"sandbagging" procedure, since it was soon lost in the legislative shuffle.

THE civil service policy of the present national administration in medical offices is decidedly unique. In 1889 Governor Fifer of Illinois appointed a negro demagogue to the Illinois Board of Health for negro partisan reason. In 1893 Governor Altgeld removed the negro demagogue for too officious partisanship. Secretary Hoke Smith, at the instance of Secretary Gresham, has removed the white medical superintendent of the Washington Freedman's Hospital and appointed this same negro politician.

DR. H. D. HINCKLEY states ("LancetClinic") that the lines of battle in the British Gynecological Society have greatly shifted. The question used to be as to the removal of sound uterine appendages for neurotic reasons and now the question is whether the appendages shall be removed at all.

THE "Kansas Medical Journal" says of the medical aspects of the strike:

The physician's sympathy must be with the striker, because it is there he sees the suffering. It is with these he sees the want and misery and disease. To them he extends his pity because he must see the futility of the struggle, the hopelessness of the cause and the inevitable results. Who can better appreciate the condition of the poor than the physician whose care they become? The same principle applied to the physician or the merchant meets with denunciation and cries of oppression. Though the physician is a laborer in another field and a necessity to the rich and the poor, he can enlist no sympathy in a strike for better pay or shorter hours. When his employers refuse to pay the fees he demands he can withhold his services, but his neighbor may take his place without opposition. He has no recourse for protection. Suppose the physicians in Kansas should refuse to answer all calls until the Legislature passed the medical practice act, what a commotion there would be. Would it be less reasonable than the present strike, which threatens to tie up not only the great railway systems but all other business as well? The physician must submit to all the losses and inconveniences occasioned by these repeated trials of strength between capital and labor, yet take no hand in the contest.

Candidly it must be admitted that many labor leaders in Chicago and elsewhere, in defiance of their own principles, have shown themselves advocates of pauper medical labor in the dispensatories, and have shown as great tendency to avoid proper remuneration for medical services as the plutocrats whom they deservedly decry. THE Kansas law "against trusts and combinations in restraint of trade and product," for

bids ("Medical World") the adoption or use of phycians' fee bills as "against public policy and unlawful," and all accounts based upon them are declared void. A physician bringing suit to collect pay for services, basing his rate of charges upon any such a fee-bill or agreement, loses the entire account and the legal costs in the case and, if prosecuted in turn, is liable to fine of from $100 to $1000, or one to six months imprisonment, or both fine and imprisonment.

The contention of the law is that such fee bills prevent that free and fair competition in all trades, professions and callings which is for the best interest of society. The law applies to transportation companies, manufacturers, insurance companies, merchants and dealers, lawyers and all who might think it to their interest to form such a combination or agreement. This law is one eminently calculated to defeat its own objects and on appeal to the United States Supreme Court would be declared unconstitutional.

THE "Louisville Medical Monthly" remarks with much truth that:

The hypodermic syringe is a good and useful instrument-to leave at home. It is resorted to only too frequently when other means might be adopted. The opium habit follows its use more rapidly than any other manner of administration of this drug.

The same result could be obtained with greater efficiency by leaving morphine at home. and taking the vast majority of the other tablets in solutions for subcutaneous use.

AN APT illustration of the fact, pointed out by the MEDICAL STANDARD, that insane jurors and insane judges are strong advocates of the Spartan method of dealing with the insane, is once more afforded by the recent insane suicide of a Prendergast juror. Like the two insane jurors who sat on Guiteau, he was strongly in favor of hanging or otherwise exterminating the insane.

ON A recent New York post-prandial occasion, in which the speakers became satirically colloquial, Dr. Wm. A. Hammond jocosely alluded to the microbe of murderous frenzy. Dr. Spitzka, defending irresponsibility of the insane, remarked that the precedent speaker must, when recommending "hanging" for lunatics, have had in view Dr. W. A. Hammond's cultivation and culture of the field of "emotional insanity," illustrated in the McFarland-Richardson and similar cases. "Under such circumstances,"

Dr. Spitzka concluded, it was a pity that then bacteriology had not sufficiently advanced to permit the employment of the "hanging-drop culture" test.

