with whom I have talked, lead me to believe that no benefit at all should be expected from any "hypo" treatment yet introduced.

I have talked with a number of cases that had taken several different methods or kinds of "hypo" treatment, as they term it, and I have never talked with one yet that believed any "hypo" treatment had benefited in any way, and I have had patients come to me who had been taking "hypo" treatments for months, but growing worse all the time, that commenced to improve immediately when they were given medicine by the stomach and continued to improve until cured.

A short time ago a man remarked, "I have been in this country five years, and I have never known of one bad case of the 'bugs' being cured by 'hypo' treatment, but I know of a number of really bad cases that have been cured by taking medicine in the stomach."

One patient said to me, "I want to try your treatment, I don't have any faith in it. I have never thought for the last year that I could get well, for I see all others in my shape die. I am just taking this to please my friends. I have taken every kind of 'hypo' treatment, except Friedmann's, that I could hear of for the past three years, and not one ever did me one bit of good, as I could see."

After seven months of medicine by the stomach he was able to do hard work that he had not done for three years, and he considers himself cured. A horse ran away with him, and dragged him by the lines, and he had two or three hemorrhages and acute run of the disease, but the last trouble was in the right lung, while the old was in the left, but though he had a severe cough and ran down until he was lighter and weaker than he had ever been, after one month's treatment, the active symptoms had all disappeared. He had gained in strength and weight and passed the examination and was admitted into one of our strong life insurance companies.

Yes, there can be absolutely no doubt that climate is a valuable curative agent in tuberculosis, as all who have the opportunity of observing results would be forced to admit.

There are many who come here and make

it their home and become free from the disease; others come here early in the disease, improve, and practically all of this class would permanently regain their health if they remained long enough, and I can conscientiously say that I believe that eight out of ten of all cases would recover if they come to the right place and take proper internal treatment, but I must leave the treatment of a future time, I have not the space here, as this article is too long already.

Deming, New Mexico.

UROTROPIN.

BY J. A. BURNETT, M.D.

It is thought that urotropin passes into the cerebro-spinal fluid and exercises an antiseptic action in same. This drug is employed in threatening or existing meningitis. There seems to be some difference of opinion as to its value in meningitis. Urotropin liberates formalin in the kidneys, thereby sterilizing the urogenital canal, and soothes the inflamed mucosa. It transforms purulent germladen albuminous urine into a clear antiseptic fluid. Talbot and Sisson, in the Boston Medical and Surgical Journal, April 3, 1913, conclude as follows regarding the general use of urotropin as an antiseptic to the urinary tract in children: "1. That all children are capable of breaking dov'n urotropin.

"2. That they all excrete formaldehyde. "3. That relatively large doses are often necessary before the excretion of formaldehyde takes place.

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4. That, as pointed out by Jordan, 'the more acid the urine the greater the decomposition of urotropin and excretion of formaldehyde.' Since it has been shown by other observers that the antiseptic power of urotropin is dependent not upon the urotropin, but upon the presence of free formaldehyde, we can further conclude.

"5. That urotropin should not be given with drugs that cause the urine to turn alkaline.

"6. Finally, we believe that to insure the efficiency of the drug specimens of urine after the administration of urotropin should always be examined for the presence of free formaldehyde."

It is claimed that urotropin is useful in all forms of cystitis and useful in bacteriuria phosphaturia pyelitis and irritable bladder from any cause.

Urotropin is said to be a powerful uric acid solvent and of value in gout and rheumatism. A physician in Mississippi uses 5 to 7 grains of urotropin in a hypodermic syringe full of water hypodemically repeated as needed in cases of urinary suffusion in cases of malarial hematuria. There is a valuable article on "The Hypodermic Use of Urotropin," California State Journal of Medicine, July, 1911. Dr. Gundrum speaks of 30 to 60 grains of urotropin being given by mouth in all cases of compound fracture affecting the meninges or central nervous system immediately upon admission to the hospital. He says:

"One night a case was brought in with a compound skull fracture, very dirty, but already vomiting, and semi-comatose from increased intra-cranial pressure. The indication for urotropin seemed so urgent that the patient was given 30 grains hypodermically at once and the dose repeated upon his leaving the table after decompression and elevation of the fragments. The ordinary tablets were merely boiled up in water and injected rather deeply into the thigh." The patient recovered without a meningitis. Dr. Gundrum's article is very interesting.

