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 physicians to write to their congressmen and

as

Sceond-Class Matter.

that

con

senators to in the bill.

physicians responded to our requests and a C. F. TAYLOR, M.D., Editor and Publisher. number of medical societies also became A. L. RUSSELL, M.D.,

active in the matter. As a result of the enJ. C. ROMMEL, M.D.,

Associate Editors. E. S. TAYLOR, Business Manager.

deavors of all who energetically interested

themselves in this work, a bill was passed Entered at the Philadelphia Postoffice

that was satisfactory to everybody connected

with the legitimate handling of drugs. SUBSCRIPTION RATES: To any part of the United States or Mexico, ONE DOLLAR per year, or FOUR

Still, a few physicians are opposed to YEARS for THREE DOLLARS in advance; to Canada ONE DOLLAR AND TWENTY-FIVE CENTS per year, or

what seems to them an unnecessary intruFOUR YEARS for Four Dollars in advance; to Eng. sion on the practise of the healing art. Docland and the British Colonies, FIVE SHILLINGS Six PENCE per year; to other foreign countries in the

tors of the right kind do not dispense narPostal Union, the equivalent of_5s. 6d. Postage free. Single copies, current issue, Ten CENTS; previous

cotic drugs to habitués. These are the ones issues, from 'TEN to Twenty-FIVE CENTS. These who consider the Harrison law as a mon

rates are due in advance. HOW TO REMIT: For their own pro

we advise

strous imposition on a beneficent profesthat our patrons remit in a safe way, such as by sion, and are righteously indignant over it. postal money order, express order, check, draft, or registered mail. Currency sent by ordinary mail But as is the case with so much of our lawusually reaches its destination safely, but money so sent must be at the risk of the sender.

making, the good must suffer because of the We cannot always supply back numbers. Should a num- evildoers. Few, if any, of the panderers to

ber fail to reach a subscriber, we will supply another, if notified before the end of the month.

the dope fiends are within the medical proNotify us promptly of any change of address, mentioning both old and new addresses.

fession, and those that are should be exIf you want your subscription stopt at expiration of the pelled. The trouble really is caused by the

time paid for, kindly notify us, as in the absence of such notice we will understand that it is the sub- sale of the drugs thru persons having access scriber's pleasure, the subscription be tinued and we will act accordingly.

to the narcotics in a surreptitious manner. Pay no money to agents unless publisher's receipt is given.

We can understand how a great many ADDRESS ALL COMMUNICATIONS TO "THE MEDICAL WORLD”

doctors feel resentment to the bill. Never1520 Chestnut Street

Philadelphia, Pa. theless, we counsel physicians to obey the

law in its entirety and endeavor to stamp VOL. XXXIII JUNE, 1915

No. 6

out the narcotic evil. As we have said, it is

a necessary law and all physicians should be The Harrison Law and the Commissioners' willing to shoulder a little burden for the Rulings.

benefit of mankind. We have, indeed, been Opposition to the Harrison narcotic law shouldering a great part of humanity's burhas developed quite considerably thruout the den, so let us bear a little more, unflinchingly medical profession; not, however, because of and ungrudgingly. the law itself, but on account of the obnox- We do not wish to be understood as faious rules formulated by the commissioner voring the rules formulated by the commisof internal revenue and foisted upon the sioner of internal revenue. We do not approfession in the guise of law. The Harri- prove of them, and consider that they are son law was originated in a humane effort to unjust and not warranted by the law. But stop the nefarious traffic in narcotic drugs we recommend that doctors observe them that was destroying thousands of human until they are rescinded by the commissioner beings annually. As such it was entitled to or congress. the approbation and assistance of every- Several medical societies have passed body. We indorsed the Harrison bill, after resolutions requesting the repeal of the law. it had been properly corrected so as not to The circumstances are such that the law interfere unduly with dispensing by physi- should not be repealed. We feel that no cians, and recommended its passage, urging good can come of antagonizing the law,

a

when the real objection is to the ruling of of their dope, are terrorizing certain sections the commissioner.

of that city. Dope fiends of El Paso have Some writers who had not paid the at- crossed the river to Juarez, Mexico, because tention they should before putting their of the inability to secure dope in Texas. views into print are counseling physicians to One failure of our antinarcotic laws is the accept the commissioner's rules as strictly absence of power to commit the habitués to necessary and justifiable. These are not an institution where they will be compelled written by physicians who are compelled by to remain until cured. Another failure is reason of their geographic situation to dis- the absence of proper public institutions for pense remedies, or they would see the matter that purpose. There are many good private in a new light. Those who wrote prescrip- institutions where these cases may be tions before will continue to do so now and treated; but commitments cannot be made are not troubled by the new law. But physi- by the courts except in a few states. The cians practising in country districts are com- legislature of Florida has a bill in its hands pelled to dispense remedies, and the needless to provide for establishing hospitals for the burden of keeping detailed records becomes commitment and treatment of narcotic haonerous.

