a cross-roads, farmers living a number of miles away, as well as the villagers, use this "phone" to call the doctor.

A mile from "A" is another small village and railroad station. Here we have "phone B," in the railroad station, which of course has the Western Union. This "phone" is the luxury part of the line. In connection with the Western Union I am able to know election returns, ball games, court decisions, etc. I can call a consultant from the city, order medicins, etc. When I am on my rounds, a call coming to the house is telephoned here, saving many miles of travel, in addition to prompt service to patients.

From "B" the line runs to a farm house a mile beyond. Here, also, calls are received. By this means I get patients who would go in other directions, for it

would be a drive of five or more miles to come to the office, while the "phone brings me nearer than the doctors in the adjoining villages.

In addition to the many social and financial advantages, the honor (?) of being President, Secretary, Treasurer and Board of Directors of a Telephone Company holding a franchise from the Empire State is not to be past lightly.

As to the cost, a line can be put up for a nominal sum. The 'phones can be bought for $4.50 up, the wire for about $6 per mile, while the brackets and insulators 5 to 6 cents per pole. The poles should be bought, delivered, for about 50 cents apiece. Thirty-two poles to the mile is about right thru the country. Holes should be dug for 10 cents a hole. A man of ordinary ability can string the wire, make connections, etc. Putting up Putting up a line is an excellent way to work off your dead-beats, and poor paying patients. "No work-no doctor" was my motto. In my case, poles, carting, and setting up were all on bills. In fact, the only financial outlay was for 'phones, wire, brackets and insulators.

Many doctors in this section have private lines, connecting themselves with cities or towns, so I am not claiming any originality. If this little squib has put an idea into a fellow practitioner's ear, it has fulfilled its mission.

H. J. SHELLY, M.D.

Ridgebury, N. Y.

Children are especially susceptible to the narcotic action of opium and its alkaloids.

" in

How to Meet Quacks. Editor MEDICAL WORLD:-"I. H.," September WORLD, page 371, wants to know "How a physician can practise medicin honestly in competition with such dishonest and disreputable scoundrels," some of whose methods he describes; and asks: "Must we do as 'Rome does'"? If the Doctor has talent, ability and scholarship he would better not do as quacks do. He is not built that way. He is built the other way. 66 He cannot practise medicin honestly in competition with such dishonest and disreputable scoundrels" by becoming one himself. ing one himself. By imitating the methods of the charlatan he would be merely the counterfeit of a quack; and in that role would sink in effectivness below the original. Other things being equal, the quack has the advantage of experience and natural adaptability. He may be an impostor from choice or necessity or both; but he has certain instincts and faculties, either natural or acquired, that the "honest" doctor has not; and these he has cultivated at the expense of other and more useful talents. As a humbug he is strong; and it is not worth while to try to beat him at his own game; but in other respects he is a weakling or he would not be a quack. And often no one knows this better than the impostor himself; and this knowledge frequently causes him to overact his part. In a contest of this kind the educated physician is handicapt by all kinds of ethical, moral and other scruples. His honest pride and self respect, if nothing else, would preclude the probability of success. Scholarship and ability inhibit loud-mouthed pretensions, which are the charlatan's stock in trade. To compete with him the Doctor would have to acquire new habits of thought and new associations of ideas. No man can persistently violate the higher impulses and instincts of his nature without paying at once a heavy penalty. The Doctor would, himself, soon have a damaged ability to distinguish truth from falsehood. Keeley, the whiskey cure quack, fell a victim to that silly delusion, Christian science. The quack by becoming a psychological pervert pays a fearful price for a little transient financial success; and his success in most cases is more apparent than real. He flaunts his pretended earnings as he does his pretended cures; and both A are magnified by the same process. reputation built up by such methods is

more unstable than a house founded upon shifting sands, or "Cesars Column" loaded with explosivs. If the ignorant pretender succeeds in building up a repu tation as a "fever doctor," that reputation will attract to him all the malignant cases, and his death list will soon be longer than that of all the other doctors combined; and if he escapes the nick name "Sudden Death" he will be lucky. As he pretends to perform miracles, miracles will be required of him; and altho he may have average success, his patients will be di-satisfied. Thus the law of compensation gets in its work. But if by energy, flattery, shrewdness or skilful dodging he succeeds in avoiding all these and other sources of disaster, he is sure to go down before the next quack whose pretensions are louder or more unique. The charlatin is "of few days and full of trouble." Like Jona's gourd, he flourishes but for a night. The people may like to be humbugged, but woe to the humbug if thru ig. norance he allows them to see how it is done, and the quack always does that sooner or later. They are often compelled to flee for their lives, or end up in prison. Dows, Iowa. J. A. MULNIX, M.D.

