he has not reached his zenith of usefulness, and when to all appearances he has reached it, any body of men should be very slow to turn him down since, wherever you put him he is not of the sort that "strikes twelve and runs down!"

Give the ripe doctor a chance for his full proportion in every State, not because he needs it (though he probably does) but because the State needs him!

The physician who is his own authority is in the best position to succeed since the doctor's patients who have proper confidence in him want to know what he thinks ahead of any one else and soon lose some of that confidence when they find him quoting medical celebrities to them or reading to them from text-books Let us be so equipped that while avoiding the shores of pedanticism and the shoals of egotism, we may stand as our own authority to our own clientele. This means a responsibility that is great, but we must not shirk or shift it.

A CLEAN SHAVE.

A quarter of a century ago, says E. S. McKee, every doctor who could and a few who could not tried to raise a beard. Now nearly every doctor shaves. This is partially due to the aseptic craze which has swept the country and partially to the advent of the safety razor. Some old poet has said that is for their sins that men have shaving, too, entailed upon their chins.. In the past decade or two we have noticed very material improvement in the barber shops. Some associations of barbers have gone so far as to engage surgeons, members of that profession which left the barbers in bygone years, to teach them how to properly administer an aseptic shave, and how to use the general antiseptic precautions. The medico-legal side of the question has probably stimulated these associations of barbers to seek this instruction for several actions for damages have been brought to reimburse those who have contracted contagious diseases from al

legedly careless shaving. To prove this connection might be difficult but the possibility of carrying numerous skin diseases is self evident. A "clean shave" should not only make the person shaved look clean but should also leave no disease behind. The hands of the barber and all his tools and appliances should, together with the face of the customer, be free from the germs which cause the disease. To destroy the germs either heat or antiseptics may be employed if of sufficient strength and duration. Towels should be used but once then sterilized. Particular stress should be laid on the fact that after a slight abrasion customers might infect themselves by rubbing the cut with dirty hands or handkerchiefs.

ANCIENT TREATISE ON ETIQUETTE.

Lewis D. Burdick treats of this topic in the Dietetic and Hygienic Gazette. The book or manuscript which is the subject of his comment dates in the last quarter of the fortieth century before the beginning of the Christian Era and belongs to the Third Egyptian Dynasty. The writer, Kaquemna, was a high public official under Sneferu, the Pharaoh of his period, who is known as the first of the monumental kings.

This treatise, or rather the part of it preserved, forms the first two pages of the celebrated Papyrus called the Prisse, after its discoverer, who gave it to the Bibliothèque Nationale, in Paris, in 1847. Although there are many inscriptions on stone more ancient, the Prisse is the earliest Papyrus yet discovered, and this belongs to a period more than a millennium later than the time of Kaquemna, the author of the first part of it. So that this fragment is not only the earliest known writing on the subjects upon which it treats, but it is also the oldest part of the oldest book in the world.

The opening paragraph is apparently an expression of the book itself of confidence in its own reception and value to

those for whom it is written. It declares that a righteous song opens the enclosures of its silences, while the approaches to its repose are surrounded by words armed with knives against intruders, with no admittance except to those who come rightfully, alluding, as interpreted by the distinguished French scholar Virey, to the gateways of the field of Aalu in the under world, which are described in the 145th chapter of the Book of the Dead as guarded by gods armed with knives to prevent only those who are pure from passing.

The author sounds no trumpet call to reform by revolutionary and offensive methods. Epitomized, he counsels repression of one's desires that lead to excess, and conformity to social customs on public occasions. As one French scholar makes it: If thou art seated with an eater who eats so much as to be obliged to remove his girdle, or if thou drinkest with a drinker who hast receive1 thee, and who would satisfy his taste as a crocodile does with meats, accept what he offers thee, refuse it not, however repugnant it may be to see a man get into a condition when he is no longer master of his speech. Maspero has suggested that this passage may refer to the Oriental custom of dividing a morsel with a guest to do him an honor, an offering which one is not at liberty to decline however unpalatable it may prove.

Moderation, toleration, self-control and charity, with neither self-righteousness nor disloyalty to one's ideals are the thoughts suggested. Affect to despise the dishes which thou lovest, says he; it is but a short time to restrain thyself, and voracity is a degrading thing and bestiality is in it. Let a little take the place of much; a glass of water quenches thirst; a mouthful of vegetables (melon according to Brugsch) strengthens the heart. He is a miserable man who is dragged along by the persuasion of his stomach. The stomach leads such people, and he who is driven by his stomach is

ignoble, yet shrink not from meat in the presence of a glutton; take what he gives thee and refuse it not; the refusal wouid be disappointing, yet eating with a glutton and trying to keep up with him might lead thee afar.

As to a man without good breeding to whom all that one can say is without effect, who makes a surly recognition to the advances of a gracious heart, he is an affliction to his mother and his friends.

