"There was detected in 71,000 examinations:

One case of heart lesion in 410 aminations.

ex

One case of weak, irritable or tobacco heart in 825 examinations.

previous eleven years, yet an approximately correct showing will give the local examiners, as a class, credit for near a hundred per cent improvement over the work of the preceding eleven years, judging by the much larger per

and the fuller understanding displayed

Taking all circulatory diseases or defects, there was detected one in 268 examinations.

Of pulmonary, bronchial or pleural lessions there was found one in 780 examinations.

Of kidney lesions, as per all signs, there was found one in 717 examinations.

Of albumin, there was detected one in 1,145 examinations.

Of sugar, there was detected one in 2,449 examinations.

Of pus, one in 71,000 examinations. Of indefinite or ill-defined kidney complaints, one in 10,143 examinations. Rated by the examiner as 'unsafe,' one in 1,775 examinations.

Of about 4,000 applicants that have (up to that time) been rejected by myself, the local examiners rated 78 per cent of them as first class; near 22 per cent as average; less than 6/100 of 1 per cent as unsafe risks."

This shows the scant opportunity that is afforded the medical referee to reject on account of disease or physical defects disclosed by the examiner. Nearly 90 per cent of rejections, in my experience, have been, not on account of disease discovered by the examiner or suspected by me, but on account of adverse personal or family history, abnormal physique or "moral hazard." The educational influences, previously enumerated, have, in the last few years, wrought a great influence for the better.

While I have not subjected the last four years of our experience to the rigid test the foregoing shows of the

gevity. While the writer's experience does not compare in extent with that of some others in the same line of work, yet it has been considerable, amounting in round numbers to 100,000 examinations reviewed, and 2,500 each of death and disability claim proofs scrutinized. Early in my experience I appreciated that there were different grades of even acceptable risks-a few, perhaps 10 per cent, could be graded as first class; 80 to 85 per cent as medium or average; and 5 to 10 per cent below average, yet seeming too meritorious to reject.

It was my practice to lessen the order's liability on the latter class by scaling them down; that is, to approve for some amount less than that applied for, as there was no provision in the fraternal scheme to compensate by means of a loaded premium for substandard risks. This class and the rejected class were nearly equal, amounting to, approximately, 7 per cent each. Certainly as many or more of the rejected class on which the order assumed no liability, have died, as have those of the reduced class. The already matured (by death) claims of the latter class enable me to estimate the saving to the order incident to both reductions and rejections as amounting to date, approximately, to one million of dollars.

I found medico-insurance an interesting field, one that has undergone intensive cultivation in the last one or two decades; and, like clinical medicine is susceptible of still greater improvement, as lessons are derived from more extensive mortuary statistics.

cians. He discovered new remedies which have gained a high standing in the modern therapeutic armament. Neusser was the first to use radium emanations in form of bath and internally in the treatment of rheumatism and nervous diseases.

That such a man of knowledge so profound and of genius so great must be a great physician, does not seem inevitable to the initiated; but Neusser was not only the great scientist, he was indeed just as great a physician. For the greatness of his mind found its harmonious complement in the benevolent, kind, all-forgiving disposition of his heart. Neusser was the great physician because he was animated by the highest desire to help his sick fellow-creatures, to repair their health, or if this was impossible, to alleviate or ease their lot. How often Neusser told us: "Of what help to the poor patient is the diagnosis of the greatest genius, if we cannot help him?"

After hours of work Neusser used to sit at the piano, finding there recreation and exaltation. Especially fond was he of his connational composer,

Chopin. It is well known that Neusser, not to disturb his surroundings, used often to visit a friend in the middle of the night, who lived in a lonely cottage in the country, to play the piano sometimes until dawn. His love of music brought the scientist together with a famous star of the Vienna Court opera, Paula Mark, whom he married. Nobody who was ever so fortunate as to hear Neusser at the piano accompanying the songs of his wife will be able to forget that artistic enjoyment. His beloved piano also helped him in his last hours over his pains and tortures.

