Bowman's capsule, so changes this molecular makeup as to interfere with dialysis, and we have a suppression.

The anesthetic or toxics from the gut or stagnation from shock are liable to precipitate this alarming condition when the kidney cell is below normal. And so we are on our guard, and always make it a rule to know the permeability of the kidney, just how well it is doing its normal work before placing extra strain.

TO AMERICAN PHYSICIANS INTERESTED IN
THE ALCOHOLIC PROBLEM.

During 1907 over two hundred papers, lectures and pamphlets were published in Europe and America concerning alcoholism and inebriety from a purely scientific point of view. Many of the authors complain that these papers were practically lost because they did not reach medical men interested in the subject. The Scientific Federation Bureau, organized in Boston two years ago for the purpose of collecting and disseminating the facts concerning the alcoholic problem, proposes to secure a list of medical men interested in the scientific study of the alcoholic problem. This list will be valuable for authors and students who wish to address a special audience of physicians, not only to increase their interests, but to stimulate more exact studies of the subject. Such a list will enable the Bureau to expend its work of accumulating papers and reprints of all that is written, and keeps authors and readers familiar with the new work that is done. All physicians who are interested in the scientific study of the alcoholic problem and research work along this line, and the studies of medical men at home and abroad, are urged to send their name sand addresses so as to be registered and receive copies of papers and abstracts from authors and others who wish to have their papers read by interested persons. As Chairman of the Board of Directors of the Scientific Federation Bureau, I earnestly request all physicians interested in this study to send me not only their own names, but the names of other medical men who would care to keep in touch with the new medical literature coming from the press, and also to know the latest conclusions of the scintific world concerning this problem.

Address T. D. CROTHERS, M. D., Chairman, Hartford, Conn.

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The writers of original articles, who wish to avail themselves of reprints, will please notify the managing editor at the time of presentation of paper; otherwise, full price will have to be charged as the type will have to be reset.

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Therapeutic
Renaissance.

Editorial.

Therapeutics, we are to understand in its broadest sense, comprehends any and all measures that may be used for the alleviation or cure of disease. There is a tendency on the part of certain physicians to decry the use of drugs, saying there is no benefit to be derived from them. What a nihilistic, pessimistic view is this. How encouraging is this attitude to the vast army of medical students and young physicians who are receiving their medical training under these self-constituted authorities, viz., our renowned surgeons, consultants and clinicians. According to some of these gentlemen, it seems that about all that is necessary is, in the one instance, to have a good nurse and a jug of water, and in the other just simply call in a surgeon and have the offending organ removed. Forsooth-simpie--is it not? What a hopeful, helpful outlook is this for the doctor who practices in the country or in a small town. (This class comprises by far the largest per cent. of our medical men.) He has neither the great surgeon nor the trained nurse, consequently he is reduced to the use of water. Do not understand us to disparage the use of water. We are hydrotherapeutists ever. We advocate

the use of water externally, internally and eternally, but (begging the pardon of the above mentioned class of authorities for the offense) we do believe in the use of drugs. If we did not, we should get out of medicine promptly. You know that Professor Hare says, "the individuals who deride the use of drugs in disease belong to one of two classes: Either they have never tried them, or have used them wrongly."

Of course carelessness and the abuse or misuse of drugs on the part of the ignorant tends to bring the subject into disrepute, destroys confidence, engenders prejudice, and renders judgment erroneous. Frequently the young, inxperienced, optimistic practician prescribes in pro- and con-fusion, changing from one prescription to another with such rapidity that he has no chance to observe the effects of any of his drugs. The result is a dissatisfied patient, a disconcerted physician and a table full of medicines. A ludicrous spectacle indeed! But how can a fair-minded man say that the fault was with drugs per se, or who would use these things as an argument in favor of the adoption of the plan of the good nurse and a jug of water.

Now there is a middle ground based upon the impreg nable foundation of sound judgment, common sense and practical experience. Years of practical experience in bedside treatment teaches us what we can do with drugs. It teaches us to recognize certain specific indications. It teaches us how to meet successfully these indications by the intelligent and timely use of drugs. Hence we learn to always have a definite purpose in the use of drugs, and best of all, it enables us to see the fruition of our efforts in the accomplishment of our purpose.

From the above mentioned method has grown the whole science of applied or practical therapeutics. You remember that Hare says: "When called to guide a patient through an illness the physician should be constantly a watchman, and a therapeutist only when necessity arises. A good physician is one who, having pure drugs, knows when to use them, how to use them, and, equally important, when not to use them. When a physician gives

a drug and the patient improves, care should be taken not to ascribe all the good results to the remedy employed. Nature must be given. credit for a large part of the improvement," and hundreds and hundreds of physicians all over the country echo these sentiments to-day.

Let us, however, examine the subject more closely and more definitely, and yet withal, quite briefly. On the face of it, it seems quite absurd that the ancient and honored subject of therapeutics should need a defense, however brief and incomplete it may be. Yet there are none so blind as those who will not see.

1st. From the definition of therapeutics given above we see that all measures whatsoever that are adapted to the relief or cure of diseased conditions really come under the head of therapeutics. Consequently, then, therapeutics is deserving of the highest possible praise.

2nd. Just retrospectively permit your mind to wander back into the not very remote past of the history of medicine, and see what drugs or therapeutics has done for the development of other branches of medicine; e. g., what has anesthesia, ether, chloroform, etc., done for surgery? What has cocaine, as a local anesthetic, done for minor surgery, and surgery of the eye, ear, nose and throat? These things for the surgeon have almost made the impossible possible.

3rd. Consider that the use of certain antiseptic drugs (used both locally and systemically) have almost revolutionized both medicine and surgery, increasing their usefulness many fold.

4th. Glance at and estimate the practical value of the wonderful and brilliant work done by certain distinguished laboratory therapeutists along the line of the anti-bodies, e. g., anti-toxins, sera, vaccines, etc.

5th. It is to be noted that we have a few direct drug specifics, c. g., mercury and the iodides for syphilis, and quinine for malaria, etc., besides a host of drugs that are partly efficacious along these lines.

6th. Finally, let us take notice of the vast hord of general indications that are always to be met, and that if

met promptly, intelligently and successfully, are productive of much good in any and every diseased condition. It will only be necessary for us to mention very briefly, or to simply diagram the lines along which we must work to obtain the results mentioned as possible under the sixth heading, as they will carry their own meaning and explain themselves to every practical physician. They are as follows:

(a) The maintenance of the vital powers by properly feeding the tissues.

(b) The elimination of waste material (which stops auto-intoxication).

(c) The equalization of the circulation.

(d) The obtaining of sedation, or rest, and thus conserving energy.

(e) The relief of important or disturbing symptoms. To the physician who knows and loves drugs, who has used drugs successfully, "Lo, these many years," the conclusion is inevitable that the use of drugs or the subject of therapeutics is and ever shall be the sheet anchor of scientific medicine.

Medical
Reciprocity.

Reciprocal favors are always a source of pleasure and oftentimes profit among all classes of society, and it is the principle of give and take that lends a charm to the whole plan of life. The gander is always willing to do his part, but when it is all for the goose and none for the gander, he loses that proud and high-headed demeanor that is characteristic of his sex and importance, and soon becomes dejected and cowed, and presents all the pathognomonic symptoms of a henpecked husband. So it is in the domestic life of our "goosling" tribe, and from them up the line of ascent to our beloved and honored profession. It has been said that no man can live alone, and certain it is that no great profession can reach the high water mark of attainment and reap the joys that come from lives well spent without the mutual help of those composing that profession.