American Party, International Medical Congress, August 29th, to September 4th. For the benefit of those who contemplate attending this Congress, we would state that ample arrangements have been made for hotel accommodations in Budapesth, a large number of rooms having been engaged a year or more ago, in the Hotel Hungaria, for the members of the American party. Reservation should be made this month, to insure good rooms. Those who join this party will have no worry as to details, a competent guide being in constant at tendance. The cost of the entire trip, including a week's board in Budapesth, meals enroute, railroad fare, tips, first-class steamship both ways, carriages for sight-seeing, visiting hos pitals; forty-one days, $395.00. Sail from New York, August 12. Full information and itinerary may be obtained by addressing Dr. Chas. Wood Fassett, secretary Medical Society of the Missouri Valley, St. Joseph, Mo. (New York Headquarters, Grand Hotel, Broadway and 31st street; Atlantic City address, Grand Atlantic hotel). Those who desire membership in the congress may send their application to Dr. J. H. Musser, chairman American Committee, Philadelphia, accompanied by a fee of $5.00, and professional card. ALASKA-YUKON-PACIFIC EXPOSITION. To the Editor of the ST. LOUIS MEDICAL RE VIEW: Gentlemen: The A. Y. P. Exposition opened June 1st, closing Oct. 16th. No doubt many of your subscribers will pay the Exposition and the Pacific Northwest a visit. We have a modern equipped Emergency Hospital and have set aside a room for visiting physicians, where they may receive their mail, write letters, etc. Will you kindly announce to your subscribers that any physician visiting the Exposition may have his mail sent in care of the Emergency Hospital at the A. Y. P. We would appreciate it very much, if you would send us a copy or two, of your magazine to have on the center-table for the use of visiting physicians. Low grade American medical colleges have repeatedly received some deserved hard knocks at the hands of the Council on Education of the American Medical Association. The United States has more medical schools than all the nations of Europe and only half are reported sufficiently equipped, 30 per cent are doing poor work and 20 per cent are unworthy of recognition. It decides that to be properly educated, a physician should have spent four years in a high school, one year in physics, chemistry and biology, two in laboratories of anatomy, physiology, pathology and pharmacology, two in clinical work and one as an interne! It does seem that the deplorable conditions are due to the fact that students with limited means cannot possibly take such a course, and that the unrecognizable colleges are the natural result of our attempt to make "doctors" of all "practitioners," a thing England has never attempted. In addition to this, European colleges are not as expensive as ours although they do require time to attain a "learned" degree.-West Virginia Medical Journal. St. Louis A MONTHLY JOURNAL OF MEDICINE AND THE YEARLY SUBSCRIPTION, $2.00. To Foreign Countries in the Universal Postal Union, $2.50. PUBLISHED BY THE ST. LOUIS MEDICAL REVIEW ASSOCIATION, ST. LOUIS, MO. Articles, letters, news items, etc., intended for publication in the editorial columns should be addressed to the "Editors of The St. Louis Medical Review," and should be accompanied by the name and address of the sender and postage to cover their return if unsuitable. All communications relative to advertising or business of the REVIEW should be addressed to St. Louis Medical Review Association, Metropolitan Building, St. Louis, Mo. Entered at St. Louis Post Office as Second-Class Matter. ST. LOUIS, JUNE, 1909. THE COMING OF THE A. M. A. According to newspaper reports the meeting of the American Medical Association is to be held in St. Louis next year. This means much to St. Louis and the Southwest in general. Not for many years has the national association favored this section of the country with its annual convention and thus made it possible for a large per cent of physi cians of the Southwest to attend. The responsibility of such a meeting, however, must not be regarded too lightly. Housing facilities will undoubtedly be ample, and the attending physicians will not find St. Louis' reputation for hospitality exaggerated. But what will the visiting men find of interest in Medical St. Louis? Will our clinics compare favorably with those of eastern cities and will our teaching facilities for medical students bear the close inspection which they will undoubtedly receive? In certain respects, yes; in others, decidedly no. The amount of charity work by St. Louisans compares favorably with that of other cities of the size, but how is it directed towards hospitals? The Hospital Saturday and Sunday Association rules arbitrarily that no hospital used for teaching purposes shall share in the distribution of their collections, thus depriving the very hospitals which are in greatest need