Biography.

EXECUTIVE COMMITTEE OF THE MISSISSIPPI VALLEY MEDICAL ASSOCIATION. Albert H. Cordier was born near Hopkinsville, Christian County, Ky., December 17, 1859. His parents were Joseph and Sarena Cordier. Dr. Cordier received his medical education at the University of Louisville, 1881, and in 1884 he graduated from the Bellevue Medical College. During part of the year 1884 he served as interne in the Bellevue Hospital. He had

Albert H. Cordier, M.D.

one year post-graduate work with Joseph Price, in Philadelphia.

He has contributed to medical literature a great many valuable papers and monographs, which are as follows:

"Cancer of the Uterus," International Journal of Surgery, 1896.

"Unusual Cases and the Lessons Taught by Them," Index-Lancet, 1905.

"Gall-Stones, Some Pathological and Clinical Phases Of," Annals of Gynecology and Pediatry, 1900, "Tubercular Peritonitis, Journal American Medical Association, 1900.

"Peritoneal Irrigation and Drainage," American Journal of Obstetrics, 1895.

"Non-Lithogencus Obstruction

of Biliary Ducts,"

Surgery, Gynecology and Obstetrics, 1906. "Peritonitis and Post-Operative Sepsis," Charlotte (N. C.) Medical Journal, 1895.

"Some Phases of Nephrolithiasis," Interstate Medical Journal, 1901.

Mixed Tumor of the Parotid Gland," Journal American Medical Association, 1908.

"Gastro-Jejunostomy in Gastrectasis," Langsdale's Lancet, 1897. "Special Operative Clinical Phases of Appendicitis," Medical Record, 1907.

"Movable Kidney, Local and Remote Results," American Journal of Obstetrics, 1896.

"Skiagraphing Foreign Bodies in the Pelvis," American Journal of Obstetrics and Diseases of Women, 1897.

"Extra-Uterine Pregnancy," Journal American Medical Association, 1893.

"Gastric Ulcer," International Journal of Surgery, 1904.

"Vaginal vs. the Abdominal Method of Dealing with Inflammatory Disease of the Pelvis," American Gynecological and Obstetrical Journal, August, 1896.

"Phlebitis Following Pelvic and Abdominal Operations," Journal American Medical Association, 1906.

In the University Medical College of Kansas City he is Professor of Principles and Practice of Surgery, his specialty being surgery and gynecology.

Dr. Cordier was President of the Mississippi Valley Medical Association in 1901, at the meeting at Put-in-Bay, Ohio; ex-Chairman Section of Diseases of Women, American Medical Association; ex-President Tri-State (Illinois, Missouri and Iowa) Medical Association; Jackson County Society of Missouri.

Correspondence.

OPTICS AS A SIDE LINE.

CINCINNATI, Angust 20, 1908.

EDITOR LANCET-CLINIC:

Although State legislatures have attempted from time to time to protect the public from malpractice and dangerous unskilfulness, we all know that the modern craze for money-getting has nevertheless made it possible for men otherwise legitimately engaged in either commercial or professional vocations to extend their work beyond the danger-line and exploit the credulous sufferer for what money there is in it. If in some way a trade becomes closely connected with the actual work of professional men, it seems as if the tradesman finds nothing to fear in taking upon himself the responsibility of furnishing his customers quite independently of professional advice or direction.

To put the matter broadly, it is about the same as if a quarryman or lumber dealer would attempt to direct the building of some intricate architectural structure because he could furnish the crude materials and make a nice penny on the side line.

These reflections are the result of reading a very naive article in the July number of the Bulletin of Pharmacy, in which the druggist is sagely advised to take up optics-meaning, of course, optics in a medical sense-as a side line, in order to make a little more money. While it might be interesting enough to subject the arguments of the writer to ordinary criticism, the main point to be observed is rather the utter innocence with which the proposition is made. There is really a question of professional integrity here-a matter of public morality. We could forgive the ignorance of arguments founded upon the hope of gain and the blindness which, while admitting the necessity of medical knowledge, would still make light of the need of a medical man.

