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culis of organized substances contain an average of about To form some conception of such large figures as even
would be equivalent to one drop of Belladonna ; and Froin the claborate investigations of Sir Wm. Thomp. further, if it were possible to prepare a one hundreth-thousson it has been demonstrated that the diameter of the andeth potency, as some claim to have done, which could gaseous molecule can not be less than sododdiqoo of a contain its share of the drop of Belladonna, it would tako centimeter, nor the number of molecules in a cubic cen- 22,222 years by taking a half teaspoonful every second timeter of gas greater than six thousand million, million of time, to swallow one drop of the medicine. In swalmillion.
lowing one drop of the medicine which contains the Thompson says, whatever may be the result of future one billionth of a drop-if it were made with water tho experiment, it cannot invalidate the conclusion, that a patient would swallow 15,448 gallons in the course of a stratum of 100,000,000 of a centimeter thick, cannot year. contain in its thickness many, if so much as one, mole- In the annual address (1973) delivered by Dr. T. F. cular constituent of the mass, and if a quantity of water Allen, of New York, before the State Medical Society. were extended to this thickness, it would have more which has just come to my notice, I quote the following: energy than the same mass of water in ordinary con- “In making our dilutions, one drop of the drug is ditions by about 1,100 times as much as suffices to warm each time added to 99 of pure water. If the wholo it by 1° Cent. This is more than enough to drive the could possibly be preserved we should have at the fif. liquid into vapor. Hence, if a film of 20:0ėjivoo of a teenth dilution our original drop of the tincture diluted centrimetre thick can exist as liquid at all, it is perfectly with an amount of water the size of this globe ; tho certain that there cannot be many molecules in its thick sixteenth would dilute with 99 other globes, and so on. ness.
Now, at the fifteenth each drop would contain one sin. The size then of the various molecules according to gle atom of the original drug. In the sixteenth only different observers would range between 750,000,000 to one drop in a hundred would contain an atom, and in 3,000,foto ogo of an inch. As Sir Wm. Thompson says to taking one drop of this (at random) to make our sevenform some conception of the degree of coarse-grained-teenth, the chances are much against our getting that ness indicated by these conclusions, imagine a rain-drop, one drop containing the atom, and in the next few poor a globe of glass as large as a pea, to be magnified to the tencies, the chances amount to a certainty that none of size of the earth, each constituent molecule being magni- the drug can be present." This paragraph has embodied fied in the same proportion. The magnified structure in it exactly what I wished to communicate, viz:--That would be coarser-grained than a heap of small shot, but after a medicine had been diluted and diluted, a time probably less coarse-grained than a heap of cricket would come when some portions of the liquid added balls."
would contain one molecule of the medicine, whilo Now for a practical application of these facts to the another portion would contain none at all-just as tho subject we are considering-it will be necessary though, soap bubble bursts when the film has been expanded first to examine the method by which the potencies are to such an extent that its thickness becomes the diame. obtained such as the first, second, third, fourth-the one ter of the molecule of water, to expand it more as a film hundredth-the one hundred thousandth and the mil. it would be necessary to expand the molecule, and this lioneth, and to calculate how many molecules of the would produce a decomposition and new bodies would be medicine are present—if any at all. According to the found having properties entirely different from water. centesimal scale, as introduced by Halınemann, ihe first Just as the molecules of the soap bubble burst and go potency must contain too part of the strength of the here and there through the air, so will a drop of mediremedy, the following each ito of the preceding one. cine burst when diluted beyoud a certain point, and its
Take for example Belladonna the medicinal strength molecules will go here and there, one portion of tho of the mother tincture being t, it will be necessary in liquid containing one molecule and another none at all. preparing the 1st potency to use 98 drops of Alcohol and Is it possible then that physicians are justified in using iwo drops of the mother tincture of Delladonna. One such high potencies as even the twentieth, the thir. drop of this solution is then added to 99 drops of Alco-tieth, &c., when science completely demonstrates that hol to produce the second potency-and one drop of the there is not even a molecule of the medicine present? second must be added to 99 drops of Alcohol to produce Dr. Allen states, “We' (?)"believe, with reasonunbiased and the third and so on indefinitely for higher potencies. So unprejudiced, that a dilution of a drug far exceeding all that the several potencies will contain the following frac- probable or even possible limits of sub-division of mat, tion of the original drop :
ter is yet active, and active too in a 'measure identical 1st Potency-will contain the tooth part of a drop.
