sension. Such a relationship is indeed undesirable and hence if a full understanding can be obtained we indeed welcome it.

Consequently we urge and sincerely hope that you, who feel you have a grievance, you who feel you have been injured, that you come to this conference and in an open sincere discussion clear up the situation and then join in a co-operative movement for better things.

We invite a goodly response, statewide, to this invitation, and bespeak your constructive criticism and advice. We confidently expect that this conference will result in putting a quietus upon unfounded, unjustified rumors and mis-statements. Plan to be in Ann Arbor and if you write to Dr. Parnall care of the University Hospital he will gladly arrange for your room at the Michigan Union. If you have a grievance and do not attend this conference you have no right to continue to utter harping criticism. Now is your opportunity to get together.

THE USE OF MORPHINE.

A number of years ago when the use and method of exhibiting therapeutic remedies was considered worthy of presentation in a paper at a medical meeting and also found welcome in the columns of medical journals it was not uncommon to read a survey of doctors' opinions as to their dependency upon certain drugs. It was usual to see an expression by capable men that of all the drugs in the pharmacopea if they were limited to a selection of three drugs they would select Opium, Calomel and Nux vomica. That was the most frequently selected combination. Of course there were some who preferred magnesium sulphate, aconite, pilocarpine, potassium iodide, digitalis, but all were agreed upon the need of having opium or its alkaloids. Much has been written and said about opium, drug addicts, the Harrison law and how the profession is responsible for the habitue's use of morphine. The Harrison law was enacted because its sponsors hoped it would limit opium traffic, retard and eventually do away with the opium habit. At least that is what they claimed, but, events and conditions point to the failure of accomplishing such a purpose. On the contrary, it is fairly apparent that the number of addicts is increasing and all that the Harrison act has done is to increase revenue returns by the three dollars per physician license fee. Neither can the charge be made that physicians are prescribing the drug in greater quantities and that the profession is thus responsible for the increased numbers of opium habitues.

An interesting article appeared in the December 11th, 1920 issue of the Journal of the A. M. A. in which Dr. Blair discusses the usage of narcotic drugs in hospital service and private practice. His article is based upon Pennsylvania statistics. The doctor reports that in one year the hospitals of Philadelphia used an average of 1.6 grains of opium and its alkaloids per patient. Those of Pittsburgh, 2.9 grains, and of several other hospitals of the state 3.1 grains. the average being in the state 3 grains per patient. In this connection it must be remembered that many of the patients were surgical, emergency and industrial, hence presenting definite therapeutic indications for the exhibition of the drug..

In private practice there is an average of one physician to every 700 people in Pennsylvania. The records show that on an average the private physician employs about four grains per patient per year in 60 per cent. of the practice and the entire private and hospital practice, including chronics, insane and addicts under treatment from the records of medical prescribing equals 15 grains of opium for every person in the state. This includes that used by dentists, veterinarians and patent medicines. In 1919, the Secretary of the Treasury reported that the annual consumption of opium showed on an estimate that counted every man, woman and child-sick and well-in the Union, an annual per capita consumption of 36 grains of opium with an additional unknown supply of smuggled-in opium to be added thereto. Consequently the physicians are prescribing not quite one-half of the opium consumed.

These are the figures for Pennsylvania and they may be taken, we believe, as a representative average of the country. However, we would like to see a similar analysis made of several other states to determine if the same relative conditions exist. In the article there is revealed that 250 physicians exceeded the 15 grains per capita average but it is pointed out that they were men who catered to the addict trade and carried them along on the discredited ambulatory reduction treatment. In all there were only some 600 who exceeded the 15 grains per capita average. Were these men to meet up to the professional average and intelligent. use of morphine the per capita amount prescribed by doctors would drop to ten grains.

On the whole the article furnishes much for reflection and indicates as we asserted in the beginning that opium habitues are not wholly the result of the profession's therapeutic use of the drugs.

