such a tax did not afford sufficient revenue, let it be extended to proprietary medicins made in this country. But first tax the foreign-made products whose monopolistic makers want access to our markets. If the markets are good, let hem pay for the privilege; let them pay for the protection this government gives; let them pay a small portion of the immense profits extorted from the American drug trade, to help pay the expense of this protection that they receive. But they go free under this wisely (?) planned law of ours.-The New Idea.

Current Medical Thought.

Local Anesthesia.

It is strange that the profession pays so little attention to local anesthesia. So long as the element of danger from the anesthetic alone is so great, in general anesthesia, this indifference is not justifiable. Prof. H. C. Wood tells his classes: "Remember, gentlemen, every time you induce general anesthesia, you take your patient into the very valley of the shadows of death." Nevertheless, we seem to be more interested in the discussion of the respec ́tive merits of chloroform, ether, and A. C. E., than in learning to be independent of any of them. Even so grave operations as major amputations and laparotomies have been successfully performed under local anesthesia, and we are convinced that too often general anesthesia, with its attendant Adangers, is chosen to the exclusion of the local method.

The arguments most often used against the local anesthetic, i. e., "bad moral effect" and "added shock" seem hardly to have been borne out in the experiments thus far recorded. One of the most horrifying experiences anyone can undergo is to feel himself slipping slowly away from consciousness. Aside from the danger (not great, it is true, but undeniably present) in general anesthesia, is it not something to save the patient from the horror of the primary stage, and the usual distressing nausea following the operation?

It is not rational to expose a patient to the dangers of general anesthesia in order that a felon may be lanced painlessly, when we have such agents as cocain, eucain, and ethyl chlorid. The readiness of the laity to submit to general anesthesia on the slightest provocation is due to ignorance of the dangers involved. of us appreciate the gravity of administering a general anesthetic, but thru custom have grown callous, and fail either to state facts to the patient, or to provide the recognized agents for emergencies. How com

Most

mon the expression, "It will not hurt you; I will give you just a little whiff of chloroform (or ether)." We believe that many of us are guilty of indifference, to say the least, on this important matter.

[An elaborate article on local anesthesia, prepared expressly for THE World, will appear in next issue.-ED.]

Dont's for the Treatment of Pneumonia. Don't believe that acute pneumonia is a self-limited disease and will get along without treatment as with it.

Don't hug the delusion that fever in any degree is a benefit to the patient.

Don't fancy that you can always tell croupous from catarrhal pneumonia.

Fre

Don't allow pain in the abdomen to draw your attention away from the chest. quently the beginning of pneumonia is accompanied by severe pain in the right groin, which may lead one to suspect the onset of typhoid fever.

Don't direct your treatment more towards the heart than towards the lungs. Don't fail to recognize the great influ ence of the brain and nervous system. Don't lose sight of the serious indication of rapid and laborious breathing.

Don't be afraid of applying ice to the chest in rubber bags. It will do no harm. Don't fail to apply as many bags as are necessary to cover the area of inflammation.

Don't think that you can get as good results from a tub-bath or from cold general spongings as you can from the local application of ice.

Don't become alarmed when the ice produces a sudden drop in the temperature and think the patient is going into collapse.

Don't fail to retain the ice so long as fever is present, and resolution has not taken place.

Don't omit to apply one or two ice-bags to the head.

Don't overlook the beneficial influence of strychnin in combating pneumonia. Administer 1-20 of a grain by the mouth every three or four hours, and besides give the same dose hypodermically once or twice a day, until the system becomes irritable.

Don't omit the hypodermic injection of of a grain of morphin once or twice a day to secure rest and sleep.

Don't fail to administer oxygen by inhalation more or less constantly if the patient is cyanotic or short of breath.

Don't fail to bleed if the cyanosis and dyspnea are not relieved by oxygen inhalation.

Don't lose sight of the great value of tincture of capsicum in relieving great nervous depression, delirium, dry blackcoated tongue, picking at the bed-clothes, etc.; give it in from a half to one teaspoonful doses in water every two or three hours, or oftener, in alcoholic pneumonia.

Don't fail to give sodium salicylate, ammonium acetate, potassium acetate, and potassium citrate, three grains of each, in a dessertspoonful of peppermint water, every three or four hours, if there is the least evidence of a rheumatic complication.

