Fibrosis and spasm were the two changes found in the arterial wall. The former was impossible of removal; the latter more or less completely amenable to treatment. The proper objects of treatment, therefore, were not to attempt the impossible task of removing fibrous tissue, but to overcome vascular spasm, conserve the failing myocardium in the later stages, and so far as possible to overcome autointoxication by rational measures. The best means for accomplishing these results must depend upon the individual case, especially the character of the dominant arterial change, whether fibrous or spastic, the stage in which the case came under observation, the degree of involvement of the heart, associated autointoxications, habits of life, etc.

If the blood pressure was high, degenerative changes advanced and the general aspects of the case threatening, rest in bed was the most important initial measure of treatment. The diet should be as near the minimum requirements of the body as possible. This was less important with regard to the starches and fats than the proteids. The storage capacity for the former was very elastic, and a, slight excess could do no harm providing primary digestion was normal. With the proteids, however, the question was quite different, as the kidneys were involved and should be saved all necessary work, and for the further reason that the very toxins were nitrogen containing bodies, the formation of which was favored by an excess of proteids. Vasodilators, iodides, and in advanced cases with failing hearts, digitalis, and in certain cases, a special bath devised by the author at 100 deg. F., the duration of which was gradually increased for one hour, were the general measures of treatment advocated. A special measure of treatment advocated in a group of cases in which the habit of cardiac hyperactivity was in excess of circulatory requirements and tended to keep up high blood pressure, was the use of aconite in increasingly hourly doses to the limit of tolerance or accomplishment of therapeutic results. With a strict hospital regime, the prognosis of even

the very serious type of cases was not nearly as bad as we had been led to believe.

In concluding Dr. McCaskey reported a case in which serious attacks of angina pectoris, due to coronary disease, in a patient sixty years of age, were completely relieved, and in which the patient had remained relatively well for ten years.

CHEMICOGENESIS.

The veracious daily papers, which never, no, never! vary from the literal truth, announce that the University of Pennsylvania savants, working in the Rockefeller Institute, have developed a method for fecundation without the connivance of the male. True, the process has been applied only to guinea-pigs, as yet; but the step between the guinea-pig and man is infinitely less than that now taken to produce the cunning little quadruped. The details so far are lacking; however, we are assured that the female has been impregnated by the injection of a solution of certain salines and "an acid similar to malic acid," and viable young cavies thereby been born, and these have been reared.

Experience with newspaper-science induces us to suspend judgment until the returns come in, when we may be able to separate the kernel of truth from the chaff added by a reporter's needs for sensational copy. But if the story is true, it is up to maculinity to inquire where we are at!

Every passing week seems to develop. new testimony of our erstwhile helpmeet's ability and willingness to get along without us, and if this last function of our sex proves superfluous, we may look forward to seeing the Amazonian commonwealth rescued from the realm of fable to confront us as a startlingly actuality. startlingly actuality. The loneliness

of life, its purposelessness, its uselessness, when this shall come to pass, may be but dimly imagined now while we the representatives of the proud sterner sex, still enjoy the blessings vouchsafed to us by Eve's fair daughters.

No longer, forsooth, in that dread

era to come, need we care for person, or for toilet, for aught esthetic, for there will be none to gaze approvingly on the manly form or its correct habiliments. Why, indeed, make efforts to secure prominence in power and wealth when no longer there are those through whom the results of our efforts may be displayed? No longer may thought of a home-coming sustain us in our labors, no longer solace us in defeat.

In that era of woman's emancipation, the enjoyment of female society can be secured only in the pristine primitive way, by lying in wait and capturing the particular specimen we desire for companion. Woman will be all sufficient to herself. Her life

will be self-ordered.

She will be selftaught, self-sustained. And, awful thought! when the time comes and she craves maternity, she will hie her to the apothecaries and accomplish the object by the aid of a few chemical reagents, with never a thought conjugal.

No doubt the development of this biochemic art will furnish means of varying the product at will, so that sex, stature, muscular male development and female pulchritude, complexion, color of eyes, curliness of the hair, mental and moral bent, and all the many other traits may be determined by the chemicaled-mother's will. The babe will be dispensed per prescription, or according to specifications furnished by the architect-for necessarily there must then be that new and all-important brand of specialist, the baby-designer-pueroartifex.

