ence. It is to be understood that nearly every eclectic and homeopathic physician is now compounding his own remedies and filling his own prescriptions at his office as well as at the bedside; the same is true of many regulars.

At his leisure, in his office, he should study his day's work over systematically and scientifically; by referring to his note book, he knows exactly what medicine is at the bedside of his patients. A second file of prescriptions is kept at his desk, and any patient receiving office treatment will be recorded in a day book, and his prescription will be numbered and filed. The earnings from outdoor patients will also be recorded and a new number given to each new patient. The more exactly a physician attends to his bookkeeping and file of prescriptions, the easier, more pleasant and successful he will conduct his professional business, and the more money he will receive for his work.

Now let us reason a little together. We are not only a transient resident on this mundane sphere, for the purpose of curing sick folks, making money, and eke out a miserable existence, leading only a vegetable life. We as progressive, intelligent physicians have a sacred duty to perform outside of attending the

sick.

"The physician's highest aim is to make himself dispensable," were the words of a very eminent teacher, and I shall never forget the meaning as long as I practice my avocation. Outside of trying to restore abnormal conditions to the line of healthy functions of the organism, we have to be reminded of our duty to teach the public how to avoid the recurrence of disease.

If we do not know how many patients were treated during a certain period, what the age and sex, what diseased conditions were manifested, and if we do not know what ratio or percentage of sickness to the number of inhabitants, how in the name of common sense can we truthfully estimate what are the most prevailing diseases, and what conditions caused such suffering? and how can we teach the laity to avoid or change such conditions, causing sickness and distress? If every physician would be compelled to keep a strict record of every patient

treated, age, sex, sickness, birth and death, then each precinct, county or state officer could easily compile a systematized statistical report. (In some larger cities we have a compulsory law to this effect, but not in the country precincts, villages, or cities of the second class.)

You may question, what would we learn from the enforcement of such compulsory laws?

To make the statistics more valuable, a unijorm schedule should be adopted. Ages should be graded under one year old, between 1 and 5 years old, 5 to 10, 10 to 20 and so on by decades.

In the classification of diseases, a simple system, which I have adopted for the last fifteen years, is as follows:

1. Diseases of the Respiratory System. 2. Diseases of the Circulatory System. 3. Diseases of the Digestive System. 4. Diseases of the Urinary and Reproductive System.

5. Diseases of the Nervous System. 6. Skin Diseases.

7. Eye and Ear Diseases. 8. Infectious Diseases.

9. Surgical Attendance.

10. Obstetrical Attendance.

The

The death record should be regulated. The foundation of reform should commence with the sexton of any precinct or township cemetery. He should be forbidden to dig a grave (punishable by heavy fine) unless a rightly filled out duplicate of death certificate has been presented and filed in a book of records, kept for that purpose. This book of records should have name, age, sex, date, and number of burial lot recorded. original death or birth certificate should go to the county clerk for registration, with whom every six months a report must be filed of the number of patients treated and their classification of age, sex and kind of affliction; and a heavy fine should be exacted in case of non-fulfillment of this law. ment of this law. I hope to hear some discussion on the subject, especially on the style of classification of diseases so to be recorded.

The following information would be developed :

Ist. Ratio of births and deaths.

2nd. In what month most people die? 3rd. At what age most people die?

4th. From what affliction most people die in a given community?

5th. What disease is the most prevalent?

6th. What are the causes of this most prevailing disease?

7th. How can we avoid such sickness, as well as the other afflictions?

We have boards of health in nearly every city. Have the boards ever taught the public how to avoid disease? Their object should be to stamp out disease, not alone to quarantine against spread of disease, nor alone to hunt for microbes in sewers and wells; their duty should be to find out the ratio of all diseases to the population, the ratio of births and deaths, and the causes of diseases in their community. They can never do this until every physician will be compelled to keep an accurate record of all patients treated. After having systematized all reports from all physicians, the Board of Health should then publish a pamphlet, setting forth in an easily comprehended manner the ways to pursue to avoid such most prevalent diseases. Only in this manner can a Board of Health be of any benefit to the masses. The American government seems to take great interest in accumulating voluminous statistics of all kinds, of species of animals, of all kinds of products-even of tin plates manufactured in the U. S. This is very valuable in its way, I admit; but the living issue-life, sickness, birth and death statistics are woefully neg. lected; it is therefore time, that the medical fraternity demands the enactment and enforcement of laws governing universal medical statistics.

The late fad of tracing all diseases to a specific microbe or bacillus is perhaps too complicated at this age of the world, and for our present purposes I have adopted the reported classification as the most practical.

Auburn, Neb. A. OPPERMANN, M. D.

[The doctor incloses a printed report of his practice for the last 15 years, which tho very carefully classified and very much condensed, is too lengthy to reproduce here. Perhaps he will send a copy to any specially interested.-Ed.]

THE MEDICAL WORLD Seeks to help you in your practice. Is such a helper worth $1 per year to you? See Order Blank on page xx.

Intolerant.

Editor MEDICAL WORLD:-I have taken your journal for the last eleven years and thought it one of the best that was published, but I do not believe in antitoxin, tuberculin or any of those animal-serum specifics recommended for the cure of disease, nor do I wish to read articles in favor of such; and for that reason do not wish to take THE MEDICAL WORLD longer. Hope the light of reason will shine in ere long and dispel these loathsome fads. Respectfully and kindly yours, E. HUMPHREY, M.D. Akron, Summit Co., Ohio, March 3, 1898. [In past ages the world has seen much of religious intoleration, which, happily, has now largely disappeared, in liberal and progressive nations and communities. Political intoleration is also rapidly declining. Intoleration among the different schools of medicine is now much less than formerly, and this magazine has done and is doing much to bring the schools nearer together. But the above letter is an example of the narrowest, most unreasonable intoleration that it has ever been our lot to come in contact with. If THE MEDICAL WORLD were devoted to the advocacy of serum therapy as a specialty, there might be some reason for such a letter. But it is well known that THE WORLD presents all sides of all medical subjects, and has no interest other than the highest and best truth.-ED.]

We

Give Final Report of Your Cases. Editor MEDICAL WORLD: — I'm a methodist-a WORLD methodist. Methodists like class meetings; so here goes: In WORLD, '97, Page 388, I reported a case of nose bleed and received aid on page 419 from our good Bro. Waugh. The boy has had no alarming hemorrhage since I put him treatment, and is getting better all the while. Has scarcely no threatenings of hemorrhage now and uses very little purgative. Have never given him chloride of lime and no aloetics. pupuric spots do not appear now. Gumboro, Del. W.THOMSON JONES, M.D.

His

[Will other WORLD readers, whether Methodists or not, kindly follow the above example? A part of a case is not a lesson of much value. To make the

lesson complete it is necessary to know the termination of the case. All who have reported cases, please go back and review them briefly, giving page references, as is given above, and tell us the result, whether favorable or unfavorable. It is important to know what treatment does not succeed, as well as to know what does succeed.—ED.]

to the questions in regard to collections know, but very few (if any?) have announced their political affiliations, and yet who after reading their replies could doubt where they belong? Those replies, biased by their political prejudice, were tame reading and worthless statistically. The fact of the matter is, we have all heard these questions discussed pro and con by men eminent in American poli

in the Case.

Editor MEDICAL WORLD:-On Feb'y 21, 1898, at 2 30 a. m., I was called to the hotel to see a working girl taken with cramps in the stomach. On examination I found that she was about to give birth to a child at full term. On stating the fact to her she set forth the usual denials and reasons why it could not be possible. In determining what to do I found that the father of the prospective child was then in the hotel, and none of her relatives within five miles. On my asking her what she was going to do, she said she wanted to be married. I found the young man and stated the case to him, and after conferring with the girl they agreed to be married. As I hold the office of Justice of the Peace, I called the hotel clerk and dining room girl as witnesses, and promptly united the couple in marriage (my first official function), and delivered the bride of a 4 lb. boy ten minutes later.

I have heard of a doctor calling in a minister to marry a couple just before the birth of a child, but never heard of a doctor having authority to handle such a case all by himself.

B. W. STEARNS, M.D.

Long Eddy, N. Y.

A Candid Criticism, with Reply Editor MEDICAL WORLD :-I am an old reader of THE WORLD, and could not well do without it. I believe I have never before encroached on your valuable space, and perhaps it would be just as well for me not to do so now; but I want to add my protest along with some others, against taking my politics medicated. Such discussions in a medical journal cannot be productive of any good, but simply affords an avenue for unloading some "gall" of the writer. We who have been reading the replies

become somewhat tiresome. I am of the opinion that most doctors are too wise to lay all blame or give all credit to any one political party or condition. We all know hundreds of people who are poor simply because they will be poor. They will not practice economy and live within their income. They spend the money they expect to draw next pay, two weeks or a month before they receive it. Who amongst us that does not know of many men who draw from $10 to $18 per week, with a family of wife and one or two children, who does not or will not pay 50 per cent. of his indebtedness? Now let Henry George (page 134, March number) or any one else try to "untwist" these people from their habits and see what will be the result. The author referred to says "they are held down to brutish levels by animal needs." Not so; but by animal passions and lack of economy-a disposition to have what they desire regardless of their income. Now try to back them around the post to untwist them from their notions. says: "I shall drive the bull in the way to untwist the rope." Any sensible bull will not be driven, but turn on his would-be driver and pick him up on his horns and toss him over a picket fence into his neighbor's yard. Any one who has tried to "untwist" some of the laborers from their notions has probably found himself in the same predicament. The writer a few months ago who referred to the bicycle and society fads as responsible in a great measure for much of our present distress is not altogether wrong in his ideas. We doctors have all our minds are able to do to combat the diseases that surround us. If men who spend their whole life in studying financial and political problems are not able to solve them, it seems a hopeless task for a doctor who may have but a few

He

[Yes, doctor, your remarks contain much truth. The people are not perfect, and never will be; but as education becomes more general, a higher standard of living, and a higher standard of morality and of responsibility is attained. This process is constantly going on, and let us encourage it in every possible way. A just and equitable diffusion of wealth is also necessary for this process. Can you study the table in March WORLD, page 134, bottom of first column (on the same page with the quotation from Henry George to which you refer)-can you study this plain and simple table and doubt that there is something wrong? Yes, some men are behind because of improvidence; but do you not know men who are poor in spite of industry, economy, and all the other commendable virtues? I know of many such, in productive lines, in mercantile lines, and in the professions. I have no excuses for the improvident; their poverty is deserved, and doctors should turn them over to public institutions or to publicly-paid physicians for treatment, where they belong; but when honest, industrious and economical men fail to get along in a country like this, thru no fault of theirs, something is wrong, which the table referred to plainly shows.

Men who "spend their whole life in studying financial and political problems" do so in their own interest, as a rule, unfortunately for the rest of us; and as a rule they get rich. We have no statesmen any more. Statesmanship doesn't pay. We have politicians, corporations, trusts and financiers. The politicians "work" the people in the interest of the corporations, trusts and financiers, and it pays them all except the people. They all say just as you do, that doctors should confine their attention to the medical problems, and that farmers till the soil, etc., while they attend to the finances and "the honor of the country." This pays them handsome

ly, as you will see by the little table referred to. They want to tickle our ears with "the national honor," "the high public credit," "the vast increase in national wealth," etc., and keep us in our places. The fact that when a man's or a nation's credit is above par it is abnormally and absurdly high, and that there is something wrong, doesn't bother them, and they know it won't bother us as long as they can keep us blind. Of all they say about our great national wealth, they never say anything about a just diffusion of it. The table referred to shows the distribution, and every one that sees it knows it is not just. This country is not governed by the people. If it shall ever be so governed, the people must give reasonable attention to public problems. Doctors are a part of the people. They can and should be a very influential factor for better government, fewer millionaires and fewer tramps.

The formula asked for will appear soon.-ED.]

Bright's Disease.