Some remarks made are quite amusing; for instance, we are told, "I believe that optics is more legitimately a side line for the pharmacist than for the watch-tinkerer" (sic). This is certainly an odd justification. What has the "watchtinkerer" to do with the work of the oculist? What has the pharmacist to do with the work of the oculist? If we should call the work of these men professional, in what way does it touch the scientfic work of the profession? Let us go on further and call in the aid of the optician. What is his legitimate sphere? Should he take up the drug proposition, the professional oculist's, or the jeweler's concern in the matter? In fact, what is to prevent the oculist, who is better prepared, according to all reasonable supposition, to take care of his patient's eyes, to become their purveyor in the matter of drugs, lenses, etc.? He certainly knows what his patients want, and he certainly should also be in a position to provide them with just what they want. It is a poor argument to urge that you should provide your customers with all that they need just because you happen to have on hand something they need. And if time and skill be necessary considerations in furnishing our fellow-men with what they truly need, let us give them the time and skill required, even if we have had to pay for it ourselves through long years in schools of medicine and under professors who have made such matters the study of their life.

There must be a line drawn somewhere. And we humbly think that the best line to insist upon is the danger-line. As stated above, it were hardly worth while to consider the arguments of the writer in the Bulletin. We don't deny that the oculist is assisted by the use of atropine, but the inference that "the oculist depends upon atropine while the optometrist relies on skill," is lamentably false. Atropine is not the only thing the oculist depends upon. He also relies upon a thorough pathological training which will enable him to diagnose the pre-existing conditions unfavorable to the proper use or work of the ocular organ, or calculated to interfere with the methods in correcting its defects. Indeed, we have the writer's confession to the same effect. He tells us that "a thorough knowledge of anatomy, particularly of the head and cranial nerves, is necessary," not to mention a complete study of optics from the point of view of the physicist. And, what is more, he tells his money-hunting brothers that the ophthalmoscope must be undertaken and mastered, not from the viewpoint of refraction, but from that of pathology. Here, indeed, we are in singular agreement with Mr. Woods. The remark that something must be known about pathology in matters relating to the practical cor

rection of eye diseases is pathetically illuminative of the writer's condition of mind.

It is just that we would recommend ourselves. There are men who are especially trained for one vocation and men who are alone in their field for another, and there are yet others who, not specially trained for one field or the other,. would nevertheless seek to gain all the legitimate reward of the professions on whose territory they live without knowledge or right of patrimony.

He tells us also, boastfully, that the optometrist-and this is "an undisputed fact"-can give the average oculist points in refraction. Well, perhaps the fact is undisputed, but what about the average optometrist? Can he give points to the oculist, who has made the eye his study, or even to the physician who has made no special investigation. of diseases of the eye?

There is an immense difference between the purely physical conditions of human organs and the physiological conditions of the same, inasmuch as these require for their safeguarding diagnosis of pathological conditions.

Truly, enough has it been said that "fools rush in where angels fear to tread."

Not rarely does it happen that a merely optical examination fails to reveal the actual condition of the eye of the patient. Oftentimes, while expecting a case of simple asthenopia, we have to deal with some one of the many complicated diseases that make themselves manifest through the disordered condition of the eye. For instance, when refraction seems to be the only question involved, it is really and truly a question of correcting some diseased condition which, when successfully treated, may leave the eye in its former normal condition. And if an attempt were made to cure the defect in sight in the case by merely optometristic methods, permanent and incurable harm might be the result.

Diseases, especially those which affect man's most delicate, sensitive organism, are not to be diagnosed by mere machines, and some of the conditions which affect eye-sufferers are such that only the best medical experience, practice and training can trace them to their genuine origin.

The different varieties of retinitis, chorio-retinitis, choked disk, optic nerve atrophy and glaucoma are only a few of the many affections at times diagnosed only by repeated and painstaking examinations by the skilled oculist.

And then the diagnosis of the true cause, and the proper treatment promptly afforded, may give to some the means of earning their livelihood, while the delay caused by changing glasses at the suggestion of careless money-hunters

would throw a burden upon the family or a still greater one upon society.

The injunction, “Schuster, bleib bei deinen Leisten," is peculiarly applicable. We feel that every druggist, jeweler and optician has a field large and sufficient without those side lines which may prove so disastrous to the best interests of those whom they profess to help. Should any one feel inclined to take up optics-as they term it-we feel sure that the study of medicine and of the eye with all its pathological affections will make them first-class oculists, and men who can be safely trusted with the health of the public, inasmuch as it is connected with the most delicate of our external organs, the eye. And then they can leave the druggist, the optician and the "watch-tinkerer" to the very broad lines of their trade. If any ambitious searcher after higher things should reach to the degree of M.D., and become an oculist as medical men understand the term, he shall be welcomed to the fold and won't be considered as indulging in the luxury of a side line.

