the kind of cell-proliferation, or change. The specific action of barium chloride on sclerotic tissue, relative to angina pectoris, may appear in another article later. Syphilitic Stricture is due to an infiltration from the blood of a substance resembling lardacein in the walls of the small blood vessels, especially the arterioles and capillaries, or in organs whose tissues are already injured by disease through malnutrition, due to anemia. In a large proportion of cases the intestines are the seat of the deposit, occasionally the esophagus, testes, etc. This infiltrated substance is soluble in water. The specific virtue of oil of hyssop is to purge the system of the specific virus. The free use of water, drinking, if possible, two quarts daily in divided portions, and two hot baths a week, cleanses the system and carries off the matter prepared to be eliminated by the hyssop.

Ulcers Accompanying Syphilitic Disease, as in other instances, is a secondary matter, due to malnutrition of the tissues, through disease of the nervous system in particular. Lower vitality of a tissue is due to interference from any cause with its nervous supply. Ulceration is due to nerve change and lessened resistance of the tissues. As syphilis is so largely a disease of the blood corpuscles, arsenic is a most valuable remedy to restore the normal standard of the corpuscles, and copper to restore the standard of nerve substance of the brain and abdominal nerves. Arseniate of copper, one one-hundredth grain, one tablet night and morning for several days at a time only, watching the same, will render most valuable service in these conditions.

A most valuable key for the discrimination of causes for those who will receive it-it is written: "For the good are good things created from the beginning; so evil things for sinners or the disobedient of the highest laws."

Enclosed find one dollar and a half for the MEDICAL BRIEF and Funny Bone. I take all the leading medical journals, and can truthfully say the BRIEF ranks with the best.-DANIEL B. CLIFFE, M. D., Nashville, Tenn.

[Written for the MEDICAL BRIEF.] Faddists.

BY JOHN A. WELSCH, M. D., Farber, Mo.

All professions have their faddists, the medical profession being no exception. They have the fellow who is looking for the lost corpuscle, those who are looking for the misplaced cell, those who are trying to discover the contagiousness of tuberculosis and of pneumonia, and the fellows who cure everything by infecting one of the lower animals and drawing off the serum from the infected animal and reinfecting the man. These fads are probably harmless to those who follow them and possibly all contain an element of truth which continued investigation and research may make of practical value to the physician, providing he is left free to use his individual judgment and make his selections after comparison and investigation.

But there is another class of faddists that are a menace to the profession as a body and individually. They are the law faddists. Nothing not original with them looks right to them, and yet they are not willing that their pet theories shall be placed before the profession and they be allowed to use their judgment in the matter and they are not usually brilliant enough nor have they professional success sufficient to make them prominent or powerful. But they are determined to secure both, and knowing the average physician to be an overworked and poorly paid individual, they realize that here is a good field to sow the seed of discontent and they proceed by telling them that if you will sacrifice your liberty and place the matter in our hands we will have laws passed that will legislate the other fellow out and you in; in other words, we will take the practice from the other fellow and give it to you by a process of legislation.

The physician being a busy man with no time to investigate beyond the sound of words, and they sound good, accepts the proposition. But the support of at least a part of the people is needed and the law faddist appeals to them after this fashion: He says to the people, Your physicians are

ignorant and incompetent, you need protection, you need a law that will insure you that none incompetent will be allowed to practice and this will save you the trouble of using your own judgment in the matter, which would likely be poor in any case, and the result laws are passed. These laws, of course, require some one to see to their enforcement. This means positions which are filled by political appointment from the ranks of the law faddists. And the result is that the physician finds himself bled for fees on every hand-competition increasing. Nondescripts of every kind springing up, his right to change his location prohibited, his right to think and regulate his own conduct questioned, his favorite medical society converted into a political machine to serve the interests of these self-appointed guardians. And possibly his very right to practice where he has served so long questioned. And, finally, these guardians, in order to make themselves perpetual, organize, and make the declaration that in the future a diploma from one of our reputable medical colleges shall serve only as a means of identification, and have no weight as an evidence of education or fitness to practice. label being the only genuine, and this can only be procured by being a member of one of the societies supporting the guardians, or, possibly, two of such societies, in addition to the means of identification; and if this, together with their extortionate fee, will not keep you out they have what they call the preliminary educational requirement, which they admit, in some places where they use it, that it is of no practical value to the prospective physician, and yet they use it. Some physicians dare to question where these politician regulators get their education which pales a diploma from one of our great institutions of learning into a means of identification and robs it of its value as an evidence of qualification.

