*Shall the Specialist Divide the Fee with the
General Practitioner?

By Emery Lanphear, M. D., Ph. D., L.L. D., St. Louis, Mo. (Formerly Professor of Surgery in the Kansas City Medical College and the St Louis College of Physicians and Surgeons; Gynecologist to

St. Joseph's Sanitarium, St. Louis.)

When an attorney in a county-seat has a client in danger of the penitentiary, and hence in need of the very best counsel, it is customary for him to seek some eminent lawyer of a great city and request his aid. In so doing does he approach the distinguished gentleman and say: "I have a client accused of who is able to pay $3,000 for his acquittal, will you take the case with me for this sum-leaving me the gratification of having done my professional duty ?" By no means! He plainly states: "My patron has $3,000 to spend for his defense; are you willing to take $2,000 of this to join me in securing justice for him ?"

Arrangements of this kind are daily made in every large city. Does anyone ever suggest that the country attorney has been doing a dishonorable act in thus securing his city brother to do the major part of the work for $2,000, he retaining $1,000 for his services? Would a doctor, sued for $100,000, regard such a transaction as disgraceful, unethical, objectionable, if thereby he were saved this sum ?

But let the question be one of saving life instead of securing liberty or preventing financial loss, and how different it is!

If a country doctor have a patient with recurrent appendicitis (upon whom he might operate with success, but fears possible failure) with a prospective fee of $600 must he, in order to be "ethical," write to some city surgeon to come to his help, take all of the $600 and leave him merely the satisfaction of a duty well performed, or possibly pay for a few visits at starvation rates? "Upon what meat doth this our Ceasar feed that he hath grown so great ?"

Why should not the country doctor plainly say to the city

*Extract from paper read at the Missouri State Medical Association, May, 1900.

specialist: "I have a patient with appendicitis who is able to pay $600. Will you operate for $400 and leave me $200 for preparation, after-treatment, etc.?" What would be wrong about this?

Let Drs. Robt. T. Morris, of New York, and Burnside Foster, of St. Paul, who so vigorously maintain that division of the fee is unethical under any and all circumstances, point out what injustice would thereby be done to (a) the patient, (b) the attending physicians, and (c) the eminent surgeon. Why should we not learn a few things from the methods of our most noted lawyers, men who are above suspicion as to unethical conduct? Have we not hitherto been too unmindful of the financial interests of ourselves and our professional brothers?

I maintain that the payment of a "commission" for all business simply "referred" to a specialist, or for mere consultations, is probably unethical-certainly demoralizing in tendency; but that division of the fee is perfectly honorable and right when the specialist and the general practitioner jointly share the work and the responsibility.

[Dr. Lanphear's presentation of this question will, we think, appeal to the judgment of nearly every member of the profession, as being entirely just and ethical. There is no good reason why transactions of the kind mentioned should not be as clearly ethical among doctors as they are with lawyers. In fact it seems to us to be the only proper way to adjust such matters between cooperating doctors and surgeons. It is fair to the patient; a straight business transaction, and has in it nothing that smacks of the commission.-Ed.]

Railroad Rates to The American Institute.

Every Homeopath should go to the Institute this year and help do honor to Hahnemann when his monument is dedicated. The railroads have granted a rate of one fare and a third on the certificate plan. To take advantage of this rate you must buy a ticket through to Washington, paying for it a full fare, and

be sure to get a certificate showing that the ticket was bought for this meeting. If the agent in your town does not have such certificates, buy to the nearest point at which they may be obtained. A simple receipt will not answer.

When you get to Washington take these certificates to Dr. David A. Strickler, who will see that they are properly signed and vised when they will entitle you to a return ticket over the same route at one-third fare.

These tickets will be on sale in the Trunk Line territory June 17th to 21st. Further west early enough to meet these dates.

They are good for continuous passage, returning, starting from Washington June 21st to 27th inclusive.

In purchasing tickets, ask your agent about the rates and return privileges to the Philadelphia Republican Convention. For any further information, inquire of

DR. DAVID A. STRICKLER,

Chairman Transportation Com.

Chilblains.

Practitioner asks for hints in the treatment of chilblains.

