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I wonder if this dean sees the point? If you do not subscribe to the trust you are not high-class-in their estimation. But you are true to the principles on which this Government was founded. You are an American without notions borrowed from effete monarchies which have all kinds of tyrannical laws and more quacks (?) than we have. Education is a necessary element of success, and the physician who would succeed is not going to handicap himself by neglecting his own. And in America all our institutions of learning should be open to everybody without any previous political red tape or extortion. If you would purify and elevate the profession eliminate the medico-political dictator and give them liberty.

[Written for the MEDICAL BRIEF.] How Medical Law is Used in Washington.

BY J. W. LOCKHART, M. D.,

St. John, Washington.

We have here in Washington the most despotic medical law that was ever conceived within the brain of bigots or tyrants. This law makes each separate act of practice a crime, punishable with a fine of not less than fifty dollars, or imprisonment of not less than three months, or both fine and imprisonment. So it is easy to see that the penalty for illegally practicing medicine in this State might, in some cases, amount to life imprisonment and total confiscation of property. The law has, however, one good quality. Its penalties are so severe, so entirely devoid of honor and justice, that there can be found but few Torquemadas in the profession who care to have it enforced. This law, like all medical laws, is more honorel in the breech than by its enforcement. That these laws exist for no other purpose than to limit competition in the practice of medicine, is now an undisputed fact. I have never known the aid of one of these laws to be invoked in any way for the protection of the general public. The fact is, that the more successful is the unlicensed practitioner the sooner will the law be enforced against him; and that, not by the public, but by some disgruntled licensed doctor who is losing his practice.

Nearly three years ago I found that it would be necessary for me to give up the larger part of my practice. I had suffered severely from nervous prostration, the result of trying for more than two years to do two men's work. One day a young man of good personal appearance came to my office and explained that he was looking for a location in which to practice medicine. Said he had graduated from a medical college in San Francisco, had passed the California State board examination and practiced two years. He had not passed the examination in this State, but thought he could easily do so at the next meeting of the board. I said, "Doctor, if you will treat me and my friends on the square and prove to be the man that every physician should be, you need look no further for a location that will give you more than a good living. I will give you a hundred dollars or more of practice every month and you are welcome to all you can get beside. The offer was accepted. The doctor proved to be honorable and successful in practice. gradually gave up most of my practice to him. He tried hard three successive times to pass the State board examination, but for some unaccountable reason, failed. Then came an evil day. He was called, over the phone, to see a patient for whom another physician had prescribed a few days before. The doctor was not informed that another physician had been called, and was, therefore, perfectly innocent of any intention of trespassing on professional preserves. However, some ugly stories got afloat about the case, and the offended doctor peremptorily notified my friend that he must immediately give up his practice or be prosecuted to the full extent of the law. I advised my friend that unless he was able to carry the case to the Supreme Court of the United States, discretion would be the better part of valor, and that he had best give up his practice until duly licensed. The doctor left here with the sympathy and best wishes of the entire community.

I

This case speaks for itself and needs no comment. This case shows plainly the practical working of medical laws. The general public here denounce the law and express indignation at its enforcement.

The question is, how long will the medical profession belittle itself by standing sponsor for such destruction of human right? Have individuals no right to choose their own medical advisers? I know of licensed doctors in this State who could not practice medicine if they had a car load of licenses, for the obvious reason that people will resort to patent medicine, self-prescribing, etc., or die without a doctor before they would employ some of these licensed incompetents. The Supreme Court of the United States has recently decided that the eight and ten hour labor laws of the several States is unconstitutional, because they infringe the right of individuals to contract for any number of hours they may deem proper. The right of contract is held to be a sacred, inalienable right of individuals; that State legislatures may not infringe or abridge. If the same principle of law applies to professional labor, it would seem that an individual might contract with whom he pleased to give him medical advice or assistance. I understand the court to mean that "the right to contract for anything that is right and honorable is, now and forever, beyond the scope of State police regulation." If that is correct, Liberty has won the greatest victory of the century. If not, the battle must yet be fought.

The Supreme Court has more than once decided that any law "enacted for the promotion of the public health or morals must bear a real and substantial relation thereto," or it is unconstitutional.

[Written for the MEDICAL BRIEF.] How to Keep Bright, Clean Instruments.

BY C. D. R. KIRK, M. D., Shuqualak, Miss.

I perform a good many minor surgical operations and extract a great many teeth, and after having tried various methods for keeping instruments bright and clean, I have found that a good article of kerosene oil and a woolen cloth is the quickest, best way to clean instruments and keep them bright and ready.

