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manner of pushing them. This is a question of journalism-a very vital question to me, and an important one to the profession. The profession is interested in having its literature kept up to a proper standard.

I.

Question 2.-Answered in reply to Question

Question 3.-The question is a ridiculous

one.

Dr. Lawrence need not talk about grafters. He has been working the most stupendous medical graft that was ever known in this country, and he has his immense fortune to show for it. As to medico-political graft, I do not know of its existence. Dr. Jackson says it exists, but I know nothing of it. He seems to indicate in his articles that it is the salaries of the State Medical Examiners. I will venture that there is scarcely one of them who does not lose more than he gains by attending to his duties as examiner. And as to the American Medical Association, there is less graft in it, compared to the importance and extent of its work, than in any institution I know of. Its chief salaried officer is its secretary and editor of its Journal, both offices filled by one man, whose salary is very low, compared with his many exacting duties and the magnitude of his responsibilities. Even if there were graft in the State Medical Examining Boards, and in the A. M. A., I have no connection with either, excepting that I am a member (a humble member, in the ranks) of the A. M. A. If there were any graft in it, I would have no access to it, so why should I defend it? You can bet your bottom dollar that if there were any graft there I would try my best to expose it. Your question is ridiculous on the very face of it, except that it brings out in bold relief the fact that Dr. Lawrence is the biggest grafter upon the medical profession of this country that was ever known.

Question 4.-Glad you grant that Dr. Lawrence publishes the Brief in the interest of his proprietaries: No, there is no other motiv than what I have exprest freely-my interest in medical journalism, and in the welfare of the medical profession. What other motiv could I have? I have nothing against Dr. Lawrence personally, and as to "medicopolitical graft," that is too absurd to think of. Even if there were such a thing, my interest would be to expose it, certainly not to defend it.

Question 5.-Answered above.

I could expand for many pages in the same tenor as the above, but I fear too much space has thus been taken already. Perhaps the conclusion that all will reach is that Dr. Lawrence has been unfortunate in his defender.

Let me further say that any man makes a grave mistake when he comes into any profes

sion with a fighting spirit. It is no wonder that Dr. Jackson has no standing with the profession of his community. If he will dispel from his mind imaginary grievances-stop fighting a straw man-and seek affiliation with the best elements of the profession of his community, apply for admission into the local societies, etc., he will find himself among gentlemen, and in a fraternity; and all these hobgoblin notions will disappear from his brain. The arms of the medical profession are wide open to all fellow workers who are candid and reasonable. But if you approach a profession in a fighting mood can you expect a cordial reception? I have had a great deal of experience with the profession, and I have nothing to complain of.

As to the state examining boards, they are filling an important niche in the progress of medical science. I would much prefer that one examination by a National board should give the right to practise medicin anywhere under the stars and stripes. But our plan of political organization will not permit that at present. I have gone over this repeatedly and fully since the question has been a live one. When our government was organized and our constitution written, this need was not thought of, hence not provided for. The states were given complete jurisdiction in such matters, each within its own borders. Now that you have come to this country, you should accept things as they are, as we do, until they can be changed--and I hope some time we can have a National medical law, which will displace all the state medical laws.

The claim that the authorities of one state should give the right to practise in other states is entirely untenable. That would rob the invaded state of self government; and it would also bring the medical standard down to that of the lowest state.

As to the claim that a college diploma should give the right to practise, I have often exprest my opinion. Teaching bodies and licensing bodies should be entirely separate and distinct. A teaching institution should teach; and a different body should pass judgment on the quality of the teaching. This division has now been accomplisht in the most of our states, and it is one of the most important steps in advance that has occurred in many decades. Colleges used to see how many students they could graduate; now they try to see how few of their students shall fail before the state board examinations, for wide publication is made of the record showing what colleges the successful candidates come from, and what colleges the failures come from. The importance of such a test, and the incentiv it is to excellence in teaching, is apparent.

