[We take pleasure in publishing the above. THE MEDICAL WORLD must always be absolutely fair to every side. In connection with the narcotic and dispensing problems we have always had in mind the retail druggists, who are interested in having more prescriptions to fill, and not the wholesale druggists, who do not fill prescriptions. It is well known that the Smith, Kline & French Company is an old and prominent wholesale drug house of excellent reputation.

We join Mr. Kline heartily in his opposition to any doctors who abuse their privilege as physicians by "the promiscuous dispensing of opiates from their offices." We think there are very few such, if any, and they ought to be driven out of the profession and their licenses should be revoked. The object of requiring that all orders for narcotic drugs be made out on official blanks is to make it possible to trace unusual quantities of such drugs. This we have always considered sufficient to catch that most ignoble character imaginable, the "dope doctor," if there really is such a character in existence. We consider it a misfortune to have the Harrison law so construed as to restrain all the members of the medical profession from dispensing these remedies in their offices according to their judgment without the trouble of making a record. But, after all, the real need for dispensing narcotics in the office is not great, except for coughs, bowel troubles, etc., and most remedies for these come within the permitted strength for dispensing without record. The greatest need for narcotics is serious injuries, such diseases as peritonitis, etc., and these are treated at the bedside, where dispensing by the physician is permitted by the Harrison law without record. But here again the Commissioner of Internal Revenue comes in with a ruling which changes the law. The law excepts record in the following words: "Except such as may be dispensed or distributed to a patient upon whom such physician, dentist or veterinary surgeon shall personally attend." The Commissioner

says: "Only such drugs as are personally administered by a physician to a patient when away from his office are exempt from record." However, we do not suppose that Mr. Kline nor his attorney had anything to do with this change in the law, administer."-C. F. T.] from "personally attend" to "personally

Circumcision Should Be Abolished.

EDITOR MEDIical World:—I am sorry to see a brilliant man like Dr. Wm. J. Robinson going wrong on the question of circumcision, for I feel we cannot afford to have

him. Judging from my own observation, I should say that quite a percentage of the circumcised are arrayed against the operation, albeit it is more difficult getting testimony or statistics perhaps on this matter than in some others.

However, some have confessed to me that they experienced more or less discomfort from the exposure of the glans to the friction of the clothing, some of them saying that they had a feeling of wanting to pull the prepuce forward and found themselves unconsciously working upon it to relieve this sensation of exposure of a part that Nature kindly covers. Others have said that this exposure caused a loss of sensation in the glans, detracting somewhat from the pleasure of coition.

Of course, I recognize diseased conditions wherein the operation might be necessary, but as a general proposition, for those who are normal I can make little out of it but a mutilation. In this light it simply stands. as a religious rite that, like many another religious rite, has its origin in superstition, to kill the bug of which should be considered not the least in our work of slaying bugs. and bacteria.

So good an authority as Bluhm says:

Circumcision is unnecessary from the hygienic and useless from the preventive standpoint.

Physiologically it is the removal of a functionally useful part, and the mutilation of an organ. From a pathologic standpoint it is unjustified. from a humanitarian point of view it is cruel and ought to be prohibited by law. Boston, Mass.

A. P. REED, M.D.

DEAR DR. TAYLOR-Inclosed find check for $3 for four years. Can't get along without THE WORLD. I guess I am not a crank, as I never get mift at any thing I read in THE WORLD. You know one will take more from a friend than from anyone else and still hold his temper. THE WORLD is surely a warm friend of mine; so say what you like about the war and everything else, and if I don't like it I will pass it up and read the rest. E. M. LING, M.D.

Merrill, Mich.

Comments on July WORLD.

Cancer.

EDITOR MEDICAL WORLD:-Were I at the beginning of my medical life instead of on the retired list, I should drop all minor subjects and devote myself to the study of one or other of the two great scourges of humanity, tuberculosis and cancer. The solution of any such problem lies not in the construction of any elaborate theory, but in study of the elements presenting, until by continually narrowing the field we approximate the truth. It was such study that cleared the way for Koch's brilliant work on tuberculosis. Look at Niemeyer's "Practice"-the great clinician died in 1875-and you will see the coming discovery of the bacillus foretold. The masterly analysis therein given prepared us for it-the niche was prepared, the pedestal erected, and the world notified that the place for the statue be made ready.

