[Written for the MEDICAL BRIEF.] Education. BY B. M. JACKSON, M. D., LL.B., Omaha, Neb. "Mankind have a great aversion to intellectual labour; but even supposing knowledge to be easily attainable, more people would be content to be ignorant than would take even a little trouble to acquire it."-Johnson. Many States have enacted compulsory education laws, and any number of thinking individuals have questioned the wisdom of the legislatures which enacted them. Would it not be well to ask ourselves seriously what can be accomplished by compulsory laws? Can laws compel individuals to be educated? What is education? Suppose an individual can read and write, does it follow that he is educated? Suppose that one holds a university degree, would even this prove that its possessor is educated? I do not think so. The individual who is anxious for a true education must educate himself. In other words, he must study, observe, compare and think. A faculty of professors teach what they have been taught and what they discover or think about themselves, and no more; sometimes less. I say less, because I have in mind a few thinking gentlemen who were dismissed from various institutions on account of expressing their personal opinions. Think of it, men pass compulsory education laws that every one may be "educated," and yet State as well as private institutions dismiss teachers for teaching those who are compelled to acquire an education. True, the compulsory education laws do not apply to higher education; but, if I am forced to attend a primary school, have I not the right to force myself into a higher one, and learn all the professors thereof know or think about? Says the Catholic institution to its professors: "You must teach this, that and the other, and no more." And, if a professor teaches more, he is instantly dismissed. Ditto the Presbyterian; ditto, the Baptist; ditto, the Methodist; ditto, the Jewish; ditto, the institution controlled by Republicans; ditto, the institution controlled by Democrats, etc. Take history as taught in Southern and Northern States respectively, and they vary on essential points. Professor Ernest Haeckel, of Germany, complains that he is not as free to express his thoughts at the University of Berlin as he is at that of Jena. Surely, there are motives for all this limitation of freedom to express thoughts. I well remember a Professor Allopath, who talked to his class about homeopathic and all other schools as if their mission was to turn out cut-throats and murderers. The American Confederation of Reciprocating, Examining and Licensing Medical Board has "resolved" that, as a prerequisite to "reciprocation," the physician who prays for a reciprocal reciprocundity must submit a certificate to the "reciprocationists," to the effect that the "reciprocander" has been, for at least one year, a member of a county, state and national medical association of the school or system to which he belongs. How does this "resolve" sound to you as compared with the "resolve" of the fellows who, as a prerequisite to their granting a passport to "heaven," one must belong to their church; must believe in all that is written in a certain book; must confess periodically what-never mind what; must contribute the "Peter's pence," the widows' mite, and other mites? At any rate, if our ancestors should come back to life they would find themselves in our midst, and I fear me much they would mock us-aye, give us the laugh. They would point out our respective degrees of idiocy and say-well, what would not they say? We have all heard the expression, "If Moses, or Christ, or Mohammed, or Luther, or Washington, or Jefferson, or Lincoln, or Emerson, or Channing, or, or, or, came back to life again!" Imagine what these respective gentlemen would not say, because we can easily guess what they would say. But to return to the subject-education. Education! Does the reader conceive how much this word education involves? I can not; aye, it seems to me almost unthink able. The limit of education is akin to limits of time and space. Who can conceive of a boundary line where space ends, and the point from which time travels, not farther? It is unthinkable! We speak of education in a sort of pedantic fashion, because we forget (our memories always betray us) that what is considered knowledge to-day is nothing but ignorance to-morrow. Also, when an individual says "Damn History," that that mortal being is ignorant to-day of what took place yesterday. One of the subjects with which we ought to be most familiar and ever remember is history; yet it is the quickest forgotten. One is careful to be familiar with and strives to remember the mul tiplication and division and addition tables; yet the fact is that some were burned at the stake for uttering truths, and others were disemboweled or their bones were broken for denying human infallibility. Most human beings forget almost the moment they hear of or read such incidents in history. The word education is hard to define so as to include knowledge and wisdom; because our knowledge is necessarily limited (who knows whether there