Their

Others would like to know why they must belong to at least two of their pet societies before they are entitled to any recognition from them, and their answer is: You have appointed us your guardians and you must not presume to think about these things. You publicly acknowledged your unfitness to use your

judgment as to your conduct as professional men and now you must not be unethical and question our wisdom, and if you do we have you where you can not help yourselves, so now be good or we will prosecute you under a new law which we propose to have passed by the incoming legislature to create a few more offices and further protect you and the people.

While the above statements look as if they were extreme, they are facts.

If some worthy practitioner who graduated some fifteen years ago will attempt to change his location he will find this to be a correct statement of affairs. Why should the medical profession have guardians? If it is a fact that such an extensive preliminary requirement is necessary, how can a man have success without it, as many of our best and ablest practitioners do? Are the people so ignorant they can not distinguish between a successful physician and an ignorant pretender? Why should a physician be compelled to belong to a medical or other society whose principal accomplishments are to devise laws to furnish salaried positions to their political promoters and work hardships on the rank and file? This does not allude to the society whose expressed objects are to promote scientific investigation, disseminate knowledge, and promote friendly intercourse between physicians. Special legislative committees are not necessary in such a society and special class legislation has no part in its working. How long, brethren, before we will wake up and dismiss the political doctor?

[Written for the MEDICAL BRIEF.] Pneumonia Not Necessarily Fatal.

BY E. V. PENNINGTON, M. D.,

Mohawk, Tenn.

Of late I see much in the medical journals and newspapers about the great mortality of pneumonia in New York and some other Eastern cities. I read these startling accounts with amazement and wonder. At a meeting of a New York medical society some weeks ago one of the prominent members of the society frankly told them they did not know how to treat pneumonia, and the sooner they would acknowledge the fact and set to

work to find a successful treatment the better it would be for all concerned. They bowed up their backs and fuzzed their tails like a set of mad cats, but when he showed them their record they had to own it. The unsuccessful part of the profession are trying to teach the people there is no cure for it in order to cover up their ignorance of its treatment.

This is very plain talk, but the result of their work shows that the undertaker gets most of their patients and the world can see at once that their efforts are a blank and a failure. I believe that the treatment used by nine-tenths of the physicians for pneumonia is a failure; but, gentlemen, it is not because there is no successful treatment for the disease. It is because they have laid down common sense and rational therapeutics. They have gone off after "fads" and have not yet returned (to the sorrow of the families of their many patients).

New York is considered a great medical center, and it is a great city and has some good men in it. They have some good medical colleges there and it is considered very popular for physicians to go there for an education (?). But how about a man trying to be a professor in a medical college and to teach other men how to treat the sick and cure a case of pneumonia when he can not do it himself? If the men at the head of the profession can not cure a case of this disease they had better "go foot" and come up again. They had better go to the country and take lessons under some "cross roads" doctor until they learn to successfully treat this, one of the easiest of all diseases to be cured.

I know this does not correspond with the teachings of some of those considered most eminent in the profession, but it corresponds with fifteen years of personal experience, and I lean on that stronger than any man's writings or my college teachings.

A few years ago a representative of a medical publishing house offered me a work on practice by one of America's most famous teachers and writers. I happened to open the book at the chapter on pneumonia. I scanned his treatment and it said: "There is no successful treatment for this disease. If there is any

thing which influences or cuts it short or cures it one day sooner than it would get well without treatment I have never found it out. Most of them will die, anyhow." I did not buy the book, of course not. The trouble with most of them is that they are all trying to act "German," or do like Koch and a host of others have tried to do-advance some great germ theory and laud some fake serum or germ killer and have all the newspapers and medical journals howling for the immortalization of this giant discoverer; and when we find the truth of the theory by a test, there has been nothing discovered. They try to catch a great big opossum out of a great big tree, when in reality it is only a small opossum sitting in the fork of a dogwood bush where they could have easily reached up and got him if they had known he was there.

