McCrae considers the following conditions amenable to this treatment:

1. Accidents from anaesthesia.

2. Edema of the lungs, edema of the glottis, and accidental interference with respiration by disease of the upper part of the respiratory tract.

3. Marked dyspnea with defective oxygenation, as in cardiac and renal disease.

4. Asphyxia of infants at birth.

5. Syncope.

6. Electrocution.

-John McCrea, M.D., in Am. Jour. Med. Science.

THE REQUISITES OF THE MODERN DOCTOR:-To achieve the greatest success in his practice, the modern doctor must be a man possessed of logical mind, medical skill and moral courage. He must not only be able to recognize the early signs and symptoms of diseased conditions, and to draw correct conclusions therefrom, but must also have the courage to tell his patients of his findings truthfully and fearlessly. On the other hand, the doctor of today owes a duty to the state. . By reporting promptly all cases of communicable disease that come under his notice, the doctor lends a valuable service not only to the community but also to his individual family. A man who allows cases of diphtheria to go without treatment until they are moribund, who refuses or fails to recognize tuberculosis until the lungs are filled with rales and the sputum with tubercle bacilli, or who neglects cases of cancer until they are inoperable, or at least beyond recovery from operation, has no place in the modern practice of medicine. The people are demanding better things and they are entitled to more consideration; on the other hand, men who are prepared to practice modern medicine need have no fear that there is no demand for such service.-Guy L. Kiefer, Jour. Mich. State Med. Soc.

TYPHOID FEVER is interestingly discussed by Dr. Solomon Solis Cohen in the January issue of the Critic and Guide. In presenting his treatment Dr. Cohen gives special attention to the importance of having patients drink large quantities of water, and in doing so remarks:

"If the patient will drink a sufficient quantity of plain water to keep the daily output of urine up to 60 fluid ounces or thereabouts, that may suffice. An output of 70 to 100 fluid ounces, however, is preferable. As a rule, if the nurse is tactful and persistent, the patient will drink a quantity of water and of alkaline-saline beverage (or of some palatable, non-aperient mineral water) that, together with the liquid nutriment administered, will keep the kidneys sufficiently active. No answer annoys me more than that of the sick room attendant ("trained" nurse, "practical" nurse, or relative, matters not) who, when asked if the patient has been given sufficient water, replies, "All he asked for." He is not sufficiently alert-he hasn't the sense of needto make him "ask for" it. His perceptions are too much dulled by the toxemia. The water must be offered to him regularly. It must be forced on him, if need be not violently thrust down his throat of course, but skillfully "forced," as a conjurer "forces" a card. And the quantity taken in a given time must be known accurately-not "about so much," but "so much, exactly."

MAYO RESEARCH FOUNDATION OF THE UNIVERSITY OF MINNESOTA:-A plan of Drs. William J. and Charles H. Mayo, of Rochester, Minn., to establish a $1,000,000 foundation for medical research in connection with the University of Minnesota under certain restrictions has been approved by the faculty of the medical department and it now is under consideration by the University Medical College Advisory Board. The interest of the fund will be used in research work at Rochester by graduates of the university medical department.-Med. Record.

INSANITY INCREASES:-The Census Bureau, in a recent report, states that the number of insane reported in institutions increased from 150,151 in 1904 to 187,791 in 1910 -an increase of 25 per cent in six years. The total population in the same period increased only 12 per cent, thus showing the insane in institutions increased twice as fast as the population. In 1904, one person out of every 543 was confined to an institution for the insane; in 1910, one out of every 490. These increases, the report says, are at least partly attributable to the extension of the provisions made for the care of the insane. Of the 60,769 persons admitted to insane hospitals in 1910, 36,654 came from cities, villages or other incorporated places of more than 2,500 inhabitants, while 20,442 came from the smaller towns or country districts, leaving 3,673 for whom the place of residence was not reported. From rural communities forty-one insane persons were admitetd per 100,000 population; from the urban communities the ratio was eighty-six per 100,000.-Cin. Lancet Clinic.

IODINE TREATMENT OF DIPHTHERIA:-The local application of iodine has been successfully employed by Dr. A. H. Thomas (Brit. Med. Jour.) in the treatment of diphtheria and scarlet fever, the form used being an ointment containing 5 per cent of free iodine. This ointment is applied as follows: Three cotton-wool mops are used, two to remove the secretions and false membrane, and to dry the affected surface; the third, after smearing it with the ointment, is thoroughly rubbed over the inflamed tissue and surrounding areas. These applications are repeated every three hours or in severe cases, every two hours, until improvment occurs.

Under this treatment, Thomas says, many cases of diphtheria clear up within a few hours, the throat becoming quite free from false membrane on the second or third day. In the scarlet fever cases, there was remarkable freedom from local complications.-Critic and Guide.

THE SOUTHERN

PRACTITIONER

AN INDEPENDENT MONTHLY JOURNAL

DEVOTED TO MEDICINE AND SURGERY

WAITING FOR THE DIAGNOSIS.

BY WILLIAM F. WAUGH, A. M., M. D., CHICAGO, ILL. Many a time and oft we have read more or less erudite disquisitions on what to do while awaiting for the coming of the doctor. The measures by which the laity are encouraged to interfere and complicate the case inevitably bring to mind the line ending-"where angels fear to tread." But in these ultra-scientific times, when nothing but a diagnosis ciphered out mathematically, through the aid of bacteriology, and half the other 'ologies in the unabridged, will satisfy the demands, are we to let the patient die; or at the very least pass beyond the stage when therapeutic intervention may be useful, while we are waiting to tag the intruding monster correctly?

It is perfectly right that we should know exactly with what we are dealing, and we can never know too much about our case; but the patient is not exactly consumed with curiosity as to what hit him-he would like to be cured. And it is unfortunately true that by the time the

Widal has satisfied us that we have to deal with a typhoid invasion, all the practical result of our labors is to know what we might have done with benefit a week before. Without seeking in the least to discourage the practician in his pursuit of accurate knowledge, we may lay down a few suggestions as to a safe and useful treatment to fill in the time.

We are far from advocating a treatment of symptoms alone, of surface indications that may depend on quite different causes and demand similarly varying treatment. Homoeopathy has carried this system to the limits of the absurd. We remember-the Professor of Practice rushed into the sick room, his face pallid and drawn with fatigue, eyes bright with fever, but radiant with triumph, crying: "I have spent the night searching my books and have found the key-it is the pain in the left ankle! You are as good as cured." Within a week the patient died, of uterine

cancer.

The Eclectics do better. They study the patient and recognize the disorder; that is, the departure from physiologic balance of the vital functions; and they apply the remedy that will correct the derangement and restore the balance. Quite justly they claim that a remedy that removes the symptoms may be assumed to cure the disease -else why should it remove the symptoms? The great value of this method is that it compels the doctor to study his patient closely, and to know his physiology. In that it is superior to the methods of the man who knows his test tubes and sections, and nothing else. There is no source of knowledge to the doctor worth nearly as much as the study of the patient. All we get from the world of general information is general; the case demands individual knowledge. We may know much of the bacteria, and their operations in general-the patient and the doctor are especially interested in the bacteria at work in this particular case, and the reactions of this particular individual with them.