Beard, lecturer on comparativ embryology in the University of Edinburgh, assisted by other eminent investigators. Stated briefly, and entirely from the layman's standpoint, Dr. Beard has found reasons for the belief that malignant tumors are the product of "aberrant germ cells," cells having a peculiar function and properly belonging to a particular part of the body, but now scattered and vagrant, as it were, thruout the tissues. Why such a cell should turn and rend its neighbors, the body cells, is a question for which no satisfactory answer has yet been found; nor why in many, or most, cases it should lie dormant for years or for life. It is a little discouraging, nevertheless, to read that everybody who has stept over the middle line of life is liable to develop cancer.

The destructiv activity of the misplaced germ cell cannot, in the present stage of investigation, be forestalled and checkt, as by an antitoxin, but Dr. Beard has discovered that a peculiar ferment secreted by the pancreatic gland, trypsin, possesses the astonishing power of disintegrating and destroying the cancerous growth. The rationale of this phenomenon is set forth in the article.

As the curativ agent is readily obtainable, it is to be hoped that a wider application of the new theory will prove its efficiency in the cure of the most hideous and hopeless malady that attacks mankind.-Editorial, Tribune.

[Like other sure cures exploited in the lay press, this one has gone "glimmering" almost before the sensational announcement reacht the public eye. American doctors have tested the "remedy" (?) and found it wanting in any beneficial results; some declaring it absolutely harmful and having the effect of hastening the cancerous progress, others asserting that it should never be used on a case where any other treatment is possible. A special dispatch to the New York Times asserts that the English hospitals have abandoned its use because of failure to derive any results from its employment. See answers to other queries in this issue.

Try to explain to your afflicted friend that all new discoveries in honest medicin are given out to and discust by the profession long before the yellow reporters to the lay press get a hint of them, and that by the time the lay press tells of some "wonderful and absolutely unheard of method or operation," such operation or method has probably been tested hundreds of times in all parts of the world, and more than likely found wanting in beneficial results or many times found to be absolutely harmful. Witness the enthusiasm of the laity and lay press over tuberculin long after the profession had decided that all the use it was laid in hurrying the hapless victim to rest in the grave. Even now, when the profession are trying to forget tuberculin, laymen will make inquiries as to where it can be purchast.

Gently assure your patient that "paste," the x-ray, the knife, or the two latter wisely combined, offer him his only hope.-ED.]

by merely digging a hole in the ground, are always vicious and dangerous. Certainly, when employed, they should not be less than six feet deep. Having no water works or sewage system, you will be forced to rely on privy vaults or cesspools of some kind. The depth of the wells has nothing to do with the matter at all. Deep wells, like yours, are often contaminated from privy vaults when shallow wells escape. It all depends on the permeability of the strata lying underground, and on the direction and dip of such strata. Thus, a well on a hill above a privy vault may become contaminated from the vault altho lying on a lower level. Any good work on hygiene will explain all these points to you, and will be interesting and instructiv reading besides.

The safest way for your council to do would be to enact a supplementary ordinance, requiring every vault to be lined with impervious brick, laid in cement, and that each vault after being so walled up, should be finisht with an inside coating of cement laid on both bottom and sides in such manner that the vault should be absolutely waterproof. Then, that the upper part of such wall should extend a sufficient height above the ground so that no surface water could enter. Further, that the closets be regularly inspected, and that the owner be required to have the contents of the vault removed by a night soiler before the level of the excrementitious material reacht the upper level of the wall. Thus, and thus only, can your "city fathers" make sure of guarding your wells. It will probably take one or two epidemics of typhoid fever to convince the average council that any precautions are necessary; but we have known of exceptional instances where borough councils really seemed to be endowed with some intelligence, and especially in such instances where the board of health had as one of its members an educated physician.-ED.]

Was it Hysteria?