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The next letter I received on this subject was the following:

What is the meaning of all the maledictions showered upon the head of the editor of the Brief?

This country is full of yap" doctors who write every medical journal on their list that they have the only journal and all others are base imitations; praise the one to which he is writing and "cuss" all others. Some prize funny man once said that "there is a good deal of human nature about some people" and I must say that it looks like it from here.

Dr. Lawrence has made himself rich on proprietaries, his proprietaries are good ones, he advertises them in the Brief, he buys and pays for medical articles that tell something; if these articles are worth a dollar a year to you, you are invited to subscribe; if not, there is no compulsion, and I must say it is a narrow medical man who cannot get a dollar's worth out of a year's subscription to the Brief.

I have no fight against THE WORLD; the fact that I am a subscriber shows that I consider it worth a dollar. I also subscribe to the Brief, and it is worth the money. The fact that Dr. Lawrence is rich, cuts no ice with me; he don't owe me a cent.

Let's see you publish this.
Shubert, Neb., April 5, 1904.

J. F. STONG, M.D.

What is the matter with Nebraska ? I suppose Dr. Lawrence would say, "She's all right!" Has Dr. Lawrence hypnotized that State? Well, Dr. Stong, you are just the kind of a "peach" that Dr. Lawrence is looking for; pay him for his journal that boosts the proprietaries, and also pay for and prescribe the proprietaries pusht. No wonder Dr. Lawrence is rich. When it comes to medical literature it is a matter of taste, you know. Have you seen a peruna almanac ? I haven't; but I expect there is some pretty good stuff in it. I don't think they charge for it.

I have always said that it would be a poor medical journal indeed that is not worth much more than its price; that the best possible investment that a doctor can make is to subscribe for plenty of medical journals, and pay for them as promptly as for any other part of his equipment. Nearly every journal has an individuality, and one cannot, as a rule, take the place of another. But the object of every legitimate medical periodical should be to serve the interests of the medical profession, and not to push the sale of proprietary medicins. It is all right for a man who thinks he has a good pharmaceutical product to try to attract the attention of doctors to its virtues.

But that isn't journalism. It is commercialism-a good thing in its way, but the discriminating doctor doesn't want the two mixt. When he gives his time to reading the editorials and other parts of a medical journal he wants to feel safe from imposition. If he is in quest of pharmaceuticals, the advertising pages are open to him; there literature concerning such things finds an ap

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Let us take all our bitter pills first; and here comes one which at first sight seems like a very bitter one. He does not "dare" me to publish it, but let us take a look at it. Here it is:

NEW YORK CITY, April 13, '04

C. F. TAYLOR, M.D., MEDICAL WORLD, Philadelphia, Doctor:-Your articles on the subject of proprietary remedies are simply "rotten." Any reader looking over the MEDICAL WORLD now and comparing it with the same journal of a few years ago, can readily discover the animus of your diatribe.

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It is patent that the advertisements you used to carry and now do not, could "a tale unfold," which would make your purpose very plain. If any of the manufacturers you are evidently attempting to "hold up," are going to pay you to discontinue your attacks, they have less gumption than I give them credit for. The success met with by some of the preparations you are antagonistic to, clearly proves that they have as many and perhaps more friends than you have, and your line of conduct is therefore liable to act as a boomerang." It would be more edifying if you were to give your readers something besides an exhibition of your personal disappointments and apparent personal chagrin over what is generally considered others' successes. On general principles you are a "knocker" and no serious minded man can listen to the "knocker's" little knocks, without developing deep at the fountain source of his moral being, a disgust and contempt for the "knocker." I think your little 'spiel" to do up your former friends, because they would not be "stood up " by you, is going to fail, or at least assist in making the WORLD a failure as a clean Medical Journal. Yours truly,

QUINCY A. HARVEY, M.D.

