There are many pharmacists who cling fondly to the old ideal of preparing most of their own preparations. In a measure the pharmacist must always do some of this, but it is futile for him to attempt to compete with the modern manufacturer in the preparation of an ever-increasing number of pharmaceutical preparations. The manufacturer has at his command the purchase of the best drugs at the cheapest prices. He can make a preparation faster and, therefore, more cheaply. By working with large quantities he can subject it to a number of rigid checks to insure its absolute accuracy. In short, with his machine he can make a better product more easily than the retailer can without machinery.

In Ohio, W. R. Hower, Chief Drug Inspector, in his 1914 report, gives the following as the result of inspecting drug stocks in drug stores and doctors' offices, as given in the N. A. R. D. Journal of July 22d:

The existing conditions of drug stocks in this state is very satisfactory. Only two samples, Only two samples, taken in the past year, were found to contain any wood, or denatured, alcohol. The cause of much of the trouble of former years, namely, that of using old and obsolete formulas in the manufacturing of U. S. P. and N. F. products, seems to have been entirely eliminated. The druggist is now buying preparations, impossible for him to make, from the manufacturers who can assure him that their products are as represented. The frequent submission by the druggist to this department, of samples so purchased, indicated a desire on the part of the druggist to be strictly in accordance with the drug law. The department found a few samples of fluidextracts and tinctures, required by the Pharmacopa ia to be assayed, that showed a wide variation from the standard alkaloidal strength, and in such instances a thorough investigation usually revealed the fact that the druggist had manufactured them without any attempt at an assay. As the action of these drugs depends upon the action of the alkaloids contained therein, it is absolutely necessary that such assays be made and the drug be brought to a definite standard.

The bureau has made seven hundred and fiftyseven inspections of the drug stocks of physicians. Only a few samples have been taken, but they were invariably found to be adulterated or misbranded.* [Italics are ours.- —N. A. R. D. Jour.] The work of the bureau along these lines has been done by the regular drug inspectors, using whatever time they could spare from the regular drug store inspection. During the last four months, they have reported all such inspections on a special blank. The physician has been erroneously under the impression that the object of the law was to prosecute the physician found with misbranded or adulterated drugs in his possession. This led to much misunderstanding, which has been removed by the inspector's explaining to the physician that the intent of the law was to compel the dealer to furnish to the physician a standard quality of drugs or preparations instead of an inferior quality under a standard label or name. That the law, and the work under it, is producing good results is becoming more and more evident. Many physicians, upon

*We would like to see further figures and a more elaborate report on this matter from the Ohio drug inspector.-ED. MED. WORLD.

purchasing a preparation from the supply house, submit a sample to the department for analysis, especially if the desired results have not been secured. Other physicians, who were in the habit of buying narcotics, especially morphin tablets, in five to ten-thousand lots, are now buying in very small quantities, as they do not wish to have the inspector report them as having on hand an enormous quantity of narcotics. When the law is explained to these physicians and they are shown the necessity of obtaining samples from the stock on their shelves, they see the advantage to be gained, and invariably give the inspector their whole-hearted support. A majority of the physicians are now very careful in their buying and are demanding from the supply houses drug preparations that comply strictly with the standards fixed by law.

Now the druggists are adding a new side line of advertising for themselves and an animadversion designed to belittle the dispensing physician. They are going to display a movie film to educate the public by showing by what extraordinary deftness and scientific acumen they can pour two or three liquids together into a bottle and charge 75 cents therefor. Or weigh out a few drams of a powder and put it in a bottle with a menstruum. At the same time they will take a shot at the doctor thus (N. A. R. D. Jour., July 22, page 801):

The picture begins with the following "fixed" title on the screen: "The best of physicians write prescriptions for the druggist to fill, because they

are assured of-." Then follow in succession such

"

44

words as 'the best service," "pure drugs," exact doses,' 'skilful treatment," and so on. Then follows a scene on the prescription counter, with the scale pans in action, balancing up and down; a bottle leaves its place on the shelf, drops down to one of the scale pans, tips up and deposits a quantity of drug upon it; the bottle rights itself upon the counter, the pan comes up and pours back into it a portion of the drug, and the bottle jumps back to its place upon the shelf. The scale pan then empties itself into the prescription bottle, and after several other quick changes, the prescription is finished. Then there appears on the screen the druggist's name and address, with any further wording or information that he may wish to convery to the public.

