sufficient to with certainty sterilize it impairs its strength. My personal experience with commercial preparations has been disappointing in that suppuration has been distinctly traceable to it. For this reason I no longer employ it. We must possess a method of sterilizing catgut which is satisfactory in that it is with certainty sterilized and its strength is not impaired. I refer to cumolization. This method has been in use in the Massachusetts Homoeopathic Hospital for the past three months. The catgut must be perfectly dry before submitting to the cumol. Heat is then applied sufficient to raise the temperature to 125° C. This is maintained for one hour. This preparation of catgut is obtainable commercially, and my experience with it has been satisfactory. Hardened catgut designed to last fourteen days (treated with chromic acid, chrome alum, or bichromate of potash) is also available commercially and is satisfactory for buried suturing where maintenance of apposition of the tissue is desirable for a longer period than could be expected from unhardened gut. The use of catgut for all deep suturing affords the satisfaction of resultant cicatrices without visible stitch hole scars. This is of great importance on all parts of the body where cosmetic effects are a consideration and avoids the danger also of stitch hole abscesses. For subcutaneous blind suturing fine silk takes precedence over catgut, in that it holds the edges of the skin in accurate contact for such periods as may be desirable (two or three weeks), and may be then painlessly removed by cutting one of the protruding ends short and pulling on the other. I have never seen such unobstructive cicatrices as result from this method of suturing. The surgeon's hands and rubber gloves. The futility of hand disinfection has been acknowledged by most surgeons. With conscientious care in cleansing the hands by the aid of soap, water, friction, and chemical germicides, occasional outbreaks of suppuration have occurred in the experience of all surgeons, attributable to no other cause than unclean hands. The rubber glove affords a covering to the hand, aseptic beyond question, for it can be boiled without injury. It is the universal report of all the surgeons who have given them trial that their percentage of suppurative cases has fallen at once to a very small figure. The present scientific accuracy of surgery is beyond the wildest dreams of surgeons of one hundred years ago. It is difficult to comprehend how further advancement can be made. It is unsafe for us to prophesy, however, for this is an era of startling progress and bewildering discoveries. In viewing the subject in its broadest light, we must admit that in the future there is likely to be less surgery rather than more. Already some of the maladies for which surgery was formerly frequently invoked have been removed from the realm of surgery, by preventive medicine. Diphtheria is an example. Tracheotomy and intubation have become obsolete. We are now hovering upon the brink of a discovery which will probably remove the necessity of surgery in malignant disease. The same is likely to prove true in tuberculosis. THE INSTRUCTION OF THE PUBLIC CONCERNING HOMOEOPATHY. BY CONRAD WESSELHOEFT, M.D. It is to be expected that the "Homœopathic Pamphlet Series" will greatly enlighten the public concerning a matter regarding which it is of the utmost importance not only to frequently repeat information, but also to be very accurate in the manner of imparting it. Yet the perusal of these pamphlets discloses certain inaccuracies which, instead of instructing, lead to certain rather serious misconceptions of things homoeopathic. One of these misconceptions is contained in Pamphlet No. 3, page 3, " concerning the actual amount of medicine in small doses," which has gone the rounds of homoeopathic literature almost from its beginning, and which, instead of instructing the public and physicians, seriously misleads them. Its opponents ridicule homœopathy by showing that "in the more diluted tinctures (meaning the thirtieth) a drop of the original tincture is distributed through a sphere of fluid the radius of which would be a line drawn from the centre of the sun to the remotest planet." To offset this, homœopaths demonstrate that "the thirtieth is made with less than ten ounces of fluid," thereby seem. ingly denying that so great an expansion is reached. A little quiet thought will convince any one that this is juggling with arithmetic; it will convince nobody and confuse many, while the truth could be simply and plainly told. Both statements are true as far as they go. Thus it is perfectly true that the proportion (always only the tenth or hundredth part of each successive dilution) of medicinal substance in the thirtieth is dissolved (if so far divisible) in a mass of alcohol representing