or veterinary surgeon, the name and address of the person to whom such written prescription is issued, and, when given by a duly licensed veterinary surgeon, shall indicate, in addition, the kind of animal for the treatment of which such written prescription is issued. No written prescription containing more than four grains of morphin, thirty grains of opium, two grains of heroin, four grains of codein, or two grains of cocain, shall be filled unless the due issuance and correctness thereof be first verified. No written prescription shall be filled, without sufficient verification, if, for any reason, the proper issuance and presentation thereof appears questionable. Such verification may be made by telephone, or by some other sufficient method. Such written prescription shall be exactly filled as soon as received, or as soon thereafter as practicable, but no such written prescription shall be filled more than ten days subsequent to the date on which it was signed. The person filling such written prescription shall write or indicate thereon the date of filling and the date when and the name and address of the person to whom he delivers the drugs so prescribed. Such written prescription shall be filled but once and shall not be copied, except for the purpose of record by the duly licensed physician, dentist or veterinary surgeon issuing it or by the person filling it, and shall be preserved on file, receiving a consecutive file number, by the person filling it, for a period of two years from the day on which such prescription is filled, in such a way as to be readily accessible to inspection by the officers, agents, employees, and officials mentioned in section 8 of this Act.

SECTION 4. WRITTEN PRESCRIPTION TO BE ISSUED IN COURSE OF PROFESSIONAL PRACTICE ONLY:-That it shall be unlawful for any duly licensed physician, dentist or veterinary surgeon to issue the written prescription required by section 1 of this Act except in good faith and in the course of his professional practice for medicinal purposes only. It shall be unlawful for any duly licensed veterinary surgeon to prescribe any of the drugs mentioned in this Act for the treatment of or consumption by a human being.

SECTION 5. DISPENSING BY A PHYSICIAN, DENTIST OR VETERINARY SURGEON-RESTRICTED: - That a duly licensed physician, dentist or veterinary surgeon may dispense, distribute or in any manner give, within this State, to his patient any of the drugs mentioned in this Act, provided such dispensing, distribution or giving is made in good faith and in the course of his professional practice for medicinal purposes only: Provided, further, That such duly licensed physician, dentist or veterinary surgeon shall keep a record of all such drugs so dispensed, distributed or given, showing, in each instance, the amount so dispensed, distributed or given, the date when, and the name and address of the patient to whom such drugs are so dispensed, distributed or given, except such drugs as may be dispensed, distributed or given to a patient upon whom such duly licensed physician, dentist or veterinary surgeon shall personally attend; and such record shall be kept for a period of two years from the date of dispensing, distributing or giving such drugs, subject to the inspection provided for in section 8 of this Act. It shall be unlawful for any duly licensed veterinary surgeon to dispense, distribute or give any of the drugs mentioned in

this Act for the treatment of or consumption by a human being.

SECTION 6. SALES AT WHOLESALEUPON OFFICAL ORDER FORMS ONLY:That, except as provided in the preceding sections of this Act, it shall be unlawful for any person to sell, barter, exchange, distribute, give away or in any manner dispose of, within this State, the drugs mentioned in this Act, except in pursuance of a written order, in the form defined in this section, of the person to whom any such drug is sold, bartered, exchanged, distributed, given away or in any manner disposed of. Every person who shall accept any such order, and in pursuance thereof shall sell, barter, exchange, distribute, give away or in any manner dispose of any of the aforesaid drugs, shall preserve such order for a period of two years in such a way as to be readily accessible to inspection by the officers, agents, employees and officials mentioned in section 8 of this Act. Every person who shall give an order, as in this section provided, to any other person for any of the aforesaid drugs shall, at or before the time of giving such order, make or cause to be made a duplicate thereof, in the form defined in this section, and in case of the acceptance of such order, shall preserve such duplicate for said period of two years in such a way as to be readily accessible to inspection by the officers, agents, employees and officials mentioned in section 8 of this Act. The official order forms and the duplicate copies thereof issued by the Commissioner of Internal Revenue of the United States Treasury Department under the Act of Congress approved December 17th, 1914, entitled—“An Act to provide for the registration of, with collectors of internal revenue, and to impose a special tax upon all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations, and for other purposes," shall be the official order forms and duplicate copies thereof required by this section. It shall be unlawful for any person to obtain by means of said order forms any of the aforesaid drugs for any purpose other than the use, sale or distribution thereof by him in the conduct of a lawful business in said drugs or in the legitimate practice of his profession, pursuant to the intendment of this Act. The provisions of this section requiring official order forms shall not apply

(a) To the sale, exportation, shipment or delivery of any of the aforesaid drugs by any person within this State to any person in any foreign country, regulating their entry in accordance with such regulations for importation thereof into such foreign country as are prescribed by the said country, pursuant to such regulations as are promulgated from time to time by the Secretary of State of the United States.

