and gives a resumé of the chief symptoms and conditions likely to point to this unwelcome disease. It contains the gist of the results of the pathologic experiments made in recent years, and shows so many symptomatic conditions that it would be exceedingly difficult for any one to absolutely diagnose his cases until the destructive mischief has been done by the infection. If one were to bear in mind all of the classifications and symptoms recently given and relegate to the background all his own clinical experience he would be inclined to look upon nearly all onsets of acute disease in children as poliomyelitis. In fact, a great many physicians seem to have lost their own individuality and have come to rely wholly on what is handed down to them from the laboratory experts. Besides, much harm has been done through publicity in the public prints in begetting a great fear among the people at large concerning what they call the "new sickness." Instead of making people careful in judiciously avoiding contact with pestilence, it has made them panicky and, in many cases, so inquisitive as to flock to the seat of disease to satisfy that curiosity concerning sickness and death that seems to be an inherent and abnormal part of some individuals. The greatest harm has come through the fear that it has engendered and the lack of faith in the family doctor, who, if honest, must tell the inquiring and anxious interested ones of the great difficulty and uncertainty in diagnosing this malady.

The second paper, by Dr. Mundy, sensibly discusses the disease as recognized by clinical symptoms and their known connection with pathologic changes in the cord. He justly shows, we believe, that most of the fatal cases are myelitis, such as has long been known, and not a poliomyelitis, from which most recover, though maimed for a greater or less period or for life. This disease, whatever it is, should be carefully and quietly studied by both clinicians in general practice and by pathologists in laboratories, each one giving due value to the observations and findings of the others. Boards of health should exercise every care to prevent epidemics, and physicians should be only too willing to aid such Boards in every possible and quiet manner. But save it from newspaper publicity and the general unrest it produces. People now almost demand a diagnosis of this disease in all acute complaints in children, and regard the physician who hesitates to so pronounce it as deficient in medical acumen and knowledge.

There is another side of the subject that demands attention and that is the senseless and reckless injunction to use urotropin in all suspected (not proved) cases and give it as a prophylactic. One advocate, with a greater exhibition of enthusiasm for the novel and spectacular in medicine than sound therapeutic sense, declares it criminal negligence for the physician to fail to use a spray urotropin locally and the drug internally in all suspected cases and for prophylaxis. It seems not to have occurred to some that the drug itself is not without harmful effects, and like all agents which split up into formaldehyde in the body, may give rise to serious poisoning by the latter product. Doses sufficient to act as is desired to destroy the provocative germ are very apt not to be tolerated by children, and small doses are pronounced ineffective.

Urotropin is a condensation product of the action of ammonia upon formaldehyde. It is also known as formin, aminoform, and chiefly as hexamethylenamine. It is used chiefly as a uric acid solvent and as an antibacterial agent in urinary disorders. It is an active substance, and is recommended in doses of from 4 to 15 grains, as high as a dram being given in a day. Think of the exhibition "in every suspected case" and to other little children. not yet ill, of an agent which may cause in susceptible individuals (one way of apologizing for lack of ability to recognize indications) a drug that may produce "gastric and renal irritation, with hematuria, hemoglobinuria, and albuminuria, also diarrhea, abdominal pain, a measly rash, headache, tinnitus aurium, and strangury" (Potter's Materia Medica, 1910). Conceive of the harm that might come and of the possibility of mistaking these symptoms for those of the disease in question. Yet some physicians will do anything with medicines they are told to do by those "in authority" and still will assume an unbelief in the efficacy of medicines in disease. If half as much energy were expended in careful, unbiased, and unprejudiced study of the effects of drugs in actual human diseases as is expended upon the search for everything but the action of remedies, doctors would be better prescribers and drug nihilists would be conspicuous by their scarcity.

The Lancet-Clinic, with its usual good sense, called a warning in a recent issue which well reveals the chaotic condition into which the gullible physicians have been thrown by authoritative directions to use urotropin. It says:

Because Dr. Flexner, of the Rockefeller Institute, mentioned in his reports, in reference to anterior poliomyelitis, that in those

monkeys in which he used urotropin as a prophylaxis the disease did not appear, thousands of people have dosed poor, unoffending children with the drug until inflammation of the bladder and gastric irritation of a high grade made them desist. Even physicians have been panic-stricken enough to telephone their families to use the drug as a prophylactic in adults and children. Doses of urotropin which might produce continuous and effective antisepsis in the cerebro-spinal fluid can not be administered for any length of time. Doses that can be tolerated by a child over weeks or perhaps months, are probably inert. Their administration may create a false sense of security and rather a neglect of apparently trifling symptoms. The antiseptic action of urotropin in the cerebro-spinal fluid is problematical.