I examined the Standard Medical Directory for Dr. Harvey's street address and professional record, but his name was nowhere to be found, either in N. Y. City nor in Brooklyn. Not being listed among the practising physicians there, the thought occurs to me that he might be an employee of one of the medicin concerns in New York. If so, all right; it is certainly no discredit. But the point is, he does not seem to be a practising physician.

Now for his letter:

Brother Harvey, please point out to me one line or one word that I have written against any proprietary medicin, or against proprietary medicins in general, except to show what some of the acetanilid mixtures are, and I have done that from time to time for years. Haven't you been dreaming? Write us again when your dream is over. But you are not entirely alone. man (I suppose it is a man) in Detroit who declined to sign his name, has been dreaming the same kind of a dream. When he wakes up and reads THE WORLD in his waking hours, he will see, and see plainly, that it is the method of pushing certain proprietaries that I have opposed. That same feeling has been rankling in the breasts of medical journalists and a large part of the profession for years. It is time for it to come out. Our Detroit friend is

concerned by the disappearance of certain advertisements from THE WORLD. Do you remember certain articles in the "Talk" department last summer? Well, I suppose that's the reason that the advertisements disappeared when the contracts expired. I expected it. It doesn't worry me. The support of THE WORLD comes from the profession more than from the advertisements. However, I have always treated advertisers squarely, and I expect always to do so; but in so doing I am not going to neglect the interests and rights of the profession. Do you think I ought? And when it comes to a question of journalism, ought not a journal speak out? As a journalist I have interests to sustain, and those interests are the interests of the profession as well. The profession will (and does in this instance) sustain a journal that stands for the interests of the profession.

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I pay for and read every word in the Brief and Alk. Clinic as well as the WORLD. They are both weak in the same spot. One recommends Iodia, Ecthol, Respiton, Seng, Chionia, etc.; the other Calcalith, Salithia, Calcidin, Sanguiferin, etc. The first you condemn, the editor of the second sends you an eagle's feather as a token of friendship. A doctor can do first class work without these high priced medicins. I avoid them as much as possible, for I know that they will keep the average doctor poor. I like to see articles on turpentine, coal oil, salt, mustard, red pepper, hot water, etc., and many a fine article on these cheap and good things are appearing in the Brief and Clinic. They are worth the price, but the reader must be on his guard.

For Colic in horses, I rub one grain of morphin on the inner surface of the lower lip, or drop it in the cup shaped lip; repeat. If convenient, give a rectal injection of hot soap suds. For stoppage of water in horses, lay cloths over the kidneys, carefully pour hot water on these. The same plan is splendid with humans. FRANK POLLARD, M.D.

Albion, Cal.

Dr. Waugh is an old friend. He seems to be taking a well earned rest from hard work, for he spent the past winter on his house boat down the Mississippi. Dr. Abbott is the real man there now, and he and I have been having a frequent and most frank correspondence about this very thing. I have called his attention to his tendency mentioned above, and suggested that the Clinic be confined strictly to its special field, that of alkaloidal therapeutics, a large, growing, and strictly legitimate field, in which Dr. Abbott and his journal have done such heroic work.

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I endorse, I wonder what we should do for an exchange list if all but the really independent were supprest. Yours is about the only one I know of that I am confident is independent. W. S. BOGART. Cleves, Ohio.

Editor MEDICAL WORLD:-Allow me to congratulate you on the airing of Dr. J. J. Lawrence. This meets my most hearty approval. I can't tell you how well pleased I am. I more than congratulate you on the airing of the Comstock Collecting Agency. They did not get a red out of me. Doctor, such straightforward push as you have makes your journal appeal to every honest doctor in the land; and it comes to stay. I only wish you would open up on the druggists. They are the greatest enemy the doctor has. They are doing more practise over the counter in some of our cities than some of the doctors. Turn your guns loose on every trap you see set for the unthinking doctor. Yours always,

Houston, Ohio.

