Issued First and Fifteenth of Every Month by the Fortnightly Press Co. UNDER THE EDITORIAL DIRECTION OF FRANK PARSONS NORBURY, M. D. AND THOS. A. HOPKINS, M. D. Secretary: CHARLES WOOD FASSETT. A COSMOPOLITAN BIWEEKLY FOR THE GENERAL PRACTITIONER Editorial Offices in St. Louis, Chicago, Cincinnati. Jacksonville, St. Joseph, Kansas City, and Pueblo, where specimen copies may be obtained and subscriptions will be taken. Address all business communications to the Fortnightly Press Company. Address all contributions and books for review to the Editors, Century Building, Saint Louis. Volume XVI NOVEMBER FIRST Editorial Department. Number 9 THE annual address in Medicine before the British Medical Association this year was delivered by Sir Richard Douglass Powell, who chose for his sub Recent ject "Recent Advances in Practical Medicine." The address is masterly and typical of the scholarly views held by Powell on medical subjects. The address is conservative, yet fully in touch with the best and most useful advances in the art and science of medicine. The Philadelphia Medical Journal published the address in full, from which we briefly present the essentials: Medicine has kept pace with the advance of the other sciences. The newer discoveries and invention should not, however, be allowed to supercede the older methods. Photography, bacteriological examination and surgical exploration should be used as aids rather than successors to auscultation and palpation. The flexible stethoscope, while it intensifies sound, practically obscures impulses. Although the rigid stethoscope renders these more audible, it cannot take the place of the tactile sense in auscultation. The sphygmograph, although not for every day use, has, through the careful study and comparisons rendered possible by its use, caused a revival of the appreciation of the value of the pulse. "The clinical habit of listening to the heart, not only with a view of hearing morbid sounds, but to estimate its work value, is also of recent acquirement, and thus we are coming better to perceive the true function and value of instrumental methods to illustrate, record, and instruct in the more accurate use of our naked senses.' It is only recently that we have learned not to regard the thermometer as a sole and sufficient indicator in febrile conditions, and to learn that it is only the sudden rise of temperature and the abnormal nervous effects that require antipyretic treatment, and not a temperature which is normal to the disease. We have become convinced that specific poisons may overlap one another in the same illness, causing anomalous fevers, which can only be rationally treated by the recognition of their dual nature. Thus the most successful treatment of tuberculosis is directed toward the secondary sepsis, and not the primary infection. The study of bacteriology promises great things; through its association with clinical observation we are acquiring a better knowledge of bacterial poisons and their effects. We have about us constantly the specific organisms of many diseases; these are, however, not virulent under normal conditions of our bodies. In order for an infection to take place there must be either an inherited or acquired susceptibility to lessen the natural resistance to this form of attack. A common cold resulting from a momentary chill may become a highly contagious disease. Many persons having a feeble vitality are constantly catching cold. Here the specific cause being always present on the mucus membrane of the air passages is not amenable to treatment, and the attention should be given to building up the resisting power of the patient. The tendency to rheumatism, which is probably caused by a micro-organism, is inherited. In chorea, a manifestation of rheumatism, the attack is usually preceded by a mental shock, which lower the resistance of the nerve centres. It is hardly possible that the shock and infection should occur at the same time; the poison must, therefore, have pre-existed in the body of the patient. A more thorough study of these facts would probably result in better methods of prevention and treatment. The success of serum therapeutics depends on the exact and early determination of the nature of the infection. A pneumococcus infection cannot be successfully treated with an antistreptococcus serum. Thus although the possibility of neutralizing the effects of a specific poison will lessen the labor of the physician, the value of the ability to make an accurate, early diagnosis will be greatly enhanced. From the researches of Haffkine and Wright and others we may reasonably expect to have a means of procuring immunity from typhoid fever and plague, in the near future. Regarding tuberculosis the author says: "Truly a disease which claims one-ninth of our mortality may well command our deepest interest. That it is au fond a right grouping to place all the previously ascertained causes of consumption among the predispositions, and to regard the disease itself as produced by a definite infection or contagion through the inhalation of sputum-dust, or by the