Case No. 4.-While eating breakfast one morning, I heard some one hollo, "hello!" at my gate. I got up from the table and walked to the door. A Mexican I knew well was standing at the gate. He said to me, "Good morning, doctor, I would like to see. you a minute." I stepped out of the house and walked to where he was. I said, "Amelia, what do you want?" He said, "Doctor, I am shot, and I want to see if you can do anything for me." I said, "Where are you shot?" and he said, "I am shot in the mouth, doctor." I said, "When were you shot?" He said, "Three nights ago; had not you heard about it?" I said, "No; open your mouth. and let me see." He opened his mouth and I could plainly see where the ball had entered the tongue a little to the right side of the median line of the tongue. I said, "Where did it go to?" He at once turned the back of his neck to me, and said, "Here is where it came out," pointing to a place just to the left of the spinal column on a level with the base of the tongue. I looked at him a moment in amazement, and then said, "You don't need any doctor; if that shot wouldn't kill you in three days you need not be afraid of dying."

The man then gave me a history of his case, as follows: He said that he was at a negro dance and was drinking, and decided that he would have some fun. He took out his six-shooter, which was a forty-four-caliber Colt's, and began to snap it around promiscuously, thinking that it was not loaded at all. Some of the negroes grabbed him and tried to get him to put the pistol up, saying, "You will shoot somebody directly." He told them, "No, there was no danger in that gun; that he could eat one of that size." And at this time he turned the pistol toward himself, opened his mouth and put the muzzle in it and pulled the trigger and it went off, the ball passing through the whole length of his tongue and out at the back of his neck, as detailed above.

The shot did not knock him down, he said, but he was very much frightened, and threw the pistol down, and ran about three hundred yards to a negro's house and went in and told them about it. He sat around for an hour or two and then went to bed. He got up next morning and did not remain in bed a minute on account of the injury. I afterward talked with the negro at whose house it occurred; he corroborated everything that the Mexican had told me.

In concluding this case, I wish to say that if I had not seen it, I do not know whether I could have believed such a thing could occur without killing the man, and I shall not think hard of

any one who refuses to believe my story. To me it seems very close to the borders of the impossible.

For Texas Medical Journal.

A Minor Surgical Operation for the Prevention of Conception, and its Applications.

BY J. W. KENNEY, M. D., SAN ANTONIO, TEXAS.

The desirability of preventing the fecundation of the ovum in certain conditions is self-evident. It is demanded in many instances. This desirability and demand has caused the manufactureof many and varied mechanical contrivances and chemical concoctions. Most of these are useless, many are injurious, and all a

nuisance.

The attention given the subject by surgeons is unworthy of note. In fact, the literature on the subject is almost as scarce as the proverbial hen's teeth.

When the frequency with which we are consulted in regard to the prevention of conception is taken into consideration, it is seemingly strange that its importance has not been realized or at least given more consideration. The answers given to such consultants are usually intended to be humorous, yet, in reality, indicate a lack of knowledge-a lack of appreciation of the importance of the question asked.

The operation which I shall describe is never injurious, nor is it a nuisance, while, on the other hand, it has been very successful in my hands. It reduces the probability of conception to a minimum; in fact, has prevented it altogether, when satisfactorily performed, in my practice during the past four years.

The operation consists simply in the placing of a valve by surgical means in the cervical canal. To do this two incisions are made in the anterior cervical lip-one on either side of the mesial line and about one-eighth of an inch from it. The tongue thus made is depressed and the edges of the two incisions are brought together over it. Some trimming is necessary to make the operation an artistic one. This, however, will suggest itself to the operator. We thus form a valve-like projection into the cervical canal which acts as a practical barrier to anything entering the cervix, while, on the other hand, it but slightly obstructs the passage of anything from the womb.

A condition similar to the one artificially produced as just de-

scribed is often found to exist naturally in the shape of small tumors in the cervix. The sterility of these women is frequently cured by the removal of these small growths. In like manner, the sterility artificially produced can be relieved at any time such a course may be deemed necessary, by the removal of the surgicallyconstructed valve in the cervical canal.

That it is the province of the medical profession, in so far as it is within their power, to legitimately regulate the quality of mankind born into the world does not admit of just criticism. Such supervision is exercised over all other animals and even plant life. Why not treat the human family like kindly? There are few among us who would not think of propagating a species of maimed, crippled or deformed or diseased horses, while there are many who are blindly propagating defectives in the human family. That such a state of affairs is wrong, none will deny. There are among us, however, those who will honestly object to any procedure that will interefere with what they are pleased to term "nature," on moral grounds. To such I can only say that the propogation of a race of idiots or humpbacks is a violation of the laws of God, and should be of man. To their argument regarding laws forbidding the marriage of such persons it can be stated that such laws are ineffective and for obvious reasons will ever be so. When instinct shows itself as passion, reason becomes subservient and laws will be of no avail. The fact that a genius sometimes makes his appearance among the vast throng of diseased and deformed is the only sane argument that can be advanced. Yet I doubt not if such an one were asked if life was worth living he would in truth unhesitatingly say "no." Should they for one minute stop to consider the humiliation and misery that is in store for their own offspring, I am sure their answer would be unhesitatingly and emphatically in the negative.

