two hours. If there be nervous tension, especially with any tendency to cerebral engorgement, and contracted pupils, give 1-2 to 1 drop of gelsemium with each dose. If a constant nerve sedative, seems to be required, give 4 or 5 drops of scutellaria with each dose. Every physician understands that rest, isolation, and full-nourishing, well-digested food are also required. With a proper attention to these conditions, the patient in nearly all the cases can be cured. This course, in the hands of my readers, has been very successful.

Dr. Gregory asks for experiences in the treatment of tetanus with gelsemium. I have a record of something like a score of cases in which that agent has been used successfully. There are two conditions that must always be borne in mind in the treatment of tetanus. The first is the neutralization or destruction of the free toxins in the system, and, second, the antagonizing of the condition of spasm, by a sufficiently powerful agent, which will also restore the efficiency and normal function of every organ at the same time, while in no way undermining the vital forces. This indication is fully met by the use of a powerful antiseptic and an equally active antispasmodic given together. For this purpose one of our physicians employed a mixture of 20 drops of 95-percent carbolic acid, 20 drops of specific gelsemium, and 20 drops of water, injected into the deep muscular structures every four or six hours. He treated twelve cases, eight of which were very severe, and cured every one.

Others have used echinacea internally and applied directly to the wound, after the wound has been freely opened, and have administered from 20 to 40 minims of gelsemium every three, four or six hours. hypodermically, with equally good results. Others, again, in two or three cases only reported, have used lobelia alone with good results; but those who have used lobelia and gelsemium together have obtained better results than when using lobelia alone. In 1884 I recommended to the faculty of the Chicago Veterinary College the use of gelsemium in tetanus in horses, because they were then having very many cases and losing more than 80 percent of them.

I recently received word from the secretary that since that time they have employed gelsemium and lobelia, reducing the mortality to 60 percent. I did not realize then that an antitoxic remedy was necessary to be used with the antispasmodic. This I now consider should always be remembered. FINLEY ELLINGWOOD,

Editor Ellingwood's Therapeutist. Chicago, Ill.

[Most of our readers will remember the paper by Dr. E. Jentzsch on the hypodermic use of lobelia in diphtheria, which appeared in CLINICAL MEDICINE in April, 1909 (page 453). This, we believe, was the first time that it was proposed to administer the remedy in this way. Since then a lot of experimental work has been done and it has been shown that results can be obtained, when it is introduced into the body subcutaneously, that seem impossible when it is taken by the mouth.

Lobelia has been used hypodermatically for a variety of conditions with gratifying results, the principal objection, however, being the pain which it caused. This was sometimes intense. Lloyd's new preparation is undoubtedly excellent. A number of our subscribers have used the concentration, lobelin, hypodermatically with good results, and one of our friends has been experimenting for several months with the pure alkaloid, lobeline. The results obtained with the latter have been brilliant, and before long we hope to give them to our readers.

One of the striking things about the hypodermatic use of lobelia is the absence of nausea, to which Dr. Ellingwood calls attention. Moreover, as the doctor says, it does not seem to be depressant. Dr. Jentzsch called it a "vegetable antitoxin." This suggestion that it may prove curative in asthma is of intense interest and should be followed up and verified, if possible, by members of the "family."

We are sure that every reader of CLINICAL MEDICINE will appreciate Dr. Ellingwood's therapeutic suggestions, and ask him to give us more of them. He has given us some hints which we shall many of us try out,

though we probably shall take the license of the active-principle enthusiast and use lobeline, macrotin and gelseminine.—ED.]

FURTHER DISCUSSION ON DR. ROBINSON'S PAPERS

As we announced last month, we have received many letters of comment upon Dr. Robinson's remarkable paper, "The Limitation of Offspring." A number of these have already been printed, and several more we are reproducing in this issue. We regret that lack of space makes it impossible to publish more of the articles sent us, and that we are compelled to abbreviate some of those which we are printing. The discussion follows:

THE MORAL ASPECT OF LIMITATION

Dr. Robinson's article (June and July issues) is certainly a very vigorous and forceful one, and appears to be written with sincerity by a man who evidently thinks himself qualified to speak with authority regarding all matters of human conduct, human responsibility and human welfare.

