Editor MEDICAL WORLD:-I would like to ask the older members of the profession, say of twenty years and more of activ professional life, the following question: In how many cases, after an abortion, miscarriage or normal labor, have you, when there was a nasty discharge from the womb, performed the activ operation of curetting with the instrument? Do you Do you think it necessary in many cases? and when? I ask it because our very modern men who sniff the air far above the rest pretend, when they follow in our footsteps in such a case, "utter neglect" by those who do not at once put the woman under chloroform and curette.

Editor MEDICAL WORLD:-I have a married couple who are very anxious to have children. They have been married over two years. Both are healthy and never have had any sexual diseases. The sexual organs of both are normal, and the sexual act is entirely complete and simultaneous. Menstruation is regular and

normal. The cervix was dilated with

tents, as it seemed small and I thought prehaps it prevented the ingress of the spermatozoa. At the same time tampons of wool were used after coitus, as the semen had a tendency to flow out of the vagina. This treatment did no good. Will your readers suggest treatment?

ILLINOIS.

Transmission of Rabies.

Editor MEDICAL WORLD:-On February 13, V. W. got a scratch on the wrist from a favorit dog. On February 16 the dog began snapping at other dogs, and saliva dribbled from his mouth. On February 17 the dog left home, and was killed after having had a convulsion. If the dog had rabies (which I conclude he had when killed), do you think his saliva would be infectious four days before death, or three days before the development of the first symptom? If so, what is the best preventiv treatment? What does the profession in general think of the mad stone? I would like to hear from the Editor and others. JESSE EWELL, M.D.

Ruckersville, Va.

[We are inclined to think that a dog could not transmit rabies until actually suffering from the disease. The exact time at which the disease develops is hard

to determin. It is unfortunate that the dog was killed; it is much better to save the dog alive in some safe inclosure, for purposes of observation. The probabilities are that your patient has not been infected; but there is no certain way of being absolutely sure. There is no no preventiv treatment except the Pasteur treatment. This has not always proven satisfactory. The profession have branded the "mad stone" as one of the kings of "fakes."ED.]

Is it Tumor of Cerebellum?

Editor MEDICAL WORLD:-Mrs. B., age 52, mother of nine children, has been a very healthy woman until eight or nine months ago, when she began to be troubled with tinnitus aurium, which gradually grew more severe. About eight weeks ago the occipital and the frontal part of her head began to ache. Some days it was When she took to her bed, very severe. four weeks ago, I was called. I found tenderness over the cervical region and mastoid proscesses; staggering gait, a tendency to fall forward when walking, and as tho she wisht to step high. Some below the knee, with some little tendernausea; tingling sensation in the leg

ness from knee to around the ankle. She states that there is a little numbness of

tips of fingers when she sits up or rises to her feet. She is troubled with vertigo. It was troubling her before her head began to ache. Kidney secretion normal. Troubled with constipation. Temperature ranges from 98° to 99°. Pulse 84 to 96. The tongue deviates to the right. J. W. HUDDLESON, M.D.

Murphysville, Ky.

Current Medical Thought. [Crowded out this month.]

Our Monthly Talk.

The Philadelphia North American, an enterprising and out-spoken Republican paper, editorially says as follows:

SOLDIERS MAKE MARKETS.

The Treasury Department, thru the Bureau of Statistics, deplores the great falling off in exports from the United States to China since the beginning of hostilities. It puts the loss at 50 per cent. in the last seven months. In practically all of the articles other than those required by the troops in the field there has been a markt decrease, the reduction being greatest in those articles which enter into the daily requirements of the life of the native people.

Evidently what is needed to stimulate trade with China is to send a larger force of American troops across the Pacific. Then the volume of exports from this country will rise rap

idly. Consider how commerce with the Philippines has grown. Only a few weeks ago the Bureau of Statistics gave out a statement showing how our imports into the Philippines, since 70,000 troops had been stationed in the islands, had increased nearly tenfold. True, they had risen last year to only $1,650,000, of which about one-fifth was represented by whisky and beer for the officers and men, and as much more by fodder for animals used in connection with the army, but the per cent. increase was most flattering. Of course, if the troops had remained at home the whisky and beer would not have been consumed in the Philippines, and our trade with the islands would not have grown so fast in other lines, so that the world would have known nothing about the extent of our business.

The conclusion to be drawn from the Treasury Department's reports on Oriental trade is obviously this: If the Chinese and Malays will not purchase as much from us as we want to sell them, we must send armies abroad to compel them to buy. If they still refuse to help build upour foreign trade, our soldiers and the camp followers will be of the greatest assistance in making a favorable report. The Bureau of Statistics has proved what an excellent plan it is to export American soldiers to the Philippines to buy American exports.

Would you call this an "eye opener?" If so, shall we open our eyes and look? And what shall we see? We shall see that the doctrin, "trade follows the flag," is a delusion and a snare. It is not right to get trade by the sword, and such attempts usually fail, as they should. When such attempts succeed, the cost is greater than the gain. It does not pay, and it should not pay.