ingestion of tubercular foods, has been accepted at least for the last ten years; but we must not discontinue to attach a due importance to the other etiological factors, because one of them may seem prima facie to be sufficient. To set heredity at naught, to regard climati consideration as of no importance, and to state that the disease is always acquired by direct contagion or infection, is, in my opinion, to ignore much that is true, and to magnify that which should be carefully guarded from exaggeration." Marriage of these patients should be discouraged. Without the inherited predisposition and in ordinary sanitary surroundings the danger of infection from a tubercular person is extremely small. "By further careful sanitation, by destroying and diminishing the careless, distribution of bacillary dust, and by withdrawing from human consum ion, tubercular food," we can still greatly decrease the 14 per 10,000 mortality from tuberculosis. The author has appended a table showing the action of the various serums. the workings of the Let Us Not WE find that we inadvertently stirred up a hornet's nest when we criticized Illinois medical practice act. Some of our friends have taken it as a personal criticism of their acts, in their endeavor to right the wrongs which the old medical practice act placed upon medical practitioners in Illinois. We recognize that there is a personal factor in the controversy, but it is far from our intentions to even insinuate that the tactics of the committee, at the time when the law was in the balance, were not the very best under the circumstances. We honor them for their persistency in bringing to an issue and consummating some very desirable reforms. But it is unfortunate that their legal advisers did not anticipate the workings of the mental healing clause. The success of the law no doubt is all that could be desired in bringing into line the irregular medical forces, but how unfortunate is it that the mental healers have a loop-hole through which they may escape, and are legally at liberty to carry on their nefarious work, The State seemingly selected. these chosen sects as subjects for the display of paternalism. The law is defective, and is creating a sad reflection upon the wisdom and foresight of those members of the legislature who could not, or did not anticipate this feature of the law. Public opinion is sure to condemn such a law which removes beyond the reach of legal responsibility the hyenalike practitioners, who prey upon the young and innocent children, who indeed, are, as Mann well said, "the wards of the State." The grown man or woman, who has escaped the insane jury, is at liberty to have all of the faith healers in the world-probably leaves less work for the fool-killersbut we insist, and emphatically too, that the children even of such degenerates, must be protected by the State. Dr. Dillon Brown in his valuable journal, Pediatrics, in a timely editorial says: "A sick child has an inherent right to the benefit of the judgment of those most experienced in dealing with the actualities of disease, and we believe that laws will soon be passed which will protect children up to a certain age of consent, from the criminal neglect of parents and the inhumanity of scientists." We do not want to mince things when we claim this law is defective, and we wish to say we are not heaping personal criticism on the efficient committee of the Illinois State Medical Society. We are after the lawmakers the lawyers who passed on the law now on the books, and we w reform. The Chicago daily papers recently recited the death of a few`days' old child, caused directly by the ignorance and inhuman Dowie followers. Must this go on for two years without protest? F. P. N. WE regret to hear of the resignation (on account of ill-health) of our personal friend and collaborator, Prof. Ernest B. Sangree, from the chair of Pathology, Vanderbilt University, Nashville. Prof. Sangree was a victim of cerebrospinal meningitis last spring, and while his useful life has been spared, his convalescence is slow. He is now East recuperating his strength. Intelligent Investigation Desired. Magnetic healing after the "Weltmer Method" displays its saintly characteristics, its divine inspiration, and certainly courts "intelligent investigation," when by the hand-bill, the poster and the "display ad." it appeals to the credulous, unthinking public. The following extract from a hand-bill dropped at my door, is typical of the meek and lowly Weltmer and his kind: MAGNETIC HEALING.