Editor MEDICAL WORLD:-In my position as physician to The Colonial at this celebrated bathing place, it has been my lot to see a great many cases of Bright's disease complicated with rheumatism, and skin, and nervous diseases. It is only my purpose to speak of one, Bright's disease, without going into the history of the complications and treatment of the complications to any great extent. These cases were bathers, and I will leave it to the readers how much a part the baths played in the treatment, and how much the drugs, which I speak of later, were the remedial agents. The analysis of the water I give from Prof. Clark.

he was propped up in a chair unable to lie down. Temp. 100° F., resp. 35, pulse 80; he was edematous all over except face. The breath was fetid, and from his history and condition I was suspicious of trouble with the kidneys and asked for and obtained some of the urine. On examination, found it fully half albumen and some granular casts. Gave an unfavorable prognosis and put the man on calisaya ferri phos. as a tonic, and gave him auri chlor., hydrobromic acid, strych. phos acid dilute. In the course of ten days the edema lessened, albumen lessened, and in four weeks it wholly disappeared, and the man has remained in the best of health to date.

Another case, a lady who came under my notice in the spring of '93, aged 36, mother of three children, had several attacks of erysipelas and several of rheumatism, eczema, and general health bad. In the general routine examination, the urine was examined and found to contain albumen in large quantities. A guarded prognosis was given, and she was put on tonics, mineral baths and auri chlorid., hydrobromic acid, phosphoric acid, and strych. An improvement was noticeable at once, and in about six weeks the albumen had entirely disappeared. Another examination was made this summer, '97, and there was a slight trace which disappeared in one week under same treatment.

Another case of the kind in '96, general health good but complained of great back ache. The urine examined and found albumen with granular casts. Was put under same treatment with the auri co. and strych. pills. At the end of three weeks there was an improvement, but case left city at that time, but continued medicine. Returned again this past summer, '97. Urine examined but no trace of albumen.

In Feb. of '97, gentleman aged 79 complaining of his lungs. An examination showed consolidation of left fung. Temp. 101° F., respiration 40, pulse 100. Complained of back ache. There were some rheumatic symptoms, coated tongue, fetid breath and eczema in hands and legs, with general health bad. The following day urine examined and test tube contained fully one-half albumen; no casts.

He was given tonic with aconite, aramat. spt. ammonia and the auri co., as above. At the end of one week iodide was given in lieu of the aconite and ammonia. In three weeks the man was showing no symptoms of the hepatization. The rheumatism and eczema as well as the albumen had disappeared, and the man regained his strength and appetite rapidly.

Miss M., aged twenty-one. Neurotic, some eczema with extreme pain in back and limbs; albumen in the e; no casts. Put on the above auri chlorid co. tonic. In six weeks albumen disappeared. Pain still remaining and

under treatment.

The tests were made by heat and nitric acid and microscope. These cases were taking warm baths in Onnection with the medication. I am of the opinion that many cases of so-called Bright's disease, if not too far advanced, by combining the warm baths with the medication to relieve the kidneys for the time being, could be restored to health again.

A. N. SHOTWELL, M.D.

Mt. Clemens, Mich.

A Phantom Tumor and a Real Tumor. Editor MEDICAL WORLD:-A druggist said to me: gist said to me: "Doctor, please tell me what is the matter with 's wife. He told me she had a billy-goat inside of her, and that you could feel the feet in the belly kicking." I told him she had a tumor in the abdomen the nature of which I could not positively state, and that she had inflammation of and gas in the intestines. gas in the intestines. The history is as follows:

Eve B. multipeia, aged 28 yrs. First came under my observation about April, 1895. Had been sick five months. Was then suffering from indigestion and tymtanites. I treated her for these troubles, and after two visits she felt much improved and passed from my cbservation. A few years later I was called to see her, and found that she had fever, was weak, emaciated, constipated, in agony, and had an intermittent tumor the size of a man's head when largest, which would rise to the hypochondriac region, pass diagonally across the navel and right lumbar region, then gradually disappear, and after a few moments, with premonitory pains, again rise and dis