have formally withdrawn their endorsement in a published letter.

CEREBRO-SPINAL MENINGITIS is prevalent in New York city and in some parts of Connecticut. Dr. Darlington, president of the Board of Health of New York city, has asked the Board of Estimates for means to organize a commission to investigate the disease. The disease has also appeared in Philadelphia, claiming among its victims Dr. Albert B. Craig, who became infected in the line of professional duty. Dr. Craig was a very promising young surgeon and one of the assistant editors of American Medicine.

DR. I. H. GARDINER of Baltimore is under bail in the amount of $10,000, charged with performing a criminal operation on Edna L. Lappe on February 7. The young woman was subsequently attacked by pneumonia and died of that disease on March 3 at the City Hospital. The arrest was made on complaint of the girl's mother, who stated that while critically ill her daughter confessed, in the presence of her mother and a priest, that she had been operated on by Dr. Gardiner. Dr. Gardiner had himself given a history of the case to the hospital physicians, including the statement that he had removed a fetus.

DR. RUSSELL MURDOCH died suddenly at Johns Hopkins Hospital, Baltimore, on Sunday, March 19. Dr. Murdoch suffered an apoplectic stroke just after completing an operation at the Baltimore Eye, Ear and Throat Hospital, and was taken at once to Johns Hopkins Hospital, where he died. Dr. Murdoch was born in Baltimore in 1839. He was educated in the University of Edinburgh, Scotland, leaving there in 1859. He graduated in medicine at the University of Virginia in 1861. He served as a surgeon in the Confederate army from 1862 to 1865. After the war he studied diseases of the eye and ear in Europe. Returning to this country in 1868, he became a lecturer on diseases of the eye and ear at the University of Maryland. Later he became professor of ophthalmology and otology in the Woman's Medical College, Baltimore. He was a founder of the Baltimore, Eye, Ear and Throat Hospital on West Franklin street. Four daughters survive him, one of them a practicing physician, another a student of medicine.

THE Maryland Association for the Prevention and Relief of Tuberculosis had a meeting on March 13 at McCoy Hall, Johns Hopkins University. Dr. Lawrence Flick, director of the Phipps Institute, delivered an address on the value of the hospital and the dispensary in the restriction of tuberculosis. Dr. Henry M. Hurd and Dr. Henry Barton Jacobs also made addresses. A number of popular lectures were given during the month in various parts of the city under the auspices of the association. The committee on lectures, under the chairmanship of Rev. Donald Guthrie, has organized a considerable corps of workers who will receive assignments wherever a local demand is found for such lectures. Of the 10 or 12 lectures given in March, that most largely attended was given by Dr. MacCallum to the congregation of Rev. Mr. Huber. Pastor Huber is deeply interested in the subject and has aroused a like interest in his congregation. The church was full to overflowing on the night of Dr. MacCallum's lecture.

THE State Board of Health has distributed to the physicians of Maryland instructions concerning the registration of tuberculosis. The recent law on the subject makes it incumbent upon physicians attending cases of tuberculosis to advise other members of the household concerning the prophylaxis of the disease. The State Board of Health is required to furnish sputum cups and other necessary supplies, with printed instructions, on the requisition of physicians. The local boards of health act as distributing agents and pass upon the claims of physicians for services rendered under the terms of the act. For delivering the supplies and giving a demonstration of their use, with a written account of the precautions taken and advised, the physician is entitled to a fee of $1.50. Blank forms concerning all necessary inquiries are furnished. These are so worded that they can be answered by one word, "yes" or "no," thus reducing the necessary writing to the smallest practical limits. If a physician does not desire to give the practical instruction required he may call upon the Board of Health to perform that duty. It has been a task of great difficulty to prepare for this work, a very small maximum cost for supplies being necessitated by the appropriation. Such advantages as were anticipated in the purchase of materials in large quantities were not realized when the board went into the market.

Editorial Comment.

THE ENFORCEMENT OF ANTISPITTING LAWS.

The Journal.

IN several parts of the country within the last two or three weeks there has been a salutary revival of the crusade against the spitting nuisance. That there has been need of such a move needs no argument, but its occurrence is good evidence of the educational work that has been done within the last two or three years. Before that time prosecutions for this offense were often thrown out of court, and it was practically recognized as one of the rights of the citizen that he might spit when and where he pleased. Now, while the victims of arrest express some indignation, they are, nevertheless, promptly fined, and the public generally is in accord with the authorities on this subject. Necessarily the enforcement of the law is likely to be more or less spasmodic, but its necessity will diminish with each raid on the spitters in public places. Many of them are merely thoughtless, and an occasional reminder that it may be unsafe is sufficient to break the habit, even if it is only when reading the police-court records in the daily press. Others may be more obstinate, but an occasional arrest or fine will go a long way toward inducing reform in manners and morals. As long as only spitting on the sidewalks and in public conveyances, etc., is attacked, there is no great hardship. If a person needs to spit he can go to the curb and spit in the roadway. Of course, this is not the sanitary ideal, but it is at least a long step in advance toward better things. Let the good work go on.

MEDICAL MEN AND SANITARY
SCIENCE.

Medical Standard.

To WHAT extent should the general practitioner be familiar with this subject?

The highest aim of modern medicine is the prevention of disease and the prevention and checking of threatening epidemics. To achieve this the physician must be familiar with all phases of hygiene, an important part of which is sanitary science as applied to the construction of dwellings and public buildings, water supply, disposal of sewage and other refuse.

In the large cities, of course, we have expert engineers, architects and sanitary specialists, who are called upon by the municipal authorities when public buildings are to be constructed or reconstructed.