(b) To the sale, barter, exchange, or giving away of any of the aforesaid drugs to any officer of the United States Government or of any State, territorial, district, county, or municipal or insular government lawfully engaged in making purchases thereof for the various departments of the Army and Navy, the Public Health Service, and for Government, State, territorial. district, county, or municipal or insular hospitals or prisons.

SECTION 7. RECORD OF RECEIPTS:-That any person who produces, manufactures, compounds, deals in, dispenses, sells, distributes, gives away, or in any manner disposes of, within this

State, any of the drugs mentioned in this Act, shall, whenever required so to do by the Department of Health of this State, render to said Department a true and correct statement or return, verified by affidavit, setting forth the quantity of the aforesaid drugs received by him in this State during such period immediately preceding the demand of the said Department not exceeding three months, as the said Department may fix and determine; the names of the persons from whom said drugs were received; the quantity in each instance received from each of such persons and the date when received.

SECTION 8. INSPECTION OF RECORDS:That the order forms and duplicate copies thereof, the prescriptions, and other records required to be preserved under the provisions of sections 3, 5 and 6 of this Act, and the statements or returns filed with the Department of Health under the provisions of section 7 of this Act, shall be open to inspection by the Department of Health through its duly authorized officers, agents, and employees, and by such officers, agents or employees of any organized municipality within this State as shall be duly charged with the enforcement of any municipal ordinance or provision regulating the sale, prescribing, dispensing, dealing in, or distribution of the drugs mentioned in this Act, and, also, by the officers, agents and employees of the United States Treasury Department duly authorized to make similar inspections under the Act of Congress approved December 17th, 1914, hereinbefore mentioned. Any such officer, agent or employee who shall disclose or use the information contained in said statements or returns, or in said order forms or duplicate copies thereof, or in the other records mentioned in this section, except as herein expressly provided, and except for the purpose of enforcing the provisions of this Act or the Act of Congress approved December 17th, 1914, hereinbefore mentioned, and except for the purpose of enforcing any ordinance of any organized municipality within this State, regulating the sale, prescribing, dispensing, dealing in, or distribution of the aforesaid drugs, and except in the public interest, unless directed by a court, shall, on conviction, be fined or imprisoned as provided by section 19 of this Act.

SECTION 9. HABITUAL USERS-TREATMENT RECORDED:-That a duly licensed physician who, in the course of his professional practice, and not for the purpose of evading the provisions of this Act, prescribes for, dispenses or in any manner gives any of the drugs mentioned in this Act to a patient known to him as an habitual user of such drugs shall keep a record of all such drugs so prescribed, dispensed or given, showing, in each instance, the amount so prescribed, dispensed or given, the date when, and the name and address of the patient for or to whom such drugs are so prescribed, dispensed or given, which record shall be preserved for a period of two years from the date of such prescribing, dispensing or giving in such a manner as to be readily accessible to inspection by the Department of Health.

SECTION 10. HABITUAL USERS-COMMITMENT:-That whenever a complaint shall be made to any magistrate that any person is addicted to the use of the drugs mentioned in this Act in a manner contrary to the public welfare, and such use is not prescribed, directed or approved by a duly licensed physician acting in the course of his professional practice pursuant to the pro

visions of this Act, and such magistrate, after a fair hearing held upon a reasonable notice, is satisfied that the complaint is sufficiently founded, he may commit such person to a State, County or City hospital or institution. Whenever it shall appear to any magistrate that such person is no longer addicted to the use of the aforesaid drugs in a manner contrary to the public welfare, or in his discretion, he may order a discharge from such commitment. The provisions of this section shall not be construed to prohibit any person committed to any institution under its provisions from appealing to any court having jurisdiction for a review of the sufficiency of the evidence upon which the commitment was made.

SECTION 11. REVOCATION OF LICENSE OF HABITUAL USER:-That the board or officers of this State duly empowered to issue a license to a physician, dentist, veterinary surgeon, pharmacist or nurse, authorizing the practice of his profession in this State, may, at any time, and after a fair hearing held upon a reasonable notice, revoke such license upon the production of sufficient evidence that the licensee is addicted to the use of the drugs mentioned in this Act in a manner contrary to the public welfare. Whenever it shall appear to such board or officers that such physician, dentist, veterinary surgeon, pharmacist or nurse is no longer addicted to the use of the aforesaid drugs in a manner contrary to the public welfare they may reissue said license.