It is to be regretted that Dr. Robinson does not manifest a better spirit in the presentation of his paper. Near the beginning, he speaks courteously concerning a diversity of opinions that "cannot be helped," and suggests that "it is better so-provided discussion be honest and sincere and not unnecessarily acrimonious." But he violates his own injunction even before he pronounces it, and also here and there throughout his article, going out of his way to sneer at the views of a large number of people, in and out of the profession, regarding matters that do not have to do directly with the question under discussion. He refers to the "free-will fetish", the "childish belief in our descent from Adam," and gives an absurd definition of faith which he seems to endorse. A true scientific philanthropist, in discussing a great question in which all are interested, ought to proceed with manly courtesy.

Dr. Robinson presents some strong arguments in support of his views, but the same kind of arguments would apply with almost equal validity in favor of suicide under certain circumstances or to the destruction of idiot infants and the permanently and wretchedly insane. Perhaps Dr. Robinson would so apply them. He speaks of "my remedies for the uplift and regeneration of humanity," and the advocacy of murder and suicide may be among the number. This is the more probable from his laudatory reference to Ingersoll, whose teachings on the subject of suicide are well known.

With a naiveté that is somewhat amusing in so scholarly a man, Dr. Robinson says, "I have considered every possible objection-whether I have answered every point satisfactorily is a different question, but I have considered them all."

At the risk of being counted one of the "peculiar people" to whom he later refers, and therefore under his anathema, I would suggest an aspect of

the question which he has not discussed, and that is the moral aspect. It seems hardly possible that he considers it but a part of the "theological argument," which he mentions but to throw aside with utter contempt. Many who care little for theology have regard for moral standards, as established by the consensus of human opinion or otherwise, and think that the moral aspects of this question are the most important of all and entitled to the fullest consideration.

Though Dr. Robinson regards illicit sexual intercourse as a venial offense, he counts abortion to be a crime, chiefly, it would appear, because of the dangers to the life of the mother. Are the violations of the rights of the unborn child to be considered at all in this connection? If so, can it be said in every case just when conception takes place? May it not in some instances be coincident with coitus? Even if it is always some time later, is not the act of bringing together the elements of life such a direct invitation to a new life that all interference with such a prospective new life would constitute an immorality, if not a crime?

Without cavil, it may properly be said that the moral aspects of this question, if not the crux of the whole matter, at least deserve careful consideration from any honest and fair-minded man who presumes to take up its discussion.

Good Hope, Ill.

A. M. STOCKING.

FROM A WOMAN WITH SEVEN CHILDREN -A DOCTOR'S WIFE

I have read Dr. William J. Robinson's article on "The Limitation of Offspring" with much interest, and I admire him because he has a deep sympathy for suffering women. Yet I, the mother of seven children, disagree with him on some points.

I know what it is to suffer all of the things which he describes, and I feel grateful that one man understands what women have to go through-yet I feel that I have been fully paid for my suffering. Yet I know what it is to be scorned and taunted by neighbors, for more than two-thirds of the people with whom I am acquainted practise "limitation of offspring."

It is perhaps true that we cannot care for a large family as well as we can for a small one, but, nevertheless, I feel that the backbone of the nation is in these large families. Here they learn to make sacrifices one for another while they are young, and if we mothers lay the foundations well we can be sure that our children will become well-educated men and women, even if our means are very limited. When there are only two children they both get the things they want, and they don't know what it is to sacrifice. If we cannot make sacrifices enough to bring up our families how can we expect the coming generation to be ready, if the need comes, to sacrifice themselves for our country or for one another?

Yes, child-bearing pulls down many a high-strung girl, but if she has real character she will come up again. If she is a brave, true woman she will not look upon her work as drudgery. I am not a strong woman, but with my children's help I do my own work, and sometimes the laundry work for the family, and I find time to read. I read much more than I did when I had only one or two children.

I, for one, know that my children have not been a curse to me, neither mentally nor physically.

I have read Dr. Robinson's "Limitation of Offspring" with great interest, and I am sorry to see from the comments that the majority don't agree with him. Dr. Robinson's remedy may or may not be right. I don't presume to say, but I know something is wrong. The maternal instinct is as strong with our women as it has ever been. We love our children. We want them, but we must remember that each generation of civilization and unnatural living breeds a more complex and highly strung race of women who are physically unable to bear the number of children that the primitive races do, and our women should be protected.

And speaking of educating the people. Can't something be done about the senseless little smattering of physiology that is taught our children in the schools? They are religiously shown a diagram of their digestive organs, their lungs and hearts, but what boy or girl ever saw a diagram of his or her generative organs? I know a girl who, until she was almost grown, thought she menstruated through her urethra. No wonder she had leucorrhea. She had never seen a fountain-syringe. Our girls are taught that it is an offense against society not to use the tooth-brush regularly, but how many are taught the importance of washing out the vagina? A DOCTOR'S WIFE.

