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The Universal Science. If there is any one science which may be said to be universal, it is the science of medicine. Every science, even every art, contributes something to it. There is no possible kind of knowledge which a physician can possess which he cannot utilize in performing his mission for humanity. If the physician takes a broad view of his work, recognizing that he is not to be a mere purveyor of pills and powders, but rather a helper of nature, a sanitary counselor respecting habits of life, a wise adviser respecting social conditions, a careful student of mental and moral as well as of physical conditions which may affect his patient, it at once appears that the widest possible knowledge cannot be amiss for the medical man who desires to do his full duty to his fellow-men.
This idea is not a new one. An Eastern writer records concerning Jiwaka, that at the close of his tutelagein medicine, his preceptor sent him into the country with instructions to examine carefully the ground for a distance of 16 miles, and to make a collection of all the fruits and flowers which he found which were of no use in medicine. After a careful search, the pupil returned with the declaration that he had met no substance which was not of use in medicine, for there was no such thing to be found on earth. This thought is a good one for the contemplation of young men and women who are meditating upon the medical profession as a life work. No profession, no pursuit in life, demands such a broad educational foundation. It is true that one may get along after a fashion with a modicum of general knowledge, and even a meager amount of a meager amount of special knowledge in the practice of medicine, but it is possible for such a person to lead a comfortable life only because he is too ignorant to be conscious of his ignorance and the blunders arising therefrom. The market is flooded with cheap doctors already. What the med
ical profession wants, what the world wants, is young men and women of good sense, good health, good natural ability, and good education, to enter upon the study of medicine with the determination of acquiring the most thorough preparation possible to obtain in the best medical schools. Such men and women will become a credit to the profession, rather than a disgrace and a burden. J. H. K.
Therapeutic Value of Mechanical Vibration. Charcot has recently called attention to the great value of mechanical vibration as a therapeutic means in certain forms of nervous disorders. This remedy seems not to be generally known to the profession, but is by no means Mortimer Granville, more than ten years ago, perfected a small device which he termed a nerve percuter, by means of which fine vibrations may be communicated to the brain, spine, and nerve trunks.
Twelve years ago the writer began experiments in the same direction, but on a somewhat more extended plan. Two forms of apparatus were constructed, one consisting of a chair made to vibrate at the rate of about 1500 a minute; the other, a vibrating bar to be grasped by the patient, having a vibratory movement of a little more than 3000 per minute. These machines have been in use for the last twelve years, and for the last ten years Mortimer Granville's nerve percuter has been employed more or less in connection with them.
While it cannot be said that these remedies are a specific for any malady, they certainly produce decided physiological effects, and are possessed of therapeutic activity. Charcot claims this means to be of special value in certain forms of muscular tremor due to central disease. The writer hopes to elucidate this subject further in an extended paper in some future number.
J. H. K.
THE writer quite agrees with Prof. Keen, the eminent Philadelphia anatomist and surgeon, who asserts that every
physician should have as perfect knowledge of the kitchen and the proper methods of food preparation as of drug-stores and the methods of compounding medicinal agents. Of the two, the knowledge of dietetics and cookery, would, in the writer's opinion, be found much more valuable than the knowledge of drugs. Both kinds of information are important, but a thorough knowledge of food stuffs and their relation to the needs of the body, must be of inestimably greater value to the physician, than the information gained by the most thorough study of pharmacy and materia medica. Physicians frequently prescribe iron for anæmic conditions without considering that blood cannot be made of iron, but must be made, if at all, from the food. Strychnia is almost universally administered as a remedy for weak nerves, the fact that nerves cannot be made of strychnia being ignored. Weak nerves can be improved by proper nourishment only. In proper nourishment lies the only remedy obtainable for nearly all chronic maladies. Hence the importance that the physician should be thoroughly posted on the subject of material alimentaria. If a good cooking-school' and experimental kitchen could be connected with every medical college and every student be required to take a thorough course of instruction both in practical and the theoretical cookery, and dietetics a revolution in the methods of treating disease would quickly follow.
J. H. K.
Percussion.- According to S. Weir Mitchell, the inventor of percussion was a certain Dr. Avenbrugger. This German physician lived in the last century, in the early part of which he wrote a little pamphlet of 22 pages, in which he
explained the methods of applying percussion in the treatment of disease, and asserted its value. It was not, however, until the early part of the present century that it was recognized by medical autho
ity as being useful; and nearly another half century elapsed before its merits were fully recognized. Even at the present day there are few physicians who understand the great benefit to be derived from systematic percussion thoroughly applied; although, as Dr. Mitchell very well says, the contents of Avenbrugger's booklet were of greater practical value to man than all the ponderous volumes written by De Haen, Van Swieten, and Sprengel, the famous German medical authors who wrote during the time of Avenbrugger, and of greater importance to the human race than the results of the vast and bloody military campaigns which were waged while this little treatise slept in obscurity.
