times, and not only when in 's presence.

mering is associated with an n of the breath, and as stamer occurs when the breath is red freely, the aim in treatd be to keep the breath flowin fact to insist on an exagfirst of the breath in the

_merer's attention is directed ty sounds he makes, and he by comparison, the correct -llabication or dividing words les is one of the best exernuch training may be given tal drill, for poise and relaxthe use of suggestion and stion are useful adjuncts for nt of the mental instability. ems dealing with simple subbe memorized and used in to emphasize the sound, form f the different words. LearnLing, and doing something epetition the stammerer can d usually without stammermarked value in that it asrestoration and continuance Confidence which he lacks. ment of a stammerer should Hertaken lightly, and never full co-operation of parents the mother. It is her duty ee that the stammerer prac1 times a day. To her falls so, of supervising the minof the patient's life; reguiet, sleep, exercise and play o his necessities. In very Idren an hour or two spent rest in bed, in the afterTo far to conserving nervous

reatment of stammering is the supervision of the entire ild for a period of from six everal years, it is the prov

undertake these cases.

Bibliography. Bluemel: stammering, etc.; Makuen: Treatment of Stammering.

The Treatment of Lisping or Baby-Talk The treatment of lisping or baby-talk consists in a replacement of the faulty sounds by correct ones.

In beginning the treatment a record chart of each sound that is made incorrectly, is kept for reference. The correct sound is then made for the lisper who repeats it until the memory of it is firmly fixed in the mind. Actual demonstrations to the lisper, showing correct mouth, tongue, lips and teeth positions are made daily.

In the case of lispers who have not learned to read, pictures, blocks, toys, games, advertisements, colored yarns, and simple geometrical forms are used to associate sounds with form.

In the treatment of both stammering and lisping the fullest co-operation of parents and friends, teachers and pupils must be insisted on with the admonition that the difficulty must be overcome in early life, before it becomes a well formed, stubborn habit.

We hear a great deal about shell shock and the mutism and stammering associated with it. While in San Francisco last Fall, I saw some cases treated successfully by the use of suggestion and the adoption of a manner of living that is found useful in all forms of acute or chronic nervous unbalance, together with the same drill in speech mechanism as is used in other stam

mer cases.

Dr. Ross Moore, who was a Major in the Neurological Section of the Army for 18 months, has returned from France and located in the Brockman building. Dr. Moore was very much missed in Los Angeles and we are glad to see him among us again.

while there is no great change in the consonants. The absence of difficulty in singing indicates then that the vowels give rise to the difficulty that leads to stammering. The stammerer's difficulty is due to failure to remember the sound of and to produce the vowel, but is not due to a lagging of the laryngeal action, as may be seen from the fact that stammering should disappear when the subject whispers there being no phonation in whispering. The fact is, however, that over 65 per cent of all cases stammer even in whispering. The trouble then does not lie with the production of voice as such.

That the difficulty is not one of vocaliization is shown by the following: Stammering may occur in the effort to produce the word MANY; when the Mis made a continuous humming or musical sound there is no delay in larynx action.

Stammering then is clearly associated with production of vowel color, or vowel quality, or in other words, the stammerer forgets what the vowel sounds like, so he cannot utter it.

The stammerer relies on for aids, in his speech, both the feeling of the sound as he utters it, and the remembered quality of the sound desired.

Very nearly 3 per cent of all school children have some speech defect, either stammering or lisping. In Los Angeles Public Schools there are about 3,000 children who are victims of this distressing habit. The stammerer is not usually mentally dull, but owing to his inability to recite in public, and to his nervous instability he cannot advance with his class and so is retarded from two to three years.

Stammering is very much more common in boys than girls, and much harder to cure. It is rare to meet a woman who stammers, but men are quite frequently the victims of this serious handicap. Stammering is a great drawback to success and much greater in men than women, because of the more

sheltered condition of the latter's lives.

