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mysteries why this procedure has won so little Everybody knows that—at least every layman. favor in civil life.
But is is also true that not a few of these proWhile prophylactic vaccination gives almost fessional incompetents could pass a very acceptcomplete immunity, its employment should be no able theoretical medical examination, often excuse for carelessness on the part of the sani- acquitting himself better than his own versatile tarian. Greater care was never taken in our and successful brother. Tests of this kind are army than is now in the disposal of excreta of value in keeping unqualified men out of the and the protection and preservation of food. We profession; but after they are once in it there is know that flies convey the infection; therefore no “examination” which so generally shows the all food should be protected against contact with practitioner's worthiness or unworthiness as his insects. In military camps all excreta are now ability to win the confidence of his patients—in burned. Only in our cities do we still permit other words, his ability to "get along." this dangerous waste to be poured into lakes and Would it not be an edifying state of things streams. The time is not far distant when such for every doctor to be compelled to “plug up'' a disposal of sewerage will be absolutely pro- for a state examination every five years? What hibited among civilized people. But meanwhile, a multiplication of "preparatory” schools-of a fairly efficacious remedy has been found for special quizzes--there would be as a result of the the treatment of contaminated water in calcium
change! Men who had time to prepare for these hypochlorite, which in very weak dilution--as
examinations would surely “pass’’; while the low as one part in twenty-five millions-seems to
poor devils who were too busy curing people of be effective in destroying the bacilli of the colon summer diarrhea or winter colds, and who might group. Many cities are now employing this chem
as a consequence be rusty on the latest theories ical disinfectant with alleged good results. in immunity or with regard to the new triumphs
These problems of prevention, whether through of pathological research, would be very likely the control of the carrier, the vaccination of the to be plucked. Fact is, that a doctor who actualindividual, the improvement in the water and ly practices his profession and fails to add somefood supplies, or the chemical disinfection of the thing to his store of useful knowledge every day water, are discussed elsewhere in this number of will soon be completely out of the running. No the Medical Standard, in our Round Table de- examination will be needed to eliminate him— partment. This is a problem of vital interest, that will be taken care of by the unerring law and as such we trust will be carefully considered of the survival of the fittest. by every reader of this journal.
Let us devote any time we may have to spare
from our own particular business for the reSHALL THE OLD DOCTOR BE DISBARRED? forming of other people to training the young
We learn from the newspapers that Dr. W. 0. man who is still aspiring only to be a medicThompson, president of the Ohio State Univer
the man who looks longingly over into our fold sity, in his address to the graduating class of the but is not yet in. He is our legitimate meat. medical department of that school, declared that When he is through his course he can pass exa professional man who has made no progress in aminations which not one in five hundred of us his education during the first five years out of would dare to go up against. Perhaps that is a college should be disbarred from further prac- good reason for keeping him from breaking in; tice.
he may prove a dangerous competitor! But who This statement is in line with that made by Dr. of us will admit that he is a better man than John B. Murphy, a year or more ago, that every we are? doctor should be re-examined every five years and if he failed to make good his license taken away.
ANOTHER WHACK AT SALVARSAN. Suggestions like these sound well in public ad- It never rains but it pours! The enemies of dresses. They are sensational, and for that rea- Ehrlich's much-vaunted specific for syphilis have son get into the public prints.
It would per
been gaining ground and showing new courage baps be presumptious to suggest that they are since the Los Angeles catastrophe, and following made for this very reason; yet we really can the attacks on Professor Ehrlich in his own city not believe that either Doctor Thompson or Doc- of Frankfort, where a suit for libel is pending tor Murphy expected to be taken seriously. against a newspaper publisher who asserted
Of course there are many men practicing med- wholesale deaths from salvarsan poisoning in the icine who ought to be doing something else. city hospital, following the use of “606'' on charity patients mainly representatives of the revived and utilized in a definite, rational and demi monde.
effective fashion. The latest assailant of the remedy is Professor Certainly in the present day not one of the conGaucher, of Paris, who according to the editor siderations cited above is any longer valid against of American Medicine, asserts that “salvarsan intravenous medication. Asepsis and surgical is a dangerous, often fatal poison to the nervous skill have made of the technique of such infusystem, that it never cures syphilis, that the ul- sions matter for a June holiday in the hands cerous lesions it cures habitually return, and that of the most unsophisticated practitioner, and it makes the disease more grave.” Really, this have reduced the operative risk to a vanishing is quite an indictment!
point. The science of hematology has made us According to Gaucher the reappearance of the familiar with the susceptibilities and the calesions after the giving of salvarsan is not due pacities of the biood. And a fuller knowledge to reinfection but is really a lighting up of the of physiological chemistry and metabolism endisease; also, the cures of early cases are not ables us to follow, with reasonable accuracy, the cures at all, but just mistakes of diagnosis; while, life-cycle of almost every known medicinal subthe numerous cases of syphilitic meningitis now stance in its course through the viae naturae. being reported are not syphilis at all but just Let us elaborate a little. In the matter of arsenical poisoning!
