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The Medical World

The knowledge that a man can use is the only real knowledge; the only knowledge that has
life and growth in it and converts itself into practical power. The rest hangs
like dust about the brain, or dries like raindrops off the stones.-FROUDE.

The Medical World go intestinal antisepsis, and the treatment

C. F. TAYLOR, M. D.

Editor and Publisher

Subscription to any part of the United States and Canada ONE DOLLAR per year. To England and the British Colonies, FIVE SHILLINGS per year. Postage free. Single copies, TEN CENTS. These rates must be paid invariably in advance.

We cannot always supply back numbers. Should a number

is complete and uniformly successful. Keeping these general principles in mind, treatment of these formerly perplexing cases is not only easy, but it would be hard to go astray. The first step is, no food at all until better, then nature's food, the mother's milk if the child is nursing, the mother being in proper condition, or good, wholesome milk or milk food. The second step is probably best achieved

fail to reach a subscriber, we will supply another, if noti- by castor oil, and slightly antisepticised

fied before the end of the month.

Pay no money to agents for the journal unless publisher's

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ADDRESS ALL COMMUNICATIONS TO

"THE MEDICAL WORLD,"

1520 Chestnut Street

PHILADELPHIA, PA.

VOL. XVII. SEPTEMBER, 1899.

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No. 9.

The Dread of Summer Mitigated. Only a few years ago summer complaint" among the children was the dread both of parents and physicians. It doesn't seem to be so now. How is it with you in your practice? Intelligent care as to the diet, and proper correction of the same when necessary, combined with gentle intestinal drainage and intestinal antisepsis, have workt wonders among the children. This is simple, isn't it? Most things are simple after we learn A diseased intestinal tract should first have rest. No food should be put into it until it is put in a condition for the reception of food. Next, it should be drained of poisonous matters which irritate locally and poison the general system when absorbed. Along with this should

but large injections high up into the colon. The third step has been fully discust in these columns in the past few years. Perhaps the sulfocarbolates are the best intestinal antiseptics. Have not the discussions in these columns done much to supplant frequent failure by uniform success in these cases? Write your notes now on your experience during the season just passing, and send them to us next May for publication; or send them to us now and we will keep them till next May.

The Culprit Has Been Found. It is reported that the following cablegram has been received at Liverpool, from Major Ross, the head of the malarial expedition sent out by the Liverpool School of Tropical Diseases: "The malarial mosquito has been found."

The Major went out to West Africa on the theory that malaria is disseminated. by the swamp frequenting mosquito. The cablegram comes from Sierra Leone.

The British Government will be askt to send a scientific force to work in conjunction with Major Ross.

This is "important if true." The causes of malaria, like the remedies for

it, are so numerous that we will be slow to put our confidence in one alone, until it is proven very conclusively. If this interesting bird, the "malarial mosquito," could be caged, it would be a stronger attraction than Barnum's white elephant. Torpedo boats are called the "wasps of the navy." They make necessary a special naval craft, the torpedo-boat destroyers. When we learn to recognize the malarial mosquito, there will be a very great demand for a malarial mosquito destroyer. We will anxiously await further news concerning the "varmint."

A National Medical Law Needed. It now requires much more time, labor and money to fit one's self for entrance into the profession than formerly. If we look back ten years we find quite a difference; if we look back twenty years, the difference is much greater. Then a majority of the states had no medical law at all. Those that did only required a diploma from some medical college, and the requirements of medical colleges were not scrutinized by the officers of said states. As early as the early eighties we advocated vigorously and repeatedly, that a diploma from a medical college should not carry with it the right to practice. The arguments were apparent. Colleges are private teaching institutions; therefore, they should not at the same time be public licensing institutions. The incentive for colleges to license as many students as possible, for profit, should not exist. It is much better that the teaching institution and the licensing institution be entirely separate. Then the colleges that do the best teaching (their true sphere), will receive the most patronage, as they should.

These arguments, made years ago in these columns, are now pretty generally accepted and realized. The state boards do the examining and licensing.

A still further step we have advocated, and hope some time to see realized. It is a great inconvenience for a physician who

wishes to move into another state to again undergo examination, and it is also a great inconvenience for those who live near the borders of states, and also to consultants or operators who may be called into adjoining states. The liberties of American citizens should not have to be readjusted at each State boundary. The flag should mean equal liberty to all wherever "Old Glory" floats. We should spell Nation with a capital N. This means that we should have a National medical law, and a National board or boards of examiners, and a license from such a body should give the right to practice medicine anywhere under the stars and stripes.

Don't Get Rusty.

We have made it a special point to present from time to time, the examination questions askt by various state examining boards. In this issue are those of two leading states. The Association of Medical Examining Boards, which meets annually to compare notes and experiences, with a view to establishing a uniformity of requirements, is performing a very important function. We hope that it is paving the way for a National Board of Examiners, whose certificate will give the right to practise any place under our flag.

