tical of any school that will guarantee to cure him in six weeks or any other specified time. SAMUEL D. ROBBINS.

64 St. James Avenue, Boston, Mass.

Treatment of Cystitis.

DEAR DR. TAYLOR:-Subscriber, on page 111, March WORLD, should get better results with his case of cystitis. The first step in treatment is to stop all injections into bladder. Washing the bladder when there is abundance of "mucus and pus" looks quite feasible on paper, but is not very satisfactory in actual practise.

He should supply himself with a few softrubber catheters, with short, sharp points, which pass most readily and with least friction the Dardanelles of the prostate; starting with the largest he can pass. He must use it once or twice a day when there is much pus in the urin or if patient cannot fully evacuate the bladder.

Internally he should give 5 or 8 grains of benzoate of ammonium two or three times a day, for a day or two, and follow up with 5 grains of hexamethylenamin two or three times a day indefinitly. He should gradually increase size of catheter every two or three days until he can pass Nos. 14 or 15, or even 16. In a week or two the urin should be clear, and acid and patient is cured, but not permanently, for this is a case of stricture, and he must avoid cold and wet, and pass a large catheter once a week or two weeks as long as he lives. The patient must be taught how to pass the catheter and he can have a long and comfortable life. I have in mind just now a man who died at 78 and for 20 years never passed a drop of water except by J. MACKAY, M.D.

catheter.

St. Catharines, Ont., Canada.

Eugenics.

EDITOR MEDICAL WORLD:-In many of the journals of late there have appeared items relating to eugenics. There seems to be quite a deal of enthusiasm developing over the matter, and a good many prominent individuals are advocating the ideas embraced under this term. For this reason, and since it seems or is claimed to relate to a forward step in the march of humanity, we may look into the matter.

Our first inquiry is, what does eugenics stand for? What does the term mean? Quite readily we get the reply-it is the better borning of better children. That this is desirable we readily admit, but how is it

to be brought about? Here, most unfortunately, there is a pause the advocates seem a trifle misty as to the means to be employed to secure the desired results.

One principle all admit, that no man should be a father who is not fitted bodily and mentally for such a privilege. One adds as a corollary that every woman has a right to decide who shall be the father of her children, and to know that he is fit for paternity. We do not like to seem in opposition to such a sentiment, or to anything our women really desire; but let us see how these propositions work out in actual life, under our present system of society.

We will suppose we are dealing with a community in which are to be found 100 marriageable men and as many like women. Study the men, and we find that one-fourth of them, 25, are unfit for fatherhood thru disease, intemperance, bad habits or temper

they are syphilitic, tubercular, neurotic, alcoholic, brutal, possest of traits that surely should not be transmitted to posterity. Of the remainder, 50 are indifferent, commonplace, with no very bad or very decided good traits. The others are better, and of them 5 are distinguisht by desirable characteristics that might with advantage be transmitted. One for manly strengtha Hercules; one for beauty-an Apollo; one for brains-a Jove; one for ingenuity -a Vulcan; and one for wit-a Mercury.

Of the women, likewise 25 are diseased, deformed, neurotic, or in other ways so obviously imperfect that it is desirable that they should not reproduce their failings. Seventy are wholesome, healthy animals, without so much wit, but very good ground in which to plant the seed; leaving 5 who present really superior qualities.

Is reproduction to be limited to these 10 superior individuals? It does not follow that their progeny must be superior to the general run-in fact, the sons of great men are so generally bad that the instance of the great Pitts is quoted as a rare exception. Moreover, if the women are neurotic in the sense of being geniuses, or extra sensitiv, they are not good breeders with any male. Rather should the great men mate with the healthy, non-mental animal type to get good children. Who is to decide? Are the few normal ones to be the only producers?

But suppose each woman is free to choose the man whom she wants to be the father of her children—and several choose

the same man! If there are more healthy women than men, how are we to act? What becomes of the men and women who are rejected as unfit-are they to live single all their lives? Who is to support the extra women? For in the analysis of society every man is supposed to support one woman and her children. Is he to do so and see another man father her children?

