available until after the registration is accomplisht, as the name and number of the registered person or firm must be printed on them before they can be issued.

The order blanks for drugs will be sold in lots of 10 or its multiple. The price for these will be 10 cents for each 10 blanks. When making out orders on the official blanks for the narcotic drugs specified in the law, duplicates of the orders must be made and kept on file for two years.

Every person, firm or company dispensing directly to consumers any of the narcotic drugs must, on the first day of March, prepare and keep on file an inventory of all such drugs on hand at that date. No special form of inventory is required, but the inventory made must fully and clearly set forth the quantity of each kind of such drugs, preparations or remedies so held, and must be verified by oath not later than the 5th day of March, 1915.

To sum up, the physician receives an application blank for registering under the act. He fills it in properly, makes affidavit to its truthfulness before a notary public or deputy collector and then takes or mails it with 34 cents (check or money order) to the collector of internal revenue of the district from whom he received it. This must be done on or before the 1st of March.

After receiving his "stamp" and application form for order blanks he fills in this application blank and sends in the amount of money necessary for the number of blanks he requires. We believe that ten or twenty such blanks would be plenty for any physician to start with.

On the 1st of March he must make an

inventory of all narcotic drugs, preparations, etc., on hand, which must be sworn to on or before the 5th of March, to be kept for official inspection upon demand.

We have already received an inquiry from a subscriber, who evidently does not wish to register under this law, asking for a list of the drugs which a doctor may lawfully carry and use in making calls and in office practise in case he does not register and pay this tax. They can be briefly They can be briefly stated to be: (1) All drugs not mentioned in the bill; (2) certain exceptions, given in the copy of the bill sent you by the collector of internal revenue and also given in our following editorial, where they are fully enumerated.

The exceptions are compounds containing only slight amounts of the narcotic drugs.

and liniments, ointments and other preparations for external use-that is, applied to the skin. Liniments, ointments, etc., containing cocain or coca preparations, however, are not excepted.

The use or having possession of opium, morphin, codein, heroin or other opium preparation or cocain or coca preparations for hypodermic use, comes within the scope of this act and the physician possessing such drugs must register and pay the tax.

Remarks on the Federal Narcotic Law. All purchases or securing, in any manner, of the narcotic drugs, subject to this law, by the physician, dentist or veterinary surgeon must be made on official order forms obtained from the local internal revenue collector, and official duplicate copies of such order forms must be made out and preserved for two years.

Prescriptions issued by the physician, dentist or veterinary surgeon authorizing the sale or disposition of the narcotic drugs subject to this law by the druggist or apothecary must be in writing and indicate certain definit information.

Dispensing: When the physician, dentist or veterinary surgeon does not personally attend-i. e., personally see-the patient he must keep a record, showing certain definit information, to be preserved for two years.

The physician, dentist or veterinary surgeon, upon the request of the local collector, must render to such collector a true and correct statement or return verified by affidavit showing the quantity, etc., of narcotic drugs received by him within a certain stated period.

Narcotic Drugs Affected by This Law: The narcotic drugs affected by this law, except as expressly exempted in the following, are: opium or any compound, manufacture, salt, derivativ or preparation of opium, and coca leaves or any compound, manufacture, salt, derivativ or preparation of coca leaves.

Narcotic Drugs Entirely Exempted From This Law: The following three classes of narcotic drugs are entirely exempted from all the requirements and obligations imposed by this law, provided, always, that such drugs are sold, distributed, given away, dispenst or possest as medicins and not for the purpose of evading the intentions. and provisions of this law, viz.,

I. Preparations and remedies (for either internal or external use) which do not contain more than

(a) 2 grains of opium, or

(b) 4 grain of morphin, or (c) grain of heroin, or (d) 1 grain of codein, or any salt or derivativ of any of them in one fluidounce, or if a solid or semisolid preparation, in one avoirdupois ounce.

II. Liniments, ointments, or other preparations which are prepared for external use only except liniments, ointments or other preparations which contain cocain or any of its salts or alpha or beta eucain or any of their salts or any synthetic substitute for them. The following ruling has been made by the Internal Revenue Department construing this exemption: Any liniment, ointment, or other preparation containing drugs not specifically exempt by the law (see I above) used for oral, nasal, aural, ocular, rectal, urethral, or vaginal administration is not an external use of such liniment, ointment or other preparation, and is, therefore, not exempt from the provisions of this law.

