Scientific American Suppl. No. 299

V >> Various >> Scientific American Suppl. No. 299

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It would be premature to assume that the murderer of Mr. Gold, or the
man who attempted to assassinate the President of the United States of
America, is insane. There are circumstances in connection with each of
these tragedies which must suggest the reflection that the assailants
were possibly, or even probably, of unsound mind. We do not, however,
propose to discuss these features of the respective cases at this
juncture. The full facts are not, as yet, ascertained; but enough is
known to warrant an endeavor to clear the way for future remark by
disposing of the objection that the suspected perpetrator of the
Brighton outrage and the would-be assassin of the President both showed
"forethought" and "method." It is a common formula for the expression of
doubt as to the irresponsibility of an alleged lunatic, that there is
"method in his madness." Nothing can be farther from the truth than the
inference to which this observation is intended to point. It is not in
the least degree necessary that a madman should be unconscious of the
act he performs, or of its nature as a violation of the law of God
or man; nor is it necessary that he should do the deed under an
ungovernable impulse, or at the supposed bidding of God or devil, angel
or fiend. The forms of mental disease to which these presumptions apply
are coarse developments of insanity. Dr. Prichard was among the first of
English medico-psychologists to recognize the existence of a more subtle
form of disease, which he termed "moral insanity." Herbert Spencer
supplied the key-note to this mystery of madness when he propounded the
doctrine of "dissolution;" and Dr. Hughlings Jackson has since applied
that hypothesis to the elucidation of morbid mental states and their
correlated phenomena. When disorganizing--or, if we may borrow
an expression from the terminology of geological science,
_denuding_--disease attacks the mental organism, it, so to say, strips
off, layer by layer, the successive strata of "habit," "principle," and
"nature," which compose the character. First in order go the higher
moral qualities of the mind; next those which are the result of
personally formed habits; then the inherited principles of personal and
social life; at length the polish which civilization gives to humanity
is lost, and in the process of denudation the evolutionary elements of
man's nature are progressively destroyed, until he is reduced to the
level of a creature inspired by purely animal passions, and obeying the
lower brutish instincts. The term "moral insanity" is accurate as far
as it goes, but it expresses only the first stage in a process of
dissolution which is essentially the same throughout, but which has
unfortunately received different designations as its several features
have been recognized and studied apart. The difference between the
subject of "moral insanity" and the general paralytic, who has lost all
sense of decency and lives the life of a beast, is one of degree. The
practical difficulty is to convince the mere observer that forms of
insanity which seem to consist in the loss of moral qualities and
principles _only_, may be as directly the effect of brain disease as any
of those grosser varieties of mental disorder which he is perfectly well
able to recognize, and fully prepared to ascribe to their proper cause.

To the professional mind, at least, it will follow from what we have
said that the injury to mind properties or qualities inflicted by the
invasion of disease may be partial, and must in every case be determined
by laws or conditions governing the progress of disease, perhaps on
the lines and in the directions which have been least well guarded by
educationary influences. A man may lose his faculty of forming a wise
judgment long before he is deprived of the power of distinguishing
between right and wrong. This is so because it is a higher attainment in
moral culture to do right advisedly, than simply to perceive the right
thing to do. The application of principle to conduct is an advance on
the mere recognition of virtue in the concrete, or even the possession
of virtue in the abstract. The question whether any past act of
wrongdoing was an act of insanity does not so much depend upon the great
question whether the person doing it was insane as a whole being, or
whether the deed done was the outcome of passion or error, the direct
fruit of limited or special disease. In short, the insanity of the act
must be inferred from the morbid condition of the brain from which it
sprang, rather than from the act itself. A partially disorganized--or as
we prefer to say "denuded"--brain may be fully capable of sane thought,
except on some one topic, and able to exercise every intellectual
function except of a particular order. Or there may be mental weakness
and neurotic susceptibility in regard to a special class of impressions.
It would be difficult to name any form of act or submission which may
not be the outcome of incipient or limited disease. The practical
difficulty is to avoid, on the other hand, treating the fruits of
disease as willful offenses; while, on the other, we do not allow the
supposition or presumption of disease to be employed as an excuse for
wrongdoing. It is, of course, clear that there may be perfect method in
such madness as springs from partial or commencing brain disease; for
every element in the mental process which culminates in a mad act may be
sane except the inception of the idea in which the act took its rise.
Thus, in the case of the suspected murderer of Mr. Gold, there may have
been perfect sanity in respect to every stage of the process by which
the crime was planned and carried out, and yet insanity, the effect of
brain disease, in the idea by which the deed was suggested. For example,
when a man is suffering from morbid suspicion, and, fixing his distrust
on some individual, purposes to murder him, the intellectual processes
by which he lays his plans and fulfills his morbidly conceived
intention, are performed with perfect sanity, as by a sane will. It is
important to recognize this. There is no difference in _nature_ between
the mental operation by which a "sane" man contrives and executes a
crime, and that by which a known "lunatic" will commit the like offense.
There may be as much _method_ in the one instance as in the other, and
the faculties which exhibit this method may be as sound and effective,
but in the one case the idea behind the act is sane, while in the other
it is insane. The brain is not one large homogeneous organ to be
healthy or diseased, orderly or deranged, throughout at any one period.
Inflammations, and diseases generally, which affect the brain as a whole
do not commonly cause insanity properly so called. The organ of the
mind is a composite, or aggregate of cells, or molecules, any number
or series of which may be affected with disease while the rest remain
healthy. At present we are only on the threshold of investigation
concerning the physical causes of insanity, and have scarcely done more
than recognize the possibility of _molecular_ disease of the brain.
Hereafter science will, probably, succeed in unveiling the obscure facts
of molecular brain pathology, and enable the medical psychologist to
predicate disease of recognized classes of brain elements from the
special phenomena of mind disturbance. This is the line of inquiry, and
the result, to which the progress already made distinctly tends. For the
present, the inferences we can surely draw from known facts are
very few; but prominent among the number are certain which it is
all-important to recognize in view of the judgment which must hereafter
be formed on the two cases now engaging public attention on both sides
of the Atlantic. The existence of method in madness is no marvel, and
that characteristic cannot therefore be supposed, or alleged, to weigh
as evidence against the "insanity" of the criminal. The perpetrators of
these heinous offenses against common right and public safety may be
more or less responsible for their acts, and, so far as these are
concerned, more or less sane or insane. The measure of the morbid
element in their individual cases will be the health or disease of the
particular part or element of the brain from which the offense sprang.
The ultimate judgment formed must be determined upon the basis of
scientific tests to be applied to the action of the brain alleged to be
the subject of partial or incipient disease. There is nothing in the
facts as they stand to supply the materials for a judgment. Precise
scientific inquiry can alone solve the enigma each case presents.

