WILLIAM MARTIN, M.D., Editor. Late President American Electrotherapeutic Association. WING to the present day demands for physical measures in the treatment of disease, and as the profession, as a whole, has had so little knowledge of things electrical, the Western Medical Times, with the idea of aiding those who have a real desire for a better knowlege of the subject, adds this department. While the Department Editor endeavors to give his readers something in the way of continuity of one article to succeeding ones, each single article will be found a complete story in itself. With the completion of the descriptions of the various modalities and their production, treatment will be taken up in detail. Written by practical men, the articles in this section will be found well worth while.-Editor. Cavernous Angiomata. These aneurismal conditions are venous and not arterial, involving the venous capillaries by dilatation, the cavities produced being of varying sizes. They are found most often in some part of the face, principally near the eye, nose or mouth, and at times large enough to fill the greater part of the half of the face. The tumor is bluish in color, is devoid of pain and soft and easily compressible. The treatment of angiomas is by electrolytic coagulation. There are two technies, the bipolar and unipolar, using the constant or galvanic current. The first method is by the use of two or more needles and the other is by the use of one needle and a dispersing pad upon the back. When the tumor is very large more than one needle at each pole will be necessary, in which case a needle holder attached to each wire, which will hold as many needles as will be necessary, can be used, care being taken that the needles are small enough not to make a wound. The object being to coagulate the blood contents of the tumor and destroy the vessels, the proper type of needles must be used for best results, cosmetically and otherwise. The needle for the positive pole must be of fine type and platinum-iridium, while the negative may be of steel. If the positive was of steel it would leave a rust mark in the skin which would be permanently objectionable, the result of ionization. This will not happen to the negative needle, so steel can be used for that. The tips alone should be bare, the rest being insulated by fused hard rubber or shellac, so when the needles are inserted into the tumor the bare tips will be within the cavity. The point of insertion is just at the edge of the tumor in the healthy skin. The strength of current must be regulated so that there will be no damage to the tumor skin. Small tumors will require less than larger ones, and the time limit varies just the same way. Usually the time of treatment is from three to five minutes, and the current strength is from twenty to forty milliamperes. General anasthesia is used particularly in infants, at which age the operation is most desirable, for the condition is found at early age. Radium has been used in the form of needles with varying success. There have been too few cases reported thus treated to give satisfactory reports upon, but the few cases reported so far have shown encouraging results. The superficial type known as telangiectasis is a capillary dilatation of a su perficial nature, and this often spreads over a large part of the face. These are congenital and are sometimes called birth marks. There may be some variation in these marks, some being very much more discolored than others. These are what are known as port wine marks or nevi and are successfully treated by several methods. Dr. W. L. Clark has cleared up many cases with the dessication method, the form of electrical destruction of which he is the originator. This is surgical and care must be taken to do it very thoroughly, other wise there may be scars and secondary hemorrhage of a serious nature. There may also be a recurrence under these circumstances. The method generally used is by the use of the ultra-violet ray, water-cooled lamp and compression method. This is done piecemeal and persistently for best results. There will be no scars from this therapeutic measure. and the results are gratifying when the proper technic is followed. DEPARTMENT OF ENDOCRINOLOGY. In starting this department, which will be devoted to consideration of all phases entering into the field of endocrinology and glandular therapy, brief introductory remarks may not be amiss. Despite the fact that animal products were used by the ancients, who fed their patients with the particular animal organs (organo-therapy) correspondent to the diseased part of the patient, scientifically the subject only of late has claimed the interest of the medical profession at large. The public press has contained more reference to glandular therapy than have the medical journals. Especially has this situation been emphasized by reference to reports that this or that person of prominence had gone to Steinach and had him perform the rejuvenating gland-transplantation operation. As a matter of fact, Steinach never did perform such operations, he being only a theorist and leaving the practice of his teachings to others. Less than two decades ago, even the term "endocrinology" was little used. and knowledge of glandular therapy virtually was confined to study of the function of the thyroid gland in connection with Graves' disease, myxedema and cretinism. There was a smattering of understanding of the influence of the interstitial tissue of the testicular glands upon masculinity, development and rejuvenation