SECTION 12. REVOCATION OF LICENSE AFTER CONVICTION:-That a duly licensed physician, dentist, veterinary surgeon, pharmacist or nurse duly convicted of a substantial violation of this Act shall be liable to a revocation of his license by the board or officers of this State, duly empowered to issue such license, after a fair hearing held upon a reasonable notice, provided such revocation shall be in the public interest. Such board or officers may, in their discretion, reissue such license.

SECTION 13. UNLAWFUL DELIVERY PROHIBITED:-That it shall be unlawful for any person to send, ship, carry or deliver any of the aforesaid drugs within this State in a manner contrary to the provisions of this Act: Provided, That nothing contained in this section shall be construed to apply to the delivery of the aforesaid drugs to common carriers or warehousemen, provided the requirements of this Act are in all other respects complied with; or to the handling of the aforesaid drugs by any employee or agent, acting within the scope of his employment or agency, of any person dealing in such drugs pursuant to all the requirements of this Act; or to the delivery of the aforesaid drugs by a duly licensed physician, dentist or veterinary surgeon to a nurse for administration to his patient under the direction and supervision of such duly licensed physician, dentist or veterinary surgeon in the course of his professional practice.

SECTION 14. UNLAWFUL POSSESSION DEFINED:-That it shall be unlawful for any person to have in his possession or under his control any of the drugs mentioned in this Act, if such possession or control is obtained in a manner contrary to the provisions of this Act: and such possession or control shall be presumptiv evidence of a violation of this Act; Provided, That this section shall not apply to the possession or control of the aforesaid drugs by any employee or agent, acting within the scope of his employment or agency, of any

person dealing in such drugs pursuant to all the requirements of this Act, and such possession or control does not operate to evade any of the provisions or the intendment of this Act; or to the possession or control by a nurse, for medicinal treatment only and not on his own account, acting under the supervision and direction of a duly licensed physician, dentist or veterinary surgeon engaged in the legitimate practice of his profession; or to the possession or control of the aforesaid drugs by any United States, State, County, Municipal or other duly authorized public officer or official who has such possession or control by reason of his official duties; or to the possession or control of the aforesaid drugs by a warehouseman or a common carrier holding such possession or control under the direction of a person who has received such drugs pursuant to the requirements of this Act: Provided, further, That it shall not be necessary to negative any of the aforesaid exemptions in any complaint, information or indictment, or other writ or proceeding laid or brought under this Act, and the burden of proof of any such exemption shall be upon the defendant.

SECTION 15. RULES:-That the rules and regulations made by the Commissioner of Internal Revenue with the approval of the Secretary of the Treasury for carrying into effect the Act of Congress approved December 17th, 1914, hereinbefore mentioned, shall, so far as applicable, be adopted for the enforcement of this Act.

SECTION 16. ENFORCEMENT:-That the State Department of Health shall be charged with the duty of enforcing the provisions of this Act, and such Department is hereby authorized to appoint such inspectors, agents or other assistants as may be necessary to enforce the provisions of this Act.

SECTION 17. APPROPRIATION:-That the sum of Dollars, or so much thereof as may be necessary, be, and hereby is, appropriated out of any money in the Treasury of the State not otherwise appropriated, for the purpose of carrying into effect the provisions of this Act.

SECTION 18. PERSON DEFINED:-That the word "person" as used in this Act shall be construed to mean and include a partnership, association, company or corporation, as well as a natural person.

SECTION 19. PENALTY:-That any person who violates or fails to comply with any of the requirements of this Act shall, on conviction, be punished by a fine of not more than one thousand dollars, or by imprisonment for not more than three years, or by both such fine and imprisonment in the discretion of the court.

SECTION 20. REPEAL:-That all Acts and parts of Acts in conflict with this Act are hereby repealed.

SECTION 21. DATE OF EFFECT:-That this Act shall go into full force and effect on and after the first day of March, 1915.

Practical Autoserotherapy. Biologic therapeutics is making some wonderful strides nowadays. Dr. Victor C. Vaughan, president of the American Medical Association, made the statement at the recent meeting of the association in Atlantic City that every cell produces its own enzyme, and this seems to be corroborated by

the work of autoserotherapeutists. A number of physicians have made use of the cells' own enzyme as a curativ product and, we are glad to say, with eminently satisfactory results. A number of intractable diseases have yielded to the treatment.

