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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.

VALENTINE'S MEAT-JUICE CO.,
RICHMOND, VIRGINIA, U. S. A.

P114

FREE TRIAL

HUSTON-BAIRD AIR CUSHION PESSARY suspended from shoulders and applied to uterus, will positively Correct Cystocele, Rectocele, Procidentia and other Uterine MalPositions. Can easily be adjusted by patient, and worn with perfect comfort. Price complete, $5; without shoulder strap, $3. We positively guarantee satisfaction. Send check with order, and if appliance is unsatisfactory after 30 days' trial, we will refund the money.

TAKE THE BLOOD

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PRESSURE

with an instrument you can depend upon to give an accurate reading. Faught's Pocket Aneroid Blood Pres sure Apparatus is the most dependable on the market. Mechanically perfect, accurate, simple, easy to use and can be applied in a moment. May be carried in the pocket. Price, including Faught's Blood Pressure Primer, 120 pages, $22.50 net. May be purchased on partial-payment turned if not satisfied after plan. Money promptly rethirty days' trial. Several blood pressure instruments, mechanically perfect, but slightly shopworn, at about one-half usual price.

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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 in April WORLD, page 127, was passed and

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

A. L. RUSSELL, M.D.,

Associate Editors.
J. C. ROMMEL, M.D.,
E. S. TAYLOR, Business Manager.

Entered at the Philadelphia Postoffice as Second-Class Matter.

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ONE DOLLAR AND TWENTY-FIVE CENTS per year, or

becomes effectiv July 1st. Cannabis indica and cannabis sativa are included with the narcotics. The minimum quantity exemptions are: Preparations and remedies containing not more than 2 grains of opium, 14 grain of morphin, % grain of heroin, 1 grain of cannabis sativa to the ounce; also liniments, ointments or other preparations for external use only excepting those containing cocain or any of its salts; also

FOUR YEARS for FOUR DOLLARS in advance; to Eng compound medicinal tablets containing not

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Philadelphia, Pa.

Need for a Just and Uniform State
Narcotic Law.

No. 5

The fight for good state narcotic laws waxes hotter. Some good bills have been introduced into legislatures, and likewise some very objectionable ones. Some of both kinds have been enacted and others have received a merited defeat. For instance, in Nebraska a bill has been passed only permitting the physician to personally administer narcotic drugs. These drugs cannot be sent by a messenger and cannot be left with a patient. When not administered by the physician they can only be had by prescription. Our Nebraska physicians have not been watching their legislature as we counseled them to do.

In Vermont House Bill No. 68, mentioned

over 1/20 grain of morphin, 14 grain of codein or any of their salts except heroin, to each pill, powder or tablet. The physician, dentist or veterinarian must keep a record (except of above exemptions) of every dispensing of the affected narcotics in a suitable book, and the names and addresses of all patients to whom he dispenses these narcotics.

In Connecticut the bill to require a physician to be a licensed pharmacist if he would dispense has been withdrawn, evidently in response to our work by personal letters to the physicians in the Connecticut legislature and to our subscribers thruout that state.

Chloral is a drug that is being included in the state narcotic laws. The druggists' "model law" (mentioned more fully hereafter) excludes from the working of the law derivativs which do not possess "habitforming properties." There is actually no telling what drug has habit-forming properties until it is given extensiv and continued

use.

All the habit-forming drugs were not known so to be until so used.

Dr. Edwin H. Moore, of Pittsburgh, Pa., believes that alcohol should be included in the narcotic law. He writes us as follows:

Suppose THE WORLD "family" demand the abolishment of the saloon and allow spirituous liquors sold only on the prescriptions of legitimate physicians-prescriptions not to be refilled. Have this law incorporated as an amendment to the Harrison narcotic law. This would be much easier than the passage of a new and special law. In this case the physician becomes the judge, but he judges the actual requirements of each individual case, and could therefore hold the applicant under perfect control.

There is too much haste in the effort to

enact antinarcotic legislation in the states, and as a result much ill-considered, unwise and unsatisfactory legislation may be put on the statute books of the various states that may have to be repealed or modified sooner or later. More care, thought and advice should be taken before these laws are drafted and finally presented to legislatures, and similar proceedings should be followed by the legislators before attempting to pass them. The usual rush procedures in legislativ bodies are not conduciv to proper lawmaking.

