CHAS. WOOD FASSETT, Managing Editor 713 Lathrop Building, Kansas City, Mo. ASSOCIATE EDITORS P. I. LEONARD, St. Joseph. CONTRIBUTING EDITORS ST. CLOUD COOPER, Fort Smith, Ark. S. S. GLASSCOCK, Kansas City, Kan. W. T. WOOTTON, Hot Springs, Ark. The Editors' Forum Take the Germ Out of Germany It's up to the Allies to now and forever take the Germ out of Germany-a Germ that has infected the evolution of the psychology of the nation for fifty years; a Germ that stimulated Bismarck to read a friendly dispatch as an insult to Germany to justify his lust for the blood of France; a Germ that has made Germany's criminal statistics three times that of France, England or America; a Germ that evolved through generations of "kultur," a national mental status that is a most striking illustration of a morbid psychology of the grandeur, thin edged, paranoid type; a Germ that has invaded and infected the very interstices of the nation's thought process till the highest ideals of German "kultur" are achieved through sacredly enacted mental reservations that justify the German embracement of perfected deceptions, artistically camouflaged lies and criminality, viciousness and if need be, the most wanton devastation of every delicate and tender tie known to the human heart-mother, babe, daughter, sweetheart or wife, none exempt; a Germ that justifies all this from the German morbid psychological view point. Yes, it's time for the Allies to take this "kultur" Germ out of Germany. S. G. B. Lesions and Treatment of Dichlo- Exposure to mustard gas results in necrosis, more or less deep, of the skin, cornea, conjunctiva and mucus membrane of the respiratory tract. Ten minutes exposure to the concentrated gas is sufficient to produce, erythema, pigmentation and necrosis of all parts exposed, even under the clothing. Chest, abdomen, scrotum, thighs, even show lesions unless clothing be tight fitting. Lesions persist for weeks even under hospital care, and after prolonged exposure of several hours death follows either from acute conditions or from depression weeks later. Treatment is symptomatic. In the eyes warm vapor, atropea, 10 per cent sodium bicarbonate solution; iodoform ointment for the lids. As a first aid treatment soda bicarb solution is used both for the eyes and for the body. For the lungs opiates and expectorants. Best results have been obtained from Dakin's solution, as a spray, application or bath. It has exhibited marked ability to prevent infection, heal lesions, ease pain and prevent scars. The toxic effects of mustard gas are those of a local escharotic, by virtue of tissue destruction, skin, mucus membrane, cornea, etc. There are no absorption symptoms. Venereal Diseases in Civil Communities J. M. B. A recent publication from Washington gives us some startling figures regarding venereal disease, and also points to the source of it. Can we not awake to the terrible responsibility upon civilian doctors not only in reporting such cases and attempting to control it, but as well to urge cooperation in our city councils by having measures passed which will aid in removing this slur upon American municipalities? Washington figures show that of all communicable diseases, including pneumonia, typhoid, paratyphoid, meningitis and scarlet fever, venereal disease is by far the most prevalent. Out of 186 cases of communicable disease in the national army 162 were venereal, leaving only 23 from all other forms of infection. During the twelve weeks ending December 7, 1917, there were reported from 31 cantonments 21,742 new cases of venereal disease. The incapacitation of these men involved not only loss of time; in addition, it cost the Government to keep them during the period of hospital confinement (which varies from one to eight weeks) more money than was required to maintain the entire command at Camp Dix (the cantonment in New Jersey, with 20,859 men) plus an additional sum for medical treatment. This is not all. Inevitably the disease will relapse in hundreds of these cases, in many in stances after the men have been transported to France and presumably put into condition for ⚫ service at the front, at a cost to the nation of probably $1,500 for each man. The important fact in this connectin is that a large proportion of venereal disease cases originate, not in the camp or in communities surrounding the camp, but in cities and towns from which the men come and through which they pass on the way to camp. Reports from the Surgeon General's Office show this. Evidence is accumulating to show that the venereal disease rate is higher in civil life than in the army and navy. The enormous cost to the Government on account of venereal disease is due largely to conditions in civil life. J. M. B. To Herald Readers We desire to call the attention of our