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THE PHILOSOPHY OF ANTISEPSIS.

Antisepsis is the state or condition of organic matter in which putrefactive or fermentive changes cannot occur. The state or condition is both natural and artificial; natural, in the normal fluids and tissues of living. organisms, and artificial, in fluids rendered incapable of such changes.

The agents of putrefactive and fermentive changes are micro-organisms -unicellular beings, and the modus of their action is vital and nutritive. Hence these processes are vital and not chemical.

The vital force is the prime and great antiseptic of the living world. Its work is stable as respects the organic subsiances which it forms. These chemical compounds-chemical so far as their constituent elements are concerned are more stable of composition than are the compound molecules of the organic world. These undergo decomposition and are recomposed under the action of physical agents. But organic substances, the products of vital action, resist the action of these agents, and remain wholly unchanged. Chemical force is not an appointed agent of their decomposition. Their decomposing force is the vital force, active in a living cell, and there operating through living matter whose function is katabolic. The function of the vital force in living matter during the process of growth is anabolic or constructive, and its products, whether solid or liquid, are not susceptible of the ordinary action of physical agents, or of micro-organisms. Hence the natural state or condition of the living organism, all of whose organs are normally active, is that of antisepsis. None of its tissues or secretions are susceptible of putrefactive or fermentive changes, because they are all anabolic. The excretions only are subject to such changes, because they are katabolic products. In these products micro-organisms multiply rapidly. Their germs-the egg state of their being-fall into or upon excretory products, and in them find their pabulum. When tissues or normal fluids of the organisms have been removed from the body, and exposed to the moisture and warmth of the atmosphere, putrefactive changes are observed to begin; and when the cause of these changes are sought, it is found in the presence of micro-organisms which continue to feed on the organic matter until they perish in their own excretions, having in their life-time consumed a great deal of organic matter, and excreted much more in the form of inorganic substances, or in the inferior grades of organic matter; in this way gradually transferring the elementary constituents of organic matter to their native state in the inorganic realm of nature. Their chief work, their intended work is katabolic. The vital cells of the excretory organs of macro-organisms do the same work. The carbonic acid and water exhaled from the lungs and the inorganic salts of the urine have a like origin. In the metabolic changes following or attending vital action in all parts of the

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living organism, the anabolic tissues become katabolic substances, in which changes new substances are formed, some of purely inorganic composition and some of a lower organic structure, these to become the subject of further change by the action of individual unicellular organisms whose initial forms are ever present in the atmosphere.

Changes in the fluids and tissues of the body, resembling the normal katabolic, take place in the body under the influence of morbific agents, by whose action abnormal substances are produced in the body; substances which are, in a greater or less degree, susceptible of the action of microorganisms. Being morbid products, they are abnormal, no longer capable of use in the body, and hence are excretory, and therefore, more or less toxic to the organism. They are eliminated from the body by the actions of its own agents alone, or under the influence of what are called remedial agents, and the body returns to the normal state or condition.

Artificial antisepsis is that state or condition of organic matter which presents such matter in a state of preservation from the action of microorganisms in their germ state. The antiseptic state is effected by substances which are, at least, not a food or a nidus for germs or spores of any species. Thus, if urine be impregnated with carbolic acid, it will remain unchanged indefinitely, and no organisms will be found in it. If animal tissue be immersed in a solution of the red chromate of potassium and alcohol no organism can attack it. The germs, though abundant in the solution, cannot germinate or develop into matured individuals, even though they be not destroyed. As germs cannot be seen by any power of the microscope, we cannot tell whether their non-development arises from their death or the non-presence of a suitable nidus or food. When an incised wound is closed by stitches, the closure does not exclude germs. These cannot, in any such cases be excluded; but they may be prevented from developing into matured individual organisms. If the traumatic inflammation is not sufficiently high to produce an abnormal product, the blood attaching to the surfaces of the wound, acting as an antiseptic, will prevent the development of the germs present, as often happens; but if the inflammation shall run so high as to give rise to an abnormal product in the wound which can be attacked by micro-organisms, then such a result may be prevented by protecting the wound by an antiseptic. In case of an open, superficial ulceration, the formation of pus can be prevented by interposing an antiseptic. While this does not form a barrier to the access of germs, it does render their development impossible, since no living thing can develop to maturity without the necessary food, and that unaffected by the presence of a toxic substance. The products of secretion are food for micro-organisms; but the so-called antiseptic so poisons the secretion that the germs or spores are either killed or prevented from developing. Hence the repar