We would suggest that the druggist show films of the two fatal cases of counterprescribing that we mentioned above, and many other unnoted cases. They should prove of great service to mankind."

Is there any fallacy in the idea of a druggist advertising his prescription department? Will the public not recognize that the film does not show that druggists' store? When they recognize it, will they not consider it a hoax? The chances are not very great for success in that line. Success to a druggist lies in having a clean, bright store; properly made prescriptions;

attentive, courteous manners, and care in not deriding or gossiping about doctors and other people.

As a final word for the N. A. R. D. Journal of July 22, the editor tells his readers how to become "big" men in their community. He says (page 802):

The druggist is, if he wants to be, the biggest man in his community-no one excepted, not even the physician, the lawyer or the politician. A druggist is not measured by the amount of money he has, as are so many business men, but by the service he gives to his patrons, both free service and paid-for service. But he needs something as a stimulant to effect these desirable attributes, and this something is publicity, not only for his wares, but also that greater publicity that results in showing the people that the druggist is their true friend, that will cause the people to correct their failing for peddler and bargain sales.

We would be glad to have the druggist become the "big" man of his community. It is a worthy, commendable effort and deserves success. We have seen such men and were proud to know them. But they cannot elevate themselves by degrading others. No man ever becomes a big man by pulling down other people. He must rise superior by his own talents. other way can he succeed.

The Tortures of War.

In no

Most of the war correspondents write glittering generalities of the European conflict and pretend they are letting the public know what is happening on the battlefields. Very few of them know how to reveal what war really is. Perhaps they Perhaps they do not know-are not permitted to see real war. The main parts of their accounts consist of personal adventures of the correspondents with the commanding officers and in other places of comparative safety. Very little of the true conditions is made known by them, with occasional exceptions. Possibly they may be instructed by the publications for which they write, to avoid the horrible realities. But the military surgeon sees the fresh and bleeding products of war, as he meets behind the firing line the stream of wounded coming from the immediate front. A description from this point of view, one real story of real war, has appeared in print, and, unpleasant reading tho it is, it should be appreciated by the public as a picture of war.

Arnold Bennett, in the New York Evening Mail for July 17th, says:

War only persists because people do not realize what it is. People object to realizing what it is, and their delicate sensibilities are carefully respected

by practically all newspaper correspondents and writers of private letters home.

Of the frightful occurrences themselves he quotes a surgeon, Dr. A. A. Martin, no novice in horrors, who writes as follows in the Manawatu Evening Standard:

I was called at the double to attend some wounded in a narrow road under shell fire two weeks ago. The scene defied description. I was absolutely silent with the ghastly horror of the scene. In the road lay mangled and bleeding men, mangled and bleeding horses, dead men lying in all sorts of convulsive attitudes, upturned wagons, smashed and splintered wood. Add to this the agonized groans of our wounded men, the screams of dying horses, and that impalpable, but nevertheless real, feeling of standing for a moment in the face of the Creator -and one can perhaps then feebly picture the scene of carnage, of the solemnity of death, and of the pitiless woe of the devastation.

Suffer Great Pain.

A cavalry ambulance accompanied by two officers came by. When the ambulance was abreast of the men the Germans landed a lyddite shell directly under the horses' feet. Eight men were killed outright on the road. One doctor was killed outright. The other doctor had his ankle and foot smashed. Ten men were badly wounded, two died the same night. Eight horses were killed, and three horribly mangled. I happened to be the first doctor at hand, and dressed the wounded and had them conveyed to the shelter of a gravel pit near by. They were all in very great pain, and all of them were given morphia hypodermically.

Terrible Shrapnel Wounds.

As a surgeon, of course, what appeals to me is the state of our wounded and dying. The wounds caused by bursting shrapnel are most severe. The shrapnel rips, tears, lacerates and penetrates the human tissues in a horrible manner, and our work consists in repairing and making good as best we Our best, alas, is too often of little avail in the face of the anatomical devastation produced. One man, for instance, had his lower jaw shattered to a pulp and his tongue cloven in two. Another man had his skull smashed, and his brain

can.

welling over his face. Another is made completely

blind. Another has the front of his abdomen ripped open, and his bowels protrude. Another has a knee joint blown open, a hand smashed, an ankle shattered, and so on and so on. One could multiply and enumerate without end. perhaps that is enough.

