that we can ever expect to check the invasion of nervous and mental disorders. Clinical psychology has shown in the neuro. pathic class (that product of heredity, plus faulty living and lack of character education) that there is much that can be done by individual study of each case.

Perhaps, the personality of the physician is a factor of greater importance in developing the so-called moral treatment, the character development of the patient, than any other therapeutic agency, excepting, of course, the nurse who shares the responsibil ity and executes in her own tactful and trained ways the orders of the physician. We know that moral education precedes mastership in every act, because the training which mastery involves reacts upon character, gives it steadiness and solidity. In our profession, when we are confronted with the probleme, essentially psychological in our patients, growing out of their wanton, careless and irresponsible ways of living, we are forcibly are forcibly reminded that it is indeed in a good moral education that the surest prophylaxis of nerVous exhaustion is found.

Again, it is by taking advantage of the opportunities presented while the patient is under our care, to inculcate principles of right living, which may become an integral part of the individual's character, so that in addition to the physical advantages to be gained in following the technique of treatment, whatever it may be, especially the rest treatment, we develop a broader, more comprehensive view of life itself for the patient, and that there may grow out of their experience while under our care, a vital relationship of the personality with all that is deepest in human nature. We must remember that these patients live imbued with auto-suggestions which they have created themselves and to lead them away from these suggestive influences requires an earnest endeavor on the part of the patient encouraged and lead by a thoughtful and resourceful physician. It is necessary for the physician to individually study his patient, and by the analytical psychological method, so that he may know his mentality and lead him by the clearness of his instructions to correct ways of seeing, believing and doing, and thus be delivered from the thralldom of his mental representations. Unfortunately, there are physicians who have so little. knowledge of the mentality of nervous people, who have so little real working sympathy that is constructive, in helping their patients, that they are more apt to do more harm than good in the task of the gradual destruction of the agglomeration of fears, theories, etc., of the patient.

Thus is the field of psycho-therapy so ably presented by DuBois in his very helpful book, "The Psychic Treatment of Nervous Diseases, "of which Dejerine says is the work of a physician as well as a psychologist. In no place in our therapeutic art do we find a call for the very highest application of educational means and methods than in the treatment of nervous disorders as found in the psychoneuroses which form such a large part of the nervous class of patients. It is an appeal to the education of self, both in the patient and in the physician in order to lead the patient. It is the influence of the mind over the body, of character, moral development against the evils which torment the nervous invalid. Educational methods alone will not give the results is my own experience, and I have faithfully, honestly and consistently endeavored in my own work to live up to the educational ideals inspired by S. Weir Mitchell and other workers in this field. I have found, as you have all found, that fatigue, bodily, intellectual and emotional, are factors with their attending physical depression, which must first be intelligently met and overcome before we can hope to create optimism, hope and encouragement; it is by systematically treating fatigue in its varied forms, building up with good fat and blood that we lay the foundation for good mental results. Then,

at the same time create that rational, helpful desire, by true sincere interest in your patient, which will remove the tempest of emotional feeling, create new ideals in character, unfolding and inspiring confidence in their own moral personality. Then, as DuBois says in his recent very happy and helpful little work designed for the layman: "This work of self-education is less difficult than one would think . . Often in some days, almost always in some weeks, they (the patients) succeed in altering the point of view, in seeing things from another angle. In proportion as they recover their mental calm under the empire of healthy reflection functional troubles disappear, sleep returns, the appetite rises, the body becomes stronger and the success of this mental treatment demonstrates the supremacy of mind over the body. It is in this self-education that the sick should find a cure and well people will find a preservation against nervous diseases. They should begin in little things, in the good habit of overlooking trifles and going bravely forward without troubling too much about their own case.

I believe in the educational growth of char acter, both in the patient and the physician, and this involves discipline, self-denial, selfsacrifice, but it is the reward which the law of

excellence demands of us if we are to succeed in our work. I hold that in clinical psychology, in the synthetic analysis of character, which plays such an important role in the success or failure of results achieved in treatment, "we find that a man must give his character firmness and fibre before he can make his talent effective or fruitful." The connection between sane living and sound work is a physiological and psychological necessity, and if I can leave just that one thought with you, you have the key to the manifold problems of clinical pscyhology.

ALVARENGA PRIZE. -The College of Physicians of Philadelphia announces that the next award of the Alvarenga prize, being the income of one year of the bequest of the late Senor Alvarenga and amounting to about $180, will be made on July 4, 1907, provided that an essay deemed by the Committee of Award to be worthy of the prize shall have been offered. Essays intended for competition may be upon any subject in Medicine, but cannot have been published. They must be typewritten and must be received by the secretary of the college, Dr. Thomas R. Neilson, on or before May 1, 1907. Each essay must be sent without signature, but must be plainly marked with a motto and be accompanied by a sealed envelop having on its outside the motto of the paper and within the name and address of the author. It is a condition of competition that the successful essay or a copy of it shall remain in possesssion of the college; other essay will be returned upon application within three months after the award.