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ative secretion continues its physiological work without being interrupted by the excretions of micro-organisms. While the organisms do not decompose the secretion, except so far as they consume it as food, yet the presence of their excretions spoil the secretion as a reparative fluid. Thus it is on ulcerating surfaces; the repair goes on by means of the film of the physicological secretory fluid immediately in contact with the surface to be repaired and under the mass of the secretion altered by the action of micro-organisms by the thorough mixture with it of their excretions. Where antiseptic dressing is used, the secreted fluid does not undergo change, and hence no pus appears on the secreting surface, though germs and spores are present in as great an abundance as when no antiseptic dressing is used.

When the local inflammation, backed by a corresponding state of the organism is such that the secretion thrown upon the imflamed surface, is pathological when secreted, the excretions of micro-organisms which substitute themselves almost entirely for a morbid secretion, form on the surface a pseudo-membranous substance-called zoöglea when formed on the infusions of animal substances, and thus tend to hold their toxic substances in contact with the inflamed surface; so that when the powers of resistance on the part of the organism have been so reduced that the expulsive lymphatics are no longer able to push back, as it were, the toxic substances of the micro-organisms, these may be absorbed, and terminate the vital contest by their toxic effect on the vital cells of the organism.

Thus, it is seen that the work appointed micro-organisms in the economy of nature, when employed in diseased action, is mild or active, according as the living organism, by its native forces, resists the toxic excretions of micro-organisms present as germs in the fluid, whether internal or external.

NEW ORGANIZATION.

A permanent National organization of the various State Medical Examining and Licensing Boards, was effected at the American Medical Association meeting, May 9th, 1895, at Baltimore, Md.

Officers were elected for the ensuing year as follows: W. W. Potter, M. D., President, Buffalo, New York; J. M. Hays, M. D., Vice President, Greensboro, N. C.; B. M. Griffith, M. D., Springfield, Ill.

Committee to draft constitution and by-laws.-Charles McIntyre, M. D., Easton, Pa.; W. W. Potter, M. D., Buffalo, N. Y.; N. Payne, M. D., Albany, N. Y.

The purposes of the association are to establish a uniform schedule of requirements for all medical colleges and examining boards, and assist in perfecting a method for higher medical education.

B. M. GRIFFITH, M. D., Secretary, Springfield, Ill.

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PAY UP!

The following means that those who are not "up to date," should hasten to be so. Procrastination on the part of many makes a good deal of difference in the state of the Association's treasury. Delay not. Strain a point if need be.-[ED.

MEDICAL ASSOCIATION OF Missouri,

OFFICE OF TREASURER, JEFFERSON CITY, MO., May 28, 1895. DEAR DOCTOR:-Your especial attention is again called to the amended by-laws of the Association, of which you are a member. See article three (3), section six (6) also sections four (4) and five (5), article one (1):

SEC. 4. Any physician, after having been admitted as a member of this Association shall retain his membership by the payment of an annual fee of three dollars, at each annual meeting, as long as he is in good standing in his profession. By non-payment of dues for three (3) years membership is forfeited.

SEC. 5. The annual dues to be paid by all members (other than honorary members) shall be three dollars, and each member shall be entitled to a copy of the Transactions.

By complying with this provision of the amended by-laws, he will retain his membership and right ultimately to permanent membership, as provided by said amendment to the constitution and by-laws. Early payment of such dues will secure the enrollment and appearance of your name in the forthcoming annual transactions of 1895.