S. G. MARTT, M.D.

DR. C. F. TAYLOR, DEAR DOCTOR :—I received the March number of THE MEDICAL WORLD and read it with much pleasure and profit. I am taking several medical periodicals, but I believe I need THE WORLD also. I think this one number is worth the price of subscription. I admire the stand you take to help the physician, even tho your advertisers do not like it. THE WORLD does not remind me of Ayer's old almanac, with a few remedies for all the ills we are called upon to treat. I take one journal that has a large number of questions in each issue. I can give the main remedy given in the answer by the editor every time before I read his reply. For any form of stomach trouble it is seng, with the variations as combinations; for any form of disease of the urinary or sexual organs it's sanmetto; and so on thru a line of preparations of a certain few manufacturers, while the products of other manufacturers, just as reliable, are never or rarely, mentioned. These earmarks are also very visible in the articles written by a certain old Esculapius, while smoking his pipe after supper. inclose one dollar for which please send me THE WORLD. B. E. DAWSON, M.D.

Belton, Cass Co., Mo.

[Doctors, please show your WORLDS, particularly this issue and the March and April issues, to your medical friends who are not subscribers. They will do as Dr. Dawson has done, every one of them. You can thus double our list in the next few weeks. We extend a cordial welcome to new subscribers. We want to work for the entire medical profession.-ED.]

Glad you are banging away at the Brief. I admire GEO. W. HARGEST. your pluck. Brooklyn, N. Y.

Editor MEDICAL WORLD:-I am pleased that THE WORLD is not devoted to advertising and boosting proprietary medicins as the Brief is. We get nothing I never use any now but respiton, seng, neurilla, etc. stuff like that. I hear the Brief abused by doctors generally, on that account.

At our District Medical Association, held in San Antonio lately, I was glad to see united under one common brotherhood all schools, regardless of name. I think this is progress. L. V. WEATHERS, M.D. Bracken, Tex.

Editor MEDICAL WORLD:-You have a good, clean, up-to-date, readable journal, and I like it for what it is. I also like it for what it is not. It blows no man's horn, and peddles goods for no house. Chelsea, Mich. A. MCCOLGAN, M.D.

DEAR DOCTOR TAYLOR:-This year's copies of THE WORLD SO far beat 'em all. I have taken THE WORLD ever since it started, I think-anyhow, for twenty-four or twenty-five years-and I have got 'em all on file. Any doctor would be a fool that would stay with anything that long if it was not "the best that is." I cut out everything that is a coal tar derivativ from my

materia medica long years ago. I not only save $45 a year, but the whole expense. Dr. Lawrence still continues to send me his Brief almost every month. I never have ordered a copy. Keep at 'em. You are doing all kinds of good for the profession. Buffalo, N. Y. ELMORE PALMER.

[THE MEDICAL WORLD was establisht in 1883; so you could not have taken it longer than between twenty and twenty-one years. I am glad to greet so faithful a follower. Almost all of the profession, I venture, will think that you have done wrong to cut the coal tar derivativs out of your practise entirely. They undoubtedly have a field of usefulness, either wide or narrow, according to the experience and opinion of each individual practician.-ED.]

DEAR DOCTOR TAYLOR: - Inclosed please find carbon copy of letter sent to Dr. Kieffer. I trust that should the Doctor be guilty of knowingly contributing to the Brief, he will admit his wrong. I like your journal and your style of hitting in the right way and place. Vienna, Mo. O. N. SCHUDDE, M.D.

DR. A. R. KIEFFER, 4628 West Belle Pl., St. Louis, Mo. My Dear Doctor Kieffer :-I regret to notice on page 150, April number of THE MEDICAL WORLD that you have been one of the contributors to the Medical Brief. If such be the case, I trust it to have been thru some misrepresentation or error, as no medical man, especially one who is held in such high esteem and regard as you, would voluntarily commit himself to such action. Kindly let me hear from you regarding this accusation. With best wishes I beg to remain Yours fraternally, Vienna, Mo. O. N. SCHUDDE, M.D.