Kerosene oil will dissolve blood in a second and remove it with only a little rubbing. It is superior to any chemical for cleaning wood or metal. It shows no stain on the sponge or cloth used, therefore the chemical constituents are dissolved and changed. It also prevents rust or tarnish, and I think it is a most excellent disinfectant. Try it.

[Written for the MEDICAL BRIEF.] Irritable Bladder in the Female.

BY W. B. WOOD, M. D., Los Angeles, Cal.

There are few diseases so common and at the same time so stubborn and difficult to treat as an irritable bladder in the female. There are many causes for this trouble. Some of which are malignant growths, tumors, stone in the bladder, pregnancy, uterine displacements and reflex irritation from some rectal disease. If, upon close examination, none of the above causes are found, its origin must be of a neurotic character. Some of the symptoms are pain, a feeling of weight and uneasiness in the region of the bladder, constant desire to urinate, voiding only a few drops at a time, accompanied by most excruciating burning pain and straining.

Treatment. First correct the torpidity of the liver by giving broken doses of calomel and soda, followed in a few hours by citrate of magnesia. To allay the nervousness, fever, and to a certain extent, the pain, give elixir acetanilid*, teaspoon. ful every two hours; also,

R Specific Tr. Elaterium...

Sulph. Atropia..
Mucil. Acacia.

Aquæ Dest......q. s....

2 drachms. grain. ounce.

ounces.

M. Sig.: Teaspoonful every three hours. This dose can be increased until the pupil becomes dilated and mouth dry, then give smaller doses. Locally, use hot hops, or cloths wrung out of hot water and turpentine. Recumbent position and perfect rest.

This is my favorite.

*Elix. acetanilid is made by dissolving two and one-half grains of powdered acetanilid to the drachm of simple elixir, with just enough of alcohol to hold it in solution.

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[Written for the MEDICAL BRIEF.]

Sabbatia Angularis.

BY J. A. BURNETT, M. D., Cecil, Ark.

All physicians who practice in malarial districts should give sabbatia angularis a trial, as it is a very useful remedy in most all forms of malaria. According to my experience here, within two miles of the Arkansas River in a malarial district, sabbatia angularis is a more reliable antiperiodic than quinine, and the most useful remedy we have in the treatment of malaria-that is, it will meet more conditions, and come nearer curing all forms of malaria without the aid of another rem. edy than any drug in the materia medica. It will prevent a chill when given in doses of ten or fifteen drops of the fluid extract every hour, for six doses, beginning so that the last dose will come one or two hours before the chill is due. At other times it should be given in half drachm doses every three hours. The anti-periodic action of sabbatia angularis is increased when combined with sweet flagcalamus or when combined with capsicum.

When the pulse is weak, or much stimulation is needed, it should always be combined with capsicum. Sabbatia angularis will clean a coated tongue, and stimulate the liver. If the liver is very torpid, and the tongue heavily coated, it should be combined with chionanthus, which will greatly increase its usefulness in this condition.

Sabbatia angularis is not only a useful remedy in malaria, but in various other conditions. It is a valuable nervine, and will sustain the nervous system. In general debility and summer complaint of children it is often a valuable remedy to sustain the vital force, stimulate the liver, and to regulate the digestive system.

Often nux vomica will be a useful remedy to use in combination with sabbatia angularis in such conditions. Sabbatia angularis is well received by the stomach if the stomach is in condition to receive any remedy. It is a stomachic, and useful in chronic dyspepsia, when there is lack of tone in the stomach. A warm infusion will promote the menstrual flow

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For years in autopsies I had noted ureters dilated in certain shapes from different causes. However, one form of ureteral dilatation arose with a certain frequency. I have termed it the swanshaped dilatation of the ureter. It consists in the ureteral pelvis assuming a dilatation in the form of a swan, as may be observed in the accompanying figure, No. 1. The explanation of the dilatation is that in certain kidneys the neck of the ureter lies in a groove in the distal renal pole, firmly bound by connective tissue. The renal groove and firm encasing of connective tissue enables the ureteral neck to withstand more dilating force than the ureteral pelvis, which gradually becomes more and more expanded. So far I am not aware of the present explan. ation being elsewhere presented, and it is original with me.

In the accompanying figure of a swan's neck dilatation of the ureter, it appears that the etiology was ureteral valves (V). Perhaps the prostatic hypertrophy (L), and especially the hypertrophy of the middle lobe of the prostate (T) enhanced the ureteral dilatation. The bladder presented extensive hypertrophy and vesical calculus at V.

SWAN'S SHAPE DILATATION OF URETER.

drawn Fig 1.-This illustration was with extreme care from a specimen which I secured at an autopsy through the courtesy of Prof. W. A. Evans. 1. Calyces; 2, dilated (swan shaped) pelvis; 3, ure

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