apropos to this discussion.

A young Englishman, named Ray, takes a seat beside me in the car, picks up the MEDICAL BRIEF, and, reading Dr. Kimmel's article, characterizes as "utterly absurd" what he says about Davos, Switzerland, where, on advice of Dr. C. Theodore Williams, of London, he spent part of a winter. He goes on to explain, for the doctor's benefit, that no invalids "have" to remain there all winter, but they prefer to do so because that is the season of the cure. And he adds, as perhaps pertinent, that he was examined by nine doctors before one-Dr. Pulmar Marsh, of Newport-found out the real difficulty, i. e., that his lung disease had reached the stage of softening. This diagnosis was confirmed immediately afterwards by Dr. C. Theodore Williams, who recommended Davos, and afterwards Colorado. This young man is now a hale fellow of one hundred and seventy-five pounds weight, and of splendid physique, apparently established by a country life in northern Colorado.

Undoubtedly Dr. Kimmel does well if, as he terms it, his "ignorant innocence" has indeed led him into so many mistakes, to determine not to recommend any more consumptives to the Rocky Mountain regions. Whether the same cause should militate against his giving advice to others to substitute the Azore islands as a permanent resort for invalids in preference to a well chosen altitude, I will leave him to determine; but a place, as he says of the Azore islands, where the annual extreme range of temperature is only seven (!) degrees, will impress most people as being very damp. If islands are far enough out to sea to be free from land influence, just as people are on shipboard, there is no question about the beneficial effects, a temporary stimulation, especially of the digestive system, making sea voyages stand next, for many people, to a life in a cool, dry and elevated resort. This latter (high climate) must necessarily be subject to great temporary changes, though, as is the case along the eastern base of the Rocky Mountains, the longer monthly averages show little variability from each other, i. e., a climate of uniform conditions.

The fact that he wore an overcoat on the day mentioned in June at Colorado Springs, has in it very slight tenor to one who understands the slight effect great changes in temperature have with the air dry, than elsewhere with the degree of air saturation near the one hundred

per cent limit. When camping in the mountains, I have seen ice half an inch thick in our water pail on an August morning, and on the same day the heat of noontime would lead us all to travel in our shirt sleeves, yet there was nothing whatever disagreeable about the change.

The argument in favor of a (1) dry, (2) cool, (3) sunny, (4) rarified, and so stimulating combination of climatic attributes, as opposed, for the great majority of consumptive invalids, to the opposite, (a) humid, (b) warm, (c) cloudy, (d) sea level, and so sedative climate, with slight variations in temperature, should perhaps best be considered without reference to locality, so as to avoid the prejudice which articles like Dr. Kimmel's engender against or in favor of a given section-Colorado, for instance. Such an argument I formulated for the International Medical Congress of 1887, very similar to what had long previously been advanced in the Rocky Mountain health resorts, and it has never yet been successfully contradicted. I will send him the latest reprint of this "The Preferable Climate for Consumption"-and also the lately revised edition of my climatic charts"Climates of the United States in Colors" that he may compare the summaries of the eight million separate signal service observations, twice used in the annual and seasonal results of the latter, with the facts claimed in the former. This he may better determine if that argument is well founded which, after all he says, is in harmony with the personal and professional experience of nine out of ten of the physicians in this part of our country. There are scores of these physicians whose successful, and to them creditable, experiences in sending well selected cases of tubercular phthisis to these Rocky Mountain regions have been published in medical literature. But if I were to particularize one of the many physicians who have

successfully recommended their tubercular patients to high altitudes, one whose researches had been as comprehensive and thorough as the most critical would desire, I should mention for his instruction the works of Prof. C. Theodore Williams, of London.

This desire that the excellent high altitude resorts of our own country should be duly appreciated is not put forth that this likely section may be peopled with the undesirable and fatal class of consumptives he mentions, but that a thorough study of the question may lead our profession to an improved diagnosis and enlightened selection of the cases which may recover under these peculiar conditions found along the base of the Rocky Mountains.

CHARLES DENISON, M. D.

Denver, Colo.

Are Puerperal Eclampsia and Puerperal Albuminuria Two Diseases? The relation of puerperal eclampsia to puerperal albuminuria renders it a disease of no little gravity; it will often so insidiously fasten itself upon the patient as to give but little warning, till the victim is gasping and struggling with the grim monster, death, in an eclamptic fit so unexpected, so terrible in its nature, and concomitant danger to both mother and child, that its causes, treatment and prevention are worthy of much attention.