Hartshorne, Oklahoma.

RATIONAL THERAPEUTICS.

By A. T. CUzner, M.D.

Therapeutics, from the Greek Therapeuein, is that part of the science of medicine concerned in the treatment and cure of disease by medication (principally by means of drugs).

But what is disease? Any departure from the normal.

Again-what is the normal? It is any departure from the standard of health.

Now the standard of health may be stated, as a condition of the body, where there are no tissues or organs in which there is a departure from their natural and functional activity, whether of repair or

waste.

From the earliest period of embryonic development up to the mature life, there is an excess of growth and repair over waste.

As life advances the balance between repair and waste varies, until the time comes when the organic machine (the body) is worn out,-in part or whole-and death comes in.

Thus we find the standard of health varies from time to time; what is normal in adult life would not be normal for an infant.

Hence the skillful physician is one who is painstaking in his efforts to find out what is ill in the working machine, and is properly prepared with repair material.

Now the human machine is like the engine, steam or gasoline, it is automatic in its action when all the parts and functions act together.

However, it is liable to get out of order, and the skilful mechanic, or physician, is one who thoroughly understands its mechanism, and is prepared to meet any emergency requiring his skilful attendance.

He knows by examination where the fault is, and proceeds with such means in his power to remedy the wrong.

Just here I note a contrast between the human machine and the engine. The former has a certain power, and powers, for there are many, of repair independent of the outside aid.

In this article we will examine but one for want of space; but before doing so, will briefly consider the ultimate structure of the human machine.

The body is, in its physical analysis, made up of an aggregation of cells or morphological units of structure and life.

Through and by their harmonious action, the normal life process goes on.

They are influenced by their environment, and excitation from both within and without; on this principle rests therapeutic practice.

There are found in this wonderful human machine certain cells and liquids that have the power of destroying, or arresting, deleterious invasions.

This power of destruction is located in the phagocytes of the blood.

There is another destructive means of arresting or qualifying disease; it is located in the blood serum.

This influence or power is called "opsonin," from the Latin "Opsono," simply meaning "to cook."

The work of the opsonin is indeed a sort of cooking process, for we find by the action of this agent, the bacteria, when thus treated, are like other vegetables of a microscopic form, when cooked, that is, more palatable and easy of digestion, when captured by the phagocytes.

Sometimes in this "battle of life" we find the phagocyte army is worsted by the diseases, germs.

This occurs when the bacteria are SO abundant and powerful, and opsonin index so low that defeat seems inevitable.

Here it is that the therapeutic reinforcement comes to the aid of the phagocytes by reinforcing the weak opsonin.

When the physician is unable to bring up reinforcement, then we find this taking place, viz.:

The bacteria, or diseased germs, so weakened by their presence, or the poison they generate by their life processes, the phagocytes, that they are unable to do their duty and thus become non-cambatants.

If the above conception of disease is correct, what are the indications for work on the part of the physician, and in what direcrection does it point? My personal answer to this query would be thus:

We must first see to it that no material has access to the body that would be likely to diminish the opsonin power of the body Second-Remove (if it already exists) from the body any and all deleterious material likely to reduce the opsonic power, and also injure or weaken the power, and decrease the number of virile phagocytes. There are several channels through which this can be effected, viz.:

The bowels, kidneys, liver, spine, and lungs are all eliminants.

All these organs are continually engaged in the work of discharging deleterious effete material from the body.

Third-Present for the acceptance of the body such material, or processes, as will best sustain the vital principle, located in the body, its tissues or fluids.

