of immigrants, and immigration stations. Marine Hospitals, including the tuberculosis sanatorium at Fort Stanton, New Mexico.

Smallpox. Ninety slides illustrating the eruptive stages of the disease, the protection afforded by vaccination and the lesions thereof.

Trachoma. The disease in its acute and chronic stages, and such effects as pannus, entropion and blindness. Trachoma among the American Indians and the relief work of the Public Health Service in the mountains of Kentucky are also shown. One hundred and twenty slides, many of which are colored. Tropical Diseases. Incomplete. Filaria, trypanosomes, and intestinal parasites illustrated, together with the common infections of the tropics. Forty views.

Tuberculosis. One hundred slides showing the economic loss from tuberculosis, susceptible races, the tubercle bacillus, pathological conditions in the lungs, the relation of the disease to improper housing and the causes predisposing to infection. Also the methods of care, precautions to be exercised and the benefits of sanatorium treatment.

Typhoid Fever. Of great public health interest. The role of uncleanliness, infected milk, polluted water, improper sewage disposal, and flies, in the dissemination of the infection. Methods of prevention, including proper care of milk supplies, avoidance of water pollution, and the prevention of fly breeding; 350 views.

Yellow Fever. Mosquitoes in different stages of development, preventive measures, including detention camps. The discoverers of the means of transmission of the disease.

How to Use the Stereopticon Loan Library

The slides are loaned to physicians, health organizations, educators, welfare workers, and others, without cost. Persons desiring slides should advise the Bureau as to what subjects they are interested in, so that the proper catalogs may be forwarded. The slides should be selected by number, and the request made upon the application blank. If desired, the Public Health Service will undertake to make the selection, provided the applicant will state what he wishes to illustrate. There is no arbitrary limit within which the slides are to be returned, but as the demand far exceeds the supply, it is expected that they will be returned at the earliest possible moment. Stereopticon lanterns are not loaned, but as the slides are of standard size, 31 by 4 inches, any lantern may be used. It is expected that slides broken by careless handling or packing will be replaced; these to be ordered from the Government contractor by the United States Public Health Service and the bill therefor to be paid by the borrower.

It is requested that in returning the slides a letter of transmittal be forwarded, stating the approximate number of persons to whom the views have been shown. The container should be labelled with the name and address of the sender, and returned by express prepaid or by mail. Photographs, from which it is possible to obtain slides of public health interest, will be gladly received and promptly returned.

PAMPHLETS RECEIVED

The Internal Secretions Some Clinical Aspects

Illustrated. By

Wm. Seaman Bainbridge, A.M., Sc.D., M.D., C.M., New York City.

The Cure of the Incurable.' A Plea for More Accurate Diagnosis and More Careful Prognosis in Malignant Disease. By Wm. Seaman Bainbridge, A. M., Sc.D., M.D., C. M., New York City.

THE NEW ENGLAND
MEDICAL GAZETTE

VOL. LI

MARCH, 1916

No. 3

Books for review, exchanges and contributions - the latter to be contributed to the GAZETTE only and preferably to be typewritten personal and news items should be sent to THE NEW ENGLAND MEDICAL GAZETTE, 80 East Concord Street, Boston. Subscriptions and all communications relating to advertising or other business should be sent to the Business Manager, 80 East Concord Street, Boston, Mass.

THE GAZETTE does not hold itself responsible for the opinions expressed by its contributors. Reprints furnished at cost.

Under the signature of "S" appears an interesting contribution from Paris to the Boston Medical and Surgical Journal bearing date of December 25, 1915. The writer has made a number of previous contributions to this Journal, all of which bear the ear marks of firsthand information or actual personal observation; hence they may be taken as official or dependable statements. In the letter of December 25th, "S" describes in an interesting style the surgical care given the wounded soldiers in French field and base hospitals, and then proceeds to give some inside information regarding the medical care of the sick soldiers who are not in any sense surgica patients. He says:

But when we come to the medical side of the subject we find a very different state of affairs. . . . But there has been one unquestionable blot on the picture, and a serious one, the handling of the army medical cases. This has really been something too awful, and if the history of this side of the question ever comes to be written, it could be fitly entitled: A treatise on how not to take care of the medical cases of an army in time of war. The fact seems to be that the organization of that branch was hopelessly bad even in time of peace, and apparently so utterly bad that it broke down so completely that every one connected with it is so thoroughly dis

heartened as to be incapable of an effort to improve it so long as the war lasts. Later on it will have to be made over from the bottom up."

The words "This has really been something too awful" might be interpreted variously, but as we already have had some information upon the subject it is not difficult to understand just what is meant. It means that the therapeutic nihilism which has gradually undermined old school medical treatment has become so widespread, that when this so-called "system was suddenly called upon to be of some actual use in a very critical period it broke down entirely, so much so that everyone connected with it is so thoroughly disheartened as to be incapable of an effort to improve it."

