commend the efforts designed to secure greater efficiency in public health, and favor such legislation as will effect this purpose." As originally drafted this plank might have been indorsed as promising something respectable. But it is now meaningless and vapid. Here is the Democratic health plank: "We advocate the organization of all existing national public health agencies into a National Bureau of Public Health, with such power over sanitary conditions connected with factories, mines, tenements, child labor and other such subjects as are properly within the jurisdiction of the Federal Government and do not interfere with the power of the States controlling public health agencies." Further comment is unnecessary at this time. But the unprejudiced reader will do some effective thinking.

According to the report of the sanitary division of the health department, the death-rate from tuberculosis is decreasing in St. Louis. The decrease in tuberculosis is attributed to the hard fight which the health department and the Anti-Tuberculosis Society of St. Louis has made during the last six months against the spread of the disease. It is believed by members of the health board and officers of the society that this work is bearing fruit and that eventually with the proper co-operation the spread of the malady can be effectively curtailed.

RUNDSCHAU.

Dallas, Tex., has fitted up an emergency hospital in the basement of the city hall. It is open at all hours.

Dr. T. L. Baxter, who has been assistant physician at the Athens State Hospital for the past six years, has resigned.

The three medical schools of Louisville have definitely decided to merge and become the Medical Department of the University of Louisville.

Dr. L. H. Mann was elected mayor of Linden Heights, a suburb of Columbus, O., Thursday, and the ticket he represented as its official head was swept in with him.

The Labbe medical bill, which aroused such acrimonious debate during its discussion in the Louisiana legislature, has been passed by both houses after the adoption of certain amend

ments.

There will be a meeting of all the mayors of Texas municipalities at Mineral Wells, July 28. Dr. C. H. Irion, of New Orleans, President of the Louisiana State Board of Health, will address them on matters of hygiene.

During the ten months of the school year ended June 26, 1908, the Chicago Medical Inspectors of Schools examined 406,919 pupils and excluded 12,240, or 3 per cent., on account of contagious, infectious or parasitic diseases.

Dr. Robert Wilson, of Charleston, has been clected dean of the Medical College of the State of South Carolina, the vacancy having been caused by the resignation lately announced of Dr. Allard Memminger. Dr. Lane Mullally was at the same time elected to the office of vice dean and registrar-a new office.

The Arkansas State Medical Board and Eclectic Medical Board held their quarterly meeting at Little Rock last week, the first named using the hall of the House of Representatives and the latter the Senate chamber. The State Medical Board has fifty-three applicants at this meeting and the Eclectic thirteen.

Dr. E. C. Levy, of Richmond, Va., the chief health officer of that city, said recently in a report: “The public does not seem to appreciate the importance of getting rid of the enemy, but a better understanding of conditions should easily establish the fact that there would be less disease with fewer flies. When we are rid of the nuisance the effect on infant mortality will be astounding."

Great English scientists have lived and labored and died, contributing the results of all their efforts to benefit mankind without any other recognition than a begrudging acceptance by an ungrateful public. Now it is proposed to build a medical college at Lucknow as a memorial to the visit of the Prince of Wales in 1905, at a cost of $1,250,000. Perhaps Quebec will do likewise as a memorial to the 1908 visit of the same "important" personage.

Physicians of Warsaw and other northern Indiana cities have decided to test the constitutionality of the prescription liquor law passed by the last State legislature. They say that the law is illegal for the reason that it specifically

provides that the prescription for intoxicants must be written and must be marked cancelled as soon as filled. The doctors hold the legislature overstepped its power in making it compulsory for the patient to leave his prescription with the pharmacist.

SOCIETY NOTES.

The Chattahoochee Valley Medical Association held its fourth semi-annual meeting at Auburn, Ala., July 14 and 15.

With many physicians present from Illinois, Michigan, Ohio and Indiana, the Northern TriState Medical Association held its thirty-fifth annual meeting at South Bend, Ind., July 14 and 15.

