facts, and if any person does not like them he is entitled to his opinion.

Incidentally, it may be added that the editor spent ten days in Florida last month seeing the East coast from Jacksonville to Miami.

Next month we will tell about the central and southern portions particularly, the general farming data here noted being largely predicated upon conditions in the northern section of the State.

Diagnoses for Business Reasons. EDITOR MEDICAL COUNCIL:

I have been amused to hear persons tell what certain doctors said about their cases. For instance, a lady was telling me about having called a doctor to see her child, and he looked very grave and told her that if she had waited nine hours longer it would have been too late! Mark you how exact he was as to the time! The patient got well, and the mother took it for granted that the doctor could tell to the minute when they called him "too late."

one

Another case of very fine diagnosis I heard of recently where a physician was called to see an old gentleman and, after examining him, told him that he had pneumonia about thirteen years before. The patient admitted that he had. Well, the point I want to get at is this: Can a man become so fine a diagnostician that he can tell when a person had had a certain disease thirteen years before, or tell within an hour of the time when it would have been too late for him to do any good? I think these things are only tricks which some of our profession work on the credulity of their patients, thereby inspiring confidence in the ignorant, by which means they get their money. As a matter of fact, I am afraid our profession has many questionable ways of getting rich. For a doctor to make half a dozen calls when one is sufficient and I have known cases where a dozen were made-is simply robbing your patient. Charging two hundred to five hundred dollars for an operation that takes an hour is another instance; charging from one hundred to thousand dollars for setting a broken leg another. Some one may say the responsibility is great; that is something that I fail to see when they get their money whether the patient lives or dies. These exorbitant charges is what has brought the profession into bad repute with the laity. They say, "Oh, he charged too much and I don't care whether I pay his bill or not." I think physicians should be paid for their work, but I don't believe they ought to have as much for two hours work as the victim makes in a year. I know men who were ordinary blacksmiths, carpenters or farmers, who took up the study of medicine, and got through college by some "hook or crook," and now make three or four thousand dollars a year without any qualifications other than an oily tongue and a diploma. Of course, our medical colleges now say a man must have some literary qualifications. The people, as a rule, pay no attention to a doctor's qualifications; if they like the man he is a good doctor. The medical profession ought to discourage young men from

entering the profession, as it is overcrowded, and it causes young men to pursue disreputable means of making a living. I heard a medical student say a few years ago, "When I get through, if I can't make money one way I will another." In other words, if I can't make it go legitimately, I'll be an abortionist.

I think if we would all apply the Golden Rule in our business, or, in other words, "Put yourself in his place," we would not get rich so fast. O. B. SURFACE, M.D. 1618 Shelby St., Indianapolis, Ind.

The Prescribing Druggist.

EDITOR MEDICAL COUNCIL:

Why are druggists allowed to practice medicine without a license? Why are they not prosecuted for illegal practice?

The following case illustrates the folly of allowing a druggist to prescribe: Mr. S., with a sore on the penis, consulted a druggist of this city, who told him he had a chancroid and treated it for five weeks. Two months later Mr. S. developed a sore mouth and consulted the druggist again, who made a diagnosis of stomach trouble, and prescribed accordingly without results and changed the medicine several times. Finally Mr. S. developed a skin eruption which the druggist called a "stomach rash" and prescribed more internal medicine; also a salve for the rash. A few weeks later the patient's hair came out in patches and his rectum became very sore. The druggist told him that he had the piles and the rash had developed in his scalp. He prescribed a pile salve and a hair tonic. Mr. S. grew rapidly worse on all of this magic treatment, until his friends began to accuse him of having the "syph" and to recommend "sure cures." Fortunately one of them recommended a physician.

Mr. S. came under my care August 7. I gave him an intravenous injection of neo-salvarsan at once, and mercury_echinacea and berberis aquifolium internally. Repeated the neo-salvarsan on August 21. At present the skin lesions have nearly all disappeared, his mouth is nearly well, and his piles (?) are not bothering him.

