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Valentine's Meat-Juice

In Diarrhoea, Dysentery and Cholera
Infantum where it is Essential to Con-
serve the Weakened Vital Forces with-
out Irritating the Digestive Organs,
Valentine's Meat-Juice demonstrates
its Ease of Assimilation and Power to
Sustain and Strengthen.

Dr. Simonyi Bela, Physician to the Israelite Hospital, Buda-Pest, Hungary: "I have tested VALENTINE'S MEAT-JUICE in the case of a child five years old who was much weakened by a severe and obstinate attack of Gastro-Enteritis, during which there was great difficulty in properly feeding him. Two days after he had begun taking VALENTINE'S MEAT-JUICE the extreme weakness began to abate and the patient recovered in a remarkably short time. I find VALENTINE'S MEAT-JUICE an excellent preparation, and in cases where a powerfully stimulating nourishment is needed it answers wonderfully."

For Sale by American and European Chemists and Druggists.


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Makers of Complete Lines of Surgical Instruments

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Our sterile solutions are carefully prepared
and have a uniform potency.
Bacteriologically and Physiologically Tested

Rochester Biologic Corporation


The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain, or dries like raindrops off the stones.-FROUDE.

The Medical World

C. F. TAYLOR, M.D., Editor and Publisher.

A. L. RUSSELL, M.D., Associate Editors.

E. S. TAYLOR, Business Manager.

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"THE MEDICAL WORLD" 1520 Chestnut Street

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Philadelphia, Pa.

No. 4

Physicians Required to Keep Records in
Spite of the Law.

The medical profession of the United. States has a large task before it. The working of the national narcotic act has proved to be more troublesome than was expected, owing to the United States Commissioner of Internal Revenue ruling that physicians must keep records of all narcotic drugs dispenst in their offices and at the bedside of patients.

The bill passed by the lawmakers does. not require any such record. As the Treasury Board is not empowered to make law, we cannot see how they can enforce any such ruling. The bill as finally approved by physicians and druggists was worded to avoid such record keeping.

For a long time we had been directing the attention of the medical profession to the present law while it was in its formativ state in Congress; but many physicians did not awake to the necessity of their looking into the subject themselves. Too many of them left it to us. We have done all that we could. But there remains a great deal that the individual members of the medical profession and the medical societies must do if it is to be done. They must join with us in our efforts. One of the things on hand now is to bring great pressure to bear on the Commissioner of Internal Revenue to induce him to rescind his action in ruling that the physician must keep a record of remedies dispenst, inasmuch as the law passed by Congress and approved by the President does not call for such record. The letter as well as the spirit of the law should be obeyed.

We have already heard of many physicians who are very bitter toward the law for compelling them to keep these records. And we have heard of some who have no cares, for they do not dispense any remedies, and they are not exerting any effort in behalf of their confrères who dispense. We consider it the duty of all physicians to act unitedly in this matter for the benefit of the profession, whether dispensers or not.

It appears that Smith, Kline & French Co., of Philadelphia, wholesale druggists and manufacturers, by the aid of their attorney, J. C. Jones, and his "view" of the law, prevailed on the Commissioner of Internal Revenue to see the matter at issue in the light of the druggists, the ulterior purpose of the druggists, of course, being to make dispensing by physicians so troublesome that the latter will write prescriptions, thus bringing more grist to the druggists'


The Cincinnati Medical News for February gives a report of the annual meeting of the Southwestern Eclectic Medical Association, at which Frank H. Freericks was a speaker. He is there stated to be "the official attorney for the Ohio State Pharmaceutic Association and of the Ohio Val

ley Retail Druggists' Association." He was very activ in his efforts to secure legislation to prevent physicians from dispensing or at least require them to keep extensiv records.


Now the eclectics are entertaining him in one state while eclectic physicians elsewhere are howling about the national narcotic law and demanding its repeal. they would avoid further entanglements of the kind they should watch the activities of the druggists and their attorneys.

