DISCUSSION. DR. JONES: "Dr. Blythe's paper marks an epoch in history; all will arise and call him blessed. He is the first man who has ever described the disease. The symptoms of the two diseases are similar, but Dr. Blythe has untied the knot. The diagnosis depends upon the point of view. The health officer will say 'smallpox' and the public will diagnose 'Cuban itch."" DR. GRUBE called attention to the fact that many syphilitics were affected by smallpox. DR. GRAVES said he had treated over five hundred cases in the last two years, and had never seen a case of Cuban itch. He commended the commissioners court for so bravely assisting him in endeavoring to suppress the disease. He received the smallpox into his county from Washington county, and during the last two years has had three hundred cases. While may cases were mild, during the last month he had some very serious ones, three or four deaths having occurred. DR. MCCUTCHAN also received smallpox into his county from Washington county and stated that it was his opinion that the wide spread of the disease from that county was due to the fact that they paid no attention to it there, calling it Cuban itch, eruption after la grippe, etc. But if it be an eruptive disease, called by any of these names, vaccination is good for it. It is my opinion that immunity, from vaccination, is hereditary. Out of 207 cases that I have treated, only fifty-three were serious, and I hold this fact due to parental vaccination. DR. MASSIE: "Being health officer of one of the largest cities of the State, I have run across as much smallpox as any gentleman present. I have seen the 'itch' in Cuba. I was there with the regi ment and volunteered my services in taking charge of the smallpox. After twenty-four days there were 250 patients and a death rate of thirty per cent., and within four or five months time 1500 cases with a death rate of seven per cent. This was to an extent due to the supreme authority of the militia. 'Cuban itch' is unknown in Cuba; we come to America to find it. However, in Houston, we consider it more complimentary to have smallpox than 'Cuban itch."" The following paper from Dr. Guinn was then read: Compulsory Vaccination. DR. E. E. GUINN, COUNTY HEALTH OFFICER CHEROKEE COUNTY. Mr. Chairman and Gentlemen of the Association of Health Officers of Texas: In response to your invitation to meet with you in Austin on the 21st inst., or contribute a paper to be read at such meeting, I assure you that I regret very much my inability to attend, but tender you iny hearty co-operation in your good work, and will say I know if the ideas of this body were only enacted into a law, that within five years there would not be a single case of smallpox to develop within the borders of this State in the person of a native Texan. My ideas briefly stated are as follows: First of all, compulsory vaccination to be repeated every five years, the State bearing the expense for the vaccine virus, and in order that this expense be reduced to a minimum, let her, upon the plains of some of her school lands, establish and maintain a State Chemical and Bacteriological Laboratory and Vaccine Farm, manufacture her own virus, as well as her diphtheria antitoxine and all other serums and antitoxins now in general use. These to be supplied to all county health officers for the free distribution to every physician in his county; and said physician to furnish gratis to every person in his territory (or locality), and this act carry with it a penalty of not less than $10.00 nor more than $100.00 to be assessed against every single individual, and every head of a family, who neglects, or refuses, to present himself or his family for vaccination. Let each physician vaccinate every infant born, at the age of thirty days, if the necessity demands, and not later than two years. Let the direction of this work be carried on by the county health officer, who shall be under the jurisdiction of the State Health Officer or State Health Board. This will clear Texas and keep her clear of smallpox, and no less stringent methods will ever do it. COUNTY HEALTH OFFICER AND HIS DUTIES. Let there be appointed by the commissioners court, at their February term, a county health officer, who shall serve for a term of two years or until his successor shall qualify, and he should be selected from a standpoint of ability. He should possess executive ability in connection with his professional ability; he should be empowered to act independently of the commissioners court in an emergency, his acts to be ratified by the court at its next meeting. He should be equipped with disinfectants, apparatus, oil suit, record books, etc. He should be paid according to the population, towit: In counties having less than 10,000 inhabitants. Over 10,000 and less than 20,000... Over 20,000 and less than 30,000.. .$ 300.00 400.09 500.00 600.00 700.00 1000.00 Over 30,000 and less than 40,000.. This to be paid by the respective counties. I arranged this schedule according to taxation, and I put it small from the fact that county health officers would have little to do after the first five years. Let each incorporated town select her city health officer at a fee of $10.00 per day while actually engaged in such work, and who shall work under the orders of the county health officer. This expense and all others connected with a quarantine and incidental thereto be paid by the State, except the county health officer's fee and equipment, which the county shall pay for. Be it enacted that every physician failing to report to the county health officer any case of smallpox, varioloid, diphtheria, yellow fever or cerebro-spinal meningitis that he be fined not less than $50.00 nor more than $500.00, or imprisonment for not less than ten days nor more than six months, or both fine and imprisonment for such failure. Each county health officer to make immediate report of such cases to the State Health Officer or State Board. Each county health officer shall make a quarterly report to the commissioners court, who shall approve his accounts, which must be itemized before presentation, and payment to be made quarterly by the State, with the exception of county health officers fees, which shall be paid by the county in which he is employed. But, gentlemen of this convention, as lovers of humanity, we have more and graver questions confronting us today than all of the above mentioned diseases, and it is the great and awful destroyer of health and happiness and future expectations, of homes and of life -consumption. Consumption is killing more people in the United States today than all the above mentioned diseases together. Is this not true? What can be done? First, we can prevent many, yes, very many, cases; we can help some, and cure a few. First, we must educate the people to take proper physical exercise, and especially should the lungs have the proper attention, and sleeping apartments kept clean and well ventilated, and of course our bodies should always be kept clean. After all debilitating diseases we are more prone to contract consumption. Our vitality can not resist the enemy that is everywhere present; therefore, we should be more anxious about our patients during their convalescence, and especially those who have been suffering from catarrhal diseases of the respiratory tract, and low grades of continued fevers, and chronic diseases. Give them first of all plenty of pure, fresh air, sunlight and water, and some appropriate tonic, and impress them with the necessity of their continuance. Let there be enacted a law with a penalty that every landlord be and is hereby required to immediately disinfect and sterilize after the removal of a tenant who has, while residing within said house, been afflicted with smallpox, measles, scarlet fever, whooping cough, mumps, typhoid fever, yellow fever, cerebro-spinal meningitis or consumption; this to be done under the supervision of the county health officer, if in reach, and if not, by his family physician. This measure alone will curtail considerably the number of consumptives. Yesterday two cases of smallpox were reported to me, and on my arrival found that twenty or more people had been exposed, and half of this number refused vaccination, stating "that I would have to vaccinate their dead bodies," etc., and "that I would have to retain their dead bodies." Now, had we had on our statute a compulsory vaccination law, these people would readily have consented. And today a citizen came to me and reported a case of smallpox in his neighborhood—and in five miles of our town-and one of our town physicians treating the patient, and when I saw the physician in attendance he stated to me that I had been correctly informed by the citizen. He said "the patient is clear of fever and convalescing." He says I told them they need not quarantine, but to be vaccinated and stay at home. I shall go there tomorrow, and should there appear more cases it should justly be charged to the action of the physician in not reporting the case and having proper action taken. Now, had we such a law as that herein indicated this physician would have been very prompt in making his report and thereby saved time and expense, and perhaps life. Rusk, Texas, March 14, 1901. Abstracts and Selections. To Remove Powder Stains. Dr. C. R. Clark reports a case of severe powder burn of the face in which he succeeded in removing all the staining resulting from the imbedded grains in less than two days by the application of three parts of hydrogen dioxide and one part of glycerine. He gives the credit for this treatment to Dr. J. Neely Rhoades, of Philadelphia, who several weeks ago by the use of undiluted hydrogen dioxide successfully removed powder stains from the face of an Italian woman in whose case other methods of treatment had entirely failed of success.-American Medicine. Pityriasis Versicolor. Dr. Jacob Sobel calls attention to the frequency with which pityriasis versicolor is overlooked, in spite of the fact that a diagnosis may be made with ease by the use of Allen's test (the application of Lugol's solution, which gives a black or deep mahogony color on the diseased surface). He believes the old idea that the disease attacks only covered surfaces is a mistaken one, and that phthisical subjects seem to be attacked more often than others merely because the frequency with which their chests are exposed during examination furnishes a better opportunity for making a diagnosis.-Philadelphia Medical Journal. Treatment of Sprains. Dr. Haldor Sneve contributes an exceedingly interesting article on the treatment of muscular and joint sprains. He objects to the method in common use of immobilizing the joint, on the ground that immobilization for a considerable time produces passive inflammatory changes and favors absorption of the synovial fluid, with roughening of the joint surfaces, and also atrophy and contraction of the muscles of the part together with absorption of the fat and areolar tissue around the ligaments and tendons. His routine method of treatment in these cases is elevation of the part, the application of a wet cheese cloth dressing and an ice bag until the height of the inflammatory process is reached. Then, after the subsidence of the acute symptoms, he uses hot fomentation and massage to assist the removal of inflammatory products. As soon as possible he has the patient take active exercise. By this treatment, he believes that the time ordinarily required for recovery can be shortened at least fifty per cent.-Journal of the American Medical Association, June 1, 1901. Physicians' Strikes. We have long wondered when physicians, irritated by a hundred forms of popular ingratitude, would go on a strike. While laboring heroically to prevent disease, and thus committing professional suicide, we are constantly maligned, the lowest kind of protection is generally denied to us by the lawmakers and government-protected quackery flourishes. But according to the proverb, even the worm will turn; and it has turned in Germany. The sickness bureaus (Krankenkassen) are the intermediaries whereby about 30,000,000 people obtain practically free medical service of course at the expense of the profession. When the bureaus made the physicians into slaves by all sorts of demands, at about fifteen cents a call, or seventy-five dollars a year, most naturally there was a "strike," or what the newspapers call a recurrence of the old question of "recognizing the union." Fifteen cent fees for cases of cbstetrics, or operations, was more than human nature, even of the long-suffering bureaucratic German type, could endure. The strange thing in all these cases is that the public does not recognize that the service obtained by such methods and prices can hardly be called medical. How can therapeutics be possible under such conditions? Physicians would be more than human who could keep such ludicrous relations from vitiating into extremes of abuse and degradation. It is as poor financial policy for the patient as for the doctor. We wish that the charges of "medical monopoly" by the hate-filled antis were truer or more possible of realization among us.-Editorial in American Medical, May 18, 1901. Suprarenal Extract in Heart Disease. Dr. Samuel Floersheim, of New York, has obtained marvelously good results from the use of suprarenal capsule in diseases of the Feart. He uses the dried and powdered gland obtained from the sheep, the usual dose of which is three grains, to be packed loosely |