MEDICAL RECORD:

A Weekly Journal of Medicine and Surgery.

GEORGE F. SHRADY, A. M., M.D., EDITOR.

PUBLISHERS

WM. WOOD & CO., 43, 45, & 47 East Tenth Street.

New York, March 9, 1895.

THE SIN OF SUBSTITUTION.

WE have recently published under the above title several of the numerous communications received in reference to the dishonesty of certain druggists. Now, while we do not believe for one moment that the dispenser is an untrustworthy man by nature, there seems to be something in the nature of his business, as conducted in different places, that gradually perverts his moral sense of rectitude and slowly leads to the crime of which so much complaint has of late been made.

To one who has given much thought to the matter, and followed the burden of these complaints, it is clear that the druggist does not begin dishonest, but that unless he exercises the greatest and most constant care he gradually is led into an easy way of looking at the physician's rights, until by a graduated course of counter-prescribing, playing the doctor, recommending something of his own as better than that prescribed, his sense of right becomes so blunted that it is no longer difficult for him to replace an expensive drug or one not in stock with a substitute.

While it may be possible that some of the talk has been instigated by unfriendly competitors, still there is unquestionably cause for much righteous indignation and bitter complaint.

The suggestion of our California correspondent, published a fortnight since, is a good one from a theoretical side, and might practically settle the question for a limited community in which the evils were pronounced. It is, however, not expedient for physicians to go generally into the drug business. There are serious objections to it, and the two professions must of necessity remain separated. The evils complained of must be remedied, and in time, no doubt, will be. In self-defence the druggist must reform. The pressure brought to bear upon him to cause this reformation will come first from us as physicians, but must be more directly applied through the schools and boards of pharmacy. They should take the initiative, and devise some stringent way of dealing with those who in disgracing themselves bring discredit upon their calling. If examples were made of some of the wrongdoers by legal proceedings much substantial good would be accomplished. It would, of course, entail some trouble in obtaining evidence, but the desirable end would more than justify Perhaps if more care were taken by phy

the means.

THE TREATMENT OF INSANITY BY INOCULATION.

SOME years ago Dr. Colin M. Campbell writing on the effect of typhoid fever said: "Perhaps at some future time when the specific fevers have become more manageable, acute attacks of insanity may be cured by inoculation." In connection with this he cited some cases showing that typhoid fever sometimes cuts short an attack of insanity.

Guesinger states that the course of the psychoses is sometimes favorably influenced by intercurrent fevers, such as pneumonia, typhoid, variola, etc. Willerding, in an article on this subject, reports a case of mania cured by an attack of pleurisy (Allg. Ztschr. f. Psych., 1888, Bd. 20, h. 1). Schutze reports a case of cure following diphtheria, and Dinter one following facial erysipelas.

On the other hand, Dr. Granger, who has studied the effects of intercurrent diseases upon two thousand cases of insanity, concludes that upon the whole such diseases have little effect. He seems to think that painful affections are more beneficial than febrile. Out of 77 cases of insanity attacked by dysentery 4 only were mentally improved, and these only temporarily. Granger attributes much more therapeutic potency to injuries than to disease. He cites six cases in which jumping from heights caused shock and injury, and in all these marked improvement followed.

We recite the foregoing evidence in connection with certain reports telegraphed from Vienna to the effect that Professor Wagner is successfully treating the insane with injections of tuberculin. It will be seen that the experience of alienists does not show that much good comes from the induction of fever in the insane, and it is most unlikely that any permanent good can come from such treatment.

THE DANGER OF TRANSFERRING THE CARE OF NEW YORK CITY'S INSANE TO THE STATE.

As will be seen elsewhere, a bill has been introduced into the State Legislature providing for the transferring

of all the insane of New York to the care of the State. This bill is said to emanate from the State Charities' Aid Association and it presumably is carefully and wisely drawn.

But we foresee many dangers ahead in this plan and it behooves those interested in our charities to go very slowly.

