needed for the immediate purposes of the academy in connection with its own administrative affairs, are rented to organizations concerned with public health. Thus is effected the centralization of as many as possible of those agencies in Toledo whose work has a medical bearing.

The Toledo Academy has 245 "active" or "senior" members, fifty-three "junior" members, ten "privileged" members and three honorary members. "Active" members are required to pay annual dues of $35; "junior" members, young men less than one year in practice, $15, and "privileged" members, $10. The total income from annual dues, on the basis of present membership, appears to be about $9,500. It is presumed that state association dues are paid out of that sum.

The Academy of Medicine of Toledo and Lucas County is larger and stronger than the average county society, but is not as large as some others that have failed to show as much enterprise and interest in organizational affairs. It is a better

society, because it has its own building, its own auditorium, its own library and its administrative offices, all in a building substantial and at the same time beautiful enough to stimulate a feeling of pride in its joint ownership in every one of its members.

It is understood that the funds for the Toledo building were secured through individual subscriptions rather than by assessments on members.

POLICE APPROVAL

The city of Los Angeles has a wide-awake police department, among other things. This police department of Los Angeles has its own bulletin. In its bulletin. for April 8, 1925, the police department of Los Angeles approved the use on physicians' cars of an "emergency" emblem-which is, or at least appears to be, made by a local concern-at $7.50 "per each." On the same page of the police bulletin that carries the assurance of the department that the emblem has been approved and will be recognized at full face value by traffic officers, appears a

letter from the president of the concern that sells the emblems. In this letter it is pointed out that physicians' tags and insignias which are permanently affixed to the car will not be recognized." In a postscript, physicians who will order and remit the required $7.50 are assured that they will receive the emblem and an "identification card signed by the chief of the traffic division of Los Angeles police department."

Now, that's what we call "official cooperation"! And as for salesmanshipwell, everybody knows that it has been developed as an art in our western metropolis.

SOMETHING NEW IN ADVERTISING

Hart & Dilatush operate a pharmacy in Spokane. They are, according to their advertisements, "professional pharmacists" and "prescription specialists." They advertise extensively in the local papers, but their advertisements are entirely different from those of the modern drug store. Instead of boosting all sorts of "patent medicines," safety razors, hair dyes, beauty "specialties," etc., etc., this Spokane firm of pharmacists, with professional ideals, uses its advertising space to carry helpful information to the public.

In one advertisement the use of iodin indiscriminately in all forms of goiter is declared to be dangerous. Those who have goiters are advised to seek medical advice, so that the nature of the disease in each case can be properly determined, and the kind of treatment needed secured. Goiter is rather prevalent in some parts of the Northwest, so the information offered in this advertisement is timely and wise.

Another of Hart & Dilatush's advertisements deals with periodic medical examinations, and the practicing physician is held out as the proper person to make such examinations.

Still another tells about insulin, which is properly described as "not a cure," but as an aid in the treatment of diabetes "not needed by all (diabetics); means life itself to others." A striking paragraph in this particular advertisement advises diabetics to "beware of nostrums promising 'bottled health' and tablets claiming to be just as good'; they are merely frauds." The danger of self-treatment is emphasized.

Two successive advertisements deal with smallpox and vaccination and two others with diphtheria antitoxin and toxin-antitoxin. These are designed to disabuse the public mind of any ill-founded fears of vaccination properly done and of antitoxin properly administered, as well as to urge the value of proved methods of prevention.

The Spokane pharmacists deserve to secure good returns from their novel and helpful advertising. They have set an example that others engaged in similar business might well follow, to their own advantage and to the public good.

TWENTY-ONE YEARS A COUNTY SECRETARY

For twenty-one years, Dr. C. S. Kenney, Norton, Kan., served the Decatur County Medical Society as its secretary. In all those years Dr. Kenney never missed nor failed to "put across" a single meeting on schedule time. Now, after establishing what we think must be a "world's record" for continuous, faithful and successful service, he has resigned.

Offhand, we would say that Dr. Kenney has earned the right to do as he pleases about resigning, but such secretaries are much needed, and it is a serious thing to lose one.

THE SPIRIT OF ORGANIZED EFFORT *

FREDERICK C. WARNSHUIS, M.D.