Editor MEDICAL WORLD:-A young lady of 20. Attack came on one-half hour after death of a relativ. She ran outdoors, sat down on bench and commenced trying to vomit; efforts grew more severe. Contraction of all flexor muscles of body gradually appeared and increast as efforts at vomiting decreast and finally entirely took their place. These vise-like contractions continued for perhaps 20 seconds with prolonged efforts at expiration with a sort of groaning noise. Then relaxation for 20 seconds or so, then another spasm without efforts at vomiting. This spasm and relaxation of muscles, perhaps repeated six or eight times, gradually grew lighter. Patient finally became quiet and said she felt all right, but was weak. Everything was well for half an hour, then the whole process was repeated, efforts at vomiting and spasms and relaxations. The head was flext forcibly with a tonic contraction of neck muscles; also flexors of arms and fingers and abdominal muscles were contracted, but flexors of legs were only slightly affected; not clonic, but tonic, contractions. Patient did not lose consciousness, and during the 20-second relaxation would talk and swallow medicin, only to be seized suddenly with another

spasm.

In all she had three attacks or three series of attacks, the last one about an hour after the second and not so severe. After the third one she said she felt all right, but was sleepless and felt queer. Has had mild attacks somewhat similar to these when excited, for several years, but not very frequent.

Treatment: Friction and rubbing limbs and arms with whiskey during attack; 1⁄2 dram of aromatic spts. ammonia when attack commenced, another dram for second attack, and still another at the third. Left I-grain asafetida tablets, one to be taken every 2 hours. What I wish to know is, what was the matter? E. M. CARTER, M.D.

Burdett, Kan.

[We think there is no doubt but that the "attacks" were purely hysterical. As a rule, in such cases, the less "treatment" the better. If any treatment is adopted, it should be of the most energetic kind. Probably a good plan, in this instance, would have been to chloroform her thoroly, and leave some reliable person to watch her till she woke; or, perhaps better, to have watcht her yourself. But your treatment was very good.-ED.]

Several Questions.

Editor MEDICAL WORLD:-Why do most writers recommend that quinin should be injected into the gluteal muscles when used hypodermically? I think I saw a statement somewhere that this was done to avoid heart depression.

Give full directions for using magnesium sulfate hypodermically. Where should it be injected?

Do you recommend shaving the vulva in obstetric cases?

Is there any danger of medicin in powder form kept in glass-stoppered bottles getting enuf glass to hurt the patient taking it? I have quit using glass-stoppered bottles (except for acids), as I have seen that when opened I could see fine particles of glass on the medicin.

When ether is used hypodermically, should it be injected full strength? What is it used this way for mostly? Would it be of any value in congestiv chills? Dean Spring, Ark. JOHN ALBERT BURNETT.

[The gluteal region furnishes one of the largest bulks of muscle tissue in the body, and consequently affords a greater number of the finer arteries than a lesser amount of muscular tissue. When quinin is given hypodermically, rapidity of absorption is generally the point aimed at, and the greater the number of the smaller blood vessels the greater the probability of quick results. Quinin, hypodermically, is not depressant to the heart, unless, by accident, the solution is thrown into a vein. Any solution thrown directly into a vein may cause sudden and alarming heart depression. A full dose of atropin, hypodermically, is the best remedy in such a mishap.

The tablets of magnesium sulfate are dissolved in sufficient water, and the injection made just as in administering any drug hypodermically. It is necessary to use the tablets as furnisht by reliable manufacturers; the ordinary commercial salt could not be employed satisfactorily. The location is immaterial. Theoretically, the quickest result should be obtained by an injection into the skin of the abdomen, as that region overlies and is close to the part upon which it is intended that the drug should act.

We do not recommend shaving the vulva in ordinary private obstetrical practise. Few heads of families would tolerate it, and if they did submit, would be certain to gossip about the procedure to the certain detriment of the attending practician. It is easy to order a warm bath for the woman as soon as the physician enters the house. This, in ordinary cases, will render the body sufficiently clean for practical purposes. If one presumed to attain absolute asepsis in such cases, a moment's reflection would teach him the futility of the attempt, because we now know that it is not possible to render the human skin absolutely aseptic by any procedure or method of cleansing, or by application of any antiseptic.

Only a very carelessly finisht stopper or neck, or very rough handling of same, would cause particles of glass to drop into the container. Certainly no medicin intended for internal use should be employed if there were particles of glass visible in it, but the use of glass-stoppered bottles is so universal that if this were a common occurrence frequent and serious trouble would ensue. The particles of glass dropping from a properly ground glass surface would be so small that they would not be recognizable as glass by the naked eye; chipt particles would be a different thing, of course. The point has never been raised with us before, nor have we ever had any such trouble.

