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Dr. Ray B. Wright, of Mart, Texas, writes me of an experience with "The Consolidated Adjustment Company of Chicago," which is the usual story of experience with collection agencies who solicit doctors' accounts for collection. Why such business is not done on the square seems strange. The fact is that the conduct of these concerns has made them a disreputable class they have only themselves to blame. Or are doctors a hard class to deal with in this way? If so, such concerns should not solicit the business of doctors. And certainly doctors would be better off if they would use the methods frequently set forth in this department in the collection of their accounts.

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Our subscribers are attending to the little formality of renewing their subscriptions with their usual promptness. But there will be some laggers-there always are. have patience with them, but they ought to break the habit, and come forward promptly and without repeated urging. We have about one-third of our list now in the fouryears-for-$3 class. This shows that they are absorbing the spirit of these Business Talks. They take the cheapest and least troublesome course a combination of economy and efficiency. Practise those principles in everything, and you will be certain to succeed.

If you will tell your medical friends to consult this department concerning their business troubles and problems, they will soon join our "family." You will thus extend our usefulness and help us to serve you better.

DEAR DR. TAYLOR:-Your valuable journal I simply cannot do without; therefore it is imperativ that I renew my covenant with you for another four years. Enclosed find check to carry me to 1919. Your medical thought, business ideas, reform work and religious thought and reasonings are excellent, and I enjoy reading them all. While I may differ on some views, your political views I am in perfect sympathy with.

Had I paid closer attention to your "Business Talks" twelve or fourteen years ago I could have been worth in United States currency several thousand dollars more than I am to-day.

Keep on drilling doctors, and DON'T LEt up.

Your collection letters are also worth ten times their weight in gold, for, as you know, I use them and have the fruits to prove it.

Hoping for a continuance of the good work and wishing you the compliments of the season, I am, W. A. PURINGTON, M.D.

Foxcroft, Me.

THE MEDICAL MONTH.

Zion City, Ill., where the fanatical Dowieites have resisted vaccination, has gotten its natural reward, an incipient epidemic of smallpox. Only when the State Health Board interfered did these bigots subside, so that the outbreak is under control.

This fall fifty years have elapst since the Geneva Convention met to organize the systematic care of the wounded during war. The emperor of Austria in honor of the anniversary, which was celebrated with ceremony at Vienna, has founded an order with silver and bronze badges to be awarded to those in Austria-Hungary who distinguish themselves in Red Cross work either activly in the field or by contributions.

Indiana, Illinois and Michigan report local outbreaks of variola, due, of course, to laxity in recent years as to vaccination. Widespread systematized prompt use of calf virus soon ends its progress.

As the terrible war in Europe will probably cause one or two years at least to pass before American students can avail themselves of the neurologic clinics and laboratories of London, Paris, Vienna, Berlin, Rome and other centers of medical instruction abroad, the neurologic staffs of hospitals and medical colleges in Philadelphia have organized a great Post-Graduate School of Neurology in that center. The neurologic wards of the Philadelphia General Hospital offer unusual facilities for instruction in nervous disease, with 400 patients illustrating all forms of organic, functional and psychopathic disease. The Philadelphia Hospital for the Insane, on the same grounds, has over 2,000 patients. The neurologic staff of the Philadelphia General Hospital is connected with neurologic services in other hospitals and institutions, which will enable its members to supplement these facilities. The time is opportune for this step.

An order has been placed with a Philadelphia firm by the British government for 6,000 packages of tetanus antitoxin, and with another for 500,000 yards of muslin for bandages.

Germany has askt for more American Red Cross surgeons for activ duty.

The Court of King's Bench, Montreal, has given judgment in a vaccination case where the parents of a child vaccinated by order of the Medical Department of Health and performed by an officer of the board of health, sought to recover $10,000 damages owing to subsequent paralysis of the arm. A jury had awarded $8,000 damages, but the King's Bench has reverst this judgment and now the case has been settled in favor of the city. The physicians called as witnesses disagreed as to whether the paralysis had been caused by the vaccine or not, so the judge ruled the jury had no jurisdiction, as it was not a matter of fact but a matter of opinion.

