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A Confusing Multiplicity of State

Narcotic Laws. In order to simplify narcotic legislation, state laws should be patterned after the national narcotic law. In our February issue we printed the complete text of a proposed uniform state narcotic law based on the national law. If this state law were adopted in all the states, in conjunction with the national law, it would serve the purpose of controlling effectivly the narcotic evil. Further incursions into the practise of medicin by such laws would be unnecessary. The national law itself is achieving the results expected of it. In Philadelphia over a hundred and fifty drug addicts have applied to hospitals for treatment. The carrying out of the provisions of the bill produced great consternation among addicts, a number of whom finally were compelled to apply to hospitals and police authorities for assistance. Thus the need for and the usefulness of the national law is demonstrated. What happened in Philadelphia doubtless occurred all over the United States. Why then should other cumbersome laws be enacted to suppress an evil that is being properly supprest without them?

Any state law that would impose further burdens on the medical profession than is done by the national law would be an unwarranted imposition and should be vigorously opposed by the entire medical profession. There have been introduced into a number of state legislatures narcotic bills that would make a great deal of trouble to physicians of their respectiv states if enacted into law.

Minnesota. In Minnesota, for instance, House Bill No. 1 revises the present narcotic law and creates a law regulating the sale of cocain, alpha or beta eucain, morphin, heroin or opium, their salts, derivativs and compounds. This bill does not follow the federal law for separate records in the case of sales at wholesale, providing different minimum quantity exemptions, etc. No provision is made for dispensing by the physician. The treatment of habitual users of these drugs is limited to the personal administration to the patient by a physician when it has been in good faith determined by two reputable and duly licensed practising physicians in consultation, to be absolutely necessary in the medical treatment of said patient. It is a very crudely drawn bill and not at all in harmony with the national narcotic law. It would compel the physician to write a prescription before dispensing. This bill was subsequently amended to include chloral, to require physicians to keep detailed records of dispensing, and to keep separate and detailed records of the treatment of habitués, etc.

Senate Bill, No. 7, limits the sale and giving away of opium, morphin, cocain, acetanilid, phenacetin, codein or any derivativ or compound of coal-tar or any preparation or combination containing the same or any habit-forming drug or preparation, except upon a written prescription of a physician.

Physicians of Minnesota must get busy very quickly if they want to stop the passage of these iniquitous bills. The legislature may have adjourned before now. It convened January 5th and was limited to a 90-day session.

Kansas. In Kansas, House Bill, No. 306, was a very thoro narcotic, pharmacy and poison law and did not hinder physicians from dispensing medicin. It was_urged for passage by Kansas doctors. House Bill, No. 804, was quite similar to No. 306. Senate Bill, No. 659, was a copy of the Boylan law of New York. The legislature has adjourned.

Nebraska. In Nebraska, Senate Bill, No. 61, was a complete narcotic law and not at all in harmony with the national law. It permitted administration but not dispensing, and treatment of habitués was like that described in the Minnesota bill. A record of all treatment of habitués must be kept, subject to inspection by the State Board of Pharmacy, state health officers, etc. House Bill, No. 113, and Senate Bill, No. 7, were equally bad. House Bill, No. 125, was another very excessiv bill. In connection with the federal narcotic bill it would have more than doubled the labors imposed on the physician in treating the sick. The legislature convened January 5th and was limited to 60 days.

Colorado. In Colorado, House Bill, No. 249, is in harmony with the national narcotic law and should be passed by the legislature. It is a pleasure to find such a good bill in a legislativ assembly and we hope the profession in Colorado will work for this bill.

Indiana. In Indiana, Senate Bill, No. 195, permitted the physician to administer narcotic drugs to his patient and forbade their being dispenst. The bill was very crudely drawn and not at all in harmony with the federal law. The legislature has adjourned and we do not know the fate of this bill.

Maine. In ne, Senate Bill, No. 45, amends previous legislation and dispenses with record-keeping by the physician of narcotic drugs dispenst. Senate Bill, No. 137, repeals the present" narcotic law and adopts the federal narcotic law.

Massachusetts. In Massachusetts, House Bill, No. 1289, is a complete narcotic law. It permits the State Board of Pharmacy to prescribe additional official order forms and requires the physician to keep a detailed record of all dispensing. It should be defeated. House Bill, No. 1814, is equally bad.

Michigan. In Michigan, House Bill, No. 124, follows the form of the Maine law of 1911 and varies considerably from and conflicts with the national laws.

Record must be kept of all dispensing.