are in fact other worlds than ours? Who knows what the future has in store for this world?) and our wisdom, including that of every "Pope," is far from infallible. Says a writer, "Instruction and breeding are to education as parts to a whole; the instruction respects the communication of knowledge, and breeding respects the manner of outward conduct; but education comprehends not only both these, but the formation of the mind, the regulation of the heart, and the establishment of (sound) principles." In other words, an education comprehends good instruction, because it teaches us what others know and think about; good breeding, because it makes us more agreeable. An educated man learns from every source whatsoever, always thinks for himself, and ever concedes this right to his fellow men. He believes in and fights for freedom, independence and progress. In freedom, because he can develop socially and politically; in independence, because his opinions may be sounder and more consistent with truth and justice than those of some "ruler;" in progress, because he can develop intellectually. Some physicians have been anxious to curtail the freedom and independence of their confreres and have thereby enslaved themselves. Now, they have to bow to "rulers," and not only this, but pay for the privilege to bow. This is not in harmony with education, however limited we may understand its meaning. I am not unmindful of the fact that we learn, to a certain extent, from associating with one another, but I have yet to find out that men do learn something in associations in which the multitude who seek knowledge are being exploited for the benefit of a few. No one can be more willing to pay his respects and render homage to intellectual leaders than I am, but I am entitled to freedom and independence, and to think for myself. If I am a "little fellow," hence not up to an imaginary standard, I am anxious to learn; because I am conscious that in the great struggle for existence merit alone counts. But I humbly object to being legislated into all kinds of hardships, because this cuts off my opportunities to progress socially, politically and intellectually. I hear some medical politician remark: "We are trying to build up and you are tearing down." To which I respectfully reply: You are not "building up" as if you were disinterested. On the contrary, methinks, that you are somewhat of a government contractor. A government contractor "builds and builds," and, by the time the roof is finished, the government has paid several times over what an individual would have had to pay for a like structure-wait a minute, and, when the government has made the last payment, the building is almost ready to collapse. Methinks that the medical politicians are "building up and up" (?) the profession and, by the time they will put on the finishing "touches," that is, by the time they will have fettered every possible chain of tyranny and extortion around the fraternity, at least that part of it which contains the ninety or more per cent of "little fellows" (general practitioners), a majority of them will have to seek other occupations. That is my humble opinion; and, considering the complaints of many physicians that they do not earn a livelihood at present, my opinion, while not infallible, has, in my estimation, some foundation in fact. From which follows that, while the medical politicians are "building up" sinecures for themselves and more and more assume autocratic powers by means of concentrating them into the hands of as few as possible, the profession is, in fact, torn down. Because the fraternity is now divided into classes, viz., specialists, politicians and "little fellows." The specialists have enacted a "code of ethics" which they violate with impunity and use as a club against the "little fellows;" the politicians have passed laws which, under the plea of "consultation," permit those who "know it all" to go from place to place, and the "little fellows" must not even go beyond a certain imaginary line; if a "little fellow" does want to go beyond an imaginary line, he must (1) pay a stiff fee which the politicians pocket; (2) submit a "passport" that he belongs to "a certain class;" (3) that he is of a certain pedigree which is ascertained from a blacklist; and, last but not least, (4) must believe in the "code of ethics" and belong to the association which enacted it. This, gentlemen, is not education, but tyranny and extortion. Remember, please, that "a kingdom (or family) divided against itself can not stand." Inasmuch as I speak to my own family, permit me to make a statement: The politics of the medical profession are very nearly alike with the politics of the Catholic organization during the Dark Ages, but that was not enough for the priests, so they allowed Ignatius Loyola to "build" further, thereby enhancing the powers of the Catholic hierarchy. See the consequences. "Power will intoxicate the best hearts, as wine the strongest heads. No man (nor set of men) are wise enough nor good enough to be trusted with unlimited power."