grains, which is less than the total in the ordinary one and one-half grain, ten-injection course.

Absorption of intramuscularly injected mercury is fully as dependent, we believe, upon accidents of absorption as upon dosage. Encapsulation, gradually increasing fibrosis in the tissues of the buttock, a wide area of distribution over the fascia lata above the gluteus maximus, trauma to the injection site, etc., distinctly influence the absorption of the drug and its effect upon the kidney.

Different individuals show wide variation in their tolerance of mercury and we have as yet been unable to definitely predict the degree of individual tolerance before beginning treatment. Age thus far seems to be a factor of minor importance. Fluctuations in individual tolerance during a single course are apparent, influenced possibly by accidents of absorption, dietary errors, etc. Due allowance should be made for spontaneous variations in urinary findings.

The presence of casts in the urine is the most reliable single criterion on which to judge the reaction of the kidney to mercury. The mouth and gastro-intestinal tract should not therefore be used by practitioners as evidence of tolerance of the drug, since renal damage may be manifest long before the appearance of stomatitis or diarrhea. Any examination of the urine made without a microscopical study of the sediment is worthless. Albumin fluctuates erratically, specific gravity is inconstant in its variations, and only once, even under high dosage, have we seen hematuria which we believed to be traceable to the effect of mercury.

Stomatitis and gastro-intestinal accidents as factors in mercurialization can be practically eliminated by sufficiently rigorous prophylaxis. Avoidance of acid foods, the use of alkaline, astringent and oxidizing mouth phophylaxis and the elimination of fruits and coarse vegetables from the diet are the main essentials. Strict regard for these principles has practically done away with such complications on our service.

The Over-Treatment Syndrome.

Those employing intensive methods should be familiar with the over-treatment syndrome which appears occasionally. It seems to include hyperirritability, extreme nervousness, insomnia and emotional instability, possibly due to excessive salvarsan, marked loss of weight, weakness, a pinched and withered facial expression with pallor, and indefinite aches and pains with stiffness of the joints. The latter features we interpret as part of the toxic effect of mercury and we have noticed that they may occur in individuals receiving mercury alone, whose kidneys, mouths and gastro-intestinal tracts show no evidence of the intoxication.

Dealing with resistant late cases, our combined course of treatment is apparently successful in re

versing the Wassermann test in approximately 60 per cent. Our symptomatic results seem exceptionally good at least thus far in bringing about the arrest of gastric crises, and the control of ataxia, sensory disturbances and the lightning pains of tabes dorsalis. We have been able to cause the apparent involution of early Charcot joints. Gastric syphilis as such, interstitial keratitis, even of long standing, and vascular lues of the meninges and brain show striking improvement in a single course. Osseous and cutaneous lues, early and late, offer no special difficulties. The results are less satisfactory in spastic and parenchymatous degenerative central nervous changes and in visceral involvement, where the damage done is of course irreparable. *

*

Summarizing, we have come to regard the effect of mercury on the kidney as the weak point in radical methods in the management of syphilis. This applies with special force to the intramuscular injection, and especially to the injection of insoluble mercurial salt, the convenience of which may easily be counterbalanced by much damage that goes undetected because of the irksomeness to the majority of physicians, of the frequent careful urinalysis. W. believe radical treatment to be indispensable and therefore urge the devising of means to protect the kidney, especially, from its very real dangers.

We have formulated the five most important deductions to be drawn from the year's work of the Section as follows:

1. Have a wholesome respect for the vascular toxicity of salvarsan and the renal toxicity of mercury. 2. Use radical methods discriminatingly, when radical results may be secured.

3. Examine the urine repeatedly, microscopically. 4. Watch for cumulative effects everywhere.

Prevents Dissemination of Knowledge.

Would You Burn One-fourth of Our Colleges?

The newspapers and magazines are patriotic; their publishers are willing to pay all the war taxes assessed on business in general. But MEDICAL COUNCIL, in common with the publishing interests of national scope in general, wishes to protest against the class discrimination imposed by the law going into effect next July-if not repealed by the present Congress-that imposes a zoning system postal classification that is, in reality, a class tax over and above the general taxes.

The outcome will be, unless the law is repealed or modified, a ruinous weight of unjust taxation upon the publishers, a necessary increase of subscription rates all along the line, and an incubus placed upon the dissemination of learning, literature and technical information that will be quite as much of a disaster as would be the burning of one-quarter of all our schools and colleges.

Doctor, won't you use your influence with your Senator and Congressman to have this unwise law repealed?

Helpful Points

Acne.

Treatment: The underlying cause must be removed; generally dyspepsia and constipation need correction. Hygienic measures such as cold baths, exercise, regular habits are indicated. The diet may need regulation. Local remedies, as sulphur, may be applied in the form of salves or pastes; ointment of zinc sulphide has been recommended; so, too, have mercurials and the use of the X-rays.

