Objectionable Features Research Articles

NEW APPOINTMENT AND PROMOTION POLICY FOR ARMY MEDICAL RESERVES

Elsewhere in this issue¹are the new regulations of the War Department governing appointment and promotion in the medical sections of the Officers Reserve Corps. The evident purpose is to give to the medical profession a more satisfactory basis for appointment and promotion, and one free from the objectionable features of former requirements. Under these new regulations, promotion in the reserve is given on the impartial and incontrovertible basis of length of commission. A man who serves five years in one grade, and who has normally developed in his profession, is eligible for promotion to the grade above, provided he is physically qualified for a commission. Professional examination is waived for promotion from the lowest grade to the highest, with one notable exception. The reserve officer who passes from the grade of major to lieutenant colonel must be tested to determine his fitness for the administrative responsibilities of the

The Present Religious Situation in India

India is now under the sway of a nationalistic movement which is reflected in the effort to get rid of the more objectionable features of faith and practice, and in some quarters in a proposal to return to the simplicity and sublimity of the Vedas, reinterpreted in modern terms. This spirit finds expression in the demand that Christianity in India be released from foreign control and that the Christian message be interpreted through the imagery and thought-forms that are familiar to the people of the country. The system of caste is coming to be recognized as incompatible with a unitary national life; it must be reduced to a mere symbol or entirely obliterated. National unification is further impeded by the fact that the real lines of cleavage are religious and racial rather than political. The Hindu-Muslim concordat is both artificial and ephemeral, while the chief political remedy employed, namely non-co-operation, is negative rather than constructive. Already Indian leaders are dreaming of a higher religious synthesis, spiritual and universal, uniting the best that there is in Christianity with the best of the indigenous faiths, a synthesis in which Jesus shall be honored as one of the avatars of the Infinite, and one of the world's redeemers along with Buddha, Rama, and Krishna.

THE MICROSCOPIC EXAMINATION OF THE MINERAL CONSTITUENTS OF SOME AMERICAN CLAYS1

The difference in structure of the English and American clay grains and mineral constituents were examined under the microscope. English kaolin consists chiefly of crystalline Kaolin being similar to North Carolina kaolins in this respect. Georgia, South Carolina and some Pennsylvania clays consist largely of “colloidal” kaolin, which accounts for their difference in physical properties. The objectionable abrasive features of the American clays causing excessive wear to machinery can be readily overcome by more “refined” refining methods but it is impossible by any present known methods or process to transform the colloidal kaolinite particles of our transported clays into the crystalline plate-like structure of the English china clay. Our only hope therefore, of producing clays in this country which will be as satisfactory as those now imported, lies in the development of the crystalline kaolins. This is possible by better mining, blending and refining processes. However, the total tonnage of clay in our crystalline kaolin deposits is limited and if drawn upon intensively they would soon be exhausted. Minerals found present in the clays are chiefly muscovite, quartz, tourmaline, biotite, zircon, alkali feldspar, plagioclase, rutile, hydrated silica and hematite.

ARTIFICIAL LIGHT FOR PHOTOGRAPHY

To the Editor:— The difficulties of getting sufficient light for the taking of clinical photographs of dermatologic interest, which is feasible for office use, led me to try the air cooled mercury quartz lamp, which has become a fixture in almost all dermatologists' offices. My success has far exceeded expectations. I have not found any source of light which approaches it in intensity, and, except for the wearing of the protective goggles, gives as much ease of manipulation and is as free from objectionable features. Speed of exposure, which is a necessary factor for good photographs, is assured with the lamp. The lens may be stopped down, which aids in giving depth to the picture. There is no attendant explosion, and no smoke to upset the office or to make further stay in the room impossible for more pictures or other purposes. (If a smoke bag is used, light is

Factors Controlling the Design and Selection of Suspension Insulators

A discussion of the factors entering into the design and operating behavior of suspension insulators and the problems to be solved in designing a suspension insulator to overcome the objectionable features shown by experience to affect seriously the operation of the insulators in service. Factors to be taken into consideration in the selection of suspension insulators for a given condition are given and a brief discussion of the general trend of future improvements is presented.

