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griddle, winter mornings, and who meekly follows him to the door, asking him for a quarter to buy some castoria for the baby.

Yet, from the meek woman of the past to the militant woman of today, women have been the queens of our lives. Queens they must ever bequeens to their lovers, queens to their husbands and sons, queens of higher mystery to the world beyond, which bows itself, and will forever bow, before the myrtle crown and stainless sceptre of womanhood-yet always a mystery.

Uncomprehended and uncomprehending,

The darling, but the despot, of our daysSmiling, she smites us-fondling us she flays; Still madly loving us, yet still contending, And proudest when her conquered heart is bending,

And most unyielding when she most obeysShe is so fashioned that her face betrays The struggle ended, long before the ending.

She's like a bubble borne along the air, Forever brightest just before it breaksOr like a lute that's mutest ere it wakes In trembling ecstasies of love divine;

Woman is always just across the line

Of her own purposes. Beware! Beware!

慌慌慌

OUR AMERICAN SPAS.

One inevitable result of the European war, says the New York Medical Journal, has been the closing of the various continental watering places. Since the discovery of radium, the beneficial effects of a sojourn at one of these resorts, once considered to be purely psychic, are now generally attributed to radioactivity of the springs, setting aside for the moment the obair viously tonic and alterative effects of open life, gentle exercise, and restricted diet. In all of these advantages numerous American watering places fall no whit behind those of Europe. We have the picturesque scenery, a more varied choice of climate, equal professional skill in the prescription of regimen, and, to complete the program, waters of appropriate saline nature and of thoroughly tested radioactive qualities. Dr. Ernest Zeublin, of the University of Maryland (Maryland Medical Journal, May and June, 1914), is firm in his good opinion of the value of radium salts in the treatment of arthritic conditions, even in obstinate cases of arthritis deformans, and discusses carefully the subject of radioactivity in spring waters, artificial solutions prepared for drinking purposes, baths, etc. The United States Government has full information in its possession concerning the saline content and radioactivity of our various springs, and the medical profession would welcome this knowledge judiciously scheduled for reference. findings of the New York State commission con

The

cerning the Saratoga springs would also furnish valuable material for consideration.

Dr. Rupert Blue, surgeon general of the United States Public Health Service, is quoted in the newspapers as stating that there are in this country springs "that possess amazing curative properties," and that our gouty and rheumatic population need feel no alarm at the temporary closing of the celebrated resorts of Carlsbad, Baden Baden, Nauheim, Wiesbaden, etc. It is averred that our people have been spending $80,000,000 annually in these foreign spas in search of relief for chronic conditions vaguely referred to the nervous system and to faulty metabolism, and an excellent opportunity is now presented to the medical profession to draw attention to the fact that there is absoluely nothing lacking at our health resorts to bring about therapeutic results as striking as have ever been achieved abroad. The State and Federal authorities should lend their aid in this propaganda, for they can do much to assist private capital in adding to the attractiveness of such resorts. The mere avoidance of sumptuary legislation is not enough; there should be intelligent constructive supervision.

SHOULD THE TUBERCULOUS HAVE

PROGENY?

It has so long been accepted almost as an axiom that tuberculous men should not beget children, on account of the danger of inheritance that it is refreshing to hear from some one who dissents. Following is the opinion of Dr. Edward O. Otis, of Boston, as published in the New Orleans Medical and Surgical Journal:

Under what conditions, if any, shall a man or woman who is tuberculous (one or the other), or who has suffered from tuberculosis, marry and have children? To state the question in detail: Shall a man or a woman with arrested tuberculosis marry and have children, both as regards danger to themselves and a predisposition to tuberculosis in their offspring? Shall a man who is tuberculous, but whose disease in a quiescent state, and who still maintains good resistance and retains his working ability, marry and have children, provided his wife is healthy? Shall a woman who has only evidence of anatomical tuberculosis with no symptoms marry and have children?

Various and conflicting answers have been made to these questions. You are doubtless familiar with the oft-asserted asseveration that a tuberculous husband and wife should be taught "not to procreate a race predisposed to tuberculosis." It seems to me that this is too sweeping a statement

without modifications. How do we know that the children will be predisposed to tuberculosis? The recently published experiment of Brooks would appear to offer substantial proof to the contrary, reasoning from analogy. In this experiment tuberculous cows were bred to tuberculous bulls, and at birth the calves were immediately taken from their mothers and fed upon modified pasteurized milk. Of more than 200 calves thus born not one became tuberculous, and there was some evidence which seemed to indicate that animals thus born were rather more resistant to tuberculosis than animals born of nontuberculous parents. Why should we not expect that children born under similar conditions and treated in the same way would show the same results?