Would such a state of things be de sirable? If not, it is time a stop were put to this thing right here. Since it is the Rockefeller Institute that is responsible, the most effective remedy would be to confiscate the Rockefeller fortune and turn it into the National Treasury a measure for which other reasons might be found, and which would command the enthusiastic approval of a large proportion of the community.-Ed. Am. Jour. Clinical Medicine.

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Another Martyr to Science.

The most recent instance where a member of the National Public Health Service lost his life in a hand-to-hand struggle with infectious disease, is that of Dr. Thomas Brown McClintic, the leading authority in Rocky Mountain spotted fever. For many years lent in the Rocky Mountain States, this peculiar disease had been prevaand every spring it had claimed an inAccording to creasing toll of lives.

Dr. Alfred C. Reed, of the Public especially virulent in the Bitter Root Health Service, spotted fever has been Valley, along the eastern slopes of the Bitter Root Mountains. It is caused by the wood-tick. These ticks attach by the wood-tick. themselves to live stock as well as to rodents, such as gophers, squirrels and rabbits. If infected, they transmit the disease to human beings through their bite. Tick fever is a

common

fatal disease and has many points in with typhoid and typhus fevers. Dr. McClintic was put in charge of the work in the Bitter Root Valley and succeeded in almost wholly eradicating the tick in that section. This tremendous task was accom

plished by dipping domestic animals

and stock in an arsenic mixture, and by killing wild mammals. He also did valuable work in search of a curative of preventive serum.

In March, 1912, he was married and soon thereafter returned to his station at Victor, Montana, to be in readiness for the tick season. In midsummer he was taken sick with the disease which claimed his life.

Thus the last victim of the pestilence was the man who had conquered it and driven it from the section where it prevailed. No other case of spotted fever has developed in that section this year. The Human Factor.

Col. William C. Gorgas of the Medical Corps of the United States Army and chief sanitary officer of the Panama Canal Zone, has been awarded the Buchanan medal by the Royal Society of England in recognition of his remarkable administration of the health affairs of the Canal.

Correspondence

A WEEK IN THE CHICAGO CLINICS.

To the busy practitioner of surgery nothing can be looked forward to with greater pleasure than a visit to the clinics of Chicago.

There are a great many reasons for this among the principal ones being the fact that the latch-string always hangs on the outside at all the clinics, and you are always cordially received and treated when you pay any one of them a visit; then too the hospitals are practically all centrally located making it easy to reach them from all the hotels and without consuming a large amount of time. Besides these facts a greater one is that almost without exception the surgeons of Chicago holding clinics are not only brilliant operators, but teachers as well, having the ability to give to the visitors a careful and exact idea of the work they are doing while they are operating and without any delay; this of course is what adds both pleasure and profit to the visit.

mere

Space forbids more than a mention of the different clinics. It is always a pleasure of course to visit the clinics of Dr. A. J. Ochsner and Dr. N. M. Percy at Augustana Hospital where one may witness a great variety of work.

Dr. J. B. Murphy whose reconstructive work on the joints has added very much to the reputation already National, if not world-wide, never fails to interest one no matter how freDr. quently they attend his clinic. Bevan of the Presbyterian Hospital, is a master teacher and his clinics are thoroughly enjoyable. The work of Dr. S. C. Plummer at St. Luke's Hospital, is always pleasing and instructive, and so one might go on almost "ad infinitum," but we do not desire to "weary with over-much talking."

Suffice it to say that no man who does surgery can afford not to pay a visit to these wonderful sources of instruction at least once each year. Yours fraternally,

El Reno, Okla.

FRED. H. CLARK.

THE DOCTOR AND THE NURSE.