MEDICAL ASSOCIATION OF THE SOUTHWEST. -Under the most favorable auspices, and with marked enthusiasm, this new society was launched at Oklahoma City, on October 30th. The Tri-State Society of Oklahoma, Texas and Arkansas was merged with the new organization, thus removing a competitor from the field, and insuring an open field for the new society, which gives promise of a most successful career. An excellent scientific program, divided into three sections, occupied two days, and afforded the two hundred delegates in attendance an opportunity to judge the caliber of the men comprising the brain and brawn of the great Southwest. The election of officers resulted in the choice of Dr. Chas. M. Rosser, of Dallas, Texas, for president, and Dr. Fred. H. Clark, of El Reno, who has been active in preliminary work of organization, as secretary-treasurer. The next meeting will be held at Hot Springs, Ark., in the fall of 1907.

He

the pharmacists met together and listened to cists relating to the history, plan and scope a number of papers by prominent pharmaof the U. S. Pharamacopeia and the National Formulary, a commentary thereon. Prof. Hemm, of the St. Louis College of Pharmacy, gave a most interesting account of the new preparations according to the third revision of the National Formulary. showed an elegant line of elixirs and syrups, emulsion and solutions, palatable and agreeable yet withal potent; moreover, the individual pharmacist's guarantee of stability of composition goes with these preparations. They insisted that the widespread use of proprietary preparations, some of which are decidedly fraudulent, is gradually depriving the educated pharmacist of bis living and of his knowledge. It was claimed that there is a "dis-use atrophy" of the functions of the pharmacist relating to the compounding of scientific prescriptions, that the modern pharmacist is compelled by the wholesale prescribing of patented articles on the part of the physician to simply pour medicines from one large bottle to another smaller one, label and hand over the counter.

The medical man listened with attention and "promised to be good," promised to sin no more, promised to always prescribe the preparations of the National Formulary and that too, by their Latin names, as requested

by Prof. Hemm. The writer straightway began the following day's prescription writing by jotting down a formula calling for "elixir digestivum compositum," which, ahem, all of us recognize as an orthodox National Formulary preparation. Within a few hours the telephone tinkled merrily and a voice purporting to issue from the sanctum sanctorum of a prominent down-town drug-store naively asked, "doctor, we have here one of your prescriptions calling for 'elixir digestivum compositum.' Will you kindly tell us what house makes this proprietary?" Needless to say, this question was answered with a sharp admonition to read the National Formulary and learn "which house makes this preparation."

The above experience shows conclusively that this reform needs the conjoined action of both the pharmacal and the medical professions; that perhaps the pharmacists should call a meeting (and we understand from Prof. Hemm that such a meeting will shortly be called) and that every druggist and drug-clerk as well as every physician should buy a copy of the National Formulary and study it diligently.

It was said at the meeting alluded to above that perhaps the medical student does not receive enough instruction in prescription writing. It is barely possible that perhaps the pharmacists in the past have not been well drilled in their learning of the official preparations of the U. S. Pharmacopeia and the National Formulary. Or, does the average drug-clerk fail to recognize the official preparations on a prescription blank because of the "dis-use atrophy" brought on by excessive reading of proprietary prescriptions written by doctors with "proprietarietis hypertrophica (apologies to Mr. Dooley)."

Sleeplessness.

R. B. H. G.

THE balance between fatigue and rest is one of the most wonderful of provisions in the scheme for the continuance of animal life, to be healthily fatigued and to sleep-can anything more beneficent be imagined? The average busy man unthinkingly regrets that he must spend so much of his valuable time sleeping, and it is cnly when this privilege is denied him that he comes to properly appreciate the worth to him of the hours he has spent sleeping, for to be fatigued and be unable to sleep is hell; to be surrounded by all that should be conducive to rest, to be properly wearied and ready for sleep and to be unable to lose yourself to it is an experience which can be explained to no one, it has

to be undergone. You are not going to be so foolish as to employ hypnotics and you first undertake to subdue yourself by the employment of some of the forms of light gymnastics which have been highly recommended, you discard your pillow and later get two, you count, you read dull books, you try various unnatural and uncomfortable postures and still the nights pass without giving you more than a hint of the sleep which has been your due. which has been your due. By the end of a week you are ready to use almost any somni. facient and you have awakened in you a most wonderful admiration for the sleeping sickness and a sympathy for anyone who has ever been deprived of sleep. If you have not already too far abused your nerves you presently find yourself sleeping again and the wonder of it is indelibly impressed on you for it comes without explaining the why of its coming, but you know that it came just in time and that had things been but slightly different the future would have been black indeed. You resolve to treat your body with due deference from this on and perhaps you do do it.

