thousand years into the future and see this organism in the bloom of youth, or a million years and see it in the vigor of manhood, it is doubtful whether we could comprehend our vision. Much less is it permitted to ordinary mortals to stand with Paul and catch a glimpse of the whole creation coming into oneness.

But a knowledge of this, the general direction of organic evolution, and even a hazy view of the goal of the human race, may teach us the true direction of our energies here and now. The processes of nature may be hastened; but forced growths are liable to early dissolution. Evolution of the race may be retarded; but with such effects as follow the damming of a mountain torrent. Whatever

our own likes and dislikes may have been, our place is to fall into line with the course of nature, to prepare the way for its resistless energy and to make its paths straight.

We are approaching a critical period in the world's history. The rapid organization of industry in the United States is accompanied by similar, tho slower, movements elsewhere. At the same time commerce is breaking down all barriers and taking forcible possession of the rest of the uncivilized world. Nothing can stop this centralizing of social energy. And when the Trust of Trusts has come, with a capital stock of ten thousand billions, based upon the wealth of the whole earth, what shall we do with it? This huge machine, which is being developt for the benefit of the few, and which will be for a little while a curse to the many, is to be made the servant of society. And whether the birth of the social organism will be attended with pain and convulsions of society, or will be as peaceful as the launching of a new-built ship into the sea, will depend upon the wisdom, the patience, and the energy of the people of this generation. "Not in vain the distance beacons. Forward, forward, let us range.

Let the great world spin forever down the ringing grooves of change.

For I doubt not thru the ages our increasing purpose

runs,

And the thots of men are widened with the process of the suns."

T. PROCTER HALL, Ph.D., M.D. Glen Ellyn, Ill.

Make It a Crime to Spread Syphilis. Editor MEDICAL WORLD:-Since Brother J. R. Cross, of Foster, Iowa (page 441), has raised the question of quarantine for syphilis, and as he has reported cases where the subjects seemed to be determined to spread the disease because of malice, it would seem to be a very difficult proposition to hold such a person in quarantine. Even then there would have to be an act of legislation before it could be carried out. It would seem that a much

better way would be to have an act of legislation making it a crime punishable by imprisonment. Then the law would have greater effect, and the victim would have revenge by law against the offender, and not by spite upon the innocent. There is certainly a demand for rigid measures along this line. We now have ample laws covering contagious diseases that have little or no comparison in the amount of destruction to the human race that syphilis has! It does not seem as tho it would require much agitation on the subject to bring this about. A. H. DOTY.

St. Paul, Minn.

The Comstock Concern under a New Name. Editor MEDICAL WORLD:About a year ago a "spruce" looking young man came into my office one evening and said he would like to collect some bad debts for me; that he, or his company, did not require any money until after it was collected. His company was the International Collecting (or Adjustment) Agency of Syracuse. He said he had made arrangements with several of the prominent men of the place to collect their bad bills, and among the number was my friend Dr. Deale. I was quite busy at the time, having several waiting, but I thought that if Dr. Deale had engaged, it would be safe for me to do so. The young man produced a contract signed by Dr. Deale, and again I thought that it was safe to do what my neighbor had done. I askt the young man if Dr. D. had read the contract before signing, and he said yes. Being in a hurry I again trusted my neighbor's judgment and signed the contract without reading it (fool-like to be sure), but stipulating that, as I was very busy, and would not be able to send in the required number of names within ten days, the contract should not be dated till I directed and sent in the names. To this the young man readily agreed and took his deparA few days later I received a letter, with a bundle of report blanks, saying that my contract dated September 1 (I think) was in full force, and that I should send in the names immediately. This made me open my eyes to the fact that if the contract was dated without my consent, I must be a dupe of some schemers, and I went around to see my friends who had also signed similar contracts. I found that none of them had read it, each depending upon the one before; and all had dated their contracts except one, Mr. McLachlan, who had agreed with the agent to abide by the terms that I had stipulated. Well after a time it transpired that there was a clause in the contract that unless the signer "lived up to his promises," i. e., to send in the names within ten days and again the names of all delinquents

ture.

