travention of the Divine plan, and we will admit the 'traction' as impious. Now, in regard to the pressure you should be specific and note that it is in pressing. Now in Part 1st of the Pathogenetic Cyclopædia you will find "Inward-pressure” remedies, and isn't it self-evident that they were designed to reduce the diameters of the foetal skull so as to adapt it to any pelvis through which it may have to pass."" I at once tendered my hat-not a new one-which the philosopher magnanimously declined, and bursting into tears, asked "Why did Dr. Guernsey advise the use of forceps at all ?" "Ah," said my friend, sadly, "Guernsey is the best of my contributors but he is not developed. He has yet to learn that the present necessity for the forceps in certain cases is owing to two facts, namely: we have not yet proven all the remedies in nature, and those which we have proven are not yet carried high enough. In the broad noon-day of Science our successors will look back with infinite compassion at our crude efforts with the 40 m." Dear reader, at the last session of the Institute, where I did hear such twaddle, I did not find Hufeland's "grave of science," no, I met too many cultivated and competent workers for that but I did behold the farce of Science and the actors were all too many! I saw more credulity in one Kopf than would suffice for all Homœopathy: but unfortunately it is not confined to one head-"like master, like man "" is the rule. Now, Dr. Dunham's charity "omnibus" is crowded to bursting, and there is no spare seat on the outside; and unhappily the very men whose phantasies make the heaviest demand upon this charity are the very ones who recognise no dubiis in Homœopathy, and award no charitas in anything. We have only to wait and the cure will come in a crisis. We will have then an Institute where the science will receive as much attention as the art; where all our Therapeutae will be also Physici; when lay practitioners, whose only qualification for a diploma is an inordinate and unbalanced symptom-appetite, will be known and estimated as lay practitioners; when no compiler of a Materia Medica will be caught ascribing a post-diphtheritic paralysis to a dose of Arsenicum; and when one need not blush for a single member of the Homoeopathic School. May that time come quickly. CARL MÜLLER, CEMRIC A Surgical Observations. BUSHROD W. JAMES, M. D., PHILADELPHIA, EDITOR. NOVEL CASE IN OBSTETRIC SURGERY. B On the evening of January 24th, 1871 I was summoned to meet in consultation a medical friend, in a case requiring obstetric aid. A married woman pregnant some three or more months had aborted and some officious attendant thinking it unnecessary to call in a doc. tor undertook to deliver the fœtus herself. The feet presenting she had good leverage to draw upon, and she tugged, and twisted, and pulled, until the child's body parted from the head at the neck, leaving the head within the uterus, and around it the organ contracted firmly. Having mutilated the fœtus in this manner both the mother and the attendant became alarmed and a physician was hastily sent for and my friend happened to be the one, he living in the neighborhood. To share the responsiblity he desired my conference. On examining the woman I found the vagina extremely sensitive and tender to the passage of the finger, as though considerable misapplied force had been used to pull and wring off the child's neck. An exploration of the vagina did not discover any foetal head. The mouth of the uterus was sought and found contracted, I wedged in my index finger and felt a globular body, evidently the head of the child. I tried to get my finger around it to pull it against the outlet of the womb and excite expulsive contractions of the organ, but it simply rolled over and over like an oiled ball. I then tried to get my finger in the foraman magnum of the foetal head but to no effect, I then tried to get my finger between the soft cranial bones to flatten it and thus pull it down but this was also futile. As hemorrhage was setting in, I next introduced the Loomis' placentaforceps, against the protestations of the woman who feared the instruments were of a cutting nature and would hurt her. After frequently assuring her that such was not the case and no injury would result, I finally determined to introduce them and pull the head away. The first time I applied them to the head on making traction they slipped sideways off of the head and came away. A second attempt resulted the same way: the next time however I introduced my finger after applying them and steadied the head until I had forcibly closed the forceps and compressed and flattened the head, then I carried the finger all around so that I might see if any of the cranial bones were projecting through the scalp or would be likely to injure the uterus or vagina, finding nothing to fear from this source I drew down against the neck of the uterus which was not yet sufficiently dilated to permit it to pass, but this traction induced two or three strong contractions of the organ which dilated its mouth and then the head slipped through and came away with the forceps. These forceps are not sufficiently known to the profession or their value fully appreciated. They were invented by Dr. Loomis who was an active and worthy member of the homeopathic profession up to the time of his death. He brought them out iu 1854 and patented them. I will illustrate them