some discomfort. The complete fixation of the spine renders many of the usual motions of the body impossible, and some time must elapse before the patient can become accustomed to moving round in this fixed position. Even in this respect, however, it is no more objectionable than the various kinds of braces formerly used.

When a jacket is properly applied, it may be worn three or four months without removal. In cases where the deformity is very marked, it is not wise to attempt complete extension at first. It should only be carried to a point where it will relieve the breathing, and the constriction of the body. In this position the first jacket may be applied, and should be worn about three or four weeks. Further extension can now be made, and the second jacket put on. In this way, a new jacket every month or six weeks, will soon completely straighten the spine, and then a longer time may elapse before changing.

In cases of lateral curvature, when the plaster has set, the jacket should be cut down the median line in front, with a sharp curved knife with a ball on the point. It is then carefully sprung open so as to remove it from the body, and immediately brought together again and fastened with a bandage. It is then left for twenty-four hours to dry thoroughly, after which the patient is again suspended, and the jacket sprung around the body. The patient is then removed from the suspension, and the jacket properly trimmed, care being taken to cut it out enough around the groin

to allow the patient to sit with ease on

an ordinary chair. It is then removed and sent to an instrument maker, who turns up the shirt so as to cover the outside of jacket, binds it and fastens two rows of eyelet-hooks in front. It is then returned ready to be sprung on and laced, as represented in Fig. 3, and makes a comfortable corset. A tight fitting shirt can now be worn under the jacket.

J.REYNDERS-CO.

Fig. 3.

In all lateral curvatures the jacket should be removed at night, after which the patient should use the selfsuspension for half an hour before reIt should be applied in the

tiring.

morning while the body is suspended in order to insure its proper adjustment.

It is sometimes advisable to fix the jacket for lacing, even in cases of Pott's Disease; but it should only be removed to bathe the body, and change the undershirt, and that even only when the patient is fully suspended.

In all cases of either form of curvature, the treatment is greatly supplemented by the daily use of Sayre's self-suspension apparatus,

be fastened to a hook in the ceiling, or to a tripod, and with the head supported the patient draws himself up so that only the toes reach the floor, and then swings back and forth. In ordering this apparatus, the weight, and height, and measurement around the chin and back of the neck must be given. This exercise should be

repeated several times a day, and continued for half an hour at a time. When the deformity is entirely overcome, a cast of the body may be made from the last jacket, and on this a leather jacket can be made which is light and durable, and can be worn in place of a corset, till it is considered safe to dispense with further support.

This jacket is made of hardened sole leather, and is provided with eyelets for lacing in front.

When Pott's disease of the cervical vertebræ is met with in a person who is fully grown, it is economy to attach the jury mast to the leather jacket as shown in Fig. 5.

At another time I will describe the various modifications of the plaster of Paris jacket that have been introduced, and report a few cases to demonstrate the remarkable results I have obtained by this mode of treating spinal deformities.

124 W. 47th Street, New York City.

ROBERT A. GUNN, M.D.

IS VACCINATION A FRAUD?

SEARCHING examination, like affliction, is sometimes not pleasant, but grievous; but, also like affliction, it often yields very valuable fruit. The historical criticism of Strauss and Renan caused much tribulation among orthodox theologians; Creighton and Crookshank are making the dry bones of medical dogmatism shake and tremble with the same weapon. No man and no thing need expect in these times to escape the most ruthless investigation. One of the shortest cuts to fame is to attack with boldness and skill cherished institutions. Whilst orthodoxy, though supported by learning, virtue, and the highest ability, may leave its supporters in complete and permanent neglect, heterodoxy, even of a flashy and comparatively unsubstantial kind, brings a man into notice at There are thousands of clever young fellows eager to make names for themselves; and nobody knows better than they the difference between the short cut of scientific or religious heterodoxy, and the long, wearisome, and uphill journey of patient and meritorious work. It is not to be wondered at, therefore, that established institutions of every kind should be constant objects of attack and defense.

once.

Many worthy persons shed unavailing tears over this tendency of the human mind to question what is, and to deny its right to continue. That is not the temper of science; it is not the conclusion of reason; it is not the way of progress and development. Man must question, exactly as he must eat, and love, and worship. It is his nature. He has been so made. He can no more resist the impulsion to question and to deny than he can check his tendency to growth in youth and to decay in old age. It is high time, in view of the unparalleled developments of science and the equally extraordinary increase of scientific capacity during the last half century, that the whole question of vaccination be made the subject of competent re-investigation. Even if compulsory vaccination were not a State institution, the mere fact of the general practice of so peculiar a method of prophylaxy would demand the thoroughest reconsideration at the hands of scientific men. But when every healthy infant in the kingdom is compelled by statute to undergo a surgical operation. and to pass through a critical disease in the interests of the public; and when the warrant for such an enactment dates from what may almost be called pre-scientific times, it is evident to every mind of any critical capacity that the day of judgment for compulsory vaccination has fully come.

The Inquiry Commission which is now sitting on this subject has no holiday task to perform. The friends of compulsory vaccination are numerous and strong. Its enemies are eager, resolute,' full of expedients, and have recently received reinforcement from an unexpected quarter. Professor Creighton, was a redoubtable champion; Professor Crookshank, of King's College, promises to be a still more ardent fighter. He has published a book which in point of mere size and price is formidable; whilst as a storehouse of industrious research it is of great value. Professor Crookshank, if his contentions can be maintained, will not only overthrow compulsory vaccination but will destroy the reputation of vaccination itself as a prophylactic. This latter seems a fact of much deeper gravity than the mere question of compulsion. If vaccination is discredited the results will be not merely the destruction of Jenner's reputation, which we all might survive, but also the blasting of the proud fame of the whole medical profession of modern times, and in every civilized country. That is the issue which is really being fought out before the Royal Commission; and it cannot be wondered at that doctors as a class, and especially those of name and

high repute, should await with some trepidation the result of the Commission's inquiries.-The Hospital.

THE ECLECTICS OF ALABAMA.

FEW Northern Eclectics have an adequate conception of the difficulties which have beset their brethren in Alabama. For years there has been a severe contest in courts, counties and Legislature, often under most discouraging odds. The purpose was to root out utterly every vestige of medical dissent, whether Eclectic, Homoeopathic, or liberal in any form. A statute was procured from the Legislature, placing the supervision of medical practice in the hands of a State Board of Censors, aided by boards in each county, all receiving their appointments from the Old School medical societies of the State and counties. No person attempting to begin practice in the State was permitted to do so except he had been authorized by some of these boards.

Dr. Jerome Cochran of Montgomery, Health Officer of the State, was the executive authority of the politico-medical machine. He had been a professed Eclectic, but had turned to the strongest party, and like other perverts excelled all common men in bigotry. It was, as in the case of others, an exemplification of the maxim of the New Testament: "Ye compass sea and land to make one proselyte, and when he is made, ye make him twofold more the son of Gehenna than yourselves." He constructed a system of arbitrary regulations, which were to be put in force all over the State. By the constitution of the State Medical Association he was installed in an absolute imperatorship. He now established the Old-School doctors of the State as a medical police, with arbitrary powers and irresponsibility. "The Medical Association of Alabama," said he, officially, " is now by far the most powerful medical organization in the United States, and, so far as we know, the most powerful in the world."

Truly the autocrat of all the Russias, the Turkish Sultan or old Tamerlane, in the plentitude of power, could take points from the apostate Eclectic overload of Alabama. And more, in his boasts, his domineering, his plans of action, every man not wilfully blind and besotted, can see and know what medical legislation in the several States of this Union really and unequivocally means.