*

But

ment, for he, like every soldier, hoped to escape damage; very probably this hope amounted to a belief. He knows that he has done his duty, and the mere fact that he is wounded proves that he has affronted risks. But he knows also that he is useless, for the time being, if not for life. He knows that he is only in the way, a dead weight, a source of possible danger, a drag on the operations. Further, his mind is perhaps perturbed by sudden anxieties about his family. Lastly, he is in great

pain, he is acutely enfeebled, and he is helpless. If ever a human being needed comfort, special attention, and the full aid of medical science, apparatus, and highly skilled nursing—if ever a human being needed to feel that he was the center and chief object of all activities in his neighborhoodthe wounded man is that human being.

But on the other hand, the army, like the wounded man, knows that the wounded man is useless and a dead weight. The army cannot help wishing that it might be freed of the immense incubus of its wounded. And it is well aware that where the interests of the wounded clash with military interests, military interests must prevail, and the wounded must be sacrificed. The devotion of Red Cross workers and of comrades is superb. All is done that in the circumstances can be done, but the circumstances are nearly invariably against the wounded, the general psychology is against them and the imperious practical necessities of the situation are against them.

Among the wounded of all the belligerents the British are beyond doubt the best treated. But while the resources of Britain are incomparable, the number of her wounded has been relatively small compared to those of other nations. The strain on the British Red Cross is only just beginning. As for the French, it is notorious that French organization has been overwhelmed by the casualities, and that hundreds of thousands of wounded have suffered appalling martyrdoms through the sheer inability of the organization to cope with the numbers. As for Serbia and Montenegro, the state of things in these countries, complicated as it is by terrible epidemics, cannot be described; it cannot even be indicated; it constitutes a supreme horror.

Some Urgent Needs.

As an example of what may happen to the wounded even in the West, may mention the experience of a man who went to the Continent as a motor driver in the British Army. He was deflected from his business at a certain place and ordered to go to a certain railway station. Under the great roof of the station were lying 1,000 wounded men (not English) urgently in need of skilled attention, and not getting it. The motor driver was told to do what he could for them, and to give five minutes to each man. Thus he moved about for a day or two helpfully among the sufferers, who were martyrized by pain, loss of blood, vermin and atrocious filth, while the insupportable odor of gangrened flesh filled the station.

Those men, however, did get some assistance. All are not so fortunate. Here is an extract from the veracious and convincing war correspondence of my_friend, Irvin S. Cobb (just published by Hodder & Stoughton, under the title "The Red Glutton"). It is a German officer who speaks:

"At once they rallied and forced us back, and now it was our turn to lose heavily. That was nearly three weeks ago, and since then the ground over which we fought has been debatable ground, lying between our lines and the enemy's lines-a stretch of four miles long and half a mile wide that is carpeted with bodies of dead men. They weren't all dead at first. For two days and two nights our men in the earthworks heard the cries of those who still lived, and the sound of them almost drove them mad. There was no reaching the wounded. * * * This kind of fact refuses comment.

I am glad to present the above. I think it is wrong to deal so gently with the sensibilities of the non-combatants at home who make the sentiment that sends the poor victims to war. Ever since the war began I have resented the censorship of the moving pictures, which stop just where the horrors would begin. If the people could see these horrors, they would be anxious to stop them and prevent their future recurrence. The entire world should be shocked to the marrow for permitting such horrors. Then a gospel of peace and good sense would arise that would overwhelm the chancelleries of the world, and convict them for their foolishness and absurdities.

The good sense of humanity should demand a better way, a more civilized way, a more sensible way of adjusting the public affairs of the world than the barbaric and ineffectual way that is in progress now in Europe.

Let us know the full barbarity of the war now in progress in Europe; let us have full, intimate and detailed descriptions, and let us see in moving pictures the actual horrors. Let us know and see the worst. in order that we may be moved to do our best to put an everlasting end to such nonsensical and unnecessary brutalityunnecessary when we have sense enuf to find a better way-unnecessary when nations become civilized in their relations to one another.

