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that there are some very able men among them) desire to take up this matter, I wish they would cite the law, or give some standard authority to vouch for the opinions that they may put forth.

Glittering generalities will do in some cases, but don't work well in law or medicin. I desire to state that my arguments are in no way personal, as I am registered in several

states.

I desire to thank Dr. Taylor for his courtesy. GEORGE W. HENRY, M.D.

Camden, N. J.

[That's right, Dr. Henry, keep it up until you get satisfaction. Your December article came in late, and I wrote my reply hurriedly, without taking time to look matters up as it is now evident that you desired; and even now I am not able to give you the citations that I wish to, as the sources are not now at hand, but will be soon. But you want the ball kept rolling now, and I will not disappoint you; tho I hope to be better equipt by next month. For the present I will analyze your position, and then give a constitutional citation.

Please fasten your eye on your second paragraph, and appreciate the fact that there is a difference between state laws and United States laws. Please realize also that there is no United States medical law, and never has been. A citizen of, say New Jersey, is a citizen of the United States; suppose he complies with all the laws of the United States, and also complies with the medical laws of New Jersey. Then he moves to New York. He is still under the United States laws, as every citizen of every state is, and while he is in New York he must be amenable to the laws of New York. He has left New Jersey and hence is not living under the laws of New Jersey. He is living in New York, hence he is living under the laws of New York. New York has a medical law, and there is no United States medical law, and there is no United States law in conflict with the New York medical law. Therefore while he is in New York he must be subject to the New York medical law--not the medical law of New Jersey, for he has left New Jersey, and New Jersey has no right to extend the jurisdiction of her laws into New York. Is that clear?

Now let's take your next paragraph: You say "legal and chartered medical college of the United States." The United States never chartered a medical college. The colleges you mention, and all other colleges, were chartered by their respectiv states. You didn't think of this, or you would not have made the argument. If you would keep before your mind the fact that the United States Government and the governments of the different

states are different, your argument would be clearer.

Now to your Fourteenth Amendment: The privilege of practising medicin is not given by the United States to any citizen of the United States, except to surgeons of the Army and Navy. There is no United States medical law. Practising medicin is not a United States privilege, except by surgeons of the Army and Navy. This part of the Constitution does not and cannot apply to privileges granted by states, under state laws. Is that clear? Keep it clear in your mind that the United States Government is one thing, and a state government is another. Every citizen of any and every state is a citizen of the United States, and as such he is amenable to the laws of the United States; he is also amenable to laws of the state in which he lives.

Art. IV, Section 2: Here is the same thing. The "privileges" granted by the United States are of a certain class, and they must be uniform in all the states; but individual states may and do go further into detail concerning privileges, immunities, restrictions, etc.; and they have a perfect right to do this so long as they do not conflict with the powers of the United States. Illustrations are given a little further down in your article. The butcher may not slaughter diseased animals and offer their carcasses for sale, nor sell tainted meat. (I think there are United States laws as well as state laws regarding this.) Bakers may not sell unwholesome bread, else the local or state board of health will get after them. Barbers are restricted by sanitary laws in some states. Milk men are subjected to careful regulation, concerning both their premises and product, differing in different localities and states. And who will say that these protectiv regulations are not wise and right?

Now as to the constitutional authority for the states doing all these things, most or all of which are placed, perhaps arbitrarily, under the head of "police powers." I have searcht the constitution for this, and it seems to me that the foundation must be the Tenth Amendment, which reads:

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectivly, or to the people."

The consensus of opinion (I beg your pardon for this expression) seems to be that the powers that we have been discussing are not given to the United States by the Constitution (see list of powers granted in Article I, Section 8). Also it is generally agreed that the powers that we have been discussing are not prohibited to the states; therefore they are reserved to the states.

Is not this clear constitutional authority? But here is a point that seems to have escaped the notice of all former observers, and I am happy to have observed it. Notice the last four words of the amendment above quoted: "or to the people." Here is a basis for a National medical law, if enacted by the people. At present we have no machinery for direct legislation by the people. If we had, here would open up vast powers to the people. Let us think of this.-Ed.]