* * * * *

SIMPLE METHODS TO STAUNCH ACCIDENTAL HEMORRHAGE.

By EDWARD BORCK, M.D., St. Louis, Mo.

At first sight it seems almost superfluous to write or say a word about
any method of arresting hemorrhage from wounds; for the practitioner,
as a rule, is well acquainted with all the different manipulations and
appliances for the purpose, and enough may be obtained from the text
books. Nevertheless, to call attention to some useful, or old, or
apparently forgotten matter occasionally, seems not to be amiss, for it
refreshes our memory, stimulates us to think about and keeps before
our eyes important subjects. A few hints on the above, I hope, will
therefore be well received.

The treatment of hemorrhage, viz., the arresting of the same from open
wounds, is not only important to the surgeon as the basis of surgery,
but it is also of great importance to the laity, and especially to
those workmen who are perpetually in danger of being injured. It is
astonishing how unknowing the people seem to be, with any method to
check bleeding from a wound temporarily; even the most simple method of
pressure is in the majority of such accidents not resorted to. The sight
of a little blood does not alone upset a timid, nervous woman, but many
times the strongest of men; and why? because it naturally creates a
feeling of awe and detestation. If a person is wounded by a machine, or
otherwise, a crowd of all his fellow workmen gather around him, and look
on the poor fellow bleeding; half a dozen or more will start out on a
run in different directions to hunt a doctor, or some old woman who has
a reputation for stopping bleeding by sympathy, either of whom they are
likely to find "not at home." In the meantime the vital fluid trickles
away; nobody knows what to do; everybody does something, but none the
right thing. Now, it is true, it does not often happen that any one
bleeds to death, wise mother nature, as a rule, coming to their
assistance, especially in lacerated wounds; but the anemic condition
produced by excessive loss of blood is followed by severe consequences,
and is to be dreaded, for it retards recovery. To save all the blood
possible ought to be apprehended as an important matter by every one.

Hardly a week passes that some unfortunate is not brought to my office,
who has been badly injured in some way; he has been bleeding, perhaps,
the distance of several blocks, and arrives almost faint. In the most of
such cases they have something tied around their wounds, but hardly ever
in any manner so as to be equal to stop the bleeding. In exceptional
cases you find a tourniquet or the Spanish windlass applied. This,
when applied by a surgeon, may answer very well, but when applied by a
non-professional person it is invariably screwed up so tight that the
pain produced thereby is so great and intolerable that the patient
prefers rather to bleed to death. This is a great objection.

Therefore I will call attention to the method of forcible flexion; and
though extreme flexion has been practiced by surgeons in isolated cases,
still to Professor Adelman, of Dorpat, is due the credit of first having
systematized the following method:

BLEEDING FROM THE UPPER ARM (ART. BRACHIALIS).