Fourth-Allay all undue excitation, wherever located, and which for want of a better name we call inflammation, because of the heat generated during its reign.

Now the alkaloidist is better fitted to combat the morbid conditions outlined above than the galenical practitioner, for he is able to present specific active agents to meet specific conditions unaccompanied by contradictory inert or deleterious material.

Just here I will explain, somewhat, the action of one of the mediums through which galencial medicines are administered for diseased conditions.

Dr. Charles E. Stewart, in summing up the results of experiments undertaken for the purpose of ascertaining what influence, if any, the ingestion of alcohol had on the opsonic power of the blood, said:

"We find in the four cases where the alcohol was taken internally. in the form of port wine, the opsonic power of the blood was greatly lowered, as is evidenced by a comparison of the normal indices obtained with the bacillus tuberculoses and streptococcias compared with indices obtained after the ingestion of wine.

The average index for the bacillus tuberculosis in the four cases cited is 1.17, for streptococci 1.12.

The average of these same cases after the administration of the two ounces of wine is 73 and .655, respectively, showing a drop in the opsonic powers of 37 per cent. in the former and 42 per cent. in the latter.

In the three cases in which peruna was used the average normal index for bacillus tuberculosis was 1.12, for streptococci 1.09; four hours after the ingestion of two ounces of peruna, the average index in the former was .133, in the latter .68, showing in the former a drop of over 88 per cent. in the opsonic power, and in the latter a drop of 36 per cent.

We realize that there are a great many factors, which influence the opsonic power of the blood, and that of necessity, there must be considerable variation in even what might be considered normal cases, but notwithstanding these variations, there is sufficient uniformity to enable us to make some very valuable deductions.

From investigations, as well as study, of the tables, there was in almost every case after the administration of a comparatively small quantity of alcohol, both internally and in vitro, a very marked reduction in the opsonic power.

So we feel justified in concluding that alcohol has a marked influence in reducing the vital forces of the body, thereby greatly interfering with the vis medicatrix naturæ.

Since, according to Wright, "out of all comparison the most valuable asset in medicine lies in raising the anti-bacterial power of the blood," the administration of alcohol, which according to our investigation, is pro-bacterial, and as such is a strong liability, instead of an asset, should consequently be eliminated from our therapeutic armamentarium, at least as far as internal administration is concerned in infectious diseases."

If the above conclusions of Dr. Stewart are warranted, then follow it not that it is much preferable to administer for diseased conditions, the active principles instead of the tincture, or alcoholic extract? To illustrate: Say we have a case of malarial fever; we find our patient with a congestive chill.

Now we know that atropine-the active principle of belladonna, has the power to diffuse the blood throughout the capillaries and thus abort the chill.

Is it wise to use the atropine locked up in the tincture of belladonna, and of unknown strength, and know that by so doing we decrease the opsonic power of the blood over the germs, and partially paralyze the leukocytes?

Is it not better, in our administrations, to leave out the alcohol and other extraneous material, and give our patients the pure alkaloid?

The same applies to fever. Why not give aconitine or veratrine instead of tinctures?

We can testify that after 13 years of almost exclusive use of the alkaloids, we could not conscientiously go back to galenical medication (except we prepare our own extracts with water, which we occasionally do).

While writing the above, I was interrupted by a female bringing her child to my office.

After a proper examination we found the child was suffering from malaria. The child was held in the fever stage; so, putting a small dose of calomel on its tongue, I proceeded to get out of my case a mild deffervesent compound pellet.

Before the patient left the office the fever went down.

Suppose I had had to give a tincture? Doubtless I would have had a time; the mother holding the child's arms while I pinched its nose to make it swallow the nauseous drug, at a great risk of strangling it.

After giving the mother written directions and the necessary medicine, I dismissed her, much pleased.

This was not my experience very many years back, before I took to alkalometry; but now I know of a better way of giving medicine, and I have no trouble.

One more reflection-which is not altogether germain to our subject.