readers to the rich feast in store for them in the list of papers read at the recent meeting of the Medical Society of the Missouri Valley. (See adv., page 68). We also beg to remind our subscribers that in spite of the great advance in our postal rates the subscription price will remain the same, $1.00, if paid in advance. If accounts are allowed to run until the end of the year, we will be compelled to charge $2.00. Remit now for 1919. Refilling Narcotic Prescriptions The Commisioner of Internal Revenue has issued the following: "Owing to the extent of the epidemic of Spanish influenza now prevailing in this country and consequent difficulty of persons in getting immediate medical attention and medicaments upon prescriptions issued by physicians, the provisions of Article II of Regulations No. 35 prohibiting the refilling of narcotic prescriptions are modified as follows: Prescriptions calling for morphine, codeine, or heroin, which are written by registered practitioners for patients suffering from Spanish influenza and any pulmonary or bronchial affections, may, until further notice, be refilled, provided that at the time of issuance by physicians instructions are noted in the body of such prescriptions, "Repeat if necessary," and the druggist filling and refilling the same shall note thereon each and every date upon which such prescription is refilled." River Pollution a Public Menace The initiative has been taken by the Merchant Association of New York looking toward a national movement to prevent the insanitary habit of the railroads of the country in discharging the contents of toilets upon roadbeds of the railways. This filth ultimately finds its way into the rivers, and in many cases disease is spread before it reaches the water. It is a movement demanding national attention. The former view held by hygienists that rivers purify themselves after a flow of three or five miles by sedimentation and air oxidation is no longer regarded tenable. Because of interstate management and health regulations such a reform has in the past been impossible. The object of the present movement is to interest Hon. W. G. McAdoo, director general of railroads, and by national cooperation accomplish some real advancement toward abating this menace to public health. J. M. B. St. Louis Medical Society Closes Its Business Bureau After an experience of over one year the St. Louis Medical Society has decided that the conduct of a business bureau is not a financial sucIn commenting upon the outcome, the Bulletin of the society says: cess. "In closing the affairs of the Seabold Busisustain a loss amounting to about $1,500. ness Bureau it is estimated that the society will "Coming as it does at a time when the society can ill afford it owing to the fact that members in the service will not be expected to pay dues, will seriously hamper the administration in its work and also cause a deficit at the close of the year. "It is to be hoped that if in the future any attempt is made by the St. Louis Medical Society to enter the commercial field, the experience of the Business Bureau will serve to frustrate any such attempt." Medical Association of the Southwest nual meeting of this association was held in Dallas, Texas, October 15-17, under the presidency of Dr. E. H. Martin of Hot Springs. The attendance was not so large as usual owing to the influenza epidemic. An excellent program was carried out, however, and the welcome extended by the Dallas profession was a cordial one. The following officers were elected: President, Dr. M. M. Smith, Dallas, Tex.; vice-president, Dr. L. von Treba, Chetopa, Kans.; vice-president, Dr. O. B. Ball, Warrensburg, Mo.; vice-president, Dr. F. W. Jelks, Hot Springs, Ark; vice-president, Dr. F. K. Camp, Oklahoma City, Okla.; secretary-treasurer, Dr. F. H. Clark (in service), El Reno, Okla.; chairman committee on arrangements, Dr. Everett S. Lain, Oklahoma City. Oklahoma City was selected as next place of meeting. 294 With What Shall We Win the War? After all the factors have been discussed, and from every angle, we must confess that the socalled "morale" stands out the over-shadowing factor as a war winner. Henry Seidel Canby brings out this thought most forcibly in Harpers for November. He says: "With every desire not to preach, and after unusual opportunities of seeing how vital is the need of food, guns, money, and material organization of every kind if we intend to win this war, I say that morale, which for us is moral earnestness, is the great hope and the first practical necessity. One finds such earnestness in France; one finds it in Great Britain roused to dogged intensity; one finds it in Ireland in curious fanatic extremity. Raemaekers, the cartoonist, told me at the front one night that he turned from the front where