help himself, without his having to say anything in the matter, just as if he were an automaton or a marionette.

No, I am not going to sit in judgment over our poor colleague. And the cant or the ignorance which brands every suicide as a coward, a criminal or an insane person is to me obnoxious. I can conceive of a man committing suicide when in the full and unimpaired possession of his mental powers and not only can I conceive, but I know of circumstances where the act, far from being one of cowardice, was significant of the highest and noblest kind of courage. No, let us not judge and let us not call names. What can we, who have never been there, know of the motives, feelings, thoughts and workings of the mind of a man who has decided to take the journey whence nobody returns?

But if we may not judge, blame or criticize, we may be permitted to offer some thoughts on the subject. Among the many causes of suicide, unbearable physical pain (tic douloureux, heart disease), incurable diseases, great mental agony, and fear of disgrace and imprisonment play an important rôle; but besides these, the most frequent cause is, in our opinion, the emptiness of life, the lack of an ideal.

To take our poor acquaintance as an example. He worked hard and made money. But he had no ideals, no high objects in life. He was not interested in any movement, he seldom or never took a book into his hands, the progress of the world did not interest him, the struggle of mankind for freedom and happiness did not thrill him, the continual battle between the forces of light and darkness did not engage his attention. As long as material things went well, as long as he saw the bank balance grow larger each month, he felt well. But a crisis occurred, the savings of a few years were wiped out, the income was merely large enuf to live comfortably-and life lost its interest. Undoubtedly the realization of the fact that he might always have to work merely to make a living, after he had imagined he would soon be able to "retire" (the unrealized hope of so many millions), upset his equilibrium; to begin over again-for that he was getting old; and besides, the average doctors nowadays do not make so much money as they used to ten or twenty years ago. And as no higher interests held him to life-he made an end of it. Dr. X. did not take me into his ante-mortem confidence, but I feel quite certain that those were the reasons that led up to the tragedy. For a friend of Dr. X., of the same professional and financial standing, did confide to me once that if he were to lose his accumulated capital, he would commit suicide. By working hard day and night for several years, running up and down the stairs of the tenement houses, he had "worked himself out," had used up all his reserve energy (for he was as foolish as most of our confrères are, and seldom took a vacation to recuperate

his nerve force), and he felt that life would have no value or meaning for him without his reserve capital. For he had nothing higher to live for.

And here is another example of a different nature. Dr. Z. worked hard and conscientiously for many years. He saved some thirty thousand dollars and then in an evil moment, at the advice of some good and wise friends, he invested them in some stocks which were to double in a very short time. Instead of doubling, they began to subdivide themselves and in a very short time he found his thirty thousand dollars worth less than three thousand. And as he could not or would not put up any more, he was soon "wiped out." The shock, he told me, was a terrible one. To see one's hard earned savings, to see the labor of several years disappear within a few weeks, and disappear not in an honorable, but in a gambler's manner, must be very hard. He thought he would never get over it. Things looked dark and gloomy for a time. But his life was not empty. He had an ideal. He was interested in many movements. He loved humanity, he was interested in its progress and its vicissitudes, good books were a delight to him, he liked his profession, and last, but not by any means least, he loved his wife and children. And in a short time he got over the effects of the shock, he started things anew, and he is now a happier man than he ever was. All because he did not live for himself alone, because he had broad sympathies, because he had an ideal.

And that's what we would advise to every man and woman not entirely devoid of mind and heart. Broaden out. Develop your sympathies. Create for yourself an ideal and live for it. For if you don't and your personal affairs do not go as well as they should, then things will look mighty dark and dreary. Broaden your sympathies, and live for an Ideal; do not live for yourself alone.

The Diseases Causing the Greatest Suffering and Having the Largest Number of Victims.

The disease that has the most victims and causes the greatest amount of suffering and unhappiness should enlist the greatest sympathy and demands the most care and attention.

It is our firm belief, based upon many years' practice and upon knowledge derived from extensive reading and confidences of many men and women, that diseases of the sexual function are more widespread and cause more misery and suffering than any other disease of the human body, barring none. And for this reason these diseases should receive by far more attention than they are receiving now. To those who

have not given the subject any thought this statement may seem, at first glance, strange or extreme. We are quite certain they will change their opinion after they have read this article thru to the end.

By the name sexual diseases we understand all diseases caused by the exercise or the non-exercise of the sexual function and by the various deviations of that function.

First we have the endless list of venereal diseases and their complications. Let us enumerate them briefly. Gonorrhea with its complications, phimosis, pariphimosis, epidydimitis, orchitis, cystitis, prostatitis, stricture, pyelitis, gonorrheal rheumatism, gonorrheal ophthalmia, ophthalmia neonatorum, endocarditis, general septicemia, cervicitis, endometritis, salpingitis, etc., etc. Chancroids and chancroidal buboes. Syphilis with its terrible ravages from which not one organ in the human organism is absolutely safe; syphilis which disfigures the body, may destroy the eyesight and the bones of the face, which attacks the liver, the heart, the kidneys, the nerves, etc., etc., which may many years after the patient had thought himself cured give rise to locomotor ataxia, paralysis, general paresis, etc., etc., which is transmitted to the first and even the second generation and gives rise to so many stillborn children.

