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The narrow utilitarian polioy of urging crime, if committed by a physician, is more a younger brother, nephew or son into a med. heinous for the fact. ical career, for the sake of subsequent assist.

TOBACCO SMOKING BY THE IMMATURE. – ance, or even because the senior may thus

We bold no brief for the cigarette, nor do we give greater assistance to the junior, for the

fail to recognize the fact that smoking by latter's sake, is to be deprecated.

juveniles is an evil, but the case for remedyWe wish to emphasize, partioularly at this

ing the evil is not helped by doubtful stateseason, when medical colleges are about to

ments. Everybody knows that tobacco is a

. open, that each one of the many thousands of

poison and the suggestions, therefore, that physicians, should exert his influence in a

tobacco is injurious because of its impurity broad and wise manner, so that the medical ma

or adulteration or because poisons are added triculants may be of higher quality than ever

to it are altogether beside the issue. If the before. The fact that better quality implies a

tobacco smoked were the purest possible leaf smaller quantity, and that this diminution in

the evil of smoking by juveniles, in our opinquantity is indicated by purely economic

ion, would be not a whit the less. If it were conditions, need not and should not influence

other wise there would be no necessity for the advice given in any particular case. For.

suppressing such smoking so long as the tunately, the conditions are such that eco

youth was supplied with pure tobacco. nomic and humanitarian ends may be served

Since tobacco is itself a poison we need by the same wise policy, and the consistent carrying out of this policy will gradually by the immature or its abuse by the grown.

no further argument against indulgence in it bring about, not a medical Utopia, but a con

up person. We can well believe that certain dition in which an adequately paid and suf

tobaccos are more poisonous than others, ficiently busied profession shall enjoy the

but we very much doubt whether substances prestige which can only be attained by an

more injurious than tobacco itself are ever even balancing of the general law of supply added to the manufactured leaf. Flavorings and demand.

and sweetening substances, such as liquorice,

glucose, and glycerine, are often added, but The annual crop of foot-ball accidents is

these are harmless compared with pure to

bacco itself. about due. One accident has already been

Statements have been freely reported from the local field.

made that morphine or even cocaine is added

to cheap cigarettes in order to give them DR. HARRISON CONVICTED. Dr. A. S. immediate soothing qualities or “to soften" Harrison, of Kennett, Mo., one of the fore- the flavor of an otherwise harsh-smoking tomost physicians of that section of the state, bacco. We cannot accept such statements was convicted in the Circuit Court of Stod. applied, at all events, to cigarettes retailed at dard County on the 13th inst. of mayhem, five or even six a penny. The tobacco in such and sentenced to serve five years in the peni- cigarettes is of an inferior and inexpensive tentiary. The victim of the brutal assault kind we admit, but we have not been able to was a farmer, Daniel Crites, who, with Har. find the smallest trace of foreign poisons in rison and one John Sweeney, had spent an some very cheap cigarettes which we purafternoon drinking and had gone to a vacant obased only recently and submitted to carehouse togetber, where they were joined by a ful analysis.

We doubt whether it would fourth man.

Crites tried to leave and was pay to add such comparatively expensive poi. struck on the bead and lost consciousness.

Opium is not cheap nor is cocaine. When he recovered he found himself on the Tobacco of common quality is at any rate railroad track and suffering great pain; he infinitely obeaper. The danger of smoking rolled off the track just before the train arises from tobacco poisoning and it is the passed. With great dificulty be made bis wholesale and unchecked poisoning of the way to town, and there it was first discovered child with tobacco, chiefly in the form of that he had been mutilated. Harrison and cigarette smoking, against which the nation Sweeney were arrested for the crime. Har. is asked to find a remedy. On what lines rison denied having entered the house with such a remedy can be made effectual we are the others, and also denied all knowledge of

It is obvious that different per. the crime. The evidence is purely circum- sons exhibit a different susceptibility to the stantial, but seems to have satisfied å jury. It poisonous action of tobacco even in the same is believed that a new trial will be granted. country. In Oriental countries, however, exIf a member of our prcfession did commit cessive smoking, which is intensified by in. such a crime, we can bave no time for sym - baling the smoke, commences almost from pathy, five years is too little punishment; but the cradle and is continued right through life if there is a obanue that he is innocent every apparently without any ill-effects.-The Lan. aid should be his to establish the fact. The cet.

not sure.