with the crude material;” and he believes " that tho 2nd. 1-10,000th part of a drop.
peculiar molecular activities or forces which endow 3rd
1-1,000,000ih part of a drop. matter with its properties can be transferred to indiffer6th “ Billionth part of a drop.
ent fluids or other molecules. wbich shall receive and 9th
Trillionth part of a drop. perpetuate these forces, and in time become active as 12th
Quadrillionth part of a drop. was the original matter.” 15th
Quintillionth part of a drop. This is a very pretty theory, but I doubt if there are 18th none at all.
many scientific men who will be willing to admit that 18th was supposed to contain the septillionth part of any medicine which possesses properties peculiar to a cera drop.
tain drug, can possess such properties when not even 21*
a molecule of the drug is present. Let us look and 800 a drop.
what would be the consequence of such a theory--the 24th*
“ Octillionth part of a drop. result would be that every glass of croton water we 27th* “ Nonillionth
drink would be medicated water; for in preparing the 30th * “ Decillionth
high powers, as a rule % of the drug is thrown away, * But contains nonc at all.
this would convert all the waters of the earth into the
fifteenth potency. But as there are several thousand • See Am. Jour. Sci. and Art, Vol. L, p. 38 and 258.
potencies made at present, all containing a peculiar #Maxwell "Atom" Ency. Brit.
drug, and of the drug is thrown away--it is difficult
for me to see why the water is not at present all medi- reconsider in every phase, all the various items which cated water. And if such is possible, where do the have any bearing upon the health and lives of children, Homeopaths (who believe in high potencies), obtain suf- in the hope that little by little we may gain knowledge ficient pure water of an "indifferent” nature to enable which will keep us on in the grand work of preserving them to make their various potencies.
human life, and improving human stock.
It is very I can see the advantage of giving medicine in as small probable that any decrease in the present high rate of inquantities as possible, when the system is in an abnor- fant mortality will be brought about more by preventnal condition, but I cannot see the advantage of giving ive medicine and strict hygiene, than by any treatment a medicine so diluted, that it has not sufficient force- of disease once begun, no matter how skilfully treatment power to demonstrate its presence by any well known may be applied. chemical reaction, and if this is my opinion, how much The point in Infantile Hygiene to which I wish to less would I think of a medicine which has not even one direct attention has never to my knowledge, been molecule of the original drug present. I can not con- brought to the notice of the profession through the nder the force-power of a drug as something indepen-press; and though it probably has little or no bearing dent of the drug--I can only consider the force-power upon the mortality of children, yet in its remote effects of the drug as the drug itself--and as the only means by it may have an important relation to the vitality and which the drug becomes known to our senses, conse consequent longevity of individuals. It may seem at. quently where we have evidences of the force-power pe first view a trivial matter, and one unworthy of consider. culiar to a drug, there we have evidences of the material ation. It is simply concerning the manner in which presence of the drug, and since there can not be one children are habitually laid hold of when about to be molecule of the drug present in the 20th potency, there- raised to a person's arms--the way in which children fore there can be no force-power other than from the are commonly lifted. menstrum in which the medicine is given.
It is to be observed this is universally done by placing What effect could a few drops of the 30th potency one hand under each of the child's arms, overcoming have in a glass of water to a person who is traveling. I their weight by holding the thorax firmly grasped in the can understand that after a while the organic and inorganic hands, thus subjecting the child's chest to a very conconstituents normally present in water, would have little siderable pressure. This pressure is necessary if chil
. if any influence on the human system, provided a per-dren are to be lifted in this manner, for the articulation son resided in one place and drank the same water; but at the shoulder is not yet firm enough to allow the to a person who travels, the impurities fluctuate in com- child's weight to be overcome by an upward tension position and have a powerful action on the system as is alone, without danger of straining that joint. well known ; is it possible then the theoretical force- We see then, that when we lift a child in this manner power present in the 30th potency could have any action our arms are strongly adducted, and our fingers quite on the system, when it had to battle with such powerful forcibly flexed upon the yielding walls of the child's competitors. Such an idea is not even reasonable and thorax, and the resulting pressure is brought to bear should not be encouraged.