THE St. Louis "Clinique" has passed into the hands of Dr. Emory Lanphear, professor of surgery in the College of Physicians and Surgeons. Dr. Lanphear will doubtless as ably conduct it in the interests of that school as he did the "Kansas City Medical Index."

THE Chicago committee on expert evidence drew up the following draft (approved by the Illinois Medical Society) of a bill for an act authorizing the judges of criminal jurisdiction in Illinois to appoint persons to act as expert wit

nesses:

Be it enacted by the people of the state of Illinois in the general assembly represented, that the judges of the circuit and superior courts of the state of Illinois, be and the same are hereby authorized to appoint in the month of January of each year, persons who shall act as expert witnesses in the medical and other sciences in giving opinion upon the evidence, as presented in a hypothetical form, of criminal causes that may be on hearing in the courts presided over by the said judges. Such expert witnesses shall hold their said appointments for one year or until their successors are appointed and qualified. They shall be entered as expert witnesses upon a list of such witnesses kept by the circuit clerk, and the said clerk shall issue a certificate of appointment as such expert witness to the person appointed as above. Such expert witnesses shall be citizens of the state of Illinois, and shall be known in the communities where they reside for their professional competency and personal probity, and it physicians they shall have been at least five years in regular and active practice. When expert opinion is desired in any cause pending in a criminal court, the trial judge presiding in such cause may, at his discretion, summon for duty under this act, such expert witnesses to the number of three. Such expert witnesses shall be paid for their services by the county in which the trial for which they are summoned is held, in such sums as may be named by the judge. It shall be the duty of such expert witnesses to give an opinion on the evidence as presented in hypothetical form in the case in which they are called. Such experts shall be subject to cross examination by both prosecution and defense; but such cross examinations shall be limited entirely to the subjects embraced in their opinion. In criminal cases previous to trial, if the state's attororney deems it advisable to have expert opinion he shall so state to the court having jurisdiction of the cause, and the judge receiving such statement may summon expert witnesses to serve under this act.

LAWSON TAIT insists ("Medical Record") that the criminal law should be amended in order to protect boys against being seduced by adult women to sexual intercourse. According to Tait this is by no means a rare offense;

53

"relatively," he says, "I am not sure if it is not as common as its converse." The "Medical Record" remarks that there is no doubt that, while every protection is afforded to the female sex by the act in question, the male sex are placed at a great disadvantage, not only in the manner pointed out by Tait, but also in the power which women possess of bringing false charges against men. There is no doubt that many a man has been made ardent in sexual pleasures from initiation by an elder female even ere he has attained puberty. In most of the United States there is no need of amendment, for, as Dr. Gibbs points out, ("McLane Hamilton's Medical Jurisprudence") the present laws would cover assaults by adult females on boys, which, as Gibbs finds, are more frequent than is generally suspected.

THE following contrasted opinions on the execution of a lunatic in Chicago appear in contemporary journals. One is from the Chicago "Inter-Ocean." The other, to the disgrace of the profession, is an attempt to stigmatize every Chicago alienist by the organ of the American Medical Association. This attempt to rise on the hangman's laurels to a congressional nomination by the editor of the "Journal" should retire him permanently from this position:

Patrick Eugene Pren- The second trial of the dergast has now suffered assassin Prendergast who the supreme penalty of foully murdered the the law, and those who Mayor of Chicago, Mr. have so long thirsted for Carter H. Harrison, last his blood have at last had autumn, resulted in a that thirst slaked. The verdict by the jury that slayer of Mayor Harrison the prisoner had not bewent to his fate without come insane since his showing the slightest conviction and sentence. signs of trepidation, mak- On the part of the public ing no harangue, but with there is apparently not almost his dying breath only no desire to "go reiterating to the father behind the returns," but confessor ministrant that a demand for speedy he killed Harrison in justice by the application obedience to a command of the lex talionis. At he could not disobey. the first trial, the plea of Undoubtedly the young insanity was set forth man was possessed of an with great ability by the insane impulse, such as counsel for the prisoner, Richard Henry Dana so and "experts" were put vividly portrays in "Paul upon the stand to give Felton," the first really testimony for and against great American novel. the lunacy of the asIf the object of punish- sassin. The jury then ment were vengeance, decided that the prisoner and the function of was sane and fully recriminal law to avenge sponsible for his acts, private and public and thereupon, in due wrongs, then surely there course, the judge procould be no doubt of the nounced sentence upon justice of Prendergast's him. execution. Seldom has His counsel in the untimely taking off due time served notice

of a public man been so deplorable. But is it any reparation or satisfaction that the crazy youth who did the deed of horror met death on the gallows?

