sets forth the normal condition of the hair and the diseases and their treatment. In some pages prescriptions are given and in others general verbal directions are put down. If a person can make the diagnosis the treatment is simple. The illustrations are abundant and from a historical standpoint interesting and instructive. The fact that the book has reached its seventh thousand attests its popularity and usefulness.

REPRINTS, ETC., RECEIVED.

The Pre-Tubercular and Pre-Bacillary Stages of Consumption. By Charles Manly, A. M., M. D., Colorado.

Inebriety and Imbecility; A Medico-Legal Study. By T. D. Crothers, M. D., Hartford, Connecticut, 1895.

The Surgical Treatment of Spina Bifida. By Henry O. Marcy, M. D., Boston. Reprint from the Annals of Surgery.

The Indications for Operation in Appendicitis. By J. W. Long, M. D., Richmond, Virginia. Reprint from the St. Louis Medical Review.

The Value of Gude's Pepto-Mangan in the Treatment of Anemia. By Hugo Summa, A. M., M. D., St. Louis. Reprint from the New York Medical Journal.

The Surgical Treatment of Inguinal Hernia. By H. O. Marcy, A. M., M. D., LL.D. Reprint from the Transactions of the New York State Medical Association.

The Etiology, Pathology and Treatment of Intestinal Fistula and Artificial Anus. By N. Senn, M. D., Ph. D., LL. D. Reprint from the American Journal of Obstetrics.

The Value of Plastic Work in Operations Involving the Peritoneum. By J. W. Long, M. D., Richmond, Virginia. Reprint from the American Gynecological and Obstetrical Journal.

Report of a Case of Pathological Separation of the Lower Epiphysis of the Femur. By A. H. Meisenbach, M. D., St. Louis. Reprint from the Annals of Surgery.

Infection and Immunity, with Special Reference to the New Diphtheria Antitoxine. By Charles Russell Bardeen, B. A., Assistant in Histology, Johns Hopkins University. Reprint from The School Bulletin. Syracuse, New York. C. W. Bardeen, 1895.

NEW TREATMENT. Northwestern Lancet.

THE most interesting addition to medical treatment during the year was the use of antitoxine in diphtheria. This agent has been tried in every part of the world where diphtheria occurs and the extent of its use has been limited only by the capacity of the laboratories that turn out the product.

QUACKERY ABROAD.

The Medical Age.

IT has been the custom to regard the United States as the great dumping ground for quacks. It is not to be denied there is an immense amount of inferior medical talent in this country, and it is somewhat notorious a large portion of such in the States bordering upon Canada is derived from the latter.

INTERNATIONAL LANGUAGE.

The Canada Medical Record.

WE have always maintained that, as the English language is already spoken by the vast majority of the inhabitants of the earth, it would entail the expenditure of the smallest amount of eneregy if those who do not speak it should make a point of becoming familiar with the English language. The present method of having a great number of different languages to express their views in consumes an enormous amount of energy among those who are writers of medical literature.

THE DOG. Physician and Surgeon.

THE State reports of Ohio give statistics showing the death of 30,000 sheep, and the injury of 23,000 through the bite of the dog. There is little doubt that he is a potent cause of disease and destruction. The devising of some means whereby the breed of these animals shall be improved is a desirable end to achieve. The dog-tax, although a considerable source of revenue, amounting in a city like Chicago to $75,000 annually, is not faithfully enough collected to render the multiplication of "curs of low degree" a thing to be avoided. The fact that the dog population almost equals the human population makes any effort to accomplish protective inoculation almost impossible.

PUBLISHERS' DEPARTMENT.

All letters containing business communications, or referring to the publication, subscription, or advertising department of this Journal, should be addressed as undersigned.

The safest mode of remittance is by bank check or postal money order, drawn to the order of the Maryland Medical Journal; or by Registered letter. The receipt of all money is immediately acknowledged.

Advertisements from reputable firms are respectfully solicited. Advertisements also received from all the leading advertising agents. Copy, to ensure insertion the same week, should be received at this office not later than Monday.

Physicians when communicating with advertisers concerning their articles will confer a favor by mentioning this Journal.

PHARMACEUTICAL.

CACTINA Pillets have become very popular with the medical profession and we see many favorable clinical reports.

CONVULSIONS may frequently be cut short like magic, by teaspoonful doses of Celerina repeated at short intervals. The nausea as an after-effect of chloroform or ether narcosis may generally be controlled in the same

manner.