Chief among the conditions calling for some means of preventing conception may be mentioned consumption, mental degenerates, syphilis, deformities and maternal decay. The elimination of conception in parties suffering with the first named disease would relieve all orthopedic hospitals of more than half their charge, while in the last mentioned the prevention of conception would give health and happiness to many a mother whose life and strength is needed to properly rear those whom she has already caused to be on earth.

The subject of preventive medicine presents many alluring fields for study, yet none can exceed in importance the successful carry

ing out of the object for which the minor surgical procedure prompting this paper was originated. All good things meet with abuse, and should a simple procedure for the prevention of conception be placed in that class, it will likewise be abused. The desire for the operation becomes more and more apparent as its simplicity and reality become more generally known. There will be those who will ask its performance as a matter of convenience -simply to relieve them of the burdens of maternity. There will be others who will seek its performance that they may illicitly unbridle their passions without fear of their sin leading to public shame. The performance of this operation, or a better one for the same purpose, will always be in the hands of the medical profession, and I feel that I can say of the members of my profession, as Longfellow did of women, "Even doctors in their deepest degradation hold something sacred; something undefiled; some precious keepsake of their higher and better nature, and, like a diamond in the dark, still retain some quenchless gleams of the celestial fire."

For Texas Medical Journal.

Resourcefulnsss of Texas Doctors.

LETTER FROM DR. HUGHES.

ST. LOUIS, August 11, 1906.

DEAR DOCTOR DANIEL: I was in your State last year as far as Dallas, and I regret I did not have time to visit you. I like the Texas doctors,-her handsome women, her noble, virile men, and her handsome houses and her new energy. The Texas country doctors are resourceful and fertile in therapeutics and surgical experiments, especially the former generations, when the drug and instrument stores were fewer and farther between than they are now. They could mash potato-bugs with a common flour or dough roller, and mix with lard as a substitute for emplastrum cantharides, and extemporize handy catheters for grave emergencies out of green wheat-straws, greased in the stem and moistened at the insertion-end, and make use of many other valuable substitute resources in pressing emergencies of practice which I will not take time now to enumerate.

Country doctors of other Southwestern States are likewise resourceful. I remember one instance where at tardy labor with the fetal head somewhat impacted in the inferior strait, the doctor in attendance improvised a forceps-blade from a hickory corset

board, such as our mothers and some of the grandmothers of some of the present-day doctors used to wear in their stays, shaving it thinner with his jack-knife, and using it as a vectis. It was from a Texas doctor that I got some of the first suggestions of my early therapeutics in country practice when I began as a general practitioner. The doctor's name was Beall,* from Fort Worth. Is he still living there or anywhere in Texas? It was a Texas or Missouri student who wrote a good thesis in 1859 on Phytolacca Decandra in the management of rheumatism or obesity, and we have phytolin from that thesis.

Very truly yours,

C. H. HUGHES.

For Texas Medical Journal.

The General Practitioner and the Railroads.t

BY P. W. BECKMAN, M. D., BEAUMONT, TEXAS.

Along the line of recent agitation for the betterment of the financial status of the medical profession, I should like to make a few pertinent observations from the standpoint of the general practitioner with regard to railroad practice, viz.: the attitude of the railroad company to the large mass of the medical profession.

First, the system by which the railroad company manages to obtain the services of local surgeons along the road for practically nothing, or for totally inadequate compensation, advantage being taken of some young man who wishes to gain prestige thereby, or who thinks that it will give him an entree to surgery or some hospital, and also to make the acquaintance of the families of railroad employes; or else some older man is holding on to the unremunerative position for fear that he is missing, or might miss, something, or to keep some younger man from getting practice.

This is certainly not charity, for these men are able-bodied men and make good salaries, and are more able to pay a doctor than two-thirds of the people who pay us, and if the per capita assessment is not sufficient to pay the doctor a half-way decent fee for his work, it should be made so, and no part of it should be diverted to the settlement of damage claims for which railroads are legally

*Prof. Elias J. Beall, M. D., Emeritus Professor Practice of Medicine, University of Fort Worth.

Editor.

Read before Jefferson County Medical Society, August meeting.