pocket formations. 3. To dilate strictures of the ureters. 4. To dislodge small calculi of the ureter. 5. To drain the kidney after nephrotomy. 6. To prevent injury to, and stitching together of the ureter in certain operations. 7. To prevent and cure renal fistula. 8. As a guide to certain operations on the pelvis of the kidney. There is comparatively little or no danger of infection if one carefully disinfects his instruments and thoroughly irrigates the urethra and bladder. The fact that it takes practice and skill, should not discredit the method, considering its importance as a therapeutic and a diagnostic factor. Ureter-Catheterism: Its Purposes and Practicability. Dr. Bransford Lewis of St. Louis read a paper before the Mississippi Valley Medical Association under the above title, and presented his cystoscope for male and female, which permits of catheterizing both ureters at the same sitting. The essayist claimed great advantages in respect to both diagnosis and treatment. The first case was that of a patient who had been advised to undergo operation for removal of three stones that were supposed to be lodged in the left ureter, the diagnosis being based on an x-Ray photograph. The ureter was found to be perfectly normal and secreting a clear and healthy urine. Case 2 was that of a rebellious cystitis and repeated infection of the urinary tract, which was finally cured by regular periodic irrigations of the infected left kidney pelvis. Also, recited two other cases of urinary infections with prolonged history which behaved similarly. Also, mentioned the diagnostic value in bi- and unilateral cases of tuberculosis of the kidney. Curettement of the Bladder in a Case of Cystitis Dolorosa. — A. Hock (Prager Med. Wochen., No. 42). Hock treated a lady, 23 years old, who had suffered with cystitis dolorosa four years, by curettement of the neck of the bladder. Previous to the operation the pain and tenesmus was very great, and there was also complete incontiCure complete. One year later no change. nence. Tuberculosis of the Testicle, Prostate and Seminal Vesicles.-(Brit. Med. Jour., Oct. 25, 1902.) Myles concludes that where only one or two nodules of a chronic type appear in a man of good physique without any signs of general infection, and without any enlargement of the prostate or vesicles, a partial operation would be sufficient. He does not put much reliance on operative treatment when the prostate and vesicles are also involved. Where suppuration exists and the testicle is markedly enlarged and practically useless, he extirpates without delay. Where general infection exists, operation is inadvisable. He does not believe there is a very hopeful outlook in operative treatment of tuberculosis of the bladder. Diagnosis of Surgical Diseases of the Kidney. -(Med. Record, Nov. 8, 1902.) Gutéras has formulated the following principles as guides to diagnosis: 1. In a case of pyuria, the seat and nature of the lesion should be. determined by all methods before an exploratory incision or operative procedure is attempted. These methods include: (1) Examination of urine, including cryoscopy and the phloridzin test; (2) Cystoscopy; (3) Ureteral catheterization; (4) Segregation of urine; (5) Radioscopy. 2. Examination of the urine is of utmost importance. 3. Careful study of pus, blood, casts, and particularly the epithelial elements to determine the nature of the lesion and seat thereof. 4. A renal lesion of suppurative character being found, it becomes necessary to locate it in one or the other kidney or to determine whether the opposite kidney is present and healthy. This may be done with the aid of cystoscopy, ureteral catheterization, combined with the phloridzin test and followed by examination of urines of each kidney, with the aid of the Röntgen rays, and if need be, in case of doubt, of exploratory incision. 