Don't overlook the important action of quinin in this disease.

Don't fail to support the patient with an abundance of nourishing food, such as milk, freshly exprest beef-juice, etc.-Dr. Thos. J. Mays, Philadelphia.

Cause of Pneumonia.

Even in uncomplicated cases of pneumonia physicians are not called upon to treat simply the pneumonia, but the patient suffering from pneumonia. At a given moment the tissues of a certain individual, for reasons in many cases not quite clear, become a favorable culture medium for the growth of a little plant, the pneumococcus. This little plant is present very often in the sputum of healthy individuals for long periods without causing any untoward effects. Once it has taken root, as it were, its growth depends on the continuance of the favorable tissue conditions that allowed the original implantation. Natural forces in the body at once begin to react to preserve the human organism. It takes a certain number of days, usually five, seven or nine, before the so-called critical period is reacht and nature's triumph is announced.-Medical News.

Cremation with Liquid Air.

A crematory is being built for burning bodies in liquid air. The corpse is to be placed in an open metallic receptacle, and some ten gallons of the liquid poured on. In a few moments, as the nitrogen evaporates first, the oxygen can be ignited and will burn up the body rapidly and thoroly, avoiding all the unpleasant features of the present method, saving much time, and reducing the expense.-Prac. Druggist.

New Remedies for Gonorrhea. It may be interesting to our readers to note that Dr. Gravagna has made extensive experiments with various new remedies in the treatment of this disease. He finds that alumnol, protargol, argentamin and argonin yield no better results than the older remedies.-Rif. Med.

Sure Cures in Mexico.

Dr. Walker Ellis says that Mexico has some unique laws affecting secret nostrums. Down in the sister republic, it appears, if a bald-headed man buys a bottle of hair oil on which there is a label stating that the preparation will restore hair on a bald head and it fails to accomplish the job, he can have the seller arrested and thrown into jail. Naturally, continues the doctor, laws of this nature have a tendency to restrict trade somewhat in the patent medicin line, and some of the prosperous concerns of the United States fight shy of Mexican soil.-Merck's Rep.

Tea and Rheumatism.

Dr. Kellogg says the habitual use of tea as a means of relieving headache is without doubt an efficient cause of rheumatism in numerous ways. The writer has met many persons who could not forego the morning cup of tea or coffee without suffering severely from headache and depression during the day. The thein or caffein of tea has precisely the same effect as uric acid, and hence has come to be a favorite domestic remedy for headache. When used habitually, however, as will readily appear, the effect must be to cause a storing up in the body of uric acid and urates, thus laying the foundation for chronic rheumatism and the various allied conditions which have their foundation in the so-called uric acid diathesis or lithemia.-Popular Science News.

The Passing of Alcohol.

The past three years have witnessed a great decline in the use of alcohol and a change of opinion among the authorities in regard to it.

The indications for its use are becoming more and more circumscribed and abridged, tho it is, perhaps, more proper to say that the indications are now being recognized and studied. In the years gone by it was customary to give alcohol, not for any special indication, but simply because the patient was sick in bed, or only feeling badly. It was a common remedy found in

nearly every home, easy to take, not at all dangerous, having a decided effect, chiefly upon the mind, in a very short while; it also had a reputation, venerable by all antiquity, of being the king of stimulants; that by its use in a critical moment, men had been snatched from the very jaws of death; that it was the one remedy to give first and freely in all cases of accident. To-day men are studying its composition, its doses, its effect upon the heart, the nervous system, the kidneys, and the liver; king no more except it shall stand the test, for scientists and workers in the laboratory, with unsanctified hands and indifferent hearts are analyzing this ruler of stimulation which the people have set up. The end is not yet, tho it has been shown that the feet are of clay.

Among the students of the drug it was first announced that alcohol was only a stimulant in certain moderate doses, after that it was sedative.

The report is now abroad that it is an anesthetic and sedative in all doses, that it has a primary stage of excitement, but is never truly stimulating.

But another reputation had alcohol some years ago that it was an appetizer, a tonic, assisting digestion, promoting strength, leading back with a strong hand reluctant health. To-day there are men rising up to deny this, claiming in certain diseases of the gastric mucosa that it is even injurious as a medicin.

