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MERCK'S
MANUAL,

Page 50.

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5,000 DOCTORS RECEIVE

The WISCONSIN MEDICAL RECORDER each month. If you are not one of them, better send along one dollar and we will send it to you for one year, and also send you, postpaid, as premium

1,000 LABELS FREE

These prescription labels are 2x21⁄2 in. in size, of the best quality, well gummed, with your name, address, etc., elegantly printed. ::

The RECORDER is a monthly medical magazine of original matter of interest to all physicians. :: ::

DR. J. P. THORNE,

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CHTHYOL Beware of

ALWAYS SPECIFY:
MERCK'S

Valuable Formulary to Physicians.

imitations

and products purporting to be
"as good as Ichthyol."

MERCK & CO., New York

instruments, that hurt both him and his patients, or good instruments that will do the work intended of them. The Chloride of Silver Dry Cell Battery Co. are well and favorably known by the profession thruout the entire United States. See their adv. on page 18.

Willis & Co. are this month making a remarkable pocket instrument case offer. In a conversation with Mr. Willis a few days ago, he told us that he has not had one case returned on this offer. "Indeed," he said, "a physician would be foolish to return it, at the price we are selling it for." See adv. on page 11.

"Much, if not all, depends upon the correct application of Antiphlogistine in each individual case. In pneumonia thoroly cover the entire thoracic walls. In bronchial affections it is often not necessary to cover more than the chest. In pleurisy cover the affected side. In inflammation of the bowels cover the abdomen from the pubes to sternum. In inflammation of the joints the synovial membrane demands immediate attention, encase the inflamed joint in Antiphlogistine to induce osmosis of serous exudate. Wherever Antiphlogistine is used, apply it warm and thick (except on burns), and cover completely with absorbent cotton and a suitable compress.' Quoted from a very interesting Antiphogistine circular. Send for their literature. See adv. on page 3.

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For Acute and Chronic
Rheumatism, Gout,
Lumbago, Neuralgia

And Kindred Complaints, prescribe the "old reliable "*
preparation,

Griffith's Compound Mixture of

Guaiac, Stillingia, etc.

which contains Guaiac, Stillingia, Prickly Ash, Turkey Corn, Black Cohosh, Salicylates of the Alkalies and Alkaloids, Iodide Potassa, and other well-known remedies, acting as a powerful alterative, so combined as to be acceptable to all patients. It has been before the profession fifteen years, and has proved perfectly satisfactory in 95 per cent. of the cases indicated."

FOR FURTHER PROOF, we will, upon request, send you by Express a regular $1.25 size bottle as a sample for trial, providing you will enclose 30c. for the Prepayment of Express Charges.

GRIFFITH & CO.

Prescription Pharmacists

67 Third Ave., Cor. 11th St., New York
WM. H. GRIFFITH, Ph.G., Successor
Carried in stock by the Principal Wholesale Druggists in
the U.S.

Advertising of this preparation is confined strictly to
Medical Journals.

H. S. Kennedy's Extract of Pinus Canadensis.

(Dark and White)

THE ONLY NON-IRRITATING MUCOUS ASTRINGENT,

It has proven to be of priceless value to the Physician
in the treatment of

Gonorrhea, Gleet, Vaginitis, Catarrh, Ulcers etc.
A specific for night sweats

Rio Chemical Co. New York.

Circulation: October, 35,497.

THE MEDICAL WORLD

The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like

dust about the brain, or dries like raindrops off the stones.-FROude.

The Medical World

C. F. TAYLOR, M.D., Editor and Publisher

A. L. RUSSELL, M.D., Assistant Editor

SUBSCRIPTION RATES: To any part of the United States, Canada, and Mexico, ONE DOLLAR per year, or FOUR YEARS for THREE DOLLARS; to England and the British Colonies, FIVE SHILLINGS SIX PENCE per year; to other foreign countries in the Postal Union, the equivalent of 5s. 6d. Postage free. Single copies, TEN CENTS. These rates are due in advance.

