Present Prevention and the Spread of Consumption.

Dr. Thos. J. Mays, of Philadelphia, in Medical Record, November 30, 1912, presents a most scholarly article upon this subject. The whole philosophy of the reform of old methods is embraced in what he says of the colored race, as follows:

"Before the Civil War the colored race was practically free from consumption—at least, its death rate in the South was not higher than that of the white population, in spite of the fact that they were probably more exposed to the disease then than they have been since. From reliable sources it is learned that the negroes 'nursed the white consumptives, washed their spittoons, bedding and clothing, swept and dusted their rooms, and in many instances slept in the rooms with them-literally being with them night and day, and were more exposed to the tubercle bacillus than now as a general thing; still they resisted the disease.' (Powell.) Notwithstanding their immunity before the war, it is well established that at the present time the death rate of consumption among the negroes of this country is from two to four hundred per cent. higher than it is among the whites. Why should the negro race, in less than half a century be transformed from the least to the most consumptive race? Why should this come to them without the change of climate, or without the influence of migration, but in the land of their involuntary adoption, in which they had continually lived for more than two hundred years? The principal reason for this change was that since they obtained their freedom their entire social, economic and political existence became revolutionized. Instead of being dependent on their owners for food, clothing, shelter, medical care, and general supervision, as was their wont in the days of slavery, they were thrown on their own resources and were forced into a struggle for a living that was as unequal as it was tragic. And it is not at all surprising that in the severe stress and strain which they were compelled to undergo to readjust themselves to their new environment-to a civilization which was thousands of years ahead of their own social status-their constitution, and especially their brain and nervous system, became undermined and exhausted, and they fell an easy prey, not only to pulmonary consumption, but to insanity in excessive proportion, and from which they were also free before the warshowing that both diseases originate from com

mon causes.

"On the other hand, it does not require a very severe stretch of the imagination to perceive that if, through some magic spell, the negroes were translated into that state in which they could enjoy the advantages of care, food, shelter, clothing and general oversight, such as they received during slavery days, without being subject to the institution of slavery, they would in time revert to their former freedom from consumption and other diseases which now threaten to decimate them To show the possibility of this, it may be incidentally stated on reliable authority that from 1860 to 1870 Spain brought 250,000 coolies under contract to the island of Cuba. They were drawn from the scum and off scouring, Drincipally of the cities of Canton and Macao, and, in spite of the most careful selection, they brought with them consumption and other diseases for which China is noted. The vast ma

jority of them were placed on plantations, and, being under contract and under the supervision of overseers, who ministered to all their physical necessities, so far as food, shelter and care were concerned, their condition being practically like those which obtained during negro slavery in the South, within the first few years consumption was eliminated, either through death or cure, and never reappeared in them or in their offspring."

Whose Ox Has Flexner Gored Worst?

When Flexner issued his first report, dealing with medical education in the United States, the Canadian and European medical press assumed an I-told-you-so attitude. Now that the immaculate European schools have been scored by his itching lancet, Flexner is not half the good fellow he used to be, is too iconoclastic and several other irreverent, impious and heterodox kinds of twister of Johnny Bull's pet lion's tail and the caudal appendages of the rest of the European managerie; but of course, he pulled no white feathers out of the American eagle's tail. Oh, no!

It all depends upon whose ox is gored. Go it, Flexner, you are doing fine! We are enjoying your stirring up of the animals; but, dearly beloved brother, we commend for your consideration Proverbs 26:17, which says: "He that passeth by, and meddleth with strife belonging not to him, is like one that taketh a dog by the ears." You may wish you had never taken hold, but you dare not let go.

And upon this text we will not further preach, but will let The Canadian Journal of Medicine and Surgery, in their December, 1912, issue, speak for the lion, when it says:

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"Flexner's first report on the method of medical training in vogue in the United States complished its object to some extent. It brought into the strong limelight of public opinion many existing abuses, and as a result a considerable number of worthless medical schools have gone out of existence, while other schools have been compelled to set their houses in order. His strictures on Canadian Schools were not quite so just and in his later report on European schools he has erred in many directions. For instance, in comparing the British to the German system of medical training, to the disadvantage of the former, he does not appear to have obtained his information at first hand. His description of British methods holds good for ten years ago, but not for the present time. Moreover, when he claims that the German method of teaching by means of professors who do nothing but teach and are without clinical experience are the best, he surely speaks without his book. No man is so well qualified to impart knowledge as he who is meeting with cases all the time, and besides such instruction must be of the most practical value. German teaching is the best theoretically, British teaching the best from the clinical standpoint. Flexner seems also to have overlooked the fact that scientific research is not neglected in Great Britain. Like most reformers the author of the report is too iconoclastic and does not dis

criminate closely enough. In order to render his argument sufficiently sweeping he is too apt to make general statements."

