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The DIMUNETTE gives you the same character of protection which 75% of the banks employ whether it be a limiting line machine or writer. Why pay $20, $30 or $40 for a machine when you can get Standard Protection for $7.50. Made and guaranteed by the oldest manufacturers of check protecting devices in the United States. Just attach your check or money order for $7.50 to this ad and mail to RALPH E. HERRICK, 307 NEW ENGLAND BUILDING KANSAS CITY, MO. and a DIMUNETTE will be sent you prepaid Refer by permission to the editor of this journal. When Writing to Our Advertisers, Please Mention The Medical Herald -67 Vol. XXXVII. Incorporating The Kansas City Medical Index-Lancet An Independent Monthly Magazine JULY, 1918 Organized at Council Bluffs, Iowa. September 27, 1888. Objects: "The objects of this society shall be to foster, advance and disseminate medical knowledge; to uphold and maintain the dignity of the profession; and to encourage social and harmonious relations within its ranks."-Constitution. No. 7 Original Contributions [EXCLUSIVELY FOR THE MEDICAL HERALD.] fortune and his temporary suffering offered unique opportunity for the service of mankind, and opened to him the life work to which he has since devoted himself with a success which could have been achieved so quickly and so completely by no one without his experience and his peculiar qualifications. His first step was to or STATE SOCIETIES FOR MENTAL HYGI- ganize and incorporate in his own state in the ENE* GERSHOM H. HILL, M. D., Des Moines, Ia. History Mr. Clifford W. Beers, of New Haven, Conn., was for several years a patient at different hospitals and sanitariums. He recovered from his malady, and soon afterward wrote the book called "A Mind That Found Itself," which not only attracted the immediate and widespread interest of the general reading public, but set the authorities of every hospital for the mentally disordered, even the best managed among them, the task of rigid self-examination. Mr. Beers wrote from a personal experience such as no other writer on the subject has ever had, with a restraint which carried conviction, from a motive which no one could question, and with rare literary skill. His affliction became a blessing to himself and to humanity. His seeming mis A paper read at the thirtieth annual meeting of the Medical Society of the Missouri Valley, Lincoln, Nebraska, Friday, September 21, 1917. year 1908 the Connecticut Society for Mental Hygiene, which has furnished the model upon which similar societies in several other states have been organized. Purposes Mr. Beers took the lead in the organization of the National Committee for Mental Hygiene, the purposes of which, as stated in its constitution are (1) "To conduct and encourage work for the conservation of mental health; (2) for improvement in the treatment of those suffering deficiency; (3) to promote the study of these diseases; (4) to disseminate knowledge concerning their causes, treatment and prevention; (5) to conduct or to supervise surveys of the care of those suffering from mental diseases or mental (6) to cooperate with other agencies which deal deficiency in states, counties, cities and towns; with any phase of these problems; (7) to enlist the aid of the federal, state and county governments; (8) to help organize and aid affiliated from nervous or mental disorders and mental state and local societies or committees for mental deficiency, impairment and derangement more hygiene. effective, were earnestly discussed. List of State Societies Such societies have already been established in the states of Connecticut, organized in 1908; Illinois, organized in 1909; Massachusetts, organized in 1913; Maryland, organized in 1913; Pennsylvania, organized in 1913; North Carolina, organized in 1913; District of Columbia, organized in 1915; Alabama, organized in 1915; Louisiana, organized in 1915; California, organized in 1915; Rhode Island, organized in 1916; Ohio, organized in 1916; Tennessee, organized in 1916; Missouri, organized in 1916; Indiana, organized in 1916; and Iowa, organized in 1917. The National Committee and the War When war was declared by the United States against Germany, a War Work Committee was formed, having its headquarters with the National Committee for Mental Hygiene in New York City, with Major Pearce Bailey, M. O. R. C., as chairman, and Dr. Frankwood E. Williams as vice-chairman. The surgeon general of the army authorized the employment of physicians under contract for a limited period of service to perform a definite kind of work at a definite place. At their termination these contracts could be annulled or another assignment could be made. Physicians employed under such contracts remained civilians, received no commission and were obliged to pass no physical examinations. There was a compensation of $150 per month, with mileage for travel under orders. This new provision made it possible for men who were over age, or who were unable for business or personal reasons to accept a commission, to render patriotic service to the government and at the same time release for more active duty many physicians whose services would otherwise be required. A sufficient number of neurologists and psychiatrists accepted this type of employment in the army, making it possible to conduct mental examinations of all the troops making up the branches of the new army. Other wars have left their thousands of cripples, and we know that this world wide conflict has already been accompanied by extensive mental breakdowns. Such Societies Needed In my opinion, every state in the Union should be supplied with a Society for Mental Hygiene. At the annual meeting of the American MedicoPsychological Association this year, held in New York City, and of the National Conference of Charities and Correction, held at Pittsburgh in June, experiences, opinions, and prospective methods, for making the prevention of mental It is a fact that more interest is now being taken in abnormal and subnormal mental conditions than ever before. Mental inferiority and mental peculiarities are now scrutinized closely in soldiers when they are first examined, when they are in camp, when they are in the trenches, and while they are in the base hospitals. In the graded schools, pupils who are subnormal or abnormal and bothersome, and pitiable because blameless, are now receiving special and separate instruction. Preventive Medicine Hygiene is that department of medical science which treats of the promotion and the preservation of health, but