But it often happens in the course of events that the family physician is called upon by his

.patrons to give his opinion upon points of sanitary science as applied to the home of his patient. Frequently recurring attacks of various infectious disease arouse the suspicions of a family, and they naturally turn for advice to their tried friend, the family physician. Be he ever so skilled in the treatment of disease and conscientious in his attendance when called, he will surely lose a good deal of the confidence placed in him if he is unable to explain causes and suggest remedies. It is therefore essential that he be posted on the most important points-such as conditions of soil, construction of substructure, ventilation, system of heating, distribution of light, plumbing, etc. The children may come home from school and complain of headaches, pain in the eyes, defects of vision, pain in the back. They may present themselves in a stooping position, with one shoulder sloping below its fellow, or even a marked degree of scoliosis. He should then be able intelligently to investigate the sanitary conditions of the school as to lighting, ventilation and construction of seats and desks.

He may be chosen by his fellow-citizens or the head of the municipal government to membership of the school board or as a commissioner of hospitals and other charitable institutions. If he is posted on the subject under consideration he will then not only render good service to the community, but reflect credit upon himself and the profession.

DEMENTIA PRECOX.

Medicine.

THE European psychiatrical world has been devoting much attention of recent years to precocious dementia. So much has this been the case that in certain psychiatrical clinics dementia precox has been erected into a cult. Conolly Norman in a recent article before the British Medical Association draws some excellent conclusions. This he is the better able to do, as the work of Kraepelin has not attracted the attention in England which it has upon the Continent. He pays a just tribute to Kraepelin's genius, but significantly calls attention to the fact that his disciples have extended his doctrine of dementia to an unwarranted extent. He does not propose to wipe out katatonia and hebephrenia, though some of his followers do. The original conception of dementia precox as a useful clinical group characterized by dementia, but having widely varying clinical characteristics, is a practically useful conception, and can be accepted even if one admits or denies the existence of dementia precox as a primary affection.

Excerpts.

PROFESSION AND PUBLIC.

THE statement has been made that physicians do more gratuitous work than any of the professional classes, and most of this work has been along the line of preventive medicine, but, unfortunately, their efforts to guard the public against pestilence, fraud, quackery and the patent-medicine habit have not been received in the spirit in which it was intended. Since the time when medical history was made a subject for even a partial record the doctor has been the most jealous guardian over the health of the community in which he dwelled, and most advances in the science of medicine which bid fair to be of some benefit to the public have had to be enforced by laws to make the public conform to certain restrictions or safeguards. During ancient times that good old physician, Moses, formulated many laws and hygienic measures, which it was found necessary to be made a part of the Jewish religion in order to make their enforcement easier. When Jenner, one of the greatest benefactors mankind ever had, first practiced vaccination he was mobbed and almost lost his life.

As we come down to more modern times all advances in medical or surgical science have been the subject of warm debates even among the physicians themselves; and we find today, were it not for laws to compel sanitation, it would be impossible to even attempt any control of the spread of contagious diseases. It seems a blot upon the history of the world that in this, the twentieth century, we should have a dissenting voice against vaccination and many other prophylactic measures; the lay press frequently gives expression to some of the antivaccinationists against this most valuable measure, when the facts of its scientific value are as evident as the utility of electricity or steam.-Dr. F. C. E. Mattison.

PREVENTION.

CLEARLY it is a poor, primitive, ineffective measure to wait until tuberculosis has fastened itself upon a man before we are privileged to institute measures to check it. It is a benighted land where we must drink polluted water till our best and dearest acquire typhoid fever before we are permitted to put out the hand to exterminate the destroyer at its source. It is a poor-spirited community; those are criminal officials who permit smallpox to progress unchecked at our very doors.

Preventive medicine occupies the best attention of the brighest minds in the professior. The fear is often expressed that when the fullness of light is shed on the means of controlling and preventing disease then the day of the general practitioner must cease-his occupation will be gone. This may be true, but that day is far distant, if ever attainable.

Meanwhile it must be evidence that the function of mere alleviation of human suffering 15 only a part, and an insignificant part, of the prerogatives of the medical expert. Our teaching> are, in the main, on a wrong basis. Worse than this, many of the customs of the community toward us are false, misleading, unfair. For one thing, the calling on the practitioner only to aid those actually suffering from disabilities is altogether wrong-it is based on a wrong corcept of our duties, our prerogatives, our usefulness. It will soon be recognized that preventable diseases deprive us of an utterly unwarrantable portion of our best brains and hands.— J. Madison Taylor, M.D.

LABORATORY SCIENCE.

It is the patient and all the phenomena of his individual case with which the practical physician has to deal, and the hope of future advance in human medicine rests upon the study of every agency by means of which the normal balance of the disturbed forces within the organism may be restored. The time has passed when drugs were the sole reliance in the sickroom, but despite the alleged disbelief in their curative effects, they remain among our most indispensable resources. The incompleteness of our knowledge concerning them is surprising, and, in view of the centuries during which so many have been in common use, little short of disgraceful to a profession calling itself scientific, more especially since their effects could have been fully studied by accurate provings and clinical tests before the laboratory How little of practical value this has added to our knowledge of drug effect is seen at once on opening any of the most modern works on pharmacology, despite its contribu tions to pathology.

era.

As we recognize pathology to be the handmaid of therapeutics, so laboratory science can never be more than an humble helper in the household of medicine. If she ventures to as sume the airs of a mistress she must be rele gated at once to her pots and kettles, where alone she can do useful work.-The New Eng-t land Medical Gazette.