Percussion may be employed by means of the hand directly applied, or by means of instruments known as muscle beaters. These were first invented by Klemm of Germany, but have since been improved and variously modified by a number of inventors.
The best time for employing percussion is on rising in the morning or after a bath. The whole body should be gone over from head to feet, giving special attention to the spine, chest, head, and soles of the feet. In percussion of the head, only the tips of the fingers should be used. In percussion of the spine, particularly the lower part of the spine, the hand should be half closed. Great care should always be taken to avoid administering hard, stiff, or jarring blows. This necessitates a free wrist movement, as in piano playing. That is, the hand should move from the wrist and not from the elbows. The muscles of the forearm are much more easily controlled, and their force more readily and perfectly modulated, than those of the
upper arm. For the general surface of the body no instrument is superior to the uncovered palm.
A good hand and the ability to administer a light, elastic, springing blow is essential in the administration of this form of treatment. This is an art which unfortunately is seldom well mastered by the professional masseur or masseuse.
J. H. K.
The Hunger Cure. It has been. shown within the last half dozen years that not only fevers, but a considerable number of chronic maladies, are due to auto-intoxication, and that the source of the poisonous agencies in a great number of cases, is decomposition taking place in the alimentary canal. In view of this fact the value of abstinence from food as a means of removing an original cause of disease, and thus aborting or checking its progress, must be recognized.
The value of fasting as a means of cure was found out more than a century ago, and practiced by the followers of Preissnitz, in connection with hydrotherapy. It was especially advocated in this country by Dr. Joel Shew, of New York. The hunger cure is a sovereign remedy for rheumatism, and is of great value in the first stages of typhoid and other acute
fevers, in which abstinence for a week o longer is a more successful means of combating the febrile action than anti-febrine or anti-pyrine, or any of the anti-phlogistic medicinal agents furnished by our modern polypharmacy.
J. H. K.
Absorption from the Stomach. J. VON MERING, an eminent German investigator, has recently shown by experiments upon a dog that in cases of dilatation of the stomach or obstruction of the pyloric orifice, absorption from the stomach does not take place normally; and that when thick gruel is given at night, the quantity of fluid found in the stomach in the morning is actually in
This observation was made on a patient suffering from dilatation of the stomach. He also observed that during the absorption of any substance from the stomach there is always more or less passage of water into the stomach from the blood. This experiment seems to show that absorption does not take place from the stomach when water is taken into an empty stomach, but that water passes into the intestine, from which it is absorbed. In cases of dilatation of the stomach, the ability of the stomach for absorption is diminished; as also is the ability to discharge the contents into the intestines, which accounts for the slowness with which liquids are absorbed, and the great thirst of persons having dilatation of the stomach, notwithstanding the great quantity of fluid taken.
Massage of the Prostate Gland.Thure Brandt, the famous Scandinavian massauer, and the originator of pelvic massage as a means of relieving the disorders of women, has made an application of the same principles of treatment to certain forms of genito-urinary diseases in men, particularly enlargement of the prostate gland. It is evident that by means of the application of massage to the gland, the absorption of pathological products may be stimulated, and by an improvement of the nutritive condition of the tissues, it is possible that the hypertrophy may be relieved. The application is simple; the patient is made to empty the bladder. Then the index finger lubricated with vaseline is introduced into the rectum of the patient. With the top of the finger, gentle pressures and frictions should be made upon the gland. Brandt directs that the pressure should be made from within, upward, that is, toward the pubic arch. Volianski directs that the movement should be in the direction of the bladder, or with the lymphatic current. The application should continue for from one to three minutes. A number of cases have been published illustrating the benefits to be derived from this application.
Tuberculosis of the Bones and Joints. By N. Senn, M. D., Professor of Surgery and Clinical Surgery in Rush. Medical College. The F. A. Davis Co., publishers, Philadelphia.
This, the latest important surgical work by Prof. Senn, is in no respect inferior to his previous remarkable productions. Dr. Senn's great activity and industry have within a few years placed him in the foremost rank of American surgeons. fact, there is probably no American surgeon whose name and methods are so well known and so frequently used abroad as Dr. Senn's. The importance of tuberculosis in the surgery of bones and joints has not been appreciated until very recently; and in bringing together the important facts which have been developed. within a comparatively recent period, and which have not been previously embodied in a work of this kind, Dr. Senn has placed the medical profession of the United States, and in fact all English surgeons, under great obligations to him. The work is written in Dr. Senn's usual practical and lucid style, and will be most acceptable to the profession everywhere. It is beautifully illustrated by several fine. colored plates which do credit to the publishers.