Leucoplakia.—Ichthyosis of the Tongue.-Report of a Case.

Editor MEDICAL WORLD:-One of the most stubborn and troublesome diseases that I have met, except cancer, is that of leucoplakia. It may be described as deep ulcerativ fissures upon the superior surface of the tongue. These fissures, or cracks, are really deeper than they appear to be unless examined by probing them, and are covered along the bottom and sides with feeble and broken-down granulations. Between the fissures, and occupying the remaining surface of the dorsum of the tongue, are island-like spaces or patches, denuded of epithelium, and covered by a thin film of tissue, resembling wet kid leather, slightly raised in the middle. They are firm, but not hard except on the immediate surface. They yield with an elastic rebound when prest upon with a probe. A dirty looking heavy coating covers the back of the tongue, and a disagreeable odor accompanies the breath.

The sides and under surface are shiny red and smooth, except small cracks and pimples upon the tip and along the borders. There is acute soreness of the organ, and ulceration inside the lips at a few points, but no swelling or tenderness of any of the lymphatics.

In Vol. II of Ashhurst's International Encyclopedia of Surgery, 1882, plate xiii, facing page 503, there is a good picture of this lesion, except the color is too dark. The color should be nearly white or grayish-white principally, on the dorsum of the tongue, with red edges.

My patient is a business man, 57 years of age, nearly six feet tall, weight 175 lbs., fair complexion. Except the use of tobacco, his habits are exemplary and neat in every way. Has had chronic muscular rheumatism for years, and severe attacks of psoriasis. This latter disease has given him much trouble, mostly during winter and spring. Scaly patches and dark areas of infiltration of the layers of the skin have occurred a time or two, and they were stubborn and hard to heal. admits gonorrhea, but declares he never had a syphilitic sore of any kind. Nevertheless it appears that iodid of potassium does him more

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good than any medicin, both for the skin trouble, when combined with arsenic, and for the rheumatism.

He called at my office last winter, stating that his mouth and tongue, which had been quite sore for some time, had rapidly grown worse, and was now giving intense pain, especially during mastication or speech. Had been smoking a special brand of very strong cigars which his firm had in stock, and thought the attack had been caused by this indulgence. His skin trouble and his rheumatism had both been better for a year or more.

Examination revealed the condition I have tried to describe, and I have tried to be as nearly exact as I could, for the reason that I do not find a satisfactory description of this disease in the books at my command.

I wiped out the fissures with a cotton wrapt probe, using a mild antiseptic solution. I then applied sol. nitrate of silver, 30 grs. to the oz., gave an alkalin mouth wash composed of Dobell's solution and a few drops tinct. myrrh. Next day patient was worse, pain and soreness more intense, slight swelling of tongue, very red and smooth at sides and under surface, pimples at tip extremely tender, altho they had been toucht with a pencil of lunar caustic. Washt thoroly with sol. hydrogen dioxid, full strength, and applied 60 gr. solution silver nitrate. Gave calomel regularly two or three times a day in 2 gr. doses until bowels were thoroly relaxt, and the fur cleaned off back of tongue to considerable extent. Diet restricted to milk. Patient at this time taking 15 grs. iodid of potassium 3 times a day.

More than a week passed with very little improvement. I then began using first one astringent and then another, antiseptics in the form of washes and sprays of various kinds, cauterizing the cracks and sores every day or two, more or less; tried protargol, argyrol, and a host of remedies suggested by eminent men in the profession with almost no effect until another week had passed.

One afternoon I stood looking down into those deep, ugly fissures, feeling blue and discouraged, and contemplating the probable necessity of a radical operation for removing the diseased area. I wondered how much longer the poor sufferer could put up with my failing treatment, my excuses and hopeful promises, without a change for the better. I was alert, and turning over things in my fuddled brain in hope of a remedy, my eye fell upon a vial containing a 40 grs. to oz. chromic acid solution which I had been using as a cauterant in nasal work. Being quite familiar with its effects, I decided after a few moments reflection to try it. Accordingly I wrapt

cotton around the end of an aluminum applicator in the form of a slender pencil, and applied a drop or two to the bottom of each fissure. The solution spread along in a yellow streak, and in a few minutes the man was fairly jumping and scringing from the sharp cauterant effect of the acid, while the saliva flowed from his mouth in a roping stream down to the cuspidor on the floor.