Is it not about time that the American Medical Association starts a worldwide fund to relieve the families of medical practicians among belligerents, who may become impoverisht or perhaps die before peace is declared?

The Associated Press wires from Paris, November 3d, that the microbe that causes gangrene to develop in bullet and shrapnel wounds has been

discovered by two Philadelphians, Drs. James Scarlett and Georges Des Jardins, now of the American ambulance service. Previously scientists have thought that the disease was caused not by a single germ, but a combination of germs. After much research and experimentation a single bacillus has been discovered and isolated, and the serum is now being prepared by Dr. Henri Weisberg, of the Pasteur Institute. The discovery is expected in medical circles to have worldwide importance. The serum is being injected into patients on the battlefield in the early stages of infection, obviating amputations and preventing great loss of life.

The recent annual representativ assembly of the organized medical profession in Germanythe so-called Aerztetag-adopted a resolution to increase the dues a trifle in order to raise a fund of about $6,200 annually to be expended in fighting quackery and nostrums.

Asiatic cholera is now epidemic in Eastern Europe, possibly due to great troop movements. America's Atlantic Gulf ports are on the qui vive for infected vessels.

G. R. Mines, professor in physiology at McGill University, met death mysteriously and tragically at Montreal, November 8th, in his laboratory. Just what caused his death is not known, but Principal William Peterson believes that Professor Mines, in the course of experiments upon himself in his chosen branch of physiology, dealing chiefly with the phenomena of the heart action and respiration, probably lost his life thru the apparatus which was attacht to his body getting out of order in some unknown manner.

Thru dread of epidemics, all the more possible in wartime, at Königsberg, in eastern Prussia, every case, even suspected of being typhoid, typhus or dysentery, must now be reported to the authorities, and also every bacilli carrier. Their dwelling places, as also all houses where there is a case of scarlet fever or diphtheria, must be markt with a yellow lantern and a placard bearing the name of the disease.

Vasectomy, as provided for in the Iowa sterlization law, is unconstitutional, according to an opinion rendered at Keokuk, Iowa, by Judge Smith McPherson, of the United States District Court for the Southern District of Iowa. A United States Circuit Judge and another district judge concurred in the opinion, which affects similar laws in other states, as it involves interstate relations.

The University of Pennsylvania Hospital, in Philadelphia, has contributed to the American Red Cross 300 woven wire splints for use in Europe.

The American Red Cross is to have its own hospital at Washington, D. C. Building has already started, and it will be a national memorial to the women of the Civil War.

By the will of the late Liberty E. Holden, a trustee of the Western Reserve University, Cleveland, Ohio, who died in 1913, his estate appraised at from three to six millions, is left to the trust fund, one-sixth of which, less $50,000, the Medical School of the University is to receive eventually. The income is to be devoted to research on problems on the cause and cure of disease.

Work is under way on a new $400,000 city hospital at Pensacola, Fla.

A substitute for radium in many forms of therapeutic treatments has been found in the new hydrogen X-ray tube exhibited November 7th,

in Philadelphia, at a joint meeting of the New York and Philadelphia Roentgen Societies. An air jacket, similar to a water jacket on an engine, keeps the tube cool and prevents the glass and electrodes from heating. Aside from its enormously increased power of penetration over the ordinary article and its prospectiv value in treatment of disease, the discovery of the air-cooled hydrogen tube opens for the X-ray a commercial and practical field hitherto closed. The X-ray can be used in sterilizing and freeing many articles from bacteria, but because of the short life of the ordinary tube its use has been limited principally to medical work; even in this, however, the use of high power tubes has been handicapped. The new tube, which lasts indefinitly and may be run for days at a time under high power, is adaptable to many kinds of commercial work, such as the purifying of cereals and other foodstuffs.

The troops in Austria and Hungary are being vaccinated against cholera on an extensiv scale, both those on the firing line and in the garrisons.

Cases of amputation of members for X-ray burns in operators are less frequently noted in the medical journals, evidence that greater care is now exercised in the use of this valuable but dangerous current.

