Each tablet is attached to all other tablets BY A THREAD, and packaged in a specially designed bottle, thereby rendering it impossible that a tablet should be used either day or night without having first detached it by cutting the thread or slipping the tablet from the thread. Besides this unique feature of threading, these tablets are TREFOIL ACCURACY, EFFICIENCY AND SAFETY ASSURED. GEORGE W. BOSKOWITZ, M. D., Editor. JOHN W. FYFE, M. D., Associate Editor. Subscription, $1.00; To Foreign Countries, $1.24 Per Annum. Contributions, Exchanges, Books for Review and all other communications should be addressed to "The Eclectic Review," 242 West 73rd Street, New York City, N. Y. Original Articles of interest to the profession are solicited. All rejected manuscripts will be returned to writers. No anonymous letters or discourteous communications will be printed. The editor is not responsible for the views of contributors. VOL. XVII. NEW YORK, FEBRUARY 15, 1914. No. 2 The Harrison Bill. This bill, which is known as the National Anti-Narcotic Bill, was signed by President Wilson, December 24, 1914, the bill having passed the House of Representatives December 10, 1914. The law will go into effect on March 1, 1915. This law was aimed at the illegal sale and improper use of narcotic drugs. The drugs under ban are "opium or coca leavees, or any compound, manufacture, salt, derivative or preparation thereof." Physicians and pharmacists will be required to keep records for which purpose the government will furnish blanks. Hints and Winnowings. The dangers of "twilight sleep" in obstetrics are well pointed out by Dr. R. W. Wilcox, in an able article on the therapeutics of the old school of medicine, published in the January issue of the Medical Times. The part of the doctor's article referring to the re-introduction in the United States of the "twilight" procedure (known as dämmerschlaf) may, as an addition to the warnings heretofore given, interest the readers of the REVIEW. In part, Dr. Wilcox says: "In marked contrast to the scholarly investigation and dignified presentation of anoci-association, is the flamboyant exploitation of the dämmerschlaf, not that this may be an immense gain to obstetric therapeutics, but the very mode of its promotion excites suspicion and provokes criticism. Notwithstanding all this, careful investigation has shown that a method twice tried and abandoned has at last secured a legitimate place in medicine-its dangers in the prolongation of the second stage of labor, although somewhat offset by its shortening of the first, and its necessary disturbance of the child, must be guarded against by extreme care in its employment. The chemistry of the mydriatic alkaloids found in or developed from the Solandelaceae is still far from resting upon a sound basis and, while the single dose of morphine (onesixth of a grain) or of narcophin (one-half of a grain) is usually perfectly safe, the amount of scopolamine (one one-hundred and fiftieth of a grain) which must be repeated so that its physiological effect shall be continuous, because an interruption of complete consciousness spells recollection of pain and a reconstruction of the entire course of the labor, introduces an element of danger which is difficult to be completely eliminated. On the side of the mother atonic post partum haemorrhage and prolonged labor; for the child, asphyxia and death, the latter very remotely possible, are dangers to be considered. So long as the actual amount of scopolamine is not determinable and the personal equation of the mother cannot be accurately estimated, the establishment of amnesia and its persistence must be the guide in the administration of the drug. Success in this method demands (1) a high degree of technical knowledge of the physiological effects of scopolamine in general. and a special knowledge of the patient in particular, (2) a marked degree of technical obstetrical skill, and (3) uninterrupted attendance on the part of the physician during labor and absolute attention to details of administration. With these limitations the method constitutes a real advance in therapeutics." Cancer of the breast, according to the estimate of the American Society for the Control of Cancer, annually causes the death in the United States of at least 7,000 women who could have been saved if they had attended to themselves at the proper time. No doubt physicians are numerous who have known such lives to be sacrificed to ignorance or unjustified modesty. One death of this class recently occurred in my own practice. In commenting upon the report of the American Society for the Control of Cancer, the editor of the Critic and Guide well remarks as follows: "Any lump or unnatural hardness in any part of the breast or in the armpit, or any reddish or brownish discharge from the nipple with or without soreness should receive instant attention and should be brought to the notice of the family doctor or a competent surgeon. And especially is the painless lump to be feared for the breast cancer in its earlier stages does not compel notice by painful sensations. Cancer of the breast is not at first accompanied by any noticeable change in the size or shape of the breast, or in the consistency of the remainder of it. The disease sometimes shows itself as a hardening or shrinking of the breast with indrawing of the nipple. In such cases the pores of the skin over the location of the disease later become very pronounced so that the appearance is much like that of pigskin. But in the beginning there is no change noticeable except the lump or hardness. If a woman discovers this sign she should go at once to a physician in whom she |