pital, lucky does the doctor consider himself when he is allowed to stand by and "watch the operation." The surgeon has sole charge of the patient until he is ready to relinquish him, and the doctor gets not even information.

In such a case, the doctor who has decided that his patient needs an operation, should think. He should reflect that the surgeon can come to the patient's home and bring with him his nurse, and, if he insist, his anesthetizer or assistant, or both. He should know that he is competent, or that if he fear that he is not, that the nurse brought by the surgeon is, to prepare any room so that it will be in proper condition for the safety of the operation, in a short time. He should realize that if he makes such arrangements, it is himself, and not the surgeon, upon whom the family will look as the real master of ceremonies. The surgeon will be lookt upon as a skilled assistant of the doctor, who is a mere incident in the case (if recovery ensue), but who is solely responsible (if any untoward incident occur). The subsequent dressing of the wound impresses most of the laity quite as much as the operation.

Circumstances being so dominated by the general practician, the family will readily appreciate that the doctor who "does half the work at the time of operation, and who makes ten trips to dress the wound where the surgeon made but one to operate, is fully entitled to half the fee paid for the operation." This is actually the way the family look at it.

Dr. Robert Abbe, in New York Medical Journal, August 28, 1906, says pertinently, in reference to the mistaken idea that it is nearly impossible to render a room in a private dwelling fit for serious operativ surgery:

"It is varied by the taste of the nurse and the demands of the operation, but I am glad of this opportunity to say that a very long schooling has brought conviction that elaborate changes in converting a living room into a complete operating room are not only an error, but in making a false show, may give a misleading sense of security and mask defects in the immediate essentials of cleanliness for perfect work. The custom of twenty years ago, to clean everything out of the room, remove every picture, hanging, curtain, shade, and carpet, strip it of all furniture, and subsequently subject it to a day or two of housecleaning before even an appendicitis operation, is a thing of the past. The finest operators to-day are aware of the fact that in emergency any room can be prepared in an hour for perfect technical work."

Anent our subject, Dr. Ely Van de Warker says:

"The young surgeon, instead of receiving a perfunctory letter of thanks from a hospital surgeon, can collect his own fee, which, if small, never comes amiss; while he can rest under the consoling assurance that it will grow larger in proportion to greater opportunities. When he is allowed to perform the operation for himself in a hospital, charges for rooms generally demand all the money the patient can spare, while the ward patients are reserved for the staff. House operating would very nearly settle the disreputable problem of the split fee. I believe that this practise is the product of the hospitals. Men

send their cases to the hospital for operation, and lose their fees and ofttimes their patients. It appears a hardship, especially when the man feels competent to do the work himself. Had he not been possest with the hospital idea, he would have made the operation at the patient's house and possibly have saved his professional virtue. In country work the family physician can have nothing to complain of, even if he sends to the city for a surgeon, because he can care for his case and honestly earn his fee."

It is fully the prerogativ of the family physician to dominate his own cases up to, thru, and after an operation. By so doing, he does not lower himself below the standard of the operating surgeon, and he retains the esteem of the family, beside keeping himself in a position to demand a respectable share of the fee.

The discussion preceding refers only to those serious cases which the general practician could not be justified in attempting. In the majority of cases of surgical operation, the general practician is fully competent to operate. Let him call in a few of his colleagues, and let them proceed to carefully and quietly operate. Their ability will not be questioned by the family, except in the rarest instances. If, in any town or community, this practice were establisht, it would not be long till one of the coterie developt a tact for anesthetization; another for acting as the "assistant"; and another for "operating." ating." The fee and the responsibility could be equally divided. The Editor knows of communities where this is done, and done with success and credit to the operators, and he wishes it were a more universal practise. There is no valid reason why it should not be.

The National Dispensatory and the National
Formulary, and Their Value to Physi-
cians, Especially those Dispensing
Their Own Medicins.