III. Decocainized coca leaves or preparations made therefrom or other preparations of coca leaves which do not contain cocain. (No preparation or remedy containing cocain or any of its salts or alpha or beta eucain or any of their salts or any synthetic substitute for them is exempted from the requirements and obligations of this law.)

Lawful Purchase, Prescribing and Use Only Permitted: A physician, dentist or veterinary surgeon, under this law, may obtain, prescribe, use or dispose of the narcotic drugs subject to this law, only for medicinal purposes in the course of the legitimate practise of his profession. Any procedure to the contrary constitutes a violation of this law.

The penalty for a violation of or a failure to comply with any of the requirements of this law, on conviction, is very severe a fine of not more than $2,000 or imprisonment for not more than five years, or both, in the discretion of the court.

If a physician, dentist or veterinary surgeon, in addition to the professional prescribing of the narcotic drugs subject to this law, conducts a distinct retail drug store for the sale or dispensing of such drugs, he must make a separate application for registry and pay a special tax, in each such case.

If for any reason an original official order form is cancelled, destroyed, or not used, the duplicate thereof should recite the exact facts. Each duplicate must satis

factorily account for the original order form.

Great care should be exercised to safely preserve for the required two years the duplicate copies of the official order forms. Otherwise, the full penalty of this law will apply. These duplicate copies must be so preserved, also, as to be readily accessible, at all times, to official inspection, upon demand. No particular place for preservation is provided.

No restriction is placed upon the source from which the physician, dentist or veterinary surgeon may obtain the specified narcotic drugs-from either the manufacturer, importer, or wholesale or retail dealer, provided, always, such obtaining is for lawful purposes. The giving of an official order may not be avoided by the writing of a prescription (hereafter described) to be filled by the retail druggist, when such a prescription is used by the physician, dentist or veterinary surgeon as a subterfuge to obtain the specified narcotic drugs for professional use without giving an official order. The retail druggist may only sell or distribute the specified narcotic drugs upon a duly issued prescription to a con

sumer.

No restriction is placed upon the quantity of the specified narcotic drugs which may be duly obtained by a physician, dentist or veterinary surgeon for medicinal use in his professional practise.

Attention is again directed to the fact that no official order form or duplicate copy is required in the purchase of any of the narcotic drugs expressly exempted from this law.

Druggists and apothecaries must refuse to fill any such original written prescription unless signed and filled out as required, and if they have reason to suspect that it was fraudulently issued or obtained.

The druggist or apothecary filling such original written prescriptions may only sell, dispense or distribute the narcotic drugs subject to this law, so prescribed, to a consumer. The physician, dentist or veterinary surgeon may not use an original written prescription to obtain the specified narcotic drugs for his own dispensing. In the latter case, the official order forms, previously described, must be used. Such original written prescriptions may not be refilled.

The druggist or apothecary filling such original written prescriptions must either1. Keep a separate file of all such original

written prescriptions, which may be numbered consecutively with other prescriptions received, or

2. Keep a record showing

(a) The file number given to each such original written prescription filled.

(b) The name of the physician, dentist or veterinary surgeon signing the same and

(c) The name of the person for whom such prescription is filled.

Druggists must furnish their own record books for this purpose.

The druggist or apothecary filling such original written prescriptions must preserve them for the period of two years from the day on which said prescriptions were filled in such a way as to be at all times readily accessible to the authorized inspection officials.

Or

Dispensing: A physician, dentist veterinary surgeon, registered under this law, may dispense or distribute any of the narcotic drugs, subject to this law, to a patient, without limitation, provided, always. that such dispensing or distributing is made for medicinal purposes and in the course of his professional practise only.

When a physician, dentist or veterinary surgeon, registered under this law, does not personally attend, i. e., does not personally see his patient, but dispenses or distributes any of the specified narcotic drugs (other than the narcotic drugs expressly exempted from this law) to such patient, in some other manner, e. g., by messenger, then such physician, dentist or veterinary surgeon must keep the following record of all such narcotic drugs so dispenst or distributed showing: (1) The date when any such narcotic drug is dispenst or distributed; (2) the kind and quantity dispenst or distributed in each case, and (3) the name and residence of the patient to whom such narcotic drug was dispenst or distributed.

No particular form or record book is provided for. Each physician, dentist and veterinary surgeon must supply himself with a suitable blank book for such record. This record must be made out on the day of such dispensing or distributing, as it must be preserved by the physician, dentist or veterinary surgeon making it for a period of two years from the date of such dispensing or distributing, always readily accessible for inspection by the duly authorized officials. No particular place for preservation is provided for. It is not required that the physician, dentist or veterinary surgeon shall personally make out this

record, so long as the record is duly made out and preserved. It is not required that the physician, dentist or veterinary surgeon shall sign any entry so recorded. Great

care should be exercised to safely preserve these records for the required two years; otherwise, the full penalty of the law will apply.

