MEDICINE Series of habit forming drugs. In too many instances physicians have been responsible for patients becoming addicted to drugs. But with the rarest of exceptions these have been due to thoughtlessness and not to any wrong intent. Finally, a few-a very few -physicians whose acts are abhorrent to every decent doctor, have sought to profit from the dispensation and sale of narcotic drugs. These are the parts or specific details of the proposition. On the other hand the great bulk of medical men have seen the menace of the habit forming drugs and have taken every precaution to reduce their evils and dangers to a minimum. When necessity has forced the use of either morphine or cocain-and right here let it not be forgotten that in their proper place and used at the right time in the right way, these two drugs are God given, if any arethey have usually been employed without the patient's knowledge and in the most cautious manner. Finally no decent physician has ever engaged in any way in the traffic of these drugs. This is the true situation as every honest physician knows it, and it certainly does not warrant any such ridiculous restrictions on his professional work as are planned in the pending bill. Correct the abuses of narcotic drugs-every honest physician to the best of his ability will help and support every effort to this end-but let no offensive and embarrassing handicap be placed on their legitimate uses. The lasting immunity conferred by proper vaccination is one of the best attested facts in medicine. When smallpox invades a community the disease is confined almost exclusively to the unvaccinated. The few cases of smallpox with a history of previous vaccination not infrequently show imperfect scars, indicating that they had never been properly protected. There is of course no question, that in a very small percentage the immunity does wear out in time, and there is also no question that every one should be vaccinated in adult life no matter how successfully vaccinated in infancy. Nevertheless if the child has been vaccinated at three or four points, it is exceedingly difficult to make it take again all the rest of its life. It is almost the rule for revaccinations to be unsuccessful, and there are no cases of smallpox on record in which there is a history of proper vaccination and revaccination which have been undoubtedly successful. There will probably therefore be some objections to the remarks of Dr. F. F. Russell in the Jour. Amer. Med. Assn. Oct. 12, 1912, in which he accepts some doubtful Japanese statistics as basis for his opinion, that the immunity confered by vaccinia is very evanescent. Kitasato reported the results of revaccination in 951 cases, and asserted that after an interval of one year revaccination was successful in 13.6 per cent. and that the percentage of successes increased with the interval, until it was 63.8 per cent. after the sixth year. He estimated that immunity was practically gone ten years after vaccination. These figures cannot be accepted for a moment. The error is doubtless due to mistaking an inflammation from pus organisms as an evidence of successful vaccination. Not infrequently also a vaccination begins "to take," but aborts, and these are generally mistaken for successes. The British Royal Commission stated that immunity generally lasts for. nine or ten years, but it is justifiable to conclude that the evidence on which this opinion was based, was also defective from the inclusion of spurious cases. Proper vaccination is far more effective than this, and we revaccinate entirely too often. In addition we generally make but one insertion whereas there should be three or four. We must also make a distinction between those burdens. As for wishing the nation to increase in numbers in face of the increasing costs of foods-that means more underfeeding. We cannot quarrel with denunciations of unnecessary abortions, but we do object to advising women to commit suicide by frequent pregnancies, trying to avoid race-suicide. immunity to vaccinia and immunity to smallpox. It is quite possible to be resistant to one disease and not to the other. A man may be able to resist a mild infection with smallpox, but unable to resist the vaccine introduced into the skin. The contrary is also known of cases difficult to vaccinate, but not immune to smallpox. Kitasato's statistics therefore have little value in determining the exact amount of immunity conferred by vaccination. Theological views of race-suicide are of no concern to physicians as physicians. We drop science when we enter the church door, and it is time for the clergy to drop religious dogmas when they enter the halls of science. A learned church-man is quoted as saying that race-suicide "is a violation of the laws of nature," though many physicians are industriously at work trying to find out what are the effects of continence. "A man is obliged to serve the natural law, of which this is a violation, and no one can do this with impunity." We should be shocked to learn that no one can be celibate with impunity, or continent if married, but the reverend gentleman has no basis in fact for his physiological views. There are not a few physicians who are firm in their conviction that men can be celibate with perfect impunity. As for prevention of conception, married clergymen must be practicing it one way or another as we have previously mentioned, or they would kill their wives by frequent pregnancies. Holy writ nowhere says that prudential restraint is defeating "the ends and aims of divine Providence." It is remarkable that those clergymen who have no experience of the burdens of paternity should be so insistent upon making everyone else take up The deterioration of nitro-glycerine tablets is such a serious matter, that the attention of the profession should be directed to it. This drug is never prescribed except in urgent cases, and it is very disconcerting to learn that many of the tablets on the market are so old, that they contain practically no nitro-glycerine at all. A