"Phossy Jaw" and Its Prevention Despite the fact that death certificates still show that phosphorous is a cause of death, and despite the fact that the experience of Germany, Denmark, Switzerland, Great Britain, Italy, Spain, Austria and Sweden has demonstrated that distress and death may be obviated by doing away with the poisonous white phosphorous in the manufacture of matches, there still lives a man in Brooklyn who had the temerity to state in the United States Senate that phosphorous poisoning does not exist. There is at present before Congress the Esch Bill which is designed to eliminate the use of white phosphorous in the manufacture of matches. The purpose of this bill is to place a prohibitive internal revenue tax on matches that are made with white phosphorous. In other words, the economics of production of matches is to be called upon to eliminate their poisonous nature, because it might be a violation of law to legislate This young widow, after four years' work as a match dipper had to have her upper jaw removed. She is only thirtysix years old. JOHN WERNER A typical case of phosphorus poisoning this poisonous product out of existence thru any other method. The Interstate Commerce Act does not afford a practicable means of prohibiting the sale and manufacture of this commodity within the State, and would merely serve to limit the disease to the particular States in which the matches were manufactured. It has been said that matches are made in heaven. The condition of some of the workers in this industry does not suggest such a benign origin. There was a time when a single match company held the American rights to the patented processes involving the use of sesquisulphide of phosphorous, which is a harmless product that will make just as good matches as the pernicious white phosphorous which up to the present has taken its toll in human jaws. The old excuse that it costs five per cent. more to manufacture matches by utilizing this harmless chemical agent, and that competition forbids this additional expenditure, no longer holds true as an argument, because in January, 1911, the patent right was cancelled and there is at present no reason why all manufacturers of matches should not avail themselves of the opportunity of making matches by the sesquisulphide of phosphorous method. In Switzerland previous to the enactment of law, one and one-half to three per cent. of match makers suffered from phosphorous necrosis of the jaw. In France two or three per cent. of the workers underwent this suffering. There is an International agreement among the countries that have been earlier mentioned which interdicts the use of white phosphorous in match making. Society must not be obliged to pay for the short-sighted, selfish and actually malevolent devices of manufacturers who are willing to sacrifice the jaws of their employees for. a few more dollars' profit. This is a match worker's reward after long and faithful service-her eyes gone, her jawbone terribly diseased, her health ruined forever It is regrettable to note that in the United States almost one-third of the workers in the match industry are women and a full nine per cent. are children under the age of sixteen years. The abolition of white phosphorous in the manufacture of matches is insisted upon by law in almost every civilized country, with the exception of the United States. There is practically no obstacle to its abolishment in this country, save the dilatory tactics of the representatives of the peo ple, in Washington, who are paid to represent constituencies and who apparently prefer to sacrifice human life or subject the workers in the match industry to a living death, altho they might be very loud in speaking against vivisection. There is no legitimate reason that can be mentioned against the passage of the Esch Bill, and if our congressional representatives would have the same social spirit as did the Diamond Match Company in relinquishing its patent rights, the defenseless workers in the match industry would find that in truth, as far as they are concerned, the government is "for the people." PATHFINDERS IN MEDICINE Semmelweis, the Obstetrician. By VICTOR ROBINSON Permit me further to express the holy joy with which I studied your work, Die Aetiologie. In the course of a conversation on the subject with a colleague here, I felt myself compelled to declare: This man is a second Jenner; may his services receive a similar recognition and his efforts bring him the enjoyment of a similar satisfaction. It has been vouchsafed to very few to confer great and permanent benefits upon mankind, and with few exceptions the world has crucified and burned its benefactors. I hope you will not grow weary in the honorable fight which still remains before you. The great Lying-in Hospital of Vienna is divided into two sections: the first obstetric clinic is for medical students, and the second for midwifepupils. The medical profession has often been accused of over-drugging, but the Vienna School of the nineteenth century had no materia medica. This school produced no therapeutists: it forgot