Koch's New Theory of Bovine Contagion

Editor MEDICAL WORLD: - No doubt your grand army of readers are more or less interested in the recent announcement of Scientist Koch, and no doubt the major ity of the medical profession denounce his new theory without proving it. I for one am desirous of having positiv proof. We are living in the beginning of a new century, and it behooves us to follow St. Paul's injunction to "prove all things and prove all things and hold fast to the good." We all know (at least, those who have kept abreast of the progress in the medical profession) that some physicians and a few boards of health in their anxiety to add to their stock of reliable information by reaching a concensus of opinion, have in the past sent circular questions to the medical profession as touching the great proposition of tuberculosis; and altho the replies to queries were ample, the result was disappointing, because in undetermined conditions the consensus of opinion does not settle anything scientifically. The decision of many who give an opinion is influenced by the confidence they happen to have in the · judgment of some other professional per

son rather than by actual knowledge they possess thru personal investigation.

In the perplexing tuberculosis proposition there seems to be unanimity enufsuch as it is-in the medical profession, but this unanimity, like the decoy duck, may be misleading. may be misleading. We need more independence and originality of thought and activ investigation to prove premises, not only in the medical profession, but in the masses of thinking men, if we hope to cut the tap roots of tuberculosis, or any oth r undetermined proposition, to destroy it or any scourge.

During the last decade Tuberculosis Congresses have been convened, papers written by our most able authors on the various methods of treatment read and discussed, old "chestnuts" crackt, and old "straw" thrasht over. There has been an almost unanimous acquiescence to such proceedings by the multitudes of witnesses, but really how much nearer are we to the eradication of this greatest of all destroyers of human life?

Now we have Koch's new theory relating to cattle contagion thrown at us, which is an undetermined proposition. Why not get at it in an intelligent manner and prove it? Why not do it at once, and find out whether Koch's theory can be substantiated or not? There ought to be fearless persons found in every commonwealth to volunteer their aid to make such provings substantial, and every state where there is a state board of health should be interested enuf in prevention of disease to take up and prove beyond a doubt every such question. In my judgment there is not as much danger of contracting tuberculosis by proving Koch's new theory as there is in submitting to bovine vaccination to prevent smallpox. Therefore I have offered to be one of twenty provers to help make the test in this my adopted state, or any part of the country.

I will not be satisfied with having sporadic tests made by individuals." One swallow does not make a summer." Hahnemann, the discoverer of homeopathy, was not satisfied with proving a drug on himself, nor with one other proving of the same drug; but the drug must, to satisfy him, be proven on several persons. And he did not launch his theories on the people until by untiring work in proving some thirty drugs covering a period of eight or ten years to find

out that his theory was correct and scientific. Then when he did make his work of science known, the consensus of medical opinion was so rooted in ignorance that he was persecuted until he was obliged to go out of his native country to find disinterested people who were willing for him to prove to the world he was right. Then it took a half century before the consensus of medical opinion would reluctantly let go the old barbarous method of blood letting. With the experiences of Hahnemann and his best followers as provers of drugs, why need we halt between two or more opinions before proving whether Prof. Koch is right or not. With his theory proven beyond a doubt-whether correct or not we can wipe out tuberculosis, or reduce its ravages to lowest terms within the next ten years. In my judgment, we should cast out fear and get at this proving business at once. I know what it is to be told by five eminent physicians that I was a hopeless case of tuberculosis, and then by dint of circumstances to make a radical change of climate and within three months to be fully restored to health. I also know from experience of ten years, and by saving some four hundred patients -victims of consumption (tuberculosis)-by climate cure, that more than 90 per cent. of such victims can be restored to health, and in from three to six months. All of this experimenting along this line was incited by the "fad" Koch launcht out in his "lymph" treatment in 1900, when so much space was devoted in the public press every where to give him prominence. His was then a new theory that did not stand the test he promist it would, and the medical profession, and "lungers," were doomed to disappointment. In my judgment, if his new theory is ever thoroly proven, it will disappoint the consensus of opinion of the medical profession fully as much as did his first one, for, so far as I am aware, no person has yet contracted tuberculosis from contact with bovines. Do not be afraid, my professional brothers, to offer your aid in proving Koch's new theory. I will guarantee that if any of you contract tuberculosis by becoming a prover (of course the proving will be made scientifically), I will give you information whereby you may in sixty days after taking on the disease regain your normal condition. Surely there ought to be found one score of provers amongst the army of THE MEDICAL WORLD readers

who will join with me to test Koch's new theory. All such men should report at once to either me, or the Editor of THE MEDICAL WORLD, and we ought to have the "nasty" job all over with before the new year is ushered in. Who will be the first volunteer?

Cordially and fraternally yours in the interest of science and the annihilation of thegreat white plague."

Residence,

W. P. ROBERTS, M.D.,

Prof. Climatology in Denham Janesville, Wis. Medical College, Chicago, Ill. [The Doctor does not make it clear just what would be expected of a prover. The proposition is, to prove that bovine tuberculosis cannot produce tuberculosis in a human being (see September WORLD, pages. 400 to 403).