Combinations for Export Under the Webb Act

Largely as a result of this recommendation, the Webb Bill passed the House of Representatives on September 2, 1916. The original House bill contained two clauses that negatived the purposes of the bill. It was provided that export trade should not deemed to include the production, manufacture, trading in or marketing within the United States or any territory thereof, of such goods, wares or merchandise or any act in the course of such production or manufacture. Again it was provided that such action should be confined to such as does not the export trade of the United It would be manifestly impossible to obtain goods for export in the United States unless the organization were to trade or market in the United States. Further, it would appear that such a combination to be effective must restrain export trade. The bill did not pass the 64th Congress. The bill was, however, passed by the 65th Congress and approved April 10, 1918, with the objectionable features eliminated. In general terms, the act as finally adopted declared that nothing contained in the Sherman Law should be construed as making illegal a combination entered into for the sole purpose of engaging in export trade or acts in furtherance thereof providing there were no resulting restraints of domestic trade, or of the export trade of a domestic competitor, nor any act of any kind whatsoever which artificially or intentionally enhanced or depressed prices, substantially lessened competition or otherwise restrained trade in 150

Horse-Breeding and Horse-Racing

THE history of the English racehorse is a chequered one. During the Wars of the Roses many studs were dispersed, but owing to the re-importation of horses from the Continent during the reign of Henry Viii. the thoroughbred breed was re-established. Later, owing to the importation of numerous Oriental and other alien stallions and mares, the English breed of race-horses was for years in the melting-pot. In 1649 the Royal Tutbury Stud was handed over to Parlia. ment, but a few years later Cromwell, though himself an owner of racehorses, found it necessary “for political reasons” to stop racing. History has been repeating itself. A valuable stud has recently been handed over to the Government, and racing has once again been virtually suspended. Further, some people not unduly biased by the objectionable features of race-meetings are asking, “Is racing necessary to maintain the pre-eminence of the English racehorse?” while others, including Sir H. H. Johnston, want to know “whether the type of horse that is evolved from horse-racing is of any use nowadays?”

A TRANSILLUMINATOR WITH NEW POSSIBILITIES

The transilluminator has become an important diagnostic agent in otorhinology. Through its use, pathologic changes in many of the accessory nasal cavities have become visualized. While the full significance of the picture it portrays may be difficult to interpret, it rarely deceives as to the fundamental facts desired—the presence or absence of disease. The instruments now in common usage require the electric current, and some a rheostat. They are expensive and of a size that does not permit them to be used within small cavities. I desire to call attention to an instrument which not only overcomes some of these objectionable features, but also, on account of its size and shape, has a far broader field of usefulness. It consists of a small dry cell battery mounted in a case similar to an ordinary flashlight, which has a small but powerful lamp mounted at the free end of a rodlike

THE DECOLORIZATION OF THE LITTLE RIVER WATER SUPPLY IN CONNECTION WITH FILTRATION AT SPRINGFIELD, MASS

Sulphate of alumina as a coagulant and decolorizer is in use on many waters in the United States, and is recognized as one of the most effectual means of reducing an objectionable color in the water prior to filtration. The river water as applied to the West Parish filters of the Springfield water supply is naturally a water of few objectionable features. No large population is resident upon the water-shed and the sanitary conditions are excellent so that there is not a large danger of serious contamination of the supply at any time. By filtration a water free from practically all objections is produced, except that at times, the remaining color is noticeable, and the present systeni of coagulation is the result of a study of the means of correcting this one objection to the water. This water was first used as a supply in December, 1909, and sulphate of alumina was used for the reduction of color in the manner in which it is usually applied. The accompanying cut showing the use of coagulant during 1910 illustrates the amount of sulphate of alumina which was necessary for this reduction. Its application during this year was in accordance with the usual practice, that is, in amounts sufficient to secure a clear-cut reaction and the coagulant was applied continuously. The present method is illustrated by the chart showing the amounts and the color of the raw and filtered water during 1912 and 1913. As at present practised, excellent color reduction is secured by the use of 0.2 grain of sulphate of alumina per gallon of water during a larger portion of the time.

