84 TABLE I-SUMMARY OF LAST WORDS ON DISTINGUISHED HISTORICAL PERSONAGES. MENTAL STATE OF DYING PERSON AT DEATH pain, is just as much the duty of a physician as to help cure disease or restore health. It is the etiquette of death. There are few cases however of great suffering, but there occur in some diseases of the heart, as angina pectoris, and especially in hydrophobia, tetanus and spasmodic cholera, but these diseases are now rare, due to the advances in the scientific study of medicine. Exceptionally severe but very rare cases are sometimes described in detail; their oddity and wide publication account for the false idea of the terrible ness of death so generally believed. It would seem that the less the fear of death, the more placid it is. To those who are conscious up to the last moment, hope is often a solace; it is the retrospect of a life well spent; religious belief also has great power in making death tranquil. If fear of death does exist, it is usually when the person realizes for the first time that he is about to die; but there is little fear at the moment death is impending. If there be a shock from the fear of death, it is only transient. When about to die, a torpor spreads softly over the whole being, the desire to live abates, as the feeling of life gradually melts away. Some fall asleep and die. In our usual sleep, breathing is slower, the pulse weaker and less frequent and the circulation feebler. In the sleep before death, the circulation being previously reduced to the lowest ebb compatible with life, is further reduced by this final sleep of death. Death from old age is the simplest and most natural kind of death; it approaches by almost imperceptible degrees. There is a gradual and proportionate decay of all functions and organs. If the normal course of decay is disturbed by supervening disorder, or disease of an important organ or by special surroundings, there may be suffering. Good nursing and light food and stimulants are usually all that is needed. In the aged, death comes gently and easy, because nature provides the best relief. Many sufferings of the dying can be lessened by ligthening the bed clothes when there is restlessness, by admitting a little fresh and cool air, by change of posture and by pillows to support the trunk of the body when there is diffi culty of breathing. Too frequent giving of food should be avoided, as well as too much; hiccup is often caused by an overloaded and distended stomach. The dry and parched condition of the tongue common to the dying and the great thirst need constant attention; ice water, ice, lemonade, etc., in the mouth are a relief. Opium is an anodyne to relieve pain and as cardiac to allay the sinking and anguish about the stomach and heart which is so frequent in the dying, indicated by pinched features, pallid complexion, and anxious expression of face. Opium not only takes away the pangs of death, but gives courage and energy for dying. There should be no whispered conversations at the death bed, as the patient may be conscious. and hear it, though seemingly insensible. There is often a sort of lucid interval before dissolution, as shown by looks and jestures, where the patient is incapable of speaking. Hustle and noise about the death bed should be prohibited. The dying often throw off the bed clothes and lie with the chest bare and the arms abroad, with the neck, arms and legs as much exposed as possible; these acts seem instinctive to let the skin have as much air as possible. Stertor can often be relieved by placing the patient on one side and supplying him with well arranged pillows. Often those near death are very sensitive and easily influenced by the looks, words and actions of persons in their presence. Calmness and quietness should pervade the sick chamber; the greatest tact should be exercised by those present. A lady was dying composedly, until aroused by the sobs of her husband, and pointing with her skeleton finger to him exclaimed, "I don't wish to live, only for him-only for him." This effort was intense and she had a painful rigor lasting two hours. Such facts indicate the necessity of carefulness as to what is said or done around those who appear about to die. BEST PREPARATION FOR DEATH The best preparation for death consists in good thoughts, based upon a just and useful life. An aged sailor's widow, ninety years old, bedridden, blind, dried up like a mummy, but with a clear mind, hearing and speaking distinctly, said she had been wishing for death a long time, and had no sorrow because she was of no use to any one. Death is as natural as life; superstitious terrors which surround death hide the truth. For the just and plain individual death is calm and can be grand; it is a natural art to know how to die, which we may call the etiquette of death. The most beautiful page of one's history can be revealed at death. Let us not trouble ourselves about death, but when it comes say, with Socrates: "Now, then Crito, good luck; if the gods so will, so let it be." BIBLIOGRAPHY OF DEATH There are comparatively few works, brochures and articles treating of death, and still fewer that can be utilized for scientific purposes. The following short bibliography, though selected, is about all the author could find useful. Binder: Ueber die Agonie, Medecinisches Correspondens Blattes Woerthem berquischen Aerztlichen Laudesvereins. Book of Death (The). Bowers, Paul E., Psychology of the Criminal under Sentence of Death. International Crimes, 1916, vol. IV, 113. Brierre de Boismont, Annals medico-psychologiques, 1850. Carrington, H. Death: Its Phenomenon. Annals of Psychical Science, London, AprilJune, 1910, pages 255-267. Chambers Biographical Dictionary, 32 vols. Octavo. Crawford, Raymond. The Last Days of Charles II, Oxford, 1909 8°, 80 pages. Delboef, J. Pourqui muros-nous? philos., Paris, 1891, XXXI, 