Under these circum

or the body generally is much debilitated. stances one should desist as soon as the opportunity presents itself. A voice that has at one time been pure in tone, but soon becomes quivering and shaky, and has, at the same time, its former quality veiled, is suffering from some serious impediment which is most likely caused by inflammation of the pharyngonasal cavity. Weariness. If a singer or speaker, during the use of his voice, perspires freely, this also indicates that his system is over taxed in the exercise of his debilitated vocal muscles, or that he is guided by an improper method in the use of his voice.

Encores.-Answers to an encore should not be given by rendering the same selection a second time, as this exhausts the larynx much more than giving a selection of an entirely different kind. The voice should not be used too long in a continuous strain; a change of tone is a rest to the laryngeal muscles. [TO BE CONTINUED.]

Sugar in the Urine.-Dr. N. R. Elliot has devised a new test (Scientific American Supplement, October 10, 1896) which he claims is most accurate. It is as follows:

When

Dissolve the cupric sulphate in glycerin, and heat. cold, add the liquor potassæ. The second solution is a saturated solution of chemically pure tartaric acid. These solutions are stable and will keep indefinitely. Pour a drachm of the cupricacid solution into a test tube, and boil gently over a spirit lamp; add two or three drops of the tartaric-acid solution and boil again. Now add the urine slowly, drop by drop, until eight drops are added. If no reaction takes place there is no sugar, but if there is a reaction, yielding a yellowish, or reddish, or greenish-gray deposit of suboxide, and which is marked and unmistakable, sugar is present. The reaction deepens in a few minutes.

Editorial Department.

FRANK L. JAMES, PH. D., M.D.,

AND

A. H. OHMANN-DUMESNIL, A. M., M.D.,

FRANK M. RUMBOLD, M.D., Business Editor.

and Proprietors.

Terms, $1.00 per annum, in advance. Foreign Countries within the Postal Union, $1.25.

All communications should be addressed to Box 626, St. Louis.

Editorial.

MISSOURI STATE BOARD OF HEALTH.

A great cry has come up in the ranks of the regular medical profession of the Commonwealth of Missouri. The cause of this commotion has been a decision of the Supreme Court which embodies the startling legal fact that a body created by a legislature is not greater nor has it more extensive powers than the body which created it. In other words, it is merely a repetition of the old axiom that the part can never be as great as the whole. No complaint can certainly be made in regard to a decision like this. And when all the judges of such an eminent body as a State Supreme Court are unanimous in a judicial verdict there certainly can be no room for making criticisms. There is no doubt whatever that the State Board of Health was never granted any law-making powers; and the fact still remains that a body such as the State Board is created to exercise gen

eral supervisory powers, and see that the existing laws are enforced. This is the true function of such a board, and it certainly has enough to occupy its attention if this function be attended to properly.

However, if a remedy for the apparent deficiency be sought for, it is ready at hand. Now that the legislature is in session, a bill should be introduced which would cover deficiencies, and be satisfactory to the profession in general. But, to accomplish this, early and prompt action should be taken, and every physician should make it a point to see the legislator from his district and obtain his promise to vote for such a bill in case it is introduced. This is certainly the only remedy for the threatened evil, which will permit the State to become a general cess-pool for all the medical flotsam and jetsam which is floating about.

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Another complaint which has been made by the profession of Missouri, and which aroused its just ire, was recently caused by the action of the Secretary. This gentleman sent circulars to physicians indiscriminately, and in the circular there was placed a warning to the recipient to immediately register and pay a dollar in order to avoid prosecution and fine. A peculiar inconsistence in connection with this circular is the fact that it was dated October, 1896. It is estimated that 350 or more were sent to St. Louis physicians, and we have not heard of any who had not properly registered and obtained a State certificate entitling him to practice. If the Secretary is incompetent to properly conduct the affairs of his office, and if he cannot obtain intelligent clerks, he should see to it that some one is paid to do this work. Men who practiced years before the Medical Practice Act was enacted, and who promptly registered with the State Board, have received what they consider a piece of impertinence, and they have resented it in no unmeasured terms. We cannot conceive of an office run in such a slipshod manner as not to keep a complete and perfect register of names of those he has registered. We have heard all sorts of direful threats from physicians who received these notices, and who saw staring them in the face the framed license to practice issued by the State Board of Health. It is unnecessary to comment upon this matter, but it is suggestive of one thing-in framing a,new law, provision should be made to pay an adequate salary to the Secretary, and then a de

mand can be made to make him attend to his duties in a proper and adequate manner.