Ether, used hypodermically, is employed full strength. So employed, it is a powerful heart stimulant, tho fleeting in effect. We could never subscribe to its use in heart failure during an anesthetization with ether, tho it has been so used; but we verily believe that we have kept a heart going for many hours by this method when nothing else could have accomplisht the result desired. It may be employed in any case of heart weakness (tho we would make the reservation noted above) when other agents have failed and a dire emergency is threatening. It is not best made an agent of early choice, nor is it well to use it where there is probability that another agent will do as well, because the injection is very painful and the suffering persistent.-ED.]

Dr. Moore's Case.

Editor MEDICAL WORLD:-I thank you for publishing this case of mine (page 304). I appreciate your criticism. I have given the case so that I might get the sympathy of medical brethren. We learn from failures, and also your criticism will be of practical value to many of us.

In answer to questions which I failed to make clear: Ist. There was premature ossification of the bones of the cranium. 2d. The large size of the head I feel sure was the cause of it not engaging. I thought of version, as I had delivered quite a number by that means, but owing to large size of head I feared it. If I was hasty in my procedure I thought then as did my medical friend who had had a similar case, the condition demanded it.

I hardly think I am mixt on the anatomy, as portions

of the broad ligament, which I could palpate, were very tender and sensitiv.

I am happy to say that since my last writing my wife is very much improved. In this interchange of thought we see that others have trouble, even make mistakes, and so we are prevented from worrying ourselves insane over ours. W. P. MOORE, M.D.

Memphis, Tenn.

[We are glad to learn of the improvement in your wife's condition, and hope it will continue till she has completely regained her normal health.

In cases of premature ossification, perforation, followed by the cranioclast and then by the forceps, is the proper procedure, when it is possible to fix the head so that perforation can be performed. It is always easier to see afterwards how things might have been done, you know. Version, of course, would hardly have remedied matters. We do, however, strongly advise every physician in general practise to purchase a set of good axis traction forceps. He may not need them for years, but when he needs them suddenly, he will "want them bad."

The reason we employed the phrase: "Mixt in your anatomy," was because we do not understand how you could make a diagnosis of injury to the broad ligaments. We do not dispute the fact that a small portion of the lower edge is palpable, but tenderness would not be evidence of injury. Every part of a woman's generativ apparatus would be tender in such a siege as that. Take your text-book on obstetrics and follow out how

the broad ligaments act as the womb enlarges in pregnancy; note their condition and position at the onset of labor; note their relation to the bladder, etc., and we think you will agree with us that positiv injury to the broad ligaments would involve other structures to a degree that would produce symptoms different from those you detail.

The main point we want to impress in this case, however, is that all practicians need to make their obstetrical examinations very thoro. Had you suspected premature ossification early in labor, you likely would have proceeded differently.-ED.]

Nauseating Effects of Morphin.

Editor MEDICAL WORLD:-Can you or any of the WORLD readers suggest an antidote for the nauseating effects of morphin? I have a case of the most excrutiating dysmenorrhea (due to a myoma?) that naught else relieves but one-half gr. of morphin hypodermically, and it relieves speedily and thoroly; but the nauseating effects of the anodyne are worse, almost, than the pain. Please give us your help. Can I relieve, or better, prevent the nausea of the morphin? How? Walkersville, Md. JNO. D. NICODEMUS.

[Have you tried codein, doctor? In some cases full doses of this drug will relieve pain almost as well as morphin, and without such intense nausea following. Antipyrin, in full doses, will often act well. Too many omit giving this drug a thoro trial. Cimicifuga, too, should be of aid, when given in combination with other drugs, in this particular case.

Chloralformamide, in 30-grain doses, has been of service in obstructiv cases. Chloroform, by inhalation, sometimes exerts a permanent influence, i. e., during one moli

men.

Digitalis, bromid of potassium, and quinin, greeable after effects of morphin. In some all have been employed to combat the disacases they are of service; in others, they are valueless. You can only tell in this case by trying.-ED.]

worse.

Ulceration of Bowels.