on the Court that the prisoner had become insane since the trial, and after much discussion, the question of his alleged insanity again came to the front with the usual tedious torturing of the testimony of the hapless medical expert. There will be a sense of relief that there is a fair prospect of ridding the world of such a monstrosity as Prendergast, and whether these wretches are sane or insane, it can not be denied that the world will be better off when its Prendergasts and Santos shall have taken leave of it. We can well spare assassins from our midst, and sympathy might much better be expressed with the state, and the families of the victims, than with the murderer.

Had Prendergast killed some member of his own family, or any ordinary person little known to the public, he would have been consigned to a madhouse by common consent and almost as a matter of course. Several such cases have occurred in this city within the last six months. If the Prendergast case is to serve as a precedent, a distinction is to be made hereafter between the monomaniac who takes the life of a private citizen and one who takes the life of a public man. There may be persons who really suppose that It is impossible to ensuch discrimination is tirely lose sight of the due to men in exalted magnitude of the crime stations, but the "Inter- committed in the examiOcean" believes now, as nation of this question, it has from the first, that and it is an evident truth the proper treatment of that if the peace of sothe homicidal insane is ciety is to be maintained, close confinement behind laws respected, and the unopening walls. Capital state preserved, we must punishment is abhorrent not obtrude a defense of to a very considerable technical insanity to element of American shield the perpetrator people, but the hanging from the consequences of a crazy man is shock- of his crime. The ining to every sense of sanity, when valid as a genuine justice, and it defense, should be clear does not seem possible, and distinct. There are in the light of all the worse perils for a country facts, including the dy- than the execution of a whose brain ing protestation, to sup- criminal pose that Prendergast may be technically aberwas sound of mind. rant, and while one view of the humanities would naturally prevent the execution of a maniac, there is no excuse for preserving the worthless lives of those assassins who are simply eccentric.

The American Medical Association cannot afford to pose as defending the execution of a lunatic, and the sooner the present tendency to pander to disreputable prostitution of psychiatry is checked the better. At the next meeting the "Journal" editor should be changed and some one elected who is not a hangman candidate for congress. When the Chicago "Inter-Ocean" can afford to be truthful in this matter, the "Journal" should be able so to do, especially when it is remembered that every Chicago alienist sides with the "Inter-Ocean."

THE "Lancet" states that the celebration, five years ago, of the eighth centenary of the founding of the University of Bologna, gave fresh prominence to the fact that she is not only the mother of seats of learning, but also of academic degrees. It was in the faculty of law that she first conferred the honor of graduation, "Doctor Legum" being the title to which Irenerius, the regenerator of the Roman juridicial system and the virtual founder of the Bologna School, promoted the "alumnus," who had attended the prescribed courses and passed the qualifying ordeal. Paris, still in the faculty of law, imitated the example of her Italian sister, whilst not till a century later did England follow suit. Medicine having, like law, assumed the dignity of a "faculty," began also to give the title of "Doctor," a word which is met with in that connection as early as the first century, when Suetonius relates of Julius Cæsar that he invested with the rights of Roman citizens "omnes medicinum professos et liberalium artium doctores." From the earliest times the practitioner of an art, particularly that of medicine, was looked up to as its teacher. And so when the healing art, incorporated in the university system, handed on the torch of "light and leading" to its disciples, it did so by "promoting" them from "alumni" to be "doctores," equally qualified to practice and to instruct.