each following fifteen days, and to pay to the agency the first $35 collected, he should forfeit or pay to the collecting agency $35. Of course no one could live up to those promises, and many times during the year each dupe has received threatening letters requiring the payment of the $35; and of course none paid it. The last of September '04, an attorney appeared and demanded settlement, saying that unless settlement was made he would sue each and all, in the village of Huntington, sixteen miles away from Babylon, thus making trouble for all. Fearing trouble all of the victims except myself and Mr. McLachlan settled up for sums varying from $9.50 to $14, Mr. McLachlan and myself preferring to fight rather than be swindled. Mr. McLachlan ordered the attorney out of his place, and was sued to appear in Huntington, sixteen miles away, on October 4. He and I took our attorney and went over to fight, but the plaintiff did not appear, and so the case, "Chas. Comstock vs. Jas. McLachlan," was dismist, and we have not heard of the International Adjustment Agency of Syracuse, N. Y., or of Chas. Comstock since. Those who settled are kicking themselves now.

I wonder if Chas. Comstock is the same as the Comstock Collecting Agency of Oswego, N. Y. What name will he come up under next? My attorney says the above agency is not known in Bradstreet's and has no rating. I would very much like to know when I can expect another slick collecting agent at my office, so that I can have my bull dog's teeth sharpened. You will say that had I kept my eye teeth sharpened I would not have had any trouble. Correct.

Babylon, Long Island. A. J. Woodruff. [It's the old story. It is getting almost funny, isn't it? I have been told that the International, of Syracuse, N. Y., was the old Comstock agency, or a branch of the same, operating under a new name, and from a new place. You see, Comstock has found the medical profession, and merchants in small places, such a "soft pudding" that he can't let it alone.

easiest to get a doctor to "bite" and these slick agents know it. If you haven't time to deliberately and carefully read any paper that you are askt to sign, tell the agent to leave it with you, and that you will consider it when at leisure, and that you will then sign and send by mail if you want the service. Of course he will offer excuses and reasons why it must be signed then, so that he can take it with him, but don't be moved from your position, and let him know that he is taking valuable time, not only from you, but from those who are waiting for your service. Also, never sign a paper and let it go from your hands unless you hold a duplicate, to which you can refer at any time for the terms of the agreement.—ED.]

Pneumonia.

Editor MEDICAL WORLD:-On page 439, October WORLD, Van Horne says mustard will not supersede fly blister. If he will try one part of mustard to six or more parts of flour in plaster, applied every night and morning and kept on all the time, I think he will be satisfied with the effects produced. I have been using it in this way for years. Do not use purgativs; think medicins act better without. Use sedativs, aconite mostly. No opiates in any form. Acetanilid if fever is high; one dose of seven grains daily in afternoon or evening. Fever almost invariably abates third or fourth day, resolution taking place promptly. pneumonia is complicated with malarial fever, quinin should be given. Epsom salts, in early morning, in teaspoonful doses, and perhaps a blister will be necessary, if the case be protracted for some days.

Blythewood, S. C.

When

J. D. F. LEVER, M.D.

The Motor Cycle.

Editor MEDICAL WORLD:-In reply to E. M. Brundage, in October WORLD, regarding the motor cycle, I would say, yes it is a practical machine, for physicians, under favorable conditions. I got one last April, and tho we have had an exceptionally wet season for our country, I've ridden it about 2,000 miles, and had to be "hauled in " only once. This was in the night, when I could not see to fix the compression valve, which had stuck. I can make twenty to thirty miles an hour and go on roads that are not as smooth as pavement. It does not tire me as much as riding in the buggy, for I'm not on the road as long. With it I can cover my rounds quicker and be ready for the next case.

The expense of operating is small, and it is easier to manage than an automobile, costs less and is not as bad in scaring horses. I find I can carry my alkaloids in my pocket case, and

Obstetrics in the Country.