HOW TO REMIT: For their own protection we advise that our patrons remit in a safe way, such as by postal money order, express order, check, draft, or registered mail. Currency sent by ordinary mail usually reaches its destination safely, but money so sent must be at the risk of the sender,

We cannot always supply back numbers. Should a number fail to reach a subscriber, we will supply another, if notified before the end of the month.

Notify us promptly of any change of address, mentioning both old and new addresses.

If you want your subscription stopt at expiration of the time paid for, kindly notify us, as in the absence of such notice we will understand that it is the subscriber's pleasure that the subscription be continued, and we will act accordingly. Pay no money to agents unless publisher's receipt is given.

ADDRESS ALL COMMUNICATIONS TO

"THE MEDICAL WORLD"

1520 Chestnut Street

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Philadelphia, Pa. No. 11.

Language is a growth rather than a creation. The growth of our vocabulary is seen in the vast increase in the size of our dictionaries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are becoming simpler and more uniform. For example, compare Eng lish spelling of a centnry or two centuries ago with that of to-day! It is our duty to encourage and advance the movement toward simple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philological Association, and list of amended spellings, publisht in the Century Dictionary (following the letter z) and also in the Standard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some of the most flagrant instances, as ugh from though, etc., change ed to t in most places where so pronounced (where it does not affect the preceding sound), etc.

The National Educational Association, consisting of ten thousand teachers, recommends the following:

"At a meeting of the Board of Directors of the National Educational Association held in Washington, D. C., July 7, 1898, the action of the Department of Superintendence was approved, and the list of words with simplified spelling adopted for use in all publications of the National Educational Association as follows:

tho (though);

altho (although);

thoro (thorough):

thorofare (thoroughfare);

thru (through);

thruout (throughout);

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"You are invited to extend notice of this action and to join in

securing the general adoption of the suggested amendments → IRVING SHEPARD, Secretary."

We feel it a duty to recognize the above tendency, and to adopt it in a reasonable degree. We are also disposed to add enuf (enough) to the above list, and to conservativly adopt the following rule recommended by the American Philological Association: Drop final "e" in such words as "definite," "infinite," "favorite," etc., when the preceding vowel is short. Thus, spell opposit,' preterit," "hypocrit," " requisit," etc. When the preceding vowel is long, as in "polite," "finite,' "unite," etc., retain present forms unchanged.

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We simply wish to do our duty in aiding to simplify and rationalize our universal instrument-language.

Some Suggestions as to Life Insurance Examinations.

Many WORLD readers make numerous life insurance examinations. We want every member of the family to be a good examiner, and hence make the following suggestions along lines where we have noticed the most frequent errors, for the companies soon learn to estimate the efficiency of the examiner. If one company learns that you do your work carelessly, or that you are incompetent, you are likely to be passed by when another company seeks an examiner in your locality:

1. Use your finger as a pleximeter; you can not lose or forget it-you always have it with you.

2. Get in the habit of carrying one of the small spring tape lines in your pocket as habitually as you carry your watch; you will need it often for other purposes if you know you have it with you.

3. When going to the country to make an examination, always take a clean, four-ounce bottle and new cork with you; such things are often lacking on the applicant's premises.

4. In the case of males, see that they void the urin directly into the container. In the case of females, see that the commode is clean and free from dust, and that none but the applicant is in the room; then retire, but remain within sight of the door until she emerges and places the warm vial in your hand. This part of the examination is embarrassing to a lady, and is best left till the last, even the signature having been procured beforehand.

5. In percussing, a thin shirt is permissible, and is desirable for the sake of modesty on the part of the applicant, and convenience and protection from offensiv odors or perspiration on

the part of the examiner. In percussing anterior portion of chest have applicant hang arms loosely at the side; in axilla, let the hands be claspt lightly above the head; for posterior part of chest, let arms be folded lightly in front: many applicants exert sufficient muscular action to foil any accurate estimation of percussion sounds.