The transfer of the county insane to the State was a measure theoretically wise and was very generally ap proved. But man proposes and politics disposes. Our State institutions are threatened with an invasion by the machine. Already two of these institutions have succumbed and become creatures of politicians. The simple transfer of our city institutions from one party to the other would do no good to the insane, or to sci

by appraisement by a commission of five citizens, two of whom are to be appointed by the Governor, two by the Mayor of New York City, and a fifth by these four. The Manhattan State Hospital is to be governed by a board of seven managers, appointed by the Governor and confirmed by the Senate, and their powers and duties shall be the same as those of the managers of the other State hospitals. Subject to the civil service laws of the State, the managers are to appoint the general superintendent, who in turn appoints all subordinate officers. The Commissioners of Charities and Correction of New York City are to surrender the lands and buildings of the existing asylum, with their furniture, fixtures, stock, and supplies then on hand, to the newly created State Hospital on October 1, 1895. An appropriation of $25,000 is made for the lease or purchase of a dock and for the purchase of a steam ferryboat. The present officers of the asylums are continued in office during the pleasure of the managers, subject to the civil service rules applicable to the other State hospitals. On and after October 1, 1895, the Manhattan State Hospital will come under the provisions of the State Care Maintenance Act, and will be organized and maintained as are the other State hospitals for the insane.

Convicted for Grave-robbing.-Three men who robbed a grave near Franklin, Ind., have been convicted and sentenced to six years' imprisonment. The body was found in the dissecting-room of the Indiana Medical College.

Treatment of Influenza in London.-Influenza continues to be extremely prevalent in London. A member of Parliament who is just recovering from his fifth serious attack, has written to the papers advising the sufferers to mix fifteen grains of citrate of potash in a tumbler of hot water with the juice of one lemon, and to sip this mixture day and night. The idea that fifteen grains of citrate of potash will do any good in influenza, will surprise medical men at least.

Exit Pithecanthropus Erectus.-Dr. Harrison Allen (Science) says that the molar tooth of Dr. Dubois's Missing Link" is human and not at all simian; the skull is also human and so is the femur. The bones found, in fact, are all human and not simian. This view is also taken by Lydekker in Nature.

Medical Society of the Missouri Valley.-The Medical Society of the Missouri Valley will meet at Sioux City, Ia., March 21st.

A Doctor Shot.-Dr. A. S. Bickel, of Florid, Ill., recently called on a farmer's wife who was seriously ill. While the doctor was warming himself by the fire, the husband came to him and ordered him out of the house, saying his services were not needed, at the same time brandishing a shotgun. As the doctor was making a hasty exit, the farmer shot at him, the entire charge entering his right side. Medical aid was summoned, but it is supposed the shot is fatal. The patient had ordered the doctor, contrary to her husband's wishes, and this enraged him. Wives will consult their husbands in Illinois hereafter before sending for a doctor.

Kings County Medical Association. The following officers have been elected for the year 1895: Presi

dent, Dr. J. C. Bierwirth; Vice-President, Dr. N. W. Leighton; Recording Secretary, Dr. F. C. Raynor; Corresponding Secretary, Dr. H. C. Riggs; Treasurer, Dr. E. H. Squibb.

The Mississippi State Medical Association meets in Jackson on Wednesday, April 10th.

Appointments at Jefferson Medical College.-Dr. William Thomson, who has been Honorary Professor of Ophthalmology, has been given the full professorship. Dr. Howard Forde Hansell, who has been Chief Clinical Assistant, has been made Clinical Professor of Ophthalmology.

The Regulation of Doctors' Fees.-A member of the Illinois State Senate, whom we may term O'Dwyer, has introduced a bill into the Senate regulating the fees of physicians and surgeons. The Journal has not been favored with a copy of this bill, but we learn by the daily press that the bill proposes to fix the maximum fee for any surgical operation at $100. Senator O'Dwyer is given credit by the veracious chronicler of the press for being the first to bring this subject to the attention of the law. Journal of American Medical Association.

The Death of M. Alphonse Guerin, of Paris, is announced as having taken place on Thursday, February He was seventy-eight years of age.

21st.

