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It seems strange, almost absurd, that en- The Ownership of the Prescription.-Colotrance requirements have not already been rado Medicine is out with a new argument placed upon a basis of uniformity. It is from analogy as to who owns the prescripwell nigh scandalous that it has not been es- tion. It states that the Supreme Court has tablished. Ignorance should not be tolerated decided an architect who receipts for proanywhere among those who contemplate en. fessional services' can protect his work and tering upon the study of medicine and the his client cannot build two houses on the colleges throughout the length and breadth same plans, while the architect who receipts of the land should agree without unnecessary for "plans and specifications forfeits his delay upon the minimum of preliminary or rights to ownership, therefore the patient entrance qualifications. This once done it who pays for professional services does not would be a comparatively short step to the own the prescription. The best argument by standardization of the methods of teaching, analogy in this much debated question is as well as the length of the undergraduate that the physician's prescription is comparterms. Finally, with these two essentials able to a ticket to a theatre seat or a railagreed upon, the licensing boards would be road journey for one trip only, and this compelled to establishi uniformity of methods should be taken up by the agent, wło comof examination, and likewise, the states could plies with the order which it contains, and no longer withhold indorsements of licenses. not repeated unless a new prescription or The Association of American Medical Col. order was reissued by the physician or comleges can be depended upon to establish the pany. first two propositions, namely, the uniform- Deaths from Diphtheria Inexcusable.-In a ity of entrance requirements and the length
recent bulletin the Chicago health department of collegiate terms and methods of teaching.
states: "Every death from diphtheria should It will then be "up to” the examining boards be made the subject of judicial inquiry, as and state authorities, to use a trite expression
other aroidable deaths resulting from negli. of the day, to see that their methods become of uniform standard and that reciprocity is
gence, culpable ignorance or criminal mal
This shows how thor. established with proniptitude. I am re
practice now are.
oghly the value of antitoxin in diphtheria suaded, from considerable observation and
has been established. experience, that interstate reciprocity in li. censing is best accomplished through the The Value of Medical Expert Testimony.avenues named, and indeed that only in this (Bryce, Southern Clinio).-If the medical way can it be accomplished with fairness to profession has made itself the laughing-stock all the variant interests, with lasting credit to of the people in any way, it surely has done the profession, and with substantial benefit more through the medium of its to the licensees who expeot to derive advan- called experts on the witness stand than by tages from this privilege. Reciprocity was all other means. The readiness with which given considerable consideration by the pres- medical men may be found to testify on ident of the American Medical Association at either side of any case and refute the testiBoston in his presidential address. Dr. Mayo mony of each other is something remarkable thought that what was needed was a bigber if we are to look upon medicine, chemistry or standard of requirements and more and better surgery as anything of a science. The effect supervision of professional schools. At the of such conflicting testimony by men sup. present time each state has its own standard posed to be fairly or exceptionally representof requirements. The conditions now with ative of the scientific side of the profession is reference to reciprocity in medical license are damaging to the entire profession, to the well nigh intolerable and restrain the individ- cause of the case pending in the courts, and ual freedom guaranteed by the constitution. to the moral tone of the witness's opinion The borders between states are imaginary and utterances. There is not the slightest lines, yet a physician on one side of the doubt that personal friendship, pecuniary border could not relieve human suffering on pressure, and prejudice are the largest conthe other side without becoming amenable to Tributors to this evil so frequently perpethe law or subjecting himself to vexations ex- trated in our courts in cases involving life, aminations which he had already successfully honor, property and happiness. The remedy passed in his own state. This must be met in a measure consists in the selection of comand speedily, by agreement between examin. petent and unpurchasable medical experts, ing boards as to the minimum of require. and in permitting no other kind of medical ments. After all, this is but a part of the men to appear upon the witness
witness stand, educational problem. If we can solve this, whether it involves the ownership of a hound licensing boards could at once adopt more dog or the chastity of some good woman uniform examinations and reciprocity. whose profligate husband would exchange her,
under the lax divorce laws of our land, for the SOCIETY PROCEEDINGS more attractive animal frequenting the resorts of the demi-monde. Regarding the
THE MEETING OF THE BRITISH MEDIcompetency of a medical witness, it should
CAL ASSOCIATION. not be inferred that because a man stands well in bis community as a general practi- TORONTO, CANADA, August 29, 1906. tioner he is competent to give expert testi. mony in matters of which he is altogether ig.