of support from any claim on that branch of charity. St. Louis has many clean and well equipped hospitals, but few of the high order which may be found in the eastern cities and especially are we lacking in what may be termed "teaching hospitals," where clinics may be held for such occasions as the meeting of the A. M. A. In this respect St. Louis will suffer in comparison with other medical centers. THE SCIENCE OF GUESSING. Mr. Theodore M. Davis of Newport, Rhode Island, has discovered the tomb of King Horemheb, a discovery of great archaeological importance. In further pursuance of the investigations of Sir William Ramsey, Monroe R. Snyder has evolved the principle of critical radioactivity-announcements such as these appear daily in every branch of science; geology, zoology, paleantology, biology, chemistry, botany and medicine, each dependent on the other, each an essential part of the whole-the universal investigation of the nature and use of things. There is a grandeur and nobility about the inspired efforts of the thousands who give their life energy, their utmost force to add something to science. It may be the discovery of the tomb of King Horemheb. It may be the giant struggle toward the cure of tuberculosis. At any rate, there is always a blue patch in the sky that means hope, and vigor in the air that means progress, for all sciences. There is one retarded development, however, which science, as the hopeful parent, must need be anxious-the science of weather forecast. For in proportion to its significance and usefulness, it is the most useless and insignificant. There has been next to no progress in accuracy and exactness. Is there a lack of interest in the pursuit of such research or are we inevitably stumped? The weather bureau should be an important institution. But it is not. And yet there are hundreds each year who suffer and die from flood and wind. In one of the leading magazines of last month there appeared, as the result of a painstaking investigation, an arraignment on the United States Weather Bureau with the following definite charges-that the bureau is unduly expensive, has made no progress, is excessively self-defensive, is evasive and ambigu ous and not specific, whereas specific service is the only sort of any value. The bureau costs the Government $1,662,260 a year. It has one central, and several district offices from which come the weather predictions for the country. The writer of this arraignment begins by admitting the fallibility of weather forecast, but his contention rests with the presumption and useless expenditure of the bureau. He holds that if the bureau, instead of claiming that 85 per cent of its forecasts are verified (forecasts so loose and vague as to be safely verified) would succeed in making good 50 per cent in local and accurate prophesy, the bureau would have a raison detre. It seems that there is some truth mixed in with the sensationalism in what the writer has to say. It is a truth so natural and so habitual that we seldom stop to consider it-that the average individual relies as lightly on the weather forecast as the word of the palmist or clairvoy ant. How can a farmer in Rainytown, Nebras ka, slumber peacefully with a prediction dished out to him from Chicago, one of the seven districts? In November, 1900, the steamer Portland was lost with 150 lives. It sailed out under the government warning, but the warning had been given seven successive days, a warning that came like the cry of the wolf in the fable. The weather bureau announced the Galveston storm of 1900. But it had given warning of scores of storms from year to year which never reached its shores. To be sure, there cannot be much certainty and assurance as to where a gale of wind starting from the Pacific, will reach at a certain time if it makes up its wilful mind to cut "cross country" in some perverse direction, or to spend its force suddenly or terrifically and never reach its Atlantic destination. The fact re mains, however, that there is great need for progress in weather prediction on the part of science and a great need for more local stations on the part of the weather bureau. In the meanwhile our sympathy goes to the bureau, which is forced to speculate on the elements, and to become resigned to an Xmas snowstorm on inauguration day with the forecast of "clear and colder." It is worth while bearing in mind that subcutaneous swellings are sometimes gummata. --American Journal of Surgery. SOCIAL HYGIENE. There has been in process of formation in this city during the past five months an organization consisting of ministers, physicians and lay members whose effort it is to devise means by which the fearful effects of the social evil may be limited. Sporadic attempts at such measures have been attempted in various cities at various times, but only in late years has the movement throughout Europe and America begun to assume a definite shape. In Germany there has been much scientific study of the sociological