Sexual Discontent.

Turn a fair-sized calf into fenced pasture containing good rich grass, and he will soon tire of the generous supply of food legitimately supplied and wander around in discontent looking for an opportunity to get some of the same kind of grass that is just outside the fence. He will butt against that fence, endeavor to crawl under or jump over, devise many clever schemes to retain the credit of staying in the pasture while he feasts on the grass outside, and yet we can see absolutely no reason for his discontent. So it is with misunderstood man. In the pleasant pasture of conjugal bliss, surrounded by the matrimonial fence, he is not often perfectly satisfied. He peeks through the fence at some plump or gracefully thin blade of grass, and at once is filled with physical discontent. He braves consequences worthy of a better cause, and invents clever schemes that might result in untold happiness if used along other lines, and barters future prospects of all human success, trying to get the few halo-surrounded blades of grass on the outside of that fence. And when he breaks through and gets what he has so strenuously been striving for, what has he got? What is his reward? What follows?

It will be a sad-looking calf. In all probability there will be bruises on its head from clubs, a sorrowful heart from disappointments, and sores all over its body from specific effects on the blood. All the other calves have no difficulty in seeing the misfortune of this calf, yet the foolish ones continue to try with all their might to get through that same fence.-A. D. Hard, in The Medical Times.

Vaccination in the Middle of the School

Year.

The Mulford Digest, a house organ of scientific worth, has raised a point which should be carefully considered, and that is to postpone the usual date of vaccination from the beginning to the middle of the school year. July, August and September are the very worst months of the year for securing satisfactory vaccination results because the vaccine must then be shipped, stored and used under the worst climatic conditions.

If vaccination is performed during the cold weather, say from December to March, the virus is not only more active and efficient, but the vaccination wounds are less exposed to dirt and dust, especially in young children, many of whom receive vaccination wounds and then go out and play in the dirt around stables in warm weather, and the vaccination sore makes an ideal "port of entry" for serious infection.

The point is admirably well taken, and common experience justifies careful heed to the warning.

The Prevention of Rheumatism.

Dr. D. T. Quigley, North Platte, Neb., in Western Medical Review, December, 1912, says: Rheumatism has passed from a medical to a surgical disease: it is an infection. He believes that "colds," dental caries, pyorrhea, gonococcal and other systemic infections, disease of the tonsils, adenoids, foci of chronic infection and an unclean mouth are the principal causes.

Prevention is of primary importance; drug treatment must be directed to the "cold" and the infection, and varies according to the case; while the radical and curative treatment, in many cases, must be surgical.

Physicians will prevent a vast deal of chronic disease, of which rheumatism is but one instance, by qualifying themselves in minor surgery, and promptly doing the many little operations which should be done. Did you ever note the fact that the parts of the body which are not clothedthe head and the hands-are peculiarly Tiable to various infections? Keep an eye upon the teeth, the throat and the fingers, and fewer infections will become serious.-EDITOR.

Furunculosis and the Rational

Treatment.

In New Orleans Medical and Surgical Journal, December, 1912, Dr. John L. Kelly, Melrose, La., after emphasizing prophylaxis, especially keeping the hair on the back of the neck clipped, divides the treatment according to stage-formation, ulceration and resolution. To abort in the first stage: bore a pointed match stick dipped into phenol firmly and deeply into the middle of the furuncle, and then withdraw it. Dr. Kelly does not approve of free incision, but he lifts off the central vesicle with a short scalpel. He dresses with plain sterile gauze wrung out of a normal saline with one per cent. sodium citrate. prevent pustulation, he applies zinc oxid ointment around the base. The patient is placed upon diuretics and tonics, giving routine dressing with hydrogen peroxid and, finally, antiseptic dry dressings.

The Lingual Tonsils.

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Dr. John H. Johnson, Coffeyville, Kans., in Journal of Ophthalmology and Oto-Laryngology, November, 1912, contends that the lingual tonsils secrete lymphocytes and contain numerous mucous and albuminous glands not to be found in the other tonsils; therefore they are protective, acting as barriers against infection. When normal they should not be disturbed, but when they become diseased they can be changed into dangerous organs of infection. Nearly all of the infections except that of rheumatism may find a site here, making it important that simple throat affections be carefully treated and the vital organs guarded. Numerous reflexes result from diseased lingual tonsils, and such reflex disturbances, as well as the disease itself, may require removal of the lingual tonsils.