Editor MEDICAL WORLD:-I saw an account in your journal of your help to the doctor at Tonoke, Ark. I have a similar patient whom I would like to help. Patient, age 49. No tubercular nor syphilitic taint. Commenced with diarrhea about one year ago; gradually got worse. Tried several doctors. Still got When he applied to me for treatment he was having about twelve actions per day and two or three per night. Was passing enormous quantities of water. I put him to using nitrate of silver, 60 grains to the quart of water, two and three times per week, with long colon tube. Patient improved. He then got worse. I then gave him, in addition to the silver treatment, bismuth in teaspoonful doses three times a day after meals, and alternated the nitrate of silver with alum water injections, teaspoonful to the quart of water. The patient is improving, but is not well. How would it do to inject bismuth and iodoform? How would you prepare them for the injection?

I should have stated that there is neither albumin nor sugar in the urin. FRANK NISBETT, M.D. Brookland, Ark.

[The success of the bismuth and iodoform injection, indeed of any injection, depends, of course, on the location of the ulceration. This is, fortunately, generally low down in the bowel. If this be the location in your case, we advise you just as we advised in the query to which you refer.

Neither the bismuth nor the iodoform being soluble in ordinary menstruum, it is necessary to incorporate them with some bland oil. A mixture of oliv (or "sweet") oil and flaxseed oil makes one of the best and most Soothing injections. The idea is to instill the fluid slowly into the bowel so that peristaltic action is not excited. Hence you do not want to use any more oil than is necessary to carry the drugs. We should say an ordinary tea-cupful would be amply sufficient for any dose that should be given, and even less oil may do nicely. Mix the oil and the drugs thoroly. Have the patient lie down with the hips elevated on a pillow, attach a rectal tube to a rubber tube of suitable length and caliber, have the medicin well stirred in the cup, fill tubes from end to end with the oil, have patient or assistant pinch the one end so that no air can enter the tube, insert the rectal tube high up into the bowel, then drop the other end into the cup of oil without allowing air to enter the tube. The oil cup is previously placed about a foot above the level of the nates of the patient. Properly done, this forms a perfect siphon arrangement, and by keeping the drugs stirred up in the oil, and taking care that the end of the

tube is kept constantly immerst, no trouble is experienced in getting all the medicament to pass into the bowel. It will take probably half an hour to allow it all to pass; and if a few moments' watching convinces one that no oil is passing thru the tube, it may be cautiously withdrawn a little ways and again inserted, or even allowed to remain in the new position, when it will be noted that the oil is again passing. The patient should remain in this position for an hour after all the oil has entered the bowel. If expulsiv action is set up, it denotes that too much oil is used, or that it has been siphoned too fast.-ED.]

[You cannot learn any language so that it will be of practical service to you in your practise from books alone. The pronunciation, the idioms, and many other little points which go to make up a practical mastery of any language cannot be satisfactorily transferred to type in an assimilable manner.

Your very best plan will be to get a Swede or Norwegian boy to attend to your stable or do other work about your place. Take him with you as a driver on your trips. Have him teach you as you ride along. It saves time, and almost before you realize it, you will have learned the language, and learned it easily, and in a way in which you will not forget it, and in a way in which it will be of practical every-day service to you.-ED.]

[We are not able to find "Ascatco" in any of the late lists of new drugs. Is not this taken from a lay paper describing some wonderful (?) discovery of an unknown plant by some eminent scientist who will gladly mail a prescription free to all sufferers? We think so. The game is old. If you apply, a prescription will be sent you which cannot be filled by any pharmacist. If you report your difficulty to the "eminent scientist," he will explain that on account of the recent discovery, some pharmacists may not yet have obtained the drug, but that he will part with a small part of his hoarded store for some such paltry consideration as $25—all in the interest of suffering humanity, you know. When the drugs come, they are found, generally, to be a simple mixture of crude and common leaves, powders, or barks. Don't bite; that is the fool layman's prerogativ and pastime.- ED.]

Some Nostrums.

MEDICAL WORLD; QUIZ DEP'T:-We are having advertised in this town quite extensivly Booth's pills, Mi-o-na laxativ, and Mi-o-na dyspepsia tablets. Can you give me the formulae for these preparations? and do they amount to anything? They are manufactured by the R. T. Booth Company, Ithaca, N. Y.

Your stand against the nostrum trade receives my hearty approval and support. I would like to convince some of my patients as to the worthlessness of such treatment. D. S. J.; MICH.

