cate exhausted or toxemic conditions, and tuberculosis in particular must be excluded.

Fourth-In arterial and cardiac conditions it is not a reliable guide, but in certain dyscrasias leading to these there is an increasingly high tension. Fifth-Hypertension may be necessary to the proper functioning of the body in certain conditions, and its reduction should be effected judiciously, if at all, after a careful study of the underlying causative influences in each individual.

Earthworms and Cancer.

Dr. H. D. Walker, Buffalo, N. Y., who has studied this subject for eleven years, presents an illustrated article in Medical Record, December 28, 1912. The doctor finds a parasite connected with the earthworm and infected with it numerous animals, which died of saromatous tumors as a result. The claim is made that the earthworms infect cabbages and other plants used as food. The organism involved is an ameba-like form.

Iron Hypodermatically.

The editor of The Therapeutic Gazette, in his leading editorial in the issue of December 15, 1912, after giving due credit to Musser, Barlow and others for their use of soluble iron salts in this connection, expresses the view that remedies which have to be administered over a long period of time should not be given hypodermatically if it is possible to obtain satisfactory results when they are given by the mouth. It is, also, very questionable whether the system will deal with iron which is placed beneath the skin as well as it will with iron which is ingested.

BOOK REVIEWS.

Building a Profitable Practice. By Thos. F. Reilly, M.S., M.D., Professor of Applied Therapeutics, Fordham University, New York City. Philadelphia, 1912. J. B. Lippincott Co. Cloth, 290 pages, illustrated. This is a text-book on medical economics especially addressed to the young practitioner and admirably adapted to his use. The matter of building a practice is presented from a high professional and ethical point of view, and yet there is a wealth of practical suggestion and wise advice. The various lines of medical service apart from private practice are suggestively discussed; the business ethics of practice, medical finance and collections, and a host of small matters making for or against success are admirably presented.

And yet, the old war horse in medicine who reads this book is amazed at how he ever made a success himself, for our worthy author expects the doctor to be a votary and ascetic constantly worshipping at the medical shrine. One who has had a whole lot of fun as he went along fails to see the sacredness in some things medical, but believes it a splendid good thing to preach it to the boys; they usually need it. This book does its preaching amiably and we want to urge all of the young doctors, and young-old ones, to buy it; it is in a class by itself and is abundantly well worth while.

Neurasthenia Sexualis. A treatise on sexual impotence in both sexes. By B. S. Talmey, M.D. Practitioners' Publishing Co., 12 W. 123d street. New York City. 1912. Pp. 196, with 19 drawings. Cloth. Price $2.00. Postage 10 cents.

Dr. Talmey, who is following in the footsteps of H. Ellis, has written other books upon sex problems and popular with physicians. This work is more distinctly clinical than are the previous writings of this able author, and is of distinct practical value.

The author takes a high moral attitude and the work is chaste but expressive. We commend it as lacking in the sensationalism and as possessing more scientific tone than do the run of books upon sex problems.

Pathfinders in Medicine. By Victor Robinson. New York, 1912. Medical Review of Reviews, 206 Broadway. Cloth, 317 pages, illustrated, handsomely bound. Price, $2.50.

In our editorial section reference is made to this work. Suffice it to say here that Mr. Robinson is a most entertaining writer who has gone to infinite trouble to collect data that he here weaves into a volume which reads like romance. The stimulation, to say nothing of the entertainment, one derives from the reading of this work well repays for the time and effort. The work is a literary gem.

Diseases of Women. By Thomas George Stevens, B.S., M.D., F.R.C.P., M.R.C.P., Obstetric Surgeon, St. Mary's Hospital, Surgeon the Hospital for Women, Physician Queen Charlotte's Lying-in Hospital, London. University of London Press, 1912. American Agents, Oxford University Press, 35 West Thirty-second street, New York City. Cloth, 431 pages, illustrated. Price, $5.50.

This able work differs somewhat from others of its class, in that it partly rejects the ordinary anatomical classification; this leads to no difficulty but renders treatment clearer. Indeed, the book is an admirable guide to both surgical and non-surgical treatment in proper proportional balance, and insists upon a sound pathological basis. Especially to be commended are the upwards of 200 original illustrations, and more notably the admirable microphotographs. The work is a credit to the printer and binder and is admirable in every way.

