[Written for the MEDICAL BRIEF.] Post-Graduate Course.-More valuable than some favorite prescriptions. A duty the doctor owes himself and his patron is a two or three months' course in some clinical or post-graduate school within every three years. He will improve physically and mentally. He will return to work with renewed vim and vigor. His knowledge will be newer and vaster. Upon his return he will find business better than when he left. He will be spoken of as an up-to-date physician, a thing of which the American people pride themselves. To leave a good practice under the above conditions is not to lose it. I write from personal experience, having taken three such courses in a limited practice of only six years. Improve yourself, and your business will improve with you.-A. B. Middleton, M. D., Pontiac, Ill.

Repeat the applications of alcohol and the ointment as often as the skin is dry until fever is under control. One bath or hot water rubbing daily will suffice, but watch carefully, and apply the other as often as dry. Good results have been obtained frequently from the above by me. -Luke Robinson, M. D., Covington, Ga.

a

[Written for the MEDICAL BRIEF.] Scalp Wound. Some time ago I was called to see a case in the country. I found a boy with half his scalp torn away. I examined for fracture, etc., and finding none sewed the wound up. A week later I was called and found anterior branch of temporal artery bleeding. Dr. country doctor, had been there, and said nothing could be done but bathe parts in cold water, or send to town for two doctors to do an operation. When I arrived, patient was too weak to take chloroform, so I took a cork and placed it over temporal artery, in front of ear, and passed strip of adhesive plaster over top of head and under chin. This stopped the hemor

[Written for the MEDICAL BRIEF.] Collections. To most practitioners, collections is a matter of vital importance. Try this: When called to a case where pay is doubtful, make one call, and when called again, get your fee for the first call before making the account larger. Make obstetric cases cash unless you know the money will be forthcoming. Collect your bills regularly as other business men do. It is your money for which you ask your debtor. It is not nearly so great an infringement on your professional dignity to ask for your fee, or to collect by law, if necessary, as it is to run into debt.-A. W. Stiles, M. D., Apalachin, N. Y.

[Written for the MEDICAL BRIEF.] Beechwood Creosote. The intelligent use of beechwood creosote by the profession for the treatment of tubercular and pyemic conditions, should receive more consideration.

I believe the prejudice existing against the use of this most valuable and timeworn remedy is chiefly due to its administration in small doses, and the consequent negative results.

It has not been my privilege to treat a greater number of consumptives than fall to the lot of the ordinary, but marvelous results have come under my observation. Be sure and get a pure article, and then give the patient the benefit of therapeutic doses.

Ordinarily, I start them on five-drop doses three times a day, increasing five drops a dose, until thirty drops are given each dose. No sense of discomfort fol lows, as a rule, a sense of warmth being the only symptom noticeable. Where a stomach is weak and irritable, the doses must be increased gradually.

I have given sixty drops three times a day without discomfort to the patient, and noticed marked improvement. A colleague of mine found it necessary to increase his doses to one hundred and ten drops three times a day to a case of tubercle, after which improvement took

place, and the patient soon got up and about as usual.

I combine five minims of ol. peppermint with each drachm of pure creosote, and administer in gelatin capsules. Have the nurse fill the capsules with the proper dose, which can easily be done with a medicine dropper. Each dose should be followed by a small quantity of wine, spirits, or milk.-C. R. Sanderson, M. D., Waynesville, Ill.

[Written for the MEDICAL BRIEF.]

Chronic Gonorrhea.-J. S. called to see me, September 16, 1903, suffering with chronic gonorrhea. I at once ordered him kali bromide, ten grains to the dose, repeated every five hours, to overcome any chordee that might arise. He reported to me three days later, and I commenced irrigation of the urethra, with a solution of kali permanganate, one grain to each ounce of water. I continued this mode of treatment every night for three weeks, the fourth week irrigating every other night. At the end of the fourth week the discharge had disappeared, and I pronounced the case cured. It is now over one year, and there has been no return of the disease.-J. C. Tanner, M. D., Hartford, Conn.

The

[Written for the MEDICAL BRIEF.] A "Rung Shell' Case.-Was called to a case of gunshot wound of abdomen. charge entered below navel, and to left of median line, point of entrance being perfectly round. Load was found in lumbar region, the shot in solid clump, with one wad in front and two behind it removed. What was the explanation to finding? Patient was shot with rung shell, one rung with knife between powder and shot. Where was the shell? Nobody knew.

