of a fatal termination, and who are constantly on the alert for any untoward indications.

No less important than the immediate effects are the more remote results of the action of the agents used on the various organs or struc tures of the body. These we are very apt to overlook in our anxiety for the immediate res toration of the patient to consciousness in an apparently normal manner, or the preservation of normal conditions during unconsciousness.

The injurious effects of the agents may be exercised upon the kidneys, producing renal congestion, temporary or more permanent, with suppression or with ultimate chronic structural change. Or there may be liver discrder with jaundice, or lung or bronchial irritation that may become serious, or heart changes of a serious character, or they may permanently influence the structure of the blood. Or glycosuria may follow, or cerebral or mental symptoms may result.

Degenerative cell changes must take place in Every case, but the vital forces in most cases produce a sufficient reaction to quickly overcome any mischief, but in every case the closest watch should be kept of the functional action of every organ, immediately after the restoration of the patient to consciousness, and for weeks following, and every deviation from the normal standard must be met promptly and persistently with appropriate treatment, and quickly restored to a normal state. A conservative, expectant course in these cases may be a fatal course, and is in no case justifiable.

The destruction of cell structure and consequent toxemias vary greatly with different individuals, and their extent and influence must be estimated upon and antagonized from the first. These facts are of vital importance and I trust they fully impress the mind of each reader in every case.-Therapeutic Gazette.

AS TO THE HOUSE-FLY.

Fulminations against flies are now the order of the day in leading cities of the United States. This is a step in the proper di ́ection, for no one will gainsay that the fly is a most de cided menace to the public health.

But the fly will not be destroyed by proclamations. This pest which, like the poor, scems destined to be with us always, will thrive as of yore, if we are to depend upon the people alone,

to carry out the necessary instructions for s eradication.

A municipality should not only enjoin upon the people the necessity of cleaning up in order to destroy the breeding place of the fly, but should also see that they do clean up.

It is useless-it savors of the ridiculous-for city health department to call upon the people to destroy the breeding place of the flies, and at the same time permit manure heaps to infest the alleys from north to south, from east to west, during the fly season, and widemouthed garbage boxes,-many overflowing, some without covers, others with covers constantly open-to remain unemptied for weeks at a time.-Bulletin Illinois State Board of Health.

REPEATED EXAMINATIONS FOR THE INSURED.

In his address before the Association of Life Insurance Examiners President Burnside Foster makes the suggestion that those insured should be requested to present themselves at stated intervals for an examination similar to that given when insurance is granted.

The advantages are obvious. Disease tendencies and diseases themselves may thus be detected in their incipiency, while as yet in the curable stage. The effect of such examinations would undoubtedly be materially to prolong the life of the insured, with consequent increased emolument to the insurance company.

This suggestion is directly in line with what we have repeatedly urged upon our brethren and what we have practiced ourselves for years.

Dr. Foster suggests that the company would perhaps find it advisable to share the expense with the insured. This, however, we believe would be scarcely necessary, since our experience has been that patients to whom we explain this matter welcome the suggestion to come for an overhauling once or twice a year, or even more frequently. Moreover, we have found that they willingly pay a larger fee, that this examination may be so complete as to be satisfactory to the insured as well as the physician. We are glad to see an examiner of such wide experience as Dr. Foster take up the matter and advocate it as sensibly, and, we hope, as effectively, as he has done.-Clinical Medicine.

Miscellany

THE DEPORTATION

OF ALIENS AFFLICTED WITH A CONTAGIOUS

DISEASE.

We have been asked whether it is possible for local authorities to secure the deportation of aliens who, at the time of landing in the United States, were afflicted with a contagious disease, from which they are now suffering.

Our answer, in brief is, yes, and without any expense to the local authorities.

As this matter is of vital importance to every physician and health officer in the State, especially at this time, when pulmonary tuberculosis is slaying its thousands annually, we have decided to publish an abstract of the laws in point.