On page 244 we read that Bell believes cancer due to toxemia; a very likely thing, but no proof is proffered. One advocates a vegetable diet, another finds carbohydrates. favor the growth of tumors. The study of tree tumors is a right step. One finds cancer most prevalent where sulfurous coal is burned, another where cider is drunk, a third where tomatoes enter the diet most largely, a fourth where tree tumors are most common.

Beebe's observation (page 246) is very interesting, in that we as yet have no definite knowledge of the powers residing in plant principles. If he will continue his work by leaving out successively the 12 plants in his poultices, he may find which is doing the work. I suspect it is the violet, rather than a combination, that induces the curious reaction he describes.

Apparently of greater importance than any recent observations were those made in Chicago some years ago. Cancer was found to be more prevalent in Germans than in Scandinavians, least so in Italians and Chinese. The degree of cancer incidence corresponded directly with the use of sausage, in which inferior meats may be hidden. The consumers of macaroni and rice were relatively immune.

Well-what's the matter with sausage? Ask your butcher if he ever finds tumors in animals slaughtered. The other day I received a chicken whose gizzard showed a

fibroid growth at the outlet, which looked suspicious.

Dr. Kelly's brief paper on radium (page 256) is startling, in the positive statements made by a man whose surgical work has brought him world-wide fame. Such a pronouncement, by such an authority, cannot be ignored; and should bring hope to many a sufferer. I shall look with interest for its reception by the great WORLD "family."

Quinin Intravenously.

Dr. Calhoun's intravenous administration of quinin is deeply interesting. If the congestive chill, pernicious remittent and other dangerous forms of malaria still persist in any section, this method should have a general application. How many lives have been lost because we could not secure from the alimentary canal the absorption of enough quinin to cope with the disease! This also illustrates THE WORLD'S place in medicinthe response from our many thousands of readers is what makes or mars such therapeutic methods.

Alcoholism.

Dr. Pearson's paper on alcoholism (page 268) contains many valuable points. The reference to the treatment of that irresistible craving by nauseants is not wholly just. Take a man in the "horrors," ready to slump into delirium tremens, incessantly begging for alcohol-inject a full dose of emetin hydrochlorid, gr. 1/12 to 1/6, and he doesn't sicken. He just goes promptly to sleep, awaking after eight hours, sane and quiet, ready to dress, eat and attend to his duties. This is not curing the habit, but treating a condition of aggravated toxemia by the eliminative method best suited to that condition. The cure is another matter, requiring a careful study of the man and his environment.

Had

Take this case-a druggist came to me for the morphin-whisky habit. In a month he was ready to return-home? He lived under the thumbs of wife and daughter, to whom he was of interest solely as the provided for their wants. Not a particle of care or tenderness was shown him. the income from his life insurance exceeded that from his work they would have cheerfully seen him die. His life was that of a slave at the treadmill. If he ground out $3,000 a year, a little more pressure might make him run it up to $4,000. Consider the state such a man is in when the drugs are removed like a snake just after shedding

and tell me what chance he would have in such a "home!"

Pruritus Ani.

One reader wrote to me objecting to my condemnation of local remedies for anal pruritus. After destroying the pruriginous area with burning nitric acid and having the itching return where the skin used to be, he may be pardoned for pessimism. But my correspondent found a treatment effective and I shall try it: Regulate the bowels: wash out the rectum and cleanse the perineum: then apply a handful of essence camphor. If you have just indulged in scratching you'll probably give an exhibition of dancing that would beat the tango, fox trot and cake walk; but it "takes holt" of the itching.

Fever.

Aconitin to regulate vascular tension, digitalin to guard the heart; strychnin arsenate tc sustain vitality-the arsenic to immunize red corpuscles against micro-organisms-if debility threatens; or veratrum if fever runs high and toxin-elimination is needed more— and we have an effective, flexible system of treating fever that deserves reliance. But always begin by eliminating fecal toxemia. from the case.

Chronic alcoholics always think they need perpetual stimulation, hence the use of bitters, especially strychnin. But if the bowels are kept free and the liver active with podophyllotoxin, there is little need for bitters.

nolsulfonate is better. In convalescence the lime salt comes in aptly.

Spasm.

Spasm is most quickly unlocked by glonoin-I forget the new name—and its evaatropin. Then, since spasm always indinescent effect is deepened and prolonged by

cates feebleness of centric control, strychnin comes in as a clincher. All in very small doses, very often, about 1/250 grain every five minutes till effect.

Urticaria.-Colic.