Next day I removed quite a lot of debris, washing out thoroly with a syringe, and applied a one-half of 1 percent solution of bichlorid of mercury. I now increast the iodid to 20 grs. 3 times a day given in syrupy solution and largely diluted. Mercurial wash kept up.

From that time the case improved steadily, the fissures healed from the bottom, the unpleasant odor left in a day or two, the pain ceast, and in less than three weeks, or in other words, after about five weeks treatment in all, recovery was complete.

Conclusions and comments: The clinical results show that this form of ulceration attacks people who have psoriasis and chronic syphilitic troubles.

That tobacco smoking is an exciting cause. That treatment must be local and constitutional.

That iodid of potassium is our main dependence, and that it must be pusht to its full effect.

That cauterants should be strong enuf to make a distinct impression, and that chromic acid seems to be the best.

Maysville, Ga. V. D. LOCKHART, M.D. [You say, "pimples at tip extremely tender, altho they had been toucht with a pencil of lunar caustic." Wouldn't you expect them to be tender after being so "toucht?" Try it on your own tongue and you will be convinced. It seems that from the date of your giving up severe applications, and confining yourself to the mild 1⁄2 percent bichlorid solution, your patient improved. Much can be accomplisht by coaxing that cannot be done by driving. Also, stopping the exciting cause, smoking, had its share in the cure.-ED.]

Treatment of Gonorrhea.

Editor MEDICAL WORLD:-The first thing I do when a patient comes to the office with the well known train of symptoms, is to demand a fee of $10 in advance, which is, as a rule, an important factor in the treatment (for the practician), considering the class of people usually afflicted. Then I proceed to lay down the law regarding hygiene, diet, habits, etc.

Hygiene: Impress upon their minds the value of cleanliness for the prevention of infection of other members of the family or house

hold; to be careful about using towels, wash cloths, etc., used by others. Caution them about washing hands after handling parts affected before rubbing eyes; change of underclothing frequently is also of utmost value as a prophylactic against infection of other parts of body or other persons. Absolute rest is essential if possible, and nonindulgence in sexual intercourse.

Dietary-is also important; patient should. be instructed to abstain from use of any alcoholic liquors, coffee, tea, salt meats and acid foods. Milk, eggs, toast, bread, cereals, potatoes and any of the carbohydrates may be allowed.

Medicinally, kava kava in combination with an alkali, preferably citrate of potash, is especially indicated in those cases in which there is atony of bladder with large quantities of residual urin, in uric acid diathesis, and in old men with prostatic trouble when urin produces a burning sensation, accompanied by considerable hyperesthesia of urethra. This remedy should be discontinued, however, if bad effects upon stomach result; as nausea, vomiting, etc.

My usual prescription for internal medication is as follows-Kava kava added if indicated:

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M. et sig.-Teaspoonful doses every two hours until relief of the immediate symptoms, burning, itching pain upon urination, general depression, etc. This alkalin preparation, neutralizing the urin, relieves the burning pain.

As for injection, I have condenst the long list to two protargol in a 2 percent solution and permanganate of potash, the latter having proven more satisfactory in the large majority of all cases, administered in the following way: Take of permanganate of potash grs. vij to distilled water 3iv; dissolve and request patient to use one teaspoonful in a pint of warm water three times daily, using the greater part of the solution at each treatment, and always caution them to urinate previous to using the syringe, in order to flush out urethra and thus free same from all discharges. give methylene blue compound tablets, one after each meal for period of one week; then discontinue them for a few days until the urin attains its natural color, then repeat for another week. B. C. PEASE, M.D.

Kirkwood, Ill.