Temperaments and the Teeth.

Dr. Gustavus North, Cedar Rapids, Iowa, in The Dental Brief, December, 1912, in addition to general points in the matter of temperament, adds some dental data. He asserts that, in the nervous temperament, the teeth are pearl blue or gray in color, long and decidedly narrower at the neck than at the cutting edge, with long bite and prominent cusps. The occlusion is close and penetrating with very little, if any, lateral motion of the jaw in masticating.

In the bilious temperament, the teeth are of a yellowish color, slightly narrower at the neck than at the cutting edge, rather long in proportion to width; occlusion firm and close, and little lateral motion.

TH

HE DAWN of the north polar day brings work to the doctors of the northern hemisphere. At this season of the year the polar atmosphere expands and there is a complete transposition of the air, resulting in high winds. In March, east of the ninety-seventh meridian, the winds. are from the west or northwest, carrying out the general lines of our winter storms, which move eastward with the westerly winds and in a line with the isothermals of the month in which they occur. And seasonal isothermals in the United States are peculiar, and they largely account for our peculiar March weather. The eastern or Atlantic seaboard of the United States, were it not for our winters, would have to be classed as tropical south of New York. So far as our annual and deciduous plants are concerned, many are tropical. Indian corn is, by some, classed as a tropical product, and a large number of our fruits and vegetables are really tropical.

Our periods of transition from tropical to frigid conditions, and vice versa, impose a tremendous stress upon body equilibrium. Just what terms will best express this stress is hard to say. Certainly it is not temperature, for, within average limits, temperature has little to do with health. The body has an immense power of adaptation

to varying temperatures, and it is chiefly because of being housed in close rooms that cold weather produces disease. We Americans fuss over temperature more than is good for us. We were over the most of our Atlantic coast during the past winter, and everywhere, north and south, people were fussing over temperature: they were all cold if it happened to change a little. What a house-ridden lot of weather cranks we are! Even the ancients knew better.

But temperature is not the whole of climate; so far as zoologic life is concerned it is of secondary importance, whatever may be said of botanic forms.

Wind and storm is a great factor, especially with man. The atmosphere is an aëriform mass with constant changes in the lower strata, giving rise to winds. This is markedly true of the month of March.

Speaking of the ancients, they had some pretty good ideas about the winds. Boreas, the fierce and piercing north wind, was represented as a bearded old man, warmly clothed, but without a water vase, and he guards his nose and mouth with his mantle. Kaïkias, the northeast wind, is an elderly man spilling olives, denoting that he is unfavorable to the fruits of the earth. Apeliotes, the east wind, is a handsome youth bearing fruits, honey and grain in

his mantle. Eurus, the southeast wind, is a morose old fellow, nearly naked and given to violence. Notos, the south wind, has a sickly aspect and clouded head, significant of unwholesome heat and dampness; he is emptying a water jar. Libs, the southwest wind, is a robust, stern chap, and is given a maritime setting. Zephyros, the soft and benign western wind, is a lightly-clad and bare-legged youth, of pleasing countenance and bearing flowers. Schiron, the northwest wind, is robust and bearded, with warm robes and boots; he carries a small water vase. All this is poetic, but largely

true.

Certain winds are provocative of some diseases, or aggravate them. North and northeast winds influence neuralgia; east winds depress those of low vitality; moist south winds will precipitate attacks of asthma in some persons. Dry and desert winds aggravate nervous cases, especially when the winds are of the peculiar electrical phase noted in some places. Moist and cold winds aggravate rheumatism.

Morbidity statistics show that March is characterized by whooping cough, croup, bronchitis, pneumonia and quinsy. The respiratory diseases generally are much in evidence, especially those having a bacterial origin. Why is this the case? Probably the winds and rains have much to do with the matter.

The prevailing winds of the west coast. are developed at sea; those of the east coast are land winds. Experiment has shown that surface winds over country areas carry air with a content of organic life 7,000 times that of marine air from high levels, while city air contains 55,000 times as much organic impurity. Is it not reasonable to suppose that this land wind is responsible for some of this increased illness?

We of the East have, in general, twolevels of clouds. The upper level comes from the western country, taking the moisture they need so badly and precipitating it upon this humid country, and this rain is

pure and wholesome, washing the air to a great height. Our lower level of cloud seldom precipitates, though it is the more apt to do so in spring and fall, and such rains are full of impurities.