The New Yorkers protest that the sooth. ing influence of their presence might benefit the dying patient. It would be just as well and more economical to just call the preacher to do that. A physician that can do no more for a pneumonia patient than that had better get him a job as a dry goods clerk or to sell "lightning rods."

This "germ theory" fad has done more harm to the profession than anything that has crossed our path yet. It has caused good men to throw down rational treatment (treating the patient and his symptoms) and go to hunting for "bugs" and microbes that unscrupulous and unscientific bacteriologists have told them was the cause of the disease. Then they spend all their time hunting for a remedy that will kill the microbe, and when they have gotten the "bug" killed the patient is killed, too. They go hand in hand together into the grave.

The microbe is not the cause of the disease, but is the result of it. Nature sends those little scavengers in there to devour the decaying tissue to prevent sepsis and consolidation of the lung.

Let the bug alone; when he is no longer needed in there Nature will remove him. He does not attack healthy tissue and can only thrive where there is decay going on. A pneumococcus never was the cause of a case of pneumonia and never will be. Then it is just as rational to try to kill

all the buzzards when your horse gets sick as it is to try to kill the microbes because a man is sick. He only destroys the dead and poisonous part of the waste from a diseased system. Pneumonia is one of the most dangerous and painful diseases we have if let run its course, but I reiterate, it is one of the most easily managed, and easily aborted at any stage, of any disease that I have ever treated.

I see no reason whatever for such a mortality from it as we are having. I think myself it is time to call a halt, consider our fatalities and the virtue of our remedies, and if we can not keep "crape off the door" with the treatment we are using, get one that will give satisfaction.

When men's and women's lives are at stake there is no time to sit around "looking wise" and wait for our personal bearing to influence the patient to recovery, and then when he dies stand around the mourning family and say: "The Lord giveth and the Lord taketh away; blessed be the name of the Lord." The Lord did no such thing. He had nothing to do with it outside of the laws of Nature.

I write this article not just to criticize somebody, but to keep the profession from shutting out hope of successful treatment of such a prevalent and fatal disease as pneumonia has been. I am tired of hearing college professors and medical writers reiterate their fool bug theories and pathological nonsense about this disease and teach budding physicians that there is no cure for it, and to be satisfied if he cures a few of them (or rather if a few get well in spite of him).

Gentlemen, it takes one hundred per cent of cures to satisfy me in treating this disease. It is very prevalent in East Tennessee, and in fifteen years of experience with it I have treated them at all stages of severity and all ages. With the treatment I use I always find them better on the second visit, and usually better every day until they are well. I always dismiss the case inside of seven days. I have never lost one, and if I ever do I shall be so dissatisfied with myself I shall quit the business. It is not so much in which remedy we use as how we use it. First we should make a positive diagnosis of existing conditions. Go at it

sensible, like a mechanic would do in dealing with a defective piece of machinery. Know what is wrong. Know what will have to be done to relieve the situa tion and then select the best one of a class of remedies that will produce that effect. When that remedy is selected, use it according to effect. Make it do what you want done, then stop. The one that is most skillful in the discharge of this duty is the one most successful in curing pneumonia. We need no new remedies or specifics to do it, but use what we have and use them for all the good there is in it. I lose patients with some diseases, but it pains me to hear of good men and women dying of this disease. Then, when the profession is trying to satisfy the public mind with their unsuc cessful clumsiness I can not help but "speak up."

I would like to go more into details, but fearing I am already too lengthy I will have to stop.

[Written for the MEDICAL BRIEF.] Case of Necrosed Bone of Head.

BY A. D. SHAW, M. D., Physician to Garland County Poor Farm. Hot Springs, Ark.

Jacob Motts, white, aged fifty-three, admitted to poor house, March, 1904.

