youngsters adopted two needy little ones from a neighboring city. Fliends remonstrated, arguing "You are still young and well fixed; why not have more children of your own?"

The man's answer was as sensible as it was simple. "I have done my part; now I will help some less fortunate parent to do his, to complete the work he started and was unable to finish.”

To care for the child already here means just this moch more than to beget another and care for it: Relief for the former often supports a broken down, destitute mother with numerous other responsibilities. Secondly, avoidance of the risk and strain inseparable from another birth, at best, never inconsiderable. Far be it from me to encourage "race suicide," but human souls that are worth begetting must be worth saving, and quality must be at least equally important with quantity.

PHYSICIANS WHO BECOME POLITICIANS

Physicians who later in life became politicians or statesmen have not shed lustre on the title of M. D. I am thinking of Clemenceau and Leonard Wood. Clemenceau-a man of high culture, but a cruel, revengeful imperialist who came pretty near ruining France irretrievably; it was lucky for France that she came to her senses in the nick of time and forever eliminated the old Mephisto from public life.

As to General Leonard Wood, he possesses neither education nor culture, and as to familiarity with modern thought and progressive movements, he might as well be living in the middle of the 18th century. If a liberal idea by chance entered his head, it would cause a dangerous commotion that might result in a cerebral hemorrhage.

And yet he may become President of the United States. For he is the darling pet of our profiteering plutocracy, and at the next election, I fear me, profiteering plutocracy is going to be all-powerful, all-conquering. And yet, who knows?

TRAUBEL'S COLLECTS

A few of Horace Traubel's Collects have been assembled in two groups and are offered as a set. The first group, comprising six subjects, is issued as six separate pamphlets. The second group, comprising twelve subjects, is the April, 1914 number of a unique little magazine called The Glebe, which has been out of circulation for several years. The number of sets available is acutely limited. The price of a set is two dollars. They will be supplied by A. M. Traubel, Camden, New Jersey.

THE ABUSE OF SOAP

Dr. F. Barendt (Liverpool Med. Surg. J., No. 69, 1916) suggests that even the best of soaps can be abused. The alkali may chip and furrow the epidermis and produce slight scaliness over the prominences of the face and hands, the regions of the body the most washed.

Furfuraceous patches on the faces of children are frequent, and it is these patches, due to abuse of soap, which are apt to become inoculated with microorganisms, and finally assume the picture of impetigo. In hospitals the nurses often use too much soap on their patients. The secretion of the skin is sluggish, and the excessive removal of the natural grease leaves the skin rough and branny.

Also, some surgeons are given to too vigorous use of soap and water at the site of the operation.

Pruritus is not infrequently brought about by a too zealous use of soap. The delicate skin of new-born babes is sometimes irritated by the zeal of the nurse in rubbing not wisely but too well with soap and water to remove the vernix caseosa. Abuse of soap causes in many instances intertrigo in infants. Frictional eczemas are invariably aggravated by soap and water.

The best type of toilet soap is represented by a combination of oleate and stearate of sodium. When a harmless soap has been selected it should be used with discretion, that is, not too frequently nor too energetically and especially should care be exercised when using it on sick persons and children.

MACROCHEILIA OR THICK LIPS

Drs. Frederick B. Moorhead & Kaethe W. Dewey (J. A. M. A., Sept. 27, 1919) call attention to macrocheilia, or enlargement of the lips, which appear twice, thrice and even six times as large as normal. The abnormality has been so marked in some cases that such a mouth has been compared to a snout or trunk. One lip or both may be involved; macroglossia may be associated with it. As to the etiology of macrocheilia, several theories have been advanced, but a satisfactory and generally accepted explanation has not yet been given.

Macrocheilia is generally congenital; but it may also be acquired. In women the condition is apt to arise at the beginning of menstroation, during pregnancy or at the menopause. A remarkable case was one reported by Sonntag, in 1914, which occurred in a man, aged 47. The lower lip and the tongue were enlarged to such a degree that the patient was unable to bite or chew, or to keep the tongue within the mouth except by holding it back with the hand. The opera

tion reported by Sonntag gave satisfactory results. Successful treatment with radium has also been reported.

PERIODIC EXAMINATIONS OF THE URINE

A detailed chemical and microscopic examination of the twenty-four hour urine of every person who has reached the age of 40 or over, should be made once every year for any indications of renal changes that may have developed. The records of examinations covering a period of two or more years should be carefully compared and studied in every detail to note any changes that may have occurred.

When such annual examinations of the urine are made. it is not at all unlikely that the kidney trouble, if discovered early, can be checked and perhaps cured by good medical advice and treatment.-Dr. J. Bergen Ogden.

BEESWAX IN THE BLADDER

R. Hottinger (Corresp. Bl.f. Schweizer Aerzte 6, 14, '19, thru N. Y. M. J.) reports the case of a boy, aged sixteen, who introduced a bougie (candle) made of beeswax into his urethra as a means of preventing himself from wetting the bed. The bougie slipped into the bladder and set up an obstinate cystitis. Boric acid solution was injected into the bladder and then about twelve c.cm. of xylol, which, being lighter than water, floated together with the wax, on the solution and dissolved the latter. The patient was directed to massage the region of the bladder from time to time by pounding it, so as to hasten solution in the same way as by shaking a test tube. The patient complained of moderate burning, but of nothing serious. After four hours he passed a milky fluid from his bladder, from which the wax was separated as it cooled. Immediate cystoscopy showed the bladder free from wax. The cystitis subsided rapidly.