bitués. In Pennsylvania the habitués who The great majority of physicians are re applied for treatment and refused to stay a quired to dispense drugs on their rounds of sufficient time were masters of their own visitation of the sick, and these are the ones destiny and are still abroad seeking the narto be considered most in the workings of the cotics. Laws are needed to compel these law.

narcomaniacs to be treated until well. The journals of the various medical or- Many methods of treatment of narcotism ganizations are the leaders in the effort to have been publisht in this and other medical have the profession accept the commission- journals, but we believe it is better treated er's rule without a murmur. We have al- in a hospital or sanatorium where special atways stood by the dispensing physician, for tention is given to this class of cases, and we know his problems.

where the patients can be under watchful The idea of presuming that the commis- care day and night. Physicians who have sioner of internal revenue is infallible and devoted years to the treatment of such cases that he can do no wrong is too preposterous are better able to treat them than those who to think of. Yet that is the position taken have not treated that class of cases. by those who would have the profession ac- In these days, when any physician may cept his rules without question. And they be called on to look after a person who has condemn physicians who dare to object. been addicted to the use of the narcotics and The doctor must preserve himself if he now finds it impossible to get the drugs, it would be of any benefit to his community. may be necessary to undertake the treatment He cannot preserve himself if he is bur- of the case at his home. But if circumdened with too much labor. It is to avoid stances permit, it is better to send him to this excess and unnecessary work of record- an institution. ing remedies dispensed that these physicians are raising their voices.

State Narcotic Laws. Let us briefly consider what has been the By this time most of the state legislatures effect of the law. Philadelphia has its slum, have adjourned. An enormous number of called "the tenderloin." In that district narcotic bills has been introduced into them some druggists and a number of dope ped- and been the bone of contention between

a dlers sold narcotics unrestrictedly before the doctors and druggists. As a result, many enactment of the Harrison law. Since of the bills were deadlocked. March 1st, according to the police records, In Colorado House Bill No. 249, which the use of these drugs has been reduced by was a model uniform state narcotic law, was 60%. What is being sold now is the supply enacted. It is in conformity with the nalaid in before the Harrison law went into tional narcotic law and simplifies the work effect and the police estimate that it will be of Colorado physicians. It is a fair law, consumed within a month, after which no just to all concerned, and worthy of emulamore will be available. Some of the victims tion in all our states. tried to substitute quinin, but it did not In Connecticut the situation at the beanswer the purpose.

ginning of the legislative session looked It is reported in the newspapers that drug almost hopeless for the physician. The habitués in New York, suffering from lack druggists had a bill entered that required

physicians who would dispense any medi- law a method of treatment for any disease, cins to take an examination and secure a for what is recognized as good treatment license as pharmacists. Another bill called to-day may be overturned to-morrow by for a detailed record of all dispensing by new investigations. “Statutory regulation" physicians. We think we can reasonably of treatment will prevent necessary investifeel that it was due largely to the great gations in treatment. The method is wrong efforts of this office in warning the profes- in principle and opposed to the best public sion in Connecticut by editorials and many interest. Any bill with any such provision letters to the physicians thruout that state in it should be defeated on sight. that these bills were dropt, and eventually We understand that physicians can regisa satisfactory law was passed that does not ter as pharmacists in Florida on the payment unduly interfere with dispensing by phy- of $15. sicians.

In New York the Bloch amendment to the In Ohio, according to information we have Boylan law reduces the minimum quantity received, two conflicting laws have been for exemption of heroin from 14 grain to passed, one being the Hay narcotic law, % grain. Physicians may dispense the narHouse Bill No. 305, and the other a so-called cotic remedies only after a physical examinapoison law, House Bill No. 132. The for- tion of the patient. Physicians are required mer bill is a splendid uniform state nar- to keep a record of all narcotics dispensed. cotic law, in consonance with the federal law In Illinois Senate Bill No. 302 requires and will be acceptable to the physicians of prescriptions to be written in English. This Ohio. The latter bill, No. 132, was offered might give rise to some confusion. If by in the guise of a "poison” law, but is a “English” is understood words defined in an narcotic law and does not permit dispensing American dictionary the end desired might by physicians unless record should be made not be attained. Aqua is in Webster's dicin every instance, whereas the former law tionary; hence is an "English" word boris fair to physicians. These laws conflict in rowed bodily from the Latin. We might their bearing on physicians. We are sug- find a great many more words there that are gesting a new law to repeal the conflicting both English and foreign. If the "English" sections in the latter law.