Why should not a tuberculous husband, if his disease is quiescent and the balance between the infection and the resistance is evenly maintained, have children if his wife is healthy? And still more so if his disease is arrested? And yet I recall a pathetic instance of the latter case when the wife, though healthy, refrained from bearing children for fear of the possible inherited predisposition on the side of the husband. Our American Anglo-Saxon race is so rapidly diminishing at the present time that one should be extremely cautious, it seems to me, in advising further racesuicide (the unpardonable sin for which there is no atonement, says Col. Roosevelt) unless from very definite and clearly determined reasons. would even go further and say that it were better to take some risks with so much to gain in the preservation of a valuable family. For example, some married people, I am sure, would be willing to shorten their own lives if, by so doing, they could continue their name and family. I do not suppose there is much difference of opinion as to sanctioning the marriage and child-bearing of a woman who has obtained and maintained an arrest

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of her disease for a number of years, or of opposing the marriage of a woman who is still actively tuberculous or who has only an apparent arrest. When the husband is actively tuberculous, but not in the advanced stage and his wife is healthy, it seems to me it is a question for him alone to decide whether he should have children; and if the child is at once removed from the father I do not believe the predisposition bugaboo need cause anxiety.

THE RED CROSS IN THE WAR. The Red Cross organizations, remarks the editor of American Medicine, play a varying role according to the country. In armies having no well equipped medical corps, the whole work of caring for the wounded is turned over to the Red Cross,

but other nations prefer not to be bothered with women who require so much more care and protection than soldier-nurses for the amount of good done. Besides all this, no Red Cross organization can get to the places where the wounded are so long neglected. If the battle line advances it is safe to reach them, but by that time they are being cared for by the soldiers.

After the disabled are taken out of the field of operations and properly bedded and housed, the work of nursing begins, and in Europe this has been done largely by religious orders and volunteers. The numbers required are so stupendous that the central government cannot control the work which is necessarily left to private or municipal initiative. The Red Cross detachments sent over from here are only a drop in the bucket.

Neutral nations simply cannot afford to relieve all the distress even if it were possible to do so. This war has already shown that many recoverable wounded must die of unavoidable neglect where no human agency can reach them. In former times they were abandoned even when it was possible to help them. The Red Cross was organized to save as many as possible but the armies themselves do this nowadays in order to get the wounded back in the ranks. The Red Cross is being relegated to the remote rear, and preferably for cases which cannot do any more fighting.

Distrust of neutral Red Cross organizations has become very prevalent in recent wars, in spite of all the good they do. They have harbored spies, partisans and immoral persons. The British in South Africa allowed a Chicago detachment to go through the lines to the Boers, but later caught some of the men fighting in the ranks. On the other hand an English neutralized corps has been recently returned to England by the Germans. Great nations are invariably offended by offers of help from neutral countries, for there is an implication that the warring country is unable or unwilling to care for its own. France has recently

notified the world that she wants no more neutral Red Cross nurses.

Besides all this, alien workers require special care and protection. Our well meaning women proved a source of embarrassment to the Japanese government ten years ago, as they required extra food and attendants needed by the sick. In due time and in a courteous way it sent them back. Our detachment is commanded by an army surgeon, and this may ease its way somewhat, but will make foreign nations feel that we are violating neutrality by sending part of our regular army to patch up soldiers who will return to the ranks. A wounded man cured by neutral means ought to give a parole not to fight again but he doesn't.

Neutralized hospitals, therefore, though intended to ease up the horrors of war, have a tendency to prolong the struggle and increase the suffering. It would be far better to use the contributions for the relief of Americans in distress due to the war. Charity begins at home, and the Red Cross has shown that it is invaluable in that line.

There is much praise bestowed on volunteers on account of their good intentions but that must not blind us to the fact that they are often unwelcome, and are neglecting home distress which Heaven knows is bad enough already. There is need of American surgeons in the American hospital in Paris, but that is an institution built and managed by Americans for Americans and now taking in sick and wounded of all nations.

The Geneva convention has long been found to be absurdly impractical in other ways and commanders must ignore it. The Red Cross flag is no protection whatever. No plan can be changed because a hospital gets in the line of fire. To save it might lose a battle, yet we can rest assured that the newspaper stories of deliberate firing upon the hospitals are not correct. The warring nations are composed of the same races as ourselves and are equally humane and intelligent. Similarly if a battle can be won by using the Red Cross vehicles to bring up guns and ammunition, no one hesitates.

Nothing can be reserved for the use of the disabled to the exclusion of the fighters' welfare. If an ambulance can be seen, the enemy must conclude that it is up to mischief. If a hospital harbors guns it must be fired on, yet the old brutality to the wounded has entirely disappeared. The Geneva convention was devised to end it and has succeeded, because it was an expression of universal humanity protecting against past methods. The new order of things would have come in time without its influence. Commanders now as then obey its provisions when possible and ignore them if injurious.