The National Standard Dispensatory, publisht by Lea Bros. & Company, Philadelphia, containing 1860 pages, and selling at $7.25, has been one of our most valued books of reference for many years. It contains full information on every article in the last United States Pharmacopeia, and in addition covers very extensiv territory among unofficial drugs and preparations. It is not only a cyclopedic guide to pharmacognosy, but it is a valuable therapeutic assistant as well. It is well indext both by a general index and a therapeutic index. The publishers follow the policy of good business sense, and submit a copy of their work to reputable medical journals for analytic review. THE WORLD gave due attention to the last edition, and we have frequently quoted from it in answer to queries and in our editorial columns. Nevertheless, there are many physicians who (thru neglecting to read reviews of late books) have never heard of it, and dispensing physicians, too. It is this careless class

among our family of subscribers who hurl queries at us which take up columns of space to answer properly. We are not complaining about reasonable queries, but about unreasonable ones. One of our valued subscribers asks us for the formulas of no less than seven different preparations. It is reasonable to assume that that man intends making these preparations, and hence that he is of the large and growing class who deem it wise to dispense their own medicins. Now, if he is a dispensing physician, we do not see how he can get along without the book mentioned above, or, at least, the one to which we shall also give consideration in this article. It is certain that he will speedily come to other problems which he cannot answer, and which he is unable to get any light upon by reference to all the books at his hand. We do not expect doctors to own extensiv libraries wherein it is necessary to have many books upon one subject in order to mass the sum total of medical knowledge upon a given point; they could not afford it, and their time is too limited to take advantage of so many works, even if they had them on their shelves. But when, in one volume, is contained practically all that either druggist or doctor needs to know about the origin, method of collection, forms of administration, action and uses, doses, and methods of preparation for use, etc., of all common drugs, we do not feel that we are imposing any hardship upon physicians when we insist upon their purchasing and using this work. Indeed, if all physicians were properly familiar with it, they would cease to feel the need of many reference works now deemed indispensable.

This book covers not only the last Dispensatory of the United States, but it gives full attention to the drugs and preparations common in other pharmacopeias.

This is in no sense an advertisment for the book, nor do the publishers of the work know that we are going to publish this editorial; we are writing solely in the interest of the mass of the profession to whose aggrandizement we are devoting our best

labors.

Some physicians may not feel able to purchase it; others may already own it; still others may want to know things which it does not touch upon; to such we recommend the purchase of The National Formulary, publisht by The American Pharmaceutical Association, Baltimore, Md., third edition, 1906, containing 243 pages. The book has been prepared by a committee of the Association named above to "palliate the existing evil chiefly caused by lack of uniformity, or want of a common standard," in various preparations in more or less common use, to satisfy the demands of their patrons, professional or otherwise." The book was thus a druggists' idea, gotten up by druggists

and for the benefit of druggists, but it is of direct interest and importance to every practising and especially to every dispensing physician. The formulas include a number which cover nearly all the ground taken up by the various proprietary remedies, so that he who wishes to follow their lines of therapy may do so without either purchasing or recommending "secret" preparations. The committee publishing the book state:

"The mission which this work is to fulfill can only be properly accomplisht by the co-operation of the medical profession. It is, therefore, of the greatest importance that the members of this profession, thruout the country, be made acquainted with the existence, contents, and object of this book, and that, if the same be approved by them, as is confidently expected, they will consent to accept the preparations made in accordance with the formulas contained therein, instead of designating any special maker's product."

The book sells at $2.50, postage 8 cts. Any druggist can secure it. All wholesale druggists sell it. Yet comparativly few druggists know much about the book, or its contents, thruout many sections of the country. We have known for some time that such a book was in existence, and have employed certain of the formulas given by it (thru having taken them from quoted articles, or from information furnisht by professional friends), yet, until this week, we had never seen a copy of the work. None have been submitted to the medical journals for review, nor have we noted any mention of it in any advertising columns of any medical journal. The drug journals quote from it to a considerable extent, and we think we recall noticing once or twice an advertisment of it in some druggists' journal. We askt our druggist about it (and he is a good pharmacist), and he said he "did not have one, but intended ordering." We then ordered from our wholesale druggist, and any doctor may do the same. It does not appear just how this association expects the medical profession to become acquainted with the work, and this is to be regretted, as it is sorely needed by the great mass of the rank and file of practising physicians.

We will continue to quote from the National Dispensatory and the National Formulary whenever requested or whenever it seems to us that the information will be of service to the profession, but at the same time we cannot forbear from urging upon physicians that they purchase and become acquainted with these works, which will be amply repaid in a more palatable therapy. Then, too, many drugs and combinations win popularity and are well tested long before they appear in the U.S. P.; indeed, many worthy preparations are never conceded that distinction. These books bridge this chasm, and provide a wider, completer, and more efficient choice of medicinal agents of known worth than does the U. S. P. They are not by any means intended to replace the U.S. P.,

ing putrefaction in the alimentary canal. To accomplish this purpose has in fact, for ages past, been a prime object in our profession. When we consider how universally mankind are subjected to the deadly influence of intestinal putrefaction, the importance of absolutely eliminating it can hardly be exaggerated.

