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Protective Association

ORGANIZED AT WINNIPEG, 1901
Under the Auspices of the Canadian Medical Association

THE objects of this Association are to unite the profession of the

Dominion for mutual help and protection against unjust, improper

or harassing cases of malpractice brought against a member who is not guilty of wrong-doing, and who frequently suffers owing to want of assistance at the right time; and rather than submit to exposure in the courts, and thus gain unenviable notoriety, he is forced to endure black mailing.

The Association affords a ready channel where even those who feel that they are perfectly safe (which no one is) can for a small fee enroll themselves and so assist a professional brother in distress.

Experience has abundantly shown how useful the Association has been since its organization.

The Association has not lost a single case that it has agreed to defend.

The annual fee is only $3.00 at present, payable in January of

each year.

The Association expects and hopes for the united support of the profession.

We have a bright and useful future if the profession will unite and join our ranks.

EXECUTIVE.
President-R. W. POWELL, M.D., Ottawa.
Vice-Pres dent-J. O. CAMARIND, M.D.. Sherbrooke.
Secretary-Treasurer-J.F, ARGUE, M.D., Ottawa.

SOLICITOR,
F. H. CHRYSLER, K.C., Ottawa.

Send fees to the Secretary-Treasurer by Express Order, Money Order, Postal Noto or Registered letter. If cheques are sent please add commission.

PROVINCIAL EXECUTIVES. ONTARIO-E. E. King, Toronto; I. Olmsted, Hamilton; D. H. Arnott, London: J. C.

Connell, Kingston; J. D. Courtenay, Ottawa. QUEBEC-H. S. Birkett, Montreal: E. P. Lachapello, Montreal; J. E. Dube, Montreal:

H. R. Ross, Quebec; Russell Thomas, Lennoxville. NEW BRUNSWICK-T. D. Walker, St. John; A. B. Atherton, Fredericton; Murray

Maclaren, St. John. NOVA SCOTIA-John Stewart, Halifax; J. W. T. Patton, Truro; H. Kendall, Sydney. PRINCE EDWARD ISLAND-S. R. Jenkins, Charlottetown. MANITOBA-Harvey Smith, Winnipeg; J. A. MacArthur, Winnipeg; J. Hardy, Morden. NORTH-WEST TERRITORIES–J. D. Lafferty, Calgary; M, Seymour, Regina. BRITISH COLUMBIA-S. J. Tunstall, Vancouver; 0. M. Jones, Victoria; Dr. King,

Cranbrooke.

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Published on the 15th of each month. Address all Communications and make all Cheques, Post Ofíc
Orders and Postal Notes payable to the Publisher, George ELLIOTT, 203 Beverley St., Toronto, Canada

VOL. XXX.

TORONTO, FEBRUARY, 1908.

No. 2.

COMMENT FROM MONTH TO MONTH.

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Progress in Medical Science in 1907.—The tendency to immediate operation in all cases of appendicitis has been on the wane. Surgeons have demonstrated that the operation in the quescent interval is practically void of any danger.

Immediate operation is only called for in acute fulminating cases and abscesses; this class of case is in the minority. Unusual articles have been reported found in the appendix during the last year, in one instance a clove, well preserved; eleven small stones in one, which on chemical analysis were found to consist of cholesterin and bile pigment; in another case four small faceted stones chiefly of calcium phosphate.

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The Association of Appendicitis to Typhoid Fever, we drew attention to many years ago in these pages, citing an instance where a young lady had been sent into one of our Toronto hospitals, with all the symptoms of acute appendicitis.

The surgeon refused to operate, stating the case was not one of appendicitis. A consulting physician stated as positively it was not enteric fever. A week or ten days later there was no doubt of it being typhoid. During the past year attention has been again called to the association of these two diseases, and it has been stated the congestion of the ileo-cæcal portion of the bowel occurring in typhoid fever predisposed to inflammation in the appendix. Cases have been quoted where the two diseases co-existed. No doubt true typhoid inflammation may be present in the appendix itself.

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Tuberculosis continues to attract a great deal of attention, and considerable advance was made in education and in the promotion of sanatoria. Although there has been much discussion in Canada and elsewhere, no distinct advance has been made except in Edinburgh and a few other places, where notification has been made compulsory. Probably health authorities have hesitated in advocating compulsory notification of tuberculosis owing to the all too great and unreasonable antagonism towards the tuberculous on the part of the laity. There have been encouraging practical results from a new phase introduced lately in sanatorial treatment, namely, that of graduated labour.

Koch's 1901 Announcements are being gradually offset and disbelieved in; and it seems to be becoming generally accepted as a fact that bovine tuberculosis can be produced in animals by certain strains of tuberculous matter of human kind. According to the second report of the Royal Commission on Tuberculosis, no reason can be shown that man is less susceptible to bovine tuberculosis than any animal. In fact, the Commission states definitely that in many cases--as many as 14 out of 60 human strains-the bacilli of human tuberculosis possessed the characteristics of bovine tuberculosis.