We have for about two years been endeavoring to prevent the placing of any restriction upon the medical profession that would unduly handicap it in the pursuance of its legitimate and humane practise, and to conserve, so far as possible, the ancient privilege of the profession to dispense the drugs which the patient requires for his recovery from illness.

Our principal thought is to protect most efficiently the public welfare. We have very zealously urged the enactment of laws which we believe to be in the public interest. And this is a subject that is of fundamental importance to the entire medical profes

sion.

One of the main objects which physicians are of necessity required to combat-and to combat very vigorously-is a clause or paragraf preventing dispensing of remedies. In some bills introduced into legislatures there has been no question about the prohibitiv feature of the bill, as in the one in Nevada, mentioned in December WORLD, 1913, page 481. In other bills the most that was aimed at along this line was to make dispensing troublesome to the doctor, so that he would write prescriptions by preference. This would make big profits for the druggists; hence druggists are doing their best to advance such measures.

The crying need of the hour is for a fair, just and equitable state narcotic law, in harmony with the national law, that can be enacted uniformly in all the states, and one that will control the distribution of narcotics in such a way as will permit their proper use and prevent their abuse. We publisht a uniform law in our February issue, which has since been modified by agreement with other physicians to permit of the dispensing of a limited quantity of the narcotic drugs without record by the physician. This seems to us to be a very effectiv and very fair bill and permits the physician to administer such remedies as he deems necessary and yet

controls and prevents the unlimited distribution of narcotic drugs.

The druggists must surely admit that it would be difficult to pass a law anywhere that would prohibit dispensing by physicians. Their association has tacitly admitted it by incorporation in a law which they offer, in N. A. R. D. Journal for March 25th, pages 1229 and 1230, as a "model narcotic law" a clause in section h excepting from recording amounts not more than 6 grains of opium or the extractiv of 6 grains, 1 grain of cocain, 1 grain of morphin, 4 grains of codein, of 1⁄2 grain of heroin or any salt or derivativ or synthetic substitute for them. But while excepting these amounts from recording, they have a clause at the end of this section that requires the drugs so dispenst to be placed

in a container which is labeled with the serial number of the prescription or the name of the substance, the date when dispenst, the name of the person for whom intended, the name of the prescriber

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To this latter we most seriously object. The idea of placing the name of a narcotic drug on a container given to a patient is radically wrong. Patients should not know when they are taking narcotics. Without such information they will not know what drug to buy, if it were purchasable, should they manifest any desire to continue the use of the remedy afterward. Druggists have nothing to gain by any such clause.

Another very fundamental fault to be found with the druggists' bill is that of placing the enforcement of it in the hands of the state Board of Pharmacy of the particular state where enacted. We have always objected, and still do, to placing physicians under the control of a Board of Pharmacy. This is strictly a matter for the Board of Health to handle. It is being done by the state Boards of Health in New York, etc. Physicians should not be placed under a Board of Pharmacy.

It might be a very satisfactory arrangement to have the state Board of Health enforce the law as relating to phsyicians, dentists and veterinarians, and the state Board of Pharmacy enforce the law as relating to druggists.

The uniform law that we advocate, allowing for the dispensing of limited quantities of narcotics without the necessity of keeping a detailed record; avoiding any unusual labeling or special container; and placing the enforcement thereof in the hands of the state Board of Health, a body fully

capable of handling the situation properly, is the best model law that we have seen.

Your Rights are Threatened.

Is the medical profession facing a danger? Has THE WORLD been sending forth false alarms? Is it true that our friend and coworker, the retail druggist, is plotting against us and our patients? To show the trusting physician that he sleeps in false security, we invite his attention to the following editorial appearing in the N. A. R. D. Journal for March 25th.

First, what is the N. A. R. D. Journal? To spell it out, it is, National Association of Retail Druggists' Journal. On the title. page these words appear prominently: "The Official Organ of the National Association of Retail Druggists." This removes all doubt of our statement that it is the official organ of the retail druggists. Realize that it speaks officially for them. It is publisht every Thursday at 122 South Michigan Boulevard, Chicago. Subscription price $2 per year; single copies, 10 cents. (This is a free advertisement.) Further, we will say that doctors could read it profitably, both on account of its instrinsic merits, and for the purpose of learning directly from headquarters just what the druggists want to do to" all doctors who venture to exercise their ancient privilege of leaving medicins with a patient.