The Washington County, Ark., Medical Association met in quarterly session at Fayetteville, July 10. The thirteen members present reported they had not lost a patient since the last meeting.

Knox County, Ind., Medical Society is making arrangements for inaugurating a training school for nurses at the Good Samaritan Hospital, Vincennes. The purpose is to begin the course of instruction next September.

The Clermont County, O., Medical Society met at Batavia, July 15, in regular session. A number of very interesting case reports were presented. Dr. Edwin Ricketts read a paper on "Clinical Diagnosis of Biliary Infection."

The MacLannan County, Tex., Medical Society, in conformity with the recent request of State Health Officer Brumby, will ask the city council to pass an ordinance eliminating the necessity for preparing two sets of birth and death certificates. It contends that a more uniform system can be had when one certificate is used by both the city and county authorities.

Because they fear that it might be too embarrassing for applicants for marriage licenses, members of the First District Georgia Medical Society, at their meeting last week, refused to give sanction to the bill pending in the legislature providing for the examination of all who contemplated marriage. The gallant stand taken by the doctors was not in accord with the opinion of some of the members of the organization and the discussion of the question was heated.

The July meeting of the Muskingum County, O., Medical Society was held at Zanesville. The most important action of the society was the adoption of this resolution:

Resolved, That the Secretary be instructed to furnish each of the newspapers with a list of the membership of the society with the request not to print a member's name with an account of a surgical operation or a case of sickness except by special request of such physician or in a paid advertisement."

The resolution is expected to do away with the notoriety which has attached itself to doctors through the mention of their names in cases reported to the local papers.

LOCAL ITEMS.

Dr. C. E. Iliff was severely injured in a street car accident last week, sustaining a contusion of the right scapula.

The engagement is announced of Dr. Clarence Ihle, the well-known dermatologist, to Miss Dollas Downard, a charming Kentucky belle.

Dull, duller, dullest! The bureau of infectious diseases reports but twenty-four cases during the past week, compared to sixty-nine for the corresponding week of last year.

The regular quarterly meeting of the AntiTuberculosis League will be held at the Union Bethel, July 30. Dr. Oscar W. Stark will speak on the work of the Tuberculosis Dispensary.

Dr. Charles A. L. Reed has had conferred upon him the Order of Chevalier in the Legion of Honor of France. There are about two hundred Americans who have the right to wear the valued little strip of red ribbon of the order. Dr. Reed studied in the hospitals of Paris, is accounted an able student of French and is President of the Cincinnati Alliance Francaise. May this example of France inspire the medical profession of Ohio to emulation in conferring honor where honor is due.

Dr. Wm. E. Shaw sold his beautiful residence at 2974 Colerain Avenue to Dr. Arthur Vos. Dr. Shaw will leave on a vacation tour August 15, when Dr. Vos will move into his new home. Dr. Shaw is an alumnus of the Medical College of Ohio, class of '73, and has been at his present location over a third of a century. His many professional friends regret his retiring from active practice, thereby severing many pleasant ties. May his future career be as happy as he desires it-it will always be useful.

Eighty-five gathered round the festive board at Avoca Park, July 18, the occasion being the annual outing of the Cincinnati Chapter of the Alumni of the Medical College of Ohio. It was a most enjoyable affair and anyone who did not feel better for being present is a fit subject for clinical and laboratory research. The base ball game resulted in a score of 13 to 2 in favor of the "Pills" against the "Bistouries." Drs. Ransohoff and Mithoefer umpired the game and live to tell the tale. Dr. Hans Wunderlich, assistant in the psychiatric clinic at Würzburg, was a guest. He will shortly return to enter the marine service at Kiel.

Correspondence.

A DISCLAIMER.
CINCINNATI, July 20, 1908.