Though Sleeping Sickness, or, rather, a knowledge thereof, is of no practical importance to our readers, it is interesting to know that two young Canadian graduates have made a special study of this unique and attractive disease, and published during the past year a review on the subject of combating it. Drs. Allan Kinghorn and John L. Todd have arrived at these conclusions: A drug as specific in its action on sleeping sickness as quinine is on malaria must be supplemented by the same preventive measures as carried out in destroying the mosquito. As there are no means of destroying the tsetse flies in large numbers yet found out or carried out, strict quarantine and isolation measures should be enforced to prevent the further spread of trypanosomiasis; the value of “atoxyl” is problematical, although it is beneficial, but it must be administered continuously and regularly.

Vaccine Therapy has been the subject of many investigations since Sir A. E. Wright brought opsonins to the attention of the medical world. He in conjunction with other investigators and observers has recently shown that the process of auto-intoxication might come under observation in the beginning of a tubercular infection; and that it is, in fact, a regular accompaniment of the hectic of advanced pulmonary tuberculosis. “They also brought forward evidence to show that in the induction of an auto-inoculation, when this is preceded and followed up by a series of measurements of the opsonic index, there exists a method which can be turned to account for the resolution of some of the diagnostic and therapeutic problems which present themselves for solution in connection with every localized infection which is not accessible to direct bacteriological examination." This will prove valuable in diagnosis in doubtful cases.

The Action of Pituitary Extract has been set forth by two scientists before the Royal Society by Prof. E. A. Schafer and Dr. P. T. Huring, who have made some very interesting experiments and important observations. These experiments were made with the extract upon the kidney. . Their conclusions were that pituitary extract has a greater diuretic activity by far than any substance in the whole pharmacopæia. By its action on the vascular system it produces an optimity in renal activity. It apparently also exerts a specific stimulation upon the renal epithelum. They regard it that possibly the extract acts as subordinate or auxiliary to the function of the kidney.

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Clean Milk is essential to infantile life; and its production and marketing should concern everybody most vitally. Von Behring believes that most of our adult tuberculosis is taken into the human system while we are yet babies in our cradles. But it is not in this fact there is all the danger. It is the most important single article of diet we have; how requisite, then, is every detail in bringing it clean and pure to the consumer! How lax, however, are some of our boards of health in this respect. Ilalifax and Fredericton have no regulations governing its production. St. John, N.B., seems to have about the best regulations of any city in Canada. Quebec, Montreal, Ottawa, Kingston, Regina, and Vancouver appear to do about as much as St. John. In Toronto the requirements are 3 per cent. butter fat and 12 per cent. total solids; inspection of milk takes place as delivered. In a recent bulletin on milk from the chief analyst of the Department of Inland Revenue, Toronto, shows poorer than any other district.

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The Campaign Against Rats has taken practical form in England. A National Society for the Destruction of Vermin is being formed, with Sir Lauder Brunton as President, Sir James CrichtonBrowne, Sir Patrick Manson, Surgeon-General A. F. Bradshaw,

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and Prof. W. J. Simpson as Vice-Presidents. When the common brown rat invaded England he gradually killed off the "Old English” black rat; and at this day the latter is only found in small numbers in ports and docks. Everybody knows it has been proven beyond question that the black rat caused thousands of deaths every year in India, through bubonic plague. This ubiquitous rodent was feasted upon and infested with fleas; the fleas deserted his dead carcase, carrying the plague bacillus to the blood of human beings. The brown rat remains mostly now in England, and he is not exempt from the charge of carrying other diseases, such as typhoid fever. This brown rat multiplies very rapidly The female will litter eleven to twenty young every six weeks; the young doe will bear a family at three months. Thus the National Society for the Destruction of Vermin will have its' work cut out for it.

The Re-organization of the Visiting Staff of the Toronto General Hospital is now said to be complete. Elsewhere in these pages will be found the announcement as it appeared in the public press. The whole scheme exhibits one very bad and rather nasty feature. Several men have had their heads pole-axed for simply attending faithfully to their duties, and leaving altogether out of sight politics, pull, etc. Now, this unsavory action on the part of either the Board or the medical advisers to the Board is abominable; and occurring as it does amongst medical men, who are sticklers for ethics, smacks of quackery. If this sort of slaughtering is to be a feature of hospital work every few years—and many of the young men recently appointed will bear in mind that their tenure of office is for a year only—then it is high time reform, thorough and lasting, should be inaugurated in all hospitals which receive governmental and municipal grants. Taxpayers, lay as well as professional, should have something to say as to the manner their money is spent. To deny the right of a practitioner, who . is a taxpayer, or whose patient may be a taxpayer, to follow that patient into the wards of any hospital, irrespective of his being or not being on the visiting staff, does not seem just as just to that practitioner and that patient as it may be advantageous to the hospital and the visiting staff. In other words, Boards care more for their hospitals and visiting staffs more for their appointments than either care for the patients. It is only the patient and the patient's doctor who is concerned in the case in hand. Every man who is licensed to practice is entitled to practise upon his patient in his own home. The conscientious doctor when he needs the aid of a confrere or specialist, he so advises. Why are

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