Sir Almroth Wright tells us urticaria indicates the need of lime. A full dose of

pilocarpin usually settles it for the time.

What's the matter with soda mints for infantile colic, reinforced by a few drops of spirit of nitrous ether? Quickly effective and soon dissipated; it gives relief while the cathartic is getting to work.

Gastric vertigo is a symptom that may have an important meaning. Nephritis, cardiac disease, intestinal clogging, high arterial tension, arteriosclerosis, ocular troubles, and others of more or less gravity may underlie it. My remedy for vertigo is a real diagnosis after causes. Then treat these.

Dropsy.

A woman, aged 33, had a sore throat, not very severe, but it was followed by nonpainful swelling of the joints, marked weakness of the left side, arm and leg, and a remarkably extensive mitral insufficiency. A curious form of dropsy developed, subject to great fluctuation. At present, 8 years later, the abdomen is greatly enlarged, the skin over the space below the umbilicus edematous and indurated, the legs somewhat but much less so. Amenorrhea complete. It is not at all a typical ascites. There is no venous distention about the navel. Under the care of my friend Dr. Carmichael, she has improved greatly, with the use of cabinet steaming to the subwaist parts, careful dieting and abstinence from liquids. From chair life she has so advanced as to be able to sleep normally, the digestive and renal functions are well performed, and she is bright and lively. The original malady must have been a true diphtheria. I attribute the peculiar dropsy to blocking of parts of the venous system, from the mitral lesion, owing to some unusual anatomic condition.

WILLIAM F. WAUGH, M.D.

Muskegon, Mich.

A New Message to Physicians. EDITOR MEDICAL WORLD:-The ordinary physician has a more or less confused view of some of the modern cults which are pressed so sharply on public mind. Christian science is one of these. To the materialistic physician the theory that mind is everything and matter nothing seems absurd. Every day's experience teaches the power of the mind in a great many ways, but to ignore matter as the vehicle in which the mind moves is inexcusable.

There are many cults and pathies which contain a substratum of truth, but the way in which it is developed and pressed on public attention antagonizes and repels thinking

men.

In many parts of the country there are little groups of thinkers who call themselves "New Thoughters." Some of them are quite intelligent and it is hard to understand what is meant exactly by this term.

In a book recently published by Thomas Y. Crowell Co., New York City, and edited by a Chicago lawyer, Mr. Abel L. Allen, there are some very expressive statements of this new phase of modern thought. A summary of some of them will be interesting:

New Thought is asserted to be the philosophy of the life of to-day. It is a question how can the present moment be made joyous, constructive and hopeful. How can we meet the most momentous questions that press upon each individual; namely, what is the purpose of life, and where does it lead, and in what way can we develop the very best possible phases of it?

Old men find that at the close of life very little has been learned. Looking back, there is a selfish struggle, with gains and losses and shadows and the question is asked, is this all? Suppose we have acquired wealth, attained eminence, what does it signify when

the hour of death comes? Each new discovery widens the range of the present and staggers our credulity and often breaks up our ideals. The great present that we are living in is one of the greatest epochs ever seen. There is war, revolution, destruction. We here do not hear or see the suffering and loss, but somehow we feel that out of this struggle there will come some great development. In our own individual lives how can we construct and build up ideals that will make the day brighter?

Every physician realizes that his work is in one sense missionary, bringing cheer and

happiness and giving strength and courage to those who are weak. The question comes back, how can he rise above the conflicts of the present and bring into his life vigor and strength and escape the pains and aches and disappointments so common.

This new philosophy teaches us that the religion of life is to-day; it is the experiences that come to us each hour. It is the right interpretation of the best things in everyone's life, and the harmonious use of the activities and duties of the hour.

It teaches us that we are the centers of a universe of our own, and we have possible powers and forces, which if utilized would go far to dispel the tears and disappointments of the present. How to rise above the fears and anxieties and worries of the present is to lift a load off the shoulders of everyone, and clear away many a tangled path.

This is not a new thought, but is old as the ages, but it comes to us with newer force than ever. It teaches that health is man's normal condition, and when he is equipped with this, he is competent to deal with every possible adversity and triumph over every obstacle.

Carlisle wrote:

There is but one temple in the universe, and that is the body of man. Nothing is holier than that high form. We are the miracle of miracles, the great indescribable mystery of God. We are each the center of a universe from which we can study and contemplate the marvelous works of the Creator. We are equally as mysterious and as little understood as the universe itself, with its systems of worlds and planets. Every soul reaches out and asks for knowledge, for freedom, for ideals, for helpfulness to live the momentous hour of our existence.