The working of the bill is considered onerous by druggists doing a strictly legitimate business and they are very much dissatisfied with it and are so expressing themselves. Eclectic writers are blaming the bill on the American Medical Association and the regular profession. And other physicians are placing the blame for the bill on the druggists.

So it looks as if we all must have had some share in it.

It is the purpose of all trustworthy physicians and druggists to secure proper control of the narcotic traffic so that it may be confined to legitimate use. To that end the professions should work together. The useless antagonism engendered between pharmacy and medicin should give way to friendship and co-operation. The regulars, eclectics and homeopaths should forget what little animosity now remains among them and consolidate. Then the united profession can secure fair and useful legislation. Without such much acrimonious legislation may be attempted.

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The question sometimes agitated by physicians of all schools is how to get together. It is like the question of how to resume specie payments that arose after the civil war and was answered by Horace Greeley that "the way to resume is to resume.' Similarly the way to get together is to get together. Attend each other's meetings and conferences and take an activ interest in those affairs. If you want to have friends be a friend-be friendly. And do not notice any antagonism that may ensue, which is likely to occur here and there in some prejudiced person.

These are the words of the new national narcotic law:

Nothing contained in this section shall apply— (a) To the dispensing or distribution of any of the aforesaid drugs to a patient by a physician, dentist or veterinary surgeon registered under this act in the course of his professional practice only;

provided, that such physician, dentist or veterinary surgeon shall keep a record of all such drugs pensed or distributed, the date and the name and dispensed or distributed, showing the amount disaddress of the patient to whom such drugs are dispensed or distributed, except such as may be dispensed or distributed to a patient upon whom such physician, dentist or veterinary surgeon shall personally attend; and such record shall be kept for a period of two years from the date of dispensing or distributing such drugs, subject to inspection, as provided in this act.

See particularly the words in italics. The following is the ruling of the Bureau of Internal Revenue:

Where a physician personally visits a patient and administers any of the drugs coming within the scope of the Harrison Act, he is not required to keep a record of such administration, but where he leaves a supply of any of these drugs or preparations to be taken by the patient in the physician's absence, he will be required to keep a record of such drug or preparation, the same as he would in his office. A physician must keep a record of all drugs or preparations dispensed or distributed in his office, whether administered personally or given to the patient to be carried away with him.

We consider this ruling very unjust to physicians. In this connection the accompanying correspondence with the Bureau of Internal Revenue may interest you. We

hold that "personally attend in the course of professional practice" should include the leaving of necessary medicins for use between visits; and also include the dispensing of needed medicins at the office after consultation; that the words of the law do not mean "personally administer."

In our editorial last month on this law we said on page 84 that "When the physician *** does not personally attendi. e., personally see-the patient he must keep a record." That editorial was written before the official interpretation by the Commissioner was made. We are not the only editors who gave out interpretations that proved to be different from the internal revenue bureau's pronouncement when made. The Journal of the American Medical Association several weeks ago stated in an editorial on this law that physicians would be required to keep records of dispensing in their offices, but not of remedies dispenst at the bedside. The Bureau now says that records must be made of dispensing at the bedside. The fact that editors and practicians almost generally believed that dispensing would not require to be recorded is fair proof that the general understanding of the law is substantially as we have heretofore stated. And it must not be

forgotten that many editors and physicians have been studying and working with this bill for many months and shaping its wording, and thereby are in a position to give a fair opinion on its intendment and on the views of the legislators in whose hands the entire wording of the law was finally settled. Surely the makers of an article know their product!

We have gone to great length in our efforts to have annulled the unjust ruling of the Commissioner of Internal Revenue and we present herewith the correspondence on the subject:

PHILADELPHIA, PA., February 17, 1915. Bureau of Internal Revenue, U. 8. Treasury Department, Washington, D. C.:

GENTLEMEN-I have been informed that the Bureau has ruled under the Federal Narcotic Law that all physicians, dentists and veterinary surgeons must keep the specified record of all office dispensing of the affected drugs (except where expressly exempted).