The Third State Tuberculosis Sanatorium of Pennsylvania, located at Hamburg, was opened for patients October 26th. The necessity for this institution is evident when it is considered that in addition to the 1,150 patients under treatment at Mont Alto Sanatorium and the 400 who are receiving care at the Cresson Sanatorium, there is still a waiting list of more than 1,000. The new Hamburg Sanatorium will accommodate 550 of these.

Dr. Walter H. Rowan, late State Sanitary Inspector of Mississippi, is now chief sanitary officer of the Republic of Costa Rica. He will also work under auspices of the Rockefeller Foundation.

The Chamber of Commerce of the United States of America, a body composed of representativs from about 600 local boards of trade, chambers of commerce, and trade associations, widely distributed thruout the United States, has taken up the study of the subject of uniform food and drug regulation. For this purpose a special committee was appointed, and it voted "that this committee hereby earnestly and heartily endorses the establishment of the bureau in the United States Department of Agriculture, particularly concerned with federal and state co-operation in the enforcement of the food and drug control laws, thereby promoting an equal and uniform enforcement of such laws, believing that this work is distinctly in the public interest."

Dr. Hertwig, of Berlin, is now serving in the eastern German army on his third military campaign. He recently celebrated his eightieth birthday in the field. He began practise in 1860.

Dr. Caroline Hedger, of Chicago, Ill., has just gone to Holland, at the request of its government, to administer antityphoid vaccine to the Belgian refugees there.

Showing again that trachoma is indigenous, and not due solely to immigrants, cases are now found in the upper Green River region, in Kentucky.

Cook County (Chicago), Ill., announces that eight new buildings and additions to buildings at the Oak Forest Infirmary have been completed at a cost of $850,000. A new administration building

adjoining the tuberculosis hospital accommodates 500 patients and many small cottages for tuberculosis patients have been finished.

Peter Bent Brigham Hospital, one more of the group of great institutions that make up Harvard Medical School, has just been opened with notable ceremony.

At the recent Missouri election seven physicians were chosen to represent districts in the legislature.

An Associated Press report from Geneva, Switzerland, November 19th, states that a preparation which, it is said, will stop almost instantly the flow of blood from a wound, has been invented by Prof. Theodore Kocher, of Berne, who was awarded the Nobel prize for surgery in 1912, and his assistant, Dr. A. Fonce. The new preparation (horse serum) is called coagulen, is in the form of a powder, and is dissolved in water before being applied to a wound. The discoverers of coagulen have made a gift of their invention to the armies in the field, and have sent large quantities of the powder to the surgical headquarters of both the German and French armies. The discovery is regarded by medical men there as likely to save the lives of thousands of soldiers, since it can be applied by untrained hands, so that the wounded man himself or his comrade, might use the solution. Has any osteopath or chiropractor or "Christian" scientist been equally altruistic?

Tuberculosis sufferers, directed to Colorado by their medical advisers, will now find a new help in the Health Seekers' Bureau of Denver, just organized by the profession there. Headquarters will be at the Denver Visiting Nurses Association, California and Fifteenth Streets.

Louisiana is now planning to reciprocate with California.

Dr. Charles Sedgwick Minot, a noted anatomist, died at Boston, November 20th. He was professor of histology and embryology at Harvard Medical School, and director of the anatomic laboratory at that institution. In 1912 and 1913 Dr. Minot was Harvard exchange professor at the Universities of Berlin and Jena. He was sixty-one years old.

A municipal laundry, to help tenement district residents, has just been opened in Chicago, Ill. New Orleans, La., has just opened its postgraduate medical school, leading hospitals offering ample facilities.

More than 600 physicians from all parts of the United States and Canada were admitted to the American College of Surgeons, which began its annual convocation at Washington, November 16th. The College pledged $250,000 toward a $1,000,000 endowment fund for the advancement of the profession thru research and education. Plans for a permanent headquarters probably to be erected in Washington, were discust, and pledges to raise the necessary money given. Brig. Gen. W. C. Gorgas, Surgeon General of the army, was made an honorary fellow of the College.

The Journal of the A. M. A. has mentioned at times the systematic campaign that has been carried on during the last decade in southwestern Prussia to stamp out typhoid fever. A series of bacteriologic stations were founded and they have sought out and tried to keep under control every bacilli carrier, and have thus materially reduced typhoid in that district. This part of the country was selected for this attempt at a campaign of extermination on the advice of Robert Koch that

it might be well to have this area free from typhoid in_case of another war with France.

