The medical profession stands with open-mouthed wonder while reading testimonials from ministers and congressmen, who have felt the rejuvenating effects of the alcohol contained in Peruna and Paine's Celery Compound, but what can we say of the doctors who lend their names (for a consideration) to the manufacturers of a secret preparation, the formula of which is not given, the name of which does not indicate its component parts or its therapy, and the action of which is as uncertain as either.

I have frequently been called in consultation in dermatological cases where the physician has been using a certain readymade ointment, the formula of which is known only to the manufacturer, and the action of which is known to no one.

By looking up the literature furnished at regular intervals, I find, according to the doctors who make a business of certifying to everything that comes out, that it is a sure cure for every eruption from tinea favus to pruritus ani, every disorganized condition of the skin from schlerema neonatorum to elephantiasis. What kind of results can one expect if he does not study the pathological condition and know the action of the drugs prescribed?

On one occasion I was asked to have a gentleman in consultation on a case of dermatitis exfoliativa, and he suggested fumigating the patient with burning wool and then anointing him with a secret preparation-the name of which, if reversed, would spell lotion.

I saw a prescription recently for an ointment which contained eight different ingredients, and another for a hair tonic which contained sixteen. In the latter prescription the last ingredient was aquae rosae, q. s. ft., one pint, and when the druggist mixed the first fifteen ingredients, there was no room in the bottle for the rose-water, and the question arose, was the prescription properly filled? The matter was finally compromised by putting in one drop of rose-water. The question still remained as to whether there were fifteen separate indications which the physician hoped to meet, or was he shooting at random, hoping that one of the drugs might hit the case?

The story of the physician who kept a bottle of "all sorts" for patients whose disease could not be diagnosticated, was probably founded on fact.

Another instance of uncertain therapeutics, or the unscientific application of remedies, is the so-called "therapeutic test" in cases of suspected syphilis. This test, although mentioned in our text books, is worth about one cent on the dollar on a dull market. I had intended enumerating all the diseases for which mercury was recommended in our text books on Materia Medica, but the list is too long.

It is said by Keys, that there is no pathological lesion of the skin that syphilis will not imitate, and as there are many skin diseases in which mercury is useful, it becomes patent to every right-thinking man that the therapeutic test is anything but scientific.

The physician who trusts to the therapeutic test to make his diagnosis in suspicious eruptions not only casts a blight on many fair names and wrecks many matrimonial ships, but in the language of the immortal Dogberry, "he writes himself an ass."

The man who cannot diagnose syphilis, with its many signs and land-marks, had better call professional assistance, or leave the case alone. When he seeks aid from drugs to make his diagnosis, he reminds me of that oft-told tale of the embryonic son of Hippocrates who threw the child into "fits" so as to bring it within the range of his therapeutic armamentarium.

Since the discovery of the gonococcus neisser, the mad rush has been to find a germicide that will cause its destruction. Remedies that will accomplish this object in the laboratory have been tried clinically and in many cases with a total disregard as to their action on the inflamed urethral mucous membrane. The injection of a germicide that is not at the same time a soothing astringent is unscientific and in many instances will increase the area of inflammation and widen the field of operation for the gonoccus.

Treating gonorrhoea with a strong germicide is equivalent to forcibly ejecting a skunk from a drawing room. It is better in either case to use peaceful methods than physical strength.

In order to thoroughly cover this subject, I might and probably should, go over the entire field of medicine, but I deem it sufficient to limit my remarks to the work with which I am fa

miliar and to the instances which have fallen under my observation.

I hope I have made my meaning plain.

I have attempted to bring out but two points:

First-Human life and health are too sacred to be lightly handled, and no physician is ever justified in prescribing for a disease unless he understands its pathology, or has exhausted all possible means of studying it; and

Second-He is never justified in using secret remedies or any other drug unless he is familiar with its therapeutic application.

DISCUSSION.

Dr. Rogers: There ought to be some word of thanks and approval conveyed to Dr. Blaine for bringing out so forcibly these well-known facts. We all agree with him. It is because there is no difference of opinion, and not because we do not approve of what he said, that there is no discussion of his paper.

FRACTURE OF THE FEMORAL NECK.

BY W. W. GRANT, M. D., DENVER, COLO.

There is, perhaps, no fracture that deserves more attentive consideration than that of the neck of the femur. A paper on this subject by Dr. Ruth of Keokuk, Iowa, under title of anatomical treatment, with illustrative specimens, was presented in the surgical section of the American Medical Association, at St. Paul, last June. To one specimen presented by Professor Maxwell, embodied in the report, I wish to invite your attention. This is an accurate drawing from the published transactions and is reported as an intracapsular fracture of the neck.

The "immediate shortening was two inches" and the case treated by direct and lateral extension with resulting bony union in four weeks and "no perceptible shortening." He died twenty years later and a post-mortem made. In the brief discussion at the time and in conversation, I expressed grave doubt as to the existence of a fracture, and when asked by the author how I could account for the crepitus and immediate shortening of two inches, I replied that fracture of the acetabular rim and consequent dislocation of the femur would abundantly explain it, as would the treatment employed the excellent result in such a condition. Further, I called attention to the fact that the neck was of normal length and the angle also natural. There were a few osteophites on a small surface near the head, but the specimen sawed lengthwise indicated no lesion of a past fracture, and the general outline was also normal. Unfortunately, in the post-mortem report there is no allusion or mention of the acetabulum and no examination of the other femur. It is well to bear in mind that the anteroposterior diameter of the neck is the smallest. The neck near the head is the smallest part, and fracture at this point is wholly

within the capsule. It is commonest in old people, and at this point, especially, non-union is the usual result, with intervening ligamentous material. Says Kocher: "All fractures of the neck

should be regarded as not uniting by bone." That it is rare is still the prevalent belief in fracture of the small part of the neck. In such a fracture the immediate shortening is very slight.

It is well to remember that the average length of the neck in a male adult is about two inches in front, two and one-half posteriorly, one and three-fourths above, and the curved under