Here is the editorial, exactly as it appears in the above mentioned publication, unabridged, with italics exactly as in the original. Read it carefully, and read and discuss it at the next meeting of your local medical society.

PROPAGANDIC WORK AND THE

DISPENSING DOCTOR.

What is the matter with the retail druggist? To answer this question in all its various phases is perhaps difficult, yet the greatest foe of the retail druggist is that individual himself, because he is, collectively, sound asleep; he is not, as a rule, awake to the benefits of being an organization man; he has no laws to protect his profession, and as a result the dispensing doctor, the medicine pedler and other competitive agencies are riding roughshod over his domain, and stealing his bread and butter.

How often must this statement be made before the retail druggist will get its meaning? Is there any way in which the retail druggist's eyes can be pried open so that he can see that his danger and the danger to his profession lies in the direction of the aggressive operations of the dispensing doctor and the medicine pedler rather than in the direction of cut prices, shorter hours, and all such minor and insignificant evils? Is the retail druggist such a short-sighted individual that he can only see the cash register contents of to-night, to the exclusion of

all factors as to where the receipts will come from to-morrow, or next year, or ten years hence?

Fight Cause Not Symptom.

There is no use in fighting symptoms. If an intelligent physician would fight disease by fighting symptoms only, his patient would soon die, because the disease itself is not checked in the least. Given a case of diphtheria with only headache and sore throat as symptoms, it would be easy to treat the headache for a few days and gargle the throat the same length of time, and then the undertaker would remove the effects of the horrible mistake. And that is exactly what the retail druggists are doingthat is, those who are not entirely asleep. There is only one way to cure any ailment and that is to get at the bottom of it, get at the prime cause and rout it out, then the disease is cured and will stay cured, and all the previous symptoms will disappear of their own accord, because there is no longer the disease that caused the symptoms.

The disease that is undermining the vitality of the profession of pharmacy, and of medicine as well, are the aggressive operations of the dispensing doctor and the medicine pedler. If the retail druggist would only rub his eyes, get paper and pad, and figure out what he loses from cut prices and from long hours, he would probably be astonished; yet if he would figure further and calculate the loss that is his through the agency of the dispensing doctor and the medicine pedler, his astonishment would turn to a near case of heart failure. And then, if he had any gumption in him at all, he would see his brother druggists and tell them about it; he would not rest, and his brother druggists would not rest, until every druggist in his state knew it; and then they would not rest until they had appointed a large and representative committee to go before the state legislature that would not leave the legislative halls until there was upon the statute books a law that would make it a criminal offense for anyone to dispense, sell or give away any kind of medicine for the cure and alleviation of sickness and disease, except in welldefined cases of medical emergency unless he complied with all the requirements of the law regarding the practise of pharmacy by pharmacists.

A Real Protective Law.

There would be no "ifs," "buts," "provideds," "excepted," or any other kind of tomfoolery in this law. It would mean business and it would mean protection. It would tell in plain English what's what, no matter who got hurt. Such a law would at once revive the rational practise of medicine and the pharmacists' art, but better still, it would give the public the protection it should have, but to-day woefully lacks.

This is no time for procrastination, delay and argument, just because there are some dispensing doctors who are high class, capable and intelligent. These will not be hurt any more than all doctors are hurt by the operations of the new Harrison antinarcotic law, and this law has no such thing as an "if," or an "except" in it. This law says "every person," and violation means a $2,000 fine or imprisonment. And a similar law can be enacted to protect pharmacy.

It seems puerile when some pharmacists plead for the dispensing doctor; not that it is not human to do so, but they forget their greater responsibility to the people on the ground of "the greatest good to the greatest number." The same reasoning, applied to the other shoe, would pinch like sixty; for are not all familiar with the all-too-patent fact

that a comparatively few black sheep in the ranks of the retail druggists have brought an odium upon the entire profession and that pharmacy has suffered untold loss because of it?

Now, on the other hand, the comparatively few in the ranks of the dispensing doctors are the good ones, and these, even with the added strength of the entire body of prescribing physicians, are not sufficiently awake to this dread evil, to offer the aggressive dispensing doctor and medicine pedler any fighting opposition.