A Manual of Elementary Zoology. By L. A. Borradaile, M.A., Lecturer in Zoology in the University of Cambridge. Oxford University Press, 1912. American Branch, 35 West Thirty-second street, New York City. Cloth, 470 pages, copiously illustrated. Price, $3.75. This is a text-book suitable for medical study. The organism is regarded as a whole and upon an evolutionary basis. This simplifies matters immensely and it would be well were some of our medical investigators to abandon views ascribing to certain morphological constituents of the body of man or any other of the higher organisms a mystical "individuality." If physicians were to study a rational work such as this, they would learn that cells and zooids are different from specialized functionating tissues, and that surgically transplanting organs and keeping them alive for months in saline solution are problems the teachings of rational biology and zoölogy render rather improbable of practical surgical attainment. The work is an eminently safe guide.

Minor Surgery. By Leonard A. Bidwell, F.R.C.S., recently deceased, Late Dean of the Post-Graduate College, Senior Surgeon to the West London Hospital, etc. Second edition. University of London Press, 1912. Sold in the United States by American Branch Oxford Medical Publications, 35 West Thirty-second street, New York City. Cloth, 300 pages, illustrated. Price $3.75.

This valuable work outlines for the general practitioner the principles and technic of the whole range of surgical work apt to be undertaken by him. The style is clear and the instruction of the most practical character. The text shows that the author was a surgeon of large experience, and the book is a useful one for the average doctor to follow.

Treatment After Operation. By William Turner, M.S., F.R.C.S, E. Rock Carling, B.S., F.R.C.S. and L. V. Cargill, F.R.C.S., three eminent physicians holding many appointments. London, 1912. University of London Press. For sale by Oxford University Press, American Branch, 35 West Thirty-second street, New York city. Cloth, 247 pages, elaborately illustrated. Price $3.75.

From our American point of view, this book is of especial value to the general practitioner who has surgeon specialists operate upon his cases, as it gives him all essential data for carrying out the after-treatment himself, quite a profitable line of work and one a well-informed practitioner should be quite capable of performing. The book is quite complete, eliminates unnecessary frills and is based upon the experiences of three authorities of large experience. We commend it unreservedly.

Health and Longevity Through Rational Diet. By Dr. Arnold Lorand, Carlsbad. American edition. Philadelphia, 1912. F. A. Davis Company, Publishers. A companion volume to "Old Age Deferred." Cloth, 416 pages. Price, $2.50 net.

Dr. Lorand has produced a charming work sure to be popular among American readers. This is not the cut-and-dried book upon dietetics based upon a discussion of calories and food chemistry, but is a first-hand discussion of food in all of its relations and in a live and entertaining style. The author is widely traveled and knows from personal observation what he has to say, and he says it with a judgment and tempered wisdom making his opinions of real value to physician and layman alike. We highly commend the volume.

Surgical Operations With Local Anesthesia. By Arthur E. Hertzler, M.D., Surgeon to the Halstead Hospital, Halstead, Kansas, and to the Swedish Hospital, Kansas City, Mo. New York City, 1912. Surgery Publishing Company, 92 William street. Cloth. 208 pages, illustrated fully and printed in two colors. Price, $2.00. Dr. Hertzler has produced an admirable work upon the basis of hard work and wide experience; it is in the nature of a special brochure, the most genuinely useful form of medical textbook writing. This is the kind of book needed in actual practice; it tells just why, when and how, and then stops with a real index. Get it and you will make no mistake.

Skin Grafting, for Surgeons and General Practitioners. By Leonard Freeman, B.S., M.A., M.D., Professor of Surgery, University of Colorado, Surgeon to the St. Joseph's, the National Jewish and the City Hospitals, Denver, Col. St. Louis, 1912. C. V. Mosby Co., Metropolitan Building. Cloth, 139 pages, illustrated. Price, $1.50.

This is a complete and graphically written little work upon an important subject. The history of skin grafting, the various methods employed today and the legal side of the question are all discussed. Especially to be commended are the exact directions as to technic and the methods of local anesthesia applicable.