On behalf of about 25,000 members of the medical profession represented in the readers of THE MEDICAL WORLD, I hasten to call this matter to your careful attention, believing that when a full appreciation of the intended and actual meaning of this law is had that it will be readily apparent that such a ruling is directly contrary to the intendment and provisions of this law, is inequitable and discriminatory, and would lend not one iota to the effectiveness of the law, but would create an embarrassment of the humane practise of the medical practitioner, of serious moment. I append hereto a statement roughly and generally presenting our views on this question.

As this ruling is of very considerable interest to the legitimate practitioner and this law soon goes into effect, I would greatly appreciate your opinion, which I may convey to our readers. I am and have been a champion of this beneficent law and endorse, without qualification, its purpose and value. Our only concern, which was the concern of Congress, is not to interfere unduly with the legitimate dispensing, by the physician, but to build a strong wall around it to insure its proper exercise. The country physician, who covers long and wide territories, must dispense so as to properly treat his patients. Our readers are chiefly general practise doctors and country physicians. If their liberties are unduly interfered with, there will be great disturbance all over this great country. We have kept our readers posted during the period of evolution of this law, and they are in favor of it and ready for it. But they will be greatly disturbed by a construction of it which robs them unduly of their ancient privilege of dispensing to their patients, either in the sick-room or their office. There are other features of the law that will prevent abuse.

I beg you to realize the gravity of this matter.
Very sincerely yours,
(Signed) C. F. TAYLOR.


OFFICE OF COMMISSIONER OF INTERNAL REVENUE. WASHINGTON, February 24, 1915. Dr. C. F. Taylor, "The Medical World," 1520 Chestnut Street, Philadelphia, Pa.:

SIR-Replying to your letter February 17th, you are advised that for purposes of checking up the quantity of drugs, coming within the scope of the Harrison Anti-Narcotic Law, received and dispensed, this office deems it necessary for a record to be kept of all

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PHILADELPHIA, PA., February 25, 1915. Mr. David A. Gates, Acting Commissioner, Internal Revenue, Washington, D. C.:

DEAR SIR:-I thank you for your reply of yesterday to my letter of February 17. But, my dear Commissioner, your reply is very discouraging. I very greatly fear an uprising upon the part of the medical profession of this country when every dispensing by a doctor must be subject to official record.

I do not see how any construction of the law can be made to limit the exempting of physicians from record to such doses "as are administered directly to the patient by the physician in person" (this is quoted from your letter). And even then only when he is away from his office.

It is generally known that physicians seldom administer remedies by their own hands either at the bedside or in the office, but from time immemorial physicians have dispensed remedies to their patients to be given by the nurse or the attendant according to the physician's directions. I believe it to have been the intention of the law-makers to exempt from record such dispensing by physicians.

If it is not too late I sincerely hope that the ruling of the internal revenue department will be revised in harmony with the ancient and humane rights of physicians to dispense remedies to their patients. I think that such a construction of the law will be necessary in order to prevent great disturbance occasioned by attempts to carry out your construction of the law. Indeed, I fear that the law cannot be successfully executed, and hence will prove to be a dead letter unless a more reasonable construction is put upon it than your reply of yesterday now before me. Very sincerely,

(Signed) C. F. TAYLOR.



C. F. Taylor, M.D., Editor "The Medical World," Philadelphia, Pa.:

SIR-Replying to your letter of February 25th I regret to advise you that this office considers it inadvisable to withdraw its requirement for physicians to keep a record of those drugs coming within the scope of the Harrison Narcotic Law, as are dispensed, distributed or administered in his office, as it is only thru this means that the government will be enabled to enforce the provisions of this law.

These drugs and preparations are so infrequently administered by reputable physicians in their office practise that the requirement that they keep a record of such administrations does not seem unreasonable or one that will cause any inconvenience to this class of physicians.