he made an inspection of medical facilities in France and England. He will make report to Secretary Baker soon. It is hinted that his next assignment may take him to Italy. Secretary Baker has paid a high tribute to Gen. Gorgas in a recent letter to Congress. Co-incident with the promotion of MajorGeneral Ireland, was the appointment of Brigadier-General Robert E. Noble, to take the place vacated by General Ireland as surgeon-general of the A. E. F., with the rank of major-general. General Noble has been associatel with General Gorgas for many years and has a wide experience in sanitation and the administrative work of the office. He is well qualified to assume the head of the medical division of our forces in France. Dr. S. Grover Burnett, who has been ill for hoped Holland would join us to save her moral several weeks, is convalescing. being.' But here in America it is backed by simplicity of character, by a consciousness of unexhausted strength, and by such energy as the world has scarcely seen since the days of the Nor mans. "Moral earnestness, and not the mere need of self-defense, carried England through the dark spring of 1918. I have talked in the last six months with English political leaders of every party. Some commanded my whole-hearted respect; others were clearly time-servers, driven by yet I found in one and all an unexpected conviction that what England did infinitely mattered, and an impressive willingness to admit responsibilities beyond their own little group, to America, even to the next generation in Germany." The New Surgeon-General of the Army To succeed Major General Gorgas, the president has appointed as surgeon-general of the army, with the rank of major-general, Dr. Merritte W. Ireland, M. C., U. S. A. The record of Gen. Ireland in the medical department has fitted him particularly for the high position which he is now to occupy. Gen. Ireland has served in the medical department since 1891. He has seen service in the Philippines and in Mexico. When we entered the war, he accompanied General Pershing to France as chief surgeon of the American expeditionary forces, with the rank of brigadier general and more recently was advanced to surgeon general of the expeditionary force. The appointment gives universal satisfaction and it is predicted that Major-General Ireland will prove a worthy successor of the much esteemed and highly honored Gorgas. Major-General Gorgas, who was retired for age, has been recalled to the service and has just re Dr. W. F. Morrow and Miss Jean Broadwell, Kansas City, were married on November 2. Dr. and Mrs. Morrow will be at home after November 15, 6007 McGee St. Free Wassermans-Dr. H. De Lameter, health director of St. Joseph, desires to offer the service of the Laboratory in making Wassermanns free of charge to those who are unable to pay the usual fee for the test. Physicians having patients apply for diagnosis and treatment for syphilis should satisfy themselves before referring them to the Health Department, they are worthy of aid. Dr. Geo. Chaffee, of Brooklyn, New York City, has located in the city of Binghamton, N. Y., and has opened an office at 100 Hawley St. He will limit his practice to modern operative bone surgery and to consultations. Dr. Chaffee has been on the surgical staff of the Polyclinic Hospital in New York City, for the past twentyfive years, where he has had the benefit of seeing and treating a large number and great variety of surgical cases. Necrological Dr. Homer Cutler Crowell died Oct. 24th. after a long illness, aged 66 years. Dr. Crowell was a graduate of the University College of Medicine of Burlington, Vermont, 1875. The next ten years were spent in New York and South America. He then returned to New York City. and after fitting himself for the special practice of gynecological surgery he located in Kansas City in 1888. Dr. Crowell did the first hysterectomy done in Kansas City. For some years he was professor of gynecology in the University Medical College. His teaching, his diagnostic ability, his judgment and operative technic made him an attractive clinician. To the medical southwest Dr. Crowell contributed much to the progress of real gynecological surgery in his best activity, at the same time enjoying the distinction of being the only specialist in that line in Kansas City who resisted the temptation to wander amuck into the field of general surgery. While progressive, Dr. Crowell was often petulant to the commonplace, everyday adversities to the extent of marring his own personal greatness; but with all this, deep down in his heart, he was penitent as a child and never understood that any should take umbrage. The writer visited him from New York in 1889; the county society was "mossbacked, non-progressive and arrogant" toward