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The Medical Society of City Hospital Alumni

President, LOUIS H. BEHRENS, 374? Olive Street
Vice-Pres., WALTER C. G. KIRCHNER, City Hospital

Secretary, FRED. J. TAUSSIG, 2318 Lafayette Ave.
Treasurer, JULES M. BRADY, 1467 Union Avenue


Scientific Communication, Wm. $. Deutsch, 3135 Washington Ave. Executive, A. Ravold, Century Building

Publication, W. E. Sauer, Humboldt Building Entertainment, Frank Hinchey, 4041 Delmar Ave.

Public Health; R. B. H. Gradwohl, 522 Washington Ave

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don't recall having read of or seen any case

in which there was any great hypertrophy of CHAS. E. BARNETT, M. D.

the tissue around these ducts, such as is found in the male. Even in cases of pseudo

hermaphroditism I do not remember any case DISCUSSION.

where there was the formation of a prostate

in place of these ducts. Dr. F. J. Taussig.–The subject is certainly one concerning which we have very

Dr. George M. Phillips.-Tbe subject is much to learn and one in which I acknowl. an attractive and a new one. For the limited edge to have had little experience. The ques. time I have been engaged in the practice of tion of gonorrheal infection of these glands medicine I have treated the fewest possible is one not given due importance either in the number of women, and I have never had a text-books or in general practice. In the deep woman remain obedient to treatment for more ducts the gonococcus may reside a long time

than the shortest while. We know today that when in other portions of the genital tract it

there are new things so far as our informahas disappeared, and doubtless serves to re- tion

goes that should bave been known to us new the infection in many cases As regards a long time, and while these glands may be a the treatment in these cases, I don't know

counterpart of the prostate, yet it would rewhether we ought to undertake very active quire a great deal more to settle the question treatment in any of these gonorrheal infec- than what has been done. In the first place, tions about the urethra. It will usually get there is a great deal about the prostate in the well by itself, and if over-treated, the disease male that we don't understand. For inwill spread to the neck of the bladder, or into

stance, it was supposed when we commenced these ducts. I am free to confess that in the making prostatectomies that the ejaculatory sections I have seen they have always been power would be abolished, but I have made in the form of ducts. They have a single the operation in a number of cases wbere canal that penetrates rather deeply. In the for several years the sexual power bad been majority of instances these caees will get well abolished, and following the operation the without treatment. I recall one case of an

sexual and ejaculatory power had been reabscess of these ducts, in wbich during labor stored, aud in one case the man absures the abscess was literally emptied by the pass

me that these powers are greater than ever age of the head and the pressure of the labor before, and he is now 67 years old. Yet I pains, so that a stream of pus came out was taught to believe that this was the printhrough the urethra. The pus can often be cipal function of the prostate. If that is milked out through the urethra, and this is true, a woman does not need such power. preferable to rupturing through the vagina. You believe, Dr. Barnett, that these enlargeOne of the cases I have seen needed surgical ments were the result of an inflammatory pro. interference. In the Bartholinian gland we

cess as far as you could determine? have a single racemose gland, and if the canal be closed the drainage is poor and Dr. Phillips. - Did this appear to be a there will fbe a tendency to abscess forma- ribrous process when examined microscopi. tion. In these cases mere incision is not cally? enough. A complete extirpation of the gland is necessary. But in these para-urethral

Dr. Barnett.--I do not know. structures we have merely a duct, and from general reasoning I should imagine the iudi.

Dr. Phillips. We should feel deeply incations for operative procedure would not

debted to the essayist for bringing this matbe as frequent as stated by the essayist. I

ter to our attention. There may be a great

deal more in it than we are at first inclined *Discussion of paper published August 25th, page 404.

to think.