And that which once we gave in place of food for the fever famisht body, must now sit upon the shelf under suspicion of having beckoned on, rather than fought back, the angel and the shroud. Scientific men are even beginning to study the relationship of alcohol as a beverage and the liability to certain diseases or to a particular form of any disease.

Dr. Le Gendre, of Paris, has come to the following conclusions:

1. The abuse of alcoholic beverages predisposes to and aggravates most of the diseases found in hospitals.

2. All alcoholic beverages are harmful. The most noxious are those containing aromatic essences, for instance, absinthe and the so-called aperitive or aperient bitters.

3. Alcoholic beverages are productive of most harm when taken upon an empty stomach, or when taken between meals.

4. An individual making a habitual use of alcohol or of various liquors, or of too much wine (more than one liter daily), in

evitably becomes an alcoholic, even if he has never been in a state of drunkenness. 5. Alcohol is a poison, the habitual use of which, sooner or later, but nevertheless unfailingly, impairs the structure of organs most essential to life; the stomach, the liver, the kidneys, the blood-vessels, the heart and the brain.

6. Alcohol is an excitant, a stimulant. but not a strength producing agent. 7. It does not take the place of food. It creates a distaste for food.

8. He who frequently drinks alcohol or who drinks too much wine (more than a liter daily) is more susceptible to disease. If he becomes ill, his illness is always more serious. The habitual drinker is exposed to delirium tremens.

9. Alcohol, by weakening the lungs. prepares the soil for phthisis; many a consumptive has been an alcoholic. Aleohol weakens tissue resistance.

10. Among the children of alcoholic parents are recruited the idiots, the epileptics, the mentally and physically dwarft, according to the Medical Standard.

Sir James Clark, in "A Treatise on Pulmonary Consumption," says that among the causes of tuberculous cachexia, a free indulgence in alcoholic spirits holds an important place; while this pernicious habit is one of the most powerful means of debasing the morals of the people, and of extinguishing the best feelings of human nature, it is no less effective in destroying the physical constitution. There is good reason to believe that the use of spirituous liquors among the working classes of the country is productive of consumption and tuberculous diseases to an extent far be yond what is usually imagined. The blanched, cadaverous aspect of spiritdrinker bespeaks the condition of his internal organs. The tale of his moral and physical degradation is indelibly written on his countenance. The evil, however, does not rest here, for by destroying his own health he entails on his unhappy offspring the predisposition to tuberculous disease."

Dr. Joseph M. Mathews, president of the American Medical Association, writes to the editor of The New Voice as follows:

"It is the consensus of opinion of the medical profession that where a reduced vitality of the system is brought about from any cause or condition, that said loss of tone of the physical body would induce to a tuberculous disposition. In other words, that by the free use of alcoholic

spirits the physical body is brought to a low standard of health, and would predispose the same to and produce a soil in the lung in which the special germ could propagate rapidly."

These things are only straws, perhaps, but they show that a current of professional opinion has set in from the East and the time is coming when we will prescribe alcohol intelligently, for certain indications, in certain doses. As a beverage, however, men will not cease from drinking until they are given a new thirst and a new throat.-- Charlotte Med. Jour.

Chicago as a Medical Center.

If anyone doubts that Chicago is a great center of medical activity, in fact, the hub of medical learning, let him consider these figures furnished by the ever-busy statistician.

There are in Chicago, all told, twentyfive medical colleges, several of which number, however, are not clast as super-classical-fifteen, perhaps, may be accepted as in good, or fair, standing. Hospitals and infirmaries there are enumerated forty-four, which does not include sanitaria, dispensaries and private institutions of this kind. Fifteen medical journals are publisht in Chicago. But the most interesting part of these statistics is that pertaining to the teaching corps connected with the medical schools of Chicago, which reaches the awe-inspiring number of over 1,000. The exact number given by our authority is 996, but that was for the year 1898, and these are distributed as follows: Regular full professorships, 572; assistant professors, instructors and demonstrators, 328; clinical operators, etc., 96. But this is the number for medical colleges in good standing (recognized by the board of health) only, and so a goodly number styling themselves professors of medicin may be added to the above total of 1,000. The total number of medical practitioners in Chicago being about 3,200, it will be seen from the foregoing that every third doctor is a professor.-Western Druggist.