Could you use in your practise a remedy which is guaranteed to absolutely prevent intestinal putrefaction, and to be absolutely harmless to the human system? I have such an one, and it is not unpleasant to take. Owing to its perishable nature, it cannot be produced in bulk and kept in stock, but can readily be produced by any physician who has my formula. On receipt of the enclosed order blank and pledge, signed by you, and five dollars, I will send this formula, together with full and explicit directions for producing and applying the remedy and a complete discourse on its nature and action. Very truly yours, [Signed.]

References furnisht on request.

The following is printed on a card which the victim is supposed to sign and return, with $5:

Very truly,

are all from Michigan. A "doctor" in New York State is sending them out, and he evidently wants $5 from every doctor in Michigan; and then perhaps he will take the other states one after another. Or maybe he is trying it on Michigan as an experimenter "tries it on the dog." This is an insult to the doctors of Michigan. Do such fleecing games pay? Are some doctors so foolish as to bite at such bait? Are any so gullible and so lacking in self-confidence? The proposition consists of an imitation typewritten circular letter and a printed card. Here is the letter, the place and name being purposely omitted, as we do not wish to give this man free advertising:

DEAR DOCTOR :-Doubtless you are aware of the many vicious and harmful effects of putrefaction in the human alimentary tract. How it gives rise to the formation of the deadly Ptomaine poisons, and that equally deadly poison, Indican, the presence of which in the human body not only induces arteriosclerosis and atrophy of the tissues, but is accredited as the most powerful agent by which time preys on we mortals.

Therefore, it is not necessary for me to dwell on the desirability, in fact, the prime importance, of prevent

A Quack Letter.

Do you know a quack letter when you see it? Here is one. Notice its general features. This is printed to look like typewriting, but it isn't. The name of the recipient is filled in at the top with a typewriter, but an expert can see the slight difference in color of the name and the body of the letter, showing that this is a stock letter, printed by the hundreds or thousands, but the patient thinks it is a personal letter, written specially to him. There are other stock letters to follow this, perhaps 6 or 8, if they can hold the patient that long. We put it in small type because it is rather long, and not worthy of space except as a sample of a quack letter, and one of the best of its kind, for there are many much worse:

Mr. J. H. Whorton,

KANSAS CITY, Mo., Oct. 27, '06.

Frost, Texas. DEAR FRIEND:-We beg to acknowledge receipt of your letter, accompanied by remittance covering the cost of the GermanAmerican Combination Inhaler, and the amount has been placed to your credit. The necessary medicins for your first month's treatment will at once be prescribed and ordered prepared and shipt forward. The remedies contained in this shipment are sufficient to last you one full month, and in order that you may be

able to take the doses accurately as prescribed, we have ordered included in the package, without charge, a graduated medicin glass for measuring the quantity directed to be taken.

Immediately upon receipt of the package, commence taking the medicins and continue in careful routine until they are exhausted. During the time you are under our treatment, keep in close touch with us. Let us hear from you every week or ten days, oftener if you deem it necessary, with a careful report of just how you are getting along. In addition to this, a strict observance of diet and other bygienic rules will be absolutely necessary in order to obtain the best results and effect a cure with the least delay, medicin, and expense. Please do not lose sight of the fact that we are practically just as anxious to cure you as you are to get well, but that in order to do so, we must have your careful affiliation. No matter how great the doctor's skill, in a case of this kind he cannot do it all, and where the treatment is taken in a careless, indifferent manner, and the patient eats, drinks, and dissipates in whatever way his fancy may chance to dictate, it is utterly impossible to secure satisfactory results-all of which must be plain to you.

We fully re dize that it largely depends upon our ability to give you satisfaction with this course of remedies as to whether you will continue the treatment or not. We feel sure, however, that you are inclined to be reasonable and fair and do not expect us to perform miracles. We, therefore, sincerely trust, for the best interest of all concerned, now that you have given us your confidence, that you will persevere in this matter which concerns you so directly, exercising care and judgment in your general mode of living, etc., not losing sight of the fact that your case is not only deep-seated but very complicated, and that you have been afflicted for some time, and cannot, therefore, consistently expect any markt change for the better in a few days, or, in fact, until a foundation has been laid for the more vigorous treatment that is to follow, and which will be prescribed as soon as your system can be put in a proper condition to accept same.