NERVE-BLOCKING AS A SUBSTITUTE FOR GENERAL ANESTHESIA IN SURGICAL OPERATIONS

Notwithstanding the inestimable advantages and blessings of general anesthesia as a method of inducing insensibility for surgical purposes, it is not without its serious drawbacks. In addition to the fact that most persons shrink from the idea of losing consciousness, general anesthesia has attached to it not only unpleasant after-effects, such as nausea, vomiting, headache, pulmonary irritation, pneumonia, suppression of urine, etc., but also the occasional, unavoidable sudden death. It has long been the hope of surgeons and experimenters that some method of inducing insensibility to pain might be discovered which would be free from all the objectionable features of practically all the present known methods of inducing general anesthesia, and this hope seems now to be realized. Physical pain is the perception of afferent impulses received from that portion of the body which is the subject of injury. If no impulses reach the brain from the injured part, no

MEATOTOMY: A SIMPLE METHOD

Now that the fact is being more universally recognized that many of the chronic urethral discharges are due to more or less extensive infiltrations of the urethral mucous membrane, and that these infiltrations can be removed only by sufficient dilatation to restore the caliber of the urethra to its normal dimnsios, the operation of meatotomy assumes a more important aspect. There are many methods for performing this minor operation, but those described in the text-books and recent medical literature have many objectionable features. The idea in all of these methods is to control the hemorrhage at the time of the operation, as well as subsequently, by the employment of caustics and styptics and by the use of plugs and other mechanical contrivances to keep the lips of the meatus apart, thus preventing union of the cut surfaces. In our experience, we have found that styptics and caustics invariably leave an

AN OPERATIVE METHOD FOR THE REDUCTION OF HYPERTROPHY OF THE INFERIOR TURBINATEOTHER THAN BY CAUTERIZATION OR EXSECTION.

If the methods of treatment now in vogue for the reduction of hypertrophy or hyperplasia of the inferior turbinate were wholly free from objectionable features it were then, indeed, superfluous to write aught concerning it. As it is there are so many, and so serious, objections to each method now commonly employed that it may not be misconstrued if an effort be made to advance some suggestion for its relief other than those generally accepted. Any treatment which primarily gives temporary relief, but whose secondary effects are hurtful, worse, indeed, than the original disease which it is sought to relieve, must be relegated to the rear as soon as another method is brought forward whose primary effect is fully that desired, permanent in nature and followed by no secondary effect whatever except that which is beneficial. If it can be proven that such result is attainable without any extraordinary instrumentation,

PHYSICIANS AND PROPRIETARY MEDICINES.

There are several particularly objectionable features connected with the proprietary medicine evil, to which it is desirable to call attention with a view to securing the co-operation of the great body of practicing physicians in obliterating them so far as possible. Every one acknowledges that a great number of secret proprietary medicines are utterly worthless and, in fact, harmful; hence all preparations which do not emanate from thoroughly reputable firms should be viewed with reserve-if not actual suspicion—until they have been examined by competent, unbiased men. It should also be remembered that the testimonials given are often of questionable value, because physicians and professors in certain medical colleges may sometimes be induced to give testimonials on insufficient knowledge. Finally, attention should be called to the well-known fact that mystery exerts a strong influence on the average mind, and a form of mystery may be said to be the chief stock

A NEW OPERATION FOR COMPLETE LACERAATION OF THE PERINEUM.

The necessity for improved technic in repair of complete laceration of the recto-vaginal septum is emphasized by an occasional failure due to infection from the rectum, which may enter the wound when imperfectly approximated or by contamination of the sutures primarily and deeper tissue secondarily. Catgut may absorb too soon and allow the parts to separate. Silk sutures cause pain, ulceration, cicatrization and may even require removal through the speculum, all of which is undesirable. To overcome these objectionable features I have devised a very simple flap operation. It consists in splitting the recto-vaginal septum, dissecting the lower end of the rectum from the vagina and drawing its anterior wall down through and external to the anus. In this way it converts a complete tear of the perineum into an incomplete laceration. The line of incision (black line, Fig. 1) starts on the external side of the sphincter dimple at

The Ninety-Sixth Street Power Station of the Metropolitan Street Railway Company, of New York City

The events which led up to the building of the new power station of the Metropolitan Street Railway Company were brought about largely by the steady growth of the company. In 1891 it was decided to adopt mechanical traction for Broadway, and the cable was selected as offering the best tractive power for heavy loads. As the company increased in size, cable extensions were built on Lexington and Columbus Avenues. Having built these, and having laid out other proposed roads, it was seen that the cable, by its multiplicity of sheave pits, curve pits and power houses, was too expensive and cumbersome to be adopted for a large system; and, as the overhead trolley, which bad proven so satisfactory in other cities, was prohibited on Manhattan Island, the company began a search for some other system which would prove satisfactory in operation and which would also overcome the objectionable features of both the foregoing systems.

