from every other standpoint, are indifferent to themselves and to others as regards the important thing of protection against infection. This should be taken up in public schools. It is ludicrous to teach about the action of alcohol, and leave the student in ignorance of this important subject. The state sends men out who are well trained in agriculture to teach them how to protect trees from borers, and their horses from glanders, but they are not taught the great importance of protection against this fearful malady. It shows a lack of proper appreciation of this subject on the part of the lawmakers. Other matters are continually knocking for their attention; so much so that this important subject is neglected. It is our duty to keep working away, unceasingly, in an effort to educate our lawmakers.

Dr. Maples: This is a subject to which I have given considerable attention and I wish chiefly to express my appreciation of these papers. For the proper consideration of any subject you must fully understand all the points involved. think medical men well understand this subject. Now the most important factor is the discovery of the causative agent. One factor in the fight against this plague is to get the intelligent co-operation of the public. That is a very difficult problem. You cannot have that treatment carried out by a large number of people. You cannot make them understand that it is important to them, you cannot talk to them as you do to scientific men, for it does not appeal to them. If you can give them an object lesson. however, you are more likely to get results. There is a family in our town in which five have died of pulmonary tuberculosis. They have been cautioned repeatedly, were told about it, about the danger of infection, but without effect. You simply could not get it into their heads, although they are considered intelligent people. When the father died, the son, who was quite an intelligent man, became imbued with the idea that they were all going to die with consumption. I told them to get out of the house and to burn up all the things that could not be disinfected. He took my advice, they all moved out and there has been no other case of tuberculosis in that family since. That was five years ago. At that time, one member of the family, who, had already contracted the disease, recovered. As a rule, if you will cite an instance of this sort to

the laity, you can secure their co-operation. There are still, however, a great many people who just go on in the old way will not take these precautions. I believe however, that are making progress. That is the case in our county. We have less tuberculosis than we had ten years ago. The prevention is the great point.

and

we

It is the general belief now that, in the first stages of the discase, there is not much danger of infection.

In closing, I wish to again emphasize the importance on our as physicians, of making continuous efforts to secure the Co-Operation of the public in the attempt to wage a successful Warfare against this disease.

aged.

Dr. Harper: I am sorry that Dr. Blake is getting discourI believe we are beginning to have a better understanding of the disease. I can remember when I began to practice medicine, a patient would consult you and his disease was diagnosed as consumption. He was not informed of the fact, for

fear

that it would hasten his end. He was given cod liver oil and told to go away. Now we are beginning to wake up, and no longer afraid to tell our patients what is the matter with them. There are supposed to be eighty million people in the United States, and of these, ten million are going to die of

are

this clisease.

The statement is made that the United States

Goverment can cure these cheaper than to pay their expenses,

to say

is a

The

nothing of the great loss. Now, about the negro. He great deal like the ostrich. The ostrich gets his head covand because he cannot see you, he thinks you cannot

They

ered 11 · P. see him. Herein lies the great danger to the rest of humanity. ost of our laundry work is done among the negroes. wash the clothes in a little old room and hang them up to and there is usually some one in the room who is spitting aroun<l. We are not sufficiently careful in hiring our domestics, which is another source of danger. I believe the medical societies can do a great deal in helping out in this matter. We can inspire editorials. These editorials would not need to come from Dr. A. or Dr. B. but a committee could be appointed to

get

up a suitable editorial for the press, telling how many die, and what precautions can be taken.

Another thing we should do is to get hold of the preachers are publishing christian papers-I do not see how they

who

can pray and preach on Sunday and point out the path of righteousness, and on week days write up advertisements of "Piso's Consumption Cure, which cures when everything else fails." Who ever heard of anybody being cured by this nostrum? It stops their cough, of course, because it contains opium, but they are getting worse all the time. We ought to get hold of these preachers and tell them to cut out these advertisements.

Dr. Sims I just want to say a few words about the point of educating the people. This is a campaign of education and this education must begin with us doctors. You know the Bible says it takes precept after precept. It certainly does in teaching people about consumption. It is not sufficient to tell them once but you must tell them many times. A short time ago I was requested to give an address on a medical subject in a negro school. I thought an address on this subject would do them more good than anything else. You have no idea how ignorant they were. I told them about putting around spittoons and how to clean them and how it was possible for them to take consumption. I did not see any spittoons in the place then, but a week after that I went through there and they had them everywhere. It did them a great deal of good. They began to talk about it all through the neighborhood. We must begin the campaign ourselves and then it will keep on going.