upon those ribs extending from the fourth to the ninth, Let sufficient medicine be given to accomplish the and is most concentrated in the mammary regions, — object in view,—and only sufficient but let' us deal slightly below and exterior to the pipple. If this comwith realities instead of theoretical quantities.
pression were only in occasional operation it would not Because good nursing, food and fresh air has restored merit any attention, but when we remember that during sick persons to health is no justification for using what the first 3 years of childhood this abnormal pressure is are called medicines, which do not contain a trace of a applied many times daily, it becomes more worthy of drug ; the time has often come when these three factors our consideration. have been overpowered and death has been the result, If we find that this method of handling children may because physicians have dealt with theories instead of bé a possible near or remote source of departure from facts.
health, we are to note the fact that those children who In a future paper I will say something with respect to belong to the better classes of society, and have there; insoluble substances. I quote the following remarkable fore the most constant and solicitous care bestowed passage from the Homeopathic Pharmacopæia: “We
upon them, are more subjected to whatever deleterious avail ourselves of a fact, unknown to chemistry, that all ofluence this mode of lifting them may exert, than aro medicaments brought by tritutration to the third potency the children of poverty who have much less attention. aresoluble in water and alcohol."I will also say a few words The especial point to be considered in relation to this As regards the wonderful force-power sugar of milk subject is this : What will be the effect which the fre. must acquire when placed in the moon's light, or under quent, daily repetition of the pressure above described the influence of the colored lights of the spectrum, as will have upon the soft and rapidly growing thoracic also when treated with melted ice or snow water; and walls of children? Will it not have a tendency to de perhaps refer to the remarkable property milk sugar crease the normal lateral diameter, and the antero posacquires when placed at the pole of a magnet, which then terior diameters of the chest, in the mammary region, enables it to cure the tendency of ingrowing toe nails. where the pressure is greatest, and thus diminish its
capacity? If it do this in even a slight degree, then its
detrimental influence must at once be acknowledged. A STUDY IN INFANTILE HYGIENE.
May we not here find a solution of the cause of that BY J. N. TILDEN, M.P., PEEKSKILL.
deformity known as pigeon breast, the origin of which
has not, heretofore, had any satisfactory explanation, The many causes which lead to the production of Dr. Alexander Shaw, author of the article on "Surgical disease in children have been very carefully noted and Diseases of Childhood," in Holmes Surgery, in speaking classified by the various authors who have written con- of this deformity, states that it is not inconsistent cerning the affections of children. Diet, air, exercise, with symmetry in other parts of the chest, and the frame clothing, cleanliness, &c., have all been considered in generally. The deformity is more frequently observed their various relations so thoroughly that the subject of in the young, which leads to the inference that patients “Infantile Hygiene” would seem to be well nigh ex- commonly outgrow it.” His theory of its causation is hausted. When we consider the large human mortality that it is produced by want of free entrance of air into which exists under the age of five years we must admit the lungs to fully distend them, and he says that “when the vast importance of this subject, and if we would the chest, as in childhood, is highly flexible, any cause perform our duty as conscientious physicians, we must that obstructs the entrance of the air into the lungs give it our repeated and almost constant attention, We may lead to changes in its figure resembling pigeon must persistently trace and retrace, and consider and breast deformity." It will be shown quite conclusive
ly a little further on, that this deformity is much more three years of age, the plane of the chest in the mam likely to take its origin from the abnormal external mary region is flattened, pressure which is so frequently applied during childhood, than from the hyper-action of the muscles of inspiration, induced by dyspnea. According to Dr. Shaw, the deformity in question is caused by the external pressure of the atmosphere, acting upon the flexible walls of the chest when the lungs are not freely inflated. The thorax acted upon by the respiratory muscles to enlarge its capacity, but as air does not fully fill the lungs there is su ficient overbalance of external atmospheric pressure to indent the chest along the line of least resistance, which is the junction of rib and costal cartilages, and this indentation leads to protuberance of the sternum.