5. An omis. sion of one or more links in the chain of methods of examination may give rise to grave errors in diagnosis, and nephrectomy is never justified when we are not in the position to say that the opposite kidney is present and in good condition, on the basis of the tests herein. mentioned. Kill the Germs. Nothing is so deadly on the germs or disease as good health. Good health for the lungs drives out consumption. Scott's Emulsion makes a specialty of supplying good health to diseased lungs. PACIFIC MEDICAL JOURNAL WINSLOW ANDERSON, A. M., M. D., M. R. C. P. LOND., etc. EDITOR AND PROPRIETOR. W. F. SOUTHARD, A. M., M. D., Managing Editor. C. F. BUCKLEY, B.A., M.D., L.R.C.P.Edin., etc. H. D'ARCY POWER, L.S.A.Eng., L.R.C.P., Ire. P. C. REMONDINO, M.D. GEO. C. MACDONALD, M.D., F.R C.S, Ed. W. E. TAYLOR, M.D. W. S. THORNE, M.D. WILLIAM S. WHITWELL, A.M., M.D. W L. ADAMS, M.D. CARL C. HANSEN, M.D. GEORGE H. POWERS, A.M., M.D. JOHN W. ROBERTSON, A B., M.D. C. A. RUGGLES, M.D. THOS. MORFFEW, D.D.S. SILAS M. MOUSER. M.D. FRANK HOWARD PAYNE, M,D. JOHN H. HEALY, M.D. A. W. MORTON, A.B., M.D. J. F. DILLON, A.M., M.D. A. P. WOODWARD, M.D. E. S. HOWARD, M.D. CHAS. E. JONES, A.B., M.D. A. C. BOTHE, A.M., M.D. F. F KNORP, M.D. WM. J. JACKSON, Ph.G., M.D. F. W HARRIS, M.D. WM. A. BRYANT, M.D., D.D.S, WALTER F. LEWIS, D.D.S. A. SCHLOSS, M.D. GEORGE P. WINTERMUTE, M.D. H. N. ROWELL, M.D. CLARK L. ABBOTT, M.D. J. J. CROWLEY, Ph.G. SOPHIE B. KOBICKE, M.D. LOLITA B. DAY, M.D. ROBERT E. O'CONNELL, D.D.S. CHAS. W. MILLS, A.B, M.D., D.D.S. THURLOW S. MILLER, M.D. C. M. TROPPMANN. Ph.G., M.D. B. F. WILLIAMS M.D. WILLIAM BURFIEND, D.D.S. JOHN M. STOWELL, M.D. BERTHA WAGNER-STARK, M.D. J. H. SEYMOUR, M.D. CALVIN W. KNOWLES, D.D.S., M.D. CORYDON B. ROOT, M.D., D.D.S. DR. MAX SICHEL, J. C. HENNESSEY, D.D.S. CARROLL O. SOUTHARD, M.D. A. F. MERRIMAN, JR., D.D.S. A. W. TAYLOR, D.D.S. S. L. STRICKLAND, D.D.S. The Editors are not responsible for the views of contributors. All matters relating to the editorial and business departments should be addressed to the PACIFIC MEDICAL JOURNAL, 1025 Sutter St., San Francisco. SAN FRANCISCO, JANUARY, 1903. Editorial. NEW YEAR'S GREETINGS. The JOURNAL extends to its many patrons and friends. the compliments of the New Year. At the same time it wishes to express thanks for the support it has received during the past year, and to thank those who have so liberally patronized us, who have contributed to its pages, and who have been its stanch patrons and friends. As the JOURNAL grows in years it grows in magnitude and in influence. Its policy is to do and to teach what is right. It supports the weak as readily and as earnestly as the strong when the cause is just. It speaks its opinions regardless of results. If it errs it errs in judgment and not in conscience; in any instance it is proud of its friends, and equally proud of its enemies. With the continued support of its many friends, and with the consciousness of right, it will continue to work for the interest of the entire profession. IS THE EDITOR OF THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION FAIR? We wish to lay the following case before the medical profession of America." On October 4th, 1902, the Journal of the American Medical Association published the following editorial: UNFAIR TESTS. It is a pity that a good law should ever be enforced in such a way as to do injustice, but that sometimes happens. Apparently a case of this kind is made against the California State Examining Board by the Pacific Medical Journal. It criticises especially the questions on pathology, taking exceptions to those asking a definition of cryoscopy and for the characteristic lesions of Hanot's cirrhosis. Neither of these questions is exactly fair as testing a practitioner's qualifications. Cryoscopy is a word not found in quite recent medical literature, and Hanoi's cirrhosis is a name only occasionally applied to hypertrophic cirrhosis of the liver. In neither case could it be fairly expected that any but one constantly posted in the most recent periodical literature would be able readily to answer these questions, and any one rejected for failure to do so would justly have a grievance. If, as our contemporary claims, some were rejected for such failure the decision ought to be revised. If, moreover, all failed on these particular questions except a few students of one school, as our contemporary says was the case, it bas a worse appearance. It is unfortunate that the examination is open to this particular criticism, as, from the published questions, in all other respects, it seemed to have been eminently fair. Such unfortunate occurrences furnish weapons for those who would abolish state practice acts and go back to the evils that have existed. Our medical examining boards ought to have a specially critical eye on themselves and orestall all such possibilities. On