Note: Attention is again directed to the fact that no record is required in the dispensing of the narcotic drugs expressly exempted from this law.

Sworn Statements: Every physician, dentist or veterinary surgeon, registered under this law, must, at any time, upon the request of the collector of his revenue district, render to said collector a true and correct statement or return, verified by affidavit, setting forth

1. The quantity of the specified narcotic drugs, received by such physician, dentist or veterinary surgeon within his revenue district during such period immediately preceding the demand of the collector, not exceeding three months, as the said collector may fix and determin.

2. The names of the persons from whom such narcotic drugs were received.

3. The quantity in each instance received from each of such persons.

4. The date when received.

Collectors will require such sworn statements in all cases where, from the number of order blanks obtained by any physician, dentist or veterinary surgeon, or from the character of the practise of any such medical practician, the collectors have reason to suspect that such drugs are being used for illegal purposes, or may be required in such other cases as the collectors may think it advisable.

Possession by the Physician, Dentist or Veterinary Surgeon: There is no restriction or regulation placed upon the possession of the specified narcotic drugs by a physician, dentist, or veterinary surgeon, registered under this law, as to the quantity which may be possest, etc.-provided, always, that such possession was lawfully obtained and had for medicinal use in the course of legitimate professional practise.

There is no restriction or regulation placed upon the possession of the narcotic drugs subject to this law by a patient, provided, always, that such possession was lawfully obtained from a physician, dentist or veterinary surgeon registered under this law or from a nurse acting under his direction, or through the medium of a prescription duly

issued, providing always such narcotic drugs were prescribed in good faith for medicinal purposes and in the course of legitimate professional practise.

There is no restriction or regulation placed upon the possession of the narcotic drugs subject to this law by a nurse, acting under the supervision of a physician, dentist or veterinary surgeon, registered under this law, provided, always, that such possession was lawfully obtained and had by virtue of his employment or occupation and not on his own account.

There is no restriction or regulation placed upon the possession by an employee of a physician, dentist or veterinary surgeon, registered under this law, provided such employee is acting within the scope of his employment, and not in violation of this law. Such employee does not have to register or pay the special tax under this law.

Hospitals and Other Institutions: All the requirements hereinbefore described imposed upon the physician, dentist or veterinary surgeon by this law relate, in like manner, to hospitals and other institutions: Provided, however, That officers of the United States Government or of any state, territorial, district, county or municipal or insular government, lawfully engaged in making purchases of the specified drugs for the various departments of the army and the navy, the public health service and for government, state, territorial, district, county, or municipal or insular hospitals or prisons are not required to register or pay the special tax under this law or to use official order forms in purchasing or securing in any manner the specified narcotic drugs and may lawfully send, ship, carry, deliver or possess such drugs, when duly acting in their official capacity.

The Value of Evidence.

For thousands of years doctors have devoted themselves to the study of the ailments of humanity and their treatment. All the plants that grow, all the minerals, metals, earths, gases, salts, and innumerable other agencies, have been tried out as remedies. Many of these have been establisht and the consensus of opinion assigns them definit places in the armory of our weapons for staying the assaults of disease. But as concerning farr too many, there is yet the widest variance of opinion as to their true place.

Here is a notable example: A journal declares that the hypophosfites and the glycerophos fates should be dropt because the hypotheses on which they were originally introduced are not now believed by the profession in general. Note the glaring error in logic: Reduce to a syllogism and we have: A remedy whose original introduction was based on a hypothesis not now generally accepted should be dropt. The hypophosfites were introduced on a hypothesis not now generally accepted. Therefore the hypophosfites should be dropt. The fallacy, of course, lies in the improved major premise. It does not follow that a remedy is useless because the original idea back of it is not now accepted.

The place of this particular remedy is due to the results noted by the profession as following its administration in cases where it appeared to be indicated. These results have been so decided that there are very few practicians who do not rely upon this combination as one of their most powerful general tonics. Comparativly few of us know, and fewer care, that the hypophosfites were originally introduced to supply an assumed lack of oxygen to the lung tissues. For that matter, has anybody as yet proved that these salts do not supply oxygen?