Cents or Dollars.

Taken all in all, pharmacists seem to be taking a "penny wise and pound foolish" policy. If one considers only the financial side of it, what does he find? He finds that the average druggist loses about 63 cents a day in profits because a few druggists sell at cut prices. However, the aggressive fight that the National Association of Retail Druggists has waged for years, which finally resulted in the introduction of the Stevens price maintenance bill in Congress, will prevent any further loss in this direction if the united body of druggists will fight hard a little while longer and push this bill until it is enacted into law, and then see that it is made use of.

With this accomplished, retail drugdom may well pat itself upon the back; for it has made a hard fight against powerful opposition, and it will win out, if retail druggists keep up the fight.

But, here is the point: If such a determined and well-directed effort can be made by a united body of druggists to regain profits of 63 cents a day (or whatever the amount may be), why is not a ten times greater effort made to regain profits of $6.30 a day that is now lost through the equally unjust actions of the aggressive dispensing doctors and medicine pedlers?

If druggists will but remove the cobwebs, their vision will become clear and normal. A little work with pencil and paper will show the loss from these two sources alone. The calculation will be somewhat like this:

Four medicine pedlers, operating six days a week in any territory, an average of three times a year, at $25 a day sales..

Two dispensing doctors, each selling $3 worth of medicine a day, every day in the year.

Total.....

$1,800.00

2,190.00

$3,990.00

This means that the druggist loses very nearly $11 in sales every day on account of this unjust and harmful-to-the-public competition. These figures are very conservative, as most druggists know, some medicine pedlers easily cleaning up sales of $40 and $50 a day, traveling their beat three times a year and requiring six days to visit the territory ordinarily contingent to one druggist. As far as the dispensing doctor is concerned, there are few who do not make sales of more than six or seven dollars a day, if one is to judge by their purchases from the physicians' supply houses. And this calculation does not embrace the drug selling of grocers, barbers, blacksmiths, beauty parlors, and so on.

Curbing Too Much Freedom.

This is a free country; the constitution protects its people from unjust prosecution; and so on and so forth. But the action of some of the people is altogether too free, mostly because they are money mad, so Congress passed laws to curb this unbridled freedom. One of these of recent enactment is the foods and drugs act of 1906, the great fault of which

lies in its exceptions which make it of little value as far as real protection to the public is concerned. The Stevens bill, when enacted into law, will also curb a considerable portion of this unbridled freedom. But the druggists should take their cue from the recently enacted Harrison antinarcotic law in shaping legislation for pharmacy's protection.

Legislation that will be truly valuable must be founded on the fact that the evils which pharmacists complain of are a true menace to the public health, and the druggists must prove it. The passage of the law then becomes a comparatively easy matter. It must be directed against all agencies that contribute to this menace, and there should be no exceptions that will afford loopholes for evasions. If a pharmacy law is to be of any use at all, that is the least that it should provide for.

The attorney of the N. A. R. D. has said. that his organization was "out to get the dispensing doctor." That is as plain as day in the above editorial. And what does "medicin peddler" mean in the above editorial? Is it a slur at physicians who carry a medicin case?

It is well known that homeopathic physicians supply most of their medicins directly to their patients. This gave them a great advantage over the "old school" doctors, and the homeopathic medicins were not disagreeable to the taste. Manufacturing pharmacists aided the regular profession to meet this competition by offering to physicians their accustomed remedies in elegant and convenient form. Other things being equal, patients will prefer a doctor who will supply his remedies except when something unusual is required, to a doctor who sends his patients to a drug store for every little thing required. The cost to the patient in the latter case is greatly increast by the profits of the druggist. Shall the doctor be compelled by law to thus tax his patients for the benefit of the druggist?

This is a matter of fundamental right. And in the case of rural practise it is a matter not only of convenience to both the physician and his patrons, but frequently it is a matter of great gravity concerning the safety of the patient.

Do you want to wake up some morning and find that your hands are bound, concerning this service to your patients? Would it not be better to wake up now, to this grave danger threatening the medical profession of every state in this country, and thus ward it off? Arouse and act!

Ammonium chlorid is too often overlookt in both subacute hepatitis and in chronic torpor of the liver. When given in solid or in pill form, sufficient liquid should accompany administration to protect the membrane of the stomach.

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