Contributed to the JOURNAL. HOMŒOPATHY VERSUS ORIFICIAL PHILOSOPHY. AN OPEN LETTER. MY DEAR DOCTOR LIPPINCOTT-Yours of the 22d instant is at hand. In it you say, "Your attack on orificial surgery and Pratt's methods was a great surprise to me," etc. I am sorry to hear you say this. It is capable of but one of two interpretations as I look at it, viz: either you do not regard me as a strict follower of the Hahnemannian precept, or you are not. It seems to me that it is impossible for any who has once comprehended the full meaning of the law of similars and its application to disturbed vitality, to endorse any such procedure as Dr. Pratt and his followers teach and practice. No person who has studied the Organon and accepted its teachings, can consistently adopt such methods. I have read Dr. Pratt's book; also most of his papers on this subject, or reviews of them, and the only conclusion I can reach is, that his philosophy contemplates only the local lesion, and his methods apply only to the suppression (not cure) of them. The teachings of Hahnemann are directly opposed to this. They admonish us that to suppress chronic local lesions will ultimately leave the patient with some other chronic malady, more obscure and more difficult of management than the original disease. And the experience of many has been, that if the Similimum, or at least a good similar, is not applied in time, the patient will surely succumb to the results of such practice. There never has been a victim to any very serious chronic local lesion, who has been successfully(?) treated by purely local measures, but who has developed or will, sooner or later, develope some constitutional disense, of which the previous condition was but a symptom and compared with which the original disease was of small consequence. This is affirmed on general principles, and is a corollary of all chronic miasms (be they three or thirty); and there is not a medical-man of any considerable experience who possesses acumen in matters of this sort, but has seen the law verified repeatedly. Even the Allopath of average intelligence has learned better than to apply a "tar cap" to the head of a tenia-capitis patient. I am sure that Dr. Pratt has himself seen the baneful effects of the indiscriminate use of the methods he so valiantly champions. If he has not, I have. As to the philosophy of orificial surgery it all comes under the general head of antipathic or palliative treatment. What does Hahnemann say of such things? Read the Organon, sections 56 to 61, inclusive. Fortunate indeed is the patient who, once subjected to such manipulations, escapes with nothing worse than a return of his old trouble. All these things are in direct violation of the principal tenets of Homœopathy. Please take down your copy of the Organon and read sections 185 to 203, inclusive; every one of them, every idea expressed is in direct contravention of the kind of practice represented in orificial treatment. Dr. Pratt and I were class-mates at the old Hahnemann college in Chicago in 1872, and I conceived for him at that time the greatest respect and admiration for his devotion to study, and general scholarly attainments, even as a student. I have watched him since with no little interest, and he has quite achieved the distinction which early life promised. One of his qualities is that he cannot be other than a leader, and that he has a large following is but natural; and therefore we are only the more solicitous that his influences be exerted on correct lines, because of his great power for good or ill. "Teach ye first the Kingdom of God and His Righteousness, and all these things shall be added." If Dr. Pratt would only teach Homœopathy FIRST then these things might be added. Without we are governed in all of our work by the Law of Similars, these other things will surely drift us upon the shoals of Empiricism, Eclecticism, Allopathy, and then will be illustrated the fulfillment of Hering's prophetic warning: "If our school ever gives up the strict inductive method of Hahnemann we are lost, and deserve only to be mentioned as a caricature in the history of medicine." Years have passed in the hope that some more able pen than mine would take up this matter; but now, in view of the fact, that my criticism of "Orificial Surgery and Pratt's methods was a great surprise" to you it is evident the time. should not be longer delayed, in simple justice to Homœopathy. Sincerely and fraternally, Contributed to the JOURNAL. TOGETHER WITH SOME CONSIDERATIONS OF THE SO-CALLED "SUNSTROKE." Translated from the Leipziger Zeitschrift. BY ALLISON CLOKEY, M. D., LOUISVILLE, KY. THE body of a grown man loses through the skin, lungs and other organs of elimination about three million heat units* each twenty-four hours, and in three different ways, viz: by heat radiation, beat conduction and contemporaneously by the evaporation of moisture. Although the skin has but a limited surface compared with other organs, it outdoes them all in the amount of heat given off. This is especially so in relation to the lungs. Notwithstanding the fact that the lung surface is one hundred times that of the cutaneous surface, the latter plays the more important part in the elimination of heat; because it not only has the advantage of radiation‡ and conduction, but because the amount of air which comes in contact with it is much greater than that which comes in contact with the lungs. From 77 to 86 per cent. of the bodily heat is lost through the skin-a very good reason for clothing ourselves more warmly as the weather becomes colder, for thus it is that we prevent our own temperature falling below a point incompatible with *A heat unit is the quantity of heat required to raise the temperature of one kilogramme of water from 0° to 1° of the centigrade scale. It is the radiation of the sun's rays from the earth after they strike it that warms our atmosphere; that this is the case we know from the fact that as we go above the earth's surface the thermometer falls, although we are nearing the sun. life. When the temperature of the air remains stationary at 31° C. (88° Fahrenheit), and the air is saturated with moisture, the conduction of heat is arrested, as is also the evaporation of moisture, which latter takes place only when the air is warm and dry. This is the reason people of hydrogenoid constitution are so uncomfortable on summer days that are warm and at the same time damp. But warm air that is in motion always feels cooler than it really is; hence the use of the fan in summer, or in warm rooms. Aside from our clothing, muscular activity and our food and drink have much to do in regulating the temperature of our bodies. The cooler the temperature the more nourishing is our food usually. Whaling vessels take on their expeditions only such sailors as have healthy stomachs and can eat a substantial quantity of food. With due regard to these factors (nourishing food, suitable clothing and accommodations and daily bodily exercise) man can go to the coldest regions of the earth without endangering his bodily temperature. Of course few escape being frostbitten at the more exposed points of the body (nose and ears). Nordenskjoeld and his companions, while in the Behring straits during the winter of 1878-79, with stood a temperature of from 37° C. to 45° C. (34° to 49° below zero F). These explorers became so accustomed to the cold that at the close of the winter they danced about in the snow with the thermometer at 1° C. (30° F.) and without any discomfort, when we would have almost frozen. It is more difficult for the inhabitants of central and northern Europe to accustom themselves to higher temperatures. We dress with the greatest ease when the thermometer is at 20° C. (76° F.) but, when suitably clothed, we can bear still higher temperatures, but not for any great length of time. With the body quite naked and in the best condition for throwing off moisture, much higher temperatures can be borne. Thus Fordyce remained for ten minutes in a steam bath with a temperature of 43, 33° C. (110° F.), twenty minutes with the temperature at 48, 88° C. (120° F.) and fifteen minutes with a temperature as high as 54, 4° C. (130° F.). The thermometer which had been put under his tongue did not rise above 37.780% C. (37° C. to 37, 50° C., normal) while the surrounding temperature was undergoing such decided variations. The above temperatures (borne in a steam bath) are much lower than those which have been borne in a dry atmosphere. Fordyce remained for ten minutes in such atmosphere with the thermometer at 92, 22° C. (198° F.), Banks for seven minutes with the thermometer at 99, 44° C. (221° F.) and Blayden eight minutes with the temperature at 127, 8° C. (262° F.). The last named felt decidedly uncomfortable till he broke out in a profuse perspiration when the uncomfortable feeling disappeared. Because of the moisture, one perspires less in a vapor bath than in a dry one; and hence the temperature of our vapor baths is seldom above 52° C. (125° F.), while that of the dry baths is sometimes as high as 85° C (185° F.). Our miners who work below the surface, where the thermometer stands at 22° C. (77° F.), would much prefer to work above ground when the temperature is from 36° C. to 40° C. (97° F. to 104° F.), because there the air, while warmer, is in constant motion. However, in the tropics, during the heated terms even the acclimated can do nowork in the, open air during the daytime. This can be easily comprehended when we mention the fact that Dr. Nachtigall, during bis trip through Africa, had to withstand a temperature which was 49, 40° C. (121° F.) in the shade, and that, according to Robert, the temperature in Abyssinia is often as high as 60° C. (140° F.) in the shade, and as high as 65° C. (149° F.) on the shores of the Red Sea. cereals, while the Esquimaux, for instance, care for nothing but blubber. One grain of fat represents nine thousand and sixtynine heat units, while one grain of the best flour represents but three thousand seven hundred and fifty-two. The less he works during the heated term the less the food he requires. The more that is required of him who works in an atmosphere of high temperature, the more liable is he to bodily disturbances, such as embarrassed and accelerated breathing, palpitation and rising of the bodily temperature, and from the saturation of the clothes felt during the construction of the St. Gotthard tunnel because the men were exposed to a temperature of from 38° C. (92° F.) to 84, 7° C. (184° F.). But also in our cooler and