THE INDICATED REMEDY-ASCLEPIAS.-In the days of the development of early American medicine asclepias was an important and valued medicine. Since the fuller development of specific medication it has come to be regarded as an accessory remedy, though often administered alone to great advantage in certain well-developed conditions. Its reputation was acquired through its efficacy in respiratory disorders, and so valuable was it regarded in pleuritis that it was commonly and widely known as "pleurisy root." Nowadays it is just as useful, but we employ it as an adjuvant to the more energetic aconite, veratrum, gelsemium, and bryonia. The particular object sought in its exhibition is the re-establishment of the cutaneous secretions. It comes nearer to being the ideal diaphoretic than any agent we possess, and the diaphoresis induced is more nearly like that of ordinary, normal, or physiologic perspiration. Jaborandi produces copious watery perspiration, but asclepias increases both the fluid and solid output. Though acting best when there is no fever or when temperature is but moderately elevated, it may be used without harm where there is hyperpyrexia and active inflammation. Specifically it best meets that condition where there is mild fever or inflammation and the skin is moist or just about to break into perspiration. Nevertheless it is not contraindicated when the skin is hot and dry. In the latter case it favors normal insensible perspiration. It is an ideal remedy for inflammatory conditions of the respiratory tract brought on by cold (we are aware that there are those who believe colds are bacterial infections only), or by restraining the cutaneous secretions. Thus it proves exceedingly useful in pneumonia, pleurisy, and bronchitis, and is even useful in the colliquative sweating of phthisis. As a remedy for cough

it is useful where the cough is dry and secretion scanty, and the skin indications are prominent. It is often serviceable and always safe in mild attacks of asthma. Dr. Herbert T. Webster, a reliable observer of therapeutics, would restrict its uses to the control of vascular disturbances in the area supplied by the bronchial arteries. In all respiratory disorders, but preferably in acute forms, it lessens vascular activity, lowers arterial tension, controls irritation and cough, and restores normal secretion. This together with its true diaphoretic action makes it an uncommonly useful agent. In chronic respiratory affections it re-establishes secretion and lessens dyspnoea. In measles it serves the double purpose of a respiratory sedative and an agent to facilitate the eruptive process. Again, it should not be overlooked in gastro-intestinal disorders of a catarrhal type and chiefly brought on by checked cutaneous functions with determination of blood to the abdominal viscera. "Pulse strong, vibratile; skin moist; pain acute and seemingly dependent on motion" (Scudder). Skin hot and dry or inclined to moisture; urine scanty; face flushed; vascular excitement marked in parts supplied by the bronchial arterioles; inflammation of serous structures; gastro-intestinal catarrhal affections due to recent colds.

DEATH OF DR. BISHOP MCMILLEN.-It is our sad duty to record the death of Dr. Bishop McMillen, one who stood high in the councils of our school, and one who with great fortitude under a most trying form of physical distress, continued to work for the good of mankind. The following sketch is from the December, 1911, issue of the Eclectic Medical Journal:

Dr. Bishop McMillen was born near Johnstown, Licking County, Ohio, August 5, 1856, and died November 15, 1911, at his home in Shepard. His parents were Lyle B. McMillen and Marinda (Cramer) McMillen, both natives of Ohio. He received his early education in the public schools of Licking County, then studied medicine with Dr. David Williams, of Alexandria, and afterward graduated from the Eclectic Medical Institute at Cincinnati, in 1881, at the head of a class of one hundred and fifteen. In 1882 he was married to Miss Eva Agler, of Mifflin Township, who has been his very efficient and faithful helpmate throughout, and who survives him. No children came to bless their union.

After graduation he began the practice of medicine at Gahanna, where he practiced till 1888, when he was appointed a member of the medical staff of the Columbus State Hospital for the Insane. He served in this capacity three years and a half, and then located in Columbus, at 1075 Oak Street. In February, 1892, on alighting from

a street car before it stopped, he suffered a concussion of the spine, which rendered him an invalid, and after a year or so ended in paralysis, confining him to his bed during the remainder of his life. Before his complete disablement he lectured for several terms in his alma mater on nervous and mental disorders, and was emeritus professor of that branch till his death.

Dr. McMillen was always deeply interested in matters pertaining to his profession, and frequently contributed to medical magazines articles on his specialty. He took great pride in his connection with medical organizations, being a member of the National Eclectic Medical Association, Ohio State Eclectic Medical Association, and the Ohio Central Eclectic Medical Society. Of the two latter he had been honored with the presidency. He was also a member of Mifflin Lodge, No. 537, I. O. O. F., whose members had charge of the funeral services.

In 1894, although permanently disabled and confined to his bed, he established the McMillen Sanitarium for the treatment of mental and nervous diseases, which he conducted with signal success, both professionally and financially, leaving the institute at his death in a flourishing condition with a well-established reputation.

Dr. McMillen was, in health, of a robust figure and had a pleasing manner. He was a clear thinker and reasoner, and while tenacious of his views, was always ready to listen to the arguments of others, being eminently fair to every one. These qualities made him highly esteemed by his friends and acquaintances.

To a surprising extent he kept informed on public questions and in touch with his friends by means of the telephone and correspondence, which helped him to bear his misfortune with remarkable fortitude.

ECLECTIC VEGETABLE REMEDIES. The circle of physicians outside the Eclectic school who are using Eclectic medicines of vegetable origin is rapidly widening from year to year. Many who at one time were inclined to view Eclectic medicines with distrust, thinking them fads of the day-"ships that pass in the night"-have now come to rely upon them as their most trusty allies in the warfare against disease. When introduced, these medicines were looked upon by some as novelties that would have but an ephemeral existence, but now that they have outlived many other forms of medicines contemporaneously or subsequently introduced, their worth and reliability have led to their increased employment by those who looked upon them as such novelties as would soon go the way of all fads. Eclectic vegetable remedies do not come into the class of fads, for fads do not outlive many years, and sometimes hold sway for but a few months. For over forty years now have the vegetable remedies introduced into the