COMPULSORY HEALTH INSURANCE. The propagandists who seek to force this class of legislation upon the profession and public are endeavoring to allay professional opposition by stating that by being represented upon administrative boards we will be able to dictate the returns for the services we render. This is the bone they are throwing to us and the "pap" they are trying to ladle out in an effort to suppress our opposition. Please don't be subdued by such meaningless promises.

When the Harrison act was passed and we were taxed one dollar to administer it, we paid. When it was raised to three dollars-we paid. When compensation acts were enacted and medical-surgical services prescribed and defined were we consulted? No! When the Volsted act limiting the prescribing of liquor and restricting its medical use were we consulted? No. The proponents will reply, we are not talking about those laws. No, but the profession is not forgetting about the treatment and consideration received by legal enactments.

Nor are we unmindful of the recompense we now receive from the state administered institutions. We refer to the following pay roll of the Chicago Municipal.Contagious Diseases Hospital; as but a sample of what we may expect:

Assistant Medical Superintendent, $150 per month (board and lodging).

House Physician $120 per month (B. and L). Ambulance Surgeon $120 per month (one meal).

Electrician $225 per month. Ambulance Driver $150 per month (one meal).

The ambulance driver, who requires but a -couple of months of training receives $30 more per month than the ambulance surgeon who was compelled to take not less than six years of college training, not counting high school. Oh, yes, we will dictate our fees and be given what we ask. The proponents know full well the show we stand when bureaucrats and politicians are on these boards to designate what we shall do and what we shall be paid.

We have yet to be shown why this plan is being proposed and pressed. We have yet to be shown why these propagandists are so insistent. We have yet to be shown wherein and how the profession has failed to care for all who need medical services. We know of no place where professional and hospital services are refused the sick and afflicted.

We would like to see the proponents of this plan list the plumbers into panels and cause them to respond night or day at 25 cents per

hour pay. No, they wouldn't dare to attempt it for the plumbers are organized while we as a profession are organized in name only. Goodness knows there are more shops, factories, business houses and homes that need sanitary plumbing, more so almost than there are people who are in sore need of medical and hospital services that they cannot obtain. Why look at us.

So again we urge our members to bestir themselves, become more than members. We want aggressive action and concerted effort to defeat this pernicious measure.

Editorial Comments

Somewhere, we cannot just recall, the statement was made or printed that we began life studying to learn and end life learning how to study. It naturally follows that he who fails to attend his county society meeting is failing to learn how to study the problems of his daily work. Hence, that individual is bound to undergo a stagnating process, and become more and more inefficient. What is required is more attending and participating members.

Has any society any particular problems that remain unsolved. If so, why not hold a special meeting for their discussion. Call in the Councillor of your District to deliberate with you.

If transportation companies, gas and electric companies and street railways are public utilities and so amendable to legislative regulations it occurs to us that the Standard Oil Company may also be listed in the class of public utilities and made amendable to regulation. With the number of automobiles in use to-day for business and commercial purposes gasoline is a commodity that is an actual public necessity and utility. With the published reports of millions of profit and increasingly large earnings there does not seem to be any other conclusion but that the present price of gasoline is exorbitant and the profits reported evidence of unjustified profiteering. Oh, yes, we realize that we can not drop a bomb in the Standard Oil Company's midst by this Editorial Comment, still we may be at least a grain of powder in the bomb that can be prepared if a sentiment is recorded.

County Secretaries are requested to forward for publication a report of each meeting of their society. Some of our counties have not reported a single meeting during the past year. Why? Will you send them this year?

The Journal solicits original articles covering or incorporating original investigations or practical observations.

A prompt payment of your dues to your county society is especially urged at this time. Please

do not make it necessary for your county secretary to send you a statement. Send in your check this week.

Watch your local papers for legislative activity and when you note that undesired bills are introduced see and also write your representatives and Senators and thus enlist their influence to defeat such proposed enactments.