Dr. Scbarff.—This subject is a very inter. markable that I have never heard of anything esting one. It has long been a question of like it. This patient had three ureters, one the analogy of some gland or organ in the fe- on the right side and two on the left side. Of male with the prostate in the male. In the the two on the left, one was infected with para-urethral glands referred to there is gonorrhea and the other gave perfectly clear really not much real glandular tissue, wbile urine. That patient had been treated by a the prostate is to a great extent made up of number of most capable men. He had for glandular tissue. In gonorrheal affections of two or three years bad persistent by recur. these para-urethral glands you find a small ring gonorrheal infection. He bad received cell infiltration rather than a hypertrophy of very thorough treatment, yet every once in a the glands. In reference to the treatment of wbile up would come this gonorrheal activ. gonorrhea in the female I noticed that Finger ity. The reason for this was never learned establishes the location of his infection in until we saw the three ureters. Then by one of four places, viz. : cervix uteri, uretbra, three irrigations of the kidney pelvis we Bartholin glands or para-urethral (Gänge) or cleared up the whole thing and he has bad canals, and applies his treatment to the no recurrence of the infection in seven affected part. It is also interesting to see how months. We tried to cure him and could he draws the line of bis responsibility from not do it until we discovered this extraordin. the gynecologist in these affections of the ary source of infection. He might have gone cervix, he treating them only as long as he on for twenty years just as well as for three thinks the disease is limited to the cervix, years in this condition. It is not a matter of and has not gone over to the body of the time; we must find these foci and Dr. Bar. uterus, tubes, etc., when he refers them to nett has told us of a new one for the gonothe gynecological department.

coccus. The more of these niduses that

lie in the human organism the more diffiDr. Bransford Lewis.- I bad anticipated cult we find the work. I don't like to accept the pleasure of trying to tear his paper up the burden Dr. Phillips has put on the prosthe back. That is one of the pleasures in re- tate, that of accelerating the ejaculation of the ceiving guests from the outer world, but I semen I have looked upon it as an organ. think Dr. Barnett bas taken advantage of ism of glandular and muscular tissue with a us, preventing this by bringing in something fibrous tissue interlacing these two. The that we don't know anything about. I can

muscle at the base is a sphincter muscle for not say anytbing against the contentions of the bladder, and I would not expect the the essayist. If he establishes his case it will prostate to have the office of expediting the make another focus of infection for us to look ejaculation of semen. out for and disinfect. My experience with

Dr. Jacobson. I do not agree with Dr. the gonococcus is limited almost exclusively Taussig that we should not attack these foci. to the male organism. In some cases we have Especially in the chronic stage we ought to found that active treatment was not well

find them and with the new aids we have for borne for certain length of time. They will

the treatment of gonorrhea we ought to cure then do better if let alone, so far as local treatment is concerned, for a certain length forces of nature to bring about a cure. The

them, or I should say,assist the antibacterial of time, yet I have no confidence in their

different portions of the urethra can be exgetting well ultimately without treatment.

posed and the retention cysts can be slit up. I do not have confidence in the necessity of

Then apply strong nitate of silver on appliresorting to internal and general treatment

cators under the direct light of the electric until the acute processes are over.

It is nec.

endoscope. This treatment repeated freessary to get rid of the gonococcus. I bave no faith in the recovery of the individual quently with assistance of antitoxins or anti

bodies found in the blood of the patient to otherwise. The gonococci must be eliminated

bring about a cure. I believe in the greater

a by some direct and radical mode of treat

majority of patients that have an attack of ment. In a number of cases in the course of

gonorrhea, the gonococci entirely disa pears in our examination of male patients we have seen

from three to ten years, and greater number not a particle of discharge from the meatus,

of males that have had said infection are able and after having the urine passed in two glasses both were found negative, and yet

to discharge lively, healthy spermatozoa. when we milked the prostate and vesicles down Dr. Jacobson.-Certainly I bave failed. would come a number of drops of gonorrheal It is much easier to locate these glands in the pus. This is an illustration of the absolute female than in the male. Sometimes they do necessity of going after the nidus before not form retention oysts. You may press that patient has a ghost of a show of getting through the vagina and the pus will come right well. We have had recently a

out. Ashton uses a strong ichthyol solution


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If you



on applicator wrapped with cotton.

method of splitting. We entered with a let them alone, as advised by one of the pre- probe and then introduced a very fine scalpel ceding speakers, reinfection will often take and opened them. You cannot do the work