There is usually some mental bias or external evidence of nervous instability in the stammerer. He is often a highly imaginative child, and given to coloring his tales, or actually telling lies and evading responsibility. The fact is that there is a pronounced Psychological factor in all cases, and no study or treatment of stammering will be successful that fails to take into account the unstable nervous system and adopt measures to restore its balance.

Stammering is quite often associated with a low grade mentality. In the ungraded school rooms are found a large per cent of stammerers for two reasons -first, they cannot keep up with their unhandicapped fellows, and second, the quality of their mental and physical endowments not being up to normal, they cannot compete successfully in a struggle with studies mainly designed for normal children.

The Treatment of Stammering Physical defects must be remedied as far as possible. Hypertrophic cryptic tonsils containing foci of infection, from which poisonous toxins are constantly given off, thereby lowering the bodily resistance, should be removed. Care must be taken that the removal is skillfully done, that permanent injury to the muscles used in speech, be not inflicted.

Adenoids, post-nasal hypertrophies, septal deviations, tongue-tie, carious teeth, crowded or mal-occluded teeth should receive proper attention. No operation per se will cure stammering, but may put the physical body into better condition to be the servant of the mind. Stammerers have poor voluntary control of their speech mechanism, including breathing, which is usually of a shallow, catchy nature. As speech is built out of breath, the stammerer must be taught breath control. Diaphragmatic breathing should be taught by lecture and example, emphasizing the fact learning as well as special training to undertake these cases.

As stammering is associated with an interruption of the breath, and as stammering never occurs when the breath is being expired freely, the aim in treatment should be to keep the breath flowing freely, in fact to insist on an exaggeration at first of the breath in the tone.

The stammerer's attention is directed to the faulty sounds he makes, and he is shown by comparison, the correct sounds. Syllabication or dividing words into syllables is one of the best exercises, and much training may be given to it. Mental drill, for poise and relaxation and the use of suggestion and Auto-suggestion are useful adjuncts for the treatment of the mental instability.

Short poems dealing with simple subjects may be memorized and used in recitations to emphasize the sound, form and color of the different words. Learning something, and doing something which by repetition the stammerer can do well and usually without stammering, has a marked value in that it assists in the restoration and continuance of the self-confidence which he lacks.

The treatment of a stammerer should not be undertaken lightly, and never without the full co-operation of parents -especially the mother. It is her duty usually to see that the stammerer practices several times a day. To her falls the task, also, of supervising the minute details of the patient's life; regulating his diet, sleep, exercise and play according to his necessities. In very nervous children an hour or two spent in complete rest in bed, in the afternoon, will go far to conserving nervous energy.

As the treatment of stammering is practically the supervision of the entire life of a child for a period of from six months to several years, it is the prov

Bibliography. Bluemel: stammering, etc.; Makuen: Treatment of Stammering.

The Treatment of Lisping or Baby-Talk

The treatment of lisping or baby-talk consists in a replacement of the faulty sounds by correct ones.

In beginning the treatment a record chart of each sound that is made incorrectly, is kept for reference. The correct sound is then made for the lisper who repeats it until the memory of it is firmly fixed in the mind. Actual demonstrations to the lisper, showing correct mouth, tongue, lips and teeth positions are made daily.

In the case of lispers who have not learned to read, pictures, blocks, toys, games, advertisements, colored yarns, and simple geometrical forms are used to associate sounds with form.

In the treatment of both stammering and lisping the fullest co-operation of parents and friends, teachers and pupils must be insisted on with the admonition that the difficulty must be overcome in early life, before it becomes a well formed, stubborn habit.

We hear a great deal about shell shock and the mutism and stammering associated with it. While in San Francisco last Fall, I saw some cases treated successfully by the use of suggestion and the adoption of a manner of living that is found useful in all forms of acute or chronic nervous unbalance, together with the same drill in speech mechanism as is used in other stammer cases.

Dr. Ross Moore, who was a Major in the Neurological Section of the Army for 18 months, has returned from France and located in the Brockman building. Dr. Moore was very much missed in Los Angeles and we are glad to see him among us again.

