may be left to the individual surgeon. What is the cause of cancer? Is it due to an infraction of the biological law" that complete life depends upon the complete discharge of function?" The pathology of cancer is still sub judice. Is there a germ which disturbs the healthy epithelium, causing it to proliferate by fission or budding? Is there an existing germ? Or is this pathological condition accidental? I believe that research and experiment will yet divulge the germ. In a recent article in the British Medical Journal, by Sir William Banks, I find this view put forward. I commend his entire article to the reader. Dr. Russell of Edinburg in 1890, published a paper on "A Characteristic Organism of Cancer." During the same year similar bodies were described by Sondakewitch and Ruffer. Mitcnikoff pronounced them "parasitic protozoa." From these authorities, and the researches of Plimmer and Buchanon of England, Sir William in reference to these germs, says: "I have been convinced that they do exist."

IRY

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EDITORIAL.

MEDICAL ADVERTISING.

Sometimes it is pleasant to be able to rest from criticism, condemning and exhorting, and to find and commend some praiseworthy thing. It is therefore very gratifying to us to read the recent remarks of some of our contemporaries upon the subject of medical advertising. And it is the more grateful that these notes of no uncertain tone come from the West, where we of the East-unjustly perhaps have been wont to look for journalism of quite another character. Of the latter there is still plenty but the attitude of the better and in some cases newer journals towards this question-an attitude that must imply financial loss, even (in the case of newer journals) to the imperilment of their existence-we cannot praise too highly nor too earnestly recommend to the consideration of many of our Eastern contemporaries. We have especially in mind the St. Paul Medical Journal, the Cleveland Journal of Medicine, the Colorado Medical Journal and the Western Medical Review. The St. Paul Medical Journal has estimated the number of strictly honest medical periodicals in the country at about a dozen, out of two hundred and fifty of all sorts. This is certainly a startling statement but the journal in question makes it advisedly.

Of course this dishonesty takes all forms, from the frankly debased. editorial or "original article" extolling the merits of some pharmaceutical preparation, down through the "reading notices" to pages of advertising interlarded in the journal; this last to be condemned more on the score of hopelessly bad taste than of actual dishonesty, inasmuch as such pages stand for what they are. Journals which exist solely for the purpose of advertising some special preparation or preparations we need not deal with now, since they possess nothing to which we can appeal and since the solution of their continuity depends upon whether physicians discountenance them and the products they advertise. It is the intermediate class, journals of good or middle standing, which yet for financial reasons allow their standards to be lowered by the insertion of advertising matter in other than their advertising pages, that we would address. They are yet open to improvement and we feel that their gain in self-respect would more than compensate them for their money loss; moreover that this loss itself would in time be made up to them by the increased actual support of physicians who look to medical periodicals for honest articles not for paid advertisements that are out of their place and look uncomfortable and embarrassed in situations to which they are not entitled. If for no higher motives than that of self-preservation we urge these journals to take this subject to heart. Not alone for commendable reasons is the matter working out its own solution. Such advertising methods will soon cease to pay because, when all manufacturing firms advertise in the same way, there will be no advantage to any but chiefly because these masquerading advertisements have ceased to appeal even to those physicians who are not disgusted thereby. The thoughtful and upright men in the profession who would now respect their journals more for a courageous stand in the matter will soon cease altogether to respect them for their lack of it. For the new ideas and higher standards have come to stay and to increase; they will carry far those who endorse them and for the time suffer for them but will bring destruction to such as continue to oppose them.

It will cost at present, all things do-there is no doubt about that. And till medical men signify their appreciation of upright motives in the journals devoted to their interests by limiting their subscriptions to the honest periodicals and by paying the subscriptions promptly (how much they fail in this respect is known only to the bitterness of the editor's heart and makes, at once, the most sordid and trying, yet imperative, question with which he must dea!), there will exist a serious financial problem to face. It is worth while,

we think, to quote in full a recent experience of the Cleveland Journal of Medicine.