I. norant from wont of personal experience in
The British Medical Association held its his daily work. In matters concerning the annual meeting at Toronto, August 21-25, insane, for example, we would attach far
under the presidency of Dr. Reeve, the dean more value to the testimony and opinion of of the Medical faculty, University of Toa sensible nurse or attendant in an insane
ronto. Toronto is a beautiful city, and the asylum who bad ample experience in such Cniversity buildings are well adapted for the capacity than to any number of medical ex
purposes of a congress. The hospitality of perts whose only expertness consisted in
our Canadian cousins has been unbounded, experience gained in the treatment of in.
and I think everyone has been charmed with fantile flatulency or adult bellyache. Now, his visit to the great Dominion. Some 1600 however honest and well.jptentioned these
members and visitors attended, the British men may be they lack the very qualifications for wbich they are summoned and are there. fore liable to do more barn than good in their testimony as experts. They may be summoned to whitewash their friends or damage other testimony, but this is not expert testimony, and the juries of the land know it, have no respect for it, and it should not be allowed.
MAJOR John M. BANISTER, of the United States Army Medical Service, giving bis observations during three years spent in the Philippines, says that scarlet fever, diphtheria, and yellow fever are unknown in these islands. He remarks: “As far as I have been able to learn not a single case, of either of these diseases ever occurred in the archipelago.” JAPANESE LOSSES IN THE WAR. — Accord.
R. A. REEVE, M. D. ing to the Tokio correspondent of the Times (London), the Japanese Minister of War, speaking at a banquet of representatives of contingent numbering about 200, and we the medical service, said that Japan at one
were glad to welcome a large number of our time during the war had 1,200,000 troops
United States friends. Altogether the Conunder arms. Of this number 70,000 died and
gress has been one of the most successful on 310,000 were wounded or sick, but only 15,000 record. died of sickness, and 9,800 died of wounds
Dr. Reeve in his presidential address dealt after coming under treatment.
largely with the history of medicine in the
Dominion and in Toronto, and viewed THE PULSE IN TUBERCULOSIS.—M. Dur. some points in the modern progress of the and says the pulse rate is a valuable diagnos- art of healing. tio sign in tuberculosis as indicating the sev. The address in Surgery was delivered by erity of the disease and its probable duration. Sir Victor Horsley, who took as his subject If the pulse rate is maintained above the "The Technique of Operations on the Cen. condition is serious, and desperate if it ex- tral Nervous System. It was a brilliant ceeds 120 for several days. Thus examina- exposition, admirably delivered before a tion of the pulse enable us to recognize large audience in the fine new Convocation curable forms of tuberculosis or at least Hall of the University, and illustrated with a those of slow progress. In doubtful cases of number of excellent lantern slides. Sir consumption don't fail to take the tempera- Victor first mentioned the cardinal symptoms
À slight rise toward night is one of of intra-cranial growths and discussed at the first signs.
what period an operation should be andertaken. He is of opinion that if the symp- Prof. Arthur Robinson, the president of the toms do not yield after three or four months section of Anatomy gave some introductory of medical treatment, an exploratory opera- remarks on the teaching of anatomy in unition should be done. If the growth could versities and medical schools. He concluded not be removed, the opening of the skull as follows: "It should, therefore, be the obwould do gocd, inasmuch as it would infalli. jeot of anatomists to avoid entangling medbly prevent blindness supervening on the ical students in a superfluity of detail. They optic neuritis; in itself no small thing, since should insist upon a thoroughly sound knowlthese cases might go on for years. As regards edge of the general relations and arrangeoptic neuritis bis experience warranted him ments of the more important organs and in saying that this first appeared always on parts of the body, a good knowledge of the the same side as the lesion. The chief risk general principles which underlie the relaof the operation was fron: shock; the patient tionships and arrangements and the advan. should be kept warm with bot water cans on tages derived from them. They should enthe operation table, which should be fitted deavor to make their students acquainted with a proper adjustable head rest, and with the general laws of growth and developthroughout the operation, the brain should be ment and with abnormal conditions so far as kept irrigated with 1.5000 corrosive sublimate they are produced by deviations from general solution at a temperature of 115 deg. F. This prevented cooling of the nerve tissues and tended muuh to prevent shock and also stopped capillary oozing. The brain tissue should be handled as gently as possible. The skull should be opened by first making a tre. phine hole, then by marking out the area of bone to be removed with a saw, and finally removing the bone with bone forceps, all traction being directed carefully away from the nerve substance. There was never any need to remove parts of the brain in order to expose the growth; the brain could always be pulled aside with spatulas. All vessels, arteries and veins, should be ligatured as long as possible. Bleeding to the bone could always be arrested with wax, and troublesome venous oozing was at once arrested by the administration of oxygen. As regards anestbetic Sir Victor uses chloroform; by means of the Vernon Harcourt regulator this could be administered in any desired amount. While opening the skull and dura 2 per cent of cbloroform in the air sufficed completely to
SIR VICTOR HORSLEY. anesthetize, but in the subsequent prooedures often } per cent was enough to keep the laws of growth and development, and, carry. patient sufficiently under the quantity being ing on the work done in the Biological De. again raised to 2 per cent during the closure partment, they should draw attention to of the wound. Asepsis and antisepsis should man's relations to other animals in all cases be carried out with the greatest care, as oper- wbere such relations are evident, and are inations on the central nervous system are structive of the methods by which man has particularly liable to be followed with septic been evolved and the means by which he reinfection.