Then we have the purely sexual disorders; masturbation with its resulting disturbances, pollutions, spermatorrhea, premature ejaculation, relative and absolute impotence, sterility, marital incompatibility (referring to the purely sexual variety), vaginismus, frigidity, nymphomania, the numerous sexual perversions (not moral, but pathologic) which we do not care to enumerate here, and the frightfully prevalent sexual neurasthenia.

Take all these diseases and consider the terrible suffering caused by them-suffering both physical, mental and moralconsider the blasted careers, the shattered hopes and ambitions, the disrupted homes, the separations and divorces, the disgrace and shame, the insanities and suicides caused directly and indirectly by these diseases and see if you will not agree with us, that in their multiplicity, in their wide-spread prevalence, in the number of people affected by them, they constitute the most important class of diseases. It is therefore right that our medical colleges and practicing physicians should pay more attention, a good deal more attention to them, than they are paying now.

"More than they are paying now." For now they are paying very little attention to these diseases indeed.

It will be said that these diseases are not very fatal. True. But fatal diseases are not always the worst. Death is often preferable to a long life of suffering, invalidism, disfigurement, incapacity, mental weakness and insanity.

The Double Function of the Testicles and Ovaries.

It was formerly assumed that the sole function of the testicles was the elaboration of semen. Advanced investigators think so no longer. We now know that besides the spermatozoa and spermatic secretion fluid, the testicles are engaged in the manufacture of an internal secretion which is absorbed by the system and which contributes to the specialization of the sex, i. e., to the formation of the male characteristics, both physical and mental. And what is true of the testicles is also true of the ovaries: besides the ova, the ovaries elaborate an internal secretion which is absorbed by the system and is very necessary to the physical and spiritual well being of the woman. Hence the disastrous results which generally follow the total removal or the pathologic non-functioning of both ovaries.

Alcohol in Medicine.

A most annoying thing to the general practitioner is the uncertainty which exists regarding the value of alcohol in disease. Some authorities proclaim its utter worthlessness and injuriousness; others equally eminent or more so declare their belief in its great value. To the latter belongs Sir Dyce Duckworth. In a recent issue of The Hospital (Oct. 2d) he deplores "the unwise teaching of the present day in regard to the employment of alcoholic beverages" and pleads that their use be not "ignored in deference to any prevalent wave of public opinion."

Bad Odor from the Mouth and Matrimony.

No woman has a right to marry who has a bad odor from her mouth. It will end disastrously. It may not end in divorce-it often does-but it will surely cause coolness and marital infelicity, and the husband will be very apt to stray into by-paths. For which we should not be inclined to blame him too severely. There is no excuse for anybody, and particularly for a member of the lovely sex, to have a bad odor from the mouth (or from anywhere else). The worst and most obstinate case of bromopnea can be cured if the causes are diligently sought for and properly treated.

Another Carbolic Acid Victim,

The newspapers of to-day (October 4th) bring the grewsome news of the accidental death of a near neighbor of ours, Dr. Ludwig Kohn, who by mistake swallowed some carbolic acid instead of a solution of strontium bromide which he had intended to take. Another name added to the fearfully long list of victims of that horrible poison. A poison which is worthless as a remedy, and which, as a disinfectant, is excelled

by many others, less dangerous, less immediately fatal. Again we say, it is time that this useless poison, which has destroyed so many lives, be discarded from the pharmacopeia and from the shelves of the drug stores. If it is used let it and its solution be colored in such a way that it may not readily be mistaken for water or other harmless liquids.

It will be a surprise to many of our readers to learn that two millions of our white population are infected with uncinariasis or hookworm disease. The disease ravages principally in Mississippi, Alabama, Georgia, Florida and the Carolinas.

It is a bad state of affairs when men will thoughtlessly write laudatory reports about a drug with which they have had insufficient experience. It is a worse state of affairs when men will for money praise a drug with which they have had no experience. But it is almost as bad a state of affairs when good physicians who have had a large and favorable experience with a drug will refuse to report their results for fear they might be accused of interested motives.

Neurasthenia Among School Teachers.

Teaching in public schools must be a very exhausting occupation, for in no profession is neurasthenia so prevalent as it is among public school teachers. In the year ending February 28, 1909, ninety-five New York teachers applied for permanent relief from duty and of these nearly one-half gave neurasthenia as the cause of their inability to continue in the blessed work of educating our citizens and citizenesses. We are not surprised. The surprise is that not more teachers become neurasthenic. The "sweetness" of many of our school boys is enuf to drive a strong man, let alone a delicate little woman, crazy.

Single Remedies or Combinations in the Treatment of Disease

While fully aware of the ridiculous absurdity and of the utter worthlessness of many of the old time shotgun prescriptions, we never belonged to the strenuous advocates of single remedies for single diseases. For we were also aware of the fact that diseases were not distinct and definite entities, but were as a rule the resultants of many different causes. And we were also aware of the fact that by combining several small doses of synergistic drugs we could often achieve better results and achieve them in a more pleasant manner than by administering one dose of one drug.

Recent investigations, and investigations not of an empiric, but of a strictly scientific character, demonstrate very de