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House Bill, No. 222, by Mr. Oakley, proposes a law similar to the New York Boylan law, and so would require the physician to make out separate order forms in addition to the federal order forms, in purchases, and would require a record in detail of all medical dispensing.

New Jersey. New Jersey has a number of bills before it. In their legislature, House Bill, No. 31, permits dispensing by physicians without record. In some respects the bill conflicts with the federal law, the exemptions being quite different. Such differences make confusion in attempting to follow two laws.

Senate Bill, No. 94, incorporates a complete narcotic law. Provision is made for official prescription blanks in which must be indicated, detailed information of each prescribing. Sales at retail are limited on the official prescriptions. Refilling of prescriptions is prohibited. The retail druggist must give to the consumer an official certificate indicating the identity of the drugs so sold. Official order blanks for all sales at wholesale are provided. The daily prescribing of these narcotic drugs for three weeks must be separately recorded, and only after consultation with another physician and official reports of such prescribing must be made to the local boards of health. The same procedure must accompany dispensing as prescribing; that is, a written prescription must first be made out and a certificate given to the patient. This is a very onerous bill and should be defeated by the united action of the physicians of New Jersey.

Assembly Bill, No. 123, is not in harmony with the federal law, the minimum exemptions differing. Dispensing by physicians is unrestricted.

New York. New York has a number of bills to contend with in its assembly. Senate Bill, No. 493, introduced by Mr. Boylan, author of the Boylan law that has riled the physicians of that state, is an amendment to the Boylan law and defines the permitted sales at wholesale, but makes no express provision as to sales to the medical profession at wholesale, tho mentioning sales to manufacturers and dealers, which renders it confusing. The recording feature is made more elaborate and cumbersome. The Boylan law is mischievous enuf as it is without being made worse.

Senate Bill, No. 664, amends the Boylan law by exempting from the prescription only limitation preparations compounded from physicians' prescriptions containing the present minimum quantities.

Senate Bill, No. 37, and Assembly Bills, Nos. 33 and 532, are penal bills relating to the Boylan law and probably will serve no useful purpose.

Pennsylvania. In the Pennsylvania legislature, Senator Gerberich has introduced two bills, neither of which is satisfactory to physicians. They are Senate Bills, Nos. 124 and 198, and should be opposed by the profession of the state, unless amended. Senate Bill, No. 198, supersedes Senate Bill

, No. 124, and requires a record of all medical dispensing.

House Bill, No. 315, is a law aimed to control the use of heroin alone. The uniform state law

that we advocate would include all narcotics and heroin. It is insufficient.

Senate Bill, No. 177, and House Bill, No. 329, propose a complete narcotic law. It embraces the fundamental features of the federal law, and in this respect is a very good bill. Medical dispensing is unrestricted, no record being required. The bill also prohibits the sale of any proprietary or patent medicins containing any of these narcotic drugs which is advertised or recommended as an infant remedy. This seems to be a good bill and worthy of the support of Pennsylvania physicians.

North Dakota. In North Dakota, Senate Bill, No. 67, limited the sale or giving away of preparations containing heroin on physicians' prescription. Prohibits the prescribing of heroin for an habitué. Prohibited a veterinarian or dentist from prescribing heroin for a human being and made a medical practician liable to a revocation of his license for a violation of this law.

House Bill, No. 379, required all medicins prepared, compounded or dispenst under a physician's prescription, recipe or formula to be labeled to indicate the contents and ingredients.

House Bill, No. 69, prohibited the druggist or physician from giving or prescribing opium, morphin, cocain, etc., to a chronic addict to the use of these drugs, except in an emergency, without consultation with another physician. The bill also provided that as soon as a druggist or physician discovers such an addict he must immediately report him to the state attorney, and the latter must immediately arrest such addict, who must then be brought before the Insanity Board, and if such board determins, after examination, that the person is a chronic user of such drugs, the board shall commit him to a hospital or other proper place for detention and treatment until cured. This manner of apprehending drug addicts reminds us of the method of "denouncing” political opponents during the French revolution, which afforded an easy method of getting certain people removed. Similar methods have been followed in Russia until a very late period.

The uniform state narcotic law should be enacted in North Dakota instead of these bills. The legislature convened January 5th and was limited to 60 days.

Ohio. In Ohio, House Bills, Nos. 305 and 390, are splendid uniform state narcotic laws and deserve the support of everybody and the emulation of all other legislatures. Ohio physicians should see that they are passed. House Bill, No. 132, intrusts enforcement of narcotic law to the Board of Pharmacy.