The Southern Medical Journal of Mobile, Ala., believes that our nation has failed to do full justice to the era-making work of Colonel Gorgas and ardently urges the prompt creation by Congress of a national department of health with Dr. Gorgas at its head. He would thus be a member of the THE President's Cabinet, as is right and proper. WORLD emphatically indorses this movement. The Boston University medical school has been given $100,000 to erect a maternity hospital.

New York is to have the first hospital devoted exclusivly to the "twilight sleep" treatment of maternity cases, which will be known as the Twilight Sanitarium and will differ materially from other hospitals. Provision will be made for a large number of patients to undergo the treatment at the same time. The room for this purpose will be arranged so as to be absolutely free from noise and strong glare of light. High sash, glazed with blue glass, will provide the light. Direct light from these sashes will be so reflected as to infuse the room with a soft blue glow, as it has been found that this character of light is the best adapted for the treatment. Adjoining this room will be a "silence corridor," where physicians and nurses can observe the patients behind glass panels without disturbing other patients.

As proof of inaccuracy of "yellow press" claims of the use of dumdum bullets by either side, the Berliner med. Wochenschrift of Sept. 14th states that the French surgeons, Delbet, Raymond, Tuffier and Doyen, have publicly commented on the mild character of the wounds among the French soldiers when vital organs are not involved, and their rapid healing. The same comment as to the mildness of the wounds and the rapid healing among the wounded is made in the official report of the German surgeon-general, referring to the wounds made by the regulation bullets.

By quickly quarantining against nearby Kentucky towns, Dr. J. H. Landis, health officer of Cincinnati, lately prevented the spread of scarlatina into Ohio's main city.

In Italy lectures on military hygiene and sanitation are being held in Rome, and other cities and towns are urged to follow this example.

Yale University has advised the American National Red Cross that it will give two ambulances for European relief work, one for Germany and the other for the American Ambulance Hospital in Paris.

Dr. William J. Hickson, head of the Chicago Municipal Psychopathic Laboratory, stated to the members of the City Council on Crime, September 26th, that crimes committed by morons, sociopaths, feeble-minded and morally weak individuals are not to be regarded as such, but that such persons should be placed in a colony maintained by the state, county or city.

That the great army of harvest hands that came to Kansas last summer sowed the germs of typhoid fever in many parts of the state, causing an unusual number of typhoid cases to appear recently, is the assertion by W. J. V. Deacon, State Registrar of Vital Statistics, at Topeka, Kan., October 18th.

The 1915 convention of the American Association for Study of Spondylotherapy will be held in midsummer at the Panama-Pacific World's Fair, San Francisco.

ORIGINAL COMMUNICATIONS

Short articles of practical help to the profession are solicited for this department.

Articles to be accepted must be contributed to this jour nal only. The editors are not responsible for views exprest by contributors.

Copy must be received on or before the twelfth of the month for publication in the issue for the next month. We decline responsibility for the safety of unused manuscript. It can usually be returned if request and postage for return are received with manuscript; but we cannot agree to always do so. Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will cer tainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.RUSKIN.

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Sun baths may be artificial or natural (the natural being preferred). The artificial bath may be taken in any suitable room, preferably one that faces the south, while the natural bath is taken in the open air. It is better that the clothing should be removed during the artificial bath, while during the natural, the patient wears a thin kimono and basks in the warm, sunshine, occasionally changing position so that the sun may act on all parts of the body, or better, engages in some light gymnastics. It is well to occasionally don a thick wrap and seek some shady place sheltered from the wind, as the cooling effect is very beneficial. He also recommends to walk thru the grass bare-footed. During either bath, the head, eyes and other sensitiv parts should be protected; care also should be taken that no markt erythema is produced.