colder climates we sometimes have very high temperatures; thus, in London, with perspiration. Much concern was on June 12, 1852, the thermometer reached 41° C. (104° F.), and in Siberia 38, 8° C. (94° F.), and even at the poles there has been noticed a difference of 103° C. (2169 F.) between summer and winter. Under certain circumstances, then, we have to protect ourselves against too great heat, as with their clothing, frequent washing, bathing, and a sparing use of those foods which produce much heat. However, a man always requires a certain amount of food, be he in a temperate climate or in the tropics. We often hear it said of the East Indian and the Chinaman that they can accomplish as much a day "with a handfull of rice" as an Arab with a handfull of dates. But, according to the statement of the Austrian CounselGeneral Scherzer, the laborers in southern China require about nine hundred grains (about two pounds of rice) per diem. Prof. Boit claims, that, while he eats more just because he has it, this would be enough for the working man of Germany if he only added to it a little albumen. We know it to be a fact, however, that the inhabitants of the warmer climates instinctively avoid fats and depend on the The result of the action of too high a temperature on the body is commonly called "sunstroke," because it is oftenest seen in summer. This name, however, is not entirely correct, or it is misapplied, because it strictly applies only to the result of the direct rays of the sun upon the body at rest. Such direct rays cause, under favorable conditions, inflammation of the skin of the first and second degree with formation of blisters; and when exhaustion results and the unfortunate one sinks to the earth and remains exposed for some time to the sun's rays, then the bodily temperature rises often as high as 42o C. (107° F.), and the heart muscle undergoes changes which often lead to death; or meningitis sets in which, though it can be recovered from, frequently results in death. Heat stroke (warme schlag) is that which overcomes a man exposed to extreme heat, but yet protected from the direct rays of the sun, and at rest. Sunstroke it is, or the contrary, which is so greatly feared by soldiers or long marchers, and which is due not alone to the rays of the sun, but to other causes as well, as for instance, the labor of carrying the outfit, etc. Loaded down with instruments of offense and defense and unsuitable clothes the soldier must often tramp for hours at a time. His clothing becomes so damp with perspiration that his body, which is often feverish from overexertion, cannot throw off the heat. And this condition of things is not improved should the barometer fall or the atmosphere become moist, or when the man must march shut in by other soldiers whose condition is the same as his own and where radiation has no play. If now the body is also deprived of water, in some form or other, the temperature rises, even to 42° C. (107° F.), and there is added to the already existing thirst, headache, oppression and faintness; the lips become parched, swallowing painful and the voice hoarse; then come ringing in the ears, swimming before the eyes, disturbances of the sensorium and feeling of anxiety; the heart's action becomes stormy, motion becomes uncertain and the limbs tremble and the man either drops behind or staggers until he finally falls unconscious. It is not only during unusual heat that sunstroke is met with; for it has been known to happen when the thermometer was no higher than 19° C. (66° F.), but the atmosphere was then very heavy with moisture. The chief thing on the march is to meet the tendency of the bodily temperature to rise by the liberal use of water (drinking and bathing) and by suitable clothing, such as will relieve the perspiration to some extent and not interfere with radiation. Gerhard Rohlfs, who spent three months in the Sybian desert, says that on the march through the desert the men had to drink twelve and a half liters (twelve and a half quarts) of water daily, so hot and dry was the air; this is perhaps overdrawn, yet the water that was used was very warm. A liter of water drunk at 10° C. (50° F.) relieves the body of five hundred and ninety-nine thousand and five hundred units of heat and a gram of water, through evaporation, relieves it of five hundred and seventy-two units of heat. These circumstances show the importance of a free use of water in summer and the sooner one resorts to its use as freely as his case demands the better can he do his work. Ophthalmology. Contributed by request of W. F. Thatcher, M. D., Dallas, Texas. TREATMENT OF THE OCULAR MUSCLES BY THE RATIONAL METHOD. BY WANDLESS, M. D. DALLAS, TEXAS. SAY "rational" because this treatment is based on good reason and judgment, while that of tenotomy, graduated or complete, as practiced by some is not based on good reason. Many who have practiced this latter without have written long articles and reported great success, and so far I have failed to find any good reason for such proceedings. In non-progressive muscular atrophy or in congenital (?) insufficiency, I would think that tenotomy would be justifiable. I have not treated a case of muscular insufficiency that could not be cured by more reasonable means than tenotomy. |