that a physician should sometimes cure. "Doctor, what medicine shall I take?" asked the invalid who had been treated merely as an object of scientific investigation. "Oh," exclaimed the Viennese medicus, as if surprised at the question, "that is immaterial." If the sufferer still insisted on treatment, he was given a standard prescription which the apothecary read as follows: "R-A little bitter-almond water mixed with considerable common water, sweetened and fortified with syrup. Skoda was enthusiastic in making diagnoses, and Rokitansky in performing autopsies-and if the diagnosis and the autopsy agreed, the patient was not supposed to complain. The dissecting-room was their temple, where they devoutly prayed to be admitted to the inner mysteries of dis Dr. KUGELMANN: "To Semmelweis." eased organs. The cadaver was considered the noblest work of nature. The subject of pathologic anatomy was immensely enriched, but little was done to heal the sick or save the dying. "Our ancestors," said Professor Dietl, "laid much stress on the success of their treatment of the sick; we, however, on the result of our investigations. Our tendency is purely scientific. The physician should be judged by the extent of his knowledge and not by the number of his cures. It is the investigator, not the healer, that is to be appreciated in the physician." The students whom we see in the First Clinic have just come from postmortem examinations, and are waiting for an instructor to take them to the obstetric cases. They have washed their hands with a squirt of water, and are now drying these organs by blowing on them, waving them in the air, or sticking them in their pockets. "Oho, Marcus, how would you like to have a sweetheart like that?" asks a future accoucheur, indicating a woman with a meteoric abdomen. "Why, Franz, that looks like the girl you were walking with last night." "Oh, you old beggar! I was with your own sister the whole evening." "You lie! Lilly said she was going out with a gentleman, so it couldn't as tenderly as if she were a queen. have been you." "I swear that I and no other-but Heavens! how the Fräulein can drink! Tokayer-a bottle; Pfaffstättner—a bottle; Gumpoldskirchener-a bottle. I have no money left. Loan me a few gulden, will you?" "So you can make my sister drunk? Why don't you take the girl to church?" "Stop that squabbling about Fräulein Lilly, fellows; here comes-" The teacher enters the clinic, but the amused smirks of the students have already been succeeded by studious looks. Their instructor is Professor Klein's assistant; he answers to the German name of Dr. Semmelweis, but he is a true Magyar, born in Budapest, and he speaks German with an accent and writes it with a hitch. Altho he is getting bald, he is still in his twenties: only a few years ago he lived and laughed in the Josefstadt-the LatinQuarter of Vienna. He is genial, sympathetic, soft-hearted; the quintessence of goodness is revealed in his open smile. He leads the way thru the wards, pointing out the interesting cases, and directing physical examinations to be made. Suddenly he stops; his brow contracts on the bridge of his nose. Before him lies a young mother exhibiting the symptoms of puerperal fever. He remembers her-three days ago he delivered her of a healthy infant. Parent and child seemed to be doing well, but now the curse of the lying-in hospital smites them. smites them. Unlike Jules Clement, Semmelweis is not accoucheur to Mlle. la Valliere, or any other royal mistress, but every servant-girl entrusted to his care he treats upon whom rested the hopes of a dynasty. For a moment he forgets his students and gazes with compassion at the stricken woman. A cold wave sweeps along her spinal cord, her pulse gallops, her skin is hot and dry, her breathing short and hurried, her countenance sunken and anxious, and at night she mutters in a lethal delirium. She is sick, and next week she will be dead. The Assistant dismisses the students from his clinic, but he cannot banish the subect from his mind. He goes out, hurries along the Haupt-Allée, past the superb chestnut trees, the epauleted officers, the prancing horses, the beautiful ladies. He walks unheeding, while all the time his ear-drums half burst from the loud queries that ring thru his head: Why do they die? What is childbed fever? How does it enter the lying-in chamber? He has read all the books he could find on the subject, and the various theories of distinguished obstetricians flit thru his mind: "It is due to the milk," says Boer. "It is epidemic," announces Klein. "It is caused by lochial suppression," thinks Smellie. "Miasma is responsible for it," declares Cruveilhier. "It is a gastricbilious disturbance," writes Denman. "Its etiology is found in peritonitis," argues Baudelocque. "Erysipelas of the bowels is the predisposing factor," opines Gordon. The conflicting notions fill Dr. Semmelweis with despair. Who knows. which is the correct solution, or if any are true? We grope in darkness; all is chaos and doubt; nothing is certain -except that the number of women who die in childbirth is appalling. In |