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During the present session of the Association the State Boards of Health are to meet in conference. The tendency of this meeting will be to review the project of a separate Association of State Boards of Health. The result purchase atarax online of such a step would prove eminently disastrous to public health reform in this country. The Public Health Association stands to-day the foremost of our great na- tional bodies, and is the recognized embodiment of scien- tific and practical sanitary knowledge and experience in this country. During the twelve years of its existence it has published a series of annual volumes which are un- surpassed by any other Association for real merit. Its influence on public thought and opinion, and on legisla- tion, both State and national, is powerful, and when con- centrated on practical reforms, is decisive. Any such dismemberment of the Association as this movement of the State Boards of Health seems to contemplate would be a most inglorious suicide. Far better will it be for the future of sanitary reform and administration in the United States to enlarge the scope and plan o( the original organization, so that, while there may be tiie greatest diversity of discussion, there shall be unity of action, and the voice that shall pronounce the judgment and conclusions of the assembled congress of health authorities shall continue to be that of the American Public Health Association. THE FIFTH VOLUME OF THE INDEX CATALOGUE.' The appearance of the fifth volume of the Index Cata- atarax price logue of the Library of the Surgeon-General's office will be hailed with the greatest satisfaction by the writers and workers of the profession, as adding another volume to the admirably exhaustive series which have opened such won- derful treasures of information and reference. Under no other auspices and under no order atarax online other management could such work be accomplished, than those which centre in the Sur- geon-General's oflice under the direction of the talented librarian, Dr. John S. Billings. In fact in no other country has such a thing been attempted, and it is safe to say, backed by the testimony of those who ought to know, that in no other place has the foundation for such work been laid. The present volume embraces an equal scope with the others, is of equal size, and comprises, as might be anticipated, an almost fabulous amount of references within its limits, viz., from Flaccus to Hearth. In brief it includes 15,555 author-titles, 5,755 volumes, and 12,596 pamphlets, also 8,069 subject-titles of separate books and pamphlets, and 34,127 titles of articles in periodicals. The utility of the series proves itself more and more with each volume, and correspondingly indicates the hearty professional endorsement of governmental patron- age. The best that can be said is that the good work is likely to go on, and every scholar in the profession will wish it Godspeed. atarax cost THE NEW CIVIL SERVICE REGULATIONS AND THE MEDICAL PROFESSION. An advertisement appears In the daily papers to the effect that "an open competitive examination, under the New York State Civil Service rules, will be held Oc- tober 2 2d, at the New York Academy of Medicine, to fill vacancies in the regular medical staff of the Hudson River State Hospital for the Insane, at Poughkeepsie, N. Y." It is further stated, that the examination is open to all graduates of reputable medical colleges. This announcement, already indicated in a previous buy cheap atarax issue of The Medical Record, is, we believe, the first application to medical positions of the New York Civil Service regulations, which went into effect last August. The regulations that have been adopted by this city show the general scope of those for the whole State, and as a knowledge of them may prove of some value to physicians who intend to become connected with the public service we venture to give some of the details here. The positions which are obtainable now only after competitive examination are those of physician, surgeon, chief of staff of hospital, medical oflScer, medical super- intendent and assistant medical superintendent, inspector of vaccination, or sanitary inspector, and those posi- tions in the Health Deiiartment requiring a medical edu- cation and experience. The rules also require an examination of all applicants for the positions of principal matron, head of training- school for nurses, orderly, nurse, and hospital attendant. These positions are included mainly under " Schedule ' Index CataloEuc of ihe Library of the Surgeon-General's Oflice, U. S. Anny. Aulhori and Subjccus. Vol. v., Flaccus-Hearlh. Washington, 1884. 4o8 THE MEDICAL RECORD. [October 1 1, li D," which includes buy atarax online all persons for whose duty special expert knowledge is required ; and " Schedule E," which includes physicians, chemists, nurses, orderlies, and other hospital and asylum attendants. Applicants for medical positions must address a letter to the Secretary of the Municipal Service Boards, New York city, stating their age, residence, nativity, etc. ; they must furnish a certificate of good character, and atarax mg must give evidence that tliey have been duly authorized to practise medicine and surgery. The examination takes place before one of the three Examining Boards appointed by the mayor, and composed of three citizens. The examination, besides requiring evidence of physical and moral qualifications, includes the following, with the relative weight given to each : medical knowledge, 50 ; exjierience, 20; efficiency and accuracy in work, 15; character for maintaining discipline, 15. Naturally, cer- tam variations from