October 25th the subjoined letter was published in The Journal, and in the same number appeared the following editorial: UNFAIR TESTS. SAN FRANCISCO, Oct. 11, 1902. To the Editor: In your editorial on "Unfair Tests," in the issue of Octobe 4, you discuss the criticism by the Pacific Medical Journal of the questions in pathology submitted by the California State Board of Medical Examiners. In order that your deductions should have full value, it seems to me fair that a full knowledge of the truth of the facts in your premises should be given you. You suppose that the writer of the editorial in the Pacific Medical Journal is orrect in stating that some were rejected for failure to answer the questions to which exception was taken-" Define cryoscopy," and "What are the characteristic lesions of Hanot's cirrhosis." First, as to the truth of this. The editor of the Pacific Medical Journal is dean of a recently organized medical school in San Francisco, and president and manager of its board of trustees. Out of a class of 40 or more graduates from this school, 11 chosen ones took the examination; certain of the others have openly stated that they never intended to take any state examination, and our worthy governor has recently given one of these a medico-political job. Of the 11 who took the examination, 6 failed in 4 or 5 of the 9 subjects. From the other two regular schools of San Francisco represented at the examination, there were 48 candidates, and 3 failed. Only one candidate was conditioned in pa ho'ogy, having obtained less than the required 60 per cent. Secondly, over 75 per cent of the candidates defined Hanot's cirrhosis more accurately than you have done in your editorial This places the statement of the editor of the Pacific Medical Journal where it belongs. As you say yourself, "from the published questions, the examinations seem eminently fair in all other respects." I think it only just to your readers to state that the examinations were particularly easy and were easily marked. A few questions may have been asked rather to test the kind of teaching done in some of the schools than to catch the students; but when a school, in this age, graduates a man who defines intussusception as "the susceptibility of some people to disease," it is time that the respectable element of the profession take steps to protect itself as well as the public by ascertaining the quality of the teaching in our institutions, and by ferreting out those who display both ignorance and defiance of the law. Respectfully yours, DUDLEY TAIT, Vice-Pres. Cal. State Bd. Med. Exam. UNFAIR TESTS. In a recent number of The Journal there was a criticism of one or two questions offered by the State Examining Board of California. The matter was of slight importance, and was only emphasized as a caution against affording the opponents of medical practice acts an opportunity to attack them; it does not appear from later information that any injustice was done to anyone on account of the questions mentioned. Nevertheless, there has been started an active fight against the board on the part of the quacks, including the employment of that frequent resource of exposed frauds, a libel suit. In this case the charge of libel against one of the medical examiners appears especially tenuous and, it seems to us, should prove a boomerang if it is ever carried to trial. There is always likely to be some dissatisfaction when an unduly large proportion of candidates from any particular school fail to pass, and though it indicates defects in the candidates rather than in the examiners, charges are liable to be made. When members of the profession fall out in such a matter it is quickly taken up and made the most of by those outside irregulars to whom all restrictive practice laws are an abomination. As a whole the California state examination was eminently fair and what any well qualified candidate should have been able to pass. The attack on the law and on the individual members of the board is clear ly unjustifiable and unworthy in its motives. In reply to this letter and second editorial, the following communication was forwarded: OFFICE OF PACIFIC MEDICAL JOURNAL, 1025 Sutter Street. SAN FRANCISCO, CAL, Nov. 5th, 1902. To the Editor of the Journal of the American Medical Association, Chicago: DEAR SIR: Permit me to call your attention to an apparent inconsistency |