A Statue of Dr. Gross.-The House passed the Senate bill granting permission to the American Surgical Association and the Alumni Association of the Jefferson Medical College to erect a statue to the memory of Samuel D. Gross in this city. The bill appropriates $1,500 for a pedestal.

The Congress of German Surgeons.-The Twentyfourth Congress of German Surgeons will be held at Berlin from April 17th to 20th. Professor Gussenbauer will preside.

A Monument to Billroth.-A monument to the memof Professor Billroth will soon be erected in the ory court of honor of the University of Vienna. The Council of the Faculty has also decided to erect a monument to Skoda and Rokitansky.

How should the Surgeon Clean his Hands ?-In Ger many the usual method for surgeons to clean their hands is that of Fürbinger. It consists in brushing the hands and nails with soap and hot water, then dipping them in an eighty per cent. alcohol solution, and finally washing with a two per cent. sublimate of mercury, each part of this proceeding to last one minute. Recently Reinecke, of Leipzig, has asserted that a sure disinfection of the hands may be obtained by rubbing them with alcohol only and washing afterward with pure sterilized water. The alcohol owes its power to surface of the skin, and enabling the bacteria which its action in dissolving the sebaceous substance on the adhere to it to be easily washed away. Instead of

in

by chemical than by mechanical means, the fine marble powder penetrating into all the folds of the skin and rubbing away all dirt and detritus.-Berlin Correspondent of Lancet.

Average Duration of Life among Physicians. A curious statistical record has been compiled by Dr. Salzmann, of Essling, Wurtemberg, on the average duration of life among physicians. He found, in going over the ancient records of the kingdom, that, in the sixteenth century the average duration of life among that class was but 36.5 years; in the seventeenth century, 45.8; in the eighteenth, 49.8; and at the present time they reach the favorable average of 56.7. It appears from the foot-notes to the above that this very great increase in longevity is due to the disappearance of the "Black Pest," the introduction of vaccination, and the great diminution in the number of typhus epidemics, three classes of diseases formerly the especial scourges of medical practitioners.

Journalistic Amenities.-At the banquet of the Mississippi Valley Medical Association we note among the toasts the following:

for some time upon the blood-serum of the horse as a remedy for tuberculosis. Demonstration satisfactory to himself having justified faith, and acting upon his belief that the horse is naturally immune against tuber. culosis, he has been using for some months the bloodserum of selected horses, carefully injecting the serum underneath the skin of the victim of tuberculosis. He

claims that the horse being naturally immune against consumption, the blood does not require artificial immunization, but can be used direct. About fifty cases have been experimented upon with almost universally satisfactory results. Dr. Paquin has presented a detailed report of his work to the St. Louis Medical Society.-Medical Mirror.

A Man with a Big Heart.-Mr. A. J. Salmon died suddenly at Battersea, London, from a pudding indigestion. Autopsy showed that his heart weighed 21 pounds!

(Temps.) This must surely be a mistake. The heart weighs ordinarily about 10 ounces. It may hypertrophy up to 20 or even 40 ounces-but 20 pounds!

Public Hospitals.-The fancy on the part of physicians to erect public hospitals is one that seems to be

Response-Dr. Frank P. Foster, Editor New York Medical Journal.

There is a kind of grewsome humor to this, which the distinguished editor evidently accepted with his usual good-nature. He described in his remarks with much eloquence the greatness of the Mississippi Valley and its Medical Association.

Further Medical Journalistic Amenities." To the pismire, whose weakness can arouse naught but a sneer, to the pale gray ass, whose offensive sounds loudly reverberate from his rear, to the gadfly buzzing around our editorial ear, we simply respond, Shoo fly, don't bother me."-Medical Mirror.