this are made in accordance with the order atarax character of the position. It IS in the power of the Advisory Board to institute non-competitive examinations for positions in the De- atarax online partment of Charities and Correction. In regulation 30 it is stated that competitors for "the superior positions in Schedule D " are not obliged to produce a diploma, but a certificate from some reputable mstitution of having studied two years, or a certificate from a professional man of having purchase atarax studied for three years will suffice. This provision, as will be seen, furnishes a possible opening for politicians to get in their friends who have not been regularly qualified as physicians. The Civil Service regulations, if carried out thoroughly, will no doubt assist to raise the character of the medical service. Yet it must be admitted that the character of this service was on the whole very good under the where to buy atarax old system. Rumors of late, however, that politics has too much influence in the Health and Police Departments, lead us to look forward with pleasure to anything that promises to remedy these existing or impending evils. RECOGNITION OF HARD PREPARATORY WORK. One of the earliest observations which a young physician learns to make is that of the enormous disparity which exists in the education, skill, manners, and general char- acter of physicians. A young man has graduated from a classical or scientific college, has spent three or four years at a leading medical school, atarax tablets has walked the hospitals, has perhaps subsequently taken special courses or stud- ied in Europe. He then settles in buy atarax practice and finds that he must meet as a brother, and must be estimated by the public in the same rank with a person who, without pre- liminary training, graduated at some provincial institu- tion, after a course of study lasting practically about two years. atarax 10mg He hears derisive comments on this brother's ig- norance or on that colleague's offensive ways, he hears the profession ridiculed for its incapacity and various standard weaknesses, and has to take his share of the obloquy, although he can feel without vanity that he is working intelligently and with some success in his chosen art. There seems to him to be something wrong. There are some evidences that the profession every- where feels that these differences between doctors and doctors are very great, and atarax tablets 25mg that the ill-repute which should fall on the careless and half-educated, should not have to be atarax 50 mg shared so completely by those who have trained themselves thoroughly, and who are working with an honest ambition. Some time ago it cheap atarax was proposed in France that a spe- cial class of physicians should be established, composed only of those who had shown some evidence of unusual capacity. In England and this country there is a tendency to indicate, in giving the medical title, the college which bestowed it, provided that institution was one whose character deserved such special designation. Certainly the degree of M.D., in this country, has a very unequal signification, perhaps to a greater extent even than that of A.M. The establishment and success of the American Acad- emy of Medicine helps^also, in a measure, to give credit to those who have taken more than the usual pains to prepare themselves for a learned calling. We are inclined to favor these plans which aim to give recognition to hard preparatory work. It may be said that such ideas are not " democratic," and that the hum- ble graduate of an obscure school may become a better physician than he who is trained by the most elaborate methods. While this may be true in some cases, certain exceptions do not invalidate the general principle laid down. Hard preliminary work deserves a little recogni- tion other than the slow and uncertain recompense fur- nished by the public. THE PATHOLOGY OF SERPENT-POISONING. A TRULY scientific account of the lesions produced by snake-poison is so rarely met with that the contribution to this subject by Dr. Romiti, of Sienne, in the Archives Italiennes de Biologic (tom. v., fasc. i.), is of great interest. The victim was a man forty years of age. Within a few moment after receiving the bite, from the viper aspis, he fell into a syncopal condition, the heart became ex- tremely slow, and death took place by asphyxia in four hours after the injury. At the autopsy, twenty-three hours post mortem, the body was still in a state of cada- veric rigidity ; but it was noticeable that the injured arm was less rigid than the other. The abdomen was enor- mously distended ; and the pupils dilated. The cellu- lar tissue atarax 25 mg around the wounded surface was infiltrated with a sanguinolent serous fluid, which also invaded the muscular tissue. The neighboring veins were filled with black fluid blood, though the wounds had not entered any vein. The superficial cerebral veins were filled with blood of the same nature, and the pons, cerebellum, and medulla were very much congested. The pulmonary vessels were full of blackish blood, as were those of the abdominal organs ; and the intestines were enormously distended with gas. The spinal meninges were con- gested, and the vessels of the cord engorged. The most interesting phenomena, however, were those found on histological examination of the blood. Two series of preparations were made of venous blood taken from the vessels of the injured arm. The first, of a single drop of the blood, generic atarax without any reagent ; the second, of blood treated by Bizzozero's method, that of mixing the October ii, 1884.] THE MEDICAL RECORD.

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