Secretary-Editor, Michigan State Medical Society
GRAND RAPIDS, MICH.

The plan, whereby in 1902 our medical reorganization was made to consist of county societies, state associations and the American Medical Association, must be conceded as not only just but also democratic. It affords an interlocking relation-. ship that unites the constituent units and correlates their activities, and at the same time amalgamates and organizes into one large body the profession of the nation. The experiences of the past twenty-three years have justified the wisdom of that plan and have created that solidarity that is so essential to achievement and progress. As times change, so too must we change. As new events create new conditions, we in turn must adapt ourselves to new relationships and assume new or extended obligations. Thus is the spirit of organized effort determined and developed. If we accept those obligations and well acquit ourselves in their performance, then do we meet up to the modern spirit and progress is recorded. Should we fail to do so, retrogression ensues and organization becomes dormant, and unless aroused, speedily disintegrates and ceases to function.

It becomes imperative then that we, who have been placed in official positions, should pause from time to time, take stock and confer, in order that we may determine whether we are causing our official acts to conform to the spirit of present day organized effort. In doing so, it is well, and essential, that we should formulate new movements and activities that progress may be evidenced. That is the purpose of this conference, which you, as county secretaries and councilors, are attending, Without further introduction or comment I shall proceed to enumerate, for your consideration, those purposes and programs that characterize the present day spirit of organized medical effort.

SCIENTIFIC ADVANCEMENT FIRST

The first fundamental of medical organization was, and still is, the providing of a place and time where members might meet, discuss, relate and appraise medical knowledge, scientific discoveries, experiences and practice-all to the one end for collective and individual improvement and professional ability. That feature embraces the scientific programs of our county society meetings. Compliance with this primal fundamental is as essential today as it was twenty-five years ago. It follows therefore that each component unit must constantly exert itself to maintain a high standard for its medical programs in order that our members may ever be abreast of scientific progress. It is the function of the county unit to keep the ruts of habit filled up and engender among local members the desire to remain in the van of modern practice. I desire to urge an increasing alertness to this basic object and advise increasing attention to the formulating of your scientific programs. Plan them far in advance with careful thought and consideration of topics, speakers and discussants.

INSTRUCTING THE PUBLIC

As individuals, as a profession and as an organization, the progress of our day no longer permits us to live unto ourselves and within ourselves. Our scientific discoveries and advancement has laid in store for us a vast fund of knowledge, which if properly imparted to the public would go far and do much for the efficiency, physical welfare, happiness and longevity of all humankind. This fund of knowledge, this civic resource, is not ours to hold and conceal for selfish purposes.

Delivered at Annual Conference, County Secretaries, Michigan State Medical Society, held in Grand Rapids, April 22, 1925.

If we judiciously disseminate it, we will retain the mastery that rightly belongs to the profession. Unless we so disseminate it, society will demand its receipt from other sources that are bound to be created, and when it does, we shall have forfeited our mastery, and our profession of today will be subordinated. That eventuality is certain to occur should we permit ourselves to become so negligent and irresponsible.

It therefore follows that the second important spirit that should motivate medical organized effort of today is the obligation we have to educate the public as to the truths and benefits of modern scientific medicine. As a state society, we have undertaken this duty as witnessed by our Joint Committee on Public Health Education. Certain ends have been attained. In certain counties splendid progress has been made. A basis has been thoughtfully constructed. As a state organization, embracing the entire state, the attitude is still characterized with far too much indifference and far too little achievement. A relatively few county societies concern themselves with this movement; more societies are indifferent and accord scant interest or support. The need presses, and I stress the imperativeness of that need, for every county unit to immediately rally to the support of this work and to become aggressively active. Speakers are available, assistance from the committee is at hand, the people are alert and eager. County society sponsorship, through an active working committee and well planned, followed-through effort, must become the concern and duty of each county medical society, in order that the public may be enlightened as to medical scientific truths and our public obligations remain unchallenged. As secretaries it becomes your duty to cause your local society to awaken and to undertake this work with intensified avidity. It is our outstanding, most essential activity. I sincerely hope you will return home fully imbued to institute this work in your county.