Dues for 1894 delinquent. Dues for 1895 delinquent.

Military Surgeons.-The military surgeons elected these officers May 23rd: President, Louis W. Reed, Norristown, Pa.; Vice-President, Albert L. Ghion, Washington; Secretary, Eustathias Chancellor, St. Louis, Mo.; Treasurer, Lawrence C. Carr, Cincinnati, O.; Editor, W. P. Harvey, U. S. A. Philadelphia was chosen as the place for the convention next year.

The Georgia Medical Association elected for the year: President, Dr. F. M. Ridley, of La Grange; Vice-Presidents, Drs. Wm. H. Doughty, of Augusta, and M. L. Boyd, of Savannah; Secretary, Dr. R. N. Taylor, of Griffin. To fill vacancies in Board of Censors, Drs. Charles Hicks, of Dublin; H. B. McMaster, of Waynesboro, and Howard Williams, of Macon.

A Defeat for Quackery.-A year and a-half ago a certain proprietary concern engaged in the exploitation of a so-called "cure" for tuberculosis had arrested, and instituted a suit against Dr. James E. Reeves, Chattanooga, Tenn., on the charge of sending defamatory matter through the mails. The bill in the criminal suit was ignored by the grand jury, and the trial in the civil suit came off on the 11th instant. It required ten minutes for the jury to render a verdict in favor of the defendant, Dr. Reeves. A similar suit against the editor of the Cincinnati Lancet-Clinic some time ago terminated in the same way. Dr. Reeves and Dr. Culbertson are to be congratulated upon the outcome of the suits.

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The Physician's Library.

OBSTETRIC SURGERY; By Egbert H. Grandin, M. D., Obstetric Surgeon to the New Maternity Hospital, Gynecologist to the French Hospital, and George W. Jarman, M. D., surgeon to the same hospital, and Gynæcologist to the Cancer Hospital, etc.; with 85 illustrations and 15 photoplates. F. A. Davis Co., Publishers, Philadelphia. 1895. Pp. 207. The title of this book indicates the field of its design, and the contents show the subjects considered all of a practical character. These are: Asepsis and Antisepsis; Obstetric Distocia and its determinations; Artificial Abortion and the indication of Premature Labor; the Forceps; Version; Symphysiotomy; the Cæsarian Section; Embriotomy; the Surgery of the Puerperium; and Ectopic Gestation. A chapter is devoted to each of these subjects, and they are treated in a clear and practical manner. The work will engage a general reading and a frequent reference. The text is illustrated by appropriate drawings and photographic plates.

THE DISEASES OF PERSONALITY; by Th. Ribot, Professor of Comparative and Experimental Psychology at the College De France, and editor of the Revue Philosophique. Published by the Open Court Publishing Co., Chicago. Authorized translation. 1891.

This book is taken up with the discussion of consciousness and personality of the animal organism. It is materialistic in that it does not clearly discriminate between the immaterial agent that lies behind the psychical phenomena of an animal organism and the material agent through which the immaterial or psychical entity operates in the production of phenomena. Then again, there is not a wholesome acknowledgment of the existence in man of a psychical personality which is not of the body, but simply a pro tempore tenant of it, which sustains connection with the external world through the psychical agent that belongs entirely to the living organism. The diseases which are personal, are, of course, of the organism; the psy chical force or agent is only immanent with the organism during life; and as the psychical force of the organism is concerned in the development of the organism, disease must belong to the psycho-material, and not to the psychic, agent. Consciousness is an attribute of this psychic agent or entity, and is affected only as the psycho-material agent is morbidly affected. The thought in the book belongs to that nondescript, psychology, which is just now urging its way into notice, and presenting numerous phases kindred to, if not identical, with that summum genus called occultism. Such works as these have a charm for those who take pleasure in things which, if they could be known, would not profit.