I gave him another injection September 21 and made frequent Wassermann tests and will keep him on treatment for at least a year. I haven't made a Wassermann up to the present, as I considered it unnecessary. Can you imagine what this patient's condition would have been if he had continued the druggist's treatment a few month's longer?

It seems to me that our medical laws need a revision upward, in favor of the medical profession. Every State has a law a yard long, but as near as I have been able to learn, they don't interfere with any class except the regular medical profession.

If a legally qualified physician of this State should decide to locate in Kansas for the benefit of his health or any other good reason, the Kansas board would put him through a grilling that would leave him in a state of nervous prostration. And, likewise, our board would do the same thing to any Kansas physician who tried to crowd in here. These laws were passed under the guise of protecting the dear people. Shucks! You will have to show me!

Northern-grown Nuts.

Last month we printed a letter from a California physician which spoke of the winter killing of the English walnut tree. It is only fair to say that there are more hardy varieties of the English or Persian walnut which are successfully fruited in some of the prairie States. Sometime since we printed an editorial expression upon the commercial phases of nut culture, and received a letter from Dr. W. C. Deming, Secretary Northern Nut Growers' Association. To present the opposite side from that of our California contributor we now print Dr. Deming's letter.

EDITOR MEDICAL COUNCIL :

It was from Dr. Morris's article in THE MEDICAL COUNCIL, "Nut Growing for Physicians," some years ago, that I got my inspiration for the work. I have always been grateful to THE MEDICAL COUNCIL for this, and in no way regret the inspiration.

Your comments on Circ. No. 2 of the N. N. G. A. is fair and thoughtful. Most of what you quote is from the pen of Dr. Morris. I think it cannot be denied that the nuts mentioned can be grown successfully by amateurs and some of them commercially, as stated. The hard shell almond fruits freely with Dr. Morris, H. B. Fullerton and others. It is still strictly a fruit for amateurs' experiment.

The only obstacle in the way of the successful commercial growing of chestnuts is the blight, but that is a very serious one. I have faith that a way to get the best of this will be found.

I would not advise the attempt to grow the filbert commercially. Almost to a certainty they will be destroyed by the hazel blight before profits materialize. Were it not for this the hazel would be a nut of great promise.

Pecans in the north are strictly experimentalbut hopeful. I have no doubt that the Persian walnut will be commercially grown in the north. The "Pomeroys" are so already on a limited scale, and the tree is perfectly hardy. So are the "Holden," "Rush," "Nebo" and many others. The best ones to plant are yet to be determined, and that will take many years. The Persian walnut is exacting as to soil conditions because we do not yet know just what those conditions are. When we do, no doubt they will seem less exacting.

Do not forget the heart nut, J. cordiformis, for which a good future can be hoped.

My brief experience leads me to say that, while I can see no likelihood of realizing much profit on nuts in the north for a good many years, yet I know of no occupation more suited to the peaceful desires of the retired physician, or fuller of delightful possibilities for study, recreation and future benefit to himself and to others.

Westchester, N. Y.

W. C. DEMING.

Five- and ten-cent store stocks are getting too thick for safety; better look out if any is offered to you.

The American Potato Company is one of the new entries, with a million in stock and big dividends certain. We can't see it; their literature is visionary.

The Retained Family Doctor. There has come a new movement which is growing rapidly in the large cities, and it undoubtedly will come into great prominence in the near future. This movement, like the first flash of dawn, is unheralded and unnoticed, but nevertheless it is coming on steadily, and slowly bringing in a new era and settling some of the great problems that at present distress the medical world. This new practice is that of retaining physicians the same as lawyers are retained in large corporations, who are given a fixed fee for looking after the interests of their clients, preparing their papers and deciding all questions of responsibility and thus preventing legal action and legal disturbances. Wise business men have lawyers retained to defend their interests as a matter of economy and sound judgment. In medicine the same thing is coming. A man pays his physician a fixed sum for calling on his family once or twice a week as may be agreed upon, and for advice on all other occasions. He becomes the family adviser in health matters, and the consultant to anticipate and prevent possible diseases. The more intimate his knowledge with the family, the more valuable his services become, and the family learns to depend on him in all questions of living and matters that pertain to health and vigor. This service is paid for, so much a year, and the physician knows his exact income and the requirements expected, and has something literal and real to work upon. The fees for such services increase from year to year. The man with a family, who pays $100 to $200 a year for the attention of the physician, finds that it is the greatest economy and wisdom, and the physician becomes more and more valuable, and his yearly practice is paid for at higher rates. The old family physician was literally a retained doctor, although not called unless some one was sick. The new plan is coming on steadily, and slowly bringing in a new era, and the physician will know the various conditions of life, of eating, sleeping and working, and be able to point out the errors and the conditions that will lead up to disease, and show a world of preventive medicine, which after all is the highest realm of medical practice.-Medical Standard.