technique, it is a simple procedure to open a This caustic critique may be only an evidence superficial vein; and Nature makes an equally of Gallic irritation to a Teutonic achievement, simple job of repairing the slight puncture needyet there may be something more in it. It is ed to inject a few cubic centimeters of fluid. said that certain Germans have petitioned their Modern mechanics has put into our hands an government to prohibit the sale or use of this almost perfect syringe with which to make the drug. For the present, however, we need take puncture with the minimum of laceration, and to neither side too seriously. Salvarsan has an es- inject the fluid without the introduction of air. tablished place in therapy. Its value is attested In the present state of our knowledge about by too many men to be denied. Yet it must be asepsis, and our facilities for carrying it out, used with caution by physicians who understand the most moderate care will preclude the possiit. That much we may all wisely admit.
bility of infection. The whole procedure is easy, quick, all but painless, and free from risk. Cer
tainly, technique can no longer stand in the way REVIVAL OF INTRA-VENOUS MEDICA
of intravenous medication. TION.
As to the effect of the foreign substance in the In times past, three considerations have con- blood-stream, in the light of modern knowledge spired to prevent the general adoption of this
this matter is almost as simple, at least in its method of medication, namely, (1) the risks at
end-aspects. While the science of hematology tending the technique of the method, (2) the un
has been, and is vet, somewhat of an intricate toward effects frequently following the introduc- one, its results. as far as they have gone, are tion of medicinal substances into the blood clean-cut enough. While there is still a large stream, and (3) the uncertainty concerning the
field of unexplored ground, yet there is a fairly chemico-physiologic fate of the substances thus
extensive group of medicinal substances that introduced. All of these considerations have
have been plainly and definitely labeled in regard helped in the past to discredit the intravenous
to their hemolytic properties, and so long as we route, until the practice was no doubt very
confine ourselves to this group we run no risk wisely—temporarily abandoned.
of upsetting the hematic balance. It is interesting to note that there now seems
And finally, in respect of the chemico-physioto be a disposition among therapeutists to revive
logic disposition of the drugs which we inject, the method in the case of certain appropriate kinds of medication, and modified, of course, by
our knowledge, although equally limited, is equalmodern scientific knowledge and technique. In ly clean-cut so far as it goes, and enables us to
All this we are but following the course pursued by pick our way with reasonable assurance. modern medical science toward several former
of the substances which we are of late proposing theories and practices which were abandoned in
to introduce by the intravenous route have been the progress of exact medicine as being too risky given by mouth from time immemorial, so that or too uncertain, or opposed to our new
the only new question in physiological chemistry cepts of disease and treatment, but which with that the intravenous method raises is whether, by the advent of still further knowledge, have been skipping the digestive tract and the portal sys
tem. these substances lose any good qualities or officers and accepting an informal dinner invitaacquire any evil ones. Our knowledge of this tion from the post surgeon and his wife. Five gastro-hepatic circuit assures us that, with the minutes later, when near the corral, he suddenly possible exception of certain mild acido-alkaline collapsed as if he had been shot, fell forward on relations, there is nothing in its chemistry or its his horse's neck. The autopsy revealed direct physiology to influence drug action one way or sclerosis of the coronary arteries of the heart-the other; and of course no one is going to put athlete's heart. None of the injuries received hurtful acids directly into the blood. Indeed, so from the fall were sufficient to have caused far as this particular consideration is concerned, death. His faithfulness to exercise killed him." anything that can be legitimately introduced by the hypodermic method, or by rectal enema, can A Mistake in Sex.—We have just received a with equal impunity be given intravenously.
letter from Dr. Ellice McDonald, of New York It seems clear, then, that the old objections to
City, in which he says: “While I appreciate intravenous medication no longer hold water.
the extent and completeness of the abstract and Neither practitioner nor patient need hesitate to
the way in which the essential parts of my article employ or to submit to the method on this score.
are quoted, I wish to say to you that you have The only real question to consider is whether the
made a mistake in my sex. In these days of intravenous route has any positive advantages feminism and militantism, I regret to say that over the prima via, and if so, in what instances.
the nearest I can come to being a woman is to We do not advocate--we think no one advocates
be the father of one, and I wish you would take --the adoption of the intravenous method for all
opportunity to correct this." medication that can be given that way. As
Of course, we are glad to correct this We stated, the revival of the mode is subject to the wrote Dr. McDonald that we could only explain modification and discrimination of modern sci
our mistake by the resemblance in sound of the ence. But, as a general proposition, it may be words Ellice and Alice. We should have known said that there is always a marked advantage in
better, of course. Dr. McDonald is too eminent introducing medication, as directly, as promptly,
a figure in the gynecologic field to be the object and as economically as possible to the tissue or of errors like this. organ which it is destined to influence. Hence the medicines to which this mode of administra- Protection Against Typhoid Fever.–Of course tion is most adapted are those which are intended the ideal method of securing protection is to to act directly upon the blood. For them the vaccinate. Last year the ninety thousand men in intravenous route is, par excellence, the mode of the United States Army were protected in this administration.