One of the most interesting observations made by Miss Jane Addams in the war countries is that this is an old man's war. but the young men have to fight it. Many of the young men feel that the old men should have managed affairs better than to allow this world war to occur for the young men to fight. Young men, as a rule, have been taught higher ideals, and they wish to live them. Now they are set to maiming and murdering one another. The German crown prince referred to this as the greatest and most unnecessary of wars. Who of the fighting millions can tell what they are fighting for? In attempting to answer, many refer to things which have occurred during the war. These are not causes of this causeless war.

Prevention of Typhoid.

The success of antityphoid vaccination is everywhere acknowledged. Armies thruout the world have been successfully inoculated. Thus the value of state or administrative medicin is demonstrated. But if such pre

Typhoid fever is possible to anyone anywhere who has not become immune to the typhoid bacillus. When there is available a means of avoiding that disease it is the part of wisdom and prudence to take advantage of it.

Why not have the entire civilian population of the United States inoculated against typhoid this month? Let us help along the good work of preventing sickness. We do a great deal of it, as it is; so let us get busy with our clientele and persuade them all to be inoculated against typhoid

for their own sake.

They should be inoculated with the typhoid vaccine in three stages, ten days apart. After each inoculation the patient stays in bed 24 hours till the reaction has passed. The vaccine is prepared in graduated doses and marked by manufacturers in the order in which they are to be used.

Another Medical Bogie Laid.

Under this apt title the Philadelphia Evening Bulletin discusses sensibly the antivaccinationist's misleading arguments against the utility, value and safety of vaccination, as follows:

No fable born of unscientific ignorance has ever had wider currency or been harder to down, perhaps, then the fixed belief spread by antivaccinationists that inoculation with smallpox virus is likely to cause tetanus. Hardly a legislative session has been held in this country for a score of years where efforts have not been made to repeal compulsory vaccination laws, opponents appearing armed with tons of literature reciting the horrible deaths from lockjaw due to the practise.

But the bogie has been laid at last, according to an announcement of the director of the hygienic laboratory of the United States Public Health Service, who says that an exhaustive study of the subject covering a period of thirteen years has proved that tetanus is never contracted thru the potentiality of the virus, but where it occurs, following vaccination, is received by contamination of the vaccination wound in the same manner as the infection of any other surgical wound, and that with ordinary precautions there is not the slightest danger from this dread disease.

Evidence presented includes the fact that not a case of lockjaw developed from 585,000 vaccinations in the army and navy during the last eleven years; that in several cases of so-called vaccination tetanus the laboratory was fortunate enough to obtain remaining samples of the identical virus used, and analysis, pathologic tests and revaccinations with the same material failed to show the presence of tetanus germs; that monkeys and guinea pigs, which are highly susceptible to both vaccination and tetanus, were inoculated with virus heavily contaminated with tetanus spores and, while

Nevertheless, the antivaccination faddists will continue their misguided efforts and will have to be combated year after year on the same subject.

Please see Dr. Slack's treatment for burns in this issue. He considers it revolutionary.

BUSINESS TALK TO DOCTORS

itself. The writer does not want his name The following communication speaks for nor location given. But it speaks for itself just as tho the name and location were given:

DEAR DR. TAYLOR:-I am inclosing to you a small piece of my experience, and as it seems just a little different from the rest of the "suckers" I want you to publish it, and at the same time to advise me if these people can collect the claim. It is this:

In 1910 I had the pleasure of meeting one of those slick-tongued mountebanks traveling thru this section soliciting subscribers to the Empire Life Insurance Company, of Seattle, Wash. He

represented that it was good for at least 15% to

20% per annum, and to show how doctors over the country were taking to the new project he exhibited a list which comprised about all the doctors in the Northwest Territory. I fell. Subscribed for $100 worth of stock. This was in October, 1910. I paid him $25 down. In three months' time the project was just a little "wobbly." In less than a year it was, as is generally the case, taken over by another company. Then it, with its associates, landed in the courts. I took it for granted I had lost my $25 and that was the end of it. But, like Banquo's ghost, it comes on earth once more and in this form:

THE EMPIRE LIFE INSURANCE CO.
Seattle, Wash.