After temperature became septic, track was opened, and shell found two and onehalf inches from site of load, between abdominal muscles and parietal peritoneum. Patient suffered on account of my ignorance of a rung shell. A rung shell shoots beyond the gun's range, shell, wad, and shot keeping together, same as rifle ball. All such wounds demand immediate interference and operation.-L. M. Winn, M. D., Clayton, Ala.

or conditions of interest or importance within the domain of medical science which may have attracted the attention of physicians, fever has at all times been viewed as presenting the most extensive and inviting field for observation and exercise of ingenuity. It is in this department that observation and research have been most industrious in accumulating materials, and that hypothesis has luxuriated in her wildest exuberance. It is considered that the destroying angel has made its most devastating visitations under the form of febrile epidemics, and in the long list of human maladies fever occurs to a greater or less extent in the majority of the subjects we are called upon to treat.

The great importance of this subject is strongly forced upon our considerations from a retrospective glance of the history of our science. We are forced to acknowledge that there is, perhaps, no subject which is more eminently calculated to humble the pride of human reason than this one. In relation to this subject, pathology has been in a continued state of revolution and unstability. Theories have been advanced in a continued and rapid series of succession, and dreams of speculation have vanished; the glory of her empire has gone by, and the genius of rational reason is now the only power under whose direction science presses forward to battle in this conquest of knowledge.

The human system is continually under the influence of causes which have a tendency to intercept and terminate its action. Life would be short in its duration, and harassed by constant disease if the animal organization were not endowed with the inherent power of resisting to a degree the influence of injurious causes. It is by the aid of this vital resistance that man is enabled to live through a long series of years amidst a multiplicity of causes which conspire unceasingly to his destruction. In relation to the degree in which this power of resisting injuries is possessed by different individuals, there exists a great diversity. Thus a wound by a needle or a rusty nail will in one individual cause great pain and constitutional irritation, in another syncope, in a third tetanus, in a fourth scarcely any

perceptible disturbance; hence the various degrees of constitutional or natural predisposition to fever. That the derangement of the nervous system constitute the initial link in the chain of morbid actions which occur in the development of fever, there can be no doubt.

Admitting that the nervous system and the lack of the power of resistance are factors largely connected with all diseases attended with elevation of temperature, it is of great importance that the two conditions spoken of be well attended to, with those who present themselves to the physician for advice and treatment.

Please find enclosed two dollars to pay for the MEDICAL BRIEF for two years. I have learned to like the BRIEF exceedingly well.-CHAS. A. DAY, M. D., Boston, Mass.

[Written for the MEDICAL BRIEF.] Diet and Destiny.

BY SAMUEL S. WALLIAN, A. M., M. D., Editor "Dietetic and Hygienic Gazette," New York.

The food of a nation fixes its rank and standing among other nations.

The diet of the individual determines his character, his ambitions, and his destiny. It measures his mental, moral and physical growth and development. It predisposes him to health, or dooms him to disease, the quality and nature of the food controlling the particular variety of the malady, idiosyncrasy or diathesis.

The infant sucks his constitution, temperament and tendencies from his mother's breast, when that normal and noble fount is not superseded by a disgusting rubber nipple and a never-clean nursing bottle of skimmed or scalded milk. The adult buys his, at two hundred and fifty per cent profit, from his adulterating grocer, the insatiate beef trust, or his alum-and-plaster-and-chalk baker.

Diet either invites or repels invasionthe infections. It either induces or prevents the inroads of the dyscrasia-tuberculosis, carcinoma, gout, rheumatism and the dermatoses.

Diet constitutes the right, left, center, and reserve corps in every battle with dis

The stomach has been proclaimed the citadel of life, but man breathes before he eats, and could not assimilate an ounce of either solid or liquid food, if he did not first appropriate a requisite and adequate supply of æriform food-oxygen. ΤΟ maintain an approximate equilibrium between the intake of air and the ingestion of aliment is a fundamental law of physiology.