Primarily women marry for supportwitness how a wealthy man is run after. She seeks to render her bread-ticket secure first; the rest she leaves for the future. Did any woman ever consciously select a husband for his fitness to be a father to her children?

There is a cold-blooded scientific way of looking into this matter that disgusts one. Society cannot be represented by a bull with a herd of cows. The greatest perfection of offspring has not been derived from any such deliberate way of selecting parents. It comes rather from those cases where a man has been carried completely off his feet by a wild surge of desire for one and one only woman out of all the world's millions. Under the sweep of this overwhelming passion he has cast off the accumulated culture of the race, in its progressiv course of millions of years, and reverted to the cave man, who grasps his mate and carries her off by force, unasking; while the same passion paralyzes her resisting powers and leaves her his not unwilling prey. Most women dream of being so loved; some realize it. From unions where every consideration of policy, duty, religion, convenience, has been swept away by the flood of passion, have come some of the world's greatest, the Charles Martels.

The liberation of woman to choose the father of her children is a dream, an impossibility. It would have to begin with the abolition of marriage; for the obligation of the husband to support his wife carries with it the exclusiv privilege of begetting her children. The choice of the woman in her youth would not be that she should make in later years; and we would see for every new cycle of thought and feeling a new mating desired by her.

I am carrying this matter out to its possibilities, because these movements_never stop just where we choose. The French Revolution did away with abuses far beyond any known to-day; but it did not stop where the originators intended, but ran away with them. It is easy to say that only obvious abuses should be abated, but are

we all agreed as to what are abuses? Suppose we say that syphilitics, tuberculous, cachectics, insane, imbecil, criminal, alcoholics, should not marry. How about the neurotics, the unsteady genius, the cruel and brutal, the epileptic, the deaf, dumb, blind, lame, rachitic, the debauchees of both sexes? The crooked backs, bowlegs, unsymmetric, weakly, bad tempered, jealous?

How are we to prevent them procreating? It is useless to expect the rejected to voluntarily abstain-they are just the ones who could not be induced to do so. We might sever the cord for the males, and do oöphorectomy for the women-but have we any right to do so, if they object, unless breaches of law bring them within its grasp?

Altogether this eugenic idea does not seem very practical. For that matter there is mighty little that can be added to the "once-over" already given, to the man who contemplates matrimony, by the female relativs of the lady. The way a man is canvast by them would astonish him.

My youthful friend, let me enlighten you: You have found some girl rather attractiv-you haven't realized it yet, but she knows it, and so do the other women. The House of Ladies holds a sitting over you, and you are discust with a thoroness beyond your dreams. Your person is criticized the shape of your nose, the straightness of your back and legs, the way your ears stand out from your head; your early history-the difficulty your mother had in getting you to use handkerchiefs instead of the ever-ready coat-sleeve, the eruption that pestered you so long, and whether it was a relic of inherited turpitude or merely the septennial variety; your characterthe bad traits you were supplied by your father, and the saving graces contributed by your mother; your ancestry-the red nose of your great uncle, the duel fought by another relativ, a sea-captain. Here the women glance at the girl, but she is engrost in the acquisition of a new crochet stitch, and apparently oblivious, so with lowered voice the woman continues:-"What her husband objected to was the Captain's sonnet to the little curl behind her ear."

The girl gives no sign of hearing this, but that night she goes to bed with a little kid curler applied to the wisp of hair behind her ear.

Meanwhile the ladies discuss your prospects-how much money you will have, make or inherit; your disposition-whether

your liberality is apt to degenerate into prodigality, or your economy into parsimoniousness; your habits-how you pick your teeth with your penknife, neglect your linen, and let your shoe-heels go unpolisht; your morals - Oh, believe me that girl you are trying to impress knows a whole lot more about you than you know of yourself.

Say, folks, don't worry over eugenics. That has been and is being seen to right along, with a thoroness of detail your eugenic advocates have not as yet even distantly approximated.

Chicago, Ill.

WILLIAM F. WAUGH, M.D.

Turtle Fingers.