Prof. Roswell Park makes the startling prophecy that if for the next ten years the present relative death rates are maintained, in 1909 there will be more deaths in the state of New York from cancer than from consumption, small-pox and typhoid fever combined.-Chicago Clinic.

Rational Treatment of Chronic Morphinism.

I submit for your consideration a method for the treatment of chronic morphinism which has been, in my hands, very satisfactory, both to myself and patients. The principal advantage to be derived from this method of slow reduction is the lessened amount of discomfort to the patient. Usually there is no pain or diarrhea, no vomiting, no profuse perspiration, no extreme nervousness, and never anything like a state of collapse; in fact, there are none of the severe symptoms, such as described by those who have written on the subject of chronic morphinism.

It is a most barbarous thing to suddenly withdraw the morphin, as in the method described by Levenstein, and now called the Levenstein method. A patient with knowledge of the symptoms which follow the sudden withdrawal of morphin who would then have the fortitude to place himself under that form of treatment, certainly must have the courage to face any event that one is liable to meet with in this life. The modifications, as described and practiced by others who have withdrawn the morphin more gradually, but yet have minimized the dose in advance of restoration of the nervous system, seem almost equally severe.

Erlenmeyer says that the sum of the suffering from the gradual reduction more than equals the suffering of the sudden withdrawal. While, perhaps, this is true with a fixed rule for reducing the quantity of morphin so much for each twenty-four hours, or if the reduction is conducted on any plan that reduces the dose before the patient is prepared for the reduction, it is not true if the reduction of the amount of morphin is made only as the condition of the patient is so improved that his necessity for the drug is lessened to the extent of the reduction made.

I always endeavor, and in 90 per cent. of the cases I am successful in so far restoring the nervous system to its normal condition in advance of withdrawing the morphin that the amount withdrawn is not discovered by the patient. I never withdrew the last fraction of a grain until the quantity used is so small that the patient is unable to tell the day he took his last dose. It is easily understood that the nervous system is in a most unfavorable condition for recuperation while the patient is suffering for want of morphin. He can neither eat nor sleep. He can not rest easy in any place or position. The effect of any drug that may be given him as a substitute, or to quiet him while withdrawing the morphin, is equally as bad and may be worse than that of morphin itself.

Nearly every patient, when he presents himself for treatment, is taking more morphin than he requires to make him comfortable. Some take two, three, or four times as much as needed. The surplus can at once be withdrawn and the patient feel and be the better for it. When the largest amount has been withdrawn that can be and still leave the patient quite comfortable, then the re

duction must cease until the system has had time to adjust itself to this new condition of things. With this lessened amount of morphin the secretions become more active. The appetite improves: sleep, while not so profound, is yet more refreshing; in fact, every function of the body approximates a more normal condition, except it be the heart. The heart. which has for perhaps many years been constantly stimulated by the use of morphin, now becomes weak and fast or irregular. However, this symptom will soon pass away under the influence of small doses of strychnin or hydrastin. In a few days the system will have so far accommodated itself to the lessened amount that another very small reduction can be made. This and all future reductions should be so small that the patient is unable to tell when they are made.

The first point that I wish to emphasize -the real key to success-is to keep the patient on just as small a quantity as is compatible with comparative comfort, and yet not to get his dose so small that he will be in misery before the next regular hour for morphin. A patient should feel almost perfectly comfortable, so far as morphin is concerned, for three or four hours after getting his dose. I give the morphin four times a day, at 7 a. m., 12 m., 5 p. m. and 9 p. m. I divide the time in this particular manner for the sake of giving the morphin just previous to meals and bedtime. Patients will eat and sleep much better thereby. It is useless to ask a patient to take nourishment when he is needing morphin, and no one thing is more essential to an easy and, rapid recovery than a good appetite. There are no drugs that can compare with plenty of good food and sleep to restore the nervous system, and the patient can neither partake of the one nor secure the other when too much of his accustomed amount of morphin has been withheld.

Erlenmeyer condemns the gradual reduction severely. However, it is evident from his description of the symptoms that, while the reduction extends over three, four or more weeks, the reductions have been made in advance of recuperation. He says that during reduction patients cannot recuperate, and convalescence is very tedious. This certainly has not been my experience. I have recently discharged two patients, one of whom was taking eight to ten grains of morphin a day when he came to me, and weighed