prescription is intended to be read by the In Florida House File No. 416 is a nar- recipient, how about ordering Italian precotic law aimed to prevent dispensing by scriptions for Italians, Spanish for Spanphysicians.* Section 3 permits the physi- iards, German for Germans, Russian for cian, dentist or veterinary surgeon to "pre- Russians, Scotch for Scots, Yiddish for scribe or administer," thus:

Jews, Chinese for Chinese, etc.? If the drug

gists hope that such a bill will enhance preSECTION 3. Any duly licensed physician, a dentist or a veterinary surgeon may prescribe or

scription writing we think they are mistaken, administer any of the before-mentioned drugs or

for doctors will dispense instead of write. preparations or their derivatives for the treatment The profession thruout the country is or cure of diseases in the course of their [? his] gradually awakening to the necessity of professional practise ;. Provided, that such phy- being prepared to oppose bills emanating sician, dentist or veterinary surgeon shall not prescribe, dispense or furnish any of the before

from the druggists and to advocate proper mentioned drugs to any person who may be ad- legislation affecting physicians. Things do dicted to the habitual use of these drugs * * *

not get done by themselves. If anything is No permission is given him to dispense to be done, it must be done by somebody.

, and he is strictly ordered not to dispense to

Committees of medical societies composed habitués, except under certain conditions as of physicians are not usually successful in to treatment, etc. This method of "treat- handling medical legislation. This is being ment by statute” is the newest wrinkle in recognized more and more. When this kind the narcotic law schemes of the druggists. of work has to be attended to, specialists Just how far the druggists will attempt to

should be secured for it. This is an age of carry such "statutory treatment" is beyond specialism. Every man who has learned to our vision. We would, indeed, be glad to do some particular thing is a specialist, see the ultimate limit. It would be delicious When a person is sick he calls in a physician. reading. It is utterly foolish to enact into When physicians seek to have proper med

ical legislation enacted they should engage *Our latest information is to the effect that this bill a lawyer to look after it. The Western was passed by the legislature and is now before the Medical Review for May, 1915, suggests to governor for his approval. We do not know if it has been amended or not.

the members of the Nebraska State Medical Association that such be done by that asso- uses of sunlight and other forms of radiant ciation.

light. The treatment of tuberculosis by Legislative committees composed of phy- cold air and sun's rays was depicted and sicians can look after medical legislation in the splendid results achieved were stated. a limited way, but the assistance of a bright But a careful review of the work of many and active attorney is requisite. Such a man authors in this field by Dr. Charles E. Woodwill be of use in any state.

rufft leads him to believe that the sun's The druggists' program is to have passed rays are more harmful than beneficial. He narcotic laws that will prevent the dispens- says that sun baths to the naked body are ing of narcotic remedies, either plain nar- slowly going out of fashion except in cotics or mixtures containing a small quan- obesity, gout, rheumatism and sluggish tity of narcotics, by physicians. To do this

metabolism. The short rays, which always they are willing to misrepresent the medical accompany the visible light rays, are harmprofession, in order to achieve their ends. ful. They increase the pulse, respiration, By placing the blame for narcotism on phy- temperature and blood pressure and may sicians they hope to influence legislators start hemorrhages. In excess they cause successfully.

headache, palpitation, insomnia and anemia. After that is brought about they aim to

They are also harmful in general weakness pass poison laws that will prevent dispens- from any cause and in the hysterical or ing. When this has been successful they

neurasthenic. will endeavor to enact legislation that will

The treatment of tuberculosis by sunstop all other medical dispensing by physi- baths he says cannot be condemned too cians. If the latter object can be achieved strongly, tho it is highly praised by a few first they will gladly welcome it.

who get good results from the other factors This is the program that the medical pro

in spite of the injury done by the light. fession must be prepared to combat. Going

The short rays, however, are beneficial in

local lesions-injuries, ulcers, lupus, etc. to sleep in the daytime while the druggist is making his hay and feeding his helpers will

He believes, however, that the improvement not save the doctors. They must get busy

is due to the irritation produced by the now. All medical societies must have com

rays and the subsequent bactericidal effect mittees to look after this legislation, and at

of the increased flow of blood serum, and least one attorney must be engaged in each

not to any direct beneficent effect on the

body cells. state to look after the legal end. It will cost the profession money; but they have got

He quotes Finsen as stating that hair to spend it or feel the effects of their false

often grew on parts exposed to conceneconomy.

trated light. This thought has been folThe economic aspects of dis

lowed by Dr. Franz Nagelschmidt, I who pensing by the physician is another subject, which we have touched on frequently and

uses a quartz lamp, a modification of the

Kromayer quartz lamp, for the growth of may do so again.

hair on the scalp. An application of this Actinotherapy and Heliotherapy.

intense light to the scalp for a period of

20 minutes once a month has caused a full We will need to revise our views of the growth of hair to occur on completely bald beneficial and harmful effects of fresh air

heads. and sunshine in health and disease. Many protected by a layer of cotton wadding.