In the "British Medical Journal" it was reported that Professor Baelz, writing from Japan, recommended the following treatment for chilblains and chapped hands:

R. Caustic potash, 1⁄2 per cent.; glycerine and alcohol, of each 20 per cent.; water, 60 per cent. The hands are bathed in warm water, and this mixture is then rubbed into the skin. This is done once daily, and in two or three days a cure is said to result. Surgeon W. G. Macpherson also wrote:

The effect of the application of ichthyol to chilblains is so marked as to deserve notice. The unguentum ichthyol (30 per cent., with lanolin or vaseline) relieves the excessive irritation completely and rapidly, and its continued use will cure the condition.-Exchange.

Notes and Personals.

Dr. David A. Strickler, who attended the Nebraska State Society meeting, May 15 and 16, informs us that the meeting this year was exceptionally good: that the attendance was large and everything indicated that homeopathy is flourishing in all parts of Nebraska.

Dr. J. W. Mastin has just returned from a hurried journey to Shannon, Illinois, where he was called to attend the funeral of his mother.

Dr. S. S. Smythe will leave Denver about June 10 for a visit to some of the Eastern hospitals and to attend the meeting of the American Institute of Homeopathy and of the American Homeopathic Society of Surgeons and Gynecologists, to be held in Washington, D. C., June 17 to 21.

The Cleveland "Homeopathic Reporter," edited by J. Richey Horner, M. D., is the latest journalistic venture. It is published in the interest of the Cleveland Medical College, and the first number is a very creditable one.

Dr. J. T. Coombs, Superintendent of the Fulton Insane Asylum, Missouri, has resigned, and Dr. W. D. Ray has been elected superintendent. This change is supposed to settle an old trouble and the Asylum will continue to make its usual good showing for homeopathy.

Through the generosity of Mrs. Charles N. Whitman, Denver is to have a new homeopathic hospital for women in the near future. Thus are we building monuments to Hahnemann and Homeopathy over all this broad land,

The antitoxin serum of Parke Davis & Co. is undoubtedly the most reliable preparation now on the market. Among our professional friends who use antitoxin in diphtheria this opinion prevails without exception, and is evidently based upon comparative tests with other serums.

The editorial offices of the "Pacific Coast Journal of Homeopathy" have been changed from San Diego, Cal., to 330 Sutter St., San Francisco, Cal. Exchanges, books for review, and all communications intended for the editor of the Journal should be addressed as above.

THE CRITIQUE wishes to correct the statement made in its last issue, announcing that the meeting of the Surgical and Gyneco

logical Association of the A. I. H. begins June 19. It should have been June 18, at the Arlington.

Dr. Clinton Enos has been appointed captain of Company C, First Infantry, stationed at Brighton, to fill a vacancy which has existed for some time.

Dr. H. T. Cooper, of Colorado Springs, relates a very remarkable case, that of attending a case of confinement, when the mother had six children all down with scarlet fever. She kept up and waited upon them until labor actually commenced. After she got up from her confinement she resumed the care of them. There were no complications whatever in the case, the mother making the usual recovery. None of the cases left the house, and one of the children with the fever occupied the bed with her during labor and following the birth of the baby.

Will all who have not used Stearns' Aromatic Cascara please make their wants known, and in doing so mention THE CRITIQUE and their wants will be supplied from Frederick Stearns & Co., Detroit, Mich. It is pleasant to take, gratifying in its action upon liver and bowels. After having got the stomach in good condition, take wine of Cod Liver Oil, and you have a combination that wins.

We are informed that charges have been preferred, in the Board of Directors, against Dr. B. A. Wheeler, for unprofessional conduct. "Good things will happen."

At the Faculty meeting of the D. H. C. & H. Association, held Saturday, May 26, a resolution was passed recommending to the Board of Directors that Dr. B. A. Wheeler be removed from the professorship of Mental and Nervous Diseases. The matter of Dr. J. C. Irvine's professorship was referred to the Dean and Registrar, who have since recommended to the directors that he be suspended from his professorship for one year. Both recommendations were adopted.

Dr. C. E. Tennant has removed his residence to 1155 Vine St., to a new and commodious house in one of the best localities in the city.

Dr. Margaret Beeler, formerly interne at the Homeopathic Hospital, has located at 1422 North Tejon St, Colorado Springs.

Dr. J. Wylie Anderson is building an eight-room summer cottage at Indian Creek Park, where a company of twenty families have over 1300 acres of land. The park is situated at the foot of Mount Evans in Clear Creek County, thirty-five miles from Denver up Bear Creek Cañon. The company have just finished a