EDITOR MEDICAL WORLD:-Inclosed find photograph, taken with a small camera, of Mr. A., who is an Austrian. Age, 38. Married, 3 children. Weight, 207 lbs. Never has been sick in his life. Machinist and steel-car repairer. On November 3,

1914, he was accidentally struck on the back of the left hand with a sledge. He came to me at this time for treatment, and I noticed the peculiar development of the distal phalanx of each finger. Thinking it would be interesting to you, I requested Mr. A. to let me have the photograph.

His father and two brothers also have the same condition, and each member of the family was normal until they were about 15 years of age. At the time they reacht the age of puberty the fingers began to enlarge.

The fingers are healthy and strong. He says the

members of his family call the fingers "turtle fingers" because they look like the head of a turtle.

If Darwin was living I am sure he would be interested in this man's fingers. Cleveland, Ohio. C. E. HOOVER, M.D., Surgeon L. S. & M. S. Ry., Cleveland.

Tact and Technic.

EDITOR MEDICAL WORLD:-I want to say a word to "P. W., Kan.," who wrote, "Remuneration of Attending Physician in a Surgical Case," as I know he is both young and inexperienced and I am old and experienced (over 40 years in the trenches).

1. He made a grave mistake to go to visit any patient in his shirt sleeves and without a hat. It lowered his dignity and cheapened his services. The surgeon who came and saw and conquered" had a hat and coat on. Now, never do that again.

2. If you cannot do this work (surgery), go and learn how to do it; but if you don't do that work with a surgeon who is at least a gentleman and, tho he don't divide fees with you, will treat you right; i.e., "does as he would be done by."

3. You made a serious mistake to try and collect $75 when the patient had paid the surgeon. The best thing for you is to do this yourself, start a small hospital, take your patients to it, and if you need some physician to assist you, send for one and both of you operate and you take care of the patient, and in that way you will make money and become famous. Tell your patients that it is dangerous to drag them all over the country if they need an operation.

The writer of this has been a country doctor and knows the ins and outs of the game. He is called a successful man and fully realizes that no man can win who is simply a guide board in his country pointing to this, that and the other physician. The advice I am giving you has cost me thousands of dollars, heart aches and no end of worry; so don't do the way you are now doing.

Another thing: don't, for one moment, think that you can't do good work anywhere on earth. The writer of this has done surgical work, and good work, in frightful environments. The Mayos have taught the world that a city is not necessary to success. McDowell was a country doctor. So was Jenner.

Honor and fame from no conditions rise.

Play well your part; there all the honor lies. All of this may or may not appeal to you now, but forty years from this time you will agree with me, but when you are outdoors, wear your hat and coat and a clean collar every day.

ŎLD SCOUT.

Difficulties of Keeping the Record. DEAR DR. TAYLOR:-I am neither a writer nor an orator, but if I could speak with the tongues of men and of angels I would certainly make myself heard in no uncertain tones in regard to my opinion of the construction of the Harrison bill by the internal revenue commissioner. I can simply say that for the bill itself I have no word of complaint to make. But how to comply with the ruling of the revenue commissioner is a quandary difficult to evolve from. To do so means more trouble and time than I have to spare, and not to do so means suffering and inconvenience to my patients. My practise extends fifteen miles from my office,

and I am fifteen miles from the nearest drug store, so prescribing is out of the question.

I started on my rounds this morning and the first patient I had was a little boy with a dry, hard cough, convalescing from catarrhal pneumonia. A drop or two of laudanum, with spirits ammonia and glycerin with each dose, would just have met the indications. But this would have meant carrying my government record along, and I didn't have it. So I substituted, of course, to avoid the extra trouble of keeping account of a few drops of laudanum.

My next patient was a case of grip, with high fever, very hot skin and dry tongue. My first thought was a dose of Dover's powder and calomel would be just the thing. But I had no scales with me, so how could I weigh the few grains of Dover's powder and keep account of it?

Then I met a case of inflammatory rheumatism and prescribed a rheumatic tablet containing t grain of codein each, and markt that down in my mind until I could get to the office and complete the record.