July 3, 1915.

It would seem that the getting of $25 in 1910 and giving nothing but a receipt therefor, is not satisfaction to these sharks, and now they are trying something else after a lapse of nearly five years. Do you think these fellows have any power of law behind them to force collection of this rotten claim? I presume if it was paid they would give me a $100 worth of "Receivers' Notes" or something similar, and then probably trump up some other charge for the next instalment. Let me know your opinion about this?

Collection agencies? Well, they had better not solicit my business. I told the last fellow I would not throw water on him if he was on fire. The first one I gave claims to collected them, or some of the best, and tho it was nearly five years ago, I have failed to get a single cent. The next collected some claims and sent me the percentage, a very small portion. The next collected one claim of $42.50 and I got $12.50, the balance being used up as charges; the next one-well-I am still working for him; i. e., I collect the claims and he puts in a bill to me for about three-quarters of each one, saying that is their method of settling claims under the agreement.

Do you blame us for being just a little harsh on solicitors of all kinds that want our business, and undertake to work the little towns?

He

I showed this communication to a 1 wyer familiar with such matters as stock subscriptions, insurance, etc., and he unhesitatingly said, tho he was sorry to say it, that the doctor is liable for the above subscription "if he has the money.' said that there is no help for it. Anyone who subscribes for stock is liable therefor, even if the company goes into the hands of receivers or is merged with another company.

Is it necessary for me to repeat my warning to look out for agents? Don't subscribe for stock. Don't sign your name to anything unless you absolutely know it is all right.

Shall We Ask Our Banker?

Here is another letter on this subject: Dr. C. F. Taylor; DEAR DOCTOR:-I notice the letter from "Newcomer," " on page 289, August WORLD. I think "Newcomer's" position is right so far as small banks are concerned. Small banks are not "investment banks." In other words, the cashier is not posted on investments, outside of real estate loans in his own vicinity. To illustrate, I will give one of my experiences:

Some years ago the word "Bank" to me meant safety. I stepped into "our bank" one day for some purpose, I do not know now what, but while in the bank the cashier called my attention to an investment which he considered good. It was the "United States Bankers' Corporation." John G. Carlile was one of the prominent men in it. I had a little idle money. I bought thirty shares. The cashier got his commission, I got my certificates of stock. That was all I got. I'm still holding_my certificates. They are utterly valueless. This cashier is considered a "good and able cashier" and is making a success of "his bank."

The point I want to make is that a banker in a small community is not competent to "pass" on securities other than real estate loans in his own territory.

But

Your advice is good and should be used. most of us learn by experience only. I have been "stung a good many times. But I'm slowly learning.

Certainly the safest loan is in one's own community where you know all the conditions and circumstances and can look after your interests yourself. ILLINOIS.

Admitting all that the above letter and the letter of "Newcomer" say, still I think that the average banker, even in small towns, knows much more about investing than the average doctor. "Consult your banker about investments" is still good advice to the doctor. You are not com

pelled to follow the advice, and it is far more likely to help you than to hurt you. In regard to local investments, see what Walt Mason says:

E. Z. Mark.

We ask him to invest in town the cash he has to spare; he turns such propositions down with cold and haughty stare. "Your dinky local enterprise," remarks this lofty gent, "looks pretty fiddling to my eyes-it won't pay six per cent. I won't unlock my treasure chest for local schemes, my friends; when I have money to invest, I want big dividends." And so he sends his cash away (with big results in view) for silver mines in far Cathay, oil wells in Timbuctoo. He buys a hundred cars of cloves, upon the Wall Street plan; he's buying Greenland orange groves, and earthquakes in Japan. Oh, anything that's far away, that's boomed by unknown sharks, looks bigger than a load of hay to all the E. Z. Marks. His once large pile is dwindling fast, 'twill soon have moseyed hence; and soon he'll view the dismal past, and wish he'd had some sense. Meanwhile our local canning mills are running day and night, and we are putting in our tills the doubloons, clean and bright.-WALT MASON, in Philadelphia Evening Bulletin.