Has it ever occured to our professional brethren that we, as a body, are largely responsible for a continuance of the drink habit?

Were we not to indorse alcohol as a good thing, and administer it so freely in our practice, the majority of the lay press would soon enlighten the people as to its evils, both as to persons in the singular and to the nation as a whole.

But some will plead that they don't perceive the evil, and that they were taught it was an excellent remedy, properly administered.

Ignorance of a law is not admitted as a plea against its violation.

Hence, as there is ample evidence that alcohol is of little or no use at all in the practice of medicine, and prescribing of drugs, we ought to thoroughly inform ourselves as to its demerits, or merits, if it has any.

We are the legally authorized conservators of the public health; hence as the alcoholic habit is known to us to be an invitation and an inducement to ill health, and that it is promoting the degeneracy of the race; therefore, we believe it is our duty not to employ it as a medicine, unless we have overwhelming evidence calling for its use.

Further-we owe it as a duty, on every possible occasion to discountenance its use as a beverage.

We have lived over 74 years, and have had medical experience extending over half a century, which has convinced us, while the evidence is still accumulating, as the

In the form of short recitations, readings, discussions, as well as by short coapesitions well selected and adapted to be within the grasp of comprehension of the child a systematic but graded course in individual hygiene should be instituted. This course should dwell upon (a) what the pupil sees of hygiene in the school and class-room, the cleaning, lighting, ventilating and heating of the same; why it should be kept so; necessity of cleaning the feet on entering the school building. This information could be all imparted in a very simple and attractive manner in the form of short stories as expressed in popular proverbs, in riddles, etc., (b) The modes and ways of keeping the body clean, clean clothing, clean feeding, clean dwelling, proper lighting, heating and ventilating of the house. Here the teacher shall discuss with the pupils the conditions prevailing in their homes, and upon the information thus gathered shall make a report to the principal, who shall, when deemed necessary and proper, address to the parents in a gentle, inoffensive manner, a printed circular that will enlighten them as to how to remedy the existing defects, for their own as well as the child's good. (c) The care that the children should take of the five senses, of the art and manner of maintaining health, what to eat and what to drink, warning them against gluttony, intemperance, etc. (d) Instruct them as to the precautions that are to be taken against infectious diseases. These instructions can further be supplemented by having in each class-room appended charts, rules and regulations bearing on the subjects thus far treated,-and these shall embrace the primary grades.

In the grammar grades the teacher of hygiene shall dwell at greater length and elaborate more fully the topics enumerated above. Besides he shall pave the way to introduce to them the principles of public hygiene. Furthermore, he shall dwell with them on topics such as (a) hygienic topics with reference to the profession the youth intends to choose, having special regard to his aptitude, inclination and physical fitness for the same, etc.

In the eighth grade the student should finally be made to understand that there are social measures to be observed which do not benefit directly only those who practice them. Thus, a boy of fourteen or fifteen years can easily comprehend that a contagious disease in his neighborhood is a menace to his health if that neighborhood lives under unhealthy conditions and surroundings. He will also just as much understand and appreciate the necessity of having, in the community wherein he lives, well cleaned streets, good drinking water, a perfect sewerage system, etc.

In the high schools the students should be instructed in the art and manner of taking care in case of sickness of those who belong to his household, as well as to understand how to give the proper first aids to those injured by accident, until the proper aid can be obtained. To the young girls who leave the school at this period, the teacher should hand in a sealed envelope a short treatise on puberity and sexual hygiene and their relative dangers. Young men, after leaving high school, who have had the advantage of such instruction, will be better prepared when they enter into the practical side of life, to cope with the social questions that will then occupy the public. mind; because it is from the rank and file of these men that men will be called to occupy important and influential positions in public life.

IV. What Hygienic Principles Shall be taught in Professional Schools?

In professional schools, such as business colleges, mining, engineering, technological, industrial, etc., schools, the students shall be instructed in those principles that have a special bearing on the maintenance of the health of the body during work and with special reference to the work of their profession or vocation, in the training of im