Kentucky.

THE LIMITATION OF OFFSPRING-A PROTEST FROM THE SOUTH

All men are influenced by their environment. Dr. Robinson is decidedly so. Men living in New York City seem to think that that city is the United States, and the remainder of the country a hazy fringe round about. Japan has a population of fifty millions of people, but the state of Mississippi, with an equal area, has two millions. Does Mississippi want limitation of offspring? Many western states have a still less dense population. Do they want their population arrested?

Six weeks ago, Waco, Texas, received a carload of babies from New York. When the train reached Houston, Texas, the women of that city tried to mob the train in order to get the babies. In a few weeks more they received a carload for themselves. Does Texas want limitation of offspring?

Our political economists tell us that the United States can support a population of six hundred millions of people. With Alaska and Canada, one billion people could live in peace and plenty north of the Rio Grande. Does this vast country want limitation of offspring? No, a thousand times, no! Last winter every night at one o'clock two thousand men formed a bread-line at the Bowery Mission in New York to get a cup of coffee and a piece of bread. (God pity their poor women!) At the same time the South and the Southwest were begging for labor and offering inducements to immigrants. Those men could be happy with their wives and children in the South. Must this entire vast country

country suffer for the conditions prevailing in a few congested areas?

Dr. Robinson says that the limitation of offspring by a knowledge of how to prevent conception would not increase illegal cohabitation. No man was ever more mistaken. We in the South believe that we have the most virtuous women on the continent. They have an inborn modesty, a shrinking from vulgarity, a sweetness of character that is proverbial. But let me tell you, brother, that, if our women, as well as those of other parts of the country, had a knowledge of some easy and positive way of preventing conception, in a few generations chastity would be as rare as it is now

common.

A girl is as conscious of her sex as a boy of his, and when enthused by a God-given passion, and under the gentle persuasion of someone whom she thinks she loves, if all restraint were removed, this girl would resist no more than do our boys today when they are subjected to a similar temptation. No, Dr. Robinson is unmindful of the fact that our young women are suppressing a volcano of animal passion; that we are but little above the brute creation in such things. The only restraints I know of are the religion of Jesus Christ and the fear of conception.

We of the stronger sex should throw all safeguards possible around our women, guard, guide and direct them, going on as we are now trying to go, to a higher and better life.

Mississippi.

C. S. H.

LIMIT REPRODUCTION OF THE UNFITBUT NOT OF THE FIT

Dr. Robinson's article in limiting offspring will doubtless receive criticism from abler pens than mine, but in response to your invitation I will submit my views.

Passing over the slurs upon ideas held sacred, I am sure, by a majority of your careful readers, I will speak only of the subject-matter of his paper. I must dissent from the proposition that large families are necessarily the result of excessive child-bearing. All pregnancies of the unfit are excessive, whether the parents be poor or rich. Cases have occurred in my practice where I felt it my duty to caution against what I considered excessive child-bearing, not because the parents were poor, but because of unfitness.

I cannot agree with the doctor that the large family of the poor is "one of the greatest causes of low wages, poverty, ignorance, idleness, sickness, crime, and death." So sweeping a statement needs proof, to say the least. Neither can I admit that the first two or three children of normal parents are dearer than those that follow. I am number eleven in my father's family, yet I never had reason to believe that I was unwelcome, albeit my father was far from being rich.

In my forty odd years of practice, more prospective mothers of the well-to-do and the socalled rich have appealed to me for fetus murdering than of the socalled poor, and in the majority of cases the plea was made in the first and second pregnancies.

In my first school on the Iowa frontier (before taking up medicine), over fifty years ago, I had pupils from three families of twelve and thirteen children each. These people were not rich, by any means, and all lived in houses of four rooms or less.

To show you that I have "practised what I preach," I am enclosing the picture of my wife and her five daughters. We have seven children, five daughters and two sons. The older son, thirty years old, is a prosperous and capable business man; the younger son, fourteen years old, is a fine, healthy boy in high school. All of the five girls are highschool graduates. Each can play the piano, cook, milk a cow, drive an automobile and set a hen. Four of them are happily married and prosperous. The wife and mother is fifty years old, in good health and happy-with not a white hair!