It has also been said that petroleum is not absorbed by the human body. We know of one instance where petrolatum rubbed upon the abdomen by a pregnant woman resulted in her having a thick layer of fat in the area so treated. In a subsequent pregnancy she did not rub in the petrolatum and did not have the fat abdomen afterward. This proves that it is absorbable by the skin. It may not be absorbed from the alimentary canal, however.

The trouble with clinical evidence is that it is uncertain, is with difficulty transmitted from doctor to doctor, and that the observations of any one practician in themselves relate only to personal experiences and environment, and are so deeply modified by the doctor's personality that they may not apply to the general requirements of his colleagues.

All these and many other objections are obviated when the testimony of one is reinforced by that of hundreds and thousands of others. Any one of us may be fooled; but the many thousands of readers of THe MEDICAL WORLD cannot all be fooled by the same thing. In this we fulfil a function that only a practician's journal, a periodical

for actual interchange of views and experiences, can supply.

If you have a good idea in medical practise, write and tell us about it. If you see a good suggestion in our pages, try it out and tell us the result. If you see one of our writers publishing what you know to be an error, write and tell us, and how you know it.

Don't be stingy. Recollect that every time you give us one of your good things, you incite many others to give you theirs, and you are all-fired smart chaps if you can't learn anything from the rest of the great WORLD family.

Fat as a Food.

Not every physician recognizes the importance of fat to the human body. Nor does the laity. The tendency for many years with great numbers of people has been to carefully avoid eating the fat attacht to meat served at the table, only

the lean being consumed, and the fat thus discarded is usually wasted unless a household pet is at hand to be fed on it. They say that a Chinese can live on what a Caucasian wastes. We have developt a very dainty appetite as a consequence and many now look with repugnance on fat as a food. We can tolerate it in cooking, such as pastry, fried meats, oysters, eggs, and vegetables; even salted, as in ham and bacon; and oliv oil in salads. But most people very carefully avoid eating the fat with the meat.

We remember one tubercular patient who went home from the office and told his sister, "The doctor told me to eat fat," showing extreme disgust in his tone and manner and his emphasis on "fat."

Fat is a splendid food. The pity of it is that we eat so little of it and waste so much. Fat is the one food that we may lay in a store in the tissues for a future time when food may be scarce, a la the hibernating bear. By eating it regularly and constantly we can build up a layer of fat around the body that may not only serve to sustain it later on, but also act as a protectiv layer for the internal organs and tissues against injuries and cold and the effects of cold. The layer of fat also serves to fill out external hollows and adds a rounded contour to an otherwise gaunt and bony form.

The great desideratum is to find a palatable fat, since humanity's taste has been turned against the most available sources.

For

many years various emulsions of fats, chiefly of cod liver oil, have been tried by the profession. They are rendered palatable by sweetening. The usual quantity taken is one tablespoonful at a dose, and, while some benefit results, the effort to build up a patient would require his ingesting as much fat as he could assimilate.

Pure cod liver and oliv oils have often been ordered by physicians to supply fat in readily available forms, with success. Various devices have been resorted to in the effort to smother the taste of these substances, with more or less success. One of these ways is to take them with milk. Another is to take them in some kind of wine or grape juice.

Milk itself has been recommended for the cream it contains. For a long time overfeeding with great quantities of milk was attempted. This, too, was partially successful. However, the small percentage of virtually impossible to secure enuf fat for cream present in the average milk makes it a wasted, wan patient by drinking whole milk. Whole milk is very often constipating. The idea of using the cream alone as a means of supplying a readily available quantity of fat occurred to a number of physicians, who have been acting on it. Its superiority to whole milk as a fatty food is apparent at a glance.

Dr. W. E. Robertson, of Philadelphia, some years ago called a patient's attention to the fact that she would have to drink eight quarts of milk a day if she were to get from that source the amount of fat she needed. He suggested that she drink cream instead. We have ourselves recommended the drinking of cream to a number of patients to build up their physiques, and with success where it has been persisted with. We have usually recommended the drinking of a half-pint of cream daily, to be increast to one pint, if possible. is to be continued for a long period of time, several years, preferably. We have seen a number of patients improve very greatly after this cream feeding for a year or more. Where the cream is too rich for toleration by the stomach it can be mixt with an equal quantity of milk. This has been found to bridge the difficulty for some patients.

This

Dr. B. J. Kendall, of Geneva, Ill., for a number of years has advocated the drinking of cream as a cure for tuberculosis. He believes it will cure all early cases. He recommends that the patient get a special