The "provers" would be expected to ingest tuberculous beef and milk under strict test conditions, and perhaps. consent to the hypodermic injection of bovine tuberculous material. As the Doctor is positiv as to his "climate cure " for tuberculosis, he will be askt to contribute an article in next WORLD on that subject.—ED]

Editor MEDICAL WORLD:-I wonder how many of the WORLD family have had any experience in treating exophthalmic goiter. I have recently lost a patient with this disease as the primary cause of death. The patient, a lady 37 years old, married, mother of one child, a daughter 18 years old, had always had good health up to about six months before death. She took to her bed by my orders about three weeks before death. During these weeks she developt many strange complications. For about a week she was awfully restless, thrashing around on the bed almost constantly; then followed an uncontrolable itching over the whole surface of her body. With coarse cloths and stiff flesh brushes the attendants would rub her, and she would scratch herself with her nails. there was not the slightest appearance of any eruption. These symptoms ceast, then followed vomiting, persistent and uncontrolable, delirium, coma, exhaustion and death.

Yet

I shall not detail the treatment pursued. Two consultations were held on the case during the last three weeks of her life, and I believe that the best known measures of treatment were resorted to. The patient was surrounded with the best of hygienic

said he had been feeling bad for a month; had no pain, but did not relish what he ate. Felt tired in the morning when he would rise from his bed; had a little fever every day. He eventually took his bed and sent for me. On my arrival, after getting his clinical history, I diagnosed the case typhoid fever in its incipiency. This being an isolated case, and knowing there was not another case in five miles of him, and no chance of infection, I askt myself the question, could not the etiology of typhoid fever be due to autotoxemia? or in other words, due to a morbid condition of the alimentary tract, a putrefaction of its contents generating a gas, which is absorbed and carried into the circulation perverting the functions of every organ of the body? Now if this is the cause of this fever, and the system is not relieved of this gas, delirium, subsultus tendinum, and tympanites, with all other typhoid symptoms will be the result. What will I do? There are but three ways to get that gaseous poison out; thru the bowels, skin and kidneys. I decided to go to work, and here is what I did. First, I ordered a gallon of warm water, put 120 drops of carbolic acid in it, injected all I could in his bowels; when that past off I repeated in 10 minutes, and continued the repetition until everything was washt out to the ileocecal valve, and the water came away clear. I then gave him 8 grains of calomel every 4 hours until he took 4 doses, or until I got a greenish operation from the bowels. I repeated my washing to the ileocecal valve every 24 hours; gave him apocynum as a diuretic, with all the cold water he would drink; gave him a granule of aconitin, veratrin and digitalin every hour until sweating began, then left orders not to let his temperature get below 99-to give whisky with ginger. He sweated 12 hours. He was up in 4 days from the time he took his bed.

I have treated six other cases since in the same way with the same results. I want to add that after the alimentary canal was clear, I used sulphocarb. of zinc as an intestinal antiseptic. My experience is, you must do something and do it quickly. Don't give a little medicin and expect it to do all. The expectant plan won't work where there is trouble ahead. Do not put too much confidence in your nurses, especially in flushing the colon. They will tell you they have done it as you said, but nine times out of ten they

Typhoid Immediately Following Delivery.

Editor MEDICAL WORLD:-I want to report a case that is very interesting to me, and I hope it will be of some interest to the readers of THE WORLD; but should you consider it unworthy of space in your journal, I shall not be offended.

On May 8th I delivered Mrs. C. of a healthy boy baby, it being her third confinement. Nothing unusual occurred during labor. The placenta and secundines were expelled in a normal way. made her as comfortable as possible, and left mother and child doing well one hour later. When making the usual post delivery visit I found nothing to excite my suspicion, and left her on the third day after labor with all appearance of normality in nature's work.

On the evening of the 13th (5th day) I was called to see her, the messenger stating that she had past a restless night, was having some fever with headache, backache, etc. On arrival I found her with a temperature of 102°, nausea, complained of being chilly. plained of being chilly. The lochia was normal; no odor could be detected; no soreness over uterin area; this after repeated examinations. The tongue was coated with thick white fur, and margin very dry and red.

14th, morning temperature 102.2°, evening 103.3°. She again complained of being chilly; lochia rather less in amount; was given a douche, but with negativ results as to odor.

15th, morning temperature 102.5°, evening 103.7°. She was nervous, diarrhea was present, skin dry and hot, urin high colored. Still no soreness over uterin area. No appetite. Again complained of being chilly, and past a restless night.

16th, morning temperature 102.8°, evening 104°. Her general condition was worse. There was some tenderness in right iliac fossa Direct pressure over the uterus failed to elicit any indication of pain or soreness.

May 17th, morning temperature 103.o, evening 103.8°. The tongue was dry, crackt and coated with a thick brown coat. There was an accumulation of sordes on the teeth. An examination of the lochia