While the relation between the two in former years was generally accepted, yet more recent observers have tended to dispute the urinary origin, but let us get to the rationale of the diseases symptomatically, as text-books classifying them as two distinct diseases, but are they? We believe not, but think the one is the product of the other; that is, that puerperal eclampsia is, in every instance, of urinary origin primarily, and nearly, if not quite always, the result of puerperal albuminuria, and that the violent, nervous explosion, while differing clinically is, in its manifestation, the same essentially as epilepsy, and we believe further that the explosion, so awful in its manifestations, so stupendous and far-reaching in its magnitude as to cause authorities to approach its discussion with a degree of veneration and awe,

is not a disease, but a pathognomonic symptom of one, and that the tissues and nerve centers of an albuminurious patient, fed and bathed by a hydremic and poisonous blood, have resisted and repulsed until exhausted nature can no longer hold out, and the patient falls with clenched fists, protruded tongue, convulsive grin, livid and cyanosed countenance and rapidly recurring convulsions. So terrible is the distortion, so fearful the facial expressions, that husbands and sons have failed to recognize their own loving wives and mothers.

But to the point, namely, to prove that this is the crowning symptom in the expression and result of albuminuria. The symptoms of albuminuria, chemically and authoritatively, of importance are: First, edema; if in the lower extremities but little importance is attached to it, but if manifesting itself in the upper extremities or face, our attention should at once be drawn to it and an examination of the urine follow. Other symptoms are: Nausea of a peculiar kind, dizziness, transient in character, photophobia, photopsia, sleeplessness, extreme irritability. Amnesia and agraphia are sometimes present, and are symptoms of more than usual gravity; urine scant and high-colored; examination reveals albumen, tube casts, and even cells are sometimes found. Women with the above symptoms, unless properly treated, usually go into eclampsia before or after parturition, and cases are sometimes found that, begin as early as we may, are not amenable to treatment, but go steadily onward from bad to worse, and, unless relieved by premature labor, end at last in eclampsia.

But, again to the point, are the above symptoms, which certainly are typical, at least some of them, in all cases of albuminuria, found prior to the eclampsia? Yes, most assuredly. Not only are they given in detail by all text books, but in all cases where symptomatology is known prior to the explosion, questioning the family or patient afterwards usually elicits many of the above symptoms. "But how," perhaps some one will ask, "do you account for those cases in which no symptoms were known, and worse still, none recalled by the patient or her friends?" By comparison of post

mortem changes if she dies; by examination of the blood and urine in the event of recovery.

One great anomaly of most authorities, who deny the relation as we see it, and as especially advanced by Braxton Hicks, is that we often have albumen in the urine before and after parturition and yet have no eclampsia. This may readily be explained by the following analogy: In some localities nearly all residents are affected with malarial poison, and yet comparatively few of this number have decided chills, and, besides, the above objection would more properly refer to the origin of albumen than its manifestation in eclampsia; neither do we claim that eclampsia always follows the appearance of albumen in the urine, but that albuminuria almost, if not invariably, is necessary to produce eclampsia, as we have endeavored to show. But more of this in my next. J. C. DRENNAN, M. D.

Vesta, Tenn. Reply to "An Obstetrical Case Containing a Lesson."

Dr. Cooper's article, under the above caption, is a good one. He managed the case of obstetrics skillfully, and his mode of procedure has many points worth remembering. I have placed it in my scrap book for future reference.

The doctor seems to be a fair minded man and speaks of his neighbor physician in kindly words; but I must say that I think Dr. T. has been very unfairly dealt with, and that he has just reasons for thinking that Dr. Cooper has not treated him rightly.

In the first place, the husband of the lady acted like an ignorant and discourteous man. Dr. C. says that he sent for him to meet Dr. T. in consultation without asking Dr. T.'s consent, or even informing him that he had done so. He does not say that Dr. T. had refused Counsel. This was far from being the treatment which is due any honorable physician.

Dr. C. did right to go, and he did right When he skillfully delivered the woman; but when he allowed the husband to Persuade him to continue the management of the case after version had been Performed, he did great injustice and

offered a great discourtesy to a doctor whom he says is a skillful and honorable physician, and whom he designates as "being an honorable, conscientious and kind-hearted man."

Dr. T. did all that is usually done in these most trying cases, and for him, after faithfully and laboriously standing by his patient, to be ruthlessly deprived of his case was grossly wrong, and does not reflect credit upon Dr. C. and the husband.

If the husband was anxious that he remain, it would have been very easy to have said: "The case is Dr. T.'s. He has treated you well. I will not take the case away from him; but if you wish, I will remain until labor is over and should Dr. T. need any assistance, I will gladly offer it."

Just here, please let me ask Dr. Cooper, how he would have felt had he been in Dr. T.'s place, and Dr. T. in his? I believe Dr. Cooper will sometime admit that it would have been better for him, for his practice, and for his reputation as a gentleman and as a physician, had he not allowed the ignorance and selfishness of the patron to overcome his first convictions of what was the proper and just treatment of his fellow physician.

So far as the medical code is concerned I will say, that the closer I follow it, the more justly and courteously I treat my brother physicians and the more of a gentleman I become. It is a pity Dr. Cooper did not allow himself to be governed by it.

V. E. LAWRENCE, M. D.

Halstead, Kan.

Assistance Wanted.

A few nights ago my house and everything in it was burned to ashes. I lost my library, drugs and instruments. I desire, therefore, to ask, through the MEDICAL BRIEF, the assistance of such of my brother physicians as may be able to aid me in replenishing my library. Any book from which I could obtain any information will be thankfully received. I was unable to save anything, and having no insurance, am left entirely destitute. Anything pertaining to medicine will be gratefully received.

Fort Payne, Ala.

G. T. BRUCE, M. D.

Medical Slavery, Chiefly Advocated by Foreigners-More Legal Dictum.

In the December BRIEF, page 1448, H. Schreschewsky, M. S., intimates rather strongly that my name and arguments do not affect him much. Poor fellow!. He has our sympathy; for how could any man with such a patronymic be affected by such a common-place name as our's.

As to our arguments, they have been invariably written nec temere nec timide, for the serious consideration of brainy, patriotic physicians who look upon legislative quackery with the same degree of abhorrence with which they regard professional quackery; men who, while they love their profession second to none, are always found in the very fore-front of the ever cycling battle for human rights; for constitutional liberty; for right against might.

We confess that we are not a little surprised that our able antagonist, with a name so suggestive of Russian despotism, and Siberian horrors, who, perchance, is domiciled in this land of liberty (?) to escape the cyclone of barbaric persecution that has and is disgracing the land of his nativity, should not be affected by our humble plea for liberty. Oh! ye hard hearts; ye cruel men of foreign despotisms, the Schreschewskys, the Schradys, the Schlominskys, the Goulds, the Inglemans, the Dietrichs, the Schertzers and the Bowditchs, who are, one and all, making such unremitting efforts to transplant the semi-civilized laws and customs of foreign tyrannies from the dung-hills of their native states to the free soil of this American Republic, why don't the tinge of shame mantle the casehardened cheek and palsy the arm that would obliterate the only real distinction between a Republic and a despotism?

These fellows come to our shores with no true conception of our American institutions, and at once proceed to place dynamite bombs, in the shape of libertydestroying laws, under the very cornerstones of our government. With their mouths they shout for protection for the dear people, of whom they know little and care less, while they are insidiously sowing the seeds of anarchy and riveting the chains of slavery on the individual.

The protection for which they cry is such protection as wolves give to lambs-seeking and devouring them. Thank God it is not only the privilege but the bounden duty of every American citizen to resist their machinations.

Consonant with the sinister arguments that have always been made in favor of medical slavery by legislative method, Dr. S. rather ostentatiously asks, "Why did he forget the very important fact that individual freedom exists only as long as it does not interfere with the welfare of our fellow-men?"

Had the doctor said, "The right to individual freedom exists, etc.," his question would be deserving of more consideration; but, even then, paradoxical as it may seem, the natural corollary to the doctor's own proposition is the best exposure of his ignorance or hypocrisy. If, as we think, the doctor intended to predicate," the right to individual liberty exists only so long as it does not interfere with the welfare of our fellow-men," it follows as a necessary logical corollary that the right to individual liberty should exist, unabridged by tyrannous legislation, just so long as it does not interfere with the welfare of our fellow-man. This is just what we have always "pertinaciously" insisted upon throughout this long-drawn-out controversy, as will be seen by reference to previous numbers of the BRIEF. Doctor, were you ignorant of that fact, or do you think the readers of the BRIEF so devoid of "gumption" as to be so easily thrown off the track?

In the case of Munn vs. Illinois, 94 U. S. 124; the U. S. supreme court said: "While power does not exist with the whole people to control rights that are purely and exclusively private, government may require each citizen to so conduct himself, and so use his own property, as not unnecessarily to injure another."

In delivering the opinion of the Court in the case of Kansas vs. Ziebold and Hagelin, Justice Harlan said: "After observing that the (Fourteenth) amendment forbade the arbitrary deprivation of life or liberty, and the arbitrary spoliation of property, and secured equal protection to all under like circumstances, in respect as well to their personal and civil rights as to their acquisition and enjoyment of property, the

Court, in the case of Barber vs. Connelly, 113 U. S., 32, said: 'But neither the amendment-broad and comprehensive as it is-nor any other amendment, was designed to interfere with the power of the State to prescribe regulations to promote the health, peace, morals, education and good order of the people,' etc. And, again, in Stone vs. Miss.: 'No legislature can bargain away the public health or the public morals. The people themselves can not do it, much less their servants. Government is organized with a view to their preservation, and can not divest itself of the power to provide for them.' And again, in K. vs. Z. and H.: 'Nor can legislation of this character come within the Fourteenth amendment in any case, unless it is apparent that its real object is not to protect the community, or to promote the general wellbeing, but, under the guise of police regulations, to deprive the owner of his liberty and property without due process of law." "

In the case of Patterson vs. Kentucky, 97 U. S., 501, the Court said: "By the settled doctrines of this Court the police power extends, at least, to the protection of the lives, the health and the property of the community against the injurious exercise by any citizen of his own rights. State legislation, strictly and legitimately for police purposes, does not intrench upon any authority which has been confided, expressly or by implication, to the National government."

It has, nevertheless, with marked distinctness and uniformity, recognized the necessity, growing out of the fundamental conditions of society, of upholding State police regulations which were enacted in good faith, and had appropriate and direct connection with that protection to life, health and property which each State owes to her citizens." Again, in the case of K. vs. Z. and H., the Supreme Court said: "It does not at all follow that every statute enacted ostensibly for the promotion of these ends, is to be accepted as a legitimate exertion of the police powers of the State. There are, of necessity, limits beyond which legislation can not rightfully go. While every possible presumption is to be indulged in favor of the

validity of a statute the courts must obey the Constitution rather than the law-making department of government, and must, upon their responsibility, determine whether in any particular case these limits have been passed."

"To what purpose are powers limited, and to what purpose are those limitations committed to writing if these limits may, at any time, be passed by those intended to be restrained? The distinction between a government with limited and unlimited powers is abolished if those limits do not confine the persons on whom they are imposed, and if acts prohibited and acts allowed are of equal obligation. The courts are not bound by mere forms, nor are they to be misled by mere pretences. They are at libertyindeed, are under a solemn duty-to look at the substance of things whenever they enter upon the inquiry whether the legislature has transcended the limits of its authority. If, therefore, a statute purporting to have been enacted to protect the public health, the public morals, or the public safety, or is a palpable invasion of rights secured by the fundamental law, it is the duty of the courts to so adjudge, and thereby give effect to the Constitution."

The italics in each case are mine.

Again we" pertinaciously" insist that medical laws must stand or fall by these measurements prescribed by the highest judicial authority in the land.

Again we pertinaciously" " insist that the friends of medical legislation adduce some proof that these laws do bear some "real or substantial relation to the public health, the public morals, or the public safety." If they have a single witness, or a single fact or statistic large enough to be seen without a microscope, we hope they will soon introduce it. Such isolated instances as the "Russian barber or German physiciau" are too easily offset by cases where great laparotomists have left such insignificant and little things as compresses, sponges, forceps, etc., in the abdominal cavities of their patients. If the “German physician" should be deprived of his liberty, why should not these great laparotomists be deprived of theirs? Besides, there is no evidence that the "German physician" actually injured his patient,