-Prof. Druitt, Magnetic Healer, a graduate of the famous "Weltmer Method" and one of his most successful students. Consult him at once if you are sick and have failed to find relief elsewhere, it may prove a blessing to have consulted this wonderful healer. He will put you on better terms with yourself, and will put new hope in you, so that life will look brighter for you in many ways. Don't delay. It may be the chance of your life-time. In most cases he will locate your disease without your telling him. The Professor don't care whether you have any faith in his method cf healing or not. He will soon create faith by getting results, and thus give you a substantial basis to build your faith upon. Magnetic healing is a fact. It is perfectly natural and is nature's own cure. Such is the uniform success of this method that we get a higher percentage of cures than by other known method of curing disease. Intelligent investigation desired. There seems to be a divinity that shapes the destiny of metaphysica healing in Illinois, for the freedom which it enjoys under the new medical practice act, is certainly honored class distinction; a deference paid to a superior class of individuals. It also shows, as Mr. Dooley would say, that "th' quarantine of irregulars is an infamous farce," and that "sum unsatisfachtrly ligislation has agin r run thru de ringer." "It coorts intilligent invistigation, do it? Well, if it kapes on it will own the coort, as it does the rayceipt fur wurkin the ligislature and the State Boord of Health." F. P. N. THE ALUMNI REGISTER U. of P. in its publication of personal jottings reads like a Sunday daily; marriages, engagements galore, but little of the news, locations, etc., of "the medics of Pennsie" we knew on the benches of old Blockley. Incontinence of Urine.-Besides the incontinence of urine symptomatic of a material lesion of the urinary tract, there exists, as is well known, an incontinence called essential, without any apparent lesion or anterior affection. In certain subjects the bladder is particularly sensitive, and the muscular fibers do not permit of extension beyond a certain limit. If it is exceeded the individual is forced to urinate. During the night sleep renders this sensation of the want to urinate still more obtuse, the child takes no notice of it, and wets the bed. According to Guinon, incontinence of urine is a stigmate of nervous heredity, for in nearly all the cases can be found hereditary antecedents in the parents who had suffered from hysteria, chorea, or other nervous affections. The medical anti-nervous treatment should consequently be the principle of the therapeutics-bromid of potassium, valerian, belladonna, etc.; frequently good results are obtained by pills containing ergot of rye, iron, and a little belladonna.-Medical Press. The Reviewer's Table. Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis THIS is a timely and much needed work, on a subject now of great interest to all concerned in the disease of tuberculosis. Every intelligent physician appreciates the modern consideration of tuberculosis, its newer pathology, treatment and preventive treatment. Knopf has displayed rare qualifications as an authority on this subject-he deals with it from a standpoint of a preventable disease, discussing the history of tuberculosis; its mortality; its curability; its communicability; its preventive treatment and its treatment in the sanitoria of Europe and America. Home treatment by aerotherapeutics, rest cure and general remedial measures. Complications are then considered. Taken as a whole this is a valuable book, and should be in every physician's library. PULMONARY TUBERCULOSIS. Its Modern Prophy- F. P. N. SOMETHING better than a year ago we had the pleasure of reviewing the first edition of this work, we then predicted a large field of usefulness for it, in fact, the author's original intention was to supply his students with a suitable text-book, but its scope was widened and the work has been pronounced a success by practitioners and specialists, and is largely used by them. The work of revision has greatly increased the value of the book, it is now brought up to date in every respect, more profusely illustrated, and made in every way suitable alike as a reference work for all classes of medical men. The season of respiratory diseases is again with us, and with it comes a realization that newer reference works are needed on this subject. Bishop will be found a valuable addition to any library. DISEASES OF THE EAR, NOSE, THROAT AND THEIR ACCESSORY CAVITIES. By SETT SCOTT BISHOP, M.D.,D.C.L., LL.D. Professor of Diseases of the Nose, Throat and Ear in the Illinois Medical College; Professor in the Chicago Post-Graduate Medical School and Hospital; Surgeon to the Post-Graduate Hospital. one of the Editors of the Largyngoscope, etc. Second Edition. Thoroughly Revised and Enlarged. Illustrated with 94 Chromo-Lithographs and 215 Half-tone and Photo-engravings. Pages 554. Extra Cloth, $4.00 net; Sheep or Half-Russia, $5.00 net. Philadelphia: THE F. A. DAVIS CO., Publishers, 1914-16 Cherry St. AMERICAN POCKET MEDICAL DICTIONARY. Edited by W. A. NEWMAN DORLAND, A.M., M.D., Assistant Obstetrician to the Hospital of the University of Pennsylvania. Containing the Pronunciation and Definition of over 20,000 of the Terms Used in Medicine and the Kindred Sciences, along with over 60 Extensive Tables. Second Edition, Revised. Philadelphia: W. B. SAUNDERS, 1899. Price, $1.25, net. THIS the second edition of Dorland is the best dictionary for the student's use we have seen. It is compact, well printed and bound, and fills the wants of the medical student for daily use. |