We note that some of the Southern railroad shares have been doing well.

The tin can makers have been seeking buyers of stock, but from financial journals we learn that there is too much frenzied finance in this industry at present.

We always take more pleasure in testifying to the merits of a good proposition than in denouncing a bad one. We have been on a trip down the Shenandoah Valley, the great apple country of Virginia, and it was an amazement to us. We know something about apples from raising them ourselves and we never saw a finer apple country than is this fertile valley.

BEST IDEAS FROM RECENT

LITERATURE

Scar Tissue and Cancer.

Dr. John M. Bell, St. Joseph, Mo., in The Medical Herald, October, 1912, makes out a good case against the theory of scar tissue forming a frequent site for cancer, when he says:

The theory that scar tissue forms an ideal soil for the propagation of malignancy, and is itself the immediate cause of its existence, has not been proved, since scar tissue generally remains scar tissue; but this is so closely associated with the real truth that a rearrangement of the premises develops it. Cancer of the digestive tube practically always locates itself upon the sphincters-the cardia, pylorus, cecum and internal rectal; or at the flexures-the hepatic, the splenic, those anatomic parts where perverted functional activity produces trauma, and increased bacterial activity maintains it; those parts of the digestive tube most liable to be the site of ulceration and where, when an ulcer once forms the same agencies maintain its existence. If by virtue of good hygienic habits or well directed treatment these points do heal, healthy scar tissue will hold its own as long as trauma and increased bacterial activity are held in abeyance. If, on the other hand, there be a lack of good hygiene or by imperfect negative treatment these ulcerated surfaces do not heal, or only partly become converted into scar tissue; or by reason of toxic material in circulation complete healing becomes impossible, then malignant proliferation is the next step, not, however, beginning upon the scar tissue, but on the unhealed and incessantly irritated surface which has been unable to progress to the condition of a scar. As pointed out by Hertzler, if scar tissue were the essential etiological factor, cancer of the rectum would be exceedingly common, when the number of individuals who carry it is considered. Statistics from Rochester and other hospitals illustrate the extreme length of time peptic ulceration may remain in statu quo without perforation or malignancy; they also show the large percentage of ulcers that undergo malignant ulceration presumably upon scar tissue, but we have no evidence of an ulcer thoroughly healed, upon a complete scar, that underwent malignant proliferation. The analogy therefore is pertinent, that malignancy follows in those cases where ulceration is maintained by incessant trauma, with bacterial activity, and where the toxic co-efficiency of the blood is so high as to render complete healing impossible.

Colony Care of the Insane.

The Psychological Clinic, October 15, 1912, in commenting upon an article by Dr. Frederick Peterson in The Survey, reproduces portions of the article, from which the following is taken:

"From this discouraging prospect it is a relief to turn to the description of two remarkable colonies or villages for the insane which Dr. Peterson has visited. One is in France, at Vanves, near Paris, founded a hundred years ago by Doctors Voisin and Falret. A park of sixty acres is divided into two parts-one for women, the other for men-by a farm in the middle. Many little cottages have been built, each with its own garden enclosed by tall hedges. Here the patient can be isolated not only from his old associations, but also from contact with other insane people.