MEDICAL LAWS AND THE

1414 South Hope Street, Los Angeles, Cal.

MEDICAL PROFESSION From the standpoint of the Medical Profession, Medical Laws may be divided into two classes, viz., (1) Legislation affecting the Medical Profession, and (2) Legislation affecting the people of the community or commonwealth. It is but natural and proper that the Medical Profession should be actively interested in legislation affecting the Medical Profession. If any criticism were offered along this line it would be that we have been rather lax in our loyalty to the Profession in the matter of legislation.

At the present time we would call special attention to the attitude of the Medical Profession regarding legislation that affects the people at large rather than the Medical Profession. Through altruistic motives, our profession has for a long time been active in securing the passage of Medical Laws that were designed and enacted for the benefit of the people at large, rather than for any effect they might have

upon our profession. Thus quackery has come to be somewhat less rampant in this State than formerly, and the practitioners of the healing art in this State are probably somewhat above the average for the United States. At any rate, the regular medical profession of the State is meeting requirements above the average. Unfortunately, less may be truthfully said regarding some of the cults and so-called religious practitioners of the healing art in this State. Their requirements for practice vary from a year or two less study than that demanded of the regular profession, down to nothing. In this State it is notably easier to practice the healing art as an irregular physician. With every meeting of our State Legislature, there comes up for consideration a crop of Medical Bills. Most of these are more or less camouflaged efforts to render easier the irregular practice of the healing art in the State. The Medical Profession of the State has pretty well formed the habit of championing the welfare of the people of the State in actively opposing medical legislation that would be injurious to the people of the commonwealth. It is decidedly doubtful whether we should continue this habit. The people of the State should be encouraged to look after their own rights and welfare in medical matters. If they do not realize now that medical laws demanding high requirements for the practice of the healing art in the State, are of direct value to the people of the State, it is not clear why the members of the regular medical profession of the State should devote special effort to securing such legislation. So far as our profession is concerned, there are comparatively few medical laws that really affect us. Regarding the Medical Laws that affect the people of the State, we would not advocate withholding advice and counsel, but we do believe it is a misuse of our time and professional ability when we as a profession make special effort regarding such legislation, regardless of how beneficial to the people we may believe it to be. As individuals we should never fail to do our full share in securing beneficial medical legislation, just as we should not fail in our duty as citizens in any other important matter. But the time has come when the people of this State may rightly be expected to secure for themselves

worthy medical legislation. Our legislative health committees should recognize the importance of the trust imposed in them. We do not believe they should require the active political activity of the medical profession to induce them to do their duty.

As to the present crop of Medical Bills before our legislature, they ought all to be defeated. Most of them tend to lower the requirements for irregular medical practice, and some are absolutely dangerous.

STANDARDIZED ROENTGEN

TECHNIQUE

E. C. Jerman, who is in charge of the scientific department of the Victor Corporation, is to pay Los Angeles a visit. Arrangements were made some time ago for him to come to San Francisco this spring and give a course of instruction in radiography. Los Angeles has some wideawake radiographers, so that arrangements have been made for him to come to Los Angeles and hold two classes in radiography, the first beginning April 21st, and the second April 25th. They will be held from nine to twelve and from two to five daily. Jerman has been an ardent advocate of standardization of Roentgen technique, and his instruction in radiography is not surpassed. His classes here will be limited in size and only two classes will be held. Reservations may be made through the local representative of the Victor Corporation, Dr. H. J. Ingersoll. However, these are strictly classes in radiography and in no sense sales exhibitions. The Victor Corporation representatives have received orders not to initiate any sales talks in these classes. The classes are limited in number to enable the individual members of the class to take radiographs, and a wide range of subjects will be covered, including visceral radiography. Only two classes will be

held because Jerman will not be here long enough to hold more classes. So if you are really interested, we would urge you to make early reservation.

HICCOUGH CURES

The San Bernardino Sun says: "Deluge of remedies for the hiccoughs flowed into THE SUN office, following the publication of the story of the serious illness of Dr. William H. Craig, who has now been hiccoughing