EDITOR LANCET-CLINIC:

If

Some of the "better" members of the profession seem to associate my name with the cadaverous emanation from the North Bend graveyard. Those who imagine that I would ever hide behind a "dead one," or any live one, for that matter, have another guess coming. there is any credit to be reaped or any blame to be borne, I am ready, provided the credit is merited and the blame is deserved. In the case of John Scott Harrison's post-mortem communication, I can neither claim the credit nor can I accept the blame. I have nothing whatever to do with the whole matter. I say this in response to a number of queries, and with all respect to John Scott, whose opinions seem to indicate that he is far from being a "dead one." OTTO JUETTNER.

THE ALCOHOL PROBLEM.
CINCINNATI, July 21, 1908.

EDITOR LANCET-CLINIC:

What is the matter with the practical working of the cerebrum of the editorial staff, when you can produce such a good editorial on the old subject, "Alcohol: a Food and a Poison," and then leave the impression that the real question is that of functional activity; or, in other words, when you leave us to infer that there is no great objection in a person taking this dangerous luxury so long as the individual does not go beyond the ability of the tissues to oxidize the substance?

After quoting from the statistics of two English life insurance companies, showing that the mortality of the temperate drinkers as compared with abstainers is as 71 to 95 in one, and 55 to 79 in the other, no note of warning is sounded, warning the people of the great danger, not of taking more than the physiologic quantity, but of contracting a desire for more and more of an unnecessary, but dangerous narcotic.

What would be the attitude of any honest, capable physician in regard to any other "food," the consumption of which would so alter the death-rate of the people? The highest prerogative of the medical profession is not the ability to recognize and cure disease, but to prevent disease, and teach the people how to live so as to avoid the things that interfere with their highest development. Why are so many of our noble profession so slow to sound an alarm as

to the insidious dangers of drug habits? Only yesterday an inebriate who had abstained for two years, and who had come up from the besotted condition of a regular drunkard to be a good husband, told me that a prominent physcian, a college professor, who knew of his former weakness, advised him to take a glass or so of half and half after each meal for a chronic indigestion. Where there is such a strong tendency for young men to drink immoderately, it only takes a hint as to the harmlessness of moderate drinking from a physician to put many young men on the wrong track. If the medical profession had courage equal to their knowledge on this great question, and would constantly point out the danger of all drug habits, much of the disease, poverty and misery of humanity would be prevented.

Wм. E. SHAW.

MEDICAL COLLEGE OF OHIO.
CINCINNATI, July 20, 1908.

EDITOR LANCET-CLINIC:

A communication entitled "The Medical College of Ohio," published in your issue of July 11, has attracted considerable attention. I read this letter with a certain amount of amusement up to a certain point, but on reaching this point amusement gave way to indignation. Let me quote: "Old practitioners tell me that the secretary has never been seen in a medical society, local, State or national, and that he has never written a paper for a medical journal or reported a case. In fact, I have never heard of him having a case except a few around George Street and Central Avenue. He seems to be a good quiz-master, but when that is said it is' done."

Granting that if the word "never" were replaced by "seldom," the first two accusations might approach the truth, it may be observed in this connection that statements which have more or less foundation in fact may be so worded as to give a wrong impression, and I take this occasion to ward off this danger in the minds of the readers of THE LANCET-CLINIC. There is a great difference in the quality of medical lectures. Some are without profit either to the lecturer or to the audience, and I regret to say that many such are annually delivered in our schools. Others, however, are full of interest and instruction, and are so delivered as to hold the attention of the students and leave indelibly impressed upon their minds some valuable facts. lectures require time for their preparation, and their delivery is followed by a certain amount of mental and physical fatigue. These are the sort of lectures that our secretary is accustomed

Such

to give, often more than one per day. In addition, he gives two or three hours of private instruction, and spends several more in the dissecting room. His friends, who are cognizant

of these facts, instead of maligning him for not attending medical societies, are accustomed to wonder at his endurance. Furthermore, when we consider that the average medical society is an institution utilized by the clever specialist to catch the ear and acquire the consultation of the general practitioner, that in the meetings much of the discussion consists of polite apology or insidious criticism, that whole hours are wasted over so-called medical politics and in dabbling in matters in which the physician's opinion is doomed to oblivion—what wonder that a man who makes a pure specialty of teaching anatomy refuses to squander precious hours in attending such meetings.