Nutrition is not the result of a series of chemical reactions, but occurs as a sequence of intricate vital transformations which we can neither understand nor describe, except by tagging them with a Greek title-Metabolism.

All the wasting diseases are inevitable sequences of faulty metabolism, and faulty metabolism is but another name for some phase of inanition, innutrition-starvation.

There is nowhere a dearth of food, but everywhere a surplus, for these are the days of bountiful harvests and universal over-feeding. Therefore, in every lapse from health, either some essential elements have been lacking in the food, or the equilibrium between alimentation and respiration has been ignored or destroyed. It is oftener poor food than impure food that underlies the health-lapse.

Wherein lies the fault?

We have not far to look. This is a generation of starch-eaters.

Too many sanitarians and dietarians have lost their bearings by accepting the physiologic vagary that starch is synonymous with stamina. There could be no more serious dietetic blunder. Starch builds an inferior and effeminate quality of either brain or brawn.

What is baker's bread? Degenerate starch. What are morning rolls? The same starch, with a little more crust,

served hot. What is pastry? Starch, undergoing fatty degeneration. What is cake? Starch, sweetened, egged and superfatted. What is macaroni? Soggy starch, drawn into cylinders, and dried. What are ordinary crackers? Starch that has been robbed of every trace of its redeeming gluten-beaten, shortened and baked. What is rice? As used in polite and refined America, pure starch; as used by the hardy Japs and heathen Chinee, an excellent proteid food, capable, with slight additions, of sustaining life indefinitely and well.

Diet will determine the ultimate outcome of the pending Russo-Japanese war. 509 Fifth Avenue.

Without sycophantism, I am a friend of the Editor of the BRIEF and like the journal. I admire the editorials; they have the right ring. Bow not to any man; treat all manly, which I believe you do. Success to the BRIEF.-L. A. SMITH, M. D., Topaz, Mo.

[Written for the MEDICAL BRIEF.] What is Suggestion?

BY A. A. LINDSAY, M. D., Principal St. Louis College of Suggestion. St. Louis.

Suggestion used scientifically in moral culture is a most efficient agent. A youth eighteen years old applied at my institution in San Francisco to become a subject upon whom I could demonstrate in teaching psychology. His thoroughly disreputable appearance made me hesitate at first, for he was foul without and within, but I decided after discovering most profound degeneracy of character that i would be an excellent opportunity to learn if the last spark of good ever does die out of the human soul. Every class of bad habits mentionable and otherwis? was fixed upon him, including dissipation in alcoholism, tobacco, gambling, lying and idleness.

I developed him as an hypnotic subject upon whom I could demonstrate every phase of physical suggestibility, such as removing the sense of pain, producing catalepsy and also show the various

con

phenomena in hallucinations. I began with treating him by first at each sitting talking to him about the unprofitableness of dissipations of various kinds. He even smiled in his hypnotic state when I began to talk of better things than he was doing. I determined that a general reformation could not be produced in him suddenly and that I would have to take up his offenses, item at a time. I saw that his incessant associations that were nected with his gambling had more to do with his catalogue of habits than any other individual situation. I conversed with him while in the hypnotic state, and when he told me how much loss there was in his practice I began the insinuation that with perpetual losses which he would always meet with he would begin to consider the matter of giving up the thing. At following sittings he would tell me he was disgusted at being cheated all the time. Feeling my way cautiously not to give a suggestion that would cause him to never return, I pressed the losing phase of gambling until he had a desire to quit, but hardly strong enough to not go and try once more. I had demonstrated so often that he would respond to every physical suggestion, I gave him the suggestion that he would not be able to pick up the card and if he should manipulate it into his hand he would close his fingers down so tightly he could not let go of the card. At his next visit he had much feeling toward his companions, for he said they kicked him out because they thought he was making fun of them acting like his fingers were all thumbs. He did not remember my suggestions at all. He becoming unfitted for his old companions was a great help, for they wanted no one not congenial, and he did not like them either after their treatment when he had bought the poker chips and was not permitted to play. I strengthened at each treatment the suggestions against gambling, then began upon the drinking. He found suddenly that all liquors had become nauseous to him (according to my suggestion) and as he had heard me teach that habits and desires were controllable by suggestions given in the hypnotic state he asked me to treat him so he could drink steam beer, for he said he wanted