of the male. These were the chief boundaries within which the general practitioner, rather casually, concerned himself with the subject. A handful of investigators in many countries were not ready to accept the limitations set by the demonstrated specific action of the thyroid in the connection cited, but they attempted to apply the same principles to other glands. From their laboratories has arisen such a wealth of startling knowledge and from their pens emanated so voluminous a library on the subject of glandular therapy that it promises to replace our pres ent-day standbys in materia medica. In fact, to a great extent it already has replaced such theories and practices. Much work remains to be done, it is true, but the earnest student of the subject can readily perceive the dawning of a new day of medical science and a revolutionizing of old forms of standard practice. Enough has been determined and standardized to warrant the prediction that, within ten years, results will be obtained beyond the fondest dream of others than the most enthusiastic endocrinologisttriumphs of therapy forefelt by only the few investigators who have devoted their lives to research. Schools of endocrinology will be founded; no medical college will be considered as giving its students an adequate education unless in its curriculum endocrinology occupies an important part. The key to success in treatment of the sick (and what "incurable" ailment will not be attacked by glandular therapy?) will no longer consist of drugs and herbs, but will be some glandular preparation. The aim will not be to subdue or to disguise symptoms, but the goal will be reestablishment of normal metabolism-the harmonious, perfectly blended and rhythmical procedure of the H&H Retarded Convalescence Pre-Tuberculosis Neurasthenia Relapse H&H can often be avoided through the Fellows' Syrup of has been acknowledged for over Sixty Years HAVE YOU TRIED IT? Samples and literature on request FELLOWS MEDICAL MANUFACTURING COMPANY, Inc. 26 Christopher Street, New York, N. Y., U.S.A. HOH building up and breaking down processes of metabolism. Deeper study and better understanding of the principles governing glandular activities will serve to explain many puzzling questions-for instance, why the indicated and most studiously combined gland products frequently fail to give the results expected. In youth, when anabolism and katabolism are under the guidance of healthy glands, nourished by a poison-free blood stream, the healthy glands themselves are able to keep the blood pure and unpolluted. As age advances, the system of the healthy young human is subjected to the repeated onslaughts of unnatural life, largely such as civilization entails; the glands become sluggish and not only do they permit intoxication of the blood to take place through insufficient elimination from urinary and alimentary tracts, but they also fail to exert their natural detoxicating influence. Most important of all, they add their own quota of poisons and thus is taken the first stride on the road that leads to premature senility, decay and disease. To prepare glandular material in such a manner as to prevent further accumulation of toxins in the blood and to dispel the poisons already present, by detoxicating the blood, is a very recent achievement. Freedom from gland-paralyzing toxins, of which cholin is the most persistent, permits suitable glandular products, in whatever manner administered, to exert their beneficial effect. Cholin is not only the ptomain which prevents the reawakening of the glandular system, but it is THE blood-polluting poison responsible for arterio-sclerosis and premature senility. Consideration of cholin in connection with arterio-sclerosis, high blood pressure and decholinizing of the blood by a glandular ferment will be among the subjects of future articles. DEPARTMENT OF NURSING. E. MILDRED DAVIS, A.B., R.N., Editor. Superintendent Bayonne Hospital and Dispensary. CENTRAL SCHOOLS FOR NURSING. (Abstracted from the American Journal of Nursing, June, 1923.) The growing spirit of co-operation between training schools is extremely gratifying, in view of all that is discouraging in nursing education of today. Schools struggling alone have been able to make little progress, if any. The combined efforts of two or three schools of this type succeed immediately in bringing about desirable changes. Difficulties of the educational program consist of lack of funds, lack of proper classroom, or places to conduct classes, meagre equipment or none, and scarcity of properly qualified instructors. When classes consist of four to twenty students the per capita cost of well equipped classrooms and laboratories, with capable instructors would be high. The nursing schools of Utica, N. Y., five in number, arranged to contralize the teaching of the preliminary subjects included in the four months course. Certain class rooms in the local high school building were used for the purpose of teaching student nurses. All necessary articles of equipment were supplied by the hospitals, and one room equipped for the practical demonstrations. The co-operation of the Board of Education in loaning these rooms to the training schools proved to be a generous contribution towards nursing education. The Central School of Nursing is in charge of a director, who is responsible for the teaching. She is assisted by the principals of the various schools, their assistant, and to a certain extent by the physicians and surgeons of the staffs of the various hospitals. The expenses of |