225, 408. Rev. Dendy, W. C. On the Physiology of Death and the Treatment of the Dying. J. Paych, Medicine, London, 1848, I, 112-124. Egbert, Walter R. Men and Women, Norristown, Pa., 1898, 8°, 192 pages. Last Words of Famous Ferrero, G. Fear of Death, Pop. Sci. Mo. N. Y., 1897-98, LI. Freund, S. Reflections on War and Death, New York, 1918. Goethe. Ueber den Uhrsprung des Todes, Hamburg, 1883. Harrison, J. B. The Medical Aspects of Death, etc., London, 1852. Henry, Thomas, Memoirs of Albert de Haller, M. D., Warrington, 16°. Horneman, G. Vom Zustende des Menschen Kurtz von dem Tode, Gotha, 1898, 38 pp. 8°. Icard, Severin, Pa. Mort. rieelic et la Mort apparente, Paris, 1897, 12°. Jaccond, Mort dans Agonie en Nouvean Dietionaire de Medicine et de chirurgie patiques Paris, 1864. Kaines, Joseph. Last Words of Eminent Persons. London, 1866, 397 pp. Legrand du. Saulle, Des approches de la mort, de leur influence sur les actes de dernier velonte Gaz. d. hop. Paris, 1861, XXXIV, 81, 85. Lippincott: Biographical History. Livois Mort. Diet. de diet de med. (supple.) Parih, 1851, 487-504. MacDonald, Arthur. Study of Man after Death. Medical Record. New York City, August 7, 1920, 8 pages; also in Indian Medical Record, Calcutta, India, June, 1920. Makenna, Robert W. The Adventure of Death, London, 1916. Mervin, Frederrick R. Distinguished Men and 1901, S°, 336 pages. The Last Words of Women. New York, Metchinoff, E. The Prolongation of Life, N. Y. and London, 1910, 373 pages, 8°, 336 pages. Minot, C. S. Problems of Age, Growth and Death, London, 1908. Munk, Wm. (1816-1898) Euthenasia, London, PUBLISHED MONTHLY BY THE MEDICAL TIMES PUBLISHING CO. NOTICE.-The Western Medical Times employs no regularly appointed Eastern or New York Advertising Representative and any contract or agreement entered into with any individual purporting to be such will be subject to the approval of the Home Office of this journal. Address all Business Communications to THE MEDICAL TIMES PUBLISHING CO. 1839 Champa St., Denver, Colo. Business Office Telephone Main 5035. Address all Articles. Personals and other items of interest, and Books for Review to Geo. L. Servoss, M.D., Editor, P. O. Box 517. Reno, Nevada. Back near the beginning of things, our pre-historic forebears would have perished from the earth if they had not understood the science of reading advertising. The cavemen didn't know much about underwear, hair tonic or phonographs, but they did have to eat. The one who could follow the tracks of the game he hunted, or read the meaning of a twisted leaf or broken twig, was best off in life. Thus, as now, the most consistent reider of advertising was best dressed, best fed and most contented. There has been something of an evolution in advertising in the last few thousand of years, but the principle is just the same. The consistent reader of the advertisments in the Medical Journals is invariably best informed on what to use in his work as a doctor, be it books, new instruments or the late drugs, and where to get them, what to do and how to do it. He's up on the most important things in life, professional or other. Consequently he gets most from life. Throughout the ages, advertising has done much to make life livable and pleasant. We owe it much. Let's make the most of it. READ THE ADVERTISING IN THE WESTERN MEDICAL TIMES 88 PHILOSOPHY Thoughts from Thomas Hobbes, 1588--1679. Concerning thoughts, they are everyone a representation of appearance of some quality or other accent of a body without us. This body is called an object. An object works upon our eyes, ears and other parts, and by the very diversity of its working produces diversity of appearances, and there is no conception in our minds that has not been begotten All the first upon the organs of sense. rest are derived from that original. An object presses the organ proper to each sense, either immediately, as in taste or touch, or mediately, as in seeing, hearing or in smelling. This pressure, by the mediation of the nerves, and other connecting strings of the body, continued indirectly to brain or heart or other, causes their counterpressure or an endeavor to deliver itself, and this endeavor, because it is outward, seems to be some matter without. This seeming is called sense. To the eye it is light or vigor, to the ear it is sound, to the nostril an odor, to the tongue a savour, and to the rest of the body, such qualities as we discern by feeling, such as heat, cold, hardness, softness, or other. the philosophic schools say, for the cause of understanding, that the thing understood sends forth an intelligible species, that is an intelligible being seen, and this, they say, coming into the understanding, makes us understand. I do not say this to disapprove of the use of universities, but I must let you see that among the things that should be amended is the frequency of insignificant speech. From hence it is that the schools say that heavy bodies fall downward, out of an appetite to rest and conserve their nature in that place which is most fitted for them, thus ascribing appetite and knowledge of what is good for their conservation, which is more than man has; this they give to things inanimate, absurdly. But When a body is once in motion it moves eternally, unless something else hinders it, and whatever hinders it cannot extinguish it in an instant, but can change it in time and by degree. When the wind ceases, the waves roll for a The imagination of them that sleep we call dreams, and because these are not the senses, the brain and nerves being necessary organs of sense are so benumbed or occupied as not to be easily moved by the action of external objects, the imagination, or dream, in sleep proceeds from the inward parts of the body and the influence of these do keep the brain in motion. The organs of sense are benumbed, there is no object to make |