In pleurisy several physicians have found excellent results follow the reinjection of the patients' own pleural effusion after having aspirated amounts varying from 10 to 200 cubic centimeters (21⁄2 fluidrams to 6 fluidounces). Dr. Charles A. Pfender, of Washington, D. C., has recently publisht a report stating that autoserotherapy is a reliable and safe method of treatment for all forms of serofibrinous pleurisy and believes it should be employed in all cases with effusion where germ infection is absent. Here, of course, surgical intervention and drainage are necessary and the use of bacterins is certainly advisable. Where, however, no infection is present-that is, where the effusion is not purulent-aspiration and autoserotherapy is the procedure of choice.

ease.

In secondary pleurisies autoserotherapy as described above may not exert any beneficial effect on the primary cause of the disIt will cause rapid absorption of the pleuritic fluid, however, and in incipient tubercular conditions has been known to arrest the progress of the disease. This is a method of treatment worth knowing, for it has long been supposed that many tuberculous infections had their origin in an attack of pleurisy.

After aspirating the effusion 30 to 45 minims are injected hypodermically. The result of such treatment will be immediate relief from subjectiv symptoms and more rapid absorption of the exudate. These injections should be repeated everv other day until decided improvement follows.

Dr. Henry M. Fisher, in the New York Medical Journal, also notes similar improvement in serofibrinous pleurisy. He states, however, that, inasmuch as 80% of such effusions show a tendency to spontaneous recovery, this treatment might better be reserved for cases that recur after tapping or do not absorb readily. We should think that if an effusion be tapt the hypodermic injection might as well be given at the same time, which can be accomplisht without entirely withdrawing the needle after the effusion has been evacuated.

Robert Abrahams, in the New York Medical Journal, reports the use of autoserum injections in a case with endocarditis due to an infection of the blood stream (bac

teremia) with streptococcus viridans. The patient was a young woman who had been sick for ten weeks with chills, fever, headache, and pains in the joints, which had started with tonsillitis. Blood was withdrawn and culture media inoculated with it. The culture media showed numerous green colonies. Three injections of the patient's own blood serum were made intravenously in 5-fluidram doses on three successiv days, by which time the pulse and temperature were nearly normal and an uninterrupted convalescence followed, the patient having entirely recovered in three weeks. The laboratory tests showed that the germs were exterminated from the blood stream, the last culture test showing none whatever.

Charles H. Duncan, of New York, has publisht several articles on injection of bacterial substances to produce immunity and cure disease. As long ago as 1911 Duncan publisht an article on the subject in the Medical Record. According to him, the tissues tend to eliminate the toxins of disease in the exudate. He withdraws the exudate and filters it thru a Berkefeld filter and 20 minims of the filtrate is then injected under aseptic precautions. He believes autoserotherapy is applicable to all localized and possibly non-localized infectious diseases. We have herein given examples of both local and general infections yielding to this treatment.

Duncan has reported on its favorable effect in gonorrhea, rheumatism; ear, nose, throat and other respiratory organs; purulent infections, genito-urinary diseases and in gynecology and obstetrics.

Dermatologists also are using autoserotherapy in the seemingly irremediable skin diseases. Howard Fox, in the Journal of the American Medical Association,* reports his experience with autogenous serum in psoriasis. In reviewing the literature on the subject of autoserotherapy in skin diseases he mentions the report of Mayer and Linser, who successfully treated a pregnant woman afflicted with herpes gestationis by means of blood serum from a healthy pregnant woman. These two authors believe that in pregnancy poisonous substances enter the maternal circulation from the placenta and act as antigens, which in the normal woman are neutralized by the formation of anti

bodies. In such as do not form the antibodies the patient suffers from auto-intoxication, manifested by eclampsia, hyper

Dec. 19, 1914.

emesis, and various skin eruptions. Mayer and Linser, therefore, sought to supply them from another source. They first injected blood serum from a non-pregnant woman, however, as a test; but the herpes were not affected. They then injected the serum from the healthy pregnant woman, as above stated, and the herpes disappeared. Others also reported similar good results in toxic dermatoses of pregnancy.

Linser then used autoserotherapy in urticaria and other skin diseases in the nonpregnant. Good results were reported in stropulus, urticaria papulosa of children, prurigo, pemphigus, and hemorrhagic diseases of the skin and mucous membranes.

Heuck reported good results in pruritus senilis. Dermatitis herpetiformis showed decided improvements. Slight temporary improvement occurred in neurodermatitis, but it failed in weeping eczema.

Pemphigus yielded varying results to this form of treatment in the hands of Praetorius and von Zumbusch.