way, and of the entire number only three con
tracted the disease, and of these, two came down EDITORIAL NOTES.
within five days after enlistment. Yes, vaccina“Excessive Exertion After Fifty.”—The fol- tion is sure, safe, and simple. We cannot underlowing quotation from the Army and Navy Regis- stand why any one should object to it. But if ter, relative to the death of a well-known army you have a patient who does protest, and who is officer, carries a message and a warning, which likely to be exposed to infection, whether on his doctors may well note, and which it is their duty summer vacation or at home, let him sterilize his to pass along to patients who have passed their drinking water with chloride of lime. This is the physical zenith. The Major was apparently in method proposed by Doctor Evans in the Chicago splendid health. “Being a natural athlete and Tribune: very fond of outdoor exercise, he kept himself in "Take a level teaspoonful of chloride of lime fine physical condition. Every morning early be- and rub it up, until there are no lumps, in a teafore going to his office he rode ten miles on horse- cup of water. Dilute this with three cupfuls of back. In the late afternoons he played golf or water, and keep this stock solution in a stoptennis, frequently both. Neither he nor anyone pered bottle for use. A teaspoonful of this stock else had the remotest idea he had heart disease. solution, added to a two-gallon pail of water and There was not the slightest warning.
well stirred up, will destroy all typhoid or other "The morning of his death he arose in fine dysentery-producing bacilli in ten minutes, and spirits, happily anticipating the return of his will make the water safe to drink. If this quanfamily for Christmas. With his mounted orderly tity makes the water taste, use a little less, otherbehind him he rode through the post, stopping in wise not. Get the chloride of lime in metallic his pleasant way to laugh and joke with various cases.''
Things to Take on the Summer Outing. Here principally exercises this public function. Too is a list of things recommended by Evans to be often it is crowded and unsanitary, and there taken on the summer outing. Any doctor can is always the suspicion that it may be a focus suggest valuable additions, and the editor of the for the spread of venereal disease. When the Medical Standard will undertake to do so. But state and municipality are doing so much for the first the list :
public welfare how does it happen that this very 1. Absorbent cotton.
useful institution, the “public comfort station,' 2. Roll of old muslin or linen and one of soft is neglected ? Its service might very readily be flannel.
broadened, so as to provide facilities for baths, 3. Bandages, two and one-half inches wide resting places for persons slightly ill, and "disand six yards long, rolled up.
pensary’ service, for dressing minor wounds and 4. Rubber adhesive plaster (Z.-O. plaster) on giving relief in minor ailments and emergencies. a spool. Kid court plaster.
5. Sharp scissors.
Is There a Conspiracy Against the Small Col7. Needles, threaded with stout thread.
lege?—Dean Henry C. Tinkham, of the Medical 8. Cosmoline, vaseline, or albolene.
School of the University of Vermont, answers 9. Ammonia--Aromatic spirits of.
this question with an uncompromising “Yes!”
In a public address he made the following re10. Castor oil. 11. Cloves-Oil of.
marks, which ought to be pondered over by those 12. Hartshorn (water of ammonia).
interested in medical liberty: 13. Laudanum.
“I am very much inclined to believe that there 14. Soda-Bicarbonate of.
is a conspiracy, and I say it advisedly after much Following are a few simple remedies which
thought that there is a conspiracy on the part may well be added to the preceding. Something of several organizations and on the part of will be needed for diarrhea, colic, and ordinary schools, to put the smaller medical schools out abdominal pains. A few chlorodyne tablets will
of business. It stands to reason that if the fill the bill, and in case of emergency can be used
smaller colleges close, the students will have to for any form of pain. It is also well to carry a
go to Columbia, Yale, New York colleges or elsefew laxative pills, the aloin, strychnine and bel
where. Dartmouth has gone through this same ladonna, or the anticonstipation pills or tablets experience, and the
experience, and the octopus has practically being most generally useful. For headaches and squeezed out the existence of the Hanover Medito control high temperature, provide a few
cal School in the past two years. I believe that acetanilid combination tablets. Tincture of io
this organization, the fundamental principle of dine is the best antiseptic, put it in a glass
which is the Carnegie Foundation, is trying to stoppered bottle. Carry some good dusting pow.
put the University of Vermont out of business. der--borated or salicylated talcum, also a good
When they release stories to the Sunday papers ointment, like unguentine, for burns or abrasions;
of New York, and, as I have learned, Springfield and if you are going into a snake country a little
and other cities, and furnish them with identical permanganate of potash to apply to or inject into
texts and identical cuts, there must be something the wound. Many other things may be added,
behind it. When they sent out the cuts of the but don't make the outfit too bulky.