E. Merck's Annual Report. Merck & Co., New York city. Paper, 419 pages. Sent upon receipt of 15 cents to pay postage. Edition very limited. This is a really valuable annual upon pharmacological research and includes practically all the drugs which became subjects of study during the year. It is a scientific, not a commercial, publication. It has the most elaborate study of the digitalis glucosides and allied drugs which we have seen.

Himself. Talks With Men Concerning Themselves. By E. B. Lowry, M.D., and Richard J. Lambert, M.D. Chicago, 1912. Forbes & Co., 443 S. Dearborn street. Cloth, 216 pages. Price $1.10 by mail.

This book is a proper and reasonable one of its class, of which there are too many. We fail to see anything very distinctive in this work requiring elaborate review, but the information therein is reliable.

1913 Businesss Almanac and Investors' Guide. S. W. Straus & Co., 1 Wall street, New York. Paper binding, 160 pages. Price 25 cents.

A compilation of a great mass of authoritative financial and investment data given dispassionately and free of bias. Physicians who have funds to invest will find reliable advice in this handy little booklet.

anything effective in limiting the rav

ages of the social plagues, it must be by the adoption of new plans; the old ones don't work. Medical and sociologic pathology are so near together in this disease of civilization that neither a medical nor a sociologic prescription will cure the disease; it must be medico-sociologic in its composition.

Removing commercial interests from warfare will reduce war itself to narrow limits; taking commercial profit from the saloon business will bring about temperance faster than will any other one factor; removing the profit from the sale of cocaine will immensely reduce the cocaine habit; take the profit from opium and China will soon be freed from the opium habit. Yet all these reforms would require the enactment of more or less law.

Commercialized vice is already outlawed, some cities and States having rigid special laws. Because of the money to be made from vice and the many lines of respectable business incidentally helped by allowing that profit to be made despite the law, the laws are not made effective. It is time we ceased arresting the victims; let us enforce the laws we already have upon the people making money out of vicious conditions and

about. We must invade business, political, social and even church circles to "get" the responsible money-makers.

So long as the medical profession contents itself with revamping the sordid history of ancient sexual perversions, speculating over eroticism, studying out the convolutions of sexual symbolism, psychologizing over sexual sins, teaching little children instead of the politician and otherwise making a polite propaganda and nine days' wonder of Professor So-and-So's last cureall for vice, just that long will we be wasting effort.

What we need to do is to let grown men and women know the peril of venereal disease as we see it as physicians and sanitarians; then we should ask them to go with us to the police magistrate and the court to demand enforcement of law. Commercialized vice can be stamped out and it is time we demand that something be done along this line. It does not take any more bookwriting to do this; the newspapers, the boards of health, the women's organizations, the medical societies and upright citizens generally can unite to abolish commercialized vice. Doing so will not abolish all vice and private immorality by any manner of means, but it will go a long ways

HE WHISKY TIPPLER is the man who regularly drinks it in small quanties; he may never become intoxicated, may be a good citizen and may never let whisky get the upper hand of him. And yet we know that in the aggregate he drinks more whisky, wine and beer than do the relatively small class of drunkards; and we also know that disease takes a rather large toll from among his fellows.

Temperament and self-control determine

outwardly quite normal people, but they take small amounts of morphine habitually and are quite uncomfortable without its stimulation. Nevertheless, they are upon dangerous ground and a fair proportion of them gravitate into great excesses.

We should be frank but kindly with these people. A neurologist learns more of actual conditions in this regard than does the general practitioner. Every physician should bear this factor in mind in his relations with his patients, and he can do a vast deal of good in making a conscientious effort to eliminate this easily-learned vice from the families under his professional care. Most of the morphine tipplers are not very hard to cure, but it is a different story with the "fiend."

Medicopolitics in England and the United States.

tates; and the morphine-taker is subject to the same factors. There are more morphine tipplers than there are morphine "fiends."