6. Always examin McBurney's point thoroly; but always examin the opposit side as well, before drawing conclusions.

7. Remember that there is cyclical, and functional albuminuria as well as true albuminuria. Remove mucus before testing. Never render a decision from the results of a single examination. Do not forget that a number of tests formerly considered reliable are now known to be fallacious. It is best to make use of two or more different tests in doubtful cases. 8. In testing for glucose, Haines' solution will be found much superior to Fehlings' solution. It is more accurate, and keeps indefinitly. It is made as follows: Pure copper sulfate thirty grains; distilled water, one ounce; make a perfect solution and add pure glycerin half an ounce; mix thoroly and add liquor potassa, five ounces.

In making the test, gently boil a dram of the reagent in a test tube and add the urin, drop by drop-boiling gently after each drop, until six or eight drops have been added. If no yellow, orange, or red precipitate appear after a moment's boiling, you may be sure that no sugar is present.

9. Do not search for an absolutely healthy

man or woman; that is not what the insurance company expects. They merely want the applicant to give physical evidence of the probability of his living 20 years.

10. "Keeleyites" are almost always rejected, tho some companies will take them after five years without relapse. The steady moderate drinker is much less dangerous than the drinker who goes on periodic sprees.

11. Never reject a man on a single application if he is willing to pay for the examination; then the company can pay for the second when the paper goes in. If he will not agree to pay for it when you have told him you can not pass him, then forward the papers; but if he pays, destroy them, and name a date for another examination, and give any needed advice gratuitously as to manner of living, eating, drinking, etc.

12. The insurance companies claim that inasmuch as "they pay you," you have no duty to the applicant. What cat's paws we allow ourselves to become! Who furnishes the money with which the insurance company pays us but the applicant himself? You should be an impartial judge, giving no favor to either

party, but giving the applicant the benefit of any doubt, since it is he who really fees you.

13. Talk as little as possible before, during, and after the examination; but never become irritable; always remain professionally cool and courteous without sacrificing positivness or dignity.

14. Get your blanks into the home office by first mail.

15. Urge a $5.00 fee, with mileage, and extra compensation for microscopical or repeated examinations, and take it up with the home office direct.

16. Absolutely decline to make an examination for less than $3.co in the office, and mileage added for country work. If we all do this we will soon be getting $5.00 for every exami nation, or the companies will have a very low grade of examiners. The doctor who makes life insurance examinations for twenty-five cents to a dollar can hardly be considered an ornament to the profession, whatever he may think of himself.

17. Be honest with applicant, company, and yourself.

Turpentine as a Hemostatic.

There is considerable confusion in nomen

clature regarding this drug, which, combined with carelessness in filling prescriptions, tends to allow it to fall into disuse. We have few, if any, agents so serviceable when employed according to indications. When the word "turpentine" is used in medical phraseology, it should only apply to the oil of turpentine, rectified,U. S. P. If care be taken to write the full name and title, mistakes should be avoided. It is to the U. S. P. preparation we refer in speaking of turpentine.

Turpentine finds its field in passiv hemorrhages from any part of the body, and is contra-indicated in activ hemorrhages. Taken internally it produces a sense of warmth in the stomach, increast pulse rate and increast heart force, a warm skin, and slightly accelerated breathing. breathing. It is eliminated by the kidneys and lungs, and gives the odor of violets to the urin. It may be given in doses of five drops upward, in capsule, or dropt on sugar.

In the passiv hemorrhages from stomach, intestins, lungs, kidneys, and mucous membranes, turpentine should always be remembered. The indications for its use are generally accompanied by debility, relaxation of the blood vessels with a low tension pulse, an impoverisht condition of the blood, and general constitutional depression. Thus epistaxis, or nose bleed; hemorrhages from the bronchial tubes; vomiting of blood from any source; intestinal hemorrhages from any cause, particularly that form noted in typhoid fever;

hemorrhages from the bladder, and from the uterus, call for turpentine in repeated doses. It is generally efficient.

Typhoid Bacilli in the Sputum and Urin. In the Boston Medical and Surgical Journal for February 5, 1903, Richardson summarizes our present knowledge regarding the presence of typhoid bacilli in the urin and sputum as follows:

1. Typhoid bacilli are present in the urin of about twenty-one percent of individuals afflicted with typhoid fever.

2. The bacilli, when present, are generally in pure culture, and their number is frequently enormousmany millions in each cubic centimeter of urin.