and medical problems involved. In France there have been attempts at some legislative control of prostitutes. In this country partly because of our Puritan ancestry, partly because of the failure of legislative measures to accomplish the desired results, the movement has as sumed almost entirely an educational character. It is a campaign of education in behalf of the innocent. A campaign to restrict the spread of venereal diseases to some extent in the same way as we do other infectious diseases. There is no attempt to make extra-conjugal intercourse more safe, but only to let everyone be properly informed of the essential facts concerning sexual hygiene and sexual diseases. The "St. Louis Society of Sanitary and Moral Prophylaxis" was founded on January 25th, 1909. It organized in a modest way with about twenty-five or thirty charter members, selected an executive committee, and then went ahead in a quiet way simply to increase its member ship and perfect its organization before attempting to do anything more directly in the line of the proposed work. The membership has steadily increase so that it now has between 100 and 150. An advisory committee of seventeen persons, consisting of Chancellor Houston, Bishop Tuttle, W. K. Bixby, Mrs. Philip Moore, and other prominent citizens, has been selected. The executive committee has met regularly every two weeks for several months and transacted much important business.. This month there appeared a small pamphlet of ten pages in which a general plan of education to be pursued by the society has been outlined. I quote in brief as follows: "We cannot of course return to the savage custom of marriage at the age of puberty, and experience has demonstrated the futility of ef forts to render prostitution safe. We must then rely upon education. Our purpose is to persist along three lines." These are: 1. The instruction of the young in sexual physiology and hygiene. 2. The instruction of the young in sexual pathology and disease. 3. The instruction, particularly of the innocent regarding the manner in which sexual diseases are communicated. We feel certain that an organization so carefully planned and so tactfully handled cannot arouse the opposition of the super-sensitive in the way that previous movements of this kind have done. The society has gone ahead steadily with its work making no fuss, but trying to accomplish its aim slowly but surely. The membership at present is composed in good part of physicians, but we feel that the representation among the medical men of this city ought to be very much greater than it is. Every physician sees almost daily instances where persons have suffered innocently through ignorance and consequently must realize how essential a campaign of education must be even if it does not accomplish more than the prevention of this unnecessary suffering of the innocent. He can help in this work by increas ing the membership and influence of the organization. THE BILL FOR REORGANIZING THE CITY'S HOSPITAL AND CHARITABLE INSTITUTIONS. Due to the untiring efforts of Dr. John Morfit, a bill is before the city council of St. Louis to reorganize the city's hospitals and charitable institutions. This bill provides for the appointment, by the Mayor, of a hospital board whose duty it will be to control the St. Louis City Hospital, the Female Hospital, and the Poor House. This board will provide for the appointment of superintendents for these institutions, whose duty it will be to look after the business side of hospital management, and who need not necessarily be medical men. They will also appoint a resident physician and an assistant resident physician and a visiting staff. The latter to serve without salary. This with the internes will constitute the hospital corps. This is decidedly a step in advance and Dr. Morfit deserves great credit for his untiring energy in promoting the measure. While discussing such a step it is only fair to consider the recent advances which the pres ent superintendent of the City Hospital has inaugurated. There is at present a visiting staff of eight medical men; a neurologist, a nose and throat specialist and three opthalmologists who serve as do the proposed visiting staff. These men have already been on service over a year and have made much progress in instituting a visiting staff routine. The city institutions, like others of their character, have many customs and methods which time has firmly fixed. The present staff has done much to pave the way for a more complete staff system and the credit is due in great measure to the present superintendent of the City Hospital, Dr. W. C. G. Kirchner. Editorial Pith RECENT WORK ON THE PITUITARY BODY. Since Marie published his first paper on acro megaly in 1889, the chief clinical interest in re gard to the pituitary body has centered around the relation of tumors of the anterior lobe to this disease. Another symptom-complex, associated with enlargement of the pituitary body, that has attracted