In the long run the public judges by resuits; they also judge things in the lump. The lump public judgment of the medical profession is unfavorable, and one must demonstrate the ability to give results before the public renders a more favorable judgment upon any individual physician. That is why, after all, it is so hard to start in practice. The man on the street does not trust a man simply because he is an M.D.

Doctor, if you resent this public estimate of the profession in the lump, just stop for a moment and think over the lump estimates of the profession you have often, like as not, expressed when talking to the man on the street; and think over what your fellow practitioners are reported to have said of you. Then don't fault the public. Boost for Efficiency.

Boost everything that increases the lump efficiency of the profession and your own individual efficiency; and stop knocking. Then perhaps the public will form a kinder estimate of us as a profession. It is a sad thing to see a doctor drinking to intoxication; to hear him deriding efforts honestly meant to promote the public health; to listen to one physician running down another that his hearers know is the better man of the two; to find him ignorantly expatiating against modern advances in surgery; and to hear his principal talk about his patients being upon what slow pay they are and how everlastingly he has to dun them. Suppose the grocers or hardware merchants pursued the same tactics, what would you think of them?

Then Get Together.

Other people get together. The medical profession is trying to. What is your attitude? Do you belong to your County Medical Society? If you do not, why not join? Nothing is perfect in this world, not even medical organization; but it offers the most logical get-together movement available, and it helps every individual member to be a better doctor, which is the foundation of financial success in medical practice.

Relative Importance of Collecting.

Many years' experience in the plan of having two classes of patients-those

frankly classed and mutually understood as charity, and those definitely expected to pay for services-has convinced us that it is thoroughly workable, mutually satisfactory and achieves financial results with all classes of people except the out-and-out dead-beat. With none of these classes does everlasting dunning pay postage. The charity patient, recognized as such, should never be dunned under misapprehension of his financial position. A certain amount of charity work should be a pleasure to any physician, and all can afford to do it. The dead-beat is a man to be promptly spotted and firmly told that his business is on a cash basis or not at all. There is positively no use whatever wasting either sentiment or temper over him. If he can't show himself to be on a charity basis, don't let him ever get over $5.00 in your debt. The trouble is we keep on industriously making dead-beats by having no financial understanding when we are first called into a new family. With a little tact this is easily enough done, and it leads to vastly less hard feeling than does putting off such an understanding.

So, then, the class with whom we enter ledger charges are exclusively those expected to pay and whom we have every reason to believe will pay; and they know we so class them. Then we do no fussing with them, merely sending out routine bills at intervals determined by circumstances in each case, not expecting every bill to be promptly paid and making money today that we will get three months from now and getting money today that was made three months ago; and each month works along amiably and comfortably without hard feeling or fussing. When for any reason a patron forgets us unreasonably long, we casually drop in on him in a friendly way, but never send him a form letter or any kind of aggravating threats. If conversation brings out a feeling that we were not skillful enough or charged more than our services were worth, the first thought is, perhaps, that is true, and we look into it from the patient's point of view. Considering the volume of practice a busy editor gets time to do, we will stack up our success in collecting against any patented system or follow-up scheme in existence. And a great beauty in it is it takes very little time in bookkeeping and billing. Furthermore, this plan has worked in country practice long before we were an editor, in city practice and among all classes of people.

Prevention is better than cure in collecting, and that is the real basis of the plan outlined. Then, too, there are certain things we don't know how to do as they ought to be done, and never attempt doing them merely for the money, always trying to give a patron a square deal. This keeps from creating a real basis for calling into question the value of services rendered.

NOTE-Unless this column is blue penciled and a bill for subscription inclosed it is not intended for you. Or if you have just recently remitted and a bill is inclosed here, please ignore it. With a subscription list well over 25,000 it takes several days for a subscription to pass through, be finally credited and the stencil transferred from one classification to another.

Good Friend and Brother

If when you pick up this copy of MEDICAL COUNCIL you feel,—"Here is a journal that truly belongs to me, a journal with only one idea to give me and my brother Practitioners real help in the problems of our everyday work" then we are reaching the goal of true service that we are earnestly striving for.

Because MEDICAL COUNCIL is not a house organ to boost first and foremost the commercial products of a particular pharmaceutical house, because MEDICAL COUNCIL considers service to its readers more important than advertising revenue, because MEDICAL COUNCIL'S one foremost idea is to give truly helpful service to you, MEDICAL COUNCIL is much more dependent upon the revenue from subscribers than some journals.

May we ask this favor-that you notify us definitely one way or the other about your subscription.