All of our children, married and single, live in Caney. John D. Rockefeller and Andrew Carnegie cannot enjoy their millions more than we do our seven children.

Caney, Kan.

THOS. A. STEVENS.

ROBINSON IS RIGHT

George Bancroft, the historian, said Wendel Phillips was "right, but fifty years ahead of his time." This is just what I thought of Dr. Robinson, after reading his address on "The Limitation of Offspring" printed in the June and July numbers of THE AMERICAN JOURNAL OF CLINICAL MEDICINE. It is a most masterly and truthful presentation of a most important subject, and must appeal with tremendous force to every sympathetic doctor. But to preach such doctrine now to the great mass of mankind would be like casting pearls before swine. I have tried it for over forty years and know whereof I speak.

The world never accomplishes but one great reform at a time, and the economic movement is the one now most pressing for consideration in all socalled civilized nations. Our cannibalistic, capitalistic, anarchy-feeding system must give way to the more sane and sensible cooperative commonwealth, in which all will have a chance to work and to get the full product of their labor (instead of one-fifth as it is now), before the masses will have the time and incentive to study this question.

With the incoming of socialism, to which Dr. Robinson evidently adheres, the superstitious part of religion, i. e., much of creedism and churchiety, will give place to the more dynamic principle of meliorism. With religion based on the great doctrine of the brotherhood of man and the fatherhood of God, and economics based on the impregnable science of biology, as taught in evolution, the science of eugenics will be studied in our schools. Then will heaven really begin on earth, and in the family relation, primarily, life will be worth living.

Fort Worth, Tex.

S. J. BROWNING.

THE DANGER OF PROMISCUITY Continence in adolescence is essential to racial vigor. We are decrying early mating among ourselves, and legislating for other races. The family is the basis of higher civilization; promiscuity is not desirable. The most advanced races are the tangible proof of these dicta. By much travail and experimentation we have arrived at a fairly true monogamy and sex continence, with late mating.

Whatever be claimed to the contrary, a general knowledge of limitation of offspring will surely lead to early excesses, promiscuity, and destruction of family life, with its development of the

community instinct. Woman, who, as childbearer, has benefited most by monogamy, will be the loser (already is) from loosening of the family ties. The only argument in favor of "limitation" knowledge is, that it may lessen abortion and infanticide. As to some of the evils to be "cured", a far better and more effective way is sterilizing potential fathers and mothers when indicated. A. VOGELER.

Chicago, Ill.

ENDORSES DR. ROBINSON'S CON

CLUSIONS

I appreciate fully that I am a very small toad in a very large puddle, but I am consoled by the fact that I have company and that very few are large enough to make so large a splash on so important a subject as Dr. Robinson.

While not fully accepting all of his reasoning, I endorse his ultimate conclusions. The subject is vital. I meet it every day, you meet it every day, and every other practitioner of medicine meets it every day. Then it must be up to us to solve it, and we alone can solve it and solve it correctly.

The comments in the August number of CLINICAL MEDICINE On Dr. Robinson's paper are red hot with criticism and endorsement. To those who stand aghast with the thought that the pages of the journal should be polluted by the ungloved handling of such a subject I wish to state a universally accepted fact, and ask a question. A normal married wo man living with a normal husband will conceive and give birth to a child at least every two years, if no steps are taken to prevent conception. Now, then, my dear brothers, how many of the families in your acquaintance keep up this standard. Have you, my brother, lived up to it? I know your answer will be negative. Then why condemn and preach against your own practice? Get in line, my brother; this question is going on to solution whether you go with it or not.

We may not know where we are going, but we are on the way.

Iowa.

E. H.

OVERPRODUCTION IN A SOUTHERN

MILL TOWN

Yes, sir, keep my journal coming. I read it from cover to cover and get more genuine good out of it than from any magazine I take. The Critic and Guide is next, as I agree with Dr. Robinson in his fight for "limited reproduction."

A word! I have been practising medicine for twenty-five years. My work is general, but naturally I have a large obstetric practice. I go into the homes of all kinds of people, high and low, rich and poor, doing work at four cotton mills and some other manufacturing plants, seeing life coming and going, and on all sides, and as a result I believe that educating the poor people along this line would be a great blessing.

I am no abortionist. Far from it. I note that some of the articles in the last number are treating the subject from that viewpoint. This is not treating Dr. Robinson's contention fairly. He does not argue to stop that which is already started, but to avoid starting.

I see the deplorable effects of those large families every day among the very poor, counting my