Rule 31 of the "Immigration Laws and Reg ulations of July 1, 1907," (fifth edition, ap proved October 5, 1908) provides that aliens who, at the time of entry into the United States, belonged to any of the classes of persons enumerated and defined below, and who should, therefore, have been then excluded, are subject to arrest, upon the warrant of the Secretary of Commerce and Labor, and to deportation to the country whence they came, at any time within three years after landing or entry -viz.:

All idiots, imbeciles, feeble-minded persons, epileptics, insane persons, and persons who have been insane within five years previous; persons who have had two or more attacks of insanity at any time previously; paupers; persons likely to become a public charge; professional beg gars; persons afflicted with tuberculosis or with a loathsome or dangerous contagious disease; persons not comprehended within any of the foregoing excluded classes who are found to be and are certified by the examining surgeon as being mentally or physically defective, such mental or physical defect being of a nature which may affect the ability of such alien to earn a living.

The case of every alien found to have become a public charge, from causes existing prior to landing, should be reported by the local authorities to the immigration officer stationed nearest the place where the alien is to be con

fined. This report must be accompanied by certain certificates. full information concernin which may be obtained from the immigra tion officer.

The cost of maintaining aliens during the pendency of warrant proceedings, is a proper charge against the appropriation "Expenses of regulating immigration;" but no expense shall be allowed for any period preceding the date of original notification to an officer of the immigration service, and then only in the event that the department, upon investigation, orders the deportation of the alien. The cost of removal of the alien to the port of deportation shall be borne by the United States, which will endeavor to recover from the contractor, procurer or other person by whom the alien was unlawfully induced to enter the United States. In special instances, the United States pays the expenses of an attendant to assist in conveying the alien from an inland point to the seaport of deportation. The deportation of aliens from the port of entry shall be at the expense of the owner or owners of the vessels or transportation lines by which the aliens

came.

Deportation by Consent.-Any alien who has been lawfully landed, but who has become a public charge from subsequently arising physical inability to earn a living, may, by consent of the alien and with the approval of the Bureau of Immigration and Naturalization, be deported within one year from date of landing, at the expense of the immigrant fund.

Mr.

Since the above was put in print, we had the pleasure of a visit from Mr. James Randall Dunn, Inspector in Charge, Department of Commerce and Labor, Immigration Service, Chemical Building, St. Louis, Missouri. Dunn's territory extends over the States of Missouri, Tennessee and Kentucky, but he may be able to look after aliens subject to deportation from points in Southern Illinois.

Mr. Dunn requested us to emphasize the fact that aliens deported under the law are treated with every possible consideration by the Immigration Service, and by the steamship or other transportation companies by which they are conveyed to their former place of abode. The Immigration Service takes especial pains to

insure the deported alien from being subjected to any hardships or discomforts. As stated, an escort is provided whenever this is deemed necessary.-Illinois State Board of Health.

AFTER SODA FOUNTAIN DRINKS.

The Bureau of Chemistry in the Department of Agriculture has entered upon a more vigor ous campaign for the purpose of bringing to justice makers who prepare soda fountain drinks with an element of cocaine contained therein. It is stated by the officers of the bureau that a very large number of such drinks more or less tinctured with the drug are being found by the investigations of the bureau agents, and in such cases suits are being instituted. This part of the work of the Board of Food and Drug Inspection seems to have the united support of all members of the board, and is likely to be prosecuted with an increasing degree of energy. Thus far the bureau has declined to give out an official list of the drinks that are found to contain cocaine, preferring to develop the names of the preparations and of those who sell them in the course of the prosecutions. It is expected, however, that be fore lon a series of notices of judgment convictions, etc., will be ready for publication and special pains will be taken to distribute these widely to the drug trade, and to retail drug gists especially. The bureau some time ago published its preliminary studies on this subject in the report of the President's "Homes Commission," where methods of making and retailing the objectionable drinks in question was discussed with particular reference to the District of Columbia. This matter was not brought out at that time by vote of the Board of Food and Drug Inspection, but was sup plied to the Homes Commission on the authority of the Bureau of Chemistry solely-of course at the request of the commission. The interest of the board has increased somewhat since that time.

ARTIFICIAL MINERAL WATER MUST NOT

MASQUERADE AS NATURAL.

Notice of judgment No. 78 for the misbrand ing of water has been issued by the Board of Food and Drug Inspection. In this, the Charles Meisezahl Manufacturing Company of New York City was found guilty of misbranding

No more important a result of the agitation carried on by Dr. Thomas Darlington, of New York; Prof. J. Pease Norton, of Yale University, and the twenty-five thousand members of the American Health League for improved health conditions has been reported than the co-operation announced today by Prof. Norton, of the great Metropolitan Life Insurance Company of New York City.