tains bis place in the world. In addition, Dr. W. S. A. Griffith delivered the address however, they must see that their students acin Obstetrics on "The Teaching of Obstet. quire a sufficient knowledge of the detail of rics," and Sir James Barr the address in the various parts of the body and their relaMedicine on "The Circulatiun Viewed from tionships to enable them to deal successfully the Periphery." Dr. Donald MacAlister was with any emergency of daily life." the president of the Therapeutic section and An interesting discussion on arterio-scleroin his address advocated reciprocity be- sis engaged the combined attention of the tween Canada and England in medical sections of Medicine and Pathology, and practice. As he is president of the General Prof. Welob, Dr. Klotz, Prof. Aschof, and Medical Council in Great Britain he evi. Dr. Clifford Allbutt among others took part dently spoke with authority.
in the discussion.
butions are invited.
The following is a synopsis of th econtri. CLINICAL THERAPEUTICS bution of Mr. Oskar Klotz, Resident Path
A forum of original experience, to which scientific contriologist Royal Victoria Hospital, to the dis
Responsibility for views promulgated cussion on the Forms of Arterio-sclerosis, their Classification and Experimental Pro. duction: Experimental arterial lesions which
VIOFORM_ITS USE IN OTOLOGY. can be produced in animals are two kinds: either a degenerative one, affecting mainly
B. P. REKO, M. D. the media, or a regnerative one, in which the intima proliferates, while little or no degenerative change is seen. It is found, too, that
Ear Department, Rush Medical College. the substances which are used to produce the former belong to the class of high pressure
This but an attempt to record my experidoes not in itself lead to the medical lesions
ence with vioform as to its clinical aspect in
otology. Its value in general surgical work noted; there is a direct degenerative astion
has been extensively demonstrated by Tavel, of the drug on the muscle fibres of the
Krecke, Schmieden, Wehrle and others. It media. Elastic fibres become affected later.
has been recommended as a substitute for The latter once giving way leads to aneurismal dilatation. The degeneration is of a
iodoform and, indeed, the chemical and bacfatty nature. The intimal regeneration ig teriological tests as well as the clinical invesconsequent to bacterial toxins, the prolifera tigations would undoubtedly confirm that tion being confined to the endothelial and
opinion. Therefore I can restrict myself to subendothelial cells. When only intimal le
a mere recapitulation of the acknowledged
facts. sions are present aneurisms are not formed.
Vioform is a derivative of chinoline, wbose The character of these lesions can be com
antiseptic, antizymotio and antipyretio propared to those in man to a certain extent. Here lesions entirely of a degenerative nature
perties become still more pronounced by the
introduction of one atom of iodine and are met with in the Moenckeberg type of peri
oblorine. pheral arterio-sclerosis, and with the form of
It is a grayish-yellow powder of This disease as it is found in the aorta, both great stability to light, heat and moisture.
It is practically insoluble in water and, as it of which processes are confined to the media.
is much lighter than water, it forms a thin The experimental bacterial lesions of vessels
film on the surface. Compared with iodoform, simulate the endarteritis chronica deformans which develop the pearly intimal plaques.
it possesses the following advantages: RICHARD T. HEWLETT.
1. Its bactericidal power is greater than
that of iodoform, wbose styptic, deodorizing (To be continued.)
and infection preventing action it retains:
2. It is non-irritant, being neutral and therefore non-caustic.
3. It is non-tosio. A GEORGIA INDEPENDENT SOCIETY.—The
4. It is stable and readily sterilized with"Atlanta Constitution" is authority for the out decomposition. statement that a new State Medical Associa- 5. It is practically odorless. tion is being formed through the efforts of a Its only disavantage is that it cannot be number of leading physicians of Georgia. used for subcutaneous injections, since abThe promotors insist that they are in po scess formation is liable to occur. sense making a fight on the Georgia Medi. My attention was first directed to this prepcal Association, but objecting to some of the aration at the Ear Clinic of Prof. Politzer in features of the American Medical Association Vienna, and afterwards in the Austrian army, they are forming a body in which they will be where vioform has been adopted for use. free to act for themselves.