[We have not heard of these nostrums before. You can write just as good formulas after a few moments' study. Dyspepsia "tablets" and dyspepsia 66 cures do not contain pepsin-it is too expensiv. They are generally made up of soda, charcoal, rhubarb, and bitter tonics. It is not possible to compound a proprietary that will "fit" all cases, and indigestion is one of the very hardest to "fit" " at random. Soda is the great standby of many of these nostrums, as very few cases but what will respond to it temporarily, but soon the patient is in worse condition than before. If you do not succeed in finding what the nostrums are made of, rest content; soon you will not hear them mentioned.

The Ripan's tablets, so widely advertised a few years back, now never heard of, were said to be composed as follows:

In August WORLD (page 323) we publisht a clipping from the Denver Post in which it was stated, concernThe liquid used in the treatment coning "Viavi": tains 85 percent morphin and 15 percent glycerin." It is evident to anybody that such a mixture would be a paste rather than a liquid. The Viavi people use a cerate; but the above-mentioned clipping refers to the liquid, and the above composition is impossible for a liquid. This article has given the Viavi people considerable concern. They have written to me repeatedly and have called to see me. They have submitted to us statements from various chemists (mostly foreign) that their medicin contains no morphin. They also stated that Professor H. M. Gordin, of the Northwestern University School of Pharmacy, Chicago, had examined their medicin for morphin, and suggested that I write to him, which I did, and received the following very courteous reply, which I unhesitatingly publish, as all we want is truth; and we want all we can get of that:

DR. C. F. TAYLOR,

CHICAGO, August 29, 1906.

1520 Chestnut street, Philadelphia, Pa.

MY DEAR DR. TAYLOR:-I have received your letter asking for positiv, not negativ, information about Viavi ; i. e., you want me to tell you what Viavi does contain, not what it does not contain. I am sorry to say that I cannot give you such positiv information, for the sim

ple reason that I have no positiv information about the preparation. I was engaged by the Viavi people for proving the presence or absence of morphin and only morphin in Viavi Liquid. I took a sealed bottle of the stuff from their office here and examined it for morphin only. Not having been able to find any of this alkaloid in the bottle I examined I so reported to them. As to what other ingredients there are in Viavi I cannot say. In the course of my examination of the liquid for morphin I could not help, of course, noticing certain indications for certain things, but without exact analysis it would not be scientific to say anything about the nature of these things. All I can permit myself to say is what can be noticed even upon superficial examination of the nostrum, and that is that it undoubtedly contains very much coloring matter and considerable glycerin. For this reason the isolation of morphin from Viavi, if morphin were present, presents considerable difficulty. The difficulties are so great that I had to devise a special method for my work. This method will be publisht in the American Journal of Pharmacy next month. I have sent my paper on this subject to Dr. Henry Kraemer, the editor of this journal, and if you would like to see the paper before it is publisht, ask Dr. Kraemer about it.

I also intend to read the paper at the meeting of the A. Ph. A. in the beginning of next month at Indianapolis, Ind.

Hoping my answer will be satisfactory, I remain H. M. GORDIN.

Yours truly,

CURRENT MEDICAL THOUGHT

Humbugs Brought to Light. Samuel Hopkins Adams is publishing in Collier's Weekly a series of articles on "Quacks and Quackery." The issue for September 1st contains the third article, entitled "The Specialist Humbug." Below we present excerpts from the last-named article:

This he will do for the moderate price of $50-sometimes for $25, but the patient must put down part of the money in advance. Give him his pay and Oneal will undertake the impossible on any one's eyes; not only this, but he will undertake to cure cases which he himself knows to be incurable. His "Dissolvent Method" is a high-sounding name for a cheap eye-wash which can no more cure any serious derangement than can plain water. This he sends out by express with impressiv directions as to its use.

When I called upon Dr. Oneal at his office he assured me that he was doing a perfectly legitimate business, and that I was making a grave error in listing him with the quacks. As he spoke he was facing a wall on which hung a number of framed documents. One was a certificate of membership in the American Medical Association, which is the standard medical body of the country. Dr. Oneal was forced out of it several years ago for unprofessional conduct. Nevertheless, he keeps the old certificate on exhibit. Neighboring the outlawed certificate were two others, one of a high-sounding organization whose sole purpose is to issue framable parchments to doctors of dubious standing, the other certifying that Dr. Oren Oneal was a member of the staff of St. Luke's Hospital at Niles, Mich. Dr. Oneal has never been in Niles, Mich. He has had no relation with St. Luke's Hospital of that town, because there is no such institution. The document he purchast from a quack named Probert, who did a little peddling business in this line, charging $20 for the framed article when he couldn't get $25. Dr. B. F. Bye, of cancer fame, has one of these, and I have seen them decorating the offices of other quacks.