It is much to be doubted if dyspnea could in this way produce so marked a deviation from the normal shape of the chest. If so, then we should expect to find it existed in every case of habitual asthma. Not only is this not the case, but it is quite common to find cases of pigeon breast where we can elicit no history of previous dispnoa.
Another point in this connection which is simply speculative ; because we have no rigid normal standard by which to judge is concerning the obliquity of the ribs. It will be borne in mind that the first three ribs are nearly horizontal in their direction from behind, forward. From the fourth their direction becomes oblique, pointing downward more and more to the ninth, when the obliquity decreases until the eleventh and twelfth are again nearly horizontal. Is it possible that the daily, often repeated compression and depression of the ribs between the fourth and ninth, which we have noted as occurring during the first three years of childhood, is in any degree responsible for this obliquity? It is well known that lacing very quickly, and materially increases the obliquity of those lower ribs which form the base of the thorax, and similarly if a like cause were in operation early in life, bringing under its influence all those ribs which have an oblique direction, might it not be the cause of this obliquity? Is this obliquity strictly normal or has it become through repetition an hereditary deviation from a better standard, which would give increased thoracic capacity, increased vitality and larger immunity from phthisical disease? If all tħe ribs were more nearly horizontal, the phenomena of respiratory action would be somewhat modified from its present mode. This point is alluded to, as it might be supposed that the obliquity of the ribs is necessary for the suitable accomplishment of respiration. In exam. ining the thoraces of children from two to four years of age, we shall almost invariably find that the full rounded curve which laterally bounds the thoraces of infants of a few months of age, has given place to a sharper or shorter curve in the subaxillary region, and the plane of the chest in the mammary region is abnormally flattened. This degree of fattening varies considerably in different children, being modified not only by constitution but by the wide variations in which they are subjected to the cause. It is also dependent upon the size and weight of the child. The chest of a large, heavy child becomes modified in shape earlier than in the case of a more delicate infant. This fact is illustrated in lines No 6, in the diagrams. In these diagrams are represented in one plate the lateral curve of the chest, extending from the spinal column around to the sternum, and in the other the outline of the anterior aspect of the thorax extending from each subaxillary space, across on a line with the nipples. These lines are reduced one-fifth from actual measurement taken from seventeen consecutive cases of children varying in age from two weeks up to three and a half years. These diagrams will fairly illustrate the average as we would find it in a hundred cases. We see from these diagrams that there is a considerable variation in the outline ; demonstrating beyond doubt that in children of It may be said that the normal shape of the thorax bas
various types, and varies in different individuals. This in spinal curvatures, extension and rubbing in partial is granted, but notice that in infants under the age of anchylosis, massage in sprains and contractures, &c. six months, and even one year, the outlines (so far as Now, if in these rigid structures manipulation applied my observation has extended, comprising nearly 300 once or twice daily has the effect of changing materially cases), have been constant, after one type, as shown in the condition of the parts operated upon, how much No. 4, aged seventeen days. No. 10, aged four more will the frequent, daily repetition of firm pressure months ; No. 14, six months, and No. 2, a small but always applied in nearly the same manner upon the healthy child aged fifteen months.
rapidly growing, easily yielding and pliant walls of a The nearest approach to the same outlines in older child's thorax have the effect of changing and distortchildren is found in Nos. 13 and 17, aged respectively ing their normal growth. 3 years and 2 years. In both these cases very little care The question now arises how may this danger be avoid. or attention was bestowed upon them after they were ed ? How shall we instruct mothers and nurses to lift one year old. These two children were then left to the and carry their children in any better manner than the care of older children 100 young to carry them, and one so universally in use ? How shall this prevailing therefore they were very seldom lifted in the habitual method be improved upon ? The answer is very plain manner. In contrast to these chest lines, observe Nos. and simple. Nature has admirably adapted the pelvis 1, æt. 3 years; 3, æt. 16 mos ; 6 æt. 34 years; 7, at 64, for supporting the weight of our bodies at all ages, It and 8, æt. 54. Notice in No. 1 a near approach to is therefore to be advised that a child should always be pigeon breast deformity. This child was a great favor- raised by placing one hand under the gluteal region, ite; had a nurse in constant attendance, and was sub- while the other hand may either in front or behind the jected to the mode of lifting under consideration oftener thorax assist in supporting the weight and at the same iban any other case which has been found. No. 3 time steady the child in a comfortable position. This is gives early evidence of the influence of thoracic com- easily done when the chid is either lying or standing, pression, for the reason that he is a large, heavy child, When in a sitting position, one hand may be passed who had unremitting attention. Nos. 3 and 4 are across the chest either in front or bebind and by a slight brother and sister, and we cannot, therefore, account hold of the opposite arm the child's body may be tilted for the marked difference in outline by ascribing it to to one side, or backward or forward as may be most variety in natural type, and the same is true of Nos. 8 convenient, when the disengaged hand may be easily and 10. We see, then, beyond doubt, that the thoracic placed under the gluteal region, and, as before, the child's outlines of children certainly change, as previously weight will thus be admirably supported by both hands, pointed out, and vary markedly accordingly as the one protecting and sustaining the thorax and the other children are subjected to the method of lifting already the pelvis, thus supporting the child's weight equally, described.