younger, aggressive members. We suggested an academy of medicine as a vent for the young man's superfluous energy. Plans for organization were left with Dr. Crowell till our return to and location in Kansas City the spring of 1889, when the first meeting was called for the organization of the Kansas City Academy of Medicine. Thus Dr. Crowell became the "father" of the Academy of Medicine and its first president. To the proceedings of the Academy of Medicine Dr. Crowell contributed the very best of his professional accomplishments. The few remaining old members of those days, with Dr. C. Lester Hall, chairman of arrangements, tenderly cared for him in his last days of mental and physical dissolution. Dr. Crowell was member of the A. M. A., the Missouri State, the Jackson County, the Missouri Valley and the Southwest Medical Societies. S. G. B. Allan J. Hughes-We deeply regret having to announce the death of Mr. Allan J. Hughes, manager of the Physicians Supply Co., Kansas City, which occurred on October 7th, at Camp Meade, Maryland, of pneumonia. Mr. Hughes volunteered for the service two weeks previous to his death. He was 29 years of age. Mr. Hughes had a wide acquaintance among physicians, and was highly esteemed for his business ability, honesty and uniform courtesy, qualities which were predominant in his character. Carpings of Our Cynic Another species of the "slacker" is the doctor who neither goes to war nor pays his local society dues. ¶ Strange as it may seem, no one has recommended tobacco smoke as a preventive of the "Spanish flu." In old K. C. it required the combined eloquence of sixteen physicians, several trained nurses, and the president of the Chamber of Commerce to convince the mayor and president of the Health Board that influenza was contagious and that a strict closing ban was imperative. And, by the way, this man Parsons, president of the Chamber of Commerce, is some producer. It was entirely through the instrumentality of the C. of C. that the ban was put on and kept on. Mr. Parsons is local manager for Parke, Davis & Co., and he has reflected credit upon his firm by his activities in the local health situation. The malicious story that doctors had been caught inoculating men in service with influenza germs and had been shot in consequence has been turned upon the Great Lakes Naval Station, following its rejection by authorities at numerous army posts throughout the Middle West. Capt. W. A. Moffett, commandant at Great Lakes, said that he had been almost swamped with telegrams, inquiring about the lie, and asked that a blanket denial be issued. He denied a yarn to the effect that whisky in large quantities had been used in combating influenza, stating that absolutely no whisky had been used at Great Lakes. ¶ We have time and again, in this column, protested against the politically appointed Health Board, with its lay president. The K. C. Star recently contained an editorial which hits the nail on the head: A Dangerous Health Board Head What sort of a man has Kansas City as president of the hospital and health board? Throughout the epidemic he has acted much more like the representative of the interests that would have put their own profits above human lives, rather than like the guardian of the public health. W. P. Motley has opposed the measures that were necessary in fighting the epidemic, and he told a meeting of the motion picture men yesterday that he had signed the closing order under protest. Fortunately for the welfare of Kansas City he was overruled by Mayor Cowgill and Mr. Benjamin and Mr. Hart, the other members of the board. It is unthinkable that this sort of man, who was ready to set up his private opinion against the best medical opinion in town, should continue at the head of a board charged with guarding the city's health. How long will the people consent to political rule in the health department? All mortality records were broken in Kansas City during October-271 deaths reported in one week, with a total of 600 or more for four weeks; 3,000 cases of influenza. Many of these could have been prevented by energetic measures, established early and maintained rigidly. A competent director of public health, with full discretionary power, unhampered by political laymen, is the only answer. The Doctors' Library "Next to acquiring good friends, the best acquisition is that of good books."