Good Friend and Brother, it only takes a minute to put a dollar bill, or better three dollars for four years (saves a dollar and bother of yearly remittances), in this safe money carrier, and to mail it, right now, before it is forgotten. You don't have to write a word-not even sign your name.

Money Back Guarantee to Subscribers

MEDICAL COUNCIL is published to give truly helpful service, of a needed practical character, to its readers in the problems of every-day practice.

If any subscriber feels that MEDICAL COUNCIL is not giving him a full, over-flowing measure of such service and is dissatisfied, if he will write us we will cheerfully refund the dollar he paid for subscription, without question.

MEDICAL COUNCIL seeks only satified, interested readers.

Subscription Continuance

Most of our subscribers want their subscriptions continued so they will not miss any issues if they should neglect to remit before expiration. Where this is not the subscriber's wish it is carefully noted.

However, if for any reason your subscription has been continued when it was not your wish if you will write us promptly we will discontinue it at once, with no charge for copies sent since expiration.

Collections are important; of course they are. But the financial arrangements in the practice of a really capable man in an ordinarily prosperous neighborhood are simple and easily handled. The sad phase of the neighborhoods in which the people are deswhole matter is the fact that there are many perately poor and in which the physicians have hard getting along. But that is another story, and it will be discussed later.

Announcements for August

This Cancer Number, which we hope you like since it has involved some special hustle to produce, makes it necessary to postpone publication of other splendid papers now in type. The following deferred matter will surely appear in August:

Inter-Oblique Abscess, Due to Pio-Appendix. Leon DeVillo, M.D., Ph.C.

Diseases and Conditions Simulating Appendicitis. Samuel Floersheim, M.D.

Ulcer of the Stomach and Duodenum. J. N. Jerome, M.D.

The Office Treatment of Hemorrhoids. Edward J. Lorenze, M.D.

Other Subjects Will Be : Strained Toes. Charles Cross, M.D. Immunity. John L. Marchand, M.D.

The Preservation of a Normal Condition During Pregnancy and Labor. Finley Ellingwood, M.D.

The Prevention of Cancer. E. M. Perdue, A.M., M.D.

THE BUSINESS SIDE. The Psychology of Patronage. P. A. Zaring, M.D.

Bringing Together the Doctor and the Druggist.

CONSTRUCTIVE REFORM. will carry several practical articles, and the editor will pay his respects to the patent medicine business. You'll find it interesting reading.

The County Medical Society

is quiescent during the hot weather, hence The County Medical Map will be omitted during July and August, since most of the Bulletins are not published those months.

Some of these papers in the August issue are somewhat different from the usual and mighty interesting. After you have gone through the August issue you'll feel well repaid and agree that MEDICAL COUNCIL is a truly wide awake, progressive journal that doesn't ease up one iota in giving its readers just as practical helpful service in every issue as a journal can give, whether it is mid-summer or mid-winter.

In your issue of May you say "Good old cod-liver oil has been doing well in our hands, despite criticism of it by many." Those are my sentiments exactly; with me, too, it has stood the test of time. In spite of its having been in the hands of the profession for such a long period of time I feel that its capabilities are not understood, recognized nor utilized to the extent that they should be. I do not wish to assume to speak authoritatively about its use in the domain of general medicine, although I am firmly convinced that it has a wide sphere of usefulness. My work is among cripples. To my clinic are brought numbers of children suffering from all sorts of complaints. If a child, especially from the age of one year up, does not act or develop as the mother or family physician thinks it ought, then it is brought to the clinic to ascertain what, if anything, is the matter and what should be done for it. When an infant gets When an infant gets to be about the age of one year it begins to make attempts at talking and standing on its feet. There is, of course, the greatest variation between different children, some being as advanced at one year of age as others are at one and a half and even more, both being equally healthy. Mothers however, are jealous, and if they suspect that their baby is lagging behind other babies. they want to know the reason why. Sometimes the infant is late in talking, often late in beginning to walk; it may have a round back or some of the common deformities of pigeon breast, bow legs, knock knees, etc. If a child appears with marked bow legs the disease of rickets is at once suggested, but in many of these cases, that

I am convinced have what is practically

rickets, the signs are not sufficient to cause the true origin to be recognized, hence the physician is at a loss for treatment. Any one practicing in surgical lines more or less exclusively has so much of his time consumed in the purely surgical aspect of his

work that of necessity he limits his therapeutic treatment to rather narrow lines. He chooses certain special drugs and uses them in very definite ways. With me cod-liver oil has been an old standby. Perhaps it has been over-valued, but it has stood the test of time. These various ailments I con

sider as being due to mal-nutrition and the children show various signs and symptoms in quite different degrees.