South Carolina. In South Carolina, House Bill, No. 159, requires that dispensing of opium or its derivativs hy a physician be made only upon a prescription. This prohibits dispensing. The uniform státe law should be enacted instead.

South Dakota. In South Dakota, House Bill, No. 49, was a narcotir law not in harmony with the national law. The minimum quantity exemptions were different. Physicians could dispense only on a detailed written prescription. Senate Bill, No. 23, was also a narcotic law. No record of medical dispensing was required. Special registration books must be kept by the dealer and physician, showing the purchases and sales. These bills should have been rewritten to conform to the national narcotic law. The legislature convened January 3d for a 60-day session.

Texas. In Texas two very objectionable bills were before the legislature. Senate Bill, No. 96, was a narcotic law not in harmony with the federal law. Medical dispensing was limited upon prescriptions, and physicians could not fill their own prescriptions in towns and cities of 2000 or more inhabitants. House Bill, No. 170, was a similar bill. These bills should have been defeated. The legislature met January 5th for a 60-day session.

Vermont In Vermont, House Bill, No. 68, is not at all in harmony with the national narcotic law. It is similar to the Massachusetts narcotic law of 1914. A record of every medical dispensing is required.

West Virginia. In West Virginia, House Bill, No. 201, and Senate Bill, No. 151, were similar to the Boylan law of New York and should have been defeated. The legislature met January 13th for a 45-day session.

Arkansas. In Arkansas, House Bill, No. 154, was not in harmony with the federal law. Medical dispensing would be limited upon written prescriptions. The legislature met January 11th for a 60-day session.

Connecticut. In Connecticut there has been introduced into the legislature, a bill requiring all physicians, dentists and veterinarians to keep a record of the name, address and quantity of every single dispensing. Violation of this law subjects the physician to the liability of the revocation of his license. House Bill, No. 797, will require a physician to be a licenst pharmacist.

Iowa. In Iowa, House File, No. 252, prohibits the refilling of opium and cocain prescriptions or of any prescription markt not to be refilled. Prohibits any person from selling or distributing opium or cocain or their derivativs, except upon the written order of a physician. This would limit dispensing upon written prescriptions only.

Senate Bill, No. 71, and House Bill, No. 65, require every person selling or dispensing medicins on prescription to keep a book or file for the preservation of the originals of every prescription. All containers must be labeled accordingly.

House Bill, No. 326, is an admirable uniform state narcotic law, exactly harmonious with the national law. Therefore it should be supported by everybody and copied by all state legislatures.

Idaho. In Idaho, House Bill, No. 249, was a complete narcotic law and included chloral hydrate. Retail druggists were prohibited from disposing of these drugs, except to physicians and upon prescription. Prescriptions must be retained for one year and could be refilled on a written order from the physician. The doctor could furnish or administer these drugs to or for his patient and

to none other. It was lawful for a retail druggist to sell proprietary preparations containing not more than 4/10 per cent. of opium, 48 grain morphin, 18 grain heroin, 10 grains chloral hydrate and the label must show clearly the percentages of such articles contained therein. Violation of this act by the druggist or physician would ipso facto make it unlawful for him to practise his profession in Idaho "forever thereafter." The legislature convened January 4th for a 60-day session.

Oregon. In Oregon, House Bill, No. 114, required physicians' prescriptions to be issued in triplicate and to contain the English name and equivalent for each medical term or symbol (not in the English language), where the English language shall have such name or equivalent, unless the prescription is issued wholly in English. The prescription must also contain the name of the person to or for whom it is issued and a plain, concise statement of the disease for which issued and the primary, direct physical or mental effect sought to be obtained. The original must be retained on file. Two copies were to be given to the person to or for whom the prescription is issued. North Dakota had a similar bill in its legislature. House Bill, No. 135, in Oregon, was a narcotic, pharmacy and poison law. The peddling of drugs was prohibited. The narcotic provisions varied radically from the national law. Dentists may not prescribe narcotics. Legitimate medical dispensing is entirely exempted. The legislature met January 12th for a 40-day session.

Utah. In Utah, House Bill, No. 79, was a new and complete poison and narcotic law, somewhat similar to the present California law. The sale of corrosiv sublimate tablets at retail was prohibited except on a recorded sale. Copies of all orders for the narcotic drugs specified, must be mailed within 24 hours to the State Board of Pharmacy. Physicians must report daily treatment of habitués to the State Board of Pharmacy. The minimum quantity of narcotic exemptions was different from that of the federal law. Physicians could only dispense narcotics on a written prescription.