Spiethoff secured a good result in psoriasis. Gottheil and Satenstein stated that their results were uniform and extremely satisfactory in psoriasis. Hilario also used it successfully in conjunction with chrysarobin. Fox treated twenty-eight cases of psoriasis with autogenous serum. The different forms of the disease, such as the guttate, nummular, and diffuse, were all represented and included varying grades of severity. The duration of the eruption varied in the different cases from two to forty-five years. In all except one case at least three injections were given, at an average interval diately followed by the local use of a 10% of from three to five days. This was immechrysarobin ointment, the action of which was increast in certain cases by covering the skin with rubber cloth. No internal medication was given and no particular stress was laid on the diet.

The results of the treatment in general were very satisfactory and in some instances striking.

Fox's technic is as follows: At each sit

ting draw off 50 cubic centimeters (1 ounces) of blood from the cubital vein (Fox uses a MacRae needle) into a steril cylindric glass bottle. The bottle and its contents are then properly balanced and placed in an electric centrifuge having a speed of 1,800 or more revolutions a minute. When the serum was entirely separated from the corpuscles and fibrin it was drawn off into a

glass syringe and injected without delay, either intravenously or intramuscularly. The amount of serum obtained thus and injected varied from 15 to 25 cubic centimeters (4 to 6 fluidrams).

Fox is of the opinion, as a result of his experience with these cases, that autogenous serum used alone does not cure psoriasis; yet Spiethoff reported a cure by it. Fox believes it is of decided value when used in conjunction with chrysarobin; that they are entirely devoid of danger when properly given and that the technic is simple.

Such a method of making serums for the treatment of disease from and for each individual patient will make the care of the sick an expensiv matter, but it is well worth while in intractable diseases where more easily applied methods are inadequate.

Legal Provision for Physicians' Pay. The Haskell County Medical Society of Oklahoma has petitioned the legislature of that state for a law "setting apart and making exempt from mortgage and so forth a certain amount of property, with a value ranging from $25 or more, to provide for medical and surgical aid for each home." Their reason for this request is that the loss of the market for cotton places the farmers of that state in financial difficulties, and mortgage foreclosures may render them homeless as well as penniless, in which event they will have no money for medical attention in case of sickness.

So far as we know, North Dakota is the only state that provides for the physician in this manner. It is time that all legislatures took cognizance of the claims of physicians for necessary services to health, for such services are always urgent and of the highest importance to humanity and to the community. These claims should constitute a first lien, anteceding all mortgages, personal notes, etc., issued for any other purpose. The health of the state and nation is a greater asset than is anything else, and the guardians of health should be given first consideration in foreclosure proceedings.

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DEAR DR. TAYLOR-Please find inclosed my check for advance subscription to THE WORLD. I have now passed my 83d birthday, but still in the medical harness, but feel now at my age I will give up my Up to this year I heavy work to younger men. have taken five medical journals, but have cut out all but THE MEDICAL WORLD for the next year. have been a subscriber to it for so many years it seems like a member of my home. I attribute my good health very much to my habits. I have never used liquors, tobacco or any of the opiates, and kept a clear conscience. Wish you a Happy New Year. West Paris, Me. O. K. YATES, M.D.

BUSINESS TALK TO DOCTORS

There is one ever-present thought in my mind, and this thought should begin this Talk; it is, how fortunate we are to live in this land of peace as well as of plenty. Nearly the whole civilized world is now

at war! The like was never known before. But we are at peace, and 3,000 miles of ocean separates us from the boom

ing cannon. We can pursue our daily vo

cation of usefulness in safety and serenity. Von Hindenburg has an army of one million men fighting the Russians in Poland. Just think of it! One million men in snow and trenches, in a Russian winter. And there are perhaps as many men on the other side. And there are fully as many men on each side in Belgium and northern France. Then there are nearly as many men on each side in northern Austria. Italy has 2,000,000 men ready for the field, and Roumania 600,000, if these countries should be involved, and Greece and Bulgaria may also be involved. The Germans say they have 3,000,000 reserve men that can be called when needed, and Kitchener says the war will not begin till next May-then look out.

What has all this to do with business? Well, there is a difference between living in trenches, wet most of the time, uncertain food and death threatening all the time, and living in a comfortable home, with three warm meals per day, and safety. Think of business conditions in the warring countries. There is no business-rather, every business has been changed into the business of killing, while your business continues to be the work of curing and saving.

We are in a land of peace, safety and plenty. These things make a good basis for business. Think of the doctors in the warring nations. Their business has been sacrificed to the war god. Families must take care of themselves the best they can. Doctors must go to the war in some capacity unless they are too old. But here we have normal conditions. Doctors have their normal amount of work to do, and their patrons are able to pay for the doctor's services. In the cotton districts of the South things are pretty bad just now on account of the closing of foreign markets to cotton. But this is only temporary. The price will come back again. On the other hand, wheat, corn, hay, pork, beef,