Do not be too modest and keep your mouth silent, but speak and let your name be known, without having pride because of thy power.

When one has acquired the experiences of life let him make it known to his children. They will honor themselves by heeding his counsels.

OLIVE OIL AND TURPENTINE IN
TYPHOID.

Arnold, in the British Medical Journal, makes the statement that none of the various methods of treatment have hitherto been successful in definitely controlling the course or limiting the duration of typhoid fever. A measure employed at the Civil Hospital, St. Helena, during the past four or six years, has resulted in a distinct shortening of the average duration of illness, and in a remarkable amelioration of all the symptoms. This particular measure consists in the administration by the bowels of turpentine and olive oil from the first day of treatment, and its regular use at stated intervals until the temperature has been normal for at least after ten days. When the case first comes under observation an enema of turpentine j and olive oil Oj is given by a funnel and tube. The foot of the bed being well raised, the emulsion is allowed to find its way slowly up the bowel. On the next day, or the day after, the same quantities are repeated. A preliminary thorough cleansing of the bowel by a dose, or preferably small divided doses, of calomel followed by castor oil, prepares the ground.

A

DECENTERING OF LENSES. LENSE is said to be decentered when its optical centre (i. e., the centre of its curvature) does not coincide with the visual axis of the eye; and as the visual axis of the eye in a state of rest is supposed to pass through the geometric centre of the lens (i. e., the point which is equidistant, vertically and laterally, from the circumference), a lens is regarded as being decentered when its geometric and optical centres are not identical. When the optical center is to the inner side of the geometric center, it is said to be "decentered in"; when the reverse, it is decentered out."

Prismatic Effect.

It can readily be understood that the effect of a spherical lens which has been decentered is that of a prism, because at any point in a spherical lens other than its optical centre the planes of the two surfaces of the lens are not parallel, but are inclined toward each other at an angle whose degree depends upon the degree of curvature.

When, therefore, the visual axis passes through the lens at any point other than the optical centre, the effect is the same as looking through a prism. Whether the prism so produced has its base in or out, up or down, depends upon whether the sphere is convex or concave, and upon the direction in which it is decentered. Since a convex lens is thickest at its optical centre, the base of the prism produced by decentering a convex sphere always looks toward the optical centre of the lens; hence, when a convex sphere is decentered in, the prismatic effect is that of "base in"; when it is decentered out, it is that of "base out". A concave lens being thinnest at its optical centre, the prismatic effect of decentering always has its base looking away from the opti

cal centre; hence, when a concave lens is decentered in, it gives a prismatic effect of base out, and vice versa.

Prescribing Decentration.

Inasmuch as a decentered sphere has the effect of a spherical lens of the strength indicated, plus a prism of the character and angular strength corresponding to the degree of decentration, and as it is often desired to combine a prism with a sphere, lenses are not infrequently prescribed to be decentered so as to give the required prismatic effect.

The stronger the lens, of course, the smaller the degree of decentration necessary to produce the same prismatic effect. The degree of prismatic effect produced by decentering a lens of 1 D. to the extent of 1 mm. is called the prism-dioptre or centrad. Hence, in determining the amount of decentration necessary to produce a given number of centrads with a lens of a given strength, we simply divide the number of centrads required by the dioptrism of the lens, and the quotient is the number of centimeteres of decentration necessary. For instance, if it is desired to produce 2 centrads with a lens of 4 D., dividing 4 into 2 gives .5; the necessary decentration is .5 cm., or 5 mm.

If the refractionist prefers to estimate the degree of prismatic effect in terms of the prismatic angle, then he has only to remember that a lens of 1 D. must be decentered 9.4 mm. in order to produce a prismatic angle of 1 degree. Thus, in determining the amount of decentration necessary, he multiplies 9.4 by the prismatic angle he wishes to produce, and divides by the dioptrism of the lens. For example, with a lens od 4 D. he wishes to produce a 2 degree prismatic angie; 9.4 multiplied by 2 is 18.8, which di

vided by 4 gives 4.7. The result in this case is in millimeters. The lens would need decentering 4.7 mm.

In prescribing this decentration of lenses, the refractionist may either indicate the prismatic angle or centrad he desires, or the number of millimeters he wishes the lens decentered.

TILTING THE LENSES.

It is plain that an ideal condition of perpendicularity is impossible, in the adjustment of glasses, for the lens can only be placed so as to be perpendicular to the visual axis when the eye is in one particular position, and any deviation of the eye from that position will disturb the relation. For example, if the glasses are adjusted so that the visual axes of the eyes at rest, i. e., parallel, cut the plane of the lenses at right angles, then the moment the eyes are converged the visual axes will cut the plane obliquely, and vice

versa.

The best that can be done, therefore, is to adjust the glasses so that the vidual axes cut the plane perpendicularly when the eyes are in that position which most nearly corresponds with the use for which the glasses are intended.