With reference to the writing of papers, many of the papers to which we listen are mere compilations, purloined from German journals and foisted upon the local medical public as semioriginal. How can a man burdened with such arduous duties as those recorded above find time or energy for this sort of thing? Human protoplasm has its limitations. And in the thoroughly explored territory of gross anatomy, what could be written that would not be a simple rehash of material already printed in the text-books?

The failure to report cases is easily explained. As a teacher of anatomy and as secretary of the college his time is fully occupied, and no rational person expects him to have cases to report.

With reference to the insidious suggestion that he never had more than a few cases, I happen to know personally that the gentleman under consideration formerly had a very good practice, until his innate love of teaching caused him to devote his time more and more to college work.

"He seems to be a good quiz-master, but when that is said it is done." The wording here is faulty. Instead of “good quiz-master" it should read "excellent teacher." That is indeed a rara avis. What more can you ask of one man? How many of those who occupy chairs in our medical schools are really teachers? So many men are appointed on account of high standing in their own student days, on account of the writing of scores of the above-mentioned papers, on account of some real or feigned research, usually of no worth at all, on account of relationship or influence or personal appearance, on account of anything, in fact, except their actual ability to teach. Of what value are all these considerations to the student of elements? He has paid his money to be taught;

he wants a teacher and thinks he has a right to have one. He wants less bluffing, less parade, and more good solid instruction. And when a man is found who meets this requirement, who sacrifices himself to the good of the cause, who bends all his energy, not to aggrandizing himself, but to inculcating exact knowledge in the minds of the young men committed to his charge, why single him out to be maligned? There are undoubtedly weak spots in our schools. Find them, expose them, eradicate them; but spare the particular individual who for years, spurred on by his own enthusiasm and love of work, has diligently and conscientiously done his whole duty. Rational criticism may accomplish something, promiscuous mud-slinging nothing at all. JAMES W. ROWE, President of the Alumni Association, Medical College of Ohio.

[We heartily concur in the above expressions of dissent from a statement in the correspondence department of a recent issue.-EDITORS LANCET-CLINIC.]

A CARD.

Advertisers have been receiving anonymous communications quoting from Dr. E. S. McKee's letter in THE LANCET-CLINIC, of June 13, which could be construed as detrimental to the St. Louis Medical Review. The Review wrote this office requesting information as to the author of these attacks on them. We replied that their letter was the first intimation we had of this matter. We knew nothing of it, and regret exceedingly any annoyance that may have been caused our worthy contemporary.

DEATHS from hydrophobia have been by no means infrequent during recent years. In 1892 there were forty-five victims; in 1903, fortythree; in 1905, forty-four; and in 1906 the number increased to eighty-five. The great increase in the latter year would go to show that the sceptics have done actual harm by minimizing the sense of danger in the public mind and so hindering the adoption of preventive measures.

SOME really astonishing things sometimes occur in the Hoosier State, as the following from the Newcastle (Ind.) Courier will show:

Lewisville, July 13.-Dr. Fackler has sold his practice here to Dr. Barr, of Chicago, and the first named is packing up to go to Cincinnati, where he will enter a medical college and prepare himself for a specialist. Dr. Barr will occupy the property vacated by Dr. Fackler.

TWENTY State organizations have ventured into the field of medical journalism.

Bacteriology.

OSCAR BERGHAUSEN, M.D.

