William J. Robinson

Chalk Paste Not a Good Substitute for Bismuth Paste

To the Editor: —InThe Journal, July 29, Dr. James R. Mitchell advocates the use of chalk paste as a substitute for Becks bismuth paste. Though my experience with bismuth paste has been slight, and with chalk paste none at all, still I would caution against the substitution of the latter for the former. Whoever has had experience with bismuth subnitrate and calcium carbonate in various inflammatory conditions, knows that chalk cannot do what bismuth salts can do. In subacute or chronic gonorrhea, in simple diarrhea, in cholera infantum or cholera morbus, in various dermatologic conditions we cannot substitute chalk for bismuth, for bismuth possesses siccative, granulation-promoting and astringent properties which chalk does not possess. That it is not the nitrate radical that is responsible for these desirable properties is evident from the fact that the same properties are possessed by other bismuth combinations, such as the subcarbonate, the oxid,

A NOVEL METHOD OF USING STRYCHNIN AND HYDRASTIN IN SEXUAL AND VESICAL WEAKNESS.

I will not weary you with a long paper. I am of the opinion that a practical point, which one can at once utilize on his patient with undoubted benefit, is of greater importance—to practical physicians—than a long abstruse paper, dealing with guesses and hypotheses and theoretical considerations, which may or may not possess value. There is a very large class—much larger than one would imagine—of patients who are suffering from a weakness of micturition. I deliberately use this indefinite term. I do not refer to difficulty in urinating due to stricture, to prostatic hypertrophy, etc. No; there is a weakness without any discoverable pathologic basis; simply the bladder and sphincters have lost their tone, and the urine comes out without any force; the stream is split up into several thin streams and at the completion of the act there is considerable dribbling, which is very annoying to the patient,

THE RELATION OF THE PHYSICIAN TO PROPRIETARY REMEDIES.HOW MAY SUBSTITUTION BE AVOIDED AND THE DESIRED PREPARATION OBTAINED WITHOUT UNDULY ADVERTISING THE MANUFACTURER

In their relation to proprietary preparations, physicians may be divided into three classes: A, B and C. To class A, unfortunately a very numerous class, belong those physicians who prescribe everything and anything that is brought to their notice. The composition of the products they prescribe is a matter of utter indifference to them. The prescribed product may consist of two or three well-known substances; it may be as common a substance as sodium bicarbonate under a disguised name, or it may contain morphin, strychnin, pilocarpin or other dangerous alkaloids in a strong alcoholic menstruum—they care not. It answers, or they think it answers, the intended purpose and they are satisfied. They are supported and encouraged in this attitude by such journals as the Medical Brief , of which many physicians of class A are readers, if not subscribers. What our opinion is of such physician it is

Gastroptosia Not Gastroptosis. Perityphlitis Not Appendicitis.

New York City, Aug. 16, 1902. To the Editor: —We physicians are frequently charged by intelligent laymen with a love for hair-splitting, with fighting over unimportant trifles, with wasting our energies on speculative theories, etc., while neglecting the most important part, the welfare of the patient. Dr. Roses letter in to-days issue ofThe Journalshows conclusively that those charges are not without foundation. To judge by the intense earnestness of his tone and by the severity of his remonstance to the journals which have been so sacrilegious as to print gastroptosis and nephroptosis instead of gastroptosia and nephroptosia, one would think that it was a matter of life and death, that it was an important question in therapeutics, the proper discussion of which involved the weal or. woe of thousands of suffering patients. Oh, those hair-splitting purists! In spite of repeated admonitions, they seem to forget (or do not