On the contrary, our trade has entered many parts of the world where we would not even think of sending our bayonets, and there our "arts of peace" are winning notable victories. From a military point of view, we are at peace with Great Britain; yet we have gone in her own territory in Africa and built bridges, winning over British contractors on account of superior skill, more prompt completion of contract, and lower prices. This is but one illustration of our invasion of British territory, heretofore considered secure to the English iron-masters. As a consequence, our iron and steel interests are flourishing; but the cruel part of it is that the working men in the iron districts of England are suffering. The point I wish to show is this: These trade victories have not been won by bayonets, nor have they "followed the flag." They have been won by the arts of peace. Do you see it?

Our Tax Burden.

Probable appropriations of the Fifty-sixth Congress, $1,500,000,000; per capita, $20. Money in circulation in the United States January 1, 1901, $2,173,251,879: per capita, $28.19.

This simple statement gives a better idea of the wholesale raiding of the Treasury by the present Congress than a page of figures. It is not exaggerated; Indeed, the amount of the appropriations is more likely underestimated.

Not since the Civil War has the per capita of expenditures been so high, and not since the year 1868, when the effects of the great sectional struggle had not yet been felt at the Treasury, has it been half so high. This is remarkable, but it is also true. More startling still is the fact that only in three of the four years that that great war lasted did the per capita of expenditures exceed the present amount and then, with the exception of 1864, by only a few dollars.

The following table shows the per capita of expenditures each year from 1837 to 1901, the figures for the last named year being conservativly estimated:

Our

1879.

166,947,884.00

5.46

5.34

This is only a small part of the story. Our agricultural and other machinery is very extensivly used in Germany, Russia and all over Europe-all over the world, in fact. locomotivs, sewing machines, typewriters, etc., are known in every country and every clime. No " 'following the flag" in this. These trade "expansions" have been going on for a very long time, and are continually increasing, but if we beat our tools of the peaceful arts into bayonets and swords, we may expect our extensiv and "expanding" trade relations to rapidly contract.

It is strange that many people don't see anything but the "band-wagon effect." With them the band-wagon is the whole circus; a military dress parade is the whole national existence ! Let us get over our "band-wagon days" and our "drum-major days," and in the consciousness of full-fledged faculties, let us look at facts as they are, and also consider right and justice, as we would wish right and justice for ourselves.

1900.

1901-1902 (Est.)...... 1,500,000,000.00

The appropriations for the fiscal year inade by the present Congress at its first session was $710,150,862. The regular annual estimates of appropriations (Continued on next page.)

The Medical World

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

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

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"THE MEDICAL WORLD,"

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 English spelling of a century 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 2) 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, recommend 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);

program (programme); catalog (catalogue);

prolog (prologue);

decalog (decalogue);

demagog (demagogue); pedagog (pedagogue).

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

The Use of Books.

Most physicians buy books without exercising good judgment; and use, or fail to use them with no better acumen. The books are too often bought on the strength of some solicitor's vivid description, or after a cursory examination of a few illustrations. They are then placed on the shelf" for reference." When the emergency occurs, the books are hastily consulted, and are generally found valueless.

The lack of satisfaction is due but seldom to deficiency in the book. The doctor has only himself to blame. He made no judicious selection of the work suited to his needs, and after getting the work, never became familiar with it. Authors are not wholly without fault. They issue a book suited only to the specialist and permit it to be commended to both special. ist and general practitioner. Or, they make the fatal error of trying to issue a work suited to both. Specialists are presumed to be erudite, and their books should give all the technicalities and details. The general practitioner wants his book well boiled down; he is satisfied to take the judgment of a man who has seen a thousand cases of a particular comHe plaint, where he has had but one.

only wants to know what the experience of the other man has taught regarding the nature of the disease, and the best the best methods of relief and cure. It is seldom possible for the most versatil writer to combine in one volume the matter suited to all classes of practitioners. Medical literature is now so prolific that books may be selected to suit the needs of each practitioner, if he but exercise the proper care in their selection. We believe that the day of massiv systems of medicin and surgery will soon pass away. Even now many of the publishers are issuing works of large dimensions, in separate volumes so constituted that any may be bought singly, and each will be complete in itself. The general practitioner needs to exercise more discretion than his favored brother-the specialist. The specialist is presumed to have all the books touching his specialty; the general practitioner can not hope to have. He should read the reviews publisht by all medical journals and see in what estimation the various books are held by different editors; he may thus form a fair conception as to the manner of book he is buying, even before he has seen it. When the book is purchast, the owner should keep it on his desk until he has become familiar with its contents, and he should carefully mark portions that promise to be of value in an emergency. The book will then become really a part of his equipment. He can then put it up in his book case feeling that he has a friend and helper ever ready for service in time of need.