I HAVE used Iodia, and am satisfied that it is a very powerful alterative, and a great improvement on the old combination of iodide of potassium and sarsaparilla, the latter drug itself being most doubtful in its effects, while the preparation is valuable also as a diuretic, a thing of no small consideration in most of the diseases in which it is indicated.Walter W. S. Corry, M. D., L. R. C. S., I. & C., Rosedale Abbey, Pickering, Yorkshire, England.

IT affords me much pleasure to state that I have given Stearn's Wine of Cod Liver Oil and Peptonate of Iron a number of severe tests, and in all it has proved itself a tissue builder of great power. I could cite many cases, yet when this excellent tissue builder is used in cases of debility from whatever cause, new tissue is rapidly made and health is restored in a surprisingly short time. I should be sorry if I had to get along without it. Report from Geo. Duffield, M. D., Detroit, Mich.

ADVANTAGES of the Elixir Six Bromides over the Bromide of Potassium: Bromide of Potassium when given alone has a tendency to produce anemia, digestive disturbances, skin eruptions, marked increase of solid constituents in the urine, and a depressing effect upon the heart. Bromide of Soda has none of these effects. The soda prevents gastric ailment, increases the action of the kidneys without affecting the solids, and has no depressing cardiac influence. The ammonia also counteracts the depression caused by the potassium. The iron the Elixir contains is a safeguard against anemia. The cannabis indica aids the soda in preventing the cumulation of the bromides in the system, hence in epilepsy and similar disorders where a bro

mide has to be long continued, the Elixir Six Bromides is specially valuable. Always use the precaution to give a laxative at least every two weeks when a bromide preparation is to be continuously administered, especially if there is a tendency to constipation.- The New York Medical Journal, Vol. LX, No. 22.

WHILE opinions vary as to the utility of pepsin in the treatment of indigestion, we believe that under proper conditions the results following the administration of it warrant its use. As in every other medicament so in pepsin purity is a great desideratum. Modern pepsin producers have exerted themselves to the utmost to improve their processes and appliances and as a result we are offered beautiful scales which are freely soluble, free from unpleasant odor and taste, nonhygroscopic and very active as a solvent of albumen. The great favor which is enjoyed by some of the best essences, cordials and elixirs of pepsin either alone or in combination with pancreatin, lactic acid, etc., would seem to prove (notwithstanding the scientific reasoning to the contrary) that these are advantageously employed to meet certain symptoms and conditions of disturbed digestion. One of the most palatable and efficacious compounds at present on the market is PanPeptic Elixir. No doubt many of our readers saw it at the A. M. A. Meeting in Baltimore where it was exhibited by Sharp & Dohme. Samples of it were freely offered to the members of the Association.

THE growth of the Barnes Medical College has been phenomenal beyond all the dreams of its promoters. It now stands eleventh in number of its students in the United States. Those who have a larger number are institutions of many years' standing. The Barnes graduating class numbered 64, all bright men. The general average of the class in their examinations was over 80 per cent. The college challenges emulation in this regard. The institution is about to erect a new building. They have outgrown their present quarters and must increase their accommodations. The cut which appears in this number of our JOURNAL represents the exterior. It speaks for itself. The building will be about a hundred feet square, and situated on the corner of Thirtieth and Chestnut streets, in

the west end of the city, a beautiful location, with the most pleasant of associations. As for the interior, the board of trustees and faculty will spare neither skill, pains or money to make it all that it should be, the best in the country. The faculty are competent and obliging. The students, therefore, are diligent and of high standing. The prices charged, while not small enough to lower the dignity of the character which the degree of M. D. has ever conferred, are not so high as to shut out those young men whose only financial means depend on their personal exertions.

TANNIGEN. In the treatment of acute and chronic catarhal inflammations of the intestinal mucous membrane, the employment of astringent remedies plays an important part. It frequently happens, however, that their use must be abandoned because of the gastric irritation to which they give rise, impairing the appetite and digestion and thus contributing to the already reduced nutrition of the patient. Tannigen, the new astringent, is free from these disadvantages, for, as it is not decomposed in the stomach, it is entirely devoid of irritating effects upon the gastric mucous membrane, and for the same reason exerts its full astringent action in the intestinal canal. Dr. C. Kunkler (Medical Week, March 15, 1895) has experimented with Tannigen in treating in the wards of Dr. F. Schultze, Professor of Clinical Medicine at the Medical Faculty of Bonn, certain patients who suffered from acute and chronic gastroenteritis, especially children. The remedy was administered to children under one year in doses from 10 to 20 centigrammes, three or four times daily, and to older children and adults in doses of from 15 to 50 centigrammes repeated several times in the twenty-four hours. In almost all of the cases the results of the treatment were excellent; the diarrhea and other gastro-intestinal disturbances rapidly ceased, even in cases which had resisted administration of calomel, naphthalene and bismuth. Dr. Kunkler is of the opinion that it would be well to try Tannigen in typhoid fever, in which it is likely that it would have a beneficial effect on the intestinal ulceration, and also in the treatment of albuminuria. At the onset of enteritis, Tannigen should be associated with a powerful antiseptic such as calomel or naphthalene.