It

And thus you see the trouble and inconvenience we doctors in the country are put to every day of our lives by a ruling that is arbitrary and unjust, and which no man can make me believe is in accordance with the letter and spirit of the Harrison Act. The act specifically states that where a doctor personally attends he need keep no record. further states that mixtures that do not contain more than 4 grain of morphin to the ounce or 2 grains of opium are exempt. Surely we are supposed to have as much right as the patent-medicin fakir. I have but one patient in my practise addicted to the use of opiates, and she is a chronic diabetic patient and is benefited by it. Yet I shall be subjected to all this trouble and annoyance, and my patients likewise, by the arbitrary ruling of a man who knows nothing of medical practise in the country. Shall we have any more of it? God forbid! B. H. RITTER, M.D.

McCoysville, Pa.

Against the Commissioner's Ruling. EDITOR MEDICAL WORLD:-Many good people seem to think Congress "overloaded the gun when the antinarcotic law was passed. This law is a long step in the right direction, but in some respects it is a hardship on the country doctor. But the good that this law will do may be sufficient to justify the trouble and inconvenience it causes. If there had been a few good doctors in Congress, especially doctors who furnish their own medicins, they could have suggested an amendment which would have been of much benefit to the country doctor and to his patients. To many of us it seems that the ends sought could have been attained without "overloading the gun," as the law-makers seem to have done.

I have in mind a country doctor who promptly complied with the law, secured his license, made affidavit as to amount of drugs on hand, and sent money for sixty blanks on which to order drugs named in the law. He has written several letters, but has received no blanks, yet the department has his sixty cents. In the meantime the doctor's patients must suffer, for he cannot secure the drugs without violating the law. This is only one of quite a number of "weak" places in the law.

Just why small doses of Dover's powders is included in this law, and other drugs far more deadly exempt, is something many of us cannot

understand. A country doctor may see a patient, leave necessary medicin and should accident happen to the medicin, or should the patient require more medicin of the same kind, the doctor must go to. considerable trouble to comply with the law. A busy doctor with half dozen patients in his office, and others at the 'phone, has little time to make a record every time he gives a small dose of Dover's powder or other absolutely harmless dose. But we must comply with the law, and in due time perhaps it can be modified, and the most objectionable features changed. C. KENDRICK, M.D.

Kendrick, Miss.

[The law does not require physicians to keep the records to which so much objection has been made. The trouble is not so much an overloaded gun as an officious assumption of authority. The Commissioner of Internal Revenue demands the record. We have discust this matter in April WORLD, pages 121 to 124.-ED.]

EDITOR MEDICAL WORLD:-I notice that the internal revenue department wants to outdo Teddy the Great. He simply wanted to reform our spelling, while they want to change the meaning of plain English. Would anyone except doctors stand for it? Do you suppose they would dare to try it on the liquor interests? Would not the saloon men raise ructions if the internal revenue department tried to make laws for them? How long would it be before they were shown thru the courts that the legislature is the only law-making power in the United States? But I suppose, being only doctors, and therefor "Easy Marks," we will fall for it. I believe the new law is all right as it stands, but all wrong as interpreted by the Department. Farmingdale, N. Y. J. F. MICHEL.

Knotted Umbilical Cord; Death of Fetus. EDITOR MEDICAL WORLD:-I wish to report a case for the readers of THE WORLD. I do not think it is a very common occurrence, as this is the first case I have known of in a large obstetric experience of seven years, tho I have read of it as one of the accidents to the fetus in pregnancy.

The patient, a large, robust, healthy-looking colored woman, 24 years of age, whom I had attended during a miscarriage (at seven months) over a year ago, the cause of which I never knew, the child only living a few hours, had her husband come to my office for medicin for her. He stated that she was pregnant again and he was afraid she was going to miscarry again. The symptoms he described were those of toxemia, headache, nausea, swollen feet, etc. I sent her some saline purgativs, diuretics, and gave instructions as to diet, and askt him to bring me a specimen of her urin, which he did the following day. This was the latter part of January. I found an abundance of albumin; I gave further directions and told him to report within a few days, and he did so, saying that she was better.