The parts not to be affected are of our investigators and writers have been teaching that direct sunshine is one of the

Nagelschmidt treated 200 cases of alopecia most beneficent forces of nature. It seemed

areata; alopecia seborrhoica; premature, a logical statement, for we have much evi

senile and seborrhea capitis. Nearly all dence to show that plants grow luxuriantly

these cases grew hair to match the previous in the hot sunshine, many of them failing occurred, accompanied by deep pigmenta

growth. Intense inflammatory reaction and dying without it. There are exceptions, tion. Slight cases of alopecia areata received of course, for ferns, mosses, etc., are killed by the hot sun. As a consequence of many

but one application; some cases of complete

baldness recovered after four treatments. investigations on the effects of sunshine we have been lauding the sun's rays to every- called attention to the fact that, in a person

Woodruff states that Charles Heater body for all ills, recommending them to get out into the sunshine for their health.

under tuberculin treatment ultraviolet light in adult consumptives seems to be made caused a more violent and prolonged effect, worse by sun exposure. and that in using the quartz mercury lamp Woodruff gives White of Colorado in skin affections in the tuberculous ex- Springs, Burton Fanning, Havorka and posures must be reduced one-half; the others as corroborating his view that the ordinary period of 60 seconds will cause sunlight increases temperature in the tutroublesome ulcers.

berculous, and even produces hemorrhage. Rolliers found that blonds who did not He recommends cold and shade instead. tan in the sunshine did not improve under Malgat found that if heat accompanies the sunlight baths, while the best results were light it may interfere with cure by causing secured in those who took on a heavy coat tissue anemia and that the light may cause of tan. According to Woodruff, this result general anemia. Hemoglobin is found to indicates that the smaller the amount of increase in the cold and dark, and probably light to penetrate the skin, the better the decreases with heat and light. Very likely effect. He believes tanning of the skin is light itself destroys hemoglobin, judging a protection against the sun's rays. Rollier from experiments by Haussmann** with thinks the light is changed into energy, but hematoporphyrin. Woodruff, in fact, says Woodruff declares it is only stepped down that it does. to infra-red frequencies (heat rays) in the Therefore it is the opinion of Woodruff brunets. In the blonds serious nervous that tuberculosis must be treated according lesions occurred, which Woodruff believes is to the climatic conditions in which the the usual result of intense light. He found individual and his ancestors evolved and a great many people who migrated to a to which they were accustomed. The hot tropical climate sooner or later become sun is not to be used in the treatment. affected with neurasthenia, which he at. Instead, the cold is the curative stimulus. tributes to the intense tropical light.

He believes the white race will not survive Martin du Pan || (quoted by Woodruff) tropical light and heat, and that tanning states that surgical tuberculosis in children is a protective effort of nature. The white unsuccessfully treated by outdoor helio- race, particularly the blond portion, should therapy can be cured or improved by indoor protect itself from the hot sun during sumapplications to the whole body of cooled mer, and those who do not tan in the sunlight from the 7,000-candlepower mercury shine are in extreme danger from its overvapor quartz lamp devised by Vignard of stimulating effects on the body, especially Lyons. But he found it necessary to exclude the nervous system. To a certain extent “some” of the ultraviolet rays by 4 mm. of we can become accustomed to it, but to glass. Under this light the skin rapidly what extent is not definitely known. tans, which Woodruff says protects the tissues from further injury by the short rays. The applications are made from 10

Getting Rid of Mosquitoes and Flies. minutes to 3 hours at a distance of several

Sanitary science is making progress in feet or yards. Jacques Loeb found that

many directions. One of the things that 1 mm. of glass prevented all effects on sea

has received attention is the eradication of urchin eggs of the ultraviolet light from the mosquitoes to eliminate malaria. Dr. C. A. 3,000-candlepower Heræus quartz mercury Campbell is teaching the cities of the South arc lamp, even when applied 60 minutes at

to build bat roosts. The bats are said to 6 inches distance, tho a few minutes' exposure to the naked light is lethal. Hence beings have been destroying bats, for no

eat mosquitoes. For a long time human the benefit only occurs after exclusion of

other reason than "because."

We rememthe ultraviolet light.

ber in our boyhood days of killing, for no Rollier reports that large doses, especially

reason that we can tell, a number that lived in blonds, cause acute attacks resembling

in a barn. actinic shock or heat exhaustion, and in

Now we find it highly desirable

to cultivate these animals in order to pretime a chronic nervous condition differing

serve our own health. If bats eat mosin no respect from tropical neurasthenia. These states are accompanied by marked quitoes, by all means let us have lots of phosphaturia. The neurasthenia so common

them around and have them eat up the