Editor MEDICAL WORLD:-I heartily endorse the expose you are making of J. J. Lawrence and his proprietary medicin almanac. I must admit that I was a subscriber to the Brief for a few years, but it finally became so brazen and arbitrary that I discarded it. The frequent "sample copies" that have come to me since have all been consigned to the waste basket. The letters from "Old Doc" are enuf to nauseate one who is acquainted with the game he is trying to work. The circulation of the Brief is confined largely to rural physicians who take but 2 or 3 journals, and are not posted on the old man's tactics. Go on with the good work, even to the end. I know other good and able men will come to your assistance thru other journals. High Hill, Mo. W. M. WHEELER, M.D.

DEAR DR. TAYLOR-I thank you very much for your fearless stand on all questions of professional rights and dignity. THE WORLD has done much in correcting abuses inside and outside the ranks, and it deserves the applause of all right-minded and wellmeaning physicians, who do not rely on some form of

deceit for a livelihood.

New York City.

P. M. WISE.

DEAR EDITOR:-Inc'osed please find $2 for subscription to WORLD, and pardon negligence, or rather pure carelessness. Have been using the analgesic given by Dr. Elderdice in March WORLD, with success and saving of money. It certainly makes one feel tired reading some socalled medical journals to have a proprietary mixture bob up in every line. I think if a person gets in the habit of using them, he loses all faculty of preparing his own, and ambition to do so. THE WORLD and its family are always welcome guests. C. L. FOUGHT, M.D. Erie, Mich.

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The Plain Truth about Seeking Health in the Southwest.

Editor MEDICAL WORLD:-For the past year I have been afflicted with tuberculosis and have been traveling from place to place in search of health. After twelve months' experience in the famous health resorts of the West, I am satisfied that it is sheer folly for physicians to send patients in the second stage of consumption away from the comforts of home and the association of those dear to them to die alone among strangers in a distant land. Unthinking physicians imagin that all that is necessary to effect a cure of this most loathsome disease is a change of climate and a strenuous out-of-door life, where the poor "lunger," far from competent medical attendance and good. wholesome food, and pure water, has to perform feats that would severely tax the strength of a strong man.

"Go out West. Get on a broncho and ride. thirty-five or forty miles a day, and inhale the pure air of the deserts, and climb mountains, and inflate that consolidated lung," says the knowing medico, who, if the truth were known, never saw a desert or rode a horse five miles in his life.

The poor deluded victim of so stupid a piece of assininity as was ever perpetrated by a biped, takes the advice of this member of our noble profession, and starts for the West. When he arrives at some city on the desert they are probably having a sand storm, and the "pure air" is about as transparent as a rubber blanket; but he is cheerfully informed by a veracious nativ that "this is an unusual season." He goes to a hotel, and is cooped up in a stuffy, poorly-ventilated room. probably contained the remains of another victim of some stupid donkey a few hours before, but that does not matter; for hasn't the bedding been hung out in the sun since noon? and a weak solution of formaldehyd has been sprinkled over the carpet.

that

He stays there a few days, while he is looking around for a suitable camping-place. He wonders why he does not get better; why his fever returns, and why he loses his appetite.

Soon getting alarmed, he consults a doctor, and is blandly told that his loss of flesh is due to "drying out." After parting with five dollars for this comforting piece of advice, he concludes that he can dry out much more satisfactorily under canvas, away from the crowd of consumptivs who sit on the verandas of the hotels, and cough and expectorate into the street, where it soon dries up and is whirled away in the clouds of dust that are constantly being blown around by the gusts of wind, that aid the garbage man and the thrifty housewife in the equalization of germs, so that one part

of the city cannot proudly claim that it is more infected than another.

