885

to be suspended for a week or more. If a public supply ofelectricity is available this may be used ; if not, a battery of20 or 30 cells. One pole of the supply is attached to theelectrode on the head ; the other is connected to a water

bath in which the child’s arm or foot is immersed, or to a

large well-moistened pad which may be bound to the arm orleg. The current must not be turned on or increased too

quickly. If it is the child will feel pain or disagreeablesensations, such as giddiness, and become restive, so that aprolonged sitting is impossible and only a weak current willbe tolerated. The child must be secured so that he cannot

suddenly break the circuit, as by taking the limb out of thewater. If he does, he will experience a shock and not againwillingly submit to the treatment. The current is slowlyturned on and gradually increased until the subject beginsto feel slight warmth in the scalp. After a few minutesit will be found the current can be increased without

discomfort. It should be increased as much as possibleshort of discomfort. When the area under treatment is

large a child usually allows 15 to 20 milliamperes to be used.Each sitting should be as prolonged as possible. Mr. Riddell

aims at from 40 to 50 minutes, as one sitting of 45 minutesis better than three of 15 minutes. The more prolonged thesitting the deeper will the ions penetrate. The pads shouldbe kept thoroughly wet ; at the end of the sitting the currentshould be turned slowly off. The treatment should be

repeated two or three times a week. It is well to have the

head washed daily or every other day with an antiseptic, suchas the sulphur, naphthol, and green-soap mixture commonlyprescribed. If the treatment makes the scalp irritable or

scaly a mild antiseptic oil may be used between the sittings,but it must be thoroughly removed before ionisation. Mr.

Riddell has found the treatment certain, rapid, and safe.The average number of long sittings required for cure wasnine.

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THE ART OF MEDICAL PRESCRIBING.

A SHORT article written by "A Retired Hcspital Physician" "

recently appeared in the Westminster Gazrtte under the title" On Decay in the Art of Medical Prescribing." The writerstated that his main design was to prove that if medical

men are to write sound and logical prescriptions theymust be properly trained to do so ; and he further main-tained that there was a gradual decay in the art of pre-scribing, which had been going on for years, and was

the natural result of defective teaching. Doubtless in

the days of the apprenticed pupil a sound knowledgeof the compounding of drugs was obtained, for to quote thewords of the article, "all around him were the weaponsof his future warfare; he saw, he handled, he weighed."There is much truth in the points that this writer has

made, for too much stress is laid to-day on the diagnosisof medical cases and too little on the details of the treat-

ment, especially in regard to the employment of drugs.There is a matter which he did not happen to mention, andit is one which hospital physicians would do well to cautionstudents concerning. The free use which is made of a

hospital pharmacor-aeia in which the dosage and combina-tion of drugs are obscured under the title of "mistura"or "haustus" is dangerous. The student becomes so

accustomed to the sonnds of the words mistura gentiansealkalina" or "haustus albus" that he forgets the actual

constituents of those preparations, ard when asked to dictatesimilar prescriptions is frequently at a loss. We believe

also, although we are quite prepared to have the opinion Ichallenged, that the constant compounding of medicines ingeneral practice according to the total quantities of drugsin a 6- or 8-ounce bottle tendd’to less accuracy than when the

details of a single dose are set down, set that the excti

quantity of each constituent taken by the patient at

each dose is borne in mind The "Retired HospitalPhysician" also referred to the manufacture and sale

of compound medicines, which certainly save ’’ the busypractitioner from the laborious pain of thinking for him-self," but it must be allowed that many of them are

good preparations made up in a convenient and palatableform. In a very interesting article, the writer has omittedto state that the medical student has to pass fairly stringentexaminations in pharmacy and materia medica, and this wasnot the case in every medical curriculum in mid-Victorian

days. -

A SEVENTEENTH CENTURY PIONEER OFANTISEPTIC SURGERY.

THE Honourable W. R. Riddell, Justice in the King’sBench Division, High Court of Justice for Ontario, Canada,in the New York Medical Journal of March 2nd, under thetitle of "A Seventeenth Century Surgeon and His Fee,"gives us the charge to the jury delivered at the Guildhall,London, on May 4th, 1687 (3 Jac. II.), by Sir Thomas

Street, Knt., Justice of the Common Bench, in the caseof Randall v. Sir Thomas Powis, Knt., a document in

many respects of surpassing interest to the medical

profession. The charge shows without doubt that anti-

septic surgery, like so many other of our modern dis-

coveries, was anticipated in the seventeenth century, not.

only in matters of practice, but also as regards the

underlying hypothesis-now a demonstrable fact, thanks

to Lister, whose merit is in no way encroached on by thisanticipation. For, as we have so often said, it is he who

compels the world’s attention to, and acceptance of, a truthand enforces or renders possible its application, who conferson mankind that benefit which is the measure of merit. Sir

Thomas Street’s charge sets forth that the defendant, havingbeen wounded in the arm, and being suddenly dejectedinto extreme debility and danger ...... employed a surgeonwho treated him in a manner recommended by his art

and mystery with topical applications." But the wounddid not improve, and the defendant, despairing to find

ease or benefit by the fruitless continuance of this

chirurgery, and fearing the speedy invasion of a

gangraene, consulted the plaintiff." Then follows this-

statement, remarkable indeed in the year 1687: "This-

new surgeon enjoined the immediate removal of all em-

plasters and other topical applications, and he washed the-wound carefully from time to time with fair clean water,covered it with a clean soft linen cloth, and cleansed it oncea day from pus and other impurities." We are further told°that " the wound hath gotten well and the surgeon sues theKnight for his reward." After a discussion of the professionalethics which, while forbidding a physician to sue for his

honoraria, permit surgeons, who "are of an inferior degreeamongst the professors of the healing art," to "demandtheir fees as of right," and a learned disquisitionon the treatment of wounds according to the orthodox

surgery of the day, the remarkable prescience of the

surgeon, Randall, is set forth as follows : "Now the plaintiffdid naught save wash and tend the wound ; he used nosympathetic powder or sympathetic unguent and he gi-tathhis reason....... He saith that the pus which all others admireand desire as showing that Nature hath armed herself for the-fight is not to be desired, but that it is itself an impuritywhich should be avoided-that it hindreth the cure and con-

tendeth against the vis medicatrix nature. He hath even in,

his mind some crotchet that pus is engendered by some small,animal or plant, some bug or gnat or beettle or fungus belikethough he saith openly that he cannot prove the existenceof such creatures. This however he contendeth - is