We are absolutely convinced that those who are engaged in devoting their entire time to the executive work in connection with the various offices centered in the headquarters building of the American Medical Association are working wholly and solely for the best interests of the profession. We know that they have your welfare at heart and are endeavoring to cause you to realize upon the results of their activities. They merit our confidence and support. As officers they are faithful to the trust imposed.

When the lack of clinical material causes desirable and able men to refuse offers of faculty appointment is it not about time that our medical schools should be re-located so as to overcome such objections?

In our December issue we did not purposely omit our News Notes. The fact was we had

no copy. Our newspaper clippings furnished nothing and likewise our correspondents. We urge that each member assume the task of forwarding news items.

The laborer or any employer who loses his life in the performance of his duty is assured that his estate will be compensated for that fatality. The doctor, practitioner or surgeon, who, in the practice of his calling, loses his life, makes the supreme sacrifice without other reward than a credit for having been faithful to his calling. Such sacrifice as a rule is passed by with but little note. Every month witnesses the death of several of our members in the United States who thus contribute their lives in the performance of their duty. And even we, their fellow members, take but pasing note of their deaths. It is only when the sacrifice occurs close to us and the one makes this sacrifice is personally known do we pause and give more than passing heed.

In the death last month of Dr. Enos C. Kinsman of Saginaw there was again recorded a supreme sacrifice on account of duty well performed and a death directly attributable to the work of his calling. A needle prick sustained during an operation upon a patient with septicemia resulted in the development of a virulent streptococcic infection of the thumb and entire arm with extension to the heart and kidneys and a fatal termination. His death marked the close of the life of a capable sympathetic and progressive surgeon. One who was respected and loved; a man whose memory we will cherish.

The answer has been given in the past that the reason the State Board of Registration in Medicine did not assume a more aggressive attitude toward prosecuting unlicensed doctors and quacks was because they had no funds wherewith

to secure the necessary evidence. Such reason can no longer be advanced-in fact, need not have been advanced during the past two years. The State Constabulary officers and men are. available and willing to dig up the necessary evidence. We were talking to a captain of the State Constabulary the other day and asked him whether his men could be utilized for that purpose. His reply was that if we would but name the suspected individuals his men would secure the evidence. Here, then, is a splendid opportunity for the Board to do some professional. house cleaning.

In the November issue of the Bulletin of theDetroit Department of Health there appears an article dealing with this subject as seen in the school children in Detroit.

At a cost of over one and one-half million dollars Detroit is building a municipal tuberculosis sanitarium at Northville. This will provide accommodations for 300 patients.

There are present in the City of Detroit from. 1,100 to 3,500 school children with seriously impaired nutrition. This group is a potential supply house for the tuberculosis of the future.

Can we build accommodations for our tuberculous as rapidly as they are being produced? Would it not be wiser to begin at the other end and try to eliminate the conditions that make for tuberculosis, to prevent as well as to cure?

A most encouraging start has been made. There are in the public schools of Detroit, openair classes for the physically subnormal child. There is the summer camp of the Health Department to bring many children back to normal weight.

The open air classes accommodate 250 children. The summer camp looked after approximately 150. Private women's clubs and organizations are giving supplementary feeding to 4,000 children.

There are a number of causes of under-nourishment. With some it is lack of food. In Detroit there are children coming to school without breakfast, sitting through the morning session to imbibe knowledge on an empty stomach.

With others it is an improper choice of food. Coffee and bread served as the breakfast of many of the school children. Coffee is a prominent item at other meals. Soup, meat and fried

foods are popular. The correct choice of food I will lead to better nourishment at less cost.

Tonsils, adenoids and decayed teeth retard some children and no amount of food will alleviate the condition until these defects are remedied.

Adequate and properly selected food can not overcome the handicap of insufficient sleep, sleeping in warm, closed rooms, over-fatigue and other violations of the rules of personal hygiene. Fifty thousand children are slipping from the pathway of good health in Detroit. Many will catch themselves before going further. There are several thousand that have already slipped and assistance is needed to replace them on their feet.