man's life may thus be lost. Perhaps the manufacturers could take steps to prevent this danger, by placing a date upon the sealed packages, and if physicians use it in this form, they must be sure that patients get perfectly fresh preparations, which have been kept in hermetically sealed glass retainers. We are quite certain that the failure to get results from this drug, is due to the fact, that the patient did not get enough to have any physiological effect whatever. It would be best for physicians to dispense these tablets themselves, in order to be absolutely sure that the patient gets what is prescribed. A prescription may fall into the hands of a druggist who does not know that his stock has deteriorated, and thus sells it, through ignorance, rather than dishonesty. It is one more instance of the absolute necessity for knowing that our patients get exactly what is prescribed. A few manufacturers have been warning against using anything except fresh tablets, but they should set a date, beyond which the tablets are worthless. MEN AND THINGS. Real progress in Eugenics is seen in the practical work one of our most esteemed contemporaries has undertaken, and will shortly carry through to what promises to be a most noteworthy success. We refer to the private production of Brieux's famous play "Damaged Goods," which will be given on the afternoon of March 10th, under the auspices of the Medical Review of Reviews and the following special committee: Mrs. Richard M. Bennett, Dr. Simon Flexner, Cosmo Hamilton, the Rev. John Haynes Holmes, Frederic C. Howe, Mrs. Charles H. Israels, Miss Helen Marot, Dr. William J. Robinson, John D. Rockefeller, Jr., Dr. William Jay Schieffelin, Mrs. Rose Pastor Stokes, Mrs. W. K. Vanderbilt, Sr.. Dr. James P. Warbasse, and Dr. Ira S. Wile, chairman. It is understood that the play will be staged by Richard Bennett, who will himself take one of the leading parts. While this undertaking is distinctly an innovation and will doubtless occasion much discussion there is no denying its splendid possibilities along educational lines. This presentation of one of the great problems of Eugenics through the agency of the drama can hardly fail to mark a new era in sociologic study and research, in this country at least. Europe has been attacking these questions from practical standpoints for some time but America unfortunately has seen fit until lately to allow prudery and false modesty to stand in the way of all progress and block all material advance. Happily, within the last few years. a healthy sign has appeared in the courageous discussion of important sex problems by a few who have dared to brave the frowns and open criticisms of those who can see nothing but evil purpose in considering such subjects. Gradually ignorance and prejudice have been overcome and for some time there has been in evidence a wholesome tendency to look these questions pertaining to sex and correlated topics squarely in the face. That some of our leading citizens and business men as well as physicians, scientists, teachers, etc., are interesting themselves in the study of these great vital problems and striving to aid their practical solution promises much for the immediate future. This latest move, wherein a leading high class medical journal-sober, staid and dignified, with character and traditions of the highest-has had the courage and willingness to undertake the presentation of a play like this fearless one by Brieux, surely deserves the heartiest commendation from every one who appreciates enterprise and purposeful effort. AMERICAN MEDICINE and every one connected with it extend sincere congratulations to the Medical Review of Reviews and wish it the most complete and far reaching success it can possibly achieve. a Doctor Johnson and the Doctors.— Medical men have been sought, not alone for treatment, but as associates, for they have always been found peculiarly interesting and attractive companions. Thus says Boswell, writing under date 1784, the year of Johnson's death, "Dr. Johnson had in general a peculiar pleasure in the company of physicians," and this was certainly not abated when he took tea at Oxford in the company of Dr. Wall, says a writer in the Lancet (London, Dec. 21, 21, 1912), "learned, ingenious, and pleasing gentleman." It was on this occasion that the great moralist prophesied, in some sort, the necessity for research into the diseases of the East and of warm climates. He fell foul of the Radcliffe Travelling Fellowship, and averred that the Fellows had done very little good. "I know nothing that has been imported by them; yet many additions to our medical knowledge might be got in foreign countries." And he cited inoculation as having saved more lives than war destroys, and the unnumbered cures performed by Peruvian bark. "I would send the Radcliffe Fellows," he cried, "out of Christendom; I'd send them among barbarous nations." Johnson's kindness to poor old Dr. Robert Levett, his pensioner, is, of course, famous, and equally so are the lines he wrote on the doctor's death at the age of 80 in 1782. Goldsmith, also a physician, was among his intimates, and the chaff bestowed on his new plum-coloured coat has become immortal. The coat, terribly , 1913 , Vol. VIII, worn and threadbare, is now in the London Museum, and suggests the pathetic supposition that the spendthrift poet-physician wore it till it was almost unpresentable. At the time of Goldsmith's death in 1774 Johnson wrote, "Of poor dear Dr. Goldsmith there is little to be told." Goldsmith probably owed £2000, not less, and this preyed on his mind and heightened a fever, which he further complicated by an excessive use of James's powders. Referring to the debt Johnson humorously asks: "Was ever poet so trusted before?" Later, writing to Bennet Langton, he says, "Let not his frailties be remembered; he was a very great man." If Goldsmith by his over-medication hastened his own death, Johnson by dint of amateur surgery did likewise. Shortly before his death he inflicted such wounds upon