WHOLE NO. 744

DURING the last decade no question in medical sociology has attracted greater attention than medical education. The requirements of our colleges not being upon a par with those of other countries, nor with other departments of education in this country, it was but natural that the profession as a whole, the medical press, and organized bodies of medical men, should join in a demand for needed reforms. During the formative period of our history it is but natural that abuses should have arisen in methods of education and obtain a firm rooting. A spirit of criticism exists that will not subside pending the definite determination of a question of such vital interest to the profession of the country.

As a nation during the first century of our history, we have established a system of common school education that challenges the admiration of the civilized world. It is a subject of regret, however, that in certain advanced lines of education our methods have proven most defective. This is true of medical education; a system having secured foothold with us, that is indeed anomalous.

Having no support other than the fees of students; without university or college connection; without support from the State, generally accorded other sys

tems of education; without restraining legislative enactments; without laws. regulating the granting of charters for purposes of medical instruction; it is indeed little wonder that at the end of the first century of our history as a nation chaos should reign supreme.

The agitation of the question of medical education is bearing fruit, however, in that a majority of the schools situated in the northern States demand at the present time evidence of preliminary fitness before matriculation, and that in a period of five years all colleges known to the writer have extended the period of time of study; with a change of the minimum length of term from five to six months. After the present year every medical school of recognized standing will require attendance upon four courses of lectures in different years, of six months' duration each course, before conferring the degree of M. D. The reforms thus far accomplished have only been secured in the face of determined. opposition at the hands of the representatives of the low grade institutions. Future opposition will result in disaster to the participants. Professional sentiment. is decidedly with those schools now operating under the advanced curricula. This is particularly manifested by the increased number of matriculates in the

last three years at schools operating under the four years' course. The fiscal matriculation at the University of Pennsylvania and Columbia is, approximately, eight hundred, Harvard, five hundred, and others in proportion; while that of the recognized low grade institutions have sensibly fallen off.

Notwithstanding the trend of public opinion, we are firmly of the conviction that our only safety consists in the establishment of efficient legislative acts in substantially every State. The high grade schools are undergoing a period of evolution and are determined to inaugurate greater system in methods of work; with low grade schools little evidence is at our command pointing to improvement.

The elevation of the standard of requirements in the latter class of schools have seemingly been entirely in response to the requirements of the respective State boards of medical examiners.

The indifference of the profession to methods of medical education has been far-reaching in its pernicious influences. Blinded by our own shortcomings we did not awaken to a realization of our environment until our interests were greatly jeopardized. We found ourselves drifting, in the estimation of both. the public and profession, towards a condition of professional inefficiency, not unlike that of French medicine in the seventeenth century, so graphically described by Molière. One of the greatest evils of our system was the flooding of our ranks with a horde of poorly educated practitioners far in excess of our legitimate demands. The latter assertion is convincingly illustrated by the statistics gleaned from the recent excellent paper of Professor Pepper on Medical Education, affording comparative . statistics relating to the proportion of practitioners to the population in different countries of the globe.

TABLE INDICATING PROPORTION OF PHYSICIANS TO THE POPULATION. Austro-Hungarian Empire.......

Belgium..

France.

German Empire.

Italy

I to 3857 I to 2841 I to 2666

I to 3038 I to 3536

It will be observed from the above that the proportion of practitioners and the number of schools are greatly in excess of other countries. Medical colleges in foreign countries are likewise independent financially, being, as a rule, directly supported by the State or possessing a direct university connection.

An investigation of this subject reveals beyond the possibility of successful controversion that the most efficient profession is found in those countries protected by efficient legislation; while a correspondingly low standard of professional fitness exists in countries not similarly protected.

At one time considerable opposition existed to the regulation of medical practice by legislative enactments. With the defeat of attempts to destroy the effects of this form of legislation by litigation and the moral support afforded by the recent decision of the Supreme Court of the United States and Supreme Courts of the several States, as well as the apparent benefits from the successful operations of the law in a large number of States, it is pleasing to note a decided change of sentiment in favor of this form of legislation.

The existing opposition to this form of legislation is greatly disappearing, being greatly confined at present to the