The matter requires the intelligent and well directed efforts of the forces of the City of Detroit.

The proper selection of foods:

1. Milk, eggs and green leafy vegetables are protective foods and liberal use should be made of them.

2. Excessive use of meats should be avoided and substituted with cheese, cottage cheese, fish, eggs, peas, beans and lentils.

3. There is no substitute for butter especially for children.

4. Fruits and vegetables are body regulators. Their liberal use is advised.

5. Avoid the excessive use of sweets. They destroy the appetite for natural foods.

6. Children should be restrained from incessant eating between meals.

7. The diet of the child should be generous. 8. The diet of the adult should be plentiful. (Bulletin of Detroit Dept. of Health, Nov., 1920, C. H. Chelson).

Deaths

Doctor Enos C. Kinsman was born in Ontario in 1864 and died in Saginaw December 5, 1920. He received his medical education and medical degree from the Chicago Homeopathic Medical School in 1895. He was appointed a member of the Michigan State Board of Registration in Medicine in 1914 and was reappointed in 1915 for the term ending October 1919. He was a member of the Saginaw Board of Health and local surgeon to the Pere Marquette Railroad and the Michigan Central Railroad.

Doctor W. H. Baldwin, Coldwater, Michigan, died November 29th of diphtheria with which he had been ill for a very short time. Doctor Baldwin was 54 years of age and was a graduate of the Detroit College of Medicine and Surgery of the class of 1893. The Doctor had practiced in Coldwater for about twelve years.

The deaths of Doctor G. C. Brock of Smiths Creek and Doctor Frank G. Legg, of Coldwater, not members of the Society, are reported.

State News Notes

Dr. T. A. Felch, who recently retired from the active practice of his profession, was highly honored at Evergreen Inn, Thursday evening, by his fellow members of the Marquette-Alger County Medical Society.

Following a turkey feast, Dr. G. G. Barnett, of this city, who was associated in business with Dr. Felch for a long period of years, took charge of the gathering as toastmaster and called upon many of the members of the society for short talks. The speakers were Dr. H. W. Sheldon, of Negaunce; Dr. L. W. Howe, Dr. Harkin and Dr. H. J. Hornbogen, of Marquette; Dr. V. H. Vandeventer, Dr. H. S. Smith and Dr. Barnett, and Dr. Felch, of Ishpeming. Dr. Smith, on behalf of the members of the organization, presented the honored guest with a handsome pair of platinum cuff links.

Several of the members of the society have been engaged in the practice of medicine in Marquette county for a long time, Dr. Felch having located here in 1875, while Dr. Sheldon and Dr. Barnett were here in the early days. Dr. Felch came to Ishpeming from Ann Arbor, where he spent his boyhood days and where he received his education. He was a member of the staff of the first hospital founded here, and later was a part owner with Dr. V. H. Vandeventer in the Ishpeming hospital. For over forty years he practiced his profession, and he is justly entitled to a rest. Although he has retired, we sincerely trust that he will continue to make Ishpeming his home.

On December 7th the Michigan Hospital Association joined the American Hospital Association following an address by Dr. Andrew R. Warner, executive secretary of the national association. The association recommended legislation providing for higher standard of qualification for trained nurses, the establishment of another class of nurses to be called attendants to assist trained nurses, the annual registration of both classes and changes in the length of appointments of members of the State Board of Health.

Through the efforts of the members of the Michigan Department of Health, the Lansing Section of the Society of American Bacteriologists was organized late in October. This Section number 50 charter members. The majority of these are either associated with the Michigan Agricultural College or with the various state departments. The local physicians are eligible to membership if they so desire.

At a special meeting of the Michigan State Board of Registration in Medicine, held in Detroit on December 15th, the licenses of Doctors E. B. Gibson and George E. Brown of Detroit were revoked. Both of these physicians were convicted in the Recorders' Court, Detroit, for violating Act 272 of the Public Acts of the State