to my mind today it means more-it includes the prevention of disease. Now all physicians and surgeons are specialists. By education and experience we are restricting our business to a particular line of work. Consequently in the Medical Record there are listed under the heading, "National Medical Societies of America," 44 associations. We have the American Public Health Association, why not make the most of the National Committee for Mental Hygiene? Every commonwealth has its state board of health, why not have also a society for mental hygiene? We are actually preventing cholera, yellow fever, typhoid fever, smallpox, diphtheria, tuberculosis, inebriety, syphilis and arterial degeneration, why not go one step farther and greatly diminish the occult disease in the psychic neurones, and the amount of mental degeneracy? Des Moines has a population of 100,000. One branch of the Chamber of Commerce is named the Public Welfare Bureau. Through it is distributed annually $100,000 to 24 charity organizations. These cooperate with the police and health departments of the city government and with the overseer of the poor connected with the County Board of Supervisors in doing relief and constructive work. An excellent and already quite abundant sup ply of trained philanthropists are now found in all large cities, also here and there in smaller cities, known as social service workers. They are the product of the National Conference of Charities and Correction. Several schools of philanthropy are giving them a practical, quite scientific and thorough course of training. They graduate as mental nurses. They are in great demand, and are making good. In my estimation, the chief advantages of a State Society for Mental Hygiene are these: First. To convey the facts to everybody concerning the nature and prevalence of physical, mental and moral degeneracy. Second. To secure cooperation between the officials engaged in the care and treatment of the demented and the feeble minded, namely, by the superintendents of state institutions, boards of supervisors and other county officials, and by municipal charity workers. Third. To formulate and promote legislation which will result in wholesome enlightenment, a harmonious unification of all the forces that can be mustered to recognize and reduce the number of mental defectives and other dependent persons. Fourth. To establish a phychopathic hospital at every state university, a psychopathic ward in every good sized general hospital, and a free mental dispensary in every city. Fifth. To assist county physicians to provide themselves with social service workers for psychopathic purposes, to do research and record work. Sixth. To enable the heads of the state institutions to employ and send to the county seats, social service workers, there to confer with the physicians and supervisors, and to visit the homes and communities from which inmates come, and thus learn definitely the causes of the mental deficiency and mental impairment. THE TREATMENT OF CHRONIC ARTHRITIS* J. M. MAYHEW, M. D., Lincoln, Neb. I offer no apology for resuming this time worn theme. Some practices offering great hope to the sufferer have been gradually cast into the discard, having refused to stand up to the crucial test. Some are new and relatively untried and offer more scientific preparation in conduct and technique than any before brought to our notice. The condition of the Chronic Arthritides is one that demands of each of us constant and increasing study and investigation. The "last word" has not been said and experimental evidence is opening fresh fields for our considera tion. Some savant very wisely has said that it is better to know a few things than to know many things that are not so. We will try and eliminate all factors that have been tried and found wanting. The Medical Journals are filled with them since bacterial investigations of concealed foci have given the study of arthritis a new impulse. I will include the methods tested by my own experience and trust to discussion to add to my fund of facts (not theories) in this realm of therapy. Read before the Medical Society of the Missouri Valley at Lincoln, Neb., Sept. 21, 1917. In order to reach a clear understanding of the field of Arthritides, let us start with a definition (of course we exclude acute and chronic gout in this discussion as they are, sui generis, of different origin). We can best define the condition accepted as chronic arthritis through a classification of the joint conditions one finds coming within the limits of the exclusive pathological findings. In Lancet, January 15, 1916, Rowlands makes a very convenient, practical and workable differentiation of the types of Arthritis as follows: 1. The Adolescent: The disease usually attacks the larger joints; knees, hips, wrists and shoulders. The onset is rapid, pain is severe and treatment is difficult-in fact possible, only if source of infection is discovered early in the disease. 2. Middle Age Types: Begins about the age of forty. The largest number of cases come in this group. It is the form of the disease most amenable to treatment, providing the source of infection can be found. 3. Senile Type: Patients are over fifty. There is little or no pain, usually attacks smaller joints to begin with, wasting of muscles and deformity are pronounced. Owing to lack of pain these patients rarely seek treatment until disease is far advanced. In the Medical Record of September 23, 1916, George R. Elliott has made an amplification of this classification on pathologic grounds as follows: 1. Proliferating or ankylotic type. 2. Degenerative or non-ankylotic Type. The first groupe is called by some, Rheumatoid Arthritis-by others, Atrophic Arthritis. He then elaborates further by differentiating the types according to their etiology. 1. A specific disease due to a specific germ. 2. No specific organism found but a form of septicaemia of staphylococcal or streptococcal origin and bearing close relationship and analogy of pyaemia. These classifications of types cover the field of defination and are sufficiently clear and inclusive to be of use in our consideration of the treatment. The etiology must be the fundamental basis of all forms of treatment. We have confront ing us, a problem of no mean proportions. The specific disease due to a specific organism. In an article in a Sourthern Medical Journal in 1916, there was advocated the following stock vaccine Bacilli Coli Cummunis 100,000,000, diplococci pneumoniae, 100,000,000, streptococci pyogenes 50,000,000, staphylococci albus, aureus |