a sphere of the above-named radius. This degree of dilution, even if possible, would be preposterous, and, hence, has been justly condemned by our opponents as well as by homoeopaths themselves. To say that this is undeserved because we actually use only about ten ounces of vehicle to make the thirtieth is very misleading, although it never deceived those who took the trouble to reflect and to study facts as they are. Arithmetic and facts are juggled with in a way to make it appear that while we dilute medicine to a transcendental degree, we take it all back again in the next breath by showing how little alcohol we actually use to do it, when it is not difficult to convince oneself that the actual amount needed to potentize the whole original drop would take more alcohol than the universe could contain, and that the fraction actually diluted would be contained in a mass equal to the universe. This kind of sophism has injured homoeopathy more than many other really great results have been able to counteract. Therefore, it is to be hoped that in some future edition of the very valuable pamphlet named, it would be better to instruct the public in regard to the matter as it actually stands, as follows: Matter is not infinitely divisible, and if it were, there is no need of going to transcendental lengths in our potencies, or to exaggerate or to overestimate the divisibility of matter. Its divisibility is already transcendentally great without adding to it by our exaggerations and unintentional mystifications. Modern researches show clearly, and all persons who have acquainted themselves with what is known, agree that matter is divisible as far as the twentyfourth potency or attenuation; that is up to the proportion of one part of medicinal matter to a volume of solvent of about fifteen thousand cubic miles; however, it is not only unnecessary, but quite undesirable, to dilute to such a degree, although practically possible, because no menstruum can be found or devised which would not contain many more medicinal ingredients (such as iron, copper, lead, arsenic, silica, etc.) in much larger proportion than that of the medicine to be diluted. There is another subject with regard to which a little more detailed accurate information might be desirable, although not of essential importance; it is the quotation from Jean Paul relating to Hahnemann. This has not only here and there been quoted inaccurately, but in some instances in an unfriendly spirit to read that Hahnemann was "either a fool or a philosopher." In the "Homœopathic Pamphlet Series," No. 4, page 1, it is given thus: "That prodigy of genius and learning." As it will undoubtedly interest the reader to know the opinion of so just and distinguished a writer as Jean Paul, it deserves to be given in full: "Hahnemann, this rare double intellect of philosophy and erudition, whose system must eventually draw after it the ruin of the ordinary recipe writers, has thus far been little adopted by practitioners, and has been more denounced than examined" (Jean Paul, Friederich Richter), in "Zerstreute Blaetter," Vol. II, p. 292). This was quoted by Dr. Ernst Stapf in his edition of "Hahnemann's Lesser Writings," 1829. DR. T. N. DRAKE has removed from Pittsfield, Me., to No. 150 Union Street, Bangor. ANNUAL REPORT OF DR. H. C. CLAPP, ATTENDING PHYSICIAN, TO THE TRUSTEES OF THE MASSACHUSETTS HOSPITAL FOR CONSUMPTIVES. During the year just ended there have been admitted to the hospital in my service 166 patients, of whom 89 have been discharged (40 men and 49 women) and 77 remain under treatment. There have been no deaths during the year. The occupations of those discharged, previous to their admission, were as follows: housekeepers (or home-makers), 29; factory workers, 11; shoemakers, 7; dressmakers, 2; carpenters, 2; masons, 2; grinders, 2; clerks, 3; electricians, 2; school children, 3; and one each of the following: teacher, bookkeeper, tailor, farmer, stenographer, clergyman, dentist, medical student, letter carrier, janitress, baker, butcher, stone cutter, pattern maker, soldier, butler, salesman, saleswoman, milliner, laborer, and domestic. Dividing the State of Massachusetts into three parts, 65 came from the eastern third, 16 from the central, and 8 from the western third. As to nativity, 62 were born in the United States, 13 in the British Provinces, and 14 in foreign lands. The average age was thirty-one years; the oldest patient. was seventy-four and the youngest nine. 2 patients were under 10 years of age. Thirty-two had had hemorrhages before admission, and 9 had them during their residence in the hospital. Only one, however, had this symptom while in the hospital who had not had it previous to admission. The number of discharged patients who gained in weight was 80. The number of discharged patients who lost in weight was 7. |