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I beg to say that the rigid regulations concerning the obtaining of supplies of these drugs by physicians, it seems to me, is a sufficient means of enforcing the provisions of the law. I heartily endorse the rigid requirements connected with obtaining supplies of these drugs, and through this means I trust that any physician who may abuse his power as a physician may be caught and properly punished. If there is any legally recognized physician in this country who will take advantage of the fact that he can get these drugs because of being a physician and should make improper use of them, he should be punished to the limit of the law. I think that the records required of the supplies will be sufficient to lead the internal revenue authorities directly to such an offender without hampering the legitimate dispensing of these drugs by the profession in general.

It seems to me that the above should at least be tried before issuing such burdensome restrictions upon physicians as your department has done.

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Chicago Medical Society Opposes Recording.

The following resolutions by the Chicago Medical Society against the ruling on narcotic recording should be emulated by all medical organizations:

Whereas, Wide publicity has been given to a letter written by the United States Commissioner of Internal Revenue, in which the ruling is made that "A physician, dentist or veterinarian must keep a record of all drugs covered by the provisions of this (the federal narcotic) law sold, bartered, exchanged or given away in his office or place of business." And

Whereas, This ruling is, in the opinion of this body, distinctly at variance with the letter and intendment of section 2 of the federal narcotic law, which declares that "nothing contained in this section shall apply to the dispensing or distribution of any of the aforesaid drugs to a patient by a physician, dentist, or veterinary surgeon registered under this act in the course of his professional practice only: Provided, That such physician, dentist, or veterinary surgeon shall keep a record of all such drugs dispenst or distributed, showing the amount dispenst or distributed, the date, and the name and address of the patient to whom such drugs are dispenst

or distributed, except such as may be dispenst or distributed to a patient upon whom such physician, dentist or veterinary surgeon shall personally attend; and such record shall be kept for a period of two years from the date of dispensing or distributing such drugs, subject to inspection, as provided in this act." And

Whereas, The official records of the discussions of this bill, prior to its enactment in the House of Representatives and in the Senate of the United States, and its whole history, clearly show that no such restrictiv meaning was contemplated by our national lawmakers as that expressed by the Commissioner of Internal Revenue in the ruling just quoted, and

Whereas, Such a ruling and similar rulings will place tremendous and, as we believe, unnecessary burdens upon the medical profession, and upon the allied professions of dentistry and veterinary medicin. Therefore, be it

Resolved, That the Council of the Chicago Medical Society, representing the three thousand members of this organization, does hereby enter an earnest protest against this or any other official extension by regulation of the meaning of the federal narcotic law; and be it further

Resolved, That while this body again places itself upon record as being heartily in sympathy with the purpose of the federal narcotic law, and pledges its co-operation with the authorities in securing its rigorous enforcement, so that every possible physician or other person illegally and inhumanly trafficking in narcotics may be brought to justice, it is absolutely opposed to this or any other extension by bureau action of the law beyond its clear and undoubted meaning as exprest in the statute, as likely to prove detrimental to the best interests of the medical profession and the millions of people depending upon it for the alleviation of pain and the cure of disease. And be it further

Resolved, That the secretary of this society be directed to send properly attested copies of these resolutions to the United States Senators from Illinois, to the Representatives in Congress from Cook County, to the Commissioner of Internal Revenue, and to the Illinois Medical Journal; and that these resolutions be published in the Bulletin of the society.

The following resolutions were passed by the society in favor of the uniform state narcotic law:

Resolved, That we do hereby order the publication, in the Bulletin of the society, of the socalled United States Chamber of Commerce Model State Narcotic Law, and recommend its enactment into law by our state legislature, in essentially the form proposed; and be it further

Resolved, That the Public Relations' Committee of the society be authorized and directed to secure the introduction of said model law in our state legislature, and that it be urged to facilitate and expedite its passage in every possible way, taking all necessary precautions that, as finally passed, it shall be in such form as to curtail the illegitimate sale of narcotic drugs, restrict the handling of these substances to persons properly authorized by law so to do, and provide for effectiv and human treatment of drug addicts, while conserving at all points the best interest of the medical profession of this state and those intrusted to their care.

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