The author shows in this book that the

highest happiness that can come to any individual is to know something of the world about him and how to apply the great laws

of the universe in his own life.

This is one of those books that clear away a great deal of the doubt and mystery which hang over the busy physician in his troubled work of helping others. It has helped me, and I therefore commend it to all. T. D. CROTHERS, M.D.

Hartford, Conn.

[The "New Thought" that Dr. Crothers. commends is not to be mistaken for another so-called "New Thought" cult of S. A. Weltmer, of Nevada, Mo., referred to in September, 1913, MEDICAL WORLD. This latter cult, we believe, is also the one that

Mr. Sol. L. Long launched forth his poetic invectives against in a little pamphlet of very interesting poems entitled "Psychic Soc Et Tuum and Other Things Concerning 'New Thought' Healers and Healing,' which we reviewed in June, 1913, WORLD, page 260. Mr. Long, we believe, was formerly connected with the "New Thought" healers as legal counsel and apparently knew whereof he spoke.

Recently the Eddy cult of so-called christian science has been dissected by Rev. N. B. Cooksey, who describes his investigations in a very interesting book entitled "Christian Science Under the Searchlight," which was reviewed in the May, 1915, WORLD, pages 199 and 200. The book that Dr. Crothers writes of was not known to us heretofore and presumably presents in a new dress the old story of optimism and persistent endeavor. ED.]

Intestinal Antiseptics.

EDITOR MEDICAL WORLD:-The reappearance of "Typhoid Mary," in New York City, in her favorite rôle of cook to a hospital has brought up again the problem of dealing with such cases. Again she has inaugurated a localized epidemic of typhoid fever in the institution, a number of nurses and other employees having partaken of the infection emanating from her bowels thru the medium of the food she prepared.

Rather disquieting, even to the least fastidious, is the thought that if this one cook manages to impart her bowel contents to the viands she serves, other cooks-all of them-probably do the same; and even if no infection be thereby transmitted, the prospect is not alluring. The first deduction therefore seems to be that the cook should disinfect the hands thoroly after every visit to the toilet, and should refrain from administering the dog's treatment for pruritus ani or vulva while engaged in her culinary vocation. Every housewife should establish rules to this effect and see that they are obeyed to the strictest letter. Such explanation as the domestic can comprehend should be effective. Here is another illustration of the justness of the claim that nowhere are intelligence and knowledge so sorely needed as in the kitchen. Yet nowhere is there such a demand for the most unskilled of female laborers the newly landed Ginnie or Wop, who never heard of such a thing as sanitation, and who could not be taught its

meaning until years of American life had unfolded her dormant cerebrum, is the one generally placed in this important and responsible position.

Typhoid Mary is not the only disease carrier. It has been calculated that New York City numbers several thousand such menaces to health, and that they are increasing yearly. A large proportion of typhoid patients are never really rid of their infective germs; many victims of the dysenteries are infective for many years after apparent recovery; and in the south we have many walking disease-breeders in the harborers of the hookworm. How many other affections are carried in the alimentary canal, and thence transmitted to those who live with the carrier, is unknown; but the probability is that we have not so much as scratched the surface of this field. The facts that the bulk of the fecal masses is made up of bacteria, and that every investigator who has studied this material at all has reported countless varieties of micro-organisms, most of which have never been classified or named, whose properties are totally unknown to us, speak strongly in favor of those who claim the alimentary canal to be the chief source of human disease.

This brings us to the consideration of the intestinal antiseptics. These agents are universally condemned by the authorities, and are employed with satisfactory results by the majority of practising physicians. Some of them have become identified with proprietary interests, to such an extent that any utterance in their favor is received with that reservation we always use when dealing with a man who advocates something he wants to sell. But the need is so pressing for effective agents of this class that, if there are any, we must know of them; if there are none, they must be developed, and it cannot be too quickly. We shall scarcely find anything more absolutely commercial than salvarsan, and the newer Teutonic remedies in general-after paying a dollar

an

ounce for many tons of seven-cent phenacetin, we can scarcely strain at the commercial gnat in native products.

Dornblueth, noting the speedy effect of glycerin on the larvae of trichina, in his laboratory studies, conceived the idea that this substance might be utilized in the treatment of that malady. The action is that of a rapid absorption of water from the bodies of the larvæ, similar to that of sulfuric acid. This demanded that the