IMPROVEMENT OF MILK SUPPLY
1902
Journal of the American Medical Association (JAMA)
for some time, naturally without any effect except an unwarranted prejudice against the doctor whose remedy did not help him. Such an annoying state of affairs may also develop when an anemic patient, by taking iron, is relieved of painful arthritic conditions due to lowered nutrition of the joint structures and persuades a plethoric individual suffering from subacute rheu¬ matism, or an occupation neurosis, to try the same-but in this case contra-indicated-remedy. The existence of an abuse in
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... his matter of prescrip¬ tion renewal is well recognized. Many physicians have their prescription blanks printed with the express pro¬ hibition of renewal. This seems an eminently advisable precaution, under the circumstances, and, as far as pos¬ sible, physicians should insist on the observance of the injunction. It is not often that prescriptions may be re¬ newed without some change in their contents if the highest good of the patient is to be consulted. While the physician seems to be consulting his OAvn interest by forbidding renewal and thus requiring further calls from the patient he is really assuring the best interests of the patient and of the community at large. There is entirely too much assumption of medical sapience by non-medical people. The practical expression of this takes the form of lending or passing on prescriptions. Physicians must at least secure themselves as far as possible against abuse of their prescriptions under condi¬ tions they Avould not approve. The mere insertion of the printed injunction not to refill will not effectually prevent the present abuse which is too deeply rooted in human nature to be thus easily gotten rid of. But it will help in the education of the public as to the dan¬ gers that exist in the practice and will act in most eases as an effectual deterrent at least of the frequent and prolonged repetition of a remedy Avithout further con¬ sultation of the physician. TOO MANY MEDICAL STUDENTS. It has repeatedly been remarked in The Journal that the study of medicine is overdone, especially in this country. There come to our desk frequent reminders in foreign medical literature that we do not suffer alone, and that we have occasion also to feel for others' woes. A late item in the Allgemeine Medicinische Centralzeitung is to the point; the local medical association (Aerztekammer) of Austrian Silesia has published a warning to prospective medical students against entering upon their studies. It was specially resolved that a circular should be sent to the heads of the Silesian gymnasia calling attention to an already published appeal of the Vienna Students' Association in which the unfavorable outlook for the medical profession was shown. It was further resolved to publish similar notices in the political journals and to seek for co\l=o"\peration of other medical bodies for the same general end. It evidently takes less to induce action over there than in this country for where they have one physician we have many. More¬ over, they are not there multiplying medical colleges and otherwise working to cut their own throats finan-cially by increasing their competitors in an already over¬ crowded profession. This is the case here; with a nec¬ essary reservation, that it is the fe\v avIio profit by ex¬ ploiting the mass of the profession. assistant chief of the Dairy Division of the Department. Its object is given in a prefatory statement, viz., to answer questions as to the means of improving the milk supply of committees by showing the ideal conditions or rather those that can be practically realized wherever it is seriously attempted. It does more than this, however, it lays down a plan of organization of local commissions mainly or entirely of physicians who are to educate the dairy men and the public as to the requirements of the ideal or model dairy product and to endorse the milk supply from such as furnish it under the proper conditions. The work of the local medical societies in New York and Philadelphia is noticed and the forms used by the Philadelphia Pediatric Society and the circular sent out by the New York County Medical Society are given in an appendix. While the methods proposed Avould require a revolution in the milk trade, they will ultimately have to be followed and the general circulation of this pamphlet will prepare the way not only by instructing the dairy men but by educating the public. There has probable been no more important minor publication issued by the Department than this one, and it is to be hoped that we shall before long see Avidespread results. FIBRIN FERMENT IN MILK. Studies with the various serums and anti-serums have led to the demonstration that milk, human and otherwise, generally contains fibrin ferment. This fact is readily demonstrated by adding a drop or so of milk to hydrocele fluid, which contains fibrinogen but no fibrin ferment, and coagulation results. We owe this observation to Moro and Hamburger1 and Bernheim-Kauer.2 Hydrocele fluid may lose the property of coagulating after standing for some days and after heating for thirty minutes to 55-56 C. The ferments in various milks do not react alike to heating, that in cow's milk not being affected by so low temperatures as the ferment in woman's milk. Bernheim-Kauer sought to obtain an antibody for the fibrin ferment in human milk by repeated injections of rabbits with milk, and with success. By suitable experiments with this anti-serum he shows that the ferment in cow's milk is not identic with that in human milk because the anti-coagulative action of the serum of rabbits injected with human milk is limited to human milk and does not affect to similar degree the ferment in cow's milk. He finds, further, that normal serum contains anti-coagulative substances in small quantities. To what extent if any the anti-coagulating substances normally present in the blood prevent clot¬ ting during life is as yet Avholly conjectural. The obser¬ vations referred to are interesting as far as they go.
doi:10.1001/jama.1902.02480200023008
fatcat:hegewphdfrh4lghasautul2hty