TRADE UNIONISM IN MEDICINE.

An association of physicians is being formed in Detroit on apparently regular trades-union principles, exclusion of all non-members from any professional recognition, "business agents" under the name of ward governors, and all the other essential outfitting of a regular trades union.The Journalis an advocate of organization of the medical profession on legitimate ethical lines, but we trust the report of the proposed action in Detroit is incorrect, at least in some of its details. It is not necessary to imitate the objectionable features of a laborers' or mechanics' organization, nor is it dignified or worthy of a learned profession. If our judgment is correct, and we have no reason to doubt it, the plan as proposed will hardly succeed and will not help the profession as a whole. There is ample opportunity for an organization of physicians that will protect their own interests without sacrificing their self-respect as

A NEW PORTABLE ELECTRIC OUTFIT.

Electricity as a therapeutic agent, while quite popular with a few specialists and wealthy practitioners, is employed by the majority of general practitioners with no scientific precision, because of lack of suitable apparatus. The results are poor, for to obtain good results good apparatus is necessary. It is therefore for this reason that electricity is decried by many as a valueless agent, while in reality it is a very valuable means of curing a large number of nervous and muscular affections. The idea prevails among many practitioners that electricty can be administered scientifically only by means of large, stationary and expensive ''machines.'' The price and impossibility of moving the batteries from the office to the bedside of the patient have proven objectionable features, preventing the general introduction and practice of electrotherapeutics. It is perhaps of interest to know that the most renowned specialists in Europe, for example Dr. Erb, who

FOR THE APPLICATION OF COCAIN TO THE UVULA.

There is always more or less difficulty to anesthetize the uvula with cocain by making application with cotton on a carrier. I had for several years used cotton on a toothpick, with very little satisfaction, and seldom getting the uvula insensible. The first attempt usually produces reflex spasms of the soft palate and faucial muscles. Rubbing the uvula with cotton keeps up this effect until the mucous membrane of the uvula is insensible to the touch. This is very disagreeable to the patient; besides, the cocain by contact spreads over the base of the tongue, the pharyngeal wall and the larynx. This often produces nausea and discomfort. I have devised a little instrument, shown in the cut, which has none of the objectionable features of the cotton probe method; besides, it does its work thoroughly and is no trouble at all. Its general contour is that of a spoon, its

THE ABORTION OF GONORRHEA AND TREATMENT OF OTHER URETHRAL AND VESICAL DISEASES BY HYDROSTATIC IRRIGATIONS.

In a paper¹read before the Society for Medical Progress, January 11 and before a Wissenschaftliche Sitzung der deutschen Poliklinik on January 17 of this year, as much of the bibliography of hydrostatic irrigations as covered the requirements was touched upon. In that paper I described an apparatus which did away with nearly all the objectionable features of these irrigations. I now propose to submit some modifications which are the outcome of constant endeavor to so simplify and render safe the treatment of genito-urinary diseases, as to make at least the most frequent thereof available for the general practitioner. The modifications of the apparatus I present, consist essentially in: The substitution of a cast-iron ring to hold the irrigator. By this means, the irrigator can more easily be attached to any wall or bookcase. A rubber tube made especially for this apparatus, doing away with the complicated

LOCAL TREATMENT OF PSORIASIS.Read in the Section on Dermatology at the Forty-fourth Annual Meeting of the American Medical Association.

Psoriasis stands in the front rank of those skin diseases whose course and duration is often chronic, accompanied by frequent relapses. This disease is one that often exhausts the medical man's storehouse of remedies, as well as his ability to keep the patient satisfied with his condition and treatment prescribed. One of the obstacles to proper local treatment is the usual objection of the patient to the remedies employed, their odor, staining qualities or ointment consistence. The essayist has no lauded specifics to offer, whose perfume or color charm the patient's nose or eyes, but desires to call out discussion on the few remedies which have been of any special value. Can these few remedies, whose objectionable features have been a vexed question, be dressed in new clothes that will give a less objectionable treatment to the patient? Can we use more agreeable remedies than the ones referred to, and