Wars are recognized as national. The opposing soldiers have no personal animosities and are invariably friendly when thrown together as helpless prisoners. We must also reject the stories of brutal treatment of women, and children. There are some scoundrels in every large body of men, and these will break both civil and military law when they think it safe to do so, but commanding officers invariably make short shift of those who are caught at it. Similarly it would be exceedingly unwise to form any judgment as to the reasons of military measures. Each side invariably puts a sinister interpretation on what the enemy does. For its own conduct, it has reasons

which are good and sufficient, to its own mind at least.

惺惺惺

THE DRUG FAMINE AND AMERICAN
MEDICINE.

The Eclectic Medical Journal has the following editorial upon this subject:

The war in Europe has had a most disastrous effect upon the American drug market. In several instances the price of drugs and chemicals has become almost prohibitive; in others, an actual drug famine exists. Upon whom does the blow fall most heavily?

For many years now, while assuming an exalted idea of patriotism and an exaggerated loyalty to America and to American institutions and interests, a very large proportion of the medical profession in America, either willfully or ignorantly, have ignored American resources and the opportunities they have offered. This is most noticeably true of American indigenous drugs and Americanmade pharmacals. Praise alone has been bestowed upon foreign drugs and only foreign drug houses have stood in the forefront in the great (!) medical journals of the country. American drugs have been unnoticed, neglected and often unjustly condemned, either ignorantly or with malice aforethought, while foreign products have been lauded and so much depended on that now, when a famine in medicines is upon us, physicians who have been biased in favor of the "made elsewhere" scarcely know which way to turn for the medicines with which to ply their calling.

Not alone has the individual physician, taught by a few leaders, brought about this dilemma, but the neglect of home products has been fostered by the medical press. It is a broad statement and a bold assertion that is implied when we ask the question as to when and where the most widely circulated medical journal in the country has extolled or even supported the pharmaceutical products of the great laboratories of America; or when has it lost an opportunity to praise and exploit the products of foreign markets. Furthermore, not only has it neglected, with unpardonable lack of home pride, but has actually waged warfare upon legitimate medicines made by American manufacturers.

Is it, think you, because of the superiority of foreign drugs and foreign chemicals? One who has watched crude shipments from the old world to our shores can scarcely accept the affirmative of this question, when all sorts of rubbish has been found as admixtures of plant products. The lists of adulterations and sophistications of foreign. crude drugs that have been published from time

to time in our journals of pharmacy show an appalling condemnation of the vaunted purity and superiority of foreign crude drugs. Can we expect very much of all their chemicals? Where, too, have most of the fake preparations and procedures, from the "elixir of life" to "twilight sleep" so greedily sought for by enthusiasts for the novel come but from out the laboratories of the old world? Has America produced any "fake medicines" or slick business procedures that can put to shame the Friedmann humbug? Can she show any greater biological uncertainty than the many strains of anti-tuberculosis medicaments? Can she hold up any greater swindles in variations than the digitalins, the apiols, and the ergotins, and a host of similar but much sought-after potencies or proximate principles in medicine? Can she uncover anything like the commercialism in medicine that has made some foreign marvels a stench in the nostrils of those awake to the vileness of "big business"? Has she to her credit as many death-dealing uncertainties as have come from the continental laboratories? No answer required. These are open questions, however, which we propound to the individual physician, who may have been one of the many victims of foreign domination in American medical affairs.

Isn't it about time that the American physician arouse himself and shake off the shackles of European forging? Isn't it time that he began to take some notice of the vast resources of his own country? In no field will he find so great and so neglected opportunities (by some) as lie in research into American medical plant drugs and their products.

We can truthfully say, and say it without bitterness and reproach, but not without regret, that the dominant school of medicine in this country has neglected the opportunity which was hers by right of birth and priority to study and foster the use of American plant drugs. She has been obsessed with the idea, adroitly encouraged and disseminated through the writings of those whose medical education was acquired in foreign schools and from continental literature, that Europe, and Europe alone, had special advantages of soil and climate, and men of greater skill and training in the raising and collecting of medicinal plant products. No digitalis will be accepted by the high and mighty that has not been watched over by the lion and the dragon. No chemical is quite so good as those manufactured from the refuse of the dumps and wastes in the Vaterland, even though a caution always flanks the statements of great therapeutic power. Power they certainly have-but death dealing. Has the salicylic acid from coal tar any advantage over the American product

from wintergreen? Is benzoic acid, so largely used in paregoric, when made from urine even though retaining the disgusting odor of the latter, so much more desirable than the natural educt from gum benzoin? Surely have the commercial "wool pullers" of the continent befogged the vision of the American, who either through shortsightedness or avarice, has been led to neglect the opportunities offered by his forefathers in the land of his birth.