PERIODIC MEDICAL EXAMINATIONS

The third essential of the modern spirit of organized medical effort is need for providing, in a systematized manner, channels and methods for the conservation of human health. I refrain from commenting upon the needs or the "why fors," and bluntly mention periodic physical examinations for infants and adults. To establish the principles by which such examinations become imperative, to formulate an acceptable examination procedure, to standardize evaluations, and to bring about every doctor's enlistment in this field of service, is a responsibility that modern events and education has placed upon medical societies and the profession. The subject is receiving the attention of our American Medical Association, and an examination blank and manual is in course of preparation for individual usage. Certain county societies in the East, Middle West and Far West have taken the initiative. We, of Michigan, must no longer delay in instituting this demand of our modern day.

I have thus briefly and superficially cited three outstanding activities that call for concerted effort on our part. They by no means embrace all that is included in our organizational program. It would consume far too much time, were I to enumerate in essential only, medical legislative education, hospital and nursing standards, membership, personnel, community practices, public clinics, our interrelationships, postgraduate instruction, and several allied features which properly. but far too often neglected, fall within our scope of organizational objects and duties.

The general appraisal and criticism appears to be justified that we are in the midst of a critical period in our profession's history. We have drifted and been self centered, giving little heed to the forces that were amassing around us. Some have leaned overly far toward the money pots of Midas, and the golden calf bids well to supplant our cherished ideals. We need not hope for any Moses to lead us out of our professional wilderness of today. It is only by the directing guidance of you who are the most important officers of our county societies that we can' hope to establish and benefit by the powerful, though now somewhat dormant forces, that

lie within the scope of our organized medical units. To do so entails time, labor, thought, effort and zeal. You must give much, and receive little or no personal reward. You may confidently expect, if you are active, much criticism, cussing and enmity. Often, you will struggle alone, depressed and inclined to toss up the sponge. If you do, of course you will fail. If you persist with fixed determination, you will win, and the reward will be the personal knowledge and satisfaction that you have labored in a most worthy cause.

A PROGRAM FOR SECRETARIES AND COUNCILORS

I am not seeking to arouse false or transient enthusiasm. I am earnestly pleading to awaken a consciousness that will convince each of you that heavy burdens rest on you as county secretaries. I am hopeful that you will depart from this conference with a fixed, unswerving purpose and determination to return to your county society and promptly undertake to:

1. Bring about better scientific programs for your regular meetings.

2. Inspire, institute and foster, with the aid of selected members, an increasing number of public meetings for the education of the public in regard to scientific medicine.

3. Adopt and develop a plan of periodic physical examinations.

4. To join with and assume directing control of all public health work, clinics and hospital activities in so far as medicine is involved.

5. To enlist and interest all the eligible members of the profession in your county in the work of your county society.

6. To cause your society to enhance the type of medical service in your community.

7. To reawaken the spirit of organized effort for the attainment of the mastery and honor of our profession.

S. To beget professional fellowship.

These, gentlemen, embrace the essentials of the present day spirit of organized medical effort. For its accomplishment and for your assistance, you will find the council and officers of your state society ever ready, to respond, in so far as it is given to them, to your requests for assistance. Michigan stands foremost in national medical progress. It remains for each county society and each county secretary to determine if we are to be relegated to the rear ranks. There are peculiar conditions and obstacles in each county. They can be surmounted by fixed determination on your part. May the discussion today assist and inspire you to that type of service.

HOW COLLECTIONS WERE MADE IN OLDEN DAYS

American doctors in 1832 did not receive $500 and $1,000 fees. Instead, they were forced to rely on paid advertisements in the newspapers to collect their modest bills.

Such, at least, is the evidence presented today by a copy of the Black River (N. Y.) Gazette, published at Lowville, N. Y., Dec. 26, 1832. In it Dr. David Perry makes this appeal:

"It is not without feelings of regret that the subscriber is under the necessity of announcing the fact that he is in want of cash and must have it, or suffer the consequences. He would fain hope that the knowledge of this fact may stimulate the many who are indebted to him (some of whom have been indebted for years) to do him an act of justice by paying their dues with all reasonable dispatch-say, by the middle of January now coming.

It is useless to conceal the fact that the subscriber must either receive the rewards of his labor more punctually, seek a new field for his professional labors, or renounce the profession altogether."-Hartford City (Ind.) Times-Gazette.