-C. C. Colton. problems still left open for argument. For example: Geiger seems to think that the bone inlay graft is desirable for most of the fractures of the patella. Fuller and the reviewer working together at Bellevue Hospital were apparently the first men in this country to open the knee MODERN OPERATIVE BONE SURGERY-With joint and wire fractures of the patella. Since Special Reference to the Treatment of Fractures. By With the advent of antiseptic surgery in this country surgeons departed from their established custom of treating simple fractures by mechanical means alone and compound fractures in a palliative way. Step by step we became bolder and wired some of the simple fractures and many compound fractures. With the advent of aseptic surgery we became safely bolder still and introduced foreign holding material of various kinds. Following the advance made by Lane, came the introduction of bone grafts, modeled and fitted with the aid of bone chisels. Then came the electro-operative motors with their fast running saws which endangered the vitality of bone cells. The last word now seems to have been spoken by Geiger with his slow running motor, although the irrigating apparatus seemed to avoid much of the danger of subjecting the protoplasm of the bone cells to high temperature. Along with these various steps in the development of bone surgery came voluminous new ideas and practical experiences recorded so elaborately by so many authorities that the ordinary surgeon found it extremely difficult to keep up to date in the presence of specialists with perfected new technique. Most of the fractures, however, must still be treated by the general surgeon, and this book of Dr. Geiger's is particularly valuable because it gives in a comprehensive yet brief way a first rate resume of the entire subject. Although writing as an enthusiast, the author of this book really gives us a well balanced judicial view of conflicting opinions, while holding that the development of osteoplastic work at present exceeds the development in any other branch of surgery. Some of us might be inclined to ask if work with the focal infections does not open a still larger vista, but without quibbling we may fairly join in the inspiration found by Dr. Geiger in his bone work. The chapters relating to the histology of cartilage and of bone, to detailed description of methods of nature's repair of bone, and to the general philosophy of the subject should be read by all who are engaged in bone work. Full details of the technique of transplanting bone are given so clearly that one who has failures in his work will understand the nature of his failures. When it comes to the question of the method of procedure in which special forms of fracture are treated we shall find some that time we have followed different advances and have been so generally successful with the method of encircling fragments with a Kangaroo tendon suture after freeing the bone surfaces, that there is some question if the addition of the bone inlay is desirable, excepting in old ununited fractures of the patella. No matter how complete our asepsis, bacteria are continually falling into every wound from the air, as may be demonstrated with Petri plates exposed in the operating room. The more time spent in caring for a fracture the more aerial bacteria will fall into the wound. In fractures of the neck of the femur in elderly people we feel that a good deal more should be said in regard to medical reports upon the character of the vital organs and the general condition of the patient before introducing the question of systematic bone grafting and placing the patient in orthopedic apparatus. Some elderly patients begin to fail from the moment that they are placed in bed and one should be able to anticipate this sort of behavior before proceeding to do the very best mechanical surgery which will sometimes have to be left out because of the physiology of the patient. The value of the book is so definite that we hesitate about making any sort of criticism of adverse character, but we assume that the author himself wishes to perfect any possible weak points in his argument. A few errors in grammar should have been edited out by the publishers, who have on the whole given us a handsome volume with excellent letterpress and valuable illustrations. ROBERT T. MORRIS. MEDICAL RECORD VISITING LIST AND PHYSICIANS' DIARY FOR 1919, Revised. William Wood & Company, New York City, Publishers. (Price, 30 patients, $1.50; 60 patients, $1.75; 90 patients, $2.25). Ample This is one of the most practical and compact little books of the year. It contains a fund of useful information which the practitioner will find of great value to have at his fingers' ends. Among the valuable tables are drops in a fluid dram; solutions for subcutaneous injections; a diagnostic table for the contagious diseases; and maximum adult doses by the mouth. space is provided for the daily record, cash account, obstetric engagements, record of vaccinations and register of deaths; besides a number of pages for miscellaneous and special memoranda. A convenient size for the pocket, this book will continue to be as popular as it has been in previous years. |