Judging from other cases we have treated which were very similar to yours, we believe that it will be necessary for you to continue this treatment for at least several weeks, but we promise you that we shall exert ourselves to hurry matters along just as speedily as possible, and we are confident, if you will do your part faithfully, that it will be only a matter of time until we shall have the pleasure of enrolling your name on our already large and constantly growing list of cured patients who never lose an opportunity to recommend us and our methods.

Trusting that the shipment will reach you in due time and good order, and assuring you of our best efforts at all times, we are, Yours for health,

F. P

File No. 13,069

Case No. 51,649

GERMAN-AMERICAN

Staff of Physicians & Surgeons Institute.
Per J. T. R. CLARK.

P. S.-Inclosed you will find Instructions for using the German-American Combination Inhaler; also "Important Instructions," which you will please read carefully and refer to often.

N. B.-After you have taken this treatment ten days, let us hear from you with a careful and comp ete statement of just how you are feeling, as it is quite possible your case will require one additional medicin, and should such prove the case, we will prescribe and have the same mailed to you promptly and without extra charge.

The Dazzling Bauble.

I don't want to keep up these financial, or anti-speculation, editorials always. I fear that the "safe and sane" portion of my readers are getting tired of them. For the past several months I have thought and hoped: "this will be the last-for a while, anyway." And I have also been hoping that the occasion for their continuance would disappear. But to my great disappointment there is at present a great boom in speculation-like a conflagration-particularly in mining stocks. Our most conservativ newspapers are carrying large, sometimes fullpage, boom advertisements of mining stocks, and the curb exchange in New York is going crazy over them. Silver has advanced to over 70 cents per oz., and that is given as a plausible reason for the increase in value of mining stocks, but how would that affect zine and gold stocks? Copper is also in good demand at an increast price, but the people have been burnt so badly on the Amalgamated copper, and this copper business was so completely exposed by Tom Lawson, that

they are careful about "playing with fire" again.

But the main reason for the speculation intoxication is too much prosperity on the part of the people, which puts the schemers in a frenzy to get the people's money. Some people can't stand prosperity. If they have more money than they actually need for necessities, the surplus makes fools of them. They lose their balance, want to dissipate, become extravagant, or go into speculation

-with no more judgment than a flea. That kind of people stay poor all the time; while the old families of the community, with one, two, or more generations of wealth and culture behind them, are stable and steadfast. They do not take "flyers." They are guided by steady, sound judgment, based on solid business experience.

Prosperity is a good thing for a nation, a community, or an individual, if rightly used. And let me say here, very earnestly: in the midst of this prosperity, be wise. Take the opportunity to collect old accounts, collect your current accounts closely, and stiffen up a little on your prices. Don't let the schemers lead your people into speculation, strip them of their money, and leave you to carry the load. The money you have earned belongs to you. Get it before the schemers get a chance at it. And when you get it, don't turn speculator yourself. In the first place, renew your subscriptions to your list of medical journals promptly. I take it for granted that you have a list; you should take about a dozen good journals and pay for them promptly. No investment pays half so well. When you have done that, and paid all your other bills, don't let the surplus burn a hole in your pocket, and don't go on a fool's errand by trying to make a fortune with it. All the schemers promise big returns, because they want your money. Their big returns will come from your pockets, if you are foolish enuf to make it so. During the present mining boom, more money will be mined from the people's pockets than from the earth. Will you furnish a part of the grist?

But there are many other propositions in the air besides mining stock, and judging from the assortment on my desk before me, sent by WORLDITES all over the country, they are after doctors hard. One letter written to me personally, being an attempt to answer my editorials, I will give in full, but in small type, so as not to take too much

une, and our journey's end would find us with so little put by that when we, the breadwinners, come to shuffle off this mortal coil there would be rarely enuf left to keep the family going..

I am a seeker after the small investor because there is no chance in my proposition to interest the "big fellow.'" He won't look at an honest proposition, the Philadelphia Ledger to the contrary notwithstanding; he must either have the whole for nothing or be able to see in it an opportunity to graft on the little fellow who invariably follows the big fellow into the scheme and takes just as much risk at one-tenth the profit because he did not dare to take the risk alone.