Treatment of Drug Addicts.

Hyos-Sco-Phine and Hyos-Sco-Piper offer a safe and rational method to the physician in the treatment of the drug addict.

These combinations are strictly ethical, meeting_the requirements of all the State and Federal laws. You will be interested in the results that many physicians are getting with these ethical combinations. Literature and price lists are sent to physicians only. Address, Combs Chemical Co., 938-958 Wolfram St., Chicago, Ill.

Where Other Foods Fail.

You can safely resort to Junket where other foods fail. Junket-made with milk-is an ideal food because it is nature's first food, milk, prepared for easy and complete digestion. It is very nourishing and has the necessary advantage of being palatable to convalescents and others whose appetite must be tempted.

An interesting treatise, "Junket in Dietetics," and

free samples of Junket Tablets will be sent on request. Address: Chr. Hansen' Laboratory, Frederick St., Little Falls, N. Y.

Glycerophos Comp. S. & D.

Even consumptives, whose stomachs are usually easily upset, take Glycerophos Comp. (no sugar) Sharp & Dohme, for many months without tiring and without any gastric trouble.

Glycerophos Comp. S. & D. is made only from the super-quality calcium glycerophosphate without which no preparation of these salts will keep well. The rich, winey flavor, like rare old amontillado, which makes it acceptable to the daintiest palate, and the high quality and dependability of this product, have made it a prime favorite among the most particular prescribers and dispensers. You will be well pleased with the results this product gives.

"Have You a Horse?"

"Last winter," writes John W. Neal, of Clifton, W. Va., to the Troy Chem. Co., "I used Save-the-Horse on spavin. Have waited some time to see if lameness would come back, but the horse is fine and I would not take the price of a full bottle for what I have left."

You will find Save-the-Horse a thoroughly reliable remedy. It is sold with a signed guarantee to return money if it fails on ringbone, thoropin, spavin or shoulder, knee, ankle, hoof or tendon disease.

Write today for free 96 page horse book, sample of guarantee and veterinary's advice-all free. Address Troy Chemical Co., 71 State Street, Binghamton, N. Y. (Helpful Points continued one leaf over.)

Helpful Points

Coughs Following Grippe and Bronchitis. Many physicians have been puzzled as to how to break up the obstinate coughs that follow grippe and bronchitis. You will find that Mistura Creosote Comp. (Killgore's) will be of value, not only in the treatment of grippe and bronchitis, but very helpful in breaking up the obstinate coughs that seems to hang on from these cases. Mistura Creosote Comp. (Killgore's) is a dependable preparation of beechwood creosote in a palatable form, and will not disturb the most sensitive stomach.

Interesting literature will be sent to you on request. Address, Charles Killgore, 82 Fulton Street, New York City.

An Aid in Difficult Cases.

A storm binder and abdominal supporter has been the most efficient aid to the active practitioner in such cases as hernia, relaxed sacro-iliac articulations, floating kidney, high and low operations, ptosis, pregnancy, obesity, pertusses, etc. Many physicians have testified to the efficient help-a modification for the particular case, of the storm binder and abdominal supporter-has given in the treatment of difficult conditions. The storm binders are made for men, women and children, of best quality materials and high-grade workmanship. Mail orders are filled promptly and literature will be sent on request. Address Katherine L. Storm, M.D., 1541 Diamond Street, Philadelphia, Pa.

An Important Point.

As one medical writer has said: "Digestion represents one long, continuous, harmonious process and not an interrupted series of unrelated events that just happen so." The makers of Peptenzyme have borne this important point in mind. The notable therapeutic value of Peptenzyme in all digestive ills is directly due to the fact that no one enzyme preponderates in its composition. Peptenzyme is a physiological association of all the enzymes of all of the glands necessary for digestion. And that is why it affords such striking relief in all cases of indigestion and restores the digestive organs to their full functional efficiency.

A trial bottle will be sent to you on request. Address, Reed & Cornwick, Jersey City, N. J.

A New Disinfectant.

Oxygenos is an ideal disinfectant. It is not an illsmelling, troublesome liquid, but a newly patented, effective disinfectant and deodorizer in large, convenient, tablet form, ready to be hung up in sick rooms, bedrooms, bath-rooms, toilets, lockers, clothes closets, etc. Oxygenos is made from formaldehyde, camphor, carbolic acid, naphthaline and oil of eucalyptus. The tablets evaporate gradually; each tablet is guaranteed to last three months, so they are economical as well as very effective.

Oxygenos tablets will be sent to you prepaid in neat, compact box, at 25 cents each, or one dozen for $2, under a guarantee of perfect satisfaction or money refunded. Address, Regent Drug Company, 562-564 Woodward Ave., Detroit, Mich.

(Helpful Points continued one leaf over.)

LISTERINE

LISTERINE

LISTERINE

Twenty-first and Locust Streets

St. Louis, Mo., U. S. A.