It is so generally the custom among medical men, to leave the entire management of the sick-room to the nurse, that it seems to be almost forgotten that this is, in a remarkable degree, a professional duty. Treatment does not consist in merely prescribing drugs, but attention should be given to the proper administration of the same. Then the surroundings of the patient are hardly less important than the medicinal means employed. We will go so far, even, to say that in the most successful physiological methods of therapy, drugs are only aids to arrest disease, and recovery of health, which Nature will accomplish, if only the case be so conditioned as to remove all obstacles, and facilitate processes hereby she is working. The scientific physician regards the placing of the patient in circumstances favorable to convalescence, as the first and most urgent step to be taken; and it is, therefore, impossible for him to look upon the management of the sickroom as of trivial, or subordinate importance. The particular conditions. will be determined by the needs of the patient. We believe one and all systeins of management must be open to objection, that does not deal directly with the lesser needs of the individual; and these lesser needs are in practice, most important. The management of the sick-room should have the most solicitous care, if a successful issue in any given case is to be assured. To relegate this art entirely to a nurse, however skillful she may be, is to surrender to others a power which may be either wasted, or applied obstructively, and simply because being disassociated from the exhibition of drugs, the management of the sick is felt to be what it really is, namely, an integral and elementary part of treatment.

To manage a sick-room wisely and efficiently, the physician should be so thoroughly versed in all the details of nursing as to be able himself, to do, if necessary, all that he expects from others. Nursing should not be such a specialty, separate, and in a large measure independent of treatment. Too much stress is laid on nursing

being nine parts out of ten in curing the sick. An intelligent practical nurse, many times, is superior to a professional, for the very reason that such a nurse is not stuck on herself; and generally is more agreeable to the sick. If a doctor is alert, and keeps track of his case, he can soon get the intelligent and faithful co-operation of an amateur.

The doctor who does not himself direct the nursing cannot be held to have control, of even half the appliances of cure, and for anything he can tell, the manner in which his patients are treated during the intervals between his visits, may be such as to be antagonistic to this method and policy. We are not thinking of the bad nursing, but of the best that can be had. The physician should be the guiding hand in everything that concerns the sick, and to this end his authority should be paramount. The most successful practitioner is one who controls and directs the minutest de

tails of every case, which his judgment and responsibility demands. Many professional nurses are very deficient in tact, discernment and correct knowledge of symptoms. Unless a nurse knows what to do in an emergency, in the absence of the physician, she is simply no more than a drug giver, without reference to whether a remedy should be withheld when untoward effects are discovered, or new symptoms arise, which may call for urgent measures entirely different

from conditions when the last visit of the doctor. Unless a professional can be depended on in emergencies, such a nurse is no better than a practical, untrained nurse.

Too many nurses are afflicted with an undue sense of their own importance, and indispensability. They get They get cranial hypertrophy. Are conceited enough to imagine that they know more than the average doctor. As à matter of fact, the advantages of a professional nurse in most cases. is purely imaginary. D. L. FIELD.

Jeffersonville, Ind.

For quick reduction of blood pressure give the nitrites-nitroglycerin or sodium nitrites.

Medical Miscellany

Medical Reserve Corps.

The New York division of the Medical Reserve Corps of the U. S. Army was formed at a meeting at the Army and Navy Club on November 7. The following officers were nominated: President, Henry Clark Coe; vice-president, Thomas Darlington; secretary, Harold Hays; treasurer, H. Sheridan Baketel; councillors, Arnold Knapp, Howard Lilienthal, Clarence A. McWilliams, Eugene H. Pool and J. B. Rae.

Missouri Historical Society.

The forty-seventh General Assembly of Missouri will be asked to make an appropriation for the erection of a fireproof building for the State Historical Society of Missouri and the University of Missouri Library. As regards the State Historical Society there are two great reasons why this request should be granted: 1st, to properly house and protect the invaluable collection of over 125,000 books and pamphlets of historical material that has already been accumulated; 2d, to permit the Historical Society to grow in the future by providing adequate facilities, especially in the way of room. The society is regularly receiving over 70,000 books and pamphlets every year. The simple question of space, i.e., where to place this annual addition, has become of paramount importance. On the other hand, no one who has ever visited the fourteen rooms of the society that are scattered all over Academic Hall of the University of Missouri can fail to rematerial alize the pressing need of placing this in a fire-proof building. Every public spirited citizen and lover of Missouri and her glorious past should endorse and urge this request to the next General Assembly.

Prof. Paul Segond of Paris, aged 61, is dead from uremia. He has been professor of surgery at the University of Paris since 1883 and long surgeon in chief at the Salpetriere.