attention is Frolich's disease -a condition characterized by sexual infantilism and an increase of panniculus. Recently Herring (Quarterly Journal of Experimental Physiology, Vol. 1, pg. 121) on the basis of painstaking histological studies has advanced the theory that the epithelial portion of the pituitary furnishes a secretion which passes through certain stages of formation and that its production is merely completed by the neu roectodermic part, in which tissue the full activity of the secretion is acquired. He further claims that there is histological evidence of the passage of this secretion into the third ventricle to mix with the cerebrospinal fluid. Cramer, in the same publication as Herring (Vol. 1, pg 189) has shown that strong extracts of the posterior lobe produce, within one or two hours, dilatation of the pupil of the enucleated frog's eye. To check the progressive blindness and to relieve the excessive headache in acromegaly, attempts have recently been made in several cases in London and Vienna to remove the en larged hypophysis with some measure of suc cess. Redford and Cushing (Johns Hopkins Hospital Bulletin, Vol. 20, pg. 105), realizing that it was somewhat premature to attempt such an operation without having some definite knowledge of the effect on the body of total hy pophysectomy, undertook the study of this phase of the question by experiments on dogs. Of 20 operations on dogs for the removal of the hypophysis 15 were successful. These animals regained consciousness and behaved in a natural way until towards the end of the second day when they became very lethargic. In some cases this state of lethargy set in earlier, in four instances it was postponed for four days and once as long as a week. From this lethargic condition they soon passed into coma with a striking incurvation of the spine, a slow respiration with a long drawn inspiratory act, a feeble pulse, a perfectly limp musculature, and often a subnormal temperature. The transition from this deep coma to death was almost imperceptible and unattended by a struggle of any kind. The subcutaneous administration of an infusion of a newly removed canine hypophysis had no appreciable effect on the condition of the animal. Postmortem examinations were made in all cases, but revealed no adequate cause of death. These results sustain Paulesco's contention that a total hypophysectomy is incompatible with life. Redford and Cushing conclude from these experimental observations that the surgery of the hypophysis must be limited either to the removal of tumors which may implicate the pituitary gland, or in case of hypertrophy, to a partial hypophysectomy.-The Cleveland Medical Journal. Deformities of the septum, enlarged turbinates, etc., should receive operative treatment only when they cause obstruction.-American Journal of Surgery. THE OPHTHALMO-REACTION IN TYPHOID. Amatore Meroni (Munch. Med. Woch., June 30th, 1908), has investigated the ophthalmo typhoid reaction of Chantemesse. He made use in his trials of a virulent strain of typhoid ba cilli cultivated in broth. The culture was treated with excess of absolute alcohol. The precipi tated toxin was separated from the rest of the culture by filtration, and dried in vacue. A solution was then made of 1 gram of this dried substance in 10 c.cm. of sodium chloride solu tion, and two drops of this liquid were instilled in the lower eyelid in the cases tested. A large series of experiments were performed, and the following are the principal conclusions: The ophthalmo-reaction with typhoid toxin may give a positive result after six hours not only in cases of typhoid but also in other diseases; (2) after twenty-four hours the reaction is positive only in typhoid, a negative result is against the condition being typhoid; (3) the instillation of typhoid toxin produce no harmful results; (4) the ophthalmo-reaction in typhoid, though not absolutely reliable, is of practical value in diag nosis. Detroit Medical Journal, May. 1909. ANTI-SPITTING ORDINANCE. (1) There is a more stringent ordinance now against spitting in public places, says the Buffalo Express, April 19. The authorities will make an effort to enforce it. Such an ordinance cannot be enforced without the sympathy and co-operation of citizens generally. Even in the Board of Aldermen the opinion has been expressed that an anti-spitting ordinance is a mere fad as well as an outrage on the liberties of Plain People. The people must be very plain who do not know that consumption and kindred diseases are spread by spittle. They must be very dense who do not realize that the habit of spitting in public is disgusting to many of their fellow beings. Perhaps a campaign of education is needed, but in the meantime the authorities should do everything possible to enforce the ordinance. A few examples might make a lasting impression. With the going into effect of the new ordinance against spitting in public places, the health department is prepared for a vigorous |