House Bill, No. 78, required the proprietor of every business where drugs are sold or dispenst to register annually with the State Board of Pharmacy. The legislature convened January 11th for a 60-day session.

Montana. In Montana, House Bill, No. 191, permitted physicians to dispense and did not require recording of drugs. The legislature convened January 4th for a 60-day session.

Miscellaneous Nebraska (House Bill, No. 195), was legislating the balm out of embalming fluids, by prohibiting arsenic therefrom, while New Jersey (House Bill, No. 339), is legislating arsenic back into it.

Oregon (House Bill, No. 114), and North Dakota (House Bill, No. 339), were considering compelling the physician to write prescriptions in triplicate and in English, one copy to be kept by the physician, one by the patient and one by the druggist. On the contrary are certain laws that aim to prevent a patient from having a copy of his prescription, especially one for narcotic

a

drugs. What will the physician do where the Many physicians who do not dispense laws conflict ?

will not care what laws are passed that are All sorts of shapes are being required for antiseptic tablets. Uniformity of shape and color

troublesome for dispensing doctors. So it or some latitude in these respects should be in- behooves every dispensing doctor to attend cluded before such bills are passed.

to the bills in his own state legislature as if In Oregon (House Bill, No. 225), they were he were the only physician looking after the attempting to legislate arsenic and cocain out of

interests of the profession in that matter. dentistry; in California (House Bill, No. 190), arsenic, cocain and alpha and beta eucain are to

It will do any physician a great deal of be prohibited in dentistry.

good to write a lengthy letter on this subThe space that we can devote to this ex- ject in support or condemnation (as the tensiv subject is too small to permit us to bill warrants) to his state senator and repdiscuss these bills in detail. We can only resentativ. Do not delay your action. Do give a few salient points of each. Among

it now. the objectionable features to be noted are those which prohibit dispensing require elaborate recording of drugs dispenst, re- BUSINESS TALK TO DOCTORS quire an additional order blank to the one prescribed in the national narcotic law,* place the supervision of physicians in the

When these lines reach you, spring will hands of a board of pharmacy, require re

be making her gentle approach in many ports to a board of pharmacy, require the parts of this great country. How does it physician to get an annual license as find you in a business way? Perhaps you pharmacist, etc. The State Board of need rest after a strenuous winter. But Health, and not the Board of Pharmacy,

don't neglect to send bills for services should receive physicians' reports. It is rendered when perhaps you were too busy manifestly a mistake to place physicians un

to send bills. And send statements to all der the surveillance or control of a board who owe you, with a gentle reminder. If of pharmacy.

you have been too busy to attend to financial A worthy uniform state narcotic law was

affairs during the hard winter months, say pending in Iowa, Colorado, Kansas and

so; and explain that you attend to the Ohio and the physicians in those states

needs of your patients first, and then look should see that they are enacted without

after your own needs. You have been faithamendment. It may mean trouble to the

ful to them, and now they should be faithful physicians if it is not passed.

However, your rule should be to present We have stated our position on these points in The World during the past pleted, and send statements on the first of

the bill as soon as a given case is comeighteen months and suggest you read

every month until it is paid. That is the them. Then get after each and every mem

way business men do.

And when you ber of the legislature and insist that the neglect doing that, because of unusually uniform state narcotic law that we publisht taxing work during winter or for any other in our February issue be passed as printed

reason, make an extra occasion of it and for reasons given in February World.

mention the fact, as above suggested, the Write to us for a copy of the law in pam

next time you send out bills and statephlet form to send to your legislature. In

ments. the few states above noted, where a satis- Don't let accounts get old. They rapidly factory law is in the legislature, urge its

decrease in value. Get the money and put passage and do not let up in your urging it in bank. Then it does not decline in until it has passed. Do not be content with

value, and you have it “on tap" for any anything else. Be insistent and persistent need. Here is a brother who comes forward in your endeavors. Only thus will you

at this opportune time to help you: succeed. Remember that the druggists are looking after their end of the bills, whereas

CLOQUET, Minn., Feb. 16, 1915.

DEAR DR. TAYLOR:- It has been some time since the physicians are dependent on themselves.

we have had anything about form letters, "followMany of the medical societies have not

ups,” etc., and I am taking the liberty of inclosing yet gotten activ in this matter.

a series of slips which I have had my printer make

for me; they speak for themselves. *How will a doctor or druggist write two orders for I keep a case record, loose leaf, and each time a one thing-using a state form and also a national true order, and which the

statement or slip is sent out the date is entered spurious one?

in the record and the number of the slip noted;

to you.

form?