DR. C. B. MORRISSE, of Central Station Hospital, Trimulgherry, India, reports (Indian Med. Rec.) two patients in a low state who expired immediately upon the occurrence of a sudden loud noise. The "Medical World" has no doubt that many patients are rendered distinctly worse by the various loud noises incident to city life, such as steam whistles, vehicles on rough streets, hucksters' cries, the ringing of bells, etc., most of which disturbance is unnecessary. Many well persons, especially women and children, are rendered very nervous by these causes. When the Philadelphia Neurologists nearly two decades ago made war on noise ("Jour. Nerv. and Ment. Dis." 1877) they found themseves frustrated by ecclesiastics, politicians, peddlers, and manufacturies.

OF THE 18,910 medical students in the United States, 16,759 attend medical colleges, 1,410 attend homoeopathic, and 741 eclectic and allied sectarian colleges.

THE Nebraska medical practice act has been construed by the supreme court to include christian scientists.

THERAPEUTICS AND PHARMACOLOGY.

ANTIPYRIN IN PERTUSSIS. Dr. J. P. Crozer Griffith (American Text Book on Diseases of Children) remarks that antipyrin, first recognized by Sonnenberger, has been used with excellent results by so many that its value in the disease is now beyond question. Although, like other remedies, it often fails to relieve, many of the reported failures with it are doubtless due to the fact that it was not given in sufficiently large doses. Children bear it surprisingly well, and bad results following its administration are rare. The initial dose should be small, and the amount gradually increased, until a child two years old receives from 1 to 2 grains, or even more, every three hours. In a desperate case of pertussis in a 4-month-old child, in which 4 gr. of antipyrin given every three hours, failed entirely to relieve, an increase of the dose to I gr. every three hours rapidly brought the patient from a condition of the greatest danger to one of comparative health. The child had suffered from very frequent and violent attacks of cough, followed by spasms of the glotti of so long duration that intense cyanosis with entire apnoea and loss of conciousness repeatedly resulted. Within forty-eight hours after the treatment had been instituted, the little patient had passed an entire night, and until afternoon of the next day, with but a single paroxysm.

UNTOWARD EFFECTS OE CODEINE.-Dr. J. S. Duff of Pittsburg, Pa., reports ("Columbus Med. Jour.") the case of a woman who suffers intense pain from congestion of the ovaries, especially during her menstrual period, but at no time is entirely free from pain in the ovarian region. This pain has made it necessary to administer almost daily large doses of morphia-as much as one grain being given hypodermically without producing sleep or any unpleasant effect. Knowing that such large quantities of morphine were dangerous, and must in time tell on her, he tried codeine. One-half grain was given internally and in a few minutes same quantity hypodermically. In about one hour he found a most abject picture of misery. She was swollen from head to foot, face and body intensely red, as if stung by bees, skin so hyperesthetic that the slightest touch on any part of it caused her

to cry out with pain. The lower extremities were cold and purple with a death-like feeling. Heart sounds feeble and irregular, pulse at the wrist almost imperceptible. Large doses of digitalis and whisky with hot applications to her feet and limbs soon restored the failing circulation. In five or six hours she felt as well as if nothing had occurred. The next day small doses of codeine were again given, producing in a less degree, in proportion to the size of dose, the same effect as on the day before.

IRON OXALATE (ferrous oxalate) has been successfully employed by Dr. Hayem ("Amer. Medico-Surg. Bull.") against chlorosis. It is a light yellow, inodorous, crystalline powder, practically insoluble in water, and best administered in wafers or pills. Dr. Hayem has used it years, and prefers it to all other inorganic iron preparations. He first gives two 11⁄2 grain pills daily, during meals, and later on increases the dose to 41⁄2-6 grains, if the patients bear the remedy well. He has given as much as 10 grains a day uninterruptedly for a long time, without ever observing any disturbance of digestion, it is reported. The results of an exact determination of the hæmoglobin and of the counting of the blood-corpuscles, after the administration of ferrous oxalate, speak well for the remedy.

DIARRHOEA.-Dr. W. T. Buckley advises ("South. Med. Rec.") the following mixture: Pulv. ipecac...

populus trem.