These conditions probably are factors in making March a more unhealthy month on the Atlantic seaboard than on the Pacific one. Be it remembered, as well, that air impurities are not all bacterial, but are largely moulds, fungi and other low-grade plant forms carried up into the air by the great ascent of heated atmosphere in the tropics. These organisms are all more or less irritant, and some of them are provocative of disease.

Fog is a large factor in making March unhealthy. Fogs come from the low strata and are unprecipitated cloud full of organic impurities, especially over cities where smoke adds its quota of filth. Melting streams, thawing land, uncovered decayed vegetation and the detritus of winter in general adds to the content of fog, which is really wet and filthy air under such circumstances. Fog takes the ozone out of the air by uniting it to nitrogen in the presence of moisture. Fog grounds whatever electrical qualities exist in the atmosphere, and renders it dead and inert. Fog wards off light and the bactericidal sunshine. Fogs may help plant growth; they are detrimental to animal life. Fogs are nearly always bad unless they sweep in from the sea, and especially is this true of the March fogs.

Nothing need be said here of ground and water contamination, except to say that the filth of winter is not buried and causes trouble in March, when it thaws out.

Surely March is a month in which the sanitarian and the physician must needs guard well their laurels, for Nature is against their fight.

Polypi sometimes occur in front of a urethral stricture. Who can clear up their pathology? Are they true papillomata or are they granulation tissue?

IT

Surgery and Osteopathy.

T IS A STRANGE commentary upon recent advance that the assumed love of science is being so identified with the real love of money; and it is most discouraging to note that, as medical science is honestly developing along reasonable and truly scientific lines, along with this advance is growing up a callously indifferent propaganda seeing few opportunities in the healing art except those of personal gain.

And, let it be noted, this is a weakness in human nature rather than of any party or school. There are honest idealists and sincere lovers of the race within the ranks of every new and assailed party or school— and there are others.

Quite aside from the general contention for and against Osteopathy, and making no indictment against it that may not be justly applied in other directions, we are, nevertheless, seriously concerned over one of its recent phases, and that is its entrance into the field of operative surgery. A recent issue of a prominent and ably-edited osteopathic monthly was almost wholly devoted to operative surgery.

We have followed up this matter very carefully and note that there is a class of osteopathic practitioners who are truly able and earnest men and who feel very much contracted in their work by the original concepts of Osteopathy. It is not to be at all wondered at that they are branching out and following each the line of his especial bent. A few of them are developing into creditable surgeons, following the most approved technic and having good results. Almost without exception, these men have had a medical as well as an osteopathic course of instruction. With these few able osteopathic surgeons we have no especial contention along general lines.

But we sincerely believe that as a school, Osteopathy, especially as represented in its journalism, is following an utterly mistaken policy in urging its ordinary run of practitioners, the least equipped ones, to

take up minor or major surgery: most of them are wholly unprepared for this work, and it is against public policy to allow them to operate.

We are not so narrow as to assert that the time will never come when Osteopathy -then probably almost merged into the general medical cosmos-may properly enter the surgical field; but that time has not yet arrived.

R. E. Hamilton, D. O., in The Journal of Osteopathy, November, 1912, among other things, says: "Surgery and Osteopathy are from their very nature more closely related than Surgery and Medicine.

Improbable as it seemed some years back, it is inevitable that in time Osteopathy and Surgery (very much rationalized and changed from its average status of to-day) will align themselves against the fallacies of medicine." We suppose the writer quoted above sincerely believes he is a good prophet. We have serious doubts in the matter.

What a small coterie of osteopathic or other practitioners believe is of comparatively slight significance so long as their beliefs do not prompt incompetent and selfseeking men to exploit the public. But we fear that the proposed alliance of surgery and osteopathic practice will result in many half-baked "Osteopaths," "Mechano-therapists," "Neuropaths," "Chiropractics," and the whole grotesque assortment of manipulators rushing in "where angels fear to tread."

We suspect that the capable osteopathic surgeons are making a bid for the surgical work of the men of their school. We cannot object to this; but we do take issue with the way in which they are doing it.

Osteopathy has added little, if anything, to surgery, unless Dr. Abrams' cure for appendicitis be so construed. A successful osteopathic surgeon is successful wholly from his skilled application of well-known surgical principles. It is ungracious, to say the least, for these men to attempt to create an impression that they are reconstruct