He gets his tent, and then his troubles begin, for the city has decided that no more tents shall be erected within the city limits. The Solons of the City Council have come to the conclusion that tents are unsanitary and sources of infection; and besides, they hinder the sale of Deacon Blank's lots, and prevent his renting his houses. The Deacon knows the danger of infection, having had a lung put out of commission several years ago in the East, himself. One cannot blame him for not wanting invalids out of doors in tents when they could localize the infected areas by staying in houses.

After our victim gets his lot and pitches his tent, then another class of sharks attack him— the tradesmen. They charge double the price he has been accustomed to pay in the East; and while they ostracize him as an unclean person, it is a strange thing to see the recklessness they show when he has any money to spend. They are then perfectly fearless.

Now, this is a true picture of the conditions to be found in the West. Something ought to be done. People far advanced in consumption should never be sent away from home. Their cases are hopeless, and their friends should be told so.

People with limited means should never be sent out here, for there is nothing for them to do, and their scanty funds will soon melt away under the exorbitant charges of the philanthropists in this part of the world..

The climate, taken as a whole, is no better than can be found in many places on the Atlantic seaboard. Any advantages it may possess in the way of sunshine is offset by poor water, and dust, and sand storms; and then, homesickness comes in as a powerful factor. Take a person who has been accustomed to green fields, brooks, lakes, and woods, and put him on a bleak waste of sand, under a broiling sun that hangs overhead like a disk of burnisht copper, not a green thing in sight, and the effect will counterbalance any good he may get from being cremated.

I have written more than I intended, but I have taken THE WORLD for years, and have always noticed that you come out firmly for that which is just and merciful. You are in a position where you can do much to check this evil, and that is why I have written this letter.

Winterport, Me. O. S. ERSKINE, M.D. [The above letter comes from Tucson, Arizona.-ED.]

In April WORLD, page 148, first column, twenty-third line from the bottom, "3j every 3 hours" should be 3j every 3 hours. Please take a pencil and mark the

correction.

Treatment of Pulmonary Tuberculosis in

the Dispensary and in the Home. Editor MEDICAL WORLD:-So much is being written, both in medical and lay journals, on the subject of tuberculosis that the very word itself has become to many of us trite and nauseating. There is, however, one phase of the matter, and one class of patients, which have scarcely received any notice either by physicians or well-meaning non-professionals; I refer to the treatment in dispensaries and at homes of the working classes who are forced to remain in the cities. These people certainly make up a very large proportion of those afflicted, and from the fact that they are ignorant of the infectiv nature of the disease, become very important agents in its dissemination.

It is a common experience among those who have a chance to see how dispensary patients suffering with this disease are cared for, to find that they are buoyed up and kept going with creasote, guaiacol and general diffusible stimulants, without receiving very much hygienic or other advice beyond the use of drugs. This is no reproach upon the profession as a whole, because it is thought that tuberculosis is so uniformly fatal among those who cannot receive special treatment as carried out in sanitoria. This view is of course wholly sane; for one can scarcely hope to get results from drugs when these unfortunates are forced to live under such wretched unsanitary conditions, and at the same time struggle for their daily bread. As tuberculosis is studied more and more, however, in its sociological and medical aspects, the profession is coming to realize that something can be done to alleviate the suffering from and spread of the disease, even if that something seems merely tentativ and temporary. To this end there are at least two dispensaries in New York City that are doing excellent work; one is the Vanderbilt Clinic, the other the Post Graduate Hospital.

At the Post Graduate, Dr. T. F. Russell has been treating consumptivs for the past three years by the method of forced feeding, but owing to some misunderstanding in regard to an emulsion that he has prepared, is receiving support from a very minor portion of the profession. Here any patient is accepted in any stage of the disease, provided it is uncomplicated by tuberculous laryngitis, emphysema, or profuse hemorrhages, and provided also that he is not too poor to buy proper food and medicins. These patients sleep with the windows open in all weather, eat all they can at each meal, especially of milk and eggs, and are obliged to allow the lapse of five hours between meals. Free catharsis by castor oil and compound rhubarb pill insures the transmission of

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