Prof. Norton states that the Metropolitan is now printing as a first edition no less than three million pamphlets on tuberculosis, which will be distributed to millions of policy-holders of the company alone.

"I believe other companies will follow the iead of the Metropolitan, which has estabished a Bureau of Co-operation in a fight on behalf of the policy-holders with preventable death. That the great insurance companies have now entered the field with the distinct purpose of attempting to lengthen the lives of their policy-holders, is, I am confident, the most important event in the history of life insur ance in fifty years. When a policy-holder knows that every effort known to science will be put into effect to lengthen his life, and that as life is lengthened perceptibly by better health laws and efficient public health adminis tration, two results will follow. The demand for life insurance will increase to an unprecedented amount, and the cost of life insurance will be greatly reduced, thereby again increas ing the demand by reason of the lower rates which will then be rendered possible.

"Mr. Lee K. Frankel, the head of the Bureau

of Co-operation of the Metropolitan, who is how co-operating with the Committee of One Hundred, has completed a most careful study of the causes of poverty and has reached the conclusion that death and sickness are largely responsible.

Prof. Norton estimates that the preventable waste from preventable sickness and death is not less than three or four billion dollars per annum. Assuming sixteen million families in the United States, this means a decreased income of two hundred to two hundred and fifty dolars per family. When we consider the millions of families in which the income is seven hundred and fifty millions of dollars or less, then it is that we may comprehend the real aning of an increased family income of thirty-three per cent, or more. Social distress is most poignant in families of small incomes, and here the per cent of increased income would be largest, resulting in a doubling and a tripling of the comfort and happiness of the people. As a business move, those companies in the field who first succeed in reducing the death rate of their policy-holders by a very small fraction will be able to sell insurance at rates with which the more conservative.companies will find competition impossible.

News and Notes

ITEMS.

Dr. Joseph L. Boehm recently resigned as member of the Faculty of the St. Louis College of Physicians and Surgeons.

The Medical Society of the Missouri Valley meets at Council Bluffs, Iowa, September 9, 10, Dr. Chas. Wood Fassett, St. Joseph, Mo., Secretary.

The new law in the State of Washington, requiring examinations for marriage licenses is receiving the hearty support of the medical profession of that State.

The next annual meeting of the German Surgical Society will be held at Langenbeckhaus, Berlin, in April, 1910, under the presidency of Prof. Bier, of Berlin.

The September number of the Proctologist, published in St. Louis will contain 25 papers, with discussions, read at the 1909 meeting of the American Proctologic Society. There will be more than 150 pages by the foremost proctologists.

The Boston Board of Health has adopted a rule that all foodstuffs shown for sale in store windows or other places must be protected from dust and flies by screens or otherwise.

Dr. Joseph Beck of North Side Hospital, Chicago, extended the utmost courtesy to one of our St. Louis ear, nose and throat specialists during a recent visit there. Dr. Beck is experimenting in the use of bismuth paste, injections in accessory sinuses, and radiography.

The annual meeting of the Americal Electrothera peutic Association will be held in New York City on September 28, 29 and 30, instead of September 14, 15 and 16. The president of the Association is Dr. Edward C. Titus of this city, and the Secretary is Dr. J. W. Travell, 27 E. 11th, street, New York City.

Three Millions Attend Consumption Exhibits.

Evidence of the popular interest in the anticonsumption crusade is given in a statement made by the National Association for the Study and Prevention of Tuberculosis, to the effect that during the year ending August 31 nearly 3,000,000 people have attended tuberculosis exhibitions in various parts of the country.

Besides the three traveling tuberculosis exhibitions of the National Association for the Study and Prevention of Tuberculosis, there are twentyeight exhibits of this kind in various parts of the country. Four years ago there were only three such displays in the entire country.

Over 300,000 people have attended the three traveling exhibits of the National Association for the Study and Prevention of Tuberculosis, which have visited ten different states and territories during the year just closed. The three exhibits are now stored for the summer months.

The Southern exhibit has been shown in Tennessee, Alabama, Florida and Georgia in ten different cities and has been viewed by about 100,000 people. Thousands of others have been reached by the literature and posters distributed, so that the number of people who have been educated directly or indirectly about tuberculosis by this exhibit is considerably over 300,000.

The Western exhibit of the National Association has worked during the past year mainly in Kansas, Nebraska and Northern Missouri. In all, fifteen cities have been reached and over 110,000 persons have visited the exhibit.