Editor MEDICAL WORLD:-In the September WORLD, page 405, Dr. Griswold asks for replies to four questions pertaining to obstetrical practise, and since he desires replies from country practicians, I will relate my method of procedure.

Query No. 1. Antiseptic precautions in examination (vaginal).

Every antiseptic precaution should be taken. What would you think of a surgeon proceeding with a laparotomy without thoroly disinfecting his hands? It is just as much of a criminal negligence to make a vaginal examination, during confinement, with dirty hands, and the results are liable to be just as disastrous. Remove coat and cuffs; roll sleeves above elbows; then scrub hands thoroly with hot water and soap (I use McClintock's germicidal soap), after which thoroly clean finger nails. Secure a clean basin or bowl and prepare a strong bichlorid solution. Wash hands thoroly in this solution and proceed with the examination. Do not anoint your fingers with vaseline. The vaseline bottle, as usually carried in the Doctor's obstetrical bag, is loaded with germs, and has been the cause of many a post partum infection. A lubricant is not necessary; simply wet fingers in the bichlorid solution.

Query No. 2. Is antiseptic cleansing of the genitals by the physician the rule?

It ought to be the rule in every case where the patient has not attended to it herself. While disinfecting your hands, if there is a lady in attendance, have her wash the genitalia with a germicidal soap solution or a bichlorid solution. Then take a clean pad or cloth, wring it out of a hot bichlorid solution, place it over the genitalia and remove it only while making examinations. If there is not a lady present competent to carry out this procedure, do it yourself.

Query No. 3. Is the Kelly rubber pad used, or not?

I have seldom used the Kelly pad. I usually have them prepare the bed in the following way: "The mattress should be covered with a large piece of rubber sheeting; over this the sheet is spread; a second piece of rubber

sheeting covers this; and over this is placed a draw-sheet-a sheet folded a number of times on itself, on which the woman is confined." Usually, however, we have to be satisfied with one rubber sheet. If a rubber sheet has not been provided, there is usually an oil cloth on the kitchen table which can be utilized, after the application of soap and water.

Query No. 4. When forceps are used, or when turning child, do you trust the ordinary nurse or attendant to administer the chloroform?

In high forceps delivery, or in version where the water has drained away some time previous and the uterus is in tetanic spasms around fetus, we try our utmost to secure the assistance of another physician. In the ordinary cases of instrumental delivery, where the head is low, or in cases of version where the presenting parts have not become wedged in the pelvis, we rely on ourselves. I usually apply the instruments first, then administer the chloroform myself. When the patient is well under the influence of the anesthetic I proceed to make traction, and delivery is often completed before patient returns to consciousness. In cases where delivery is more prolonged, it may be necessary to have one of the ordinary attendants administer the anesthetic under one's personal direction.

Many

It is often difficult to secure asepsis in our obstetrical work. It is no uncommon thing to find a woman in labor lying on an old feather bed, old discarded quilts and rugs, or even horse blankets. I believe over half of our country patients know nothing of asepsis, and realize no danger from such a source. physicians are timid about assuming authority and insisting on the bed as well as the patient being properly prepared. They fear they will lose the patient's good will and patronage. This is a mistake; they will think more of you and have more respect for you if you insist on things being done right. What are we here for if not to educate our patients along these lines? Hundreds of women die every year from sepsis, due to the doctor's negligence. Because we are called to attend a case of confinement where domestic and personal cleanliness is below the normal standard is no reason why we should neglect the patient. Teach them the necessity of cleanliness and the therapeutic efficiency of soap and water, and mortality by sepsis will be reduced. Minnesota.

C. L. S.

Peroxid of hydrogen dropt in the ear will speedily dissolve and cause extrusion of hardened wax. Never attempt to pick this wax from the wall of the meatus with a spud; you will be almost certain to scrape off some of the diseased cuticle, and cause a sore which will seldom heal kindly.