"Etis" or "Itis."- An unfortunate uncertainty obtains among the profession of this country as to the proper pronunciation of the large class of words whose termination is -itis. Many prefer the continental vocalizing of, giving it the sound of English . The English profession and a very respectable portion of the American profession use the vowel i with its long English phonation-i. There can be little doubt of the correctness of the usage of the latter group, so long as it is English we speak and not German or French. There is absolutely no authority for a continental vocalization of in English speech, for if custom is pleaded in its favor, it is easily shown that custom is widely at variance, and that "itis" has more users. than "etis." Neither is there any uncertainty among the lexicons, whether medical or general, for with quite remarkable unanimity they give the English phonation. Expressing our sympathy for the adherents of the continental sound, we must needs leave them to their fate. -Western Reserve Medical Journal.

Treatment of Tuberculosis with the Blood-Serum of the Horse.-Dr. Paul Paquin, for many years Professor of Bacteriology in the State University at Columbia, Mo., and more recently member of the State Board of Health of Missouri, has been experimenting

himself in this way, and M. Henri Schneider has built and presented to the town of Creuzot, France, a hospital with accommodation for fifty beds.

An Anti-cigarette League, representing twenty-five thousand public-school boys in this city, has been organized.

The Communion-cup and the Homœopaths.-At the Forty-fourth Annual Meeting of the Homœopathic Medical Society of the State of New York, held in Albany, February 12th and 13th, it was

Resolved, This society is in full accord with the statement that the prevention of disease is preferable to its cure, and, believing that the adoption of sanitary methods tends to the prolongation of life and the prevention of disease, desires emphatically to place itself on record as being in perfect sympathy with the movement, now becoming widely spread, to dispense with the usual method of distributing the communion wine, and urges the speedy adoption of the individual-cup system, thereby avoiding the possibility of contracting many forms of infectious disease.

Barred Out of the Massachusetts Medical Society.— The Massachusetts Medical Society has voted to debar from its membership all graduates from the College of Physicians and Surgeons of Boston.

Reviews and Notices.

ATLAS UND Grundriss dER OPHTHALMOSKOPIE UND OPHTHALMOSKOPISCHEN DIAGNOSTIK. Mit 5 textund 102 farbigen Abbildungen auf 64 Tafeln. Von DR. O. HAAB, Professor an der Universität und Direktor der Augenklinik in Zürich. München: Verlag von J. F. Lehmann. 1895.

In this small volume, one of a series of medical handatlases, we have a contribution to ophthalmoscopic diagnosis and pathology not less valuable than the large works of Jaeger and Liebreich. Being small, its

pictures cannot be judged by the same standard of fine quality which belongs to them. But their execution is really admirable, and the illustrations representing conditions nowhere else portrayed are not few. To the beginner as well as to the expert in ophthalmoscopy, the book will be most useful. Sixty-nine pages are devoted to description of the technique of the ophthalmoscope and its use, and to the appearances of the normal fundus oculi. The shadow test is adequately explained, not only in its method of use, but as to both its merits and its deficiencies.

The various appearances of the normal fundus are given in seven pictures, and if, in Fig. 3 a, the glittering reflex from the retina seems overdrawn, the attempt to show what sometimes is met with, will suggest the true explanation of an appearance which might be supposed to be a severe type of inflammation of the retina. The congenital anomalies are figured in eight pictures. It is proper to speak of seven sketches in Fig. 37, showing the senile alterations at the macula, which are by no means infrequent and are liable to be overlooked, leaving unexplained a serious loss of vision. A very interesting series of pictures, Figs. 38 to 45, shows the lesions due to blows upon the globe and to the entrance of foreign bodies. The white patches on the retina of only a few hours' duration, Figs. 39, 40, caused by direct blows (Berlin), have never before, the writer thinks, been depicted in color. That the presence of a small bit of iron adhering to the retina should occasion a lesion at the macula, when this locality has not been touched, is an observation not less important than novel. See Fig. 41.

In brief, this little atlas is a compact and admirable store of information. It is creditable to both author and publisher, and it is most agreeable to recognize that the high standard of ophthalmological teaching, which was so famous in Zürich during the lifetime of the lamented Horner, is being sustained by his succes

sor.

FESTIGKEIT DER MENSCHLICHEN GELENKE, mit besondere Berücksightigung des Bandapparates. Habilitationsschrift für die Universität München. Von Dr. med. J. FESSLER. München: M. Rieger'sche Buchhandlung. 1894.