We have had this matter brought to our attention by agents of large drug houses and by our smaller range of observation in practice. We have made inquiries regarding the volume of morphine sales, and they are immense. On our own account we have asked several retail drug stores to tell us how much morphine was sold by them in a year. So far as we secured figures, the upper class and the lower class stores do the greater business in morphine; the stores in residence districts of the middle classes sell the least morphine. Quite aside from the stores catering to the trade of habituates, and there are relatively few of such stores, the reputable druggist is called upon to sell to his regular patrons so many small parcels of morphine pills that some of them were astonished themselves when they turned to their order books and found out the large yearly aggregate.

The morphine tippler is usually a man or woman whom we least suspect; they are

picion upon the policy of socializing the medical profession. Admittedly, in so far as the State should undertake medical services along hygienic and preventive lines, a socialistic tendency is proper; but for it to undertake individual medical service is a dangerous experiment.

State or established religion has long been under test, and much can be said both for and against it. Nevertheless, it is becoming less of a factor and is liable to lose. out against the world-wide sweep of popular democracy. The history of State religion is too long to recount here, nor do we care to do so, but it has its lessons for the advocates of State medicine.

The National Insurance Act is a wellmeaning experiment by the British Government, and is based upon two assumptions, both erroneous. The first one is that the British Medical Association membership places altruism ahead of their own bread and butter; the second one is that the rank and file of the British public prefers that the Government select their doctors for them. As even the Christian ministry has historically resented intrusion upon their

rights as men when their proper living was in peril, it is vain to suppose that medical men will be more complaisant under duress. Even more than in the past, the public stands upon individual right, especially in England.

The result of this legislation is deplorable from nearly every point of view. The political element in the profession gets all the favors; the State doctors are controlled and their destinies determined by men, nearly all of whom are of inferior intelligence to physicians, although generally estimable in their way; the rank and file of people are not allowed free choice of a physician; the independent element in the profession is almost destroyed by legal enactment, and the people are compelled to accept what may be very inferior medical service.

The profession itself is split into two more or less disorderly factions; and an amount of strife, bitterness, blackleg politics and "strike" tactics are being indulged that threatens to turn back fifty years the dial of British medical advance. The whole thing is evolving into a disgraceful mess and is deplored by the best-but helpless elements in the honorable English profession and by a large part of the public.

We hope that the Government and the medical profession in England will speedily find a way out of their difficulties, and we believe they will after a lot of damage has been done. Incidentally, the British Medical Association, and some of the British medical journals, are partly to blame. Like their American cousins, the smug and prosperous element of doctors who have nothing to lose and like public applause, have been industriously blowing pretty socialistic smoke rings during their pipe dreams and draping them as wreaths about the hallowed heads of the profession which works wholly for glory. It were time that sort of bosh be dropped everywhere: it never was true of the medical profession or any other.

And what is the lesson for us? While our division into a large number of sov

ereign States, each having police power, almost assures us against the dangers of a national insurance act, we do have the danger of political intrusion into purely professional matters. So long as our medical societies merit the support of the whole profession and of the public, and keep clear of politics, we are reasonably assured against political disaster.

To our mind, the part of the average doctor consists in seeing to it that our local, state and national medical societies represent the whole profession worth representing, allow every member a vote and urge him to such expression, try to get every reputable and qualified doctor into membership, avoid favoritism, eliminate the faddist, keep out of politics and make their officers keep out during their incumbency, attend strictly to the purposes for which they are organized, be conservative but active in advancing proper propagandas for the good of the people and the profession and educate both the public and the doctors into a sympathetic appreciation of each other's rights and interests. If we do these things, we are comparatively safe.

The doctor, as an individual citizen, should be no more criticised for proper political effort than should the hardware merchant. Aside from public health work, medical societies have no more business in politics than have an association of the hardware interests. Mixing up with politics is going to kill even the trusts. Did you ever think about this? Then keep out from between "the upper and the nether millstone."

Committing an Alleged Lunatic.

The cases are rare in which a physician is justified in committing a stranger for lunacy upon the findings of a single examination. An excellent plan is to get in touch. with the family physician, or one who has long known the party alleged to be insane.

We have known of transient drug effects, such as the effects one may get from hyoscine, cocaine or chloral, to result in a phy