Many small and inexpensiv books are now being publisht upon the various specialties, and no practitioner has any excuse for poor book equipment. We take especial pride in our reviewing column. We want our readers to read it as well as other parts of the magazine. The labor of studying all these books is cheerfully undertaken for the benefit of WORLD readers, and we do not want to see any reader lose the fruits of this labor of love.

The Passing of the Coroner. The office of Coroner as conducted in the United States today, is a relic of medieval times. We might still consistently call them "Crowners," as they did then. Just what exact facts regarding the manner of death may be ascertained by a man who knows nothing of anatomy or pathology must remain a query. The coroner is seldom a doctor, and in very many inquests the doctor is not in attendWith the jury as ignorant as the "judge," it is little wonder that such lugubriously humorous verdicts are often returned.

anee.

In case a postmortem is ordered, the verdict of the operating physician is always taken without question. If he is then to be in fact both judge and jury, why should he not reap the benefit of his skill and knowledge, instead of having the fees go to a coroner and a jury? As a matter of actual fact, the doctor does the work, judges the case, and renders the decision. He gets about $10.00 for his postmortem work, time, expenses and witness fees; the jurymen get about $1.50; the coroner gets a nice big fee; and the county gets no information for their expense, except what the doctor has furnisht.

The office of coroner, in populous counties, pays enuf to justify it being sought by capable physicians, if they would rise to the need. With a physician coroner, and a physician witness, even if the present ludicrous jury system maintain, the chances of getting at the base of truth and justice would be much greater. A better plan would be to have a coroner appointed from a list of capable physicians, at a salary that would justify; let him summon witnesses, if there be any. If in doubt on pathology, let him summon other physicians at fair remuneration.

On account of the inefficiency and antiquated nature of the present system, a bill has been introduced into the New York Legislature providing for a new

It

system. The scope of the bill is logical, and it is stated that, if adopted, it will save the State $100,000.00 yearly. recognizes that, in an inquest, two things are to be determined. First, if a crime has been committed; this is naturally a function of the police. Second, the manner of death; this is exclusivly the function of a trained physician.

The office of coroner has long been a nice political job; and the inefficiency of the service has not troubled the politicians. The time has come for a revolt; and if the physicians do not lead the assault, the denouement may be long delayed. We want to prod every WORLD reader to activ work for the profession, for themselves, and for humanity. Each reader has a certain definit influence with legislators, and if this were exercised regularly and persistently, we could keep all the legislatures interested and uneasy. The indifference of the medical profession to their best interests has long been a joke among politicians, because they realize that if we would exercise our power we could drift most public questions our way.

Culpable Neglect of Venereal Affections by the General Practitioner.

There are probably no items of general practise upon which the average practitioner of ten years standing is as deficient as in the modern scientific treatment of venereal affections. Why this should be is explained by two statements. Ten years ago, facilities for clinical instruction were very inferior; and because the subject was practically ignored clinically, the doctor became callous or indifferent, and never workt the subject up properly after leaving college. The second reason is that many practitioners treat these cases carelessly because they do not seek that kind of practise: they personally dislike it, and they dread the reputation of being a "pox-doctor."

either our commiseration or skill; at least, until we may assert confidently that any disease is not the result of sin or indiscretion on the part of the victim or some other. That the affections are filthy, gives no better dismissal; many of our duties are as unattractiv. The patient may have sinned; and he may be an innocent victim of the sins of others; but the doctor's idea of duty should scorch his conscience into activity when he dares neglect these unfortunates. You are neither judge nor executioner; you are the priest of things physical, to whom the unfortunate turns in his extremity, and you are bound by every true professional feeling to do all you can to relieve him; and moreover, you should be qualified to do this properly. We make Lo specialty of venereal troubles, but every chancretouches our heart," tho we touch it as little as possible with our fingers. We are toucht when we think of innocent posterity, and we suffer in soul when we realize the possibilities awaiting innocent and trusting maidens, and the horror is complete when the bride of the victim consults us six months later.

If you are not satisfied to do your full duty in medicin by assuaging pain, and by giving hygienic counsel and moral suggestions in cases suggesting them, you would better hunt other shelter than the shield of Esculapius. Because the sufferer may have been a traitor to morals or to sanctity, is no reason why you should prove either a coward or a traitor in the ranks of your honorable profession. We are much ashamed of the manner in which many venereal cases are treated.

Not one general practitioner in a dozen can give a diagnosis between chancre and chancroid. Seven out of ten cauterize every venereal sore. A few do not use mercury or potassium iodid even when syphilis is well markt. The condition is most deplorable.

We assuredly need to make better use of the proper methods of combatting these affections. We need to counsel the unfortunate victim, not only as regards coitus, but also as regards morality, and we need to practise as well as preach.

Get a modern work on venereal troubles; study it well, and practise modern methods. Cauterize less, and sooth more; yet be relentless in the rare cases actually demanding it. Cure your patient first, and if you must preach, do it afterwards.