JOHN RANLEY, M.D.

THE QUESTION OF INEBRIETY.

HARTFORD, CONN., August 17, 1908.

EDITOR LANCET-CLINIC:

You have placed the profession under a debt of gratitude by calling attention to a most serious evil in your editorial of August 15.

It is a pioneer effort along a new line. Many years ago I published some statistics of about 3,000 medical men, and showed fully 10 per cent. were known spirit and drug users. The late Dr. Shrady, of the Medical Record, sustained this, and some leaders in Philadelphia denied it. The matter was taken up by some of the great dailies in a personal canvas. In Philadelphia 22 per cent. of all physicians were found victims; in New York, 19 per cent.; in Baltimore, 24 per cent.; in Boston, 21 per cent. The matter was then dropped. No one cared to defend or explain these figures. Your editorial is excellent, and outlines what is coming in the near future. The doctors are not wholly to blame; the fault lies with the college professors, whose teachings are wrong. The students are ignorant of the danger. It is sad and pathetic.

Take up the subject again. It is most practical, and I most sincerely thank you for this effort. Most sincerely yours,

T. D. CROTHERS, M.D. [Dr. Crothers is editor of the Journal of Inebriety, and an authority on this subject. It is both pleasure and satisfaction to receive approval and encouragement from such a source. -ED.]

Book Reviews.

BORDERLAND STUDIES. Miscellaneous Addresses and Essays Pertaining to Medicine and the Medical Profession, and their Relations to General Science and Thought. Vol. I. By GEORGE M. GOULD, M.D., formerly editor of Philadelphia Medical Journal, American Medicine, author of a series of medical dictionaries, "Biographic Clinics," "Concerning Lafcadio Hearn," etc. Pp. 312. P. Blakiston, Son & Co., 1012 Walnut St., 1908.

To those who, l'ke the writer, have been following Dr. Gould's career through his various vicissitudes as editor, lexicographer, litterateur, ophthalmologist and free lance, these "Borderland Studies" confirm the impression received as to his versatility. The first volume, bearing the same title, was published in 1896, since which Dr. Gould has ventured into various fields, and, strange to say, nearly always with success. That his financial affairs have not always prospered may be laid at the door of the economic conditions obtaining to-day, which forces one into business or into the love of books-no one can have both. Had Dr. Gould entered mercantile pursuits exclusively, he would have been a marked success in that, too. But the science of medicine and the world of literature would have been the loser thereby.

The essays herewith presented are of unequal value, though all are readable. Dr. Gould seems to be at his best in venturing upon humorous or ironical fields, pertaining to the fetiches worshiped by the average American or the average physician. “Intellectual Weeds of American Growth" takes up the "New Thought" cult, and in a delightful way exposes it to ridicule. "The Life-Study of Patients" brings out most prominently the author's own crotchet, that in making a rigorous analysis of an individual patient's illnesses, they would be found due to reflex causes, principally from some defect of the eyes. But everyone knows the author's foible, and hence no one takes it too seriously. However, it must be admitted that Dr. Gould's influence and prestige have led many into a closer examination of reflex symptoms, frequently finding the eyes at fault.

The reviewer recalls some instructive articles in the Philadelphia Medical Journal in the heyday of its success on style and on the psychology of words. The strictures laid upon the average writer's misuse of words and phrases were always timely and generally helpful. They are here reprinted. The cuts embellishing the first article in the book are of the stock variety.

without tenderness (for there is no tenderness at first), the patient surely has an obstruction of the bowels from some cause. At first one can handle the abdomen with perfect impunity, so far as causing pain and tenderness is concerned. When such a condition exists, there is an intestinal obstruction due to one of the many conditions which may be found to exist when the abdomen is opened and explored.

It has been shown by Halstead and others that when the obstruction is high up in the intestinal tract, the symptoms develop much more rapidly than when situated at the lower end of the ileum or in the colon.

must be undertaken at once. Exploratory incision is frequently a confession of ignorance, but such confession is evidence of sincere concern for the good of the patient. When the diagnosis is made, the surgeon should endeavor to make up his mind as to the location of the obstruction.

The most common seat of obstruction is the right lower quadrant of the abdomen. The lower portion of the ileum and the cecal region, therefore, should be inspected first. Volvulus, however, is most apt to occur in the sigmoid colon, especially in the aged. Intussusception is not particularly common in the ileo-cecal region, but it is perhaps most frequently found