Some are fat, others thin; some good color, some bad color. They may have bow legs, knock knee, pigeon breast, funnel breast, or Harrison's groove extending to each side from the point of the sternum. enlarged epiphyses at the wrist or ankle; Some have the rounded back, others the others have beaded ribs, and many have the Most are or have been bottle fed and posanterior fantanella insufficiently closed. sess the protuding abdomen. They are slow who show these signs and symptoms are to begin walking and talking. Children suffering from a disturbance of nutrition. This disturbance is in no way different from that which is usually termed rickets. This being so, I consider all such children are How is it to be done? Far be it from me to be benefited by improving their nutrition. to speak disparagingly of the expert pediatrist. I cannot hope to emulate them in their chosen field. Still they are the very ones who will send these cases to me for treatment, and perforce I must face the problem. I therefore, from experience, have evolved a procedure somewhat like this:

The child has not been doing well on what it has had, so I will make some sort of a change. Hence I inquire into the feeding and alter it. I have heard that orange juice is good for sick children, so if the finally some medication will be needed, at child is not too young I will suggest it;

least to satisfy the parents, and here comes in the cod-liver oil. I am sometimes content to refrain from altering or changing the food or ordering the orange juice, but the cod-liver oil I never will give up, and

practically every child that shows malnutrition or rickets, whichever you choose to call it, has got to take it. Begin with the pure oil, twenty to thirty drops after meals, and increase gradually to a teaspoonful three times a day. In the majority of cases if this can be taken the problem is solved, and the child progressively improves. Sometimes in spite of all managing and devices the child will persist in vomiting the oil, then, instead of abandoning it, it is to be rubbed in the skin instead of being administered by the mouth. Sometimes it is given

in the form of emulsion. In this form it can do good, but it is so far inferior to the pure oil that in only rare cases is it to be preferred.

This plan of treatment may be primitive, but it is efficient. Many a time have I seen a child that has been on all sorts of modified foods pick up at once on taking codliver oil. Many times children are given iron, hypophosphites and other medicines, when what they needed was cod-liver oil. I cannot speak of it too highly. It is the sheet-anchor for rickets and the best thing known for the mal-nutrition of children, young and old. I am convinced that it is not valued and appreciated and used as it should be, and therefore feel justified in speaking strongly in its favor.

The central thought for the physician is that, in "good faith," he may, "in the course of his professional practice only," prescribe or dispense such narcotics as medical science and human necessity justify.

That which is not so justified no honest physician should wish to do.

The second thought is that the patient who is not acting in good faith has no claim upon a physician, in his capacity of a legally authorized handler of narcotic drugs. We must duly impress this fact upon the minds of persons who consult us.

This journal has faithfully reflected all reasonable views for and against-upon the Harrison law; but the law is now working such immense benefit to the public, and imposes such slight burdens upon

fessional practice only."

This office construes the words "dispensed, distributed, or prescribed," used in the act, as erinary surgeon "dispenses" within the meaning synonymous, and that a physician, dentist, or vet

of the law when he writes a prescription calling for any of the narcotic drugs to be filled by a registered dealer.

While the law does not limit or state the

quantity of any of the narcotic drugs that may be so dispensed or prescribed at one time, it does provide that it shall be unlawful to obtain by means of order forms any of the aforesaid drugs for any purpose other than the use, sale, or distribution thereof, in the "conduct of a lawful business in said drugs, or in the legitimate practice of his profession." Further, that all preparations and remedies containing narcotic drugs coming within the scope of this act are "sold, distributed, given away, dispensed, or possessed as medicines and not for the purpose of evading the intentions and provisions of this act," and it is further provided that it shall be unlawful for any person not registered to have in his possession or under his control any of the drugs, preparations, or remedies "which have not been prescribed in good faith by a physician, dentist, or veterinary surgeon registered under the act."

Therefore, where a physician, dentist, or veterinarian prescribes any of the aforesaid drugs in a quantity more than is apparently necessary to

meet the immediate needs of a patient in the ordinary case, or where it is for the treatment of an addict or habitue to effect a cure, or for a patient suffering from an incurable or chronic disease, such physician, dentist, or veterinary surgeon should indicate on the prescription the purpose for which the unusual quantity of the drug so prescribed is to be used. In cases of treatment of addicts, these prescriptions should show the good faith of the physician in the legitimate practice of his profession by a decreasing dosage or reduction of the quantity prescribed from time to time, while, on the other hand in cases of chronic or incurable diseases, such prescriptions might show an ascending dosage or increased quantity. Registered dealers filling such prescriptions should assure themselves that the drugs are prescribed in good faith for the purpose indicated thereon and if there is reason to suspect that the prescrip

tions are written for the purpose of evading the