I also

Felter and Lloyd state that when a frequent desire to urinate is accompanied with a burning pain at the urethral outlet, the urin passing in drops and mixt with a little blood, oxydendron is an especially valuable remedy. It is given in doses of 1 to 10 mínims of the mixture, or 3 to 6 grains of the solid extract.

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Misce et pone in caps. xxiv. Sig. One capsule every 4 hours, until urin becomes light blue; then use 2 or 3 a day to keep urin colored.

In conjuction I use Valentine's permang. injection, and one picratol (Wyeth) gr. ss. bougie on retiring. I have had the greatest success by these measures, coupled with proper diet, hygiene, etc. Some day I will endeavor to write a neat little article on gonorrhea for our brethren of the WORLD fraternity.

Denver, Colo. FRED'K AMMON, M.D.

More Quackery.

Editor MEDICAL WORLD:-A full page advertisement in a popular magazine tells how a Kansas City, Mo., doctor cures cataract, squint, and all diseases of the eye by his "Mild Medicin Method." Saying that I am a farmer (not entirely untrue), I wrote the advertiser in reference to treatment for a "terigium" (purposely misspelled). I inclose herewith the reply which I received, and which THE WORLD is at liberty to use if worth the space. I described no symptoms of any eye trouble except pterygium.

One does not need to be an eye specialist to recognize the gross dishonesty in the doctor's reply. The advertising eye specialists have been having very free use of the advertising pages of the magazines and religious periodicals of late. It has been my policy for some years not to contribute to the support of any publication carrying such advertisements, a policy which I would be glad to know that THE WORLD readers approve and practise. Bloomsburg, Pa. H. W. CHAMPLIN, M.D. KANSAS CITY, Mo., Oct. 24, 1905.

MR. H. W. CHAMPLIN,

Bloomsburg, Pa.

Dear Mr. Champlin :-Your eye disease is an inflammation of the optic nerve, which has been produced from a congestion of the glands of the eyeball. (And I want to say here that the sight proper has no direct communication of blood, but derives all its food supply from the secretions.) These secretions give nourishment to the optic nerve as well as the various little nerves branching off from it, the same as the system is nourisht by taking food into the stomach.

It is the diminishment of these secretions that has produced your present difficulty. In plain words, it is a partial paralysis, or atrophy, of the optic nerve, caused by the nerve not receiving proper nourishment.

With my Mild Medicin Method I can bring on an over-abundance of these secretions, so as to give a bountiful supply of nourishment directly to the end of the nerve; when this is done the nerves will gradually take on new life and eventually all of your nerve trouble will be relieved and your sight restored to normal. Please understand that the disease of "inflammation of the optic nerve" does not necessarily mean that your eyes present an inflamed, bloodshot appearance. On the contrary, it is usually the case that the disease presents few, if any, outward indications. It is on account of the insidious character of this disease that makes it so dangerous.

Now for a few points concerning which you will be anxious to inquire: (1) You can use my treatment at home without interfering with your occupation or daily duties just as effectivly as I could administer it to you in my office. (2) It will probably take from two to four months to effect a complete cure-sometimes a little less, sometimes a little longer. (3) My treatment will not only cure you of your main trouble, but it will at the same time remove all reflex complications and associate diseases.

The total cost to you for my home treatment is $5.00 per month, and upon receipt of this amount I will prepare and send you a month's treatment of my remedies covering every phase and condition of your case. If at the expiration of thirty days' use of my treatment your improvement is not sufficient to warrant you in continuing the treatment until cured, or if you are not entirely satisfied with the results of my treatment, write me to that effect, and I will return every cent you have paid me. You are to be the judge-your word shall decide it.

Hoping that I may have the pleasure of prescribing for you in the near future, so I may place you on the road to speedy recovery, I remain, Yours truly,

Dict. F. G. C. Steno. W. I. S.

F. G. CURTS, M.D.

How Can Fleas be Banisht?