Treatment of Dysentery. Editor MEDICAL WORLD:-In answer to "Dysentery," in the October WORLD, I note that the Doctor has never found a satisfactory treatment for this dreadful malady.

Believing that certain elements of the classical treatment as "Salts to open, and opium to close" are in a sense antagonistic to true physiological repair, I beg to submit the following: before taking up the subject of therapy, let us first consider at least a few of the pathological conditions to be overcome.

The physician is met at the bedside by a toxic invasion of the alimentary tract which if opened and spread over the surface of the body would appear most stupendous.

From this vast surface, bacteria are multiplying and the elaboration of toxins goes on unmolestedly except in so far as nature is enabled by the process of osmosis to flush out the tube at varying and irregular intervals.

Coupled with this, nature's mechanical method of meeting the difficulty, comes the natural antiseptic principles of the blood rein forced by whatever number of leucocytes are able to survive the scalding acid condition of the media in which they properly functionate. By reason of the failure of these means to conquer the bacilli, reinforcements of leucocytes are called; and to accomplish this the blood is drawn from the surface to the interior, filling every available capillary in the intestinal wall with hordes of willing workers. As a result of this loss of circulatory equilibrium the surface of the body becomes cold, and is often covered with a clammy cadaverous sweat.

It is here that opium closes the door, elimination is cut off, the bacteria multiply more rapidly than nature can destroy them, and death ensues.

The rational treatment, it seems, is to eliminate, as far as possible, the source of the toxemia; to disinfect the bowels; to stimulate leucocytosis; to restore the alkalinity of the blood; to equalize the circulation, and to nourish the patient.

To accomplish these ends, begin by giving minute doses of calomel, followed by a mild saline, thereby flushing out adherent mucus and removing bacteria en masse. As an intestinal antiseptic the sulfocarbolates of zinc, lime and soda should be given in from 5 to 10 grain doses, every one, two or three hours as indicated.

Test the saliva with litmus, and if acid in reaction begin the free use of lithia until the normal reaction is obtained. Nuclein should be given from the start, either in tablet form or in solution; but in advanced cases it is better injected direct into the blood stream.

After a few hours of this treatment, fever

usually subsides and the use of aconite and similar agents are seldom required. The visceral engorgement should not be overlookt. Hyperemia being the presence of too much blood in a given part, must necessarily mean a diminisht amount elsewhere; and therefore an abnormal distribution of the original volume.

It is here that atropin acts with that dependable precision of the alkaloids, driving out the blood from the engorged vessels of the interior back to the flabby, paretic vessels of the surface.

It is a beautiful demonstration of modern therapy to see the color returning to the face, and a feeling of warmth flow gently back to the trunk and extremities in this stage of the disease. With strychnin to tone up the blood vessel walls, the normal equilibrium is maintained.

As to diet, those foods which furnish the greatest nourishment and leave the least ashes behind are of course best, and of these albumin water, perhaps, stands at the head. In cases of absolute loss of absorption in the alimentary tract, inunctions of oliv oil are valuable, while in desperate cases the subcutaneous injection of this agent will often tide the patient safely out of the breakers and into the port.

Hygienic measures are too well understood to need consideration here.

Anodynes are often necessary, of which opium in some form is best.

In cases of infants and children, Waugh's anodyne acts most beautifully, and in lieu of the old paregoric bottle, leaves little to be desired. R. G. HENDRICKS.

Rosston, Indiana,

Treatment of Dysentery.

Editor MEDICAL WORLD:-I notice in the Quiz Department in October WORLD, which arrived an hour ago, a question by Dr. Daniel in far away Arkansas which appeals to me, who am just now in an epidemic of dysentery. The disease here corresponds with that described by Osler as "acute catarrhal" dysentery with rather sudden onset, fluid stools, at first of feces differing little except in fluidity from normal, but soon accompanied by the characteristic tenesmus and changing to bloody mucus or pure blood. Stools are frequent. I have been called in where patients said they went every ten minutes." There is little or no fever, and the pulse is seldom much disturbed. The course is from a week to ten days. I mention these points because I have a lingering doubt whether Dr. Daniel may have amoebic cases on his hands, which would offer difficulties in which I have no experience.

Mix the tinctures and aromatic acid with the syrup first and add to the MgSO, solution. If you put the tinctures in the salts solution you are liable to get a precipitate of MgSO, at once, as the alcohol seems to subtract water from its combination with the salt. The solution finally will not be clear, but the various insolubilities will be tolerably well suspended. I dispense this mixture with the further addition of the salts solution, one part of the acid mixture with three of salts solution, and direct it to be taken in doses of a tablespoonful after each movement and at least once in two hours, at first anyway.

If I am called early enuf I give the salts solution alone in half ounce doses. I cannot claim to abort the course of the disease, but my patients like (!!!) the mixture with sugar and observe a reduction in the frequency of the stools and great improvement in comfort within less than half a day. It takes about a quart of the diluted mixture to carry a case thru, and I seldom give anything else unless the pain at first calls for a hypodermic of morphin and atropin in appropriate dose. As the case improves, doses are at longer intervals.

Some cases get out in four or five days, but I order bed rigidly, and expect to have them stay there a week, and tell them so. Then if they get well quicker they are so much the better off and so am I.

I

The cold weather current just now, together with indiscretions in fruit, etc., are to my mind responsible for the present little epidemic. have so far had no fatal cases among either adults or children. The number of cases is, however, not large in the aggregate-about twenty at most, scattered along three weeks' time.

I owe the suggestion of these remedies to Hare's Therapeutics, first edition.

May this or something better help somebody out of difficulties.

I cannot refrain from saying I wish I had known as much about the Comstock Agency six or seven years ago as THE WORLD has recently revealed.

And the unspeakable Brief! "Soc et tuum," "wictch is Latin," as Josh Billings used to say. E Douglas, Mass. PAUL F. ELA, M.D.

(Harvard, '94-)

Potassium Chlorate in Recurrent Abortion. Editor MEDICAL WORLD:-On page 275, July WORLD, chlorate of potash is recommended in 10 gr. doses, t. i. d., for recurrent abortion. Moreover, it is suggested to continue the powerful and sometimes dangerous salt from the third month until the end of gestation. As this would amount to over 5,000 grains in the course of six months, I should fear injury to the fetus if not to the kidneys of the mother. It is eliminated by these latter organs, after being absorbed into the blood, and I have read of smaller doses doing much harm to the kidneys.

Prior to the advent of gynecology we made use of placebos and possibly an opiate, with Those were complete rest, with much success. possibly cases of habit, and to that extent I believe in maternal impressions.

I shall be glad to learn the rationale of chlorate of potash in such cases. San Diego, Cal. C. M. FENN, M.D.

In September WORLD, page 381, Dr. Ira Puderbaugh, of Ozawkie, Kan., under heading, "Was Malaria Transmitted to the Child in Utero?" asks two questions which I shall try to answer, after relating an experience.

In the fall of 1892, while practising in Bangor, Cal., this county, I was called to see an infant about one week old that had had a chill, followed by high fever every day, in the afternoon, since its birth. While I was present the child turned from the mother's breast and began vomiting milk tinged with bile; and as the child continued to vomit, the proportion of the bile increast until it was apparently all bile. I was told this was a daily occurrence. The mother had been having chills and fever for some time before her confinement and continued for some time after.

I gave the mother quinin in good sized doses, and the child quinin by inunction, but death relieved the little sufferer about the third or fourth day after I first saw it; the mother recovered and afterward moved out of the neighborhood. By way of explanation will add that during that fall most everyone in that community, doctor included, had chills and fever.

Dr. P. does not say whether or not the mother had had quinin in large or small doses prior to her premature delivery, but the answer to his first question, viz.: "Did the