.gr. x

3i

thought that it was due to the liver, and explained it quite ingeniously on the ground of comparative physiology. His assertion was that "gout is hepatic reversion-the formation of primitive urine products by a mammalian liver." Vindevogel alleges the chief factor in gout an enfeeblement or lessened activity of the trophic nervous centers, and a loss of equilibrium between the processes of assimilation and disassimilation, by which the products of disintegration are rendered incomplete or toxic to the economy. Quite recently Da Costa, in discussing lithæmia, states that there may be other excrementitious or pathogenic principles at fault besides uric acid, and strongly objects to narrowing the consideration to a single chemical substance. He believes that this is taking entirely too restricted a view of the condition. For him lithæmia is a morbid state in which the income of nutrition is in excess of the outgo of waste. The quantity of food is greater than either the needs of the system requires or the organs of excretion can properly dispose of. There is defective oxidation as well as deficient climination. The consequence of excessive ingestion of food is that the functions of the liver are imperfectly performed, and there is generally more or less hepatic disorder. The blood contains urates in excess and frequently oxalates, also other imperfectly elaborated products of waste; possible it may be yet further poisoned by ptomaines resulting from imperfect gastric and intestinal indigestion. It seems evident, therefore, that while a great difference of opinion exists as to the ultimate cause of gout, whether it be of nerve or blood origin or due to failure of liver, kidneys, or the digestive organs, all authorities are in accord upon one thing, and that is that the condition to which our theraputic efforts must be directed in order to relieve the patient is an excess of uric acid and other waste products in the blood. It is to this condition that the symptoms and sequelæ are now generally attributed. It is quite probable that there may be a failure of the glands of the skin to properly perform their functions, as has been asserted by some observers. At all events, it can easily be shown that certain forms of eruption upon the general surface are of a gouty nature, and are curable by applying the treatment suitable for the underlying gouty condition. Dr. Shoemaker has found "Buffalo Lithia Water" to give peculiarly reliable permanent results in these cases. TRIONAL IN NEURASTHENIA.-Insomnia is one of the most frequent symptoms of neu

rasthenia. Unless the obstinate wakefulness which characterizes these cases be removed, little can be hoped for from other therapeutic measures, and yet the list of hypnotics in this affection is not large. Morphine is generally contraindicated as it is apt to disturb the digestion, and by increasing the constipation from which these patients ordinarily suffer prevents elimination of those poisonous substances which pass from the system by way of the bowels. Neurasthenics, moreover, readily fall victims to the morphine habit. Chloral is a dangerous sleep-producer. Bromides are not trustworthy; they occasionally succeed, but more often fail in producing sleep. The ideal phynotic in neurasthenia must possess the combined qualities of safety, efficiency, promptness of action, ease of administration, and freedom from unpleasant after-effects. Dr. J. G. Kiernan, whose experience is corroborated by that of Dr. Harriet C. B. Alexander, finds that the "sleep habit" can be best inaugurated by divided doses of sulphonal and then continued by trional. The untoward effects of this last, while comparatively infrequent, resemble, as might be expected, those of sulphonal, albeit less in degree.

STATIC ELECTRICITY, according to Dr. Monell ("N. Y. Med. Jour."), affords the most certain and permanent relief for lumbago, sciatica, rheumatic and muscular pains. Neuralgias of every kind seem to yield to it more speedily and permanently than to any other form of treatment. In the various types of head pains and in insomnia it is peculiarly efficacious. No other agent equals static electricity in combating hysterical states and associated conditions. It furnishes our best method of treating functional nervous diseases. It is an efficient regulator of deranged bodily functions, and is not surpassed by any other agent in the successful treatment of that important class of ailments known as functional diseases. As a general tonic and as a stimulant to depressed nervous functions, it is of the utmost service, especially in neurasthenia and in old cachexias. As a means of improving the general nervous tone of patients it is without a rival. Reflex irritation, peripheral neuroses, etc., yield, in most cases, to proper applications of this agent. Pruritus of various forms, the itching of eczema, etc., are cases in point. dietetic diseases it acts with decided benefit; it produces remarkable improvement in disturbed visceral functions, nausea, vertigo, dyspepsia, constipation, colic, etc. In chlorosis and anemia,

In