Will

Editor MEDICAL WORLD:-In the September WORLD, page 364, Dr. J. H. Sanborn gives some excellent applications to destroy certain insects, but he does not mention one of the most abominable pests on earth: fleas. you please inquire of him or any one else for something that will banish these little pests? as there are several states in which they are very prevalent, and this is one of them. Many reputed remedies, such as pennyroyal, pyrethrum powder, and various oils are of no use whatever. Pyrethrum or buhach powder, some years ago was of some good, but now, thru adulteration or deterioration, I find it useless; and with some persons it poisons the skin much the same as rhus. It is impossible here to sit in any public place (church, halls, theatre, &c.), without being infested with those little pests, and ladies are as a rule more especially annoyed by them. If you publish an effectiv remedy for this evil, you will confer a great blessing on many sufferers therefrom. CALIFORNIA.

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In biliousness due to dietetic indiscretion, after the bowels have been thoroly cleansed by calomel and ipecac, the following medication is indicated:

Dilute nitro hydrocloric acid. . 10 drops Elixir taraxacum compound. . 2 drams Mix, and direct to be taken half an hour before meals.

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[King's American Dispensatory, by Felter and Lloyd, publisht by The Ohio Valley Company, Cincinnati, Ohio, 1900, is, we believe, considered the authority in these matters among eclectics. From it we quote as follows: Stillingia Liniment: Compound Tincture of Stillingia,

"Preparation:-Take of oil of stillingia, 1 fluid ounce; oil of lobelia, oil of cajuput, of each, 1⁄2 fluid ounce; alcohol and glycerin, of each, 2 fluid ounces. Mix in the order named. This formula is that revised by Prof. W. E. Bloyer, and is far preferable to the formula given below. Prepared in this manner, the component parts of the liniment do not separate as readily as in the old preparation, the formula for which is as follows: Take of oil of stillingia, 1 fluid ounce; oil of cajuput, % fluid ounce; oil of lobelia, 2 fluid drams; alcohol, 2 fluid ounces. Mix together.

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Stillingia liniment is prone to precipitate, and often thickens to a magma or jelly. It should be well shaken before being used. If it has solidified, it should be replaced by a fresh supply."

Oil of stillingia costs 90 cents, and oil of lobelia $1.50, an ounce.-ED.]

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Literature of Interest to Doctors.

22. A Country Doctor. By Sarah O. Jewett. 23. Dr. Grimshawe's Secret. By Nathaniel Hawthorne.

24. Dr. Nikola. By Guy Boothby.

25. Dr. Antonio. By Ruffini.

26. The Surgeon's Daughter. By Sir Walter Scott. 27. Joseph Balsamo. By Alexander Dumas. 28. The Viking's Skull. By John R. Carling. 29. The Sociable Ghost. By Olive Harper and Another.

30. Told by the Death's Head. By Maurus Jokai. 31. Dr. Breen's Practise. By William D. Howells. 32. Dr. Phillips. By Frank Danby.

Mrs. Julia Frankaus uses the pseudonym "Frank Danby" on the title page of her works of fiction, and it is only of late that her identity has become known. She is the wife of a wealthy Jewish merchant of London, and she is a prominent figure in the musical, literary and artistic set of the English capital. In her first and strongest novel entitled "Dr. Phillips," which gives an extraordinarily vivid picture of the more unpleasant features of middle Jewish life, she delineated the principal character with so much fidelity to her model, a leading London physician, that he secured an injunction in the courts against the circulation of the book.

33. Ralph Marlowe. By James Ball Naylor, M.D. Dr. Naylor, of Malta, Ohio, has written some entertaining books: In the Days of St. Clair, The Sign of the Prophet, Under Mad Anthony's Banner, and Ralph Marlowe. The last mentioned is the only one that has a doctor for the main character.

34. The Strange Story of the Quillmores. By Augustus L. Chatterton. Rocbus," a medical man, is the leading character in this interesting novel. The book contains frequent references to the masonic fraternity:

"Ira," called the doctor, "turn your head this way a minute. That's the sheriff's posse we hear coming and we're ready to be captured-listen. This man is a brother mason! He has correctly communicated the words and tokens. We have unwittingly saved a brother of our order from direst peril and did not know it at the time."

This book, while of interest to physicians, should be of special interest to practicians who are members of the F. & A. M. DR. GRACE M. NORRIS.

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