In Porto Rico, the Spanish exhibit of the National Association, the first of its kind, has met with decided success. Twenty-two cities, including about one-third of all the towns in the island, were visited and over 100,000 people viewed the exhibit. The poor transit facilities in the island made it necessary to haul the exhibit from place to place on ox-carts, like a traveling country circus.

As a direct result of these exhibition campaigns, laws relating to the anti-tuberculosis campaign have

been passed in Tennessee, Florida, Nebraska, Kansas and Porto Rico. In the latter territory, a coinprehensive governmental campaign against tuberculosis has been started. Owing to the fact that over 80 per cent of the natives of Porto Rico are illiterate, the problems there are very difficult. Another result of the work has been that nearly a million people have received instruction about the dangers of tuberculosis, and the ways to prevent it.

Tulane University Alumni.

Tulane University of Louisiana, in keeping with its progressive spirit, has already arranged for a meeting of its alumni in our city during the meeting of the Mississippi Valley Medical Association in October, and also during the meeting of the American Medical Association in June next.

A committee composed of resident alumni, Dr. H. J. Scherck, Chairman; Dr. H. McJohnson, Dr. R. C. Atkinson and Dr. R. C. Finley, have arranged to conduct a central registration bureau where all the alumni can register, giving their home address and their stopping place while here. A banquet on both occasions will be arranged for and the occasion will be made a most pleasant one for the visiting alumni, renewing old friendships and bringing the ties closer together of the Tulane Alumni.

The committee will also be glad to answer all communications addressed to them in regard to hotels, clinics and any other information, by addressing all communications to the chairman. It is intended to make their stay in the city of St. Louis a pleasant one and one long to be remembered.

International Medical Congress, August 29 to September 4.

Dr. Emil Grosz, secretary-general of the Congress, has notified the American Committee that a statue of George Washington stands in a suburban park near Budapesth, having been erected by Hungarian countrymen who live in the United States, out of compliment to their adopted country. Dr. Grosz suggests that the American party should select a time for visiting the monument, and the matter will no doubt be arranged to the satisfaction of the American delegates and with appropriate ceremonies.

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.

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 con

stant attendance. The cost of the entire trip including a weeks board in Budapesth, meals en route, railroad fare, tips, first-class steamship both ways, carriages for sight-seeing, visiting hospitals; fortyone 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, care Hotel Ostend, Atlantic City, N. J., until August 10, and Grand Hotel, New York City, from August 10 until ship sails.

The New Grand Hotel has been chosen headquarters in New York City, on account of its central location, 31st and Broadway, where members of the party may meet and make final arrangements for the trip. Programs of the Congress and applications of membership may be obtained here; while Dr. Fassett will be pleased to arrange sight-seeing trips for those who may wish to spend a day or two in New York. Rooms should be engaged in advance.

Medical Society of the Missouri Valley at Council Bluffs, September 9-10, 1909.

The annual meeting of this progressive society will, as usual, be held in the city of its birth, Council Bluffs, Iowa, on Thursday and Friday, September 9 and 10. Already the scientific program is assuming attractive proportions, and it is evident that another successful meeting will be enjoyed by those who attend. The secretary announces that three interesting addresses will be given on the evening of the first day as follows: President's address, Dr. C. B. Hardin, Kansas City; address in Medicine, Dr. Alfred C. Croftan; and Dr. Jno. E. Summers will deliver a timely address on "Cancer a Constitutional Disease; Its Rational Treatment." The last two above-named addresses will be open for discussion. The arrangements are in the hands of a committee appointed by the local county society, of which Dr. V. L. Treynor is chairman. The secretary, Dr. Chas. Wood Fassett, will be pleased to send program and full information to those desiring same.

PHYSICIAN (MALE).

Indian Service. September 8, 1909.

The United States Civil Service Commission announces an examination on September 8, 1909, at the places mentioned in the list printed hereon, to secure eligibles from which to make certificaton to fill two vacancies in the position of physician (male) in the Indian Service at Nett Lake, Minnesota, and Volcan, California, at $1,000 per annum, and other similar vacancies as they may occur in the Indian Service, unless it shall be decided in the interest of the service to fill the vacancy by reinstatement, transfer, or promotion.

The examination will consist of the subjects mentioned below, weighted as indicated: