of enclosed testimonial in own hand receipt the plainly signed your honor conferred on with the decision of the writing. it, accepted pleasure On receipt of this testimonial we will ship you one of these representatives of the various countries gathered at Madrid and free. physician's outfits absolutely set about the work with the enthusiasm. The execu- Trusting that you will give this your prompt and immediate at¬ greatest tention, and thanking you in advance for this favor, we remain, tive committee and the committee on organization have already Respectfully yours, Ü. S. Standabd Electrical Woeks. been appointed, and the varjous sections of the congress now- Per F. J. Osius, Près. being formed will complete the organization. Following the Enclosed with the letter was the it was following, which precedence of former congresses the executive committee has hoped I would sign and return: decided to establish in all the countries which will send dele¬ November 1903. 17, to Lisbon, subcommittees or bureaus of information, 7. gates jS. Standard Electrical Works, Chicago, III. convinced that with the of the Gentlemen:—I am pleased to recommend your Electric Bath Ma¬ being hearty co-operation pro¬ chine. I have used one for the last few weeks and will say that I fession the Fifteenth Congress will achieve the end for which could not afford to be without it. Please ship me another by re¬ this international scientific gathering was intended, viz.: the turn express and greatly oblige, Very truly yours, advancement of medical science. For this reason I appeal to Enclosed also was a cut of the machine for which the lying your aid in organizing the bureaus of correspondence and of was I shall endorsement requested. respond to the communica¬ information in the . tion as follows: Miguel Bombarda, Secretary-General. united States Standard Electrical Works: Your letter of the 22d inst. is received. I am perfectly astounded by it. Is it possible that you expect a reputable physician who has never seen your bath to sign a letter dated Nov. 17, 1903, stat¬ Queries and Minor Notes. ing that he recommends it and that he has "used one for the last few weeks ?" You say that on receipt of a testimonial for which the form is prescribed, one will be sent without cost. The proposi¬ anonymous Communications will not be noticed. Queries for tion seems to me wholly corrupt and I think it my duty to give it this column must be accompanied by the writer's name and ad¬ in The Journal of the publicity American Medical Association. dress, but the request of the writer not to publish his name will C. B. Bukb. be faithfully observed. Very truly yours, C. B. Burr. PASTORAL MEDICINE—THE BUSINESS SIDE OF PRACTICE. Chicago, Dec. 22, 1903. To the Editor:—I would like to see in your Minor Comments De¬ Organization in Iowa. partment what you think in regard to the addition to the medical Iowa City, Iowa, Jan. 22, 1904. course in colleges of lectures in what might be called pastoral medicine To the Editor:\p=m-\Inbehalf of and in to the medical analogous to those on pastoral theology in divinity schools'. justice The covers the relation of I submit the corrections. Dr. latter of the minister to his flock collectively profession Iowa, following and individually, to his fellow to church property, to in his "Plea for Unification" Jan. clergymen, McCormack, (The Journal, types of human nature, etc., covering a number of things relating 16, 1904, p. 167), uses the following language: to the success of his work. It seems to me that we who are students It is true that in nearly every state where this plan of organiza- ought to have the benefit of lectures by an experienced man with a tion has been as was natural and to be academic proposed, expected, broad outlook on human nature and with the to handle the and purely theoretical objections have been made to some feature ability of it, usually to the council, the house of delegates or to coincident questions relating to the physician's getting on in the world, having membership. Such objection has always been made in advance of granted a reasonable scientific equipment. Such things as location, a trial of and have been almost to them, they confined entirely buying a practice, relations to other to re¬ states which have been practically without organization heretofore. physicians, politics, Conditions in Iowa illustrate this point well. quirements for office, location of office, how to make a professional call or how not to make one, are a few of the that I have italicized what seems to me a and things might totally unjust be covered. It seems to me the young physician might be headed unintentional use of Iowa as an as probably example, which, off from a great many blunders in this way. it stands, is open to interpretation the furthest possible from E. P. S. Miller ('05, P. & S.). truth for the the of the case. We assert, medical profession of Answeb.—Our correspondent has touched on a matter that has Iowa, that it has been not only well organized, but that in pro¬ aiways seemed to us of great importance. The first duty of a med¬ portion to the population it has been the best organized and ical school is, of course, to impart a thorough and scientific knowl¬ edge of medical matters. But a and the most harmonious in its associations of state in the it might well go little further any instruct the young physician regarding the right way to put his Union. Its state society numbers 805 members, all (except 15, knowledge to practical use as a means of earning a livelihood. To with more than thirty years' membership) having entered as be sure, each man has to work out his own salvation. No amount can tell him how or delegates from county societies. Iowa has 543 members of of teaching when to make a professional call. He learns by experience ; or if he have not the right make-up he never the American Medical Association, a number exceeded only by learns, always blunders and is a failure. But many fundamental New York, Pennsylvania, Ohio and Illinois. Nor are the ob¬ principles as to the practice of the art could be imparted to stu¬ dents, that would tend to their as to jections in Iowa of the nature alleged by Dr. McCormack ; there broaden views their life work, make it appear more as a profession and less as a save them has been no to the of the trade, objection principles original report from many serious mistakes and perhaps save them from that dis¬ of the committee on reorganization, as made by Dr. McCor¬ astrous termination of many a brilliant career, the degradation mack, at St. Paul in 1901. There have been and are into a sordid money maker. At least an elective course, consisting objections of to the of the of the "standard" at lectures by a competent man, should be given in every college, validity alleged adoption to afford to the student the opportunity of learning concerning Sioux City, April 17, 1903, and to the "standard" as repre- these matters that are of such practical importance. In addition senting the principles of the St. Paul report. C. M. Hobby. to the subjects referred to by our correspondent such topics might be considered as the ethics of medicine, fees, that curse "commis¬ sions," medical societies, medical literature, malpractice, the phy¬ Fifteenth International Congress of Medicine. sician's recreation, etc. Some colleges provide one or more lectures, but none, so far as we know, recognizes the importance of such a Dr. John A. Wyeth, , has sent us a letter which course of lectures. he has received from Prof. Miguel Bombarda, secretary-general of the International Congress of Medicine to be held at Lisbon DOES INGESTED FORMALDEHYD HARDEN THE LIVING 1906. Dr. in Wyeth expresses the hope that the unpleasant . TISSUE? experiences of our delegates at Madrid will not deter us from Webb City, Mo., Jan. 13, 1904. taking an interest in the Lisbon congress. He suggests that To the Editor:—Considering the well-known effect of formalde- it would be well for The Journal of the Association to in- byd hardening tissues, the question of the action of the drug on augurate this movement by printing at this time this invitation. the epithelium of the kidney tubules following the administration of remedies containing the suggests itself to me. Has there A translation of the letter referred to is as follows: drug been any report showing the effect, as found postmortem, on the Lisbon, Dec. 22, 1903. kidneys of patients who have, during life, taken urotropin, for- Sir and most honored confr\l=e`\re:\p=m-\Atthe last international min, cystogen or other preparations containing formaldehyd ? congress at Madrid, Lisbon was designated as the place of L. C Chenoweth. meeting of the Fifteenth International Congress of Medicine, Answer.—So far as we know, there have been no reports to show and the medical of the that urotropin, etc., cause any permanent changes in the kidneys. profession Portugal, appreciating great The exact place in the urinary tract where urotropin forms formal-

Downloaded From: http://jama.jamanetwork.com/ by a University of User on 06/13/2015 dehyd does not seem to be known definitely. It may be that the formaldehyd does not have the chance to act as such on the cells Marriages. of the kidney. Then, again, the dilution may be so great that while the are no cellular and antiseptic properties still apparent, yet Giovanni . to Miss Marie both of reactive changes are produced. Investigations on persons who have Bruno, M.D., Lagorio, habitually used foods, etc., preserved by formaldehyd may be of Chicago, January 18. value. The Department of Agriculture experiments on humans Henry Clay Gemmile, Jr., M.D., Indianapolis, to Miss Helen under Dr. Wiley's supervision may add some facts. Coleman (Med. Bringhurst of Philadelphia, January 12. News, Aug. 29, 1903,) has collected and reported a number of cases of temporary toxic effects, strangury, hematuria, gastric and Hugh C. Beazley, M.D., Bowling Green, Ky., to Miss Carrie intestinal disturbance, etc., following the use of urotropin, which he B. Redd of Hopkinsville, Ky., January 20. attributes to idiosyncrasy, interference with the usual disposition Samuel L. Edwards, M.D., Memphis, Tenn., to Miss Lillian of the formaldehyd in the body, or in the liberation of an unusual Urbansky, at St. Kan., 6. amount of formaldehyd. In all the cases the discontinuance of the Marys, January drug was followed by rapid disappearance of the symptoms, which Howard Davis Lewis, M.D., Baltimore, to Miss Katherine were altogether exceptional. Toxic effects from the drug as ordi¬ Gray Blackshire, at Baltimore, January 14. narily given are very rare. U. S. Grant Sparks, M.D., to Miss Kate Garueh, both of Mantua, N. J., at Camden, N. J., December 19. INFANT DEATH BATE AND SCHOOL HYGIENE. George Archibald Hogan, M.D., Bessemer, Ala., to Miss Clark Gaines of 27. Sioux City, Jan. 21, 1904. Myra Northport, Ala., January James H. Banks, to Miss Maude M. To the Editor:—1. Can you give me the death rate of children M.D., Lincoln, 111., Wendell of New Holland, 111., at Lincoln, 13. from birth to at least three years old, especially where the cause January is mostly due to feeding? Or what proportion of all children born Robert W. Cochran, M.D., Madison, Ind., to Miss Leonora die before the third year is reached? 2. Can you refer me to some Livingstone Howard of Johnson City, Tenn., January 12. article on ventilation of public schools? Milton Daily. Answer.—1. The average death rate of children, as given in Newsholme's "Vital Statistics," varies from about 100 to 300 per Deaths. thousand births in the different countries during the first year of life. The "Vital Statistics Report" of the United States Census Bureau gives the death rate for the year 1900 in the first year of EDMUND ANDREWS, M.D. 193.2 and life as ; 85.3 added to this number during the second and Dr. Edmund Andrews, scientist, pioneer in surgery and in third years make a total of 278.5 under three years of age per education in the thousand medical west, and student to the end of his of population. The registration area in this country, life, died in however, is so small and the vital statistics so imperfectly reported Mercy Hospital, Chicago, January 22, aged 79. through the greater portion that this can not be taken as the actual average for the whole. The death rate of children under three years of age would probably average not less than 250, and possibly higher for the first three years of life. The fact that the registra¬ tion areas include the large cities where infant mortality is high must be considered. 2. We know of no recent article especially devoted to school ven¬ tilation ; various works, like that of Morrisson's, published in 1887, are to be had through any book seller. But the subject is treated of in general works on hygiene like Chapin's "Municipal Sanita¬ tion," Egbert's "Hygiene," etc.

LITERATURE ON ILLEGITIMACY. Chicago, Jan. 23, 1904. To the Editor:—In answer to the inquiry of J. E. D. of (The Journal, Jan. 23, p. 256), I beg leave to state that the most satisfactory treatise on illegitimacy is the little book of Leffing- well (E. H. Colegrove, 65 Randolph St., Chicago. Price, $1.00.) He shows, much to the surprise of the casual observer, that illegiti¬ macy prevails in certain sparsely settled, mountainous districts of Scotland to a greater extent than elsewhere in the world. His ex¬ planation, that the inhabitants are the descendants of pirates and that hereditary influence is the etiologic factor, has never been sat¬ isfactory to me. I have always maintained, and my views have been pretty generally upheld by sociologie students of experience, that there is a more likely explanation. The absence of prostitutes in these districts, the inadequate knowledge of sex relationship, which unfortunately is almost universal, and the misdirection, through faulty or deficient education, of the domination of the sexual instinct on the part of the male, are, to my mind, factors of chief importance in the consideration of illegitimacy. Denslow Lewis.

THE ETHICS OF REPORTING AN IMAGINARY OPERATION AS HAVING BEEN PERFORMED. EDMUND ANDREWS, M.D. Humboldt, Tenn., Jan. 18, 1904. To the Editor:—Is a physician justified, under any circumstances, He was born in Putney, Vt., April 22, 1824, and there and in in writing an article for a medical journal in which he asserts that Rochester, N. Y., received his preliminary education. He was he has performed an operation, giving technic and results, when in from the first devoted to botany and At the age of his geology. fact he has performed no such operation, but has only conceived 17 family moved to central Michigan, and he entered the the idea that the operation would be applicable to the condition , Ann Arbor, where his work in mathe¬ matics and stated? Please publish this with your reply in The Journal for natural science was especially notable. He was the benefit of any who may be concerned. Yours in the interest also honored by being made president of his college literary of science and truth. Sidney Thompson, M.D. society, and was graduated with the degree of B.A. in 1849. He entered the of Dr. Z. Answer.—We do not know to what article our correspondent office Pitcher, Detroit, in 1850, and refers, but his question seems to be answered in the asking. attended lectures in the Medical Department of the University of Michigan. At the end of his first year he was made dem¬ onstrator of anatomy; received his degree in medicine in the fol¬ training school for male nurses. lowing year, 1851, and was then made lecturer in comparative Dr. N. N. Sallujie, Toledo. Ohio, inquires where there is a hos¬ anatomy. By honesty, care and system he dispelled the com¬ pital or other institution where male nurses are trained. mon apprehension regarding dissections while occupying this

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