all respects most fitted for the task before us. Though these facts are familiar to every one, they have not yet been practically utilized in the prophylaxis of plague. Random researches in distant lands will not necessarily lead to the successful accomplishment of our object. The most useful things are rather to be found among the commonplace and the readily accessible, as in this instance.

"However, in employing cats for this purpose we should determine a certain system, and follow it out in an orderly manner, in the main, as follows:

"1. Pass laws requiring each house to keep a certain number of cats and cause the police to make frequent inspections.

"2. By establishing a system of prizes, seek for cats of approved ability

as ratters.

"3. Carry on a world-wide search for strains of cats especially skilled as ratters and encourage their introduction and propagation.

"4. We should stimulate interest in the breeding of improved strains of cats by promoting cat shows, etc., just as in the case of horses and cattle. "5. Vessels plying betweeen plague-infected ports should be obliged to carry a fixed number of cats, the number depending upon the tonnage of the vessels.

"6. Building regulations should require that attics and other places frequented by rats be provided with openings large enough to admit cats.

"7. In the case of plague-infected districts or areas threatened with invasion by plague, special companies of cats should be organized and at fixed intervals they should be isolated and the presence or absence of plague among them should be determined.

"The above is merely a sketch in rough detail of a scheme for employing cats in antipest work. The method is extremely easy of execution and by no means involves great expense. Further, as its efficacy is not merely of temporary duration, we should eventually accomplish our object of exterminating the rat. Moreover, during the time of a plague epidemic, the trouble involved in rat examinations should be lessened. If from time to time we isolate and keep under observation the cats that have been feeding upon rats, not only do we obviate any fear of spreading the infection, but at the same time we have a means of determining the exact extent of the spread of the disease.

"Since a multitude of artificial devices of human contrivance are not equal in efficiency to one of nature's methods in destroying rats during antipest campaigns, the most efficacious means of accomplishing our object is the utilization of the cat."

Beginning with such places as Osaka and Kobe, where plague infection constantly lies dormant, the encouragement of the breeding of cats with a view to demurization is the urgent duty of the present hour.

EDITORIAL

PHYSIC AND PHARMACY.

The President of the British Pharmaceutical Conference, Mr. Robert Wright, at the recent meeting of that body at Aberdeen, as we learn from the British Medical Journal, devoted a considerable part of his annual address to the discussion of counter-prescribing on the part of the druggist and dispensing on the part of the medical man. Mr. Wright, while he acknowledges that there are limits beyond which the druggist ought not to go, claims, to use his own words, "that the counter-prescribing of simple remedies for simple ailments is quite in harmony with the fitness of things," and ought to be permitted without protest from the doctors. He thinks, as if there were no other alternative, that it is better for the druggist to prescribe harmless remedies for ordinary diseases than for the doctors to dispense, or for the people to dose themselves with patent medicines. He fails, however, to state how the pharmacist or his customer arrives at anything like a correct diagnosis of the "simple" ailment to be treated, the sine qua non for the intelligent treatment of any disease. As is usual with druggists, when they attempt to defend counterprescribing, Mr. Wright sails into the physicians for dispensing and for using proprietary remedies, as if one wrong practice justified another, and asserts that the physician who prescribes medicines of unknown composition and strength for diseases about which he is supposed to be able to diagnose correctly, is more culpable than is the pharmacist who prescribes drugs of which he knows more than anyone else for diseases and ailments of which he knows little. In other words, while he admits that both are culpable, the physician, he contends, for the reasons set forth, is the more so. And then he goes on at length to show the dangers to the public which must accompany the dispensing of medicines by the doctors.

We can not concur with Mr. Wright's conclusions as regards these questions. In the first place, one offense does not justify another and the tu quoque argument is a mighty weak one, always. By no sound process of reasoning can the right of the pharmacist to take upon himself the responsibility of prescribing be sustained, even though the ailment he attempts to treat may appear to him to be a "simple" one, and he employs only "simple" drugs in his treatment. What may seem like a "simple" ailment to the pharmacist may, in reality, be the premonitory expression of some grave disorder, which the practiced eye of the trained physician only would be able to detect. The treatment, therefore, which the pharmacist may employ, though it may be ever so simple,-though it may not

directly harm the patient,-may cause delay, which might result in much suffering to the patient, if not in the loss of his life. The druggist, presumably, makes his diagnosis of the "simple" ailment from subjective symptomatology and mere casual inspection. Certainly, he is not qualified or in a position to examine the patient's body with that care and completeness which is necessary for purposes of diagnosis. In short, it is not the function of the pharmacist to diagnose disease at all. It is his duty, only, to understand the practice of pharmacy, and if he has acquired proficiency in his own science, he has accomplished much, and nothing more can be expected of him.

We do not undertake to say that absolutely and under no possible circumstances can the pharmacist legitimately recommend medical treatment, for in great emergencies rules must give way to common sense. Under extreme circumstances, however, the pharmacist will act on his judgment regardless of any and all rules, and he needs not to be told that he can do so. But he should bear in mind that, even in these cases, he is going outside his province, and is treading on forbidden ground. When, therefore, a man in Mr. Wright's position contends before a body of pharmacists that they may prescribe, even under extreme circumstances, there is danger that he will be misunderstood-he will appear to many in the light of defending the practice of prescribing on the part of druggists as a right, and not as a privilege to be exercised with great caution, which is quite a different thing.