The other colony is the charming village of Iwakura, near Kyoto, Japan. About nine hundred years ago the temple and holy well of Iwakura became famous through the cure there of the Emperor's daughter who had suffered from melancholia. In 1889 the village consisted of 239 families, each receiving one or two insane patients 'to share in the occupations of the household, which are chiefly out-of-door employment in fields, gardens and parks and some of the arts and crafts of the ordinary Japanese home.' Dr. Peterson remarks upon the charm of the place, the simplicity of its architecture, the beauty of its gardens and woods, the airiness of the little houses, the exquisite cleanliness of everything, and best of all the delightful manners of the inhabitants. 'No doubt we of the West,' he concludes, 'will some day be glad to copy this Japanese model when we finally awaken to how far we have drifted from an ideal system of care and treatment of the insane, with our immense, expensive and complicated machinery of mere support and custody.' But with an unmistakable accent of regret he adds, 'I believe such gentleness, kindness, patience and assiduous attention to the sick could be found nowhere else, for nowhere else exists a whole race of people who never scold, quarrel, or manifest impatience, but always turn a smiling face and extend a helping hand to one another.'"

Nitrous Oxide-Oxygen-Ether Anesthesia.

Drs. Fred'k J. Cotton and Walter M. Boothby, of Boston, in Surgery, Gynecology and Obstetrics. September, 1912, give the details of and illustrate a perfected apparatus which permits one to avail himself of the many advantages of this combined anesthesia.

In their experience, nitrous oxide-oxygen anesthesia is effective in major surgical work, but is not safe if pushed to any degree of cyanosis. They disapprove of the procedure of increasing intrathoracic tension of the gases for the purpose of deepening the anesthesia, but safely produce moderately profound anesthesia by admitting a minimum amount of ether vapor. method results in quick and agreeable recovery from the narcosis and largely reduces the danger of supervening post-operative "surgical shock.'

This

It appears that nitrous oxide requires both skill and great care in its administration, and makeshift apparatus should never be used.

Rheumatic Fever.

Dr. A. M. Nodine, a dentist of New York City, in New York Medical Journal, September 14, 1912, concludes an article upon septic mouth and carious teeth in relation to rheumatic fever, as follows:

1. Rheumatic fever is an acute or attenuated general infection accompanied by toxemia, autointoxication, chorea, high blood pressure (51), anemia, carditis and arthritis.

2. The microorganism, and its toxine most concerned in the stimulation of the particular symptoms evinced in rheumatic fever, is diplococcus rheumaticus of the streptococcus family.

3. The portal of entry for the infection is the oral cavity.

4. Oral sepsis plays a direct part in the causation of rheumatic fever by supplying the necessary conditions and ingredients for the absorption, via the gastrointestinal tract, of the factors concerned in the excitation of the symptoms exhibited.

5. Oral sepsis plays a direct part by supplying the necessary conditions also for the absorption from the mouth of the agents that induce the train of symptoms manifested in rheumatic fever.

6. The correction of the conditions contributing to oral sepsis will exert a positive and favorable influence in preventing and curing rheumatic fever.

Treatment of Whooping Cough.

Oppenheim, in Progres Medicale, recommends in the treatment of this disease, substantial diet in a concentrated form and in frequent small quantities. A little black coffee, he finds, restrains the vomiting. Older children can, with advantage, use a gargle containing a mere trace of hydrated chloral or 1 per cent. salol.

Night and morning introduce into each nostril a small quantity of the following: Resorcin, 0.40 gms.; boric acid, 3. gms.; vaselin, 30. gms.

A mixture composed of 10 gms. each of oils of thyme, encalyptus and turpentine, and 250 c.c. alcohol, is vaporized from the surface of boiling water at intervals of proper frequency for the size of the apartment.

The thorax is annointed with the following preparation: Guaiacol, 5 gms.; quinine bisulphate, 4 gms.; aromatic vinegar, 200. gms.

For internal use, valerian, bromides, bromoform and antipyrine are suggested.