-Colton. Taking an organization in which a few have autocratic power, they become intoxicated with it and forget their duties toward confrères in particular and the public in general. Two instances worthy of mention are: Nero who burned built-up" Rome, and Ignatius Loyola and his followers who undermined the "built-up" Catholic hierarchy. Two Past and present history prove the same thing over and over again, yet man heeds not. Man! Education! words that no mortal being can fully comprehend. They are part and parcel of the world, and like the mysterious world itself, are incomprehensible and undefinable. Man is full of intellectual light, yet he is content to keep the rays within himself. He can be as free as a bird, yet prefers to be a slave. He is like a shadow always following. "See him from Nature rising slow to Art! the Mole to plow, the worm to weave; Learn om the little Nautilus to sail, Spread he thin oar, and catch the driving Gale.' -POPE. 311 Ramge Block. After having examined a copy of the MEDICAL BRIEF. I decided it would be a help in my practice, for which herewith find enclosed one dollar for one year's subscription.-J. G. SMITH, M. D., Nevada, Texas. [Written for the MEDICAL BRIEF.] Oxygen in the Treatment of Diabetes. BY ROBERT A. GUNN, M. D., New York City. It is not my purpose in this article to discuss the causes or symptoms of diabetes. The impaired nutrition is apparent in the early stages, and the other symptoms are easily recognized, even though the nature of the predisposing causes a:e not definitely known, For the purpose of treatment it is immaterial whether there is an over-production or under-consumption of sugar in the system; but it is important that we should get rid of the excess, which causes the malnutrition. A careful inquiry into the history of diabetic patients will usually show a condition of defective oxidation of the blood. This led me to recommend the inhalation of oxygen in these cases, and a report of a case treated in this way will illustrate the results obtained. Mr. R. C., a merchant, thirty-five years of age, of an active, nervous temperament, consulted me in June, 1900, after having been under the care of several other physicians. He said he had been under severe mental strain for the two previous years, on account of business losses and family difficulties. His usual weight had been about one hundred and eighty pounds, but in six months after his business troubles began he had lost twenty-five pounds. He had the usual symptoms of excessive thirst, enormously increased flow of urine, loss of strength and the presence of sugar in the urine. When he consulted me his weigt was one hundred and thirty pounds, and the urine contained acetone and nearly three per cent of sugar. His breathing was restricted so that the expansion of the thorax on full inspiration was less than two inches. He had been following a rigid antidiabetic diet for over a year, and had massage treatment of the muscles three times a week for several months. I told him that he should increase his lung capacity by breathing exercises, and ordered him to inhale oxygen several times a day. I also recommended the use of faradic electricity, applied once daily over the entire body, so as to bring all the muscles into action. He supplied himself with two tanks of oxygen gas, one of which he kept in his residence and the other in his office. This he inhaled regularly for five or six minutes at a time, every hour, so that he took on an average about ten inhalations a day. In a month's time he noticed a marked improvement and began to gain a little flesh. The quantity of the urine decreased, his thirst diminished, his strength improved and the sugar was reduced to less than two per cent. He continued the oxygen inhalations for four months, at which time the sugar had disappeared, as well as the other symptoms that had been so pronounced. In that time his weight had increased to one hundred and fifty-four pounds, the chest expansion was four and one-half inches, and he was able to attend to his business without fatigue. Of course, he continued to exclude the carbohydrates from his diet, and for a time he took an elixir of pepsin, bismuth and strychnine to improve his digestion. At the present writing he weighs one hundred and seventy pounds, attends regularly to business and has had no recurrence of the diabetic symptoms. He still keeps a tank of oxygen at his residence, and whenever he goes home fatigued, after a hard day's work, he takes two or three inhalations before bedtime. I have every reason to consider this a cure, and I attribute it to the oxygen inhalations. I have treated other cases in the same way with equally good results, and believe it to be the most rational treatment of diabetes. The increased oxidation of the blood undoubtedly burns up the excess of sugar that has not been consumed by the tissues, and thus removes it from the system. In my opinion, this excess of sugar clogs the absorbent vessels, and thus prevents the nutritive material from being carried to the several tissues from the blood. With the increased oxidation the lymphatics are freed from