If he educates pharmacists to the idea that they have a right to prescribe "simple remedies for simple ailments," there is great danger that self-interest may step in and influence their judgment as to what are "simple" remedies and simple ailments, with the result that, the bars being once thrown down, counter-prescribing will become the rule rather than the extraordinary exception, which it should be.

NEPHRITIS IN INFANCY.

Nephritis is more common in infancy than many practitioners believe. Repeated and routine examination of the urine of infants is not nearly so rigorously carried out as it ought to be. Some explain this on the ground that the matter of collecting the urine of infants is difficult in private practice. This is not true. It is very easy to catheterize a young baby and obtain a sample in that way. The catheterization of the bladder of a young child can easily be effected with a small rubber catheter, using the usual precautions of asepsis in doing so. If it is not practical to obtain it under these proper conditions, the urine can be collected in boys by securing the penis in the orifice of a china or vulcanized bottle, and in girls by placing a cup over the vulva in the napkin or by a boat-shaped vessel retained in a position by strapping or by a many-tailed bandage.

It is a mistake to suppose that edema is always an accompaniment of nephritis in infancy. This is more apt to be the exception than the rule. Definite nephritis in association with gastro-intestinal catarrh, occurring with or without fever, is also quite common and should not be overlooked by the careful practician. Albuminuria may be associated with any complaint of the gastro-intestinal tract and with simple dyspepsia even, apart from definite pathological alterations in the renal epithelium. The acute infections like scarlatina seldom attack infants, so this can be disregarded as a source of infantile nephritis. Pneumonia, varicella, erysipelas, meningitis, eczema, impetigo contagiosa, aphthous stomatitis, tonsillitis and tetanus represent frequent causative agents for nephritis in infancy. It appears that syphilitic virus retards renal development, and pathological changes have been found in the kidneys, ante-natal and post-natal. These changes may be glomerulitis, cystic degeneration of the glomeruli, fibrous thickening of the capsules of the glomeruli, etc.

Another fact to explain the belief of the profession in the infrequency of nephritis in infancy is the lack of proper and careful observation at autopsy of renal changes in such cadavers. Kidneys may look healthy to the naked eye at autopsy, yet microscopical examination will show decided changes from the normal. Therefore, a better understanding of the frequency of this condition will only come with microscopic study of kidneys at autopsy and routine urinary examinations in every sick infant.

THE CANCER PROBLEM.

There are two problems which confront the medical profession today: tuberculosis and cancer. The one has practically been solved, the other is still with us, unfathomable, of unknown cause, and, consequently, no true scientific treatment has yet been discovered for it. We know what causes tuberculosis and we know how to diagnose it early. And if it is diagnosed early, the most skeptical therapeutists must now admit that its cure is easy if the patient only follows intelligent medical advice. regarding living in the free air and the eating and drinking of proper food. That tuberculosis is very contagious is also admitted, and preventive medicine is making great strides in checking the spread of this contagion.

With cancer, we find other less flattering conditions. Not knowing the cause, we can take no steps to check its apparently constantly increasing prevalence. It is true that there are some in the front ranks of medicine who continue to regard cancer as a microbic disease, but no man has ever yet scientifically demonstrated that this is true. The history of medicine. in regard to cancer shows that this disease was known even in the days of Hippocrates. Ever since his time there have been numerous attempts

made to find the cause of cancer, but all have been futile. The minute structure of cancer was not known until the advent of the microscope into the domain of medicine in the first half of the last century. While we know its minute anatomical structure intimately at this time, we are as far from knowing anything about its true etiology as were Hippocrates, Galen, Celsus, Ambrose Paré and others of the ancients in medicine who wrote so interestingly of this disease. And yet, even though we find running down the ages, century after century, most outlandish explanations of the causation of cancer, each in turn overthrowing another and each again being toppled over by other theories, the treatment has been consistently surgical. It is to the knife that the ancients in medicine looked for relief in the treatment of cancer, and it is to the knife that the modern surgeon fastens his faith upon the curability of this disease. The ancients said, remove the tumor and if it does not come back, it is not cancer. If it comes back, it is cancer. Today the modern surgeon removes a piece of the suspicious growth, if it is situated in an accessible region, examines it microscopically, and then does a wide extirpation if he finds it is canHe maintains that if the diagnosis is made early, the cure by

wide extirpation is positive.

This brings up the question of the hopelessness in cases of cancer that are situated within the body in structures that are inaccessible to our methods of examination. Some promise seems to be forthcoming from the work of Crile, who has introduced the hemolytic test into the domain of early cancer diagnosis. He claims that with this test, by hemolysis, we shall be able to ascertain the existence of a cancer that is situated within the internal viscera in the earliest stages of the disease. This will bring occult cancer up to the plane of visible cancer, and will materially lessen the mortality of the disease by the institution of early radical surgical treatment. If this hemolytic test becomes a practical and successful diagnostic agent, cancer will no longer be that dreaded disease for both patient and physician. If by means of this new test the cancerous growths that affect stomach, liver, kidneys, etc., can be made out early and removed, then the term "cachexia" will be no longer heard-a consummation of Roswell Park's hope recently expressed that this term ought to disappear from the literature of medicine.

ARMY MEDICAL CORPS EXAMINATIONS.

The Surgeon-General of the Army announces that the first of the preliminary examinations for the appointment of first lieutenants in the Army Medical Corps for the year 1909 will be held on January 11, 1909, at points to be hereafter designated.

Full information concerning the examination can be procured upon application to the "Surgeon-General, U. S. Army, Washington, D. C." The essential requirements to securing an invitation are that the applicant