Thos. W. Dewar, in British Med. Jour., September 21, 1912, recommends intravenous injections of iodoform in the treatment of whooping cough in adults. He uses 1 grain of iodoform dissolved in 10 minims methylated ether of a specific gravity of 0.720. Dewar has long used such injections in tuberculosis, but some of his imitators have met with unpleasant experiences in its employment.

McCarthy, pathologist at the Mayo clinic, has shown that 1⁄2 per cent. of all appendices removed for chronic appendicitis are carcinomatous.

Cell implantation during operation accounts for many recurring cancers. Before closing the wound swab with iodine.

Bryant warns against the use of active cathartics in intestinal obstruction.

"The Serum System."

If some gentlemen think we are getting frivolous, we hope they will forgive us for this temporary lapse; but we cannot resist the temptation of reproducing from the Boston Post the following:

Once upon a time, not so very long ago, a boy This was born, and they named him Willie. boy's mother did not nurse him, but he was put on the bottle. Fortunately a learned scientist had discovered how to pasteurize milk so that the boy did pretty well on most any old cow's milk.

When this boy was two years old he caught the whooping cough. Fortunately, Professor Bordet, of Brussels, had discovered that antitoxin serum from a cat would cure whooping cough, and some cat serum was injected into Willie.

Soon after Willie got about again, he was taken with the measles. Fortunately Dr. John P. Anderson, of Washington, had discovered that antitoxin serum from a monkey would cure the measles. So they pumped monkey serum into the boy, and the measles didn't kill him.

One day Willie was playing with his pet terrier, when the dog scratched him. So his folks, dreading hydrophobia in its worst form, rushed him down to New Jersey, where there is a great institution in honor of Professor Pasteur, who fortunately discovered that antitoxin serum from a dog was a fine thing for rabies. They pumped dog serum into little Willie for two months.

Willie pulled through nicely, but on the way home rode in a Pullman sleeper in which a smallpox case had been discovered. Fortunately Dr. Jenner had discovered that antitoxin serum from a cow would cure smallpox and so, on getting home, they pricked some cow serum into Willie's

arm.

Well, Willie lived along until he was ten years old, when one night his folks were sent into a panic by discovering that he had black diphtheria. Fortunately a noted physician had discovered that antitoxin serum from a horse would cure diphtheria, if anything would, and so they gave Willie some horse serum hypodermically.

Finally, at forty years of age, Willie was taken with a mysterious malady. None of the doctors could tell definitely what it was. At last, as Willie was very low, a very learned scientist from a great eastern institute visited him and pronounced it "general debility." "But, cheer up, my man!" said the scientist, "I have here an antitoxin from-”

"No more menagerie in mine,' sighed Willie. "Life has been but one blamed serum after another." Whereupon he turned over and died, much to the regret of the scientist, who felt sure that he was about to enrich medical science with another great discovery, since he was about to try serum from a hen and an alligator on "general debility."

We don't know that there's any moral to this story. But there's a whole lot of truth to it, anyhow.

Meltzer, speaking of the therapeutic nihilist, says: "The history of the use of iron in the treatment of chlorosis ought to be a lesson. Great laboratory men like Bunge and Schmiedeberg denied persistently that inorganic iron could be absorbed. The struggle lasted for nearly a quarter of a century."

The Therapeutics of Peritonitis.

Dr. Richard A. Barr, Nashville, Tenn., in Southern Medical Journal, after a discussion of the surgical factors involved, has this to say:

It

With regard to drugs, I believe in the use of morphine before and after operation. In my opinion, opium does not mask symptoms. may lull the patient into a fancied sense of security; not so the physician in charge. A history of the amount of morphine required to quiet a patient is about as instructive as a sight of the suffering patient. I much prefer a patient who has been narcotized to one that has had persistent efforts made at purgation. The administration of purgatives in acute abdominal troubles is only justified by excluding their surgical nature or by waiting until after operation has been performed. After operation I give calomel promptly, and at the same time give enough morphine hypodermatically to quiet pain and excitement. I have never found that morphine causes any difficulty in getting the patient's bowels moved. In fact, in my opinion, the only contraindication to the use of morphine after operation is an idiosyncrasy on the part of the patient.