with an engraving. (A) shows them closed as when ready for use. They look like one-half of the instrument only, one handle is hook-shaped and this enables it to closely fit around the oval finger piece of the other handle. This hook can also be used as a blunt hook in some cases in an emergency. The joint however is the peculiar and ingenious part of the instrument. It not only allows the handles to open and shut but it permits the hooked handle to turn half way around on its own axis, so that this blade, which fits into the other when closed, with its convex surface to the concave surface of the other blade can, on opening the handles a little, be made to rotate around so that the concave surfaces are opposite each other and the instrument becomes a pair of forceps. They are long and slender and delicate in their appearance so that they can be readily inserted into the uterus. They are introduced closed, and then opened; then the blades are turned around so as to grasp the placenta or other object, when, by closing the handles as much as possible, compression and grasping of the object is performed and traction causes its removal. By referring to the cut it will be observed that the handle which has the ring thumb-piece is expanded and sets off at an angle about its middle, and through this there is a quadrangular opening. On the other handle to correspond with this, are two small pieces of metal which when close together form an oval knob flattened on each side, and that handle and this knob is held by a pivot on the handle so that it can make a semicircular turn and no more around. Now when the two blades are united by slipping the hook-handled one through this quadrangular opening in the other, and then when this flattened oval knob has reached the opening, a small screw at each side fastens it there, (except for the back and forth motion) on these screws which act as pivots, and this enables the handles to open and shut. Then for the turning around motion of the hook-handled blade, instead of the knob turning around the blade as before the instrument is put together, the knob is now fast to the handle of the other blade, this handle itself rotates half way round and back through the knob, giving the closing up movement of the instrument as required for introduction into the uterus. THE PRESERVATION OF SURGICAL INSTRUMENTS. Surgeons should always have their instruments well washed after using them and then rubbed dry with a towel and subsequently with chamois skin just as they are being replaced in the velvet lined case. It is best to wipe them with chamois skin always after handling them, and especially in warm weather when the fingers aro covered with moisture. Whenever the prespiration comes in contact with the bright instrument a red rust will be likely to result but if it does not remain too long this is easily removed with a woolen cloth one end of which has been dipped in olive oil, or a little oil can be dropped on the rusty spots and rubbed well with the cloth after which it should be rubbed with span ish whiting. If the rust has remained until it becomes black and has destroyed the polished surface it will have to be repolished and this can generally be accomplished with emery or emery paper. THE SURGERY OF OUR INSTITUTIONS. One evidence of the healthy condition of our homœopathic colleges is noticeable in the improved state of the surgical clinics from year to year. Surgery in the early days of homoeopathy was neglected by our practitioners and hence our opponents took advantage of this fact to influence their friends to believe that our school knew nothing about surgery; but public opinion is now changing, and in a few years we doubt not it will be found that homoeopathic surgery will be sought for by the laity in preference to any oti.er, on account of the superior advantages which our remedies afford in the after treatment of operations. We would like to have annual reports from all our colleges as to the number, character, and results, of the various cases under surgical treatment at their clinics, and likewise the summary of surgical cases from our various hospitals and dispensaries throughout the country so as to sum up what our public institutions are accomplishing in the way of homoeopathy for we know that not only the profession but the friends of our cause generally will be gratified at the aggregate result. I herewith append a report of surgical operations performed in connection with the Clinic of the Hahnemann Medical College of Philadelphia, from date of last report, March, 1870, until August 1st, 1871, By Malcolm Macfarlan, M. D., Prof. of Clinical Surgery: Removal of stone in the bladder, weighing nearly one ounce, by perineal lithotomy, lateral incision..... Ligation of both the Ulnar and Radial Arteries for aneurism of the palm...... ........ 1 1 Removal of tumors from the neck, cystoma one, fibrona one......... 2 Forcible rupture of organic structure of the urethra by Thompson's instrument...... .... .... Removal of an Ovarian Tumor at patient's residence, before summer course students- weight of fluid and emptied cysts, 35 lbs,... Double harelip operations.... Single harelip operations.. Division of the masseter muscle for false anchylosis of the jaw...... Plastic operation on the soft palate... Resection of a portion of the lower jaw for osteo sarcoma.. Operations for radical cure of Hydrocele...... 1 1 2 3 1 1 1 3 |