Suppose the American physician had profited by the examples set him by Barton and the Bigelows, Rafinesque and Porcher, Thomson and Beach and others, who sought strenuously to inculcate the advantages of American vegetable medicines. Would he now be lamenting the fact that the world is confronted with a European drug famine? Would he, too, have wrought the havoc in illness with powerful foreign synthetics that has now become an opprobrious historic record?

Once more it is the turn of the Eclectic to be congratulated. While he may miss aconite and belladonna and foreign digitalis and a few other potent agents that he has acquired through foreign teaching, yet is he so strongly intrenched in the knowledge of. hosts of American drugs that he need scarcely be disturbed by the war-locked conditions of the drug market? Belladonna, if needed, can be, and as successfully, raised here, and the digitalis of this country, experimentally produced, does not have to yield position to the British leaf. If aconitum napellus can not be had, possibly the mountains of Montana can furnish its therapeutic cousin, the aconitum fischeri. Perhaps the reckless use of powerful febrifuges and narcotics will be prevented by the scarcity of such drugs. The happy thought remains, however, that the Eclectic has not neglected his home products and has at his behest hundreds of potent agents, the heritage handed down in the evolution of the American materia medica. While his rivals in medicine, if inclined toward repentance of foreign domination, will have to begin anew to study the American resources, the Eclectic, forearmed and fortified by the long study of these therapeutic agencies, need give himself no worry and less alarm.

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PHYSICAL REMEDIES FOR PAIN.

Last month we began the discussion of some of the non-medicinal methods of treating pain. The subject has developed considerable interest, hence we continue it in this issue of The Medical Standard.

As we have already stated, it is time that the medical profession realized their responsibility in this matter. While anodynes and analgesics are indispensable to the practice of our profession, they are two-edged tools and their use should be avoided as far as possible. Most of us do not take the pains we should to get at the causes of pain. True, the surgeon no longer tries to drown the cry of the tissues with opium; but the physician too often resorts to some standard tablet for headache. If we understood the etiology of pain we could treat it always with greater intelligence, have more real cures, and without resorting so often to the administration of anodynes.

It is because we realize the importance of a thorough understanding of this symptom that we urge every reader of these lines to purchase and study Behan's masterly volume on "Pain," published by D. Appleton & Co., of New York.

We present herewith several more contributions on the subject:

Dr. John M. Shaller, Cincinnati, Ohio, explains the anodyne action of heat in the relief of neuric or muscular pains as follows: Pain is produced by tonic muscular contraction, or by congestion; irritation of some kind precedes either. Heat relaxes muscular contraction, and as muscular contraction produces pain by its pressure, pain is relieved when pressure is removed. Heat dissipates congestion and thus relieves.

Doctor Shaller does not believe that any definite technique for the use of electricity can be given which must be specifically followed in order to relieve pain. In his opinion every individual will probably find that pain can be relieved by any kind of electricity, applied in almost any way, the

chief consideration being the dose, i. e., the length of time of application.

Massage may be employed in the treatment of pain, since in nearly all painful conditions there exists muscular contraction (tonic), and the relaxation of these muscles follows gentle stroking, deep kneading, or rolling the muscles between the hands. Complete general relaxation of the patient is the chief feature. The tension must be reduced and the mind must be calmed. When complete muscle relaxation is produced pain is relieved.

Doctor Shaller has also used the vibrator for the relief of pain, applying it directly over the muscles until the pain has disappeared. He does not believe that the stroke or the rapidity are of great importance. The exit of the spinal nerve which is connected with the seat of pain, directly or through the sympathetic system, should be vibrated. The doctor states that while he is a so-called regular, he has relieved severe intercostal and sciatic pains and migraines by means of chiropractice or spinal adjustments, and considers this method worth investigation.

In treating neuralgic or neuritic pains, Doctor Shaller advocates direct treatment to the spine, at the exit of the spinal nerve which is connected with the painful area. Sometimes this nerve is tender along its entire course; again the pain may be reflected and the structures over the exit of the spinal nerves are tender on pressure. In these conditions, vibration or the chiropractic thrust will afford relief.

In cases of myalgia he employs vibration directly over the muscle, or at the exit of the spinal nerve which supplies the muscle, i. e., where it leaves the vertebræ. A stimulating ointment, such as Rubifax, vigorously applied with the hand, will often be found useful in the treatment of myalgia, as well as the use of the hot water bag. As for medicinal remedies, he has found cimicifuga, bryonia, rhus tox and aspirin of value in this condition.

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