obstruction and normal nutrition is re-established. If such results can be obtained by inhaling an increased amount of oxygen for a few minutes at a time, at intervals of an hour, how much better results might be obtained if a diabetic patient could sleep for several hours in a chamber containing double the amount of oxygen that is present in the atmosphere. It is reasonable to suppose that sleeping in such an atmosphere every night, would more rapidly oxidize the excess of sugar in the system, and thus work a more rapid cure than occasional inhalations of oxygen. Here, then, I claim another application of the advantages of my artificial air chambers, as described in the MEDICAL BRIEF for November, 1904. Let the diabetic patient sleep in this chamber six or seven hours every night, and thus breathe the extra oxygen without any effort, and we are sure to have sufficient oxidation to remove all effete material, including sugar, from the system and to restore the normal nutrition of the body. I expect to be able to report a case treated in this way in the near future, and I shall faithfully record the progress of the case, and the results obtained for the benefit of the profession. In the meantime, no matter what treatment is followed, it should be supplemented by frequent and continued inhalations of oxygen. Enclosed please find one dollar bill for the BRIEF for 1905. Must have BRIEFcan't do without it. I look for it as often as I do my meals.-H. B. COBLENTZ, M. D., Washington, D. C. [Written for the MEDICAL BRIEF.] A Brief History of Modern Surgery. BY E. J. KEMPF, M. D., Jasper, Ind. During all the ages up to the present time, surgery was considered to be a part of the healing art relating to external diseases, or those subject to treatment by mechanical or operative measures, and to injuries of any part or organ, their treatment, and the operation adapted for their cure. Formerly surgery was entirely a mechanical art, and was practiced by barbers and other uneducated persons; later the art of surgery was dependent more on anatomy and practical efficiency; to-day, surgery is a science based not only on anatomy, but also on an intimate knowledge of all the other branches of the medical sciences. Up to the time of Hunter (1728-93), surgery, and indeed, medicine, were based in their practice almost entirely upon tradition and dogma. Hunter, by his labors in the direction of anatomy and physiology, lifted medicine from the obscurity of philosophical doctrine to the firm foundation of facts and imparted an impulse that is still felt and is still in evidence in the methods of research employed today in the fields of comparative pathology and experimental medicine which promise most for the advancement of the medical and allied sciences. From Hunter's period to the introduction of anesthesia there is no remarkable fact in the development of surgery. It is the object of this paper to give a brief review of the vast advancement made in the science and art of surgery during the last hundred years. Statis In 1867, Joseph Lister first published his experiments on the antiseptic treatment of wounds. He thoroughly appreciated the work of Pasteur, and applying his theory to the process of healing, recognized that living organisms must be excluded from wounds. On this basis he founded a system of antiseptic surgery which has almost done away with pyemia, septicemia, gangrene, etc., and greatly reduced the mortality in hospitals. tics show that in 1861, in the hospitals of Paris, there were three deaths resulting from each five cases of amputation, and the state of affairs in Great Britain, Germany and Austria were almost as bad. After Lister's introduction of his methods into his hospital wards at Glasgow, the death rate after major amputations fell from forty-five to fifteen per cent in two years. Later it fell still lower. In the earlier years of antiseptic surgery the results were not as good as they are now, which is due to the great improvements made in the technique of operative surgery. In 1881, Professor Koch, of Berlin, announced to the scientific world that perchloride of mercury or corrosive sublimate was a more powerful antiseptic than thymol, eucalyptus oil, iodoform, boric acid, salicylic acid and carbolic acid, which are all still in use at the present time, depending on the nature of the field of operation. Corrosive sublimate and carbolic acid are, however, the remedies modern antiseptic surgery depends upon. The hands, the clothing, the instruments of the operator, his assistants, the dressings for the wound, the operating rooms and the atmosphere are carefully cleansed or sterilized before an operation is performed, and such treatment is called aseptic, and enables the operator to dispense with disinfecting the wound with strong chemicals, unless the wound is already an infected one. Armed with antiseptics, or with the newer aseptic methods, the surgeon can perform feats which were scarcely imagined half a century ago. Antiseptics have revolutionized surgery in the nineteenth century, and have placed it on a higher plane than internal |