THIS work contains the report of a series of experiments to test the strength of the human joints, that is, the power of resistance offered by their ligamentous structures. The values were obtained by means of three machines, one used for testing the traction-strength of wire, the other two being powerful levers. In the collaboration of a surgeon with a professor of physics we have a guarantee of the correctness of the results, which is but too often wanting in works of this kind.

THE PHYSIOLOGY OF THE CARBOHYDRATES: Their Application as Food and Relation to Diabetes. By F. W. PAVY, M.D., LL.D., FR.S., Fellow of the Royal College of Physicians; Consulting Physician to, and formerly Lecturer on Physiology and on the Practice of Medicine, at Guy's Hospital. London : J. & A. Churchill. 1894.

THERE seems to have been recently a revival of interest in the subject of glycosuria and of the whole question of carbohydrate metabolism, and this work by Dr. Pavy is therefore most timely. The author's views are known to all students of this subject through his former writings and utterances, and especially through the doctrines promulgated in his Croonian Lectures delivered last June. In this book the arguments in support of his theory are stated at length and the experiments from which they were deduced are described in detail and freely illustrated by micro-photographs. Dr. Pavy is known as the strongest opponent of the theory built up by Claude Bernard in his experiments, and he has here set forth most convincingly and interestingly the grounds for the faith that is in him.

A MANUAL OF ORGANIC MATERIA MEDICA AND PHARMACOGNOSY. BY LUCIUS E. SAYRE, Dean of the School of Pharmacy, Professor of Materia Medica and Pharmacy in the University of Kansas, etc. Pp. xx., 555. Philadelphia: P. Blakiston, Son & Company. 1895.

IN this substantial volume we find described the botanical and physical characteristics, source, constituents, and pharmacopoeial preparation of the official, as well as of a large number of unofficial, drugs. The drugs derived from members of the animal kingdom also receive attention. The subject of pharmacal botany is discussed in the chapters devoted to morphology and to structural botany. In order that the student may understand the proper relationship of drugs, a two-fold classification is employed: 1, That of prominent characteristics, rhizomes, barks, cellular drugs, extractive substances, etc.; and 2, that of natural orders. In both classification to each drug is assigned the same number. This double classification is ingenious and facilitates reference. While an attempt to treat the subject of pharmacal botany in eighty-five pages necessarily results in a somewhat sketchy presentation, the author has accomplished his purpose of laying before the student the essential facts of botany. In the second part, although the pharmacopoeial definitions are not followed, they are concise and, in general, excellent. The illustrations, nearly five hundred and fifty in number, are mostly from original drawings, and add greatly to the value of the book. Of especial interest are the appendices treating of insects injurious to drugs and of organic remedies formed by synthesis. In the latter appendix we recognize many old friends, and, as well, the newer acquisitions to materia medica. Their classification, as of the paraffin series, halogen derivatives, alcohols, ethers, esters, derived ureas, oxybenzoic acids, etc., is especially helpful, and tends to reduce to orderly precision the chaos which exists in the average mind when it attempts to understand the relationship of the numerous synthetic compounds. A third appendix is devoted to pharmacal microscopy, quite too brief, we believe it to be, and to a very satisfactory glossary of botanical and therapeutical terms. have read this book critically, and we believe that the presentation of these subjects is a very satisfactory one and a faithful representation of the present existing knowledge which obtains in these closing years of the nineteenth century.

We

THE ESSENTIALS OF HOMEOPATHIC THERAPEUTICS. By W. S. DEWEY, M.D., Late Professor of Materia Medica, Hahnemann Hospital College of San Francisco, Cal., etc. Pp. vi., 266. Philadelphia: Boericke & Tafel. 1895.

THIS little book is a quiz-compend upon the application of homoeopathic remedies to diseased states, and under chapter headings of diseases and symptoms are found the various symptoms and indication for the use of drugs. Doubtless the homoeopathic practitioner will find this a very convenient book for reference.