For his own glory or fame Neusser never cared. He was the prototype of modesty and bashfulness; he depreciated himself, he, whom others worshiped as a star, all his colleagues, his students and his patients. They all stand at Neusser's bier deeply mourning. Their heartfelt grief is alleviated by a feeling of proud joy: Neusser's head is wreathed with the evergreen laurels of a master of science, a medical artist. Edmund von Neusser lived to live for eternity.

210 Metropolitan Bldg.

SALVARSAN NO THERAPIA

STERILISANS MAGNA IN

been given "606" once every week for three consecutive weeks commenced to show, after six, seven, nine months or a year, the dreaded mucous patches.

So much has been written and so much has been said about the undoubted efficacy of arsenobenzol, and it has now been used long enough so that, not considering the profound admiration that I have for Prof. Ehrlich, I believe it is the right time to discuss the true value of the remedy.

Finger of Vienna, Koffman and Kromayer of Berlin, Marshall of London, Gaucher of Paris, Tomasczewski of

Berlin, Wynn of Indianapolis, Goldenburg and Kalinski (Amer. Jour. of the Med. Sciences, 1911), Winfield and Potter of Brooklyn, N. Y., were among the first to notice and publish that "606” did not eradicate the disease. From my own observations I have arrived at the following conclusions:

First. That it has, no doubt, a rapid healing action on the primary lesion, but that it does not, by any means, sterilize the syphilitic organism, because after the use of salvarsan the relapses are more numerous than after the usual mercurial treatment, a fact that proves beyond a doubt that it cannot cure syphilis.

Second. That we must not depend absolutely on the negative Wassermann reaction, because in many cases the reaction proved negative, although made a month previous to the secondary manifestations.

Third. That the remedy has a delaying action on the evolution of syphilis, a fact that renders it a treacherous one, because patients treated with it believe that they are cured, while six, seven, nine months and even a year and a half after treatment they present mucous patches rich in spirochoetae pallidae.

Fourth. That I believe, with Gaucher of Paris (owing to the serious renal disturbance manifested in patients after taking "606") that the remedy is a dangerous one, because, as all arsenical preparations are in heavy doses dangerous to the kidneys, it is bound, some time or other, to produce a toxic congestive nephritis.

As I have gone so far, I deem 't necessary at this moment to briefly quote a case of Professor Paul Mulzer of the University of Strassburg, reported in The American Journal of Dermatology and Genito-Urinary Diseases (June, 1912), which can leave no doubt of the fallaciousness of the remedy:

The case is one of a medical student of Professor Mulzer's university. After

a prolonged sexual continence, this student ventured coitus with one whom he considered a healthy prostitute. On the day following intercourse he showed up at the clinic with a badly torn frenum, which was repaired by stitching. The next day he returned with an acute gonorrheal urethritis. In conformity with the German law, the prostitute was reported to the authorities at once, and upon examination a diagnosis was made of gonorrheal bartholinitis, and in addition she was found to be affected with a fissure and fistula in ano, and a general scleroadenitis. The latter symptom being to Professor Mulzer suggestive of syphilis, the young man was given intravenously 0.4 gram of salvarsan as a prophylactic. The injection was given on the third day following intercourse. Exactly twenty-two days after his exposure our future colleague showed a primary lesion, plentifully endowed with the dreaded spirochaeta pallida, just at the site of the torn frenum.

I have been tempted many times to give salvarsan to my patients, but on second consideration I emphatically refused to do so, for the sole reason that I did not feel justified in administering to them a remedy that I would not unhesitatingly take myself. And today I do not regret in the least that for twenty-two years I have given to these unfortunates, intravenously, mercury, the remedy that has stood the test for the last 400 years.

In the past, as far as I know, "606" has only been given in cases of secondary and tertiary syphilis, but when we stop to consider that it will not arrest nor cure the disease, even if given three days after sexual intercourse, as in Professor Mulzer's case, just quoted, I feel that we should ask ourselves if the time has not yet arrived to relegate this dangerous drug to the armamentarium of the old, old pharmacopoeia and refrain from taking patients' money under false pretenses; that is, promising an absolute cure for