THE PRESENT STATUS OF ROENTGENTHERAPY.

BY WM. ALLEN PUSEY, A. M., M. D., Chicago, Ill.
Professor of Dermatology in the University of Illinois

I appreciate very highly the honor of your invitation to present a paper before this Society upon the subject of Roentgentherapy. I take it that it is an indication that you regard Roentgentherapy as a subject which is not a passing fad, but has established itself as a positive therapeutic agent.

There can be no doubt that the subject of electro-therapeutics has not been held in great esteem by the profession. It is highspectacular, and lends itself with beautiful facility to exploitation. Unfortunately, brilliancy in application has been one of its chief claims to consideration, and among the class of men who are not particularly concerned about impressive office furniture, it has not always been looked upon without suspicion. X-rays, of course, are not electricity, any more than light produced by an electric lamp is, but the fact that electricity is sole means of producing them, associates Roentgen-rays with electricity and Roentgen-therapeutics with electro-thera

011 r

peutics.

It is a source of some satisfaction to me that it is now generally recognized that X-rays produce definite effects and are

of

definite value in meeting some indications, and have thus rescued themselves from the limbo to which ultimately and justly those pseudo-therapeutic agents are consigned whose chief claims for consideration rest upon the fact that they are impressive and produce pleasing titillations of the surface.

It has seemed to me that I could not do better in taking up this subject before you than to review briefly the field of application of Roentgentherapy. It is, of course, impossible, without unduly imposing upon your time, to ponder more than briefly the various conditions in which it is of use. In order to save time, I shall have to confine myself to my own experience, but in doing this I trust it will not seem that I have any inclination to overlook the work of others.

Early in my experience with Roentgentherapy, I worked out the inclications for the application of Roentgen-rays which have

since

to be

guided my work. These indications seemed to me then very definite, and I have had no reason to change my opin

ion upon that point since. This classification of the therapeutic indica tions has been of great assistance to me, at least, although I cannot claim that I recall any great amount of flattery that I have gotten from others concerning its value. It is based Upon the study of the effects of X-rays upon tissues, upon bacteria in tissues, and to some extent upon clinical results. The indications are:

I.

2.

To remove hair.

To cause atrophy or diminution in size of functional activity of the sebaceous glands or sweat glands.

3. To destroy bacteria in tissues through increase of phagocytosis, not by any direct bactericidal effect.

4. To influence the metabolism of the tissues, particularly the skin.

5. To cause destruction of tissues of low resistance.

6. To relieve itching and pain through their anodyne effects. All of these actions of X-rays are not equally positive, but none of them, I believe, is imaginary.

The first five of these indications have to do almost exclusively with skin diseases. The sixth indication covers its most important application, its application in malignant diseases, glandular hyperplasias and similar conditions.

As to the usefulness of X-rays in many diseases of the skin, dermatologists the world over have concluded that it is one of the most important, probably the most important, therapeutic agent at their command.

For the removal of superfluous hair, X-rays are only a limited success. In my experience, hair can be permanently removed with X-rays in many cases, but the method is so tedious, and, if you are to stay within the limits of absolute safety from damage to the skin, so uncertain, that I do not advocate it except in cases where the need of relief is very insistent.

In the treatment of parasitic affections of the hair, such as sycosis and tinea tonsurans, X-rays are, perhaps, the best method of treatment that we have. They produce permanent results more quickly than can be obtained by any of the older methods of treatment, and in some of the exceedingly intractable cases they succeed where other methods have failed.

Among the minor uses of X-rays there is none of greater value than its application in that extremely trying and rebellious condition of young adult life, acne. Acne, of course, is a trivial affection, but it is one that causes an immense amount of humiliation, and I know of no more unsatisfactory task than to undertake to cure a rebellious acne by building up healthy boys and girls, squeezing out blackheads and using antiseptic applications. Under intelligent use of X-rays-and it must be intelligent, because one cannot afford to run the risk of injuring patients in treating a cosmetic trouble-the results in acne are usually prompt and definite. The inflammatory lesions in the follicles disappear, and, not only that, comedones cease to form, the skin loses its greasy, dirty color, and the large follicular