3. The invasion of the urin by the bacilli takes place in the later stages of the disease. Unless measures are taken to remove the organisms they persist frequently for weeks, occasionally for months, and rarely for years, and thus constitute (a) a danger to the patient himself (cystitis, and possibly orchitis and epididymitis), and (b) what is more important, a grave source of danger to the public health.

4. The necessity for the rigid disinfection and supervision of typhoid urin is apparent.

5. In urotropin we have a drug which will, in the vast majority of cases, remove the typhoid organisms from the urin, not only in the cases of simple bacilluria, but also in those in which a cystitis has resulted. Very rarely an obstinate cystitis may require the use of vesical irrigations. Very infrequently a case will be seen in which the use of urotropin is followed by hematuria. In such cases the drug should be omitted and irrigation of the bladder substituted.

6. This subject in its relation to the public health is of the utmost importance. In my opinion, it should be a fixt rule, and one rigorously enforced, that no typhoid convalescent be discharged as well until his urin has been proven permanently free from bacilli. In large hospitals, with their well equipt laboratories, such supervision can be carried out with ease.

Cases

in private practise should be in the care of the local boards of health. In this way only can we prevent a considerable percentage of our typhoid convalescents from becoming unsuspected foci for the further distribution of the disease.

He has been able to isolate the bacilli from

the sputum of a case of typhoid fever complicated with pneumonia, and other investigators have shown that it can be present in the sputum, especially if there is a co-existing bronchitis or pneumonia. The subject needs further study, but enuf is known to show that the sputum is another excretion which must be carefully disinfected. The comparativ ease of disinfecting sputum by carbolic acid, formaldehyd, or lime should bring such practise into universal use. All up to date practicians already disinfect the stools, and it would be little trouble to include the urin in the same treatment. We hope to learn that this is being carried out by our readers. Disinfection after being voided would be much better than no disinfection at all, and with the light we now have on it, it is culpable negligence not to take this precaution.

Try tar, in pills, during the epidemic of coughs sure to follow early winter winds.

Eye, Ear, Nose, and Throat Work by the General Practician.

With the multiplication of specialties and specialists, the thinking general practician wonders how much farther his field is to be circumscribed. Ten years ago the specialties were few; now they make quite a formidable list, and the list is growing. Very little thought is enuf to convince one that it is high time that he prepare to defend his practise against the numerous encroachments in the future, better than he has done in the past, and this fact is borne home more poignantly when every little town of 5,000 is now beginning to boast of a specialist in one or more lines. The manner of "specialist" which he may be has little to do with the question. He may be poorly equipt with instruments and yet more deficient in knowledge, but if he but label himself a specialist in diseases of the eye, ear, throat, and nose, the general practician will see his practise dwindle along these lines. And you can not blame the laity. Here is a man claiming to have special skill in these specialties, and their family physician has never made such a claim; or at least he has no such instruments, because he has never shown them or suggested doing any little operation, in their remembrance; but he has always sent them off to the city specialist whenever there was anything the matter with their eyes, ears, nose, or throat. Now you may have a pretty fair equipment of such instruments, and you may have had better training along these lines than your specialist competitor; yet this is just how the laity think and reason unless you make a bold and decisiv stand.

Get a

Get a

There is just one way to defend yourself. Get a fair supply of the essential instruments, and familiarize yourself with their use. good modern text book on these subjects and study it well. Learn to use the head mirror, the tongue depressor, the ear and naval specula, the laryngoscopic mirrors, etc., by practising on some member of your family, until you have attained grace and skill in their use. good comprest air outfit, with nebulizers, and study up the therapeutics of the nose and throat till you can compound the necessary ingredients in the medicaments employed, intelligently. Then, when the next patient presents himself complaining of anything upon which you can make an excuse to examin his ear, nose, or throat, do so; if you do not find anything wrong in these parts, you are getting experience in technic; if you do find anything wrong, tell him so, and proceed with suggestions as to the course of treatment you purpose instituting, just as if you had done such things all your life. You can familiarize yourself

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