tions, it is impossible to know the condition the urethra is left in when the patient is dismissed. I frequently have patients who, having had a gleety discharge from the urethra for years, and having been treated with sounds for stricture until completely disgusted with instruments, make a permanent cure of the granular condition by a dozen or fifteen applications through the endoscope. The endoscope I use, and think one of the best, is Otis's instrument, with electric attachment, and Klotz tubes. The ordinary urethral tubes, with a head mirror to reflect the light, will not give satisfaction. It is necessary to the surgeon's success and the patient's welfare to ascertain the condition of the patient's kidneys before doing an operation upon the urethra. I remember very well a case where an external urethrotomy was absolutely necessary to relieve a tight stricture of the deep urethra, that had caused a rupture, and the patient died from suppression of urine fifteen days after the operation, due to structural derangement of the kidney that was present before the operation. In urethral surgery preparatory treatment is very necessary. The bowels and kidneys should be in good working order, the urine should be rendered aseptic as far as possible, the parts to be operated upon should be thoroughly cleansed, and a dose of quinine before and after the operation is advisable. Taking these precautions will, I feel satisfied, reduce the mortality in surgical operations upon the urethra. In closing, I would like to emphasize the importance of irrigation before surgical operations upon the urethral canal, whether it be only the passage of a sound or an internal urethrotomy. If this is done there will be fewer cases of urethral fever and less irritation and inflammation after using instruments. Within the past twelve months I have used "hydrostatic irrigation" in the treatment of inflammatory conditions of the urethra and bladder, and it is far superior to any other method. The container which holds a prescribed quan A tity of the solution to be used, at a temperature of 110 degrees F., is placed eight or nine feet from the floor. glass nozzle is used to throw the fluid into the urethra and bladder. The anterior urethra is first thoroughly washed cut, and then the nozzle is pressed firmly against the meatus, and the patient told to breathe deeply or try to urinate, and the fluid flows back into the bladder. When the bladder is full the patient is allowed to pass it out, and the bladder is refilled. The value of this method is that the urethra is distended to its full capacity, which forces the pus and germs from the glands and follicles of the canal. Bibliography.-G. Frank Lydston, M.D., "On Stricture of the Urethra." E. L. Keyes, M.D., "Genito-Urinary Diseases and Syphilis." Prince A. Morrow, M.D., “A System of Genito-Urinary Diseases, Syphilology and Dermatology." DISCUSSION ON DR. CHAMPION'S PAPER. Dr. J. C. Olmsted, Atlanta: I would like to say, sir, that I consider Dr. Champion's paper a very able one. He has enunciated those principles of treatment which I think are recognized by all experienced and competent men. I particularly indorse what he said in regard to the utter worthlessness of plain sounds in the diagnosis of stricture; knowing that the bulb sound alone is fit for that purpose, and again, I think the matter of cleanliness of instruments is a point well taken. I have known a number of cases of infectious disease contracted by filthy instruments in the hands of practitioners. I also think, Mr. President, that the point the doctor made in regard to not passing urethral sounds too frequently is one we are apt to overlook. I wish to express my thanks to the gentleman for his able summary in regard to the present status of urethral instrumentation. THE RELATION OF THE STATE BOARD OF MEDICAL EXAMINERS TO THE MEDICAL PROFESSION OF THE STATE. BY E. R. ANTHONY, M.D., Griffin, Ga., The crowning glory of the medical profession is its everlasting allegiance to the cause of science and humanity. Its devotion to science and humanity could have been demonstrated in no stronger way than its unceasing and persistent fight, in the last two decades, for a higher standard of medical education. The men in our profession who should be enshrined in our hearts as objects of undying gratitude, are those who have fought hardest for the enactment of a law creating Boards of State Medical Examiners; for the great and broad principle upon which such laws are based is the protection of the people and the elevation of our profession. The enactment of such a law had its friends and its foes; the former lauding its event as a most welcome factor in the elevation of our profession; the latter protesting against it as an infringement upon personal rights, and a restriction upon personal liberty. The indifference of legislators to the just demands of our profession for legislation along these lines, and the ignorance of the masses from whom they are selected upon the medical sciences, have retarded and sometimes throttled all legislation which had for its object the promotion and encouragement of medical learning. At last the light of a brighter day has dawned upon us, and our lawmakers have realized the fact that a demand for a higher standard of education for medical men is not only in the interest of the profession, but is a necessity for the public weal. Hence the enactment of the law under which the State Board of Medical Examiners has been created. So varied are the views held by the public, and by some members of our profession, as to the duties of the board, and so little understood are its powers, that a discussion, before this assembly of representative medical men of the "Relation of the State Board of Medical Examiners to the Profession of the State," can but prove beneficial and advantageous. A discussion of the "Relation of the Board to the Profession" cannot be made intelligently without necessitating a presentation also of its "Relation to the Applicant for Examination," and the "Duty of the Profession to the Board." Permit me to say right here, that under the law, as it now exists, the State Board of Medical Examiners are not prosecuting officers. No power to deal with the violators of this law has been delegated to the board. Indeed, to have done so would not only have been without precedent, but absolutely impracticable. This act, no doubt, would be classed by our brethren of the legal profession as a “remedial statute." If it is, we should follow the rule of construction laid down by Blackstone, and always construe the act so as to "suppress the mischief and advance the remedy." To" suppress the mischief" in the prosecution of the illegal practitioners is, as it should be, purely a function of the court; to "advance the remedy" by seeing to it that no incompetent man is licensed to practice, is the duty of the board. Simply this and nothing more. Every member of the board in accepting the appointment "incurs a sacred obligation to the profession of the State to exert his best abilities to maintain its dignity and honor; to exalt its standing; and to extend the bounds of its usefulness." This is the great object which the board should hold steadily in view, and to which it should make every other consideration subservient. To the extent that it advances this object, in the same degree does it discharge its obligation to the State. In carrying out this laudable purpose, it should be governed by wisdom in the protection of the public against unscientific men and methods; justice to the profession in excluding those who would humiliate and break down its claims to rank as one of the learned professions, and moderation in passing upon the merits of the applicants who are knocking timidly at the door of our profession for admission. It is not within the province of this paper to criticise this law under which the Board of Examiners was created -no one has a right to criticise a law unless he can offer a better in its stead. That the law has its defects, no one can controvert; that it has its objectionable features, no one can deny; that the board has not, and cannot have, power to deal with violators of this law, is a matter of regret; that the duties of the board are very simple, we will admit; but repeal this law, defective as it may be; abolish this board, restricted as its powers and duties are, and you make this State the dumping-grounds for quacks and the promise land for impostors. In every country where the medical profession is held in high esteem-"the estimation in which the medical profession is held is always a criterion of the intelligence of a community"— the entrance to the profession is guarded by a Board of Examiners. This, then, is the essence of the duty of the board to the profession-to guard its entrance with jealous care and see that no incompetent and unworthy ones enter its sacred precincts. The past, with its diploma mills, has bequeathed to us evil results which Examining Boards cannot entirely overcome. It is not within the power of the board to redress every past wrong, neither can it clear the waters that have so long been fouled by the questionable men who have |