For the conduct of a perfectly legitimate business these were three obviously rotten props. A fourth was supplied by a copy of the New York Health Journal, used by Dr. Oneal as a warrant of professional standing, and containing an "unqualified editorial indorsement" (leading editorial) of that gentleman's method

and practise. Now, the New York Health Journal (since happily defunct) was, as I have observed before in the Liquozone matter and elsewhere, a fake, pure and simple. It printed no editorial indorsements" except for cold cash. As Dr. Oneal doesn't remember paying for his puff, I assume that the firm which places his advertising did it for him. One other bit of suggestiv evidence is found in the Nebraska State Board of Health Records, showing that in 1899 the Board Secretaries recommended the revocation of Dr. Oren Oneal's license "on the ground of unprofessional and dishonorable conduct."

*

The superintendent of a great institution for the deaf and partly deaf states that nine-tenths of those who come there do so only after having spent from three hundred to one thousand dollars each on quack treatments, vibration methods, and mechanical ear drums. Certain kinds of deafness are curable, it is true, and it is also true that the quacks, with their hit-or-miss system, sometimes benefit mild cases of catarrhal deafness; but these are cases which any aurist could handle better, cheaper, and more quickly. For, it must be borne in mind, the purpose of the quack, who treats at so much per month, is to keep his patient under treatment as long as possible. Outside of simple catarrhal cases, the self-vaunting "specialist" is far more likely to do irreparable damage than to be of any benefit.

What Oneal and Coffee are to the diseased-eye market, Dr. Guy Clifford Powell is to the ear trade. So completely and satisfactorily does Powell fulfill every tradition of the quack industry that I shall catalog him under specific headings, as an instructiv type.

(A) Claims. "Deafness Cured at Last. Wonderful New Discovery for the Positiv Cure of Deafness and Head Noises. At last, after years of study and research, the wonderful Nature Forces have been harnest together, and Deafness can be cured. If I did not know positivly that my method could cure I would not allow my name to be connected with this treatWrite today to the discoverer, Guy

ment.

Clifford Powell."

(B) Catchword. Electro-Vibration. "Electro-Vibration, which is my method of treatment, is heralded by the greatest scientists of this country as the most scientific and certain treatment of the age.'

"

(C) Religious Sponsor. Rev. Father Sydney G. Jeffords, rector of St. Stephen's Church, Peoria, Ill., who writes a to-whom-it-may-concern letter, in which he says: I consider Dr. Powell one of the most careful and exhaustiv investigators in his special line to be found anywhere."

(D) Editorial Sponsor. The National Journal of Health (a congener of the fake New York Health Journal and of the American Journal of Health), which editorializes as follows: "Dr. Guy Clifford Powell has perfected a system of treatment that actually cures, as we know from its results. It is known as the Electro-Vibratory apparatus for the cure of deafness and head noises," etc., etc.

(E) Depreciating Scale of Prices. From $100 by swift degrees to $15.

(F) Typical Correspondence. (The diagnosis of the case indicated, beyond possibility of doubt, hopeless deafness from destruction of the apparatus of hearing by an explosion.) Letter I-Addrest " Dear Friend," assures the patient of complete and permanent cure "at your home."

Letter II-Admits that the case is difficult, but refers the sufferer to the cured case of a Mr. Kelly, almost exactly similar, whose address Dr. Powell has unfortunately lost. Price of treatment, $100; reduced to $30 because of "special interest" in the case.

Letter III-Warning that the $30 price lasts only fifteen days.

Letter IV-Expressing surprise that "Dear Friend" has failed to avail himself of the unparalleled opportunity. Dr. Powell "firmly believes" that if the patient had ordered at once he would "at the present moment be well on the road to recovery." Terms now $5 down and $25 after trial. "I could not make an offer more fair to my brother," he pathetically avers.

Letter V-Price drops to $25. Should you place