, place and the tubes may become involved, by injections. The female urethra is very then you will have a salpingitis and a dan- hard to treat, unless you have bad large exgerous operation confrouting you. And al- perience. We never forced the injections, always bear in mind when you find it necessary ways gently pressing in only so far as was to remove the tubes, there may be such strong easy, and I never got any infection by this adhesions that you have to exercise great care

It is very important to give atten. and patience in their removal to prevent rup- tion to these para-uretbral ducts. This is the ture of the tube or tearing a hole in the ad- first time I have ever seen any communicaherent bowel or bladder. Calouli bave been

Calouli bave been . tion between the para-uretbral ducts and the found in these little pockets or cysts; there glands. It is, therefore, surprising to me to may be tuberculosis present, then excision hear of these cases. The analogy is somewith general antitubercular treatment is in- thing really striking. Dr. Barnett has predicated.

sented something new, and if he only would Dr. Norvelle Wallace Sbarpe.—The ordin

bave taken the time and care to show us hisAry infection is not very troublesome to the tological proof, I would be glad to say that patient or to the physician in charge. Any

we have had the demonstration of a discovinfection which may be cured by the instilla

ery. tion of fluids is not troublesome, nor is it serious even when encountered in glands that

Dr. Barnett, in closing.-In naming this may be removed. The real difficulty arises

paper "The Female Prostate," the question wben the infection occurs in glandular struct

came to me whether medical men would not ures where the focus is not easily reached. If look upon that as belittling the subject, or it can be cured by a simple milking process,

putting out a red flag to attract attention. In well and good. Fortunately the female

my opinion, and I bave been investigating urethra is short and we may readily expose

this subject for four or five years, we have the the orifices of the ducts, or we have the histological proof. If I had named my paper further opportunity of splitting up the duct the "Deep Urethral Glands,” the man pracso as to reach the infected gland.

The en

ticing medicine would bave thrown it aside, tire interest in this matter rests in the fact

and said it was nothing to him. Some of the that we have a focus from which a re-jnfec.

older men will tell you of the formation of an tion may be started up at any time upon pro

abscess and the reformation, etc. I just vocation. As to the surgical procedure, the

wanted to bring the subject to the attention following will prove a satisfactory routine :

of the profession. If I am wrong I want to cleanse the urethra, examine the urethra, as

be set right, and if some one will prove that certain ducts from which pus or infected ma

we have abscess formation without glandular terial escapes; cleanse same and instill what tissue, which to my mind is practically im. medicament seems indicated. If this prove possible. And, according to the size of the insufficient, split ducts and make thorough abscess, there is enough to call attention to local applications; if this too proves inade it, even if there is no glandular tissue. Dr.

I have quate, extirpate the infected masses from the Pbillips is a doubting Thomas. vaginal side. Suturing if the operation has

found hypertrophic glands in a number of been in normal tissue, packing if it has not.

dissections. I had a section for Dr. Sharpe

to examine, but somehow the section never Dr. Wolf.- I have had much experience got there, but I believe the tissue was both in this matter because I was chief of Pro- glandular and muscular. As to the analogy, fessor Lange's clinic in Vienna. The dis- we have the prostate in the male and the deep cussion has drifted a little from the subject urethral glands in the female, we have Barpresented. Dr. Barnett has presented some- tholin's glands and the vesiculae seminales. thing with which I have never met. These As to constitutional trouble from the Neis. are not at all glands, they are only ducts. In serian infection, I tbink we have more constithe normal cases, they have not a trace of tutional trouble than from any other infecglandular tissue. I have never met a case tion with the exception of tuberculosis. In where these ducts communicated with these the bladder work I think Dr. Lewis is at the glands. Dr. Barnett tried to make an anal- very top of the heap. Understand me, I don't ogy between these and the prostate. Possibly believe this is a big subject, but I do believe if he gave us a bistological demonstration we it is a little subject that needs attention. I would be readier to see the resemblance. I believe there is communication between the have seen these ducts involved, and at Product and the gland, and that it will be proven essor Lange's clinic we had the surgical histologically.