Breast-Feeding and Tuberculosis.

Dr. George S. Strathy, Toronto, in Canadian Journal of Medicine and Surgery, Sept., 1912, in the course of a very sensible article, says:

There is a steadily-rising wave of opinion that the transmission of bovine tuberculosis to human beings is rare, if it ever occurs. The majority of cases of tuberculosis are the result of infection in early childhood from persons suffering from pulmonary tuberculosis. The tubercle bacilli may lie dormant for years, usually in the mediastinal or mesenteric glands, and later give rise to active tuberculosis of bones, lungs or other organs. In the Tuberculosis Clinic at the Hospital for Sick Children we find in over 90 per cent. of the cases a history of exposure to infection from a parent or some other person who has pulmonary tuberculosis coming in close contact with the child. This may sound like a strong argument against breast-feeding from tuberculous mothers, but as the father is almost as frequently the source of infection as the mother there is no reason to believe that the child is infected through the milk. Tubercle bacilli have never been found in human milk when the breast was not diseased. Cows' milk frequently shows the presence of tubercle bacilli because tuberculous ulceration of the udder is common. *

On the question of tuberculous mothers nursing their babies I am not prepared to give a decided opinion, but my practice at the present time with poor patients, who will be with their children anyway, is to allow maternal nursing so long as mother and child are thriving. The mother is given explicit instructions to avoid danger of mouth infection by kissing, etc. Amongst the well-to-do, where a nurse is employed to take care of the baby, the chances of infection by mouth are unnecessarily increased by allowing the mother to nurse and handle her child. This risk should be lessened by insisting on bottle-feeding after the first few weeks, and during that time precautions should be taken to prevent infection.

"AN HONEST CONFESSION IS GOOD FOR THE SOUL."

A Pennsylvania physician, in a local medical society announcement bulletin, The Mirror, probably stated a sad truth when he said:

Several weeks ago, the window of Huston's Drug Store, in Connellsville, contained an interesting exhibit, consisting of prescription files of forty years ago. We

are so accustomed to talk of the great advances in medicine in recent years that we have come to regard the physicians of the Seventies as being what Abe Potash would call "a lot of ignorant low-lifes." It was somewhat of a shock, therefore, to see that the files of 1872 contained far more intelligent prescriptions than those of 1912.

The doctors of forty years ago used good reliable drugs, combined them intelligently, and knew what they were giving.

"Bust Developers.”

To see what they were, the editor sent for circulars of advertised preparations of this character. Almost without exception they were filled with "before and after using" illustrations. The illustrations of the "after" type were genuine enough, but the "before" ones were the genuine retouched so as to make the subjects look flatbusted, and some of the retouching was very poorly done. What a fake they were!

Physicians' Drug News gives a formula for a bust massage cream, as follows: Cocoa butter, 2 ounces; lanoline, 2 ounces; extract saw palmetto, 2 ounces; oil cajeput, 1 ounce; oil sassafras, 1⁄2

ounce.

Internal "treatment" usually is the following, or some modification of it: Fluidextract galega, 1 fluidounce; fluidextract saw palmetto, 1 fluid ounce; calcium lactophosphate, 3 drachms; simple elixir, q. s. 16 fluidounces.

When you go out into the world take your taffy stick along. You'll find it very useful. Some men talk lunar caustic, and leave a sting behind them; some use the glum rod of silence, and some the shallow flood of chatter; but you use the taffy stick invariably, and not only will life move as smoothly as a river of grease, but you will leave smiling faces behind you, and nugget-laden bouquets will be flung at your feet. But it must be sincere, truthful taffy.

Bainbridge states that Oscar Wilde was found, upon autopsy, to be the victim of a large brain abscess of otitic origin, and he states that mental alienation and even crime may often be traced to such abscesses.

Henry Ling Taylor claims that spontaneous fracture is apt to be an initial or early symptom of tabes dorsalis.

The best way to prevent blindness is to prevent gonorrhea.