These questions will give prospective medical students an idea of what will be required of them. But our chief object in presenting them is that they may serve as a text to inspire older practitioners to beware of becoming "rusty." A medical man should be a student always. The older students should keep up with the young students. The questions publisht in this issue could serve as the text for an entire winter's study. We have known some doctors in small towns to be loafers a large part of their time. Frequently the nearest drug store is the favorite loafing place. Let these realize what they do not know by reading these questions. This may make them ashamed to waste any more time in loafing.

However, a better way is to lay out a

course of reading for every winter. Take up a certain line of thought and master it before you leave it. Thus you will gradually acquire a leadership in your community. Dr. J. G. Holland used to say that the manner in which a young professional man used the first ten years of his professional life determined the degree of his success or failure. But this does not apply only to young men and beginners. Those who may have been wasting precious time can yet redeem themselves by settling down to close, systematic study, and they will soon see this in the firmer grasp they will have on the principles and practice of medicine. The best teachers are not the instructors, but the inspirers. If we could inspire every practitioner who reads these columns to become a close, systematic student, the instruction would take care of itself-as we were told in our school days, "take care of the minutes and the hours will take care of themselves; and "take care of the cents and the dollars will take care of themselves."

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ORIGINAL COMMUNICATIONS

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Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors.

Copy must be received on or before the twelfth of the month for publication in the next month. Unused manuscript cannot be returned.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.-RUSKIN. RECORD,

READ.

REFLECT.

COMPARE.

Medical Reminiscences.
No. 1

MY FIRST PRESCRIPTION.

Editor MEDICAL WORLD:-My first prescription was not a very complicated one knowledge to write it or skill to compound nor did it call for a great amount of it. It spite of its simplicity, however, it caused me much mental anxiety and trepidation.

It was not my first case. I had been giving medical advice and consolation, sometimes with and sometimes without medicine, for some months, in a charitable institution, under my father's watchful supervision.

I had fitted up a small dispensary there and dispensed all kinds of concoctions, the more bitter and nauseating, I soon found the better. It was this way; the women were mostly from the courts and on probation; that is sufficient description of the character of their mind and body. I soon found that advice wasn't appreciated, unless medicine went with it and pills didn't count as medicine.

These probationers wanted something something bitter and in large quantities, to drink, whisky if they could get it, but anyway, something that would leave a lingering taste in the mouth and be filling.

That experience was very useful to me in later practice; when I was called to a patient, of poor but honest means, I knew I would make more of an impression in regard to the appreciation of my talents,as a doctor, if I gave the bitterest medicine possible in the largest amount of liquid menstrum, for such people judge of the efficacy of medicine, to a great degree, by the material taste. Spiced syrups and elixirs and wines don't appeal to their taste, for if they taste good they think they have no medicinal power.

My first prescription, to return to the subject, called for a powder of bromid of soda and pepsin with a dash of Dover's powder. I have forgotten the proportions, but they were small enuf to do no harm, and as I look at it to-day, no good either. Besides it made rather a messy powder that didn't keep very well, as the bromid of soda absorbed water and made a paste.

After I had duly imprest the family with my prescription writing ability I went home to consider. As my bump of caution is rather large, I began to doubt my knowledge of things in general and of prescription-writing in particular. I began to think I might have written ten ounces of Dover's powder instead of grains and I pictured to myself the "poppy" sleep of the little one for whom I had written it.

Then I imagined a funeral, and latter an inquiry, and then the dock, and then a blasted name and a long sojourn in a little room with a grated door and no conveni

ences.

As I lookt around at my cosily fitted office I thought it would be a good idea to stop the prescription in transit. I hunted I hunted around in the closets and found a sample bottle of some fluid preparation of pepsin, and with that in my hand I hastened to my own rescue,

I have forgotten what excuse I made for substituting on my own prescription, but altho it was doubtless a lame one, it past. Altho my doubts said to myself that the child had probably taken a dose, my hope encouraged me to trust that he had not, and hope was right.

I wrote that prescription on a blank kindly furnisht me by a druggist. The covers were of sealskin and the perforated blanks were beautifully printed with my name at the bottom in small type and the kind druggist's name in somewhat larger letters at the top. That saved me.

The father of the family went about three miles to that drug store because he thought that was the only place he could have the prescription filled. As he was poor, he walked, and ere he had covered the six miles I was at hand to welcome him home.

That episode was an eye-opener, for I found at the send-off that prescription blanks with the druggist's name at the head were of some value to the druggist, and I considered that he had probably more than made up for the cost of the pretty book on that one prescription.

Incidentally, it pleased me to think that the man had gone to the aforesaid druggist, as that druggist had put up my father's first prescription, some thirty odd years before.

After all, I came out with flying colors with my first prescription, and had many a laugh afterwards with my father and the druggist and my friends who had also written first prescriptions and who had worried more or less over them.