My intentions were to keep record of the MAKING COCAINE FIENDS.— William Jay
effects of this remedy in cases of middle-ear Schieffelin, the wholesale druggist, declared suppuration, based on the rhodan kali (poat a hearing at Albany, that there were drug
tassium sulphocyanide) test of the saliva. stores in New York City which gave away
Prior observations at the clinic of Prof. cocaine for the purpose of developing the
Politzer led me to ascribe great value to this
test in diseases of the middle-ear, since absence habit and creating customers. He says that
or only traces of rhodan kali (potassium sul. 20 per cent of the cocaine manufactured in
phocyanide)-KONS-in the saliva suggests this country is converted to illicit uses. His
a disease of the middle-ear with lesion of remarks suggest that the public is insufficiently protected against unscruppulos drug- Vide: Alexander & Reko: “Beitrag zur Verwertung der
Rhodanprobe des Speichels bei Ohrenerkrankungen." gists.-Texas Med. News.
Wiener Klinische Wochenschrift, 1902, No. 42.
the tympanio plexus, while the reappearance MEDICAL MISCELLANY
Juglans is a good vermifuge and it is
olaimed that it bas destroyed tape. worms. Where bilateral suppuration permitted a more critical comparison of the different anti- MORTALITY FROM HOMICIDE AND
V10septics en vogue, I improved the oppor- LENCE. — The number of homioides and deaths tunity to test the superiority of vioform by violence in the United States in 1905 over jodol, airol and derinatol. In all ob
was 9,212, as against 8,482 in 1904. Sui. served cases vioform acted as an ideal anti.
cides, 9,082, as against 9, 240 in 1904. Killed septio and siocative, bastening the reappear. on steam railroads, in 1905, 3,142; injured, ance of the rbodan kali (potassium sulpho
15,904. Killed on electric and elevated rail. oyanide) in the cases where a oure was per. roads, 464; injured, 2,622. These statistics, formed. In acute suppuration I found it of collected by the Chicago Tribune, are unoffi- . better advantage to follow the dry treatment
cial, but perhaps they are none the less trust. and use boric acid for the first days after per- worthy on that account. We murder and foration, as it readily dissolves in the secre
manslaughter nine times as many as the Gertion, and does not easily interfere with drain
mans; four times as many as the English, age. The after-treatment consisting of the use Sootch and Welsh. America seems to be a of vioform as dusting powder finished the little careless, to put it mildly. process of resorption speedily.
Of special interest to me were
cases of radical opera- THE KLEPTOMANIAC. — “A New York spetion, where I could observe, whether or not cialist got, on a certain morning, the card of vioform would shorten the time of recovery, one of the richest of our Western millionaires. which in uncomplicated cases amounts to He went down instantly and found a wellabout four weeks, as indicated by the typi- dressed man, who said: cal reappearance of the rhodan kali (potas- “ 'I am bere, sir, on a delicate and painful sium sulphocyanide) at that time in all our matter. My wife is a victim of kleptomania, observed cases (fifteen) at the Ear Clinic of and, knowing your skill in mental diseases, Í Prof. Politzer. Unfortunately my observations have brought her on for treatment under in this direction were limited to a single you.' case of radical operation during the time of ‘Bring the lady to see me tomorrow morn,
ing,' said . cided favorable action of vioform on the 'It will be course of the healing process was very much office,' faltered the millionaire.
The sight pronounced.
The granulations were clean of other patients might excite her. and small, and the restoration was performed gestin two weeks, as shown by the rhodan kali "I'll receive her in my drawing-room. (potassium sulphocyanide) test. Similar re- Will that be better?' asked the physician. sults were obtained by Lindt and Sieben- “ 'Oh, much better,' said the other, in a mann, who use vioform exclusively. Lindt relieved tone. observed that vioform does not tend to favor "And the next day the Western millionaire abnormally marked granulations, and does led into the physician's drawing-room a not harm epithelial growth in the exposed young woman of singular beauty. She was middle-ear cavities after radical operations. magnificently dressed, but her eyes were furi.
Siebenmann found that wounds after radi. tive and restless, and when she thought no cal operations were repaired quicker than by one was looking at her, she secreted under her airol or dermatol. “Vioform is recommend- coat three or four valuable ornaments. Tbe able for after-treatment in radical operation, physician and the Westerner smiled slightly as it excites less granulations than under the at one another. application of iodoform, and the new forma- “The physician, after his examination of tion of epithelium progresses quicker there- the patient, told the husband to return the fore."
next day alone. My observations are not limited to the use “And when I come,' the husband ans. of vioform in otological cases. I use vioform wered, I'll bring back these things that she very extensively in my private practice after has taken.' operations in the nose, where tampons of rio- " 'Do,' said the said the physician. form gauze may be left for days without be- " 'I will,' said the Westerner. coming malodorous owing to decomposition. “But be didn't. He won't. He and his From my observations I am led to the con- wife are thieves, and they have worked their viction that vioform deserves first rank among kleptomania dodge in nearly every city in the antiseptics in use in rhino-laryngology. America."