On February 15th I was called hurriedly to see her, and found her in labor, the cervix dilated a couple of inches. She was having pains regularly, but they were mild, and continued so. While waiting I questioned her about her previous symptoms, and she told me that she had not felt any movements for two weeks or since her husband first came to see me. Upon examining the abdomen with the stethoscope I could not detect any fetal heart sounds. I then told them they

need not expect a living baby. Another signa foul odor-made me suspect a dead fetus. The pains were not severe at any time, and the baby was expelled almost before I was aware of it. I saw at once, as I had suspected, that this baby was dead, and upon moving it from between the mother's thighs I saw the cause: the cord, which was a very long one (probably six feet), had a knot tied in it, just one loop, about 18 inches from the umbilicus, and drawn very tight, so that the blood supply was completely obstructed. The fetus was beginning to undergo decomposition, emitting an odor, but not so very foul. The skin would slip off on handling it. Its head was soft and flabby, the bones not united.

The baby lookt to be perfectly formed, and if this accident had not happened would have lived to term, which, according to their calculation, would have been two months longer, and according to my judgment this was correct. The membranes were small, and were expelled with scarcely any blood at all. The mother has completely recovered. She had no trouble of any kind whatever.

I simply report this case because I think this is a rare accident among the many that may occur to the fetus during pregnancy. I have seen it enumerated in textbooks, as one of the causes of death to the fetus, but this is the first case I have known of. J. A. RICHMOND, M.D. Grant, Ky.

[A few years ago quite a number of such cases were described in THE WORLD. Not every physician meets with such a case.-ED.]

Birth Reports in Michigan.

EDITOR MEDICAL WORLD:-It may be of interest to your readers to know that Michigan pays the doctors 50 cents per head for all births, provided report is made in accordance with law, so that no doctor or midwife can truthfully say that they received no pay for a confinement. Also note that a prophylactic clause is printed on the blank and you will realize what a good thing it is for the eyes of our newborn babies in Michigan. I trust this may be of sufficient interest to secure a place in your journal.

solution of the specially coated pills of papain and steapsin.

Brieger (Deut. med. Woch., Nov. 14, 1912) recommends that pancreatin be given without coating, in the belief that the gastric juice does not harm it and that it will be activ when it reaches the intestin. Consequently the Carnrick Co. does not put keratin or salol coating on their digestiv ferment tablets, finding that the results are secured without it.

We have prescribed veronal in capsules coated with salol in order to get the hypnotic effect_late at night or early in the morning, and have been much pleased with the result. Dr. Waugh, in his comments in this issue, states his belief that salol and keratin coatings do not prevent dissolution of the capsules or pills, but our experience with the veronal leads us to believe that it does. However, the coating must be thoroly applied, as any little defect in the coating will allow the gastric juice to dissolve the capsule and medicin.—ED.]

1925-1930 A. D.

A Modern Fable, by E. Clair..

The beautiful town of Sunshine, stretching along the banks of the River Saco, in the mountain valley, was one of the first to adopt the system of town doctor. The lead in this now quite universal system was probably due to the great love and esteem the citizens had for their only physician, Dr. Trustworthy.

The Board of Health, composed of three respected citizens, had just met and re-elected the old Doctor for a term of five years, at a salary of $2,500 a year.

During the evening several villagers called to pay their respects. They had been afraid that they were going to lose the services of their faithful old physician, for there had been rumors that he was going to retire to the seclusion of his little farm. So they were in high spirits when he assured them of his decision to continue as their town physician.

As the evening wore on many of the younger citizens came in, and the old doctor became reminiscent.

"Years ago," he said, "I used to be paid for my services by whoever was unfortunate enuf to be in need of me." He continued after a moment's pause: "In those days I had many bad bills, for a great many good people, thru misfortune, were sick and needed my help, but they had no money to pay me.

"I tell you, I know what hardship and suffering some of those poor old honest souls endured. "Now I treat the rich and the poor alike, and no one owes me anything.

"I am glad that my profession has kept abreast of the times, for the system is such an advance over the old way, where those who could least afford it had to support me and my family."

Dr.Trustworthy continued to reminisce in this vein until the wee hours of the new day, and his talk was so interesting that no one realized how late they were keeping up the temperate Old Doctor.