I have stated it, in respect to all his duties and responsibilities." In speaking of the compensation offered for expert testimony he says: "In such a case what shall be the measure of his (the physician's) compensation? Shall he be required to wait and attend upon the beck and call of a stranger, of one who is in no sense entitled to his services, and for the paltry pay which is allowed to an ordinary witness? To ask such a question is to answer it. For it must be borne in mind that it is not the knowledge of facts that is sought, but his generalization of facts already sworn to by others, and his scientific interpretation of them, by the skill, experience and learning of an excellent profession. * *And the party who would seek or the court who would enforce gratuitous contributions from a physician would ipse facto prove that he is not a seeker or minister of justice, but a wrong-doer in the one case, and an ignorant, official tyrant in the other."

*

Dr. Gadbury gives a plan for the abortive treatment of pneumonia, which depends upon the following principles: (a) To give rest to the injured organs by paralyzing the respiratory nerve centers so as to reduce the respiratory movements nearly to the normal standard, (b) to arrest the congestion and excudation, (c) to reduce the temperature and pulse, and (d) to support the system. For the first the following combination, modified to suit the age and idiosyncrasy of the patient is used:

R. Calomel,

Bicarbonate soda...
Quinine

Acetate morphia.......

.ăā grs. xij.
3j.

grs. iv.

Mix and make twelve powders. Sig. One powder every two, three or four hours until the respirations are reduced nearly to the normal standard or profound narcotism ensues. Veratrum and aconite are used to aid in the reduction of temperature and the system sustained upon alcohol.

Dr. Vaughan, in his report upon new remedies, speaks favorably of cascara in constipation, napthaline in the spasmodic stage of whooping cough, pilocarpin in the removal of dropsical accumulations, artificial inflation in diseases of the lungs, and the application of dry earths after Hewson's method in irreducible hernia.

Dr. Ward brings forth many weighty arguments to prove that the chief cause of cholera infantum, entero-colitis and the choleriform diarrhoea of French authors is the effect of the excessive heat of summer on the nervous system, and to correct this he uses in all cases quinine together with the remedies ordinarily used.

The volume contains other papers of interest which space will not permit us to abstract.

(3) President Allen gives a strong plea for a thorough medcal education. He strikes at the root of things and lays the

.

disgrace where it belongs. Of our medical schools, he says: "It is proper to state that nearly all of them in the United States and especially in this State (Missouri) are private institutions except the State University. Furthermore, any number of gentlemen may band themselves together and by complying with the law be incorporated, and have granted them the power to confer the degree of M. D. on any person they may wish. In this grant of power, the State has neglected to protect itself from incompetent teachers, by not requiring that they be learned in their profession, nor does it protect the citizens, since it does not require a certain amount of medical knowledge of each student before the degree of M. D., shall be conferred upon him. We want the protection of the citizens. from incompetent men, thereby increasing our obligation to graduate none but competent students. The same is true in the other states. Therefore, the degree of M. D. has no fixed value but simply represents the ideas or interest of the teachers who confer it. Hence, it does not command the respect it should." Of the journals read by the routinist, he has none save those sent by some enterprising drug house gratis, and which contain accounts of new remedies and are filled with prescriptions of "old retired physicians, guaranteed by the certificate of considerate clergymen." These he copies in his daybook and carries in his pocket for ready reference. He does not hesitate to prescribe "Harter's iron tonic," "Hembold's buchu," or any other nostrum he may find in these gratis journals.

Dr. Lutz reports a case of gastrototomy with many interesting physiological as well as surgical points. It was found that stomachic digestion was greatly aided by previous mastication and insalivation. Therefore, all the patient's food, both solid and liquid, was first masticated and then passed by a rubber tube through the fistula into the stomach. The operation was performed on November 15, and the patient survived until July 2.

Dr. King pleads for the bath in fevers. He uses a Knowlton's rubber bath, and has the water at from 90° to 80° for children, and from 90° to 60° for adults, according to age and severity of symptoms.

Dr. Todd calls attention to the fact that asthma is sometimes due to nasal polypi, the removal of which is followed by relief of the asthmatic difficulty.

Dr. Lee reports two interesting cases of spontaneous version and involution in shoulder and arm presentation. In the first case, the doctor found a shoulder presentation with ultimately a descent and protrusion of an arm. Seeing the case was to be a difficult one, he gave a heavy dose of opium and sent for aid. After two or three hours, pains again came on, when an examination showed that the arm had been withdrawn and the

head was presenting. In the second case, the presentation was changed as often as three times.

From the report of the committee on medical education, we judge that some members of the association do not consider the rapid multiplication of medical schools in the state as likely to advance thoroughness of study. Well may there be danger when eight medical schools, seven of which are dependent for support upon the fees of students, bid for favor in Missouri.

(4) Alabama has probably the best organized State Medical Society in our country. All the local societies are subject to the State Society and by this complete organization the profession has been able to accomplish more in the way of medical legislation than has been done in most States. President Anderson's address is replete with suggestions of value. Nearly thirty years ago, Dr. Anderson, as chairman of the committee, on medical education in the American Medical Association, recommended that the granting of degrees with license to practice by colleges should be discouraged by the Association, and that such power should be delegated to a national board, appointed by the association, and which should sit for several weeks annually at the national capital. Had something of this kind been done the standard of our profession would have doubtlessly been much higher to day than it is.