There is no joke in this sleeplessness business. It is a condition which is especially liable to be found in the medical camp and it is worthy of serious contemplation, it is a condition which should be anticipated and hindered. When you find the man who has once experienced a season of it you will find one who will tell you that there is no physical suffering in the same class. Most of the therapy directed against it is irrational for it is directed against the effect instead of the cause and while it is necessary to give rest, even though temporary, and without regard for the cause still the reason must be found and overcome. This not infrequently means an absolute change in the manner of life, and almost invariably in our cities it means at least a considerable increase in time spent out of doors and in play, these sleepless people have usually forgotten how to play and they simply have to learn again. We have gotten a mighty distance from nature these days and we know little of good old Mother Earth and the smell and feel of her soil and we are having to pay penalties, that's what these people who cannot sleep are doing and it seems that their salvation lies in discovering their need before it is too late.

THE local health physicians have lately completed their annual vaccination campaign. There has been less objection to vaccination this year than usual, and while it has been nicely effective there have been few bad arms.

To Assemble the Literature of the Local Profession.

A MOVEMENT to assemble and make accessible the writings of members of the St. Louis profession has been inaugurated by President Homan of the St. Louis Medical Society and is worthy of the co-operation of all who have written on medical or other scientific subjects. Dr. Homan issued the following call to members of the St. Louis Medical Society:

While the maintenance of interest in the current scientific work of a medical body is of prime importance and cannot safely be neglected for a day, the collection and preservation of the records of past or of this kind by out members is also a function peculiarly appropriate to a body such as this one is, and which undertaking, if found workable, cannot but redound to the credit of this society and prove an additional stimulus to scientific effort.

It has occurred to me therefore, that a valuable and interesting-if not unique-departure could be made in beginning the formation of a collection of reprints-that is each member who contributes papers on scientific subjects for publication, would be requested to donate to the society a complete set of such reprints, or as nearly sc as possible-a memorandum being inserted to show the date and place of publication of the papers that are not included in the collection-and this collection to be preserved by the society and held conveniently accessible to the entire membership.

Comparatively few of our members have access to a medical library, and one advantage of the proposed plan would be the ease of consulting a production on any specific subject of which the seeker had heard or of which his own copy was lost, particularly those topics that are treated of by the various specialties as the eye, ear, lungs, heart, etc.

No time would be lost in searching through files of medical journals, and this advantage would appear more distinctly as such a collection grew in volume and value.

There is in this suggestion also an appeal to the natural pride of authorship, which should stimulate interest in the undertaking, while the cost involved would be inconsiderable, as self-binders of suitable size can be had at wholesale for fifty cents each, while an appropriate case for safe-keeping need not be of an expensive character.

Later, if the project should be well received by the members, its scope could be enlarged, and all prominent medical writers could be invited to make contributions in kind to the suggested special library or collection.

THE consolidation of the Female and City Hospitals is being discussed by the daily

The Female Hospital.

press, and it seems worth pulling for. Conditions have greatly changed during recent years, and there is not the reason for a separate institution for females which once existed. The Female Hospital has become a lying-in institution, and is doing a work which does not justify so large a force as is necessary to its administration as now conducted; its buildings are dilapidated and must be renewed. Wisdom would point to rebuilding as one of the City Hospital group and conducting both institutions under a single administration and with the one office force.

THE death of Dr. Sylvester L. Nidelet on October 30th has removed another of the older and more picturesque medical characters of St. Louis. Dr. Nidelet

Dr. Sylvester Nidelet.

was born in Philadelphia 77 years ago, bis parents were St. Louis people, and he always considered himself a St. Louisan by birth.

He graduated in medicine here and went to Texas. There he entered the army as a surgeon, and during the years spent on the frontier in that capacity, became well acquainted with the Indians, and learned several of their tongues.

When the civil war began he enteered the Confederate service with Gen. Price, and later became chief surgeon of the department of the Gulf under Gen. Lee. He was wounded at the capture of Mobile. The year after the war, he was sent for by Gen. Sherman because of his knowledge of the Indians and again became a surgeon in the United States Army. He was stationed for five years at the Whetstone Indian reservation.

Later, he resigned his commission at the request of his brother, Dr. James C. Nidelet, and has practised in St. Louis since, except for two intervals. For one year he was Indian agent to the Sioux and he disappeared for several years, during which time he was in the Orient.

Dr. Nidelet was elected coroner in 1882 and

served two years. It was during this time that the dead body of Preller was found in a trunk at the Southern Hotel, and it is due to the persistence of Coroner Nidelet, and Dr. J. C. Nidelet, who assisted his brother, that Maxwell was finally captured and convicted of a cold-blooded murder.

Dr. Nidelet was unmarried, and is survived by his sister, Mrs. Charles E. Michel, and his brothers, Jas. C. and Frank.

AN informal reception was given at the new Frisco Hospital in this city, on October 20th,

The Frisco Railroad

Hospital.

that institution being thrown open to medical and other friends for their inspection. The building is beautifully constructed and is a model of hospital architecture, embracing so much of that which is best in modern hospital construction that it seems to leave nothing to be desired. A feature unique to hospitals in St. Louis is the location of kitchen and dining rooms on the top floor, a change which appeals to us tremendously.

Dr. Geo. W. Cale, chief surgeon of the Fricso, has removed his office from Springfield to the institution, and since October 22d patients have been received, and the work of the hospital moving in its normal groove.

Mississippi Valley Medical Association,

THE thirty-second annual meeting of this association convened in Hot Springs, Ark., on on Tuesday, November 6, with an attendance of about one hundred. The sessions were held in the Eastman Hotel, which is admirably suited for the purpose. Dr. J. H. Carstens, of Detroit, presided over the general sessions, while Drs. Frank P. Norbury and H. H. Grant occupied

the chairs in the medical and surgical sections.

The small attendance is partially accounted for by the fact that the date conflicted with State elections in all parts of the country-a mistake which should be guarded against in the future.

The first evening was devoted to the address of the president, the orations on medicine and surgery, and later a reception and ball at the Arlington Hotel-all of which were thoroughly enjoyed by those in attendance. The address on Medicine, by Dr.Frank Parsons Norbury, and that on Surgery, by Dr. Florus F. Lawrence, reflected the progress being made along the lines of psychical therapeutics and surgical principles, and will both be found printed in full in this issue of the FORTNIGHTLY. Dr. Carsten's presidential address was a forceful argument in favor of unity and fraternalism, in which he paid a glowing tribute to the medical profession of the period.

The profession of Hot Springs spared no pains to make the event a success, both socially and scientifically, and the program included a trolley ride to the Alligator and Ostrich farms, coach rides up the mountain side, receptions at the residences and institutions, an inspection of the Army and Navy hospital,

and closing with a "Deutches Bumperfest" at the Park hotel on Thursday evening. A more delightful series of entertainments has never been enjoyed by this society.

A detailed report of the scientific proceedings will appear in our next issue.

The nominating committee reported as fol lows the list of officers for the ensuing year: President-H.Horace Grant, Louisville, Ky. First Vice-President-G. A. Hebert, Hot Springs, Ark.

Second Vice-President-T. C. Witherspoon, St. Louis, Mo.

Secretary-H. E. Tuley, Louisville, Ky. Treasurer-S. C. Stanton, Chicago, Ill. The next meeting will be held at Columbus, O., in the fall of 1907.

DR. ALBERT ABRAMS of San Francisco is at present in Paris where he is devoting his time to research work and to the completion of the manuscript of his work on Clinical Medicine which is shortly to appear from the press of the Rebmans.

HOSPITAL SATURDAY AND SUNDAY COLLECTIONS.-The annual collections for the benefit of St. Louis hospitals by the Hospi tal Saturday and Sunday Association will be made December 1 and 2. The collection last year amounted to about $30,000. Considerably more is expected and needed this year.

DR. WILLIAM K. OTIS, of New York, a graduate of the College of Physicians and Surgeons in 1885, died at his home after a short illness of peumonia, September 22, 1906, aged 36 years. He was a son of Dr. Fessenden N. Otis and was following the general line of practice pursued by his distinguished father, and in which he himself was achieving fame. He was a member of many local and other societies and was professor of genito-urinary diseases at the New York School of Clinical Medicine. He also had service in several hospitals.

SALICYLIC ACID FOOD AS A PRESERVATIVE. -As a result of observations on a "poison squad" of twelve young government clerks, Dr. Harvey W. Wiley, Chief Chemist of the Department of Agriculture, has announced that while salicylic acid is not as harmful as a food preservative as has been generally supposed, its use for this purpose is reprehensible. Its administration was found to be temporarily stimulating to the digestive organs, but in the course of time the processes of nutrition were interfered with, and a loss of weight was noted in the members of the squad.