himself, in the hope of obtaining relief, as to suggest the idea of suicide. He used a pair of scissors in an endeavour to void the water of dropsy. Johnson's last words were many. To the faithful Langton he said tenderly: "Te teneam moriens deficiente manu.' Of his man nurse he said, with a flash of the old humour: "Sir, the fellow's an idiot; he's as awkward as a turnspit when first put into the wheel, and as sleepy as a dormouse." His last recorded words were to a young lady who had asked for his blessing: "God bless you, my dear." This was spoken on Dec. 13th, 1784. It was to this young lady, doubtless, that he wrote a priceless letter of farewell, now in the possession of Dr. H. T. Scott, the great authority on autographs. As Dr. Scott says, such a letter is a part of the august dead, and should not be parted with at any price. TO PROSPER AND TO LIVE. To work, to help and be helped, to learn sympathy through suffering, to learn faith by perplexity: to reach truth through wonder,behold! this is what it is to prosper, this is what it is to live. PHILLIPS BROOKS. Give us courage and gaiety and the quiet mind. Spare us to our friends, soften us to our enemies. Bless us, if it may be, in all our innocent endeavors. STEVENSON. The Depopulation of France.-Some two months ago the French Government, says a correspondent in the Med. Press and Circular (Feb. 12, 1913), appointed a National Commission, consisting of over 100 members, and including several ex-Prime Ministers, to examine the population question from every point of view. Some important facts have already been published. In 1910 the excess of births over deaths was only 71,418, while in Germany it was 879,113, in Austria-Hungary 573,520, in Great Britain 413,779, and in Italy 451,771. Indeed, in the years 1906 and 1911 the number of deaths in France, although gradually diminishing, had exceeded the number of births. In some of the other countries mentioned a diminution in the birth-rate was also recorded, but it bore no comparison with the diminution in France. Another feature of the statistics is that in 1908 there were in France 1,350,000 unmarried men over 30 years of age, and a somewhat larger number of unmarried women. There were 1,804,710 families without children, 2,966,171 families with only one child, 2,661,978 families with two children, 1,643,415 families with three children, and only 967,392 families with four children. The total number of families with four children and more was only 2,328,780. France has not enough people for her home requirements; she can spare none for her vast oversea territories, misnamed colonies, which she has acquired within late years; her numbers are, in fact, kept up by immigration of Italians, Swiss and Germans. The number of foreign residents in France has increased since 1851 from 399,000 to 1,132,000; a number sufficient to destroy her distinctive nationality within a few generations. The question of the effect of excessively small families or of total suppression of the philoprogenitive instincts on married couples is being discussed, and the effect upon the quality of the offspring noted. It is recognized that there is being carried on a gigantic system of artificial selection; and that if the first born of the possible broods which might be produced are as a rule physiologically not the best bred, it follows that an inferior race is being developed. Syphilis, the one disease certainly hereditary, affects most frequently the first-born. In France, among families in the provident classes, the main It aim is to get the daughters married. matters very little what her physical and intellectual defects may be, a mate can be nearly always found for a French girl with the fortune called for in her rank. I heard lately of the marriage of the hunchbacked daughter of a wealthy house to whom a big dot was assured. Marriage for the men of the same station and quality is also mostly possible, albeit, as the statistics given above. show, the marriage rate remains a very low one. The question of the morale of children reared in very small families; the effects of the "spoiling," from which they can rarely escape when only one or two in number-inquiry into these and other aspects of the case begins to suggest the gravest doubts as to whether the customs which have become so deeply rooted in the national life are likely to result in the increase of individual happiness or in the growth of stability and power in the state. THE DOCTOR'S WIFE. BY A. BROTHERS, M. D.1 Who thinks the doctor is handsome Can see the warts and pimples That make the children cry? Who thinks he is a great manThe greatest 'neath the sky?— The doctor's wife! Who wastes her youth and beauty Who slaves from early morning Who 'tends to house and house work Who answers 'phones at night-time When doctor's on the route To his confinement cases Or some such work-no doubt; Or when he's snoring loudest Who lies and says he's out?- Who asks about his cases Just those that cause him care; If case is young and pretty, (With paint and golden hair) Who sizes up the "patient" In th' office with a stare? The doctor's wife! Who 'tends the children's buttons The doctor's wife! Who clings to every patient By sheer devotion led; Who cuts down house expenses- Who sacrifices all things In dress, in sport, in play; Who willingly will work all night (E'en after work all day); Who slaves and strives for love alone Without a cent of pay?— The doctor's wife! Who, suffering pain and torture And works on just the same; Whilst the doctor keeps on telling her Who shows angelic patience When the doctor's heart is sad; Who compliments his virtues And covers vices bad; Who makes him smile and happy When ill luck drives him mad?The doctor's wife! Who gives him most attention And when the parting comes at last Then drink, ye Aesculapians!— Till laughter flows like wine! The many physicians who knew the late Dr. Abram Brothers, will be interested in these verses presented by him at one of the last banquets attended before his untimely death. |