This Company was started by small investors, myself among the number and there is no more promising opportunity today to make $1000 grow into $2000 in the next ten years than right in If you are genuinly interested and would like to become a small investor in a good business, I will gladly pay your expenses up to the quarry to give you a chance to investigate it. This is no mine, requiring the opinion of an expert. Any one can see whether or not we have the finest grade of marble in this country. Any one can see whether our claim of a million tons deposit is correct or not. Any one can see whether our plant is doing effectiv work or not, and whether the work already done is worth the money put into it. About $35,000 has been spent in development work, equipment, and permanent improvements, each of us chipping in according to his means, some $500, some $5000, every man receiving the same percentage of interest pro rata to his investment, and we shall have to spend from $10,000 to $12,000 more to put us on a dividend paying basis, but the man who goes in now will be like the man who bought Telephone stock at 15 cents or Standard Oil below par, or Union Pacific at $14. He was often a small investor and he had to take some risk, but now he is reaping the reward of having the courage of his convictions.

Of course there are one hundred fake schemes put out to one good one, but the man that rushes blindly into an investment where he can't investigate the property himself or doesn't know the men he is dealing with, deserves to lose his money. When a man can find an investment that will bear his personal investigation and one that is backed by men of standing in the community, and when that investment shows every indication of a healthy, prosperous growth that will double his capital in a few years, he is declining one of Dame Fortune's invitations if he does not accept the call.

Hoping that I may again meet you personally some day, I remain, Very truly yours,

Suppose we take some of the gentleman's statements. He speaks of the opportunity of making $1000 grow into $2000 in the next ten years." Suppose you put a $1000 mortgage on a neighbor's farm at 5 percent or 6 percent interest, and reinvest the interest for ten years, and you will have a total of nearly $2000 without running any risk. Suppose the management should fail to get the additional $10,000 to $12,000 necessary to put the quarry on a paying basis, then what is already in would be pretty dead. Such things have often happened. Doctors would better keep out of the quarry business.

But let us take the gentleman's word when

he says, "there are one hundred fake schemes put out to one good one." Suppose we invest $100 in each of 100 schemes, and only one turns out good. Then where are we? That is a worse showing than any that I have ever put out, and he considers me a pessimist. Let us take him at his word, and resolve to keep our money at home, in bank, or loaned on good real estate security.

There is a great effort being made to saddle Telegraphone stock on the medical profes

amass a great fortune entirely outside of their own line of work." They almost always lose, when they attempt speculation, and frequently their investments are bad, unless they invest in a farm, which they frequently do.

Dr.

A flood of Dr. Abbott's "HighlandsConsolidated" proposition has come to me, with questions and various comments. Kindly excuse me from discussing it. Abbott is an honest man (and that goes a great way in a mining stock proposition), and he has the same right to go into the mining business that any other man has; but I wish he would do it without bothering the doctors about it. There are plenty of business men with capital who will go in with him, if convinced that his proposition is as good as represented. I am trying to make the doctors content with their profession and their lot; and trying to protect them from the birds and beasts of prey that are constantly on their track. One really good opportunity of a speculativ nature (if there be such) embraced and profited by, will give rise to a fever of speculation in many men, and they will be sure to lose all they have made and all the rest besides before they stop. Don't begin. Even if your beginning should be successful (and it rarely if ever is), your end will be disastrous.

Be everything that your abilities and opportunities will enable you to be, as a physician, first; then if you find yourself prosperous, don't give your prosperity to people who want to coax you into the speculativ field. Keep your prosperity for yourself. If you are poor, all the greater need for keeping what you have.

Here is a "bucket shop" proposition. Everybody's Magazine has effectually exposed this system. If you want to contribute to the prosperity of bucket shop sharks, send your money to them. You will thus be made richer in experience, but not in money. They will get the money. They coax the money out of your pocket by fantastic tales of profits, like in the following letter, but if you go in you will wind up with a loss, every time. Some fools have to try it before they are convinced:

DR. SMITH, CLEBURNE, TEX.:

October 29, 1906.

Dear Sir:-Hundreds of thousands of dollars have been made this year by buying STOCKS. Stocks are now too high and it is dangerous to buy them, there