easily, and without possible danger of harm. The accomCombe, in his work on infancy, says that "in lifting panying illustrations show the two positions above deyoung children the nurse should be very careful never scribed and this method of lifting children will be found to lay hold of them by the arms, as is sometimes thought- equally as convenient as the mode commonly in use, lessly done, but always to place the hands one on each while its superiority consists in the entire absence of side of the chest immediately below the arm pits. those possible dangers which have been pointed out as This caution is well so far as it prevents nurses from liable to a ise from compression of the chest. raising children by the arms, and in small, light children is safe, but in large children, weighing within the first year from 15 to 25 pounds, the amount of compression required to raise such children to the nurse's arms is sufficient to distort the anterior aspect of the chest from its normal shape. We need not be reminded that these pliant thoracic walls serve to protect those organs most concerned in our vitality and strength. No. 3 illustrates this point: It is the outline from a child who weighed over twenty pounds before he reached the age of one year. Compare it with No. 4, the outline of his infant sister, aged two weeks.
It is possible, inasmuch as children after three years of age are seldom lifted by thoracic compression, that the energetic vitality of childhood soon suffices to correct in a great measure and in the large majority of cases, any deficiency of thoracic capacity or other deviation from normal growth which the cause under consideration may have produced. If, however, this compression of the chest become recognized as even an occasional source of departure from a normal condition; if ever a case of pigeon breast deformity be traced to this cause; if by diminishing thoracic capacity in the slightest degree it thus impairs vitality, then, indeed, does it demand the attention of our profession! In the progress of our science we more and more recognize our duty to lie rather in the prevention of disease than in its cure. It is our paramount duty to use every means at our command to develop and improve the physical condition of our race, for through physical advancement will come The fact that we are unable at present to demonstrate also intellectual and moral progress.
any actual disease directly produced by this cause does In the consideration of this question, it will be well not prove that it is unworthy of notice. Even if the for us to look a moment at what is accomplished by writer has exaggerated the importance of this subject it simple manipulation in the treatment of diseases. It is must be admitted by the most skeptical that there is not necessary here to go into details, for it is well estab- room for doubt and the only rule to be followed must lished that in many surgical diseases treatment by man- be, “ In case of doubt take the safe side." A mau may ipulation in its various forms is of the greatest import- use tobacco and alcohol for many years without appar ance. Take, for instance, the daily use of suspension lent harm but this fact, though often repeated, does not
prove these articles to be innocuous, The capacity of a sound as I ever heard, and accompanied with so great the human mechanism to accommodate itself to extremes a sense of suffocation that it was with difficulty he could in its various processes and surroundings is one of the restrain himself from getting up and running to a winmost wonderful features of our existence. We find vari- dow for fresh air. Expectoration very slight, yet a little ations in all degrees in diet, exercise, clothing, cleanli did occur in his most violent paroxysms of coughing, ness &c. We frequently see all the laws of hygiene set and was bloody mucus. I administered Aconite 1008, at utter defiance and yet find robust and vigorous health two doses at intervals of two hours, and four hours when we would only expect to find disease. And again later one dose of Spongia 1000th, and by evening there under the most favorable auspices of careful hygiene, was a great modification in the cough, the expectoration where every condition would seen to promise health we of bloody mucus became quite free, and from that time often find sickness and death.
there was little trouble in the case, excepting the second day, and after the croupy cough had wholly disappeared, he had every indication of having taken a severe cold in the head, without having been out of his room. I explained the nature and reasons for this in the fact of the congestion passing up from the larynx into the nostrils, when his wife spoke and said she had always observed the same result in their little girl, who had been quite subject to the croup ; and she felt entirely safe when that occurred.