"In relating the following experience, the Journal is actuated by the hope of doing some good by enlightening professional opinion upon certain matters of which medical editors have intimate knowledge. To avoid possible misrepresentation of motives, the Journal refrains from the use of names.

"Recently--and to this extent it is an almost everyday experience -the Journal refused to publish a paper submitted by a pharmaceutic concern between which and the Journal pleasant relations had long been sustained. The products of the firm were straightforward honest drugs with no taint of secrecy of composition, and the profession is always entitled to hear candid opinions by reliable men as to the practical worth of such remedies. The Journal refused to publish the article because it did not come from its natural territory, and because for that reason, coupled with the character of the article, many of our readers would naturally have at once concluded that the Journal had abandoned its well-known high standard in this matter. The Journal considered its reputation of greater worth than the patronage of any drug house, and courteously explained to the firm in question its attitude in this matter, pointing out that it was to the advantage of any honest drug not at any time to have cast upon it the suspicion of being forced upon the market by unethical methods. It is a pleasure to say that by most of the firms with which the Journal does business this explanation would readily have been received in the spirit in which it was made. In the present instance, however, the Journal was soon after this occurrence informed that the firm's advertising appropriation had run out, and that in consequence the Journal would be dropped from its list. In order to get the matter straight the Journal subsequently had a personal interview with the advertising manager of the firm in question, and readily ascertained that the real reason for discontinuance of the business was the refusal to publish the aforesaid paper. Warming up to the discussion the advertising manager, who be it said in sorrow is a physician and a member in good standing of the representative organization of the American medical profession, frankly said: 'To HELL WITH MEDICAL ETHICS! It is the dollars. that I am after.' The Journal is very far from thinking that this is a representative instance among the better class of pharmaceutic firms, and is rather of the opinion that the official head of this advertising manager would pay for his indiscretion did the Journal in a desire for revenge inform his employers of this occurrence. At least 90 per

cent. of the medical journals in this country would gladly have published the article declined by the Journal for the sake of obtaining an advertisement from the firm, and the Journal wonders somewhat how many of its readers care as to its stand in this matter. Its position in reference to all such matters is irrevocable and is not under discussion as to its continuation, but, from a hope of securing added support, respect and friendship from its readers, it seems advisable at times to take them into its confidence and to indicate how expensive it is for a medical journal to keep its pages strictly clean."

"The Journal wonders somewhat how many of its readers care as to its stand in this matter." Not many, we fear, but some; and the good opinion and good wishes of the latter are worth while and their number will increase.

Our own attitude upon this subject can be inferred in great measure from what our reading pages lack. Of the requirements for admission to our advertising pages less may be known and a word may not be amiss. Patented preparations can of course find no place nor anything, whether patented, secret or non-secret, that is advertised or sold to the laity direct. So-called secret preparations, unpatented, brought to the profession's notice in a proper manner and dispensed only upon physicians' prescriptions it seems not fair to debar, though even of these no article is advertised unless its formula be known to the editor; and this rule is strictly insisted upon. It does not seem right to require such formula to be published, though it should be accessible to any honest. physician; for pharmacists are not doctors and cannot be required to share their knowledge with their brethren. They appear to have no "code of ethics"; hence if a preparation be good and its formula published it would quickly be imitated by all the pharmaceutical concerns in the country (indeed the evil is great enough already), leaving no rights or emoluments to its originator. This would manifestly be unfair, for such preparations cannot be patented unless their owners wish to damn them forever in the eyes of physicians and to place them directly before the public.

That there should be a place in current medical literature for the unbiased discussion of the various newer preparations is true; but that in the present state of affairs seems impossible. While in so many journals what appears to be such unprejudiced discussion is paid advertising, no self-respecting journal can afford the appearance of evil; moreover the manufacturer is only too ready to take advantage of such articles and use them for his private ends, so that what aims to be an opinion ends by being an advertisement. It is only necessary to refer