Which is

the

double up.

4.

5.

1.

in this way I keep track of the sequence and do not and we will arrange some terms satisfactory to us

They bring in the money without both and in this way avoid further trouble for us ruming the patient and usually he comes in with an both. apology for his delay unless he is a dead-beat; of

This is the last of a series of statements that I course this class of patients are immediately made peevish upon receipt of the first bill and usually

have sent you. Your account is over half a year begin to dodge you on the street. I waste no

old and possibly older. I have given you plenty postage on them and if a judgment is collectible,

of time and opportunity in which to arrange some I sue for it.

form of settlement and you have paid no attention Thinking this may help some one out, I am

to my requests. Sincerely,

If you do not do something with this account ALEXANDER BARCLAY.

inside the next thirty days I promise you I will, The Doctor incloses a set of five slips,

and you know I have always kept my word with

you. printed in plain type on paper of different The laws of this state permit a doctor to sue colors, with a small number, 1 to 5, at the an account and obtain judgment. All the court bottom of each. No. 1 is white, 2 salmon,

costs are added to the original bill and must be

paid by the debtor. 3 pink, 4 yellow and 5 blue. Here is the

A judgment when entered takes precedence over text on each, in consecutiv order:

a garnishment no matter how large or small the I try to send out statements the first of each

amount, and your wages can be collected at any month for services rendered.

time until the judgment with all court costs In addition to the practise of my profession, I

attacht is satisfied. am my own hired man, bookkeeper, etc., and my

Judgments may at any time be advertised in the time is not always my own. I find that I make newspapers for sale with details plainly set forth. mistakes in making and sending out statements,

What you do with this account in the next thirty as happens occasionally with us all.

days determins my actions in the matter after

that. If you have received a former bill you will understand the statement enclosed and this note; if

It is up to you. not, this will explain the reason for my seeming

S negligence.

A Pennsylvania brother asks about the Herewith please find statement of your account.

“Central Business Men's Association of If this is the first one you have received the fault Chicago.” You wouldn't think it, but it is is mine and is due to the fact that altho I try to an insurance company! Why should not an send statements the first of each month, I have

insurance company have a name indicating many calls on my time, am often interrupted and sometimes accounts are skipt in transferring from

its nature? And why should a concern with my journal.

a name so local reach way over into PennThe account is past due, please give it your sylvania for support or patronage? attention.

The keeping of accounts, sending out repeated A Missouri brother asks about some sort statements and collecting of hundreds of old bills, I find, is the hardest part of the practise of my

of colony advertised by a man named

Lewis. profession.

The Doctor is 79 years old and Doubtless you do not appreciate this.

does not want to sacrifice his little home, My time is not always my own, I am busy caring but his wife wants to go. He says the for the sick, I lose much sleep, my hours for meals advertising is very alluring. Colony adverare irregular and I work hard for all I earn. It is not right that a doctor must earn his fees

tising always is alluring, but the reality is many times over in collecting the account long very different. Few things are as cruel as after the memory of the service rendered is gone. to allure people away from comfortable I think this is the third or fourth statement I

homes, rob them of all they have and dump have sent you.

Please come in and arrange to settle the account.

them down amid the hardships of an un

developt community. Colonies have never I have sent you several statements of your succeeded except when based account and you have paid no attention to them. religious fanaticism. The Shakers are an

What would you think of a doctor if you sent for him repeatedly in times of need and he paid no

example of the latter. Secular colonies have attention to you?

always failed. I send out bills because I need the money. When I get a ton of coal I have to pay for it; The “Hercules Oil Corporation," of Ada, when I order a bushel of potatoes or a sack of oats

Okla., "is financed principally by druggists, it would not be delivered unless the storekeeper KNEW he was going to be paid for it. I have to

doctors and dentists.” This is quoted from pay my bills to keep my credit good.

their circular letter, which is headed “Dear Don't you have to do the same?

Doctor.” Dr. W. A. Howard, secretary and Keep your credit good with your doctor as you

treasurer of the Howard County (Okla.) never know when you may need him. He will attend you if you are known to be "good for it,"

Medical Society, got one of these letters, even if you have no money in the house. If you which he sent to me, with the following can't pay the account in full, come in and see me comment:

2.

3.

on

some

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