The duration of the artificial bath may be from fifteen to sixty minutes, while the natural bath may last for an hour at first, and be gradually increast as the patient becomes accustomed to it. The best results are obtained between 10 a. m. and 4 p. m. At the conclusion of either bath the patient should receive a cool shower or sponge bath, or alternating warm and cool showers, as the physician may think best. After dressing, the patient should promenade for about ten minutes, then retire to his room

and partake of a light lunch, perhaps milk and toast. The physiologic effect of this treatment is produced partly by the action of the heat rays upon the sweat glands and partly by the irritating effect of the chemical rays upon the skin. Either tends to bring the blood to the surface of the body, thus flushing the capillaries, promoting oxidation and relieving congestion of the internal organs.

Diseases Benefited.

The results obtained by this method of treatment are very satisfactory. Persons troubled with such affections as neurasthenia and hysteria show a markt improvement in a short time, while those suffering from locomotor ataxia who are treated by this method at sanatoriums, particularly when taken at its early stages, improve rapidly, the severer symptoms disappearing in four or five weeks; and the patient is able to go home in a fairly comfortable condition. This treatment, when combined with alternating hot and cold douches over the spine (particularly the affected part), gives excellent results in poliomyelitis.

Arteriosclerosis and certain heart affections, particularly fatty heart, provided degeneration has not progrest too far and compensation is fairly good, yield very nicely to this treatment.

Persons suffering from kidney diseases. are laid on a mattress in the sun, the clothing being removed gradually. After the sweating has become quite profuse they are placed in a dry pack and allowed to remain in the sun from six to eight minutes longer. They consider this method preferable to the vapor or light bath, and in chronic Bright's disease, after the kidneys have become considerably congested, the urin is loaded with albumin and the uremic symptoms are quite pronounced, recovery takes place in a short time, the functions being restored to their normal condition and the albumin disappearing from the urin.

Rheumatism and rheumatic diseases are treated by placing the affected part in hot sand and allowing the sun to act upon the whole surface by occasionally changing its position. In the Doctor's own words, "The material which has been gathered and the testimony of those who have been treated by this method in sanatoriums are sufficient to furnish all the evidence as to its efficiency that one may desire." Other conditions are treated with equally as good results, but limited space will not permit of their description.

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Conclusion.

I would say, in conclusion, that Dr. Wilheim is not overenthusiastic in regard to this method of treatment, but strongly urges that when unfavorable symptoms are produced or the diagnosis seems to indicate some other method of treatment, the physician uses his own discretion in regard to the matter. But judging from the report given by Dr. Wilheim, of the results obtained by this treatment in the German sanatoriums, and knowing what we do about the effect of sunlight upon both plant and animal life: that by means of it we are able to accomplish all that can be accomplisht by the vapor, Turkish and light bath, and to produce the same chemical, irritating and bactericidal effects as may be produced by the Finsen, leucodescent and therapeutic arc light, and when combined with the pure air that one always obtains during the treatment, the development of the lungs and other organs of the body brought about by the light gymnastics, the balancing of the circulation produced by the alternating hot and cold effects which take place during the treatment, the immense discharge of superfluous nervous energy occasioned by walking thru the grass bare-footed, the stimulating effect of the shower bath, it promises to be one of the most efficient methods of treating some diseases. F. L. JACKSON, M.D.

Westbrook, Maine.

The Gilbert Sphygmomanometer. DEAR DR. TAYLOR:-I am expressing herewith a crude, unfinisht blood-pressure apparatus of which I spoke to you in a former letter.

The idea was suggested to me by the admirable instrument so kindly presented to the profession by Dr. Attix, of Philadelphia.

Heretofore the main objection to all mercury instruments has been their large size and the consequent difficulty of carrying them about from place to place. This I believe is at least partly obviated in the instrument that I send you, it being possible to slip it in the overcoat pocket or lay it in the bottom of an ordinary obstetric or other bag measuring thirteen inches. The dimensions of the apparatus are (closed) 121⁄2" x 22" x 134", and it might be even made smaller without materially interfering with its usefulness.

For the benefit of those not familiar with a sphygmomanometer I will state that it is

The Gilbert Sphygmomanometer. the dimensions are 12" x 14" x 1"; 12" x 24" x 11⁄2".

Made in metal, made in wood,

a, A clip is attacht to the end of each rubber tube when the cuff and bulb are detacht to prevent the escape of the mercury. The bulb is to be attacht to the long rubber tube, the cuff to the short one.

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