The "old man," the father of the little child, who didn't take my first prescription, had a jumping toothache when I made my first call, and as I had some crystals of chloral in my case I put one into the hollow of the tooth and stuffed some cotton over it. That was a lucky hit of mine and there was nothing too good for me in that family afterward.

The old man's gratitude gave me a pointer, and altho I didn't need mercenary prompting to take an interest in all suffering, I gave my helpful advice with added encouragement, and I have always found that it pays to make friends with the grandmother and pat the baby on the head and treat all generations between with becoming and heartfelt sympathy, and it even pays to say "How do you do?" to the cook and the chambermaid.

The old man was poor, but his gratitude was abounding; and thru him I was recommended to his employer, who was a sufferer from dyspepsia, and every one knows what kind of a trouble that is to treat. You can put that man's name on your first page the first day of January as a New Year's offering, and it will be on the last page the thirty-first of December, and every day in the year between.

After my experience with my first prescription, I got my father to write out a series of about fifty sets of symptoms. These were such as would be met with in daily practice, but were not named. I pasted these in a book, and having diagnosed the disease, I wrote several prescriptions opposite each to meet the requirements in each. Then I had my father criticise them and find all the faults he could. Then before I knew it I was an expert prescription writer. I could write them as easily as I could say my letters or the multiplication table. To tell the truth, I had learned many of them by heart, just like the alphabet.

Before I had completed my education. in the prescription line I wrote my second real kill or cure prescription. It was for

a girl about 17 years of age who had the summer complaint. I had a prescription that I workt out in college that I thought was strong enuf to tie up the east wind.

I learned a lesson from that, too. The directions said, take as required; but the girl didn't consider the requirements of any account. She kept at it until she

had taken four ounces of the mixture at intervals of three hours, and even got up in the night to avoid skipping a dose. Her zeal was commendable, but the result was annoying.

This girl was not an inmate of the Home, but I had gone to see her at the suggestion of the Matron, it being the custom at that time to attend to those who were worthy and had any claim on the Home thru having relatives or friends there.

The Matron told me one morning that she thought I ought to call on Annie S., as she had got over the summer complaint and was suffering badly from the opposite condition. I did call and wrote no prescription. I furnisht her with heroic doses of all the cathartics and purgatives that I could think of with no effect, but finally a liberal draught from the spiced syrup of rhubarb bottle did the work, and Annie resumed her wonted good health and normal functions.

That taught me another lesson-never to write for large quantities of a medicine to be taken as required. When I wrote the prescription I told Annie she could keep what remained for time of need, but Annie thought it was too good to keep, with the results just described.

Doubtless many other physicians have had amusing experiences in their early days, and many have had amusing experiences with prescriptions in later days.

My father had a prescription for a face lotion which was very good to remove sun burn and whiten the skin. During summer or winter vacations he would occasionally give this to some young lady at a hotel. He gave it to a young lady in Florida one day, and heard from it that night about the time when church yards yawn.

This young lady's father was under my father's care and took a dose of medicine every night just before retiring. Mabel, as she may be called for convenience, had obtained the face wash and her father took a dose by mistake. The taste betrayed the mistake, and he ran across the corridor to my room to get an antidote, but

nothing was needed beyond mental encouragement and soothing words of reassurance. The face wash contained sulfur, glycerin and rose water, and needless to say, was not dangerous but simply a little cathartic.

In still another case that prescription played a very important part. On the face of my father's prescription blanks was the caution to the druggist against refilling the same. refilling the same. A certain druggist put up the prescription for a lady once. Some months later, when my father was not at home, the druggist came to me and said that Mrs. Blank was making a great ado because he wouldn't give her a copy of the prescription.

A few hours later Mrs. Blank came to me herself, and after maligning the druggist, askt me for a copy, and she took me so by surprise that I gave it to her.

A few days later a druggist in another part of the town said: "Mrs. Blank had quite a quantity of that face lotion of yours put up yesterday."

"Is that so?" said I. "Yes, it is," said he. "How much?" said I. "Five gallons," said he. "Good Lord!" said I. "what is she going to do with it?" "Sell it, I guess," said he, sentitiously. "What makes you think so?" said I. "Because," said he, "she wanted to know where she could buy four-ounce bottles by wholesale, and she wanted to know where she could get labels printed cheaply. I recommended her to go to Typo's." I went to Typo's, too, and there I saw the rise, if not the progress, of a patent medicine. Typo was printing some beautiful labels with a full-length figure of Venus adorning them, and he was preparing a lurid circular, and told me that when the paper came out for that week it would have an advertisement in it. in it. Sure enuf, the advertisement duly appeared, and Mrs. Blank's face lotion was launched on the market.

There's the history of many a patent medicine in that, for many people think they can do what they please with a doctor's prescription when they get hold of it, and if they can cheat the doctor, so much the better.

Of course, all these stories about prescriptions (which are true) have their morals, but you will be obliged to pick those out yourself. I could tell a number of tales about the adventures and misadventures of numerous other prescriptions, but they and the morals will have to wait while some one else takes up the thread of

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