University of Vermont, they sent a picture of
the old medical building, now used as a lodging Public Comfort Stations. We call special at
house, and the worst building connected with the tention to a brief article quoted from the Jour
University. They felt they ought to have two nal of the American Medical Association, which
buildings and they choose the next smallest, a we print elsewhere in this number. It is a study good one and a new one, but small—the agriculof conditions in New York, as regards provision
tural building. I should like to know what noble for the sanitary needs of the individual. The mind-spirit must have inspired somebody to send condition is even less satisfactory in Chicago than
out these cuts when we have such good buildings it is in New York. Here, the individual requir
as you know there are on the campus.” ing toilet facilities has no place where he can go except a saloon, hotel, or department store. At If the babies have diarrhea, try giving them night the stores are closed, so that his choice the Bulgarian bacillus in tablet form. These are of a place is cut down to the two former. A perfectly harmless and very effective, and make poorly dressed person is not welcome in good ho complete stopping of milk diet unnecessary in tels, so that the “poor man's club,” the saloon, most cases.
THE CALL OF THE TWENTIETH CENTURY.
By HENRY S. MUNRO, M. D,, Omaha, Nebraska.
(CONTINUED FROM LAST MONTH.)
OR JESUS, the Jew, I have the fortunate children of fate, and learned to look
profoundest respect, particularly with compassion upon them in their efforts to for the virile manhood displayed adapt themselves to the new order, as the result in his denunciation of hypocrisy, of the Emancipation Proclamation. We acceptlying, Pharasaical self-righteous- ed the decree of government after a fierce and
ness, and deceit. Of the psycho- bitter conflict, since slave traffic had the consent sexual perversions, by which religious tradi- and protection of the laws of our country. tions, under the guise of “the teachings of the We now face a reversed situation. Slavery Holy Bible," are today being expressed, with in another form, more despotic and tyrannous is its disastrous influence upon human life, happi- holding millions of our fellow citizens, men, ness, sanity and the home, and into which our women and children, in its grasp; the many are American youth are being systematically trained, exploited by the few; church and capital are I will speak at the close of this series.
exercising a despotic tyranny over our free eduThat the church too often does not deserve cational institutions by taking advantage of the respect of truthloving, honest, and fair- those whose lack of educational qualifications minded people the overwhelming majority of forbid them the power to extricate themselves. physicians frankly acknowledge.
In the words of the immortal Helen Kellar, physicians have lacked the manhood to shake off whose life has been wounded and whose spirit the debasing influence of theological hypocrisy, has been deprived the pleasure of gazing upon I know from my own personal experience. So our beautiful world of flowers, fruit and sunlong as they can participate in the spoils that shine, “Let us banish from our schools dead come from allying themselves with the vested in. histories, dead languages, dead philosophies. Let terests, they are willing to co-operate with any us learn about the things that are near to uskind of scheme by which the people are exploit- that concern our daily life; the cause of slums ed, regardless of human life, happiness and and social disease, sex hygiene and other truthis sanity.
in which lie the safety of our bodies and minds. One of these “cburch doctors" said to me in Philanthropy is good; everything that amelioconfidence: “You are right. You have the line rates hard conditions helps; but the thing that of professional work that is bound to predom- realiy counts is light." inate in the future of the practice of medicine. Unborn children at the middle and at the end Science, human welfare, and practical thera- of the twentieth century are calling us to manpeutic results attest the worth of the evolution- hood. Shall we refuse to answer their call? ary principles that you so steadfastly defend, The great need of the world today is men but I can make a living better by passive acqui- and women who will give the starving children escence to the church, since I am too old to train of this age bread, instead of feeding them on my patrons to conform to the new regime." stones; those who will speak out and tell the
A thousand times would I prefer to shoulder truth as the more enlightened people see it, so a pick and shovel and laboriously toil for my that the coming generations can be qualified to daily bread rather than be false to the highest live useful, efficient, healthful lives; those who dietates of conscience, honor, professional duty will not be intimidated by the obstacles set in and citizenship.
our path of progress by the traditions of barFifty years ago, our American government de- barism and ignorance, which is still exercising cided that slavery must go; that to exploit hu- such a life-stiflink influence upon our present man life and liberty was wrong. At the point of civilization. our bayonets and amidst the shell and shot and With all of the light that has been thrown roar of musket and cannon, we gave freedom upon heredity and eugenics by recent scientific to a down-trodden race.
investigators, one is surprised to note, when he Some of us were brought up among these un- refers to his own actual observations, how small