If the glasses are to be used for distant vision, then the visual axes are regarded as parallel, and the lenses are adjusted in one plane, a vertical plane, at right angles to the axes. When the glasses are prescribed for near work, such as sewing, reading, etc., the inclination of the visual axes is calculated from the degree of convergence proper to the distance at which work is to be done, and the lenses adjusted in two opposite planes, inclined to each other, each at right angles to its visual axis. In cases where the glasses are intended for constant wear, the general rule is to adjust the lenses at right angles to visual axes at an inclination midway between the parallel and the convergence proper to the patient's working distance.

DUST IN THE EYE.

A very common source of trouble to the eyeball, especially in large cities in these days of heavy traffic, is found in the clouds of dust that circulate in the air and lodge upon the conjunctiva. Those who wear glasses are more fortu. nate in this respect than their fellows whose vision does not require them to do so, for the lenses serve to keep out a great amount of dust.

The effect of this continued invasion of dust, in greater quantities than the tear-ducts and winkers can dispose of, is frequently to set up a mild chronic conjunctivitis. In some cases it induces a still more chronic process of productive inflammation, by which a web of tissue grows over the sclera, forming what is known as a pterygium. When this encroaches upon the cornea it gives rise to astigmatism, and has to be removed.

The only effective safeguard against the invasion of dust consists, of course, in the wearing of goggles. It is hardly to be expected, however, that the ordinary man will submit to any such unesthetic adornment, and most people will prefer to take their chances with ordinary precautions. Those who are out in the dust a great deal will find it beneficial to wash their eyes each evening, when they get home, with a copious instillation of boric acid solution, or other mild astringent.

FINDING THE NEAR POINT. A method of ascertaining the near point described by Thorington consists in seating the patient so that the light in the room will come over his shouder and fall upon the card of test type held in front of him. The operator, to one side of the patient, holds the card in one hand, and a meter stick in the other, the eye which is not being tested being covered with a card blinder, and the ptient is told to select the smallest type on the card which he can read or spell;

and as he continues to do so, (aloud) the operator gradually approaches the card. to the eye until the patient says the letters commence to grow hazy and he can scarcely decipher them.

Another way is to hold the card close to the patient's eye and gradually withdraw it until he can just recognize the letters; when this point is reached, the distance from the eye to the card is measured by the meter stick, and this distance, together with the size of the type which was read, is carefully recorded. For example, the patient selecting the type marked .50 and able to read it as close as 8 cm. and no closer, the record will be "near point equals type .50 D. at 8 cm." or, abbreviated, would be, "type

.50D. 8 cm."

In some instances the patient may not be able to read any of the near type without the aid of a glass, and if so, it will be necessary to place a plus sphere in front of the eye to assist in finding the near point. For example, if a +2 S. were employed, then the record might be, "near point equals type .50 D. at 12 cm. with 2S." or "+2 S.-type .50 D. at 12 cm."

A HELP TO EYESIGHT.

Most people begin to notice failing eyesight at the age of fifty or a little sooner. Many people find their eyes "stuck up" in the morning and it is some time before they can see clearly.

Something can be done every day to benefit the eyes without taking up too much time, or interfering with other duties. Take a few drops of sweet oil, or any simple emolient, on the hands, and thoroughly massage the entire face, giving special attention to the region about the eyes. Do not rub the eyeballs, but carefully rub the tissues above and below the eyes with the end of the fin

gers, drawing the fingers away from the nose outward. Continue this some minutes, then exercise the muscles that control the eyeballs, by looking upward as far as possible, then downward, then sideways, in both directions. Do this at least once a day, and as much oftener as may be agreeable.

HYDRARSAN is the name given by J. C. M'Walter (British Med. Jour., June 17, 1911) to a compound of phenacetin, 10 grains, mercuric chloride, % grain, arsenic chloride, o grain, and potassium iodide, 5 grains. In syphilis, a few doses effect an apparent cure, but the remedy must be persevered with to prevent a rclapse. Hydrarsan is given in solution,

combined with tincture of cinchona.

LITHIO-LAXINE is an effervescing preparation containing lithium citrate, 5 grains, and sodium phosphate, 30 grains, in each teaspoonful. It is recommended as a liver stimulant.

PHAGOTAXINE is described as a saturated aqueous solution of oxygen, which is readily transformed into ozone under the influence of ultra-violet rays. It is used as an antiseptic application in boils, burns, etc.

PHENALETTES are effervescing "headache powders" containing a phenacetin compound.

SULPHOFORM is a trade-name for triphenylstibine sulphide.

VIN URANE (Pesqui) is a wine containing uranium nitrate, recommended for diabetes.

ZEOZONE is prepared from a derivative of æsculin, a substance which has the property of intercepting the ultra-violet rays of sunlight. It is used by Unna in the form of paste or ointment for the prevention of sunburn, etc. A stronger preparation, Ultra-Zeozon is used for chapped skin, frost-bite, etc.