J. H. K.
The Relation of Peripheral Irritation to Disease. - By Simon Baruch, M. D., New York.
Dr. Baruch has for a number of years been doing good work in the interest of rational medicine, by the publication of the good results which he has obtained with hydrotherapy and other hygienic In this little paper, Dr. Baruch shows the possibility of the cure, by means of hydrotherapy, of many cases which it is fashionable nowadays to subject to operations upon the eye for "muscular insufficiency," or to laparotomy for re
moval of the ovaries. Referring to the first class of cases, Dr. Baruch well remarks that "the mournful record of these mutilated eyes and disappointed patients is a sad chapter in the history of this subject." He also calls attention to Dr. Roosa's recent observation that 84 per cent of all healthy persons present more or less lack of muscular equilibrium. We are glad to be able to endorse, most heartily, the following remark by the author: "I cannot bring myself to the belief that the removal of ovaries or tubes not presenting palpable and well-defined pathological changes, is ever called for, and I deem such a procedure an outrageous violation of the highest aims of our calling, which demands the condemnation of every decent physician."
J. H. K.
Les Functions du Cerveau. — Par Jules Soury, Paris, Bureaux du Progrès Medical.
The work presents in an admirable manner the doctrines of the school of
Strasburg, and those of the Italian school relating to the functions of the brain. The work is one without which the library of a neurologist or a student of mental science cannot be complete. J. H. K.
Report on Abdominal and Pelvic Surgery, including Thirty-two Successful Cases of Laparotomy.— By William H. Wathen, M. D., Louisville, Ky. An excellent paper by an excellent surgeon. The author calls special attention to the experiments of Grawitz, Laruelle, and Pawlowsky, and others, which show conclusively that the danger from peritonitis is increased by the use of antiseptic solutions in the abdominal cavity when septic matter is present, and that the tendency to adhesions is also increased. The author records thirtyone successful laparotomies, certainly a splendid record.
J. H. K.
BATTLE CREEK, MICH., U. S. A., AUGUST, 1893.
THE NON-SURGICAL TREATMENT OF OVARIAN DISEASE.
BY J. H. KELLOGG, M. D., Battle Creek, Mich.
WHEN a pupil of the late eminent Prof. E. R. Peaslee, M. D., of New York City, the writer was most forcibly impressed by the conscientious conservatism and the painstaking and laborious attention to minute details with which this pioneer in modern gynecology applied his therapeutic measures in the treatment of chronic ovarian disease. Dr. Peaslee did for American medical gynecology, indeed we may properly say, for modern medical gynecology, what Simms and Emmett did for gynecological surgery. But the brilliant successes of the surgical treatment of ovarian disease achieved in modern times through the skillful labors of Hegar and Tait and their followers, have so eclipsed the hard-won and often by no means brilliant victories which have been obtained by therapeutic and non-surgical means, that the possibility of curing disease of the appendages without resorting to the use of the knife seems to have been, in some quarters, almost totally forgotten.
There seems to the writer to be, indeed, very great danger that the rising members of the profession will receive the impression that ovariotomy is about the only remedy for a diseased ovary. Witnessing almost daily in the amphi theaters of the hospitals connected with medical schools, the removal of ovaries, presumably more or less diseased, and hearing the report of the brilliant results thus achieved, while having little if any opportunity to witness the results of the
long-continued, patient, and thorough application of non-surgical means, they go out to practice after graduation, perhaps with the theoretical knowledge that there are non-surgical means of treating ovarian disease, but with little practical experience calculated to impress this important fact upon their minds. Instead, they have probably heard reiterated many times, while the surgical knife has been held in hand by the professor, ready to make the first incision in a laparotomy, words something like the following: "Gentlemen, this is a case of intractable ovarian disease. Removal of the appendages is proposed as the only means by which a complete and permanent recovery can be hoped for." And after the operation is completed, the professor passes around the diseased tubes and ovaries, calling attention to their pathological condition, and expatiating eloquently upon the absurdity of expecting a cure in such. a case, from the application of hot water, Churchill's tincture, medicated pledgets, faradism, galvanism, or any other but surgical means. In all probability the surgeon is right, the operation necessary, and in most cases successful. Nevertheless the fact that the majority of cases of ovarian disease which come to the attention of medical students in such a way as to strongly impress them, are women of the poor class who cannot afford to submit themselves to a long course of treatment, both because of the expense attending such a plan, and because of their inability to absent themselves for so great a time from their domestic duties, gives to the students of our medical colleges little opportunity for observing what can be done by persevering application of non-surgical measures; besides, there is something of a temptation in the eclat which accompanies the surgical operation, and the promptness and brilliancy of the results when successful.