In accounting for uterine hydatids, Dr. Seelye ventures, "the theory that from some peculiar dyscrasia, either in the mother or father, the product of conception is not endowed with sufficient vitality or energy to perfect the work of nutrition. In consequence the proliferation of cells by which the intra-uterine growth is normally affected is arrested, and the parent cells instead of developing new nuceli which may in time grow to perfect cells, fall short of this part of their functions. They grow and increase in size by imbibition of the surrounding fluids, but fail to develop into perfect cells with contained nuclei which inturn by segmentation multiply themselves into perfect cells. Hydatids are then dropsical cells of the chorion, which were not endued with sufficient inherent vitality to enable them to perfect their work."

Dr. S. uses pure carbolic acid injections in internal hemorrhoids, prefering the pure acid to that diluted with glycerine. The amount of acid is regulated by the size of the tumor.

Dr. Huestis prevents hemorrhage when performing the operation of circumcision by rolling back an India rubber ring, of sufficient tightness, to the root of the penis, the pressure of the ring forcing out the blood and preventing the loss of a single drop during the operation.

Dr. Fort, after failing in difficult labor to dilate the os by digital manipulations, injects with hypodermic syringe into the

os from one-sixtieth to one-hundredth of a grain of belladonna (atropia?). He uses fluid extract of viscum album instead of ergot as an exytocic. For after pains he uses potassium bromide and morphine, and condems the tendency among physicians to give nothing to relieve these pains.

(5) For varicocele, Dr. Boyne " makes a simple incision with antiseptic precaution through the scrotal walls, exposes a single enlarged vein and ligates it with catgut or the finest thread of silk thoroughly carbolized, preferably the former. In either. case the ligature is cut short and left to take care of itself— the catgut is absorbed, the silk encysted. The after-dressing is the Lister gauze. This operation is repeated at suitable intervals until all the varicose veins are obliterated. So far, these proceedures have been unaccompanied by inflammatory reaction and have been practically free from distress."

As to removal of pacenta in cases of miscarriages, Dr. Crummer gives the following instructions:

“(a) One index finger introduced into the womb while the organ is depressed well into the pelvis, and steadied by the other hand applied externally. In this way a moderately contracted os may be dilated, a sharp anteflexion of the uterus straightened, and, using the finger as a hook, the uterus may commonly be thoroughly emptied.

"(b) With one or two fingers in the vagina for counterpressure against the anterior surface of the womb, and the other hand making firm pressure over the fundus and posterior surface of the uterus, the contents of the womb may sometimes be pressed out. These procedures, though somewhat painful, do not require an anesthetic. But we must confess that in a certain proportion of our cases they do not succeed. Very often the detached afterbirth can be just felt at the tip of the finger or glides from it in any effort at extraction. We may then resort to:

"(c) The introduction of the hand into the vagina and one or more fingers into the uterus, and this requires an anæsthetic. "(d) In some cases where the vagina is small, or anæsthetic not desirable I have succeeded admirably with Loomis placenta forceps in grasping and removing the offending substance."

Dr. F. C. Hotz thus sums up the evidence as to the value of homatropine as a mydriatic: "It enlarges the pupil and paralyzes the ciliary muscles as quickly and thoroughly as an equally strong solution of sulphate of atropia; but the effects of the homatropine upon the eye disappears entirely in twelve to twenty-four hours, while the effects of the atropine continues for many days, and while it lasts disables the patient for reading and writing." For this reason homatropine is preferable when temporary dilatation of the pupil is desired.

Dr. Maynard states that ringworm of the scalp in children

is often obtained from the lower animals. In the treatment of the affection isolation is necessary to prevent its spread. In boys the hair should be cut close, with girls this is necessary only when there are several patches. The scabs should be removed by soaking with one part of sulphurous ond to four of After thorough cleansing one of two classes of remedies

may be selected:

(a) Those that act on the parasitic growth by causing severe inflammation; as cantharides, glacial acetic acid, tincture of iodine and chrysophanic acid.

(b) The milder and so-called parasiticides, as sulphur, sulphurous acid, carbolic acid, tarry preparations and mercurials. The stronger applications are used only where there is a simple patch or a number of very small ones.

(6) To our mind President Bailey gives the true cause of so many isues or schools in medicine. It is duce to the fact that so many meh enter our medical colleges without any adequate preliminary education, and without habits of study. The great value of a thorough literary course is not so much in the facts learned as the mental discipline acquired.

Dr. Hamilton in a paper entitled "facial hairy growths in insane women," comes to the following conclusions:

(a) Abnormal growth of hair, especially upon the face, is frequently closely connected with disturbed function of the pelvic organs of women.

(b) That in the insanity of women, especially when it lapses into dementia, and cutaneous nutritive changes exist, such growths of hair are by no means of uncommon appearance.

(c) That their unilateral character, so far as preponderance in growth is concerned, and their association with unilateral cutaneous lesions, such as bronzing and nail-changes, indicate their nervous origin.

(d) Their appearance chiefly upon the face of insane patients, and relation to trophic disorders incident to facial neuralgia, points to the fifth nerve as that concerned in the pathological process.

(e) The development of hair with the deposit of pigment and skin lesions, and occasional goitrous swellings suggests the inference that the neuro-pathological process which leads to the growth of hair in the chronic insane, is akin to that which gives rise to Addison's disease.

Dr. Bulkley uses for depilation in favus sticks made from the following mixture: