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hand on at least three occasions during its progress through the legislature, and should expect to do this at precisely the right movement. Every man must remember that the game is divided into halves, and that the second half is always the hotter contest.

LOCAL BOARDS OF HEALTH.

It does not seem certain that the Faculty will propose a general law to increase the efficiency of local boards of health. It is probable that the Carroll County Medical Society will seek legislation to improve the local sanitary administration. In this connection some points in the recent history of local boards of health are of interest.

In 1897 there were 15 local health officers in Maryland outside of Baltimore. The law requiring boards of health to be organized in every county had been in force for several years, but had not been generally complied with. Some of the boards of health in existence in 1897 were of little or no value. They were not intended to be useful, for this they could not be without the expenditure of money. They were organized for no better purpose than to show a formal compliance with the law. The health officers were paid at the average rate of about $25 a year. Some of them received no salary. Here and there some good work was done notwithstanding the adverse conditions. The local sanitary organization of that time was worth what it cost, or perhaps it would be better to say that, the local sanitary organization cost a little less than it was worth.

In 1905 there are 23 county boards of health, having 37 medical officers, and there are 16 town and district health officers, making in all 53 local health officers outside of Baltimore. Of this number five or six receive $25 or $50 a year and four or five receive no pay at all. But the average salary of the 53 officers is about $125 a year. The number of officers has therefore increased three and one-half times in eight year, and the salary has increased five times.

In 1897 local health officers had no routine duties of any sort. There was no law on notification of infectious diseases nor any registration of births or deaths. In the absence of any alarming disease, local health officers had no official duties. In 1898 a notification law was passed, and a hygienic laboratory was established by the State Board of Health. In 1900 a registration law was passed. In this way the local health officers got routine duties of great importance, and with the activity of smallpox in the four years after 1898 were able to command somewhat better pay than formerly. Under the registration law of 1900 county health officers became local registrars of vital statistics, with the power to appoint subregistrars in each election district, and they were entitled to fees for the registration of births and deaths. There are now upwards of 450 registrars and subregistrars on the official roster of the 23 counties.

In 1902 the law on local boards of health was amended so as to extend the one-year term of office to two years and to fix the reasonable salary of health officers. Finally, in 1904, the tuberculosis laws were passed, further increasing the duties of health officers.

At every legislature substantial progress has been made, not only increasing the efficiency, but improving the economic status of the local health

officers. It is true that the duties of health officers have multiplied much faster than his emoluments, and that those health officers who are worth any salary at all are worth very much more than they receive, but that is not the fault of the laws nor of those who have secured the passage of these laws. County commissioners have no difficulty in finding physicians who will serve as health officers at less than the authorized rates of compensation, and it is not surprising that the average salary, which should have increased twelve times in eight years, has actually increased but five or six times.

If the local societies have, in fact, such power as the improved status of professional organization is said to imply, they can raise the salaries of 22 county health officers from an average annual sum of $125 to an average of $390 by simply causing the county commissioners to levy the amount authorized by the general law on the subject.

The Medical and Chirurgical Faculty can do no more than this by an appeal to the legislature.

MR. ADAMS ON THE PATENT-MEDICINE EVIL.

Collier's Weekly is making a most vigorous attack on the patent-medicine and proprietary frauds. A series of articles by Samuel Hopkins Adams began about three weeks ago, and promises to run for two or three months. Mr. Adams has studied the subject in a leisurely manner and with great thoroughness. Mr. Adams' previous papers on tuberculosis and typhoid fever, appearing in McClure's, will be remembered by most physicians. In those articles it was manifest that Mr. Adams had studied his subject at first hand in many localities, avoiding no difficulty of time or distance. This thoroughness of preparation is no less evident in his articles on the patent-medicine evil, and to this, far more than to Mr. Adams' excellent gifts of expression, we must attribute the interest of what he has to say. In the issue for October 26 Mr. Adams discourses Peruna and other "hypocritical cocktails."

The fraudulent character of these preparations and of the means of exploiting them are well described both in the text and the illustrations. It is highly edifying to have the testimonial swindle exposed as Mr. Adams exposes it, showing an advertisement bearing the portraits of ministers of the gospel who believe in Peruna or in Duffey's Malt Whiskey, followed by authoritative histories of these clerical individuals. One has prostituted his ecclesiastical functions in the management of a matrimonial bureau; another is an internal-revenue collector, formerly a preacher and racehorse man; another is a very obscure cleric in a very remote hamlet who was repudiated by his church on account of the testimonial which he gave to one of these hypocritical cocktails. In a previous article Mr. Adams shows the device by which the proprietary swindler controls the daily newspapers. Physicians have often been surprised at the instant and unanimous responsiveness of the press in defense of the patent-medicine man. The secret lies in an inconspicuous clause of the formal contract for long-term and lucrative advertising. When a legislature is asked to regulate the patent-medicine evil the patient-medicine man simply calls attention to this clause in the contract. He presses the button and the presses do the rest.

Medical Items.

BALTIMORE.

A FUND is being raised at the College of Physicians and Surgeons to put a portrait of Dr. Thomas S. Latimer in the college library.

DR. MORRIS WIENER, a distinguished German physician, scientific man and litterateur, died at his home in Baltimore on October 12 at the great age of 94.

THE third-year class, College of Physicians and Surgeons, has lost a member, Mr. Herbert Tabor, who died of typhoid fever at his home in Providence, R. I., on October 10.

THE second course of Herter lectures was delivered on Wednesday and Thursday, October 4 and 5, at Johns Hopkins Medical School by Prof. Hans H. Meyer, director of the Pharmacological Institute, University of Vienna.

A PUBLIC meeting will be held in McCoy Hall, Johns Hopkins University, on November I to discuss the mosquito problem. Addresses will be made by Mr. George Stewart Brown, who has been agitating the matter in the Baltimore city council during the past two years; by Mr. Homer Coffin, whom Dr. Howard Kelly engaged several months ago to study the local problem; by Professor Simons, the Maryland State entomologist, and by Dr. John B. Smith of the New Jersey agricultural experiment station.

THE American Röntgen Ray Society held its sixth annual meeting in Baltimore on September 28, 29, and 30. The presidential address by Dr. Charles Lester Leonard reviewed the 10 years' history of the Röntgen ray in medicine and surgery. Dr. Henry Hulst of Grand Rapids, Mich., read a paper on the Röntgen ray in the diagnosis of diseases of the stomach and intestines. Dr. P. M. Hickey of Detroit gave a lantern-slide demonstration of the boney development of the elbow joint. Dr. George E. Pfahler of Philadelphia discussed the interpretation of lung negatives. Dr. Baetjer of Baltimore discussed the diagnosis of thoracic aneurism. Dr. E. G. Williams of Richmond, Va., read a paper

on "Regulation and Measurement of Therapeutic Dosage of the Röntgen Ray." Dr. O. S. Barnum of Los Angeles, Cal., read a paper on "The Technique of Röntgen Treatment of Keloids." Dr. Gordon G. Burdick of Chicago read a paper on the "Present Status of Radiotherapy." Dr. George C. Johnson of Pittsburg read a paper on the "Treatment of Carcinoma;" Dr. Wm. B. Coley of New York one on "Late Results in the Treatment of Sarcoma;" Dr. George H. Stover on the "Röntgen Ray in Carcinoma;" Dr. G. P. Girdwood of Montreal on "Treatment of Lupus and Rodent Ulcers." Dr. C. F. Smith, U. S. N., spoke on the "Röntgen Ray in Military Surgery." Dr. J. F. Smith of Chicago read a paper on the "Treatment of Leukemia by the Röntgen Ray," and Dr. Henry Pancoast one on the "Röntgen Treatment of Hodgkins' Disease, Leukemia, and Polycythemia." Dr. R. H. Boggs of Pittsburg read a paper on the "Technique of Calculus Diagnosis." Dr. J. Rudis-Jicinsky of Cedar Rapids, Iowa, read a paper on the "Pathological and Physiological Effects of Röntgen Rays." The next meeting will be held in Chicago.

MARYLAND.

DR. T. CHALMERS PEEBLES of Lutherville, Baltimore county, has removed to Falmouth, Mass.

THE Montgomery County Medical Society held its autumn meeting at Kensington on Tuesday, October 18. Twenty-three members were present. The afternoon session was attended by delegations from five women's clubs, who were invited to participate in a general discussion on tuberculosis after an address on that subject by Dr. John S. Fulton of Baltimore.

THE Carroll County Medical Society met at the Second Hospital for the Insane, Sykesville, on Wednesday, October 19. Luncheon was served in the administration building by the Women's Group. At the afternoon session Dr. Henry P. Hynson of Baltimore made an address on the changes in the U. S. Parmacopeia. Dr. John S. Fulton discussed the organization of local boards of health. Dr. Billingslea, the president, appointed a committee to draft a law

to increase the efficiency of the local board of health of Carroll county. The committee includes Dr. J. C. Clark of Sykesville, Dr. Brown of New Windsor, and Dr. Foutz of Westminster. A clinic on mental diseases was given by Drs. J. C. Clark, C. S. Carey, J. N. Morris, C. T. Hill, and C. Fisher of the hospital staff.

GENERAL.

MR. W. B. SAUNDERS, the well-known publisher, died at Atlantic City on October I.

THE New York State Medical Society and the New York State Medical Association have at last united, thus closing the most important gap in medical organization in America.

THE monkeys in Lincoln Park Zoo, Chicago, are to have the outdoor life in the hope of eradicating the tuberculosis which afflicts them. It is an interesting, but very doubtful experiment.

AT the recent meeting of the New York State Medical Association it unanimously passed a resolution calling on the committee on legislation to prepare and present at the coming general assembly a bill creating a single medicalexamining board in place of the three such boards now in existence.

AMONG the American delegates to the International Congress of Tuberculosis in Paris were Dr. Henry Barton Jacobs of Baltimore, Dr. S. A. Knopf of New York, Dr. Charles Harrington of Boston, and Dr. Henry G. Beyer, U. S. N., of Washington. Dr. Wm. Osler was also in attendance.

ON October 15 the State Board of Health of New Jersey put into effect its rule excluding New York physicians from practice in New Jersey unless they are qualified by examination in New Jersey. Heretofore New York physicians have been admitted to practice in New Jersey without examination, but the New York State Regents have steadily refused to accord like privileges to physicians qualified under the laws of New Jersey.

GEORGE W. COTT, a wealthy civil engineer, recently died in New York, having bequeathed his body to a medical college "to be used in such a manner as will be most conducive to the advancements of medical and surgical knowledge." The body was accordingly delivered to the Bellevue Medical College. At autopsy it is said that the antemortem diagnosis of cholelithiasis and peritonitis was confirmed, but an unsuspected finding was the complete atrophy of the pancreas. No indication of pancreatic disease had been observed during life.

Ar the second International Sanitary Conference of American Republics in Washington October 9 to 13 a convention was signed by the delegates providing for uniform quarantine regulations among the signatory governments. The articles were substantially those of the last Paris conference, the only difference being the substitution of medical observation for the surveillance practiced in Europe. The agreement is not yet binding on the governments represented, but the delegates will ask ratification by their governments. Twelve republics of Central and South America were represented.

NEW YORK CITY is preparing to spend $2,000,000 on a city sanitarium for consumptives. Last spring $200,000 was appropriated for beginning this work. The site is on Staten Island, overlooking the Narrows and the lower bay. The spot is said to be the highest on the Atlantic coast between Maine and the Gulf of Mexico. The architect is Mr. Raymond Almirall. The ward buildings will be in the form of an arc; the windows are all to extend to the floor and open on verandas. The roof is to be treated as a roof garden, one portion being enclosed in glass. There are to be two buildings devoted exclusively to the cure of advanced cases in single rooms. Patients in all stages of the disease will be admitted. The site selected is on city property, and the $200,000 already available will, it is estimated, provide accommodations for at least 100 patients.

MARYLAND

MEDICAL JOURNAL

A Journal of Medicine and Surgery

Vol. XLVIII No. 12 BALTIMORE, DECEMBER, 1905

Whole No. 1051

BERIBERI AS MET WITH IN THE PHILIPPINES. By H. M. Cohen, M.D., Baltimore,

Late Captain and Assistant Surgeon, U. S. V.

WITH the acquisition of the Philippines and our taking over of the Panama canal the study and treatment of tropical diseases must be added to American medicine, and among the number of ailments likely to attract our greatest attention in both of these tropical countries, perhaps the one of most interest is beriberi.

This disease has already been met with extensively by American physicians in our far-off Oriental possessions, and in view of its tendency to prevail along the routes of great works of a character such as the canal project, it will no doubt be of advantage to us to know more of its nature and treatment.

Beriberi is perhaps one of the oldest diseases transmitted to us, and dates as far back as 2600 years before the present era, to which time Hwangti, in his Chinese work entitled "Neiching," is said to have traced it under the name of kiohki. In the third century the Japanese described it as kak-ke, and in 700 Sen-Kin-Ko, a Chinese writer, made mention of it. In Europe perhaps the first to study the disease was Bontius, who considered it a paralysis. Tulpius mentioned it in 1651, and later Fontana, an Italian, appears to have written learnedly upon the subject.

We find the first mention of it in the Philippines in 1745, in at work by the Spanish friar Caspar de San Agus. The Dutch in their early experiences in the East seem to have been bothered considerably with the disease, and in the early part of the nineteenth century Jachivon-Nanki, a Japanese, brought out a work which was later translated into English by Scheube, and which was no doubt the first real attempt at a scientific study of beriberi. Among the British Malcomsen, Carter, Waring, and Morehead studied it in India.

But it was not until a comparatively recent epidemic in Brazil that much progress was made, and in 1884 Lacerda, a Brazilian.

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