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One of the results of the decision of the Supreme Court has been to put out of joint the noses of those medical colleges which complied with the requirements laid down by the Board. Those colleges which acted in good faith in complying with these requirements have suffered so far as the number of matriculants in the Freshman class is concerned. They have really gained in the better quality of material which was obtained. But all their best efforts and intentions are, to a great extent, nullified, as their graduates will find it a task of the greatest difficulty to obtain license to practice in those States in which stringent laws exist in regard to this matter. Those colleges which gave little or no heed to the Board's requirements are practically on the same footing as those who did, so that the long-looked-for elevation of the standard of medical education is threatened with an early and speedy dissolution, unless vigorous action is taken by the entire medical profession, and the most strenuous efforts made to have laws passed such as will be adequate, and so constructed as to stand the most rigid tests so far as their constitutionality is concerned. We cannot afford to retrograde. The good work which has been done must be pushed to a successful conclusion, and Missouri must be placed in the foremost rank of progressive States which are proud of their medical men.

Action of the Health Board Against Rear Tenements. -The referee appointed in an action brought by the board of health to compel the destruction of two rear tenements has filed a report sustaining the board in every particular. The testimony clearly proved that the tenements were unfit for human habitation, and that they were not reasonably capable of being made fit for human habitation. It also showed that the death rate was 45.87, against an average of 24 for the city. The defendants pleaded the unconstitutionality of the act, but the referee assumed the contrary, and the case was tried upon its merits. Should the act be sustained by the court when the referee's report comes up for approval, the board of health will proceed immediately against about fifty more rear tenements.

Medical Progress.

THERAPEUTICS.

On the Manufacture and Purity of the Phosphoglycerates. In 1844 Pelouse first prepared phosphoglycerate acid by heating glycerine at 100 degrees C. with anhydrous phosphoric acid, and in 1856 Gobley found the same acid in the yolk of egg.

This salt is now made by digesting glycerine at 28° for six days at a temperature of a 110° C., with phosphoric acid 60 per cent. The mixture allowed to cool on the seventh day, leaves a glassy transparent mass, which is then saturated with the milk of carbonate of lime. The whole is then filtered and the clear liquid exactly neutralized with lime and again filtered and precipitated by alcohol at 90°. The precipitate is drained as dry as possible and dissolved in cold water, filtered and evaporated at a very low temperature. Various modifications of this general mode of manufacture have been proposed, but the phosphoglycerate of lime prepared by Chapoteaut process (late assistant to Pelouse) is the one generally used in dispensing. It is important in prescribing phosphoglycerate of lime, to insist on a chemically pure and fresh preparation, as there are numerous adulterations, especially as the phosphoglycerates have always a tendency to decompose, however well prepared. Capsules of

four grains each are the best form for internal administration, as the salt is then preserved from the action of the air. Hypodermic injections should always be freshly prepared, as recommended by Professor Albert Robin.

The following test will easily detect impurities:

A solution of pure phosphoglycerate of lime (Chapoteaut) gives no precipitate with the ammonio-magnesium reagent or acetate of uranium.

It is precipitated by heat, alcohol and ether.

Nitrate of silver causes a precipitate (which is redissolved by an excess of water), also acetate of lead (soluble in acetate acid). The dry phosphoglycerate of lime treated with alcohol, leaves no sticky residue on evaporation of the alcohol.

The very prominent position which phosphoglycerate of lime