Again, another class of cases that occurs as often as either those where the disease goes to the nostrils or to the frontal sinuses, when cured in the lungs, are those where it appears in the throat, and also frequently breaks out upon the lips in cold blisters during, or after, the relief given the lungs. In all these cases the physician must exercise the most scrupulous care against every kind of local applications, gargles, etc., unless he wants his patient to have a relapse, or be left with a broken constitution.
While upon the subject of lung diseases, I will give another, from a different cause. About a year ago, & large, powerful man called to consult me for a severe cough from which he was suffering. The cough had its immediate origin in a serious form of chronic bronchitis. And this I learned followed soon after the suppression of erysipelas upon one of his hands the spring before. Finding Belladonna clearly indicated by the
character of the cough and other symptoms, I prescribed The wisest theories of the physiologist and therapeu
it in the 2000th potency. By that night the cough was tist are often set at naught by the actualities of practice. easier and his breathing freer, and the next day the eryThese contradictory problems are not to discourage us.
sipelas broke out upon the same hand again. He called We are not to yield because our science refuses to become to see about that, but not finding me in, and being someexact. Slowly and little by little does our knowledge
what alarmed, he called upon another physician, who of the human body, its diseases and their treatment come suppressed it again, and the last I heard definitely about Let us therefore, each for himself, investigate this phase his case, his lungs were as bad as before. of " Infantile Hygiene” and in this way we shall finally will cite. A corpulent lady had erysipelas of the left
Another case of suppressed erysipelas of the hand I eliminate whatever errors the writer may have advanced hand last spring, which, under the advice of a physician, and the true degree of importance which attaches to was treated with applications of cold wet compresses, this subject be properly established.
painting with Iodine, etc., until suppressed, when followed great pain in the arm, and finally paralysis,
which, upon being relieved by Rhu8. tox. 200th, was LOCAL APPLICATIONS.
itself followed by erysipelas. BY R. R. GREGG, BUFFALO.
And so the murderous work goes on; and the mon
grels of our school abate not in their delight at imitating Another class of cases, similar to the foregoing, are such bad examples. those where the lungs being relieved, the disease goes to None can plead want of proof, as so often said before, the mucous membrane of the nostrils, and congests that to correct such errors in their own practice, and point it just as a cold does so commonly in the first instance be out in that of others, for clear and positive cases are ocfore it goes to the lungs. A case of this kind was that of curring everywhere and in great numbers, if physicians a daughter of the lady just spoken of, whom I attended will but look for them. Only a few days ago I received only two or three weeks since for congestion of the lower by mail a pamphlet, describing “ Pond's New Phonoportion of the right lung, accompanied by a severe graphic Sphygmograph,” in which was given the followcough. As soon as the congestion of the lung was re- ing case: lieved the nostril became very much “stuffed,” as though *A. R., nineteen years ago, had the first attack of a severe fresh cold had been taken, and the family feared palpitation of the heart ; health previously robust. Three such was the case, but I assured them it was not, and it years ago had what was supposed a severe attack of all passed off in a few days without the lungs showing sciatica; when this left, pain commenced in the chest further signs of disturbance.
about the heart; had about this time a fit, falling insenAnother similar case, in results, was that of a patient sible for a few minutes; having pain, used Morphia, whom I discharged cured, yesterday, Dec. 7th. This which habit has been continued ever since. Patient has patient was a large, stout man, aged forty years, who had pain, palpitation, dry cough, distress after taking for the first time in his life had genuine congestive or food, headache, sometimes dizziness, and occasionally & inflammatory croup. He had suffered severely through feeling of suffocation. The pain extends through from the night, and called me in the early morning, four days the sternum to the right shoulder; any excitement now ago. His cough was violent, of as harsh or croupy causes the heart to beat with great violence, with throb