On my first visit to farm after his admittance, on close examination and history, diagnosis was: Syphilitic necrosis of parts of temporal and frontal bones. Center of necrosis was at sutures of said bones. He contracted syphilis some twenty years ago. Had taken treatment here for a period of ten years, off and on, as a sore would break out, until all his money was gone, hence going to the poorhouse.

After examination, I gave patient constitutional treatment, until in June, without any good results, I advised an operation. Not having any place to operate at the poor farm, had patient brought to my office, on June 20th.

Assisted by Drs. R. G. Davis and S. D. Weil, we proceeded to operate, mind you, in a private office. Patient being a pauper, and no fee from him, only the paltry fee of $50 from the county

for the operation. Patient cleansed, placed on chair and etherized. We made our incisions as follows: Commencing about one inch above and in front of ear, extending to eyebrow. Along suture of bones, upward an inch, and along same suture downward two inches. Exposing five and one-half square inches of necrosed bone, with lines of demarkation very plain; lifted out bone and exposed an abscess containing an ounce of pus. A fistula had formed along the frontal bones, which was removed. Wound cleansed and dressed, and patient put on cot a few hours. After operation patient went to his room, coming up every morning for the wound to be dressed. The wound was healed by granulation, not putting in a plate of any kind. Patient has made a complete recovery.

Now, what was the cause of the necrosis? Was it due to syphilis, or was it due to mercurial salts deposited in the sutures of bones. As I have two more cases of necrosed bones, one of leg and one of arm, in syphilitic patients out at the poor farm, for when they go to the poor house they have had the treatment here, viz., rubbing mercury, and taking kali iodi. from one to ten years, off and on, as a sore will break out. I would like to hear from members of the BRIEF family as to the causes of the above troubles. Success to the BRIEF and its readers. 234 Central Avenue.

[Written for the MEDICAL BRIEF.] Halitosis, Bad Breath.

BY C. W. CANAN, M. D., B. S., PH. D., Orkney Springs, Va.

In treating this subject we will be as brief as possible, owing to limited space. The exhaled air, called the breath, is composed of nitrogen and oxygen; the latter is less in proportion than found in the atmosphere. The breath also contains aqueous vapor, ammonia, organic impurities, and a little over four per cent of carbonic acid. The last named ingredient is increased in the early stages of the acute infectious diseases, viz., measles, scarlatina, small-pox, etc., except typhus fever, when it is diminished. The

temperature is slightly less than that of the body, being influenced by that of the external air, but seldom falls below 92° F. In fevers, the temperature is increased, but in the algid stage of cholera, and when death is pending, in many diseases it is almost cold.

In perfect health the breath is almost odorless, but is modified by very slight causes, and under many conditions becomes valuable as a diagnostic sign.

In diabetes mellitus there is a peculiar sweetish odor, likened to those of honey, sweet apples, or new mown hay. In glaucoma a peculiar breath known as haleine safranee is invariably present. In pyemia there is a peculiar breath that is hard to describe, but when once detected will seldom be forgotten. The breath of chronic alcoholisms is very offensive, possessing a peculiarity, unlike any other odor. Many volatile substances when entering the system through the ordinary channels are excreted to a certain degree through the lungs, and contaminate the breath. These are chloroform, turpentine, alcohol, etc.

Bad breath may be due to either local causes or systemic disease. Among those that are local will be found dental caries, and various affections of nose, mouth, larynx, pharynx, tonsils, and lungs. Bad breath more frequently results, in those who have decayed teeth, from particles of food that are undergoing decomposition than from the teeth themselves. This is sometimes the cause where there are no caries, in persons that are careless about their teeth.

In cancrum oris, follicular tonsillitis, and necrosis of the jaw, the breath has a very characteristic sickening odor. In follicular pharyngitis, the odor is due to decomposition of the secretions and food particles that fill up the follicles, and is characteristic of fecal matter. The breath in diphtheria is suggestive of putrefaction.

There is a condition known as catarrh of the tongue, which occurs as a disease per se, or may be associated with dyspepsia, in which the odor is due to decomposition of mucus, epithelial scales and particles of food.

Offensive breath is always present in dyspepsia, either gastric or intestinal. The cause, or wherefore, is easily under