In the June number of Pediatrics Henry V. Robinson gives his results following the use of antistreptococcic serum in scarlatina. As a rule a single dose of 20 c.c polyvalent serum (Parke, Davis & Co.), or 10 c.c. proteolytic serum (F. Stearns & Co.), were used. Although only five cases were treated in this manner, he ventures the following conclusions: (1) That the serum reduces the temperature and pulse in about thirty-six hours. (2) That it makes a serious case mild by allaying unfavorable symptoms. (3) That it prevents or curtails complications. (4) That it aids in a favorable convalescence. In the June number of the Texas CourierRecord of Medicine W. H. Porter reports four cases of epidenmic cerebro-spinal meningitis, in three of which good results followed the use of diphtheria antitoxin. In the fourth case it was given late in the course of the disease, and its use was followed by little or no effect. He urges the value of a bacteriological examination of the spinal fluid in making a positive diagnosis.

In the June number of The Montreal Medical Journal F. G. Bushnell gives the results of the treatment of infective diseases by bacterial vaccine. He claims that a happy medium should be drawn between a too rosy and a too pessimistic view of the value of vaccine treatment.

The New York Medical Journal for June 27, 1908, contains five original articles on the use of vaccines for diagnostic and therapeutic purposes. E. R. Baldwin, of the Saranac laboratory, reports that results in this laboratory do not encourage the expectation of much practical use of the opsonic index in pulmonary tuberculosis in the usual method of its application. G. M. Illman and A. A. Duncan report thirty-six cases, mostly tuberculous, and are able to make the following report: Thirteen cured, nine improved, in eight no result. They draw the following conclusions: That vaccine therapy offers a chance of cure in many cases of disease heretofore regarded as incurable. That in the majority of cases stock vaccines are just as efficient as the autogenous. That cases can be treated with fewer actual index observations than was at first supposed. That cases treated with the clinical phenomena alone as a guide should only be so treated by some one well versed in vaccine therapy, and then only after having been under previous observation for a period long enough to have determined "the phase" the patient is in. That very small initial doses should be employed when the opsonic index has not been previously determined. That

the best results at the present time are obtained in tuberculous conditions and staphylococcic or streptococcic infections, as in acne, etc. That to get the best results vaccine treatment must be instituted as soon as the diagnosis is made.

Ernst Moro gives the following formula for the ointment he introduced to secure the cutaneous reaction in tuberculous cases: R. Koch's old tuberculin, 5 c.c.

Anhydrous wool fat, 5 grammes.

He claims that a positive result obtained by this method is as conclusive of a present or previcus tuberculous infection as is that obtained by the conjunctival reaction ог cutaneous method of Von Pirquet. That the inunction method is harmless, and that patients never obiect to its use.

H. H. Pelton, after an experience including twenty-five cases, mostly tuberculous skin and lung affections, of the ophthalmic reaction as a diagnostic measure, comes to the following conclusions: (1) The ophthalmic test is an aid of some value in the diagnosis of tuberculous conditions of the lungs, but in many instances is unnecessary, since the diagnosis may be assured by the examination of the sputum and by physical examination. However, in incipient cases with equivocal signs the test may be of distinct assistance provided its results can be relied upon. Whether reliance is to be placed upon it or not further study of the reaction will show. (2) In lupus vulgaris and tuberculosis of the type of necrotic granuloma (follicles) the ophthalmic reaction seems to afford a very material help in the diagnosis of the condition.

In an article on "The early Diagnosis of Typhoid Fever by Blood Cultures from the Ear," in the Boston Medical and Surgical Journal for June 4, O. R. Mabee claims that blood cultures in early cases of typhoid fever (that is, within the first week) give an accurate diagnosis in 90 to 100 per cent. The information obtained in this way is therefore extremely valuable, because the Widal reaction is rarely obtained before the ninth or tenth day of the disease. The simplicity of the method of obtaining blood from the ear for blood cultures warrants its general use by practitioners. In early cases 1 c.c. of blood is sufficient for each culture. In cases of two or three weeks' duration a larger quantity of blood gives a higher per cent. of positive cultures. In febrile conditions of a few days' duration, with symptoms simulating typhoid fever, a negative blood culture probably excludes typhoid fever. In septicemias due to the staphylococcus pyogenes aureus, it is possible to recover this organism from the blood by the ear method with the use of ox bile as a culture medium.