Could any one ask for a more complete and outspoken acknowledgment of the failure of old school medical treatment to meet present day requirements than is given by this writer. who has been in the field and knows whereof he speaks? Can there be any greater travesty upon "modern scientific medicine" which so blatantly claims to represent "all there is in medicine" and which denounces every other claim to therapeutic value as "sectarian medicine" than this statement by one of their own number, who says that the medical treatment of the sick soldier in the French hospital is a "blot upon the picture, and a serious one," and who further states that when it comes to be written up in full it could be fitly entitled "A treatise on how not to take care of the medical cases in time of war "?

To justify this "awful state" our friends of the old school may claim that this woeful lack of medical treatment was due to a lack of organization, which may be partly true; but there can be no effective organization without a basic element of principle backed by confidence. As there is palpably no principle or system in old school therapeutics, only chaos or nihilism, how can there be confidence? One cannot have confidence in something that is so intangible and unreal that it does not exist even in imagination, hence cannot be organized.

The reason that there has been no organization for the care of sick soldiers requiring internal treatment is because the Medical Corps in charge of affairs and composed of old school men have felt their utter helplessness when it comes to prescribing drugs. It is just as "S" says: "Everyone connected with it is so thoroughly disheartened as to be incapable of an effort to improve it."

Now turn to the other side of the picture and note what a handful of enthusiastic homœopathic physicians are doing for these same sick soldiers whose care by old school methods has

been a "blot upon the picture." It is quite possible that "when the history of this side of the question comes to be written up it will not be entitled a treatise on how not to care for the medical cases in time of war."

44

The hospital at Neuilly, France, which has been established and is maintained by homœopathic friends and whose recognition as a hospital unit was made possible only by the earnest pleas and powerful influence of "friends at Court," is doing. a splendid work for the non-surgical sick soldiers by giving them the benefit of internal treatment with drugs, the selection of which has a tangible basis of scientific value. The enthusiasm and devotion manifested by the physicians in charge of this hospital is an evidence of their belief in the power of drugs when administered by a method that is backed by some semblance of science. "The proof of the pudding is in the eating" and these scientific prescribers are obtaining results in that they are curing their patients and sending them back into the trenches. Surely there is nothing "too awful" about this hospital nor is it a "blot upon the picture."

If this were the first time that old school therapeutics had utterly broken down in time of need the picture would not be quite so dark. Although eighteen years have elapsed, it is easy to recall and still easier to read of the "flunk" made by real "scientific medicine" in the days of the Spanish War. Can there be found in history a more disgraceful episode in "scientific medicine" than the widespread prevalence and high mortality of typhoid fever which attended the American soldiers at the time of the Spanish War? Their methods failed utterly to prevent or to cure typhoid fever. And right here permit us to make a statement which we are ready to back by facts. It is this: That the typhoid-stricken soldiers who were sent home, to be cared for in hospitals, made more rapid recoveries with a consequent lower mortality when placed in homœopathic hospitals under homœopathic physicians than did those in old school hospitals under old school treatment.

Is it not almost time for the representatives of a "system which has become an acknowledged failure (this acknowledgment coming from their own leaders), to look about them and if not ready to accept some other system to have at least the temerity and the breadth of mind to investigate a system which has stood some pretty severe tests for over a hundred years?

D. G. W.

VACCINES IN MEDICINE

By W. H. WATTERS, A.M., M.D., Professor of Pathology, Boston University, and ELIZABETH Ross, M.D., Instructor in Pathology, Boston University.

Now that approximately a decade has passed since bacterial vaccines have been introduced as a general therapeutic aid, it would seem to be advisable to review some of the results in order to ascertain their true value. The first period of undue over-enthusiasm with application of the method to most diverse conditions, logical or illogical, has passed. So also has passed the resultant period of undue pessimism, during which many physicians, disappointed because all the promises made by unwise enthusiasts had not been fulfilled, consigned the entire method to oblivion or to perdition according to their temperament. At present it is possible to look back upon both of these eras and, profiting by the benefits and errors of each, to arrive at a somewhat adequate conclusion concerning the scope of vaccines in medicine as well as their limitations. Such an attainment, such a summary of results and conclusions derived therefrom is the object of this paper. These conclusions will be much influenced by consideration of the results attained by the writers during an extensive experience over a period of nine years in a large general hospital and with private cases outside. During this period thousands of inoculations have been administered to a large number of patients under most diverse conditions, and in all of these cases as they are briefly viewed in retrospect it has been impossible to find a single inoculation the administration of which has been regretted. In other words it is believed that the method properly used will be followed by no permanent injury to the individual. It must be remembered that in theory each injection produces an injury, else there would be no satisfactory reaction, but this in practice is indeed merely theoretical in the majority of cases. In prophylactic treatment there is often some evidence of clinical injury rapidly followed by a return to and beyond normal. This is, in fact, the object desired. It is of course also conceivable that in the terminal stages of a disease when the body is literally overwhelmed with the toxin, an unwise massive dosage of vaccine might be followed by permanent injury. Such cases should only be treated by or under the direction of one experienced in vaccine therapy when such treatment would be most carefully avoided.

In beginning a paper on vaccines it is perhaps unnecessary to state that the name itself is a misnomer given by the theoretical similarity of action to smallpox vaccine. The name given to these preparations by one of the commercial firms, "bacterins," is much more correct but will probably not replace the older one in popular usage.