MENTAL DISTURBANCE AND GASTRIC DISEASE W. Plönies (Arch. f. Psych. and Nervenkrankh, vol. 46) expresses the opinion that a definite relationship exists between the nervous system and the digestive apparatus of such a character that disease of the stomach may condition mental disorders. Impulsive ideas as a symptom of stomach lesions were observed in upwards fifty-three per cent. among women in one series of statistics. It is presumed that the mental state is induced by a toxemia which acts more vigorously the greater the psychopathic heredity of the individual. The author concludes that various mental disturbances other than impulsions may likewise be related to stomach disorder and that a definite relationship exists between the psychosis and gastric disorder.

OBLIVIOUSNESS OF ONE'S ORGANIC FUNCTIONS

Every organ and structure in the body is represented in consciousness, but happy is the individual who is oblivious of the functions of the organs of digestion, circulation and respiration; for, if the mind dwells upon these organic functions, their normal automatic action is disturbed, discomfort and pain result, which reacting back upon consciousness, add to the mental apprehension and a vicious circle is soon established. Dr. F. W. Mott.

SUGAR A NON-ESSENTIAL

The N. Y. M. J. (10, 11, '19), editorially, recalls the fact that before man turned to agriculture the sole source of sugar was wild honey-a very limited supply of which was available at any time. As late as the days of Queen Elizabeth sugar was little more than a curiosity in England, but the per capita consumption of sugar in Great Britain in 1914 was estimated at about forty-eight pounds, while the U. S. consumed about seventy-five pounds annually for each member of its population.

It is true, sugar is a food in a most concentrated and palatable form, and for this reason it is a valuable food for persons doing heavy manual labor, tho they are the ones who get relatively less than their share. The consumption of candy, which has grown enormously of late years, is fraught with danger, mainly from two viewpoints. First, that it is eaten between meals and tends to prevent the use of a normal amount of the ordinary foods at the regular meal time. The other danger is that when eaten between meals it clings to the teeth and is likely to cause fermentation, producing an unhealthy condition of the gums. While it would be extremely inconvenient to have to forego the use of sugar in coffee or tea, sugar is by no means a necessity and the health of the community would probably be improved by a sugar shortage rather than undermined.

THE NEURASTHENIC HYSTERICAL WOMAN

Dr. Mayer Shoyer (Med. Council, Oct., 1919) suggests that there is a disease partaking both of hysteria and neurasthenia, but whose course is milder than the severe grades of hysteria or neurasthenia. It may be that in the etiology, heredity plays a part, but environment is a prominent factor, such as the steady grind and lack of recreation of the woman who lives on the farm, and luxurious living among certain classes of society. Among the symptoms there is a depression, physical exhaustion, irritability, discontent, headaches, palpitation of the heart, constipation. In neurasthenic hys

teria one must be careful not to overlook some basic organic lesion; every organ is to be investigated; sometimes a corrected eyestrain simplifies treatment. Prophylaxis is of importance. A child with a neurotic tendency should have her physical and mental forces conserved. The young mother should be taught how to care for herself.

Hydrotherapy is to be recommended. In the morning before rising the spinal pad (a folded bath towel) is wet with cold water and applied for five or ten minutes. This is followed by massage and friction of the muscles.

Electro-therapeutic treatment is useful if only for its psychic effects. Mental therapeutics is useful and should be used persistently. Many patients are greatly benefited by absolute rest in bed, with a trained nurse in attendance and isolation from solicitous friends.

Treatment with drugs has its place. For the physical exhaustion one may prescribe the glycerophosphates, or a combination of tr. of nux vomica, acid hydrochl. dil. in the elixir of calisaya, or lecithin to stimulate metabolism. There is no harm in the limited use of the bromides alone or in combination with valerian or asafetida. If insomnia is present, it is easily controlled with chloretone, grs. 10 to 15, at bedtime in capsules or wafer. If the hysterical element is pronounced, benzyl benzoate is worthy of trial.

All patients with neurasthenic hysteria should have the eyes examined by a competent ophthalmologist.

REMOVAL OF FOREIGN BODIES FROM THE BLADDER BY THE NATURAL ROUTE

Dr. George Luys recommends the direct vision cystoscope for the rapid and effectual removal of foreign bodies from the bladder.

He describes the case of a woman, aged 26, who had allowed a hairpin to enter her bladder. The "accident" had taken place nine days previously. Since then she had frequent, difficult, painful urination. On introducing the direct vision cystoscope the pin was seen occupying the classical transverse position. The object was brought into the anteroposterior position and then extraction was easy and painless. It was a fork-shaped celluloid hairpin, 71⁄2 centimeters long, and already incrustated at the points. The patient was able to take the train for her home that evening.

A girl, aged sixteen, with symptoms of acute cystitis. attributed her trouble to overwork in the factory but finally admitted that some time previously she had permitted a wire hairpin to enter her bladder. By the aid of the direct vision cystoscope the object was readily discovered and removed. [Poor women. People would be astonished if they knew how often a hair-pin is found in a girl's bladder.-W. J. R.J