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without knowing anything at all about sur. gery, but we believe just as firmly that no

man can be a first class surgeon who is not Issued Tenth and Twenty-Fifth of Every Month. a good physician. The reasons will easily THOMAS A. HOPKINS,

appeal to any thinking man, but when we Managing Editor.

state the fact that there are a number of sur. Editorial Stat :

geons in our experience who are extremely 0. E. LADEMANN. Internal Medicine.

skillful in surgery itself, and yet cannot JOHN MCHALE DEAN, Surgery.

grapple with the simplest medical complicaF. P. NORBURY, Nervous and Mental Diseases. R. B. H. GRADWOHL. Pathology and Bacteriology. tion in a case, we are not putting too high W. H. VOGT, Obstetrics and Gynecology. WALDEMAR FISCHER, Ophthalmology.

an estimate upon the necessity of the surgi. A. LEVY, Pediatrics.

cal practitioner keeping up bis reading and W.T. HIRSCHI, Therapeutics. A. F. KOETTER, Otology.

observation, and, if he can do so, bis experHERMAN STOLTE, Laryngology and Rhinology. T. A. HOPKINS, Genito-Urinary Diseases.

ience in general medicine. When it comes ROBERT H. DAVIS, Dermatology.

to the narrow specialties of the eye, ear, Editorial Rooms, Suite 319-321 Century Building, St. Louis. throat, and so on, the same dictum holds,

and the failure to attain the best results is EDITORIAL

often due, not to the lack of skill in the specialty, but to the lack of knowledge in

general medicine." We often hear it said that we live in a day A knowledge of general medicine and the of specialism in all lines of commercial and maintenance of a well-rounded medical char.

scientific activity, and acter is essential to success in a specialist's

in the abstract this ap- work. We all know specialists who can see Specialism as it

pears to be an ideal only their own little group of organs, and Sometimes is.

state, but it is an un- who view every obscure trouble as originat.

fortunate fact that the ing from some disorder within their prov. term "specialist” has, in medicine, no ince. Acute diagnostic acumen would frecessarily limiting or warranting significa- quently send cases to the internist or back tion. The problem of specialism would be to the general practitioner which are treated simple indeed were specialists always men of by the urologist. We too infrequently hear of special attainment in their special line, and a specialist returning a patient to the general did they confine their attention to the work practitioner, because he fails to find anything to which they profess to limit themselves. within bis province; he doesn't fail, because We have in mind a man recently arrived to him every symptom points to his field, from the University of Vienna, but shortly and he can see no other, graduated, who posed as a specialist, telling The real day of specialism will be tre time of special training to bear out his claim in when only those will aspire to this dignity gynecology, pathology and bacteriology, sur. who have drunk deep of learning and who gery, urology, dermatology and internal med. bave a breadth of scientific horizon which icine, all within a few weeks, bis line depend. brings within their vision the whole realm of

a . ing on his audience. He was getting his medicine, even though they may not choose bearings when he found the line be thought to tread all its devious and varied paths. the most pronising in this community, be an- Such there are now, and it is to them that nounced himself a specialist therein, but we look with gratitude for they keep the there is no indication that he confines himself good word specialist from utter disrepute. to it. Graduates of Americau schools are less rash, for they know local conditions and appreciate that they cannot command so credu- The laying of the corner-stone of Missouri's lous an audience, but their real unprepared. State Sanitarium for the Treatment of Incipi- . ness when they announce themselves as spe.

ent Tuberculosis OCcialists is frequently quite as apparent. A

curred at Mt. Vernon

The Missouri four years spent in medical study does not

on August 15. The prepare a man to launch himself as a spec


ceremony was con

Sanitarium. ialist, such an one must spend years round.

ducted under Masonic ing himself out in general work and special

auspices and were all in post-graduate study before he is fit to be re- impressiveness that the Masonic rites assure. garded as specially an authority in any Addresses were delivered by Mr. W. B. Skin. brach. Speaking to this point the editor of ner, of Mt. Vernon, Governor Folk, Dr. Wm. the Post-Graduate says:

Porter and others, each picturing the re"We have always considered it an axiom sponsibilities and possibilities of the instituthat a man may be an excellent physician tion.

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