Bring the elbows of the patient as near as possible together upon the
back, and fasten them with a bandage. From this point let a doppelt
bandage pass down to and over the perineum; separate the bandages again
in front, let one end run over the left, the other over the right groin
back again to the elbows (see Fig. 1)

[Illustration: Fig. 1.]

"The illustrations will explain at a glance."

BLEEDING FROM THE ARTERIES IN THE UPPER THIRD OF THE ARM.

Acute flexion of the elbow, simple bending of the forearm upon the upper
arm, will suffice. But if there is bleeding from the arteries near the
joint of the hand or from any part of the hand, then the hand must also
be brought into flexion, and secured by a bandage. (See Fig. 2.) The
bandage must always be wrapped around the wound first.

[Illustration: Fig. 2.]

BLEEDING FROM THE THIGH (ART. FEMORALIS).

It needs no other explanation, as Fig. 3 shows the mode of stopping the
hemorrhage from that region temporarily.

Bleeding from the front part of the leg (Art. Tibialis Ant.), same as
Fig. 3.

[Illustration: FIG. 3.]

Bleeding from the posterior part of the leg (Art. Tibiailis Post, et
Peronea) same as above, with the addition of a tampon or compress under
the knee joint, or like Fig. 4.

BLEEDING FROM THE FOOT (ART. PLANTARIS ET DORSALIS PEDIS).

Flexion of the leg upon the thigh, and flexion of the foot upon the
front of the tibia.

Objections might also be raised to the above method on account of the
pain which it may produce; but the flexion never needs to be so forced
as to be unendurable to the patient; the position may be a little
uncomfortable to a very sensitive person, that is all. Furthermore, it
has been proven that a limb can be kept in a flexed position for several
days, "nine by some authors," without any injury, and with a complete
closure of the arteries. We do not expect, however, that this method of
arresting hemorrhage will ever be adopted as "the" method in surgery,
neither will it be necessary here to point out any cases where the
practitioner can have and under certain circumstances be obliged to have
to resort to this simple method. Military surgeons may also profit by
it, for it is certainly a valuable and admirable mode, and so easily
applied in cases of emergency by any one, if the unfortunate should be
distant from surgical aid. I also believe that it would be advisable and
certainly humane, to instruct the people in general, by popular lectures
or through the press, the manner of stopping hemorrhage temporarily.

[Illustration: Fig. 4.]

The simplest of all methods, however, to arrest hemorrhage is the
rubber bandage. It has displaced in surgery the old tourniquet almost
completely, which required a certain skill and anatomical knowledge to
apply it; not necessarily so with the rubber bandage. Any one can apply
it, for the amount of pressure needed to arrest the hemorrhage from a
wound suggests itself. The rubber bandage produces but little pain; the
patient is comparatively comfortable and out of immediate danger and
anxiety; while in the meantime the proper attention can be secured.

I think it would be well if our health officers would direct their
attention a little to the accidental hemorrhages, and if they do not
possess the power, to refer the matter to the proper tribunal to enact
a law that would compel all owners and corporations of factories, saw,
planing, and rolling mills, and, in fact, every establishment where
the laborers are constantly in danger of accidents, to keep on hand a
certain number of strong rubber bandages, according to the number of
men employed, and that at least several of the men, if not all in every
establishment of that kind, be instructed in the application of the
bandage. Steamboats and other vessels should carry a supply, and
railroad companies should be obliged to furnish all watchmen along their
respective roads with rubber bandages, and see that the men know how to
use them in case an accident should occur. Every train that goes out
should have some bandages on board in care of some employe, who knows
how to handle them when needed. Many pounds of precious blood may thus
be saved, and danger to life from this cause be averted.--_Indiana
Medical Reporter_.

* * * * *

HOT WATER COMPRESSES IN TETANUS AND TRISMUS.

Sporer has successfully treated cases of tetanus by merely applying to
the nape of the neck and along the spine large pieces of flannel dipped
in hot water, of a temperature just bearable to the hand (50-55 deg.
C.).--_Allg. med. cent. Zeit_., January 15, 1881.

* * * * *

TRIALS OF STRING SHEAF BINDERS AT DERBY, ENGLAND.

After a week's postponement, rendered necessary by the unripe condition
of the crops on the first of the month, the trials of sheaf-binding
machines, using any other binding material than wire, instituted by the
Royal Agricultural Society of England, began on Monday morning, the 8th
of August. By nine o'clock, the time appointed for beginning operations,
there was a very large number of gentlemen interested in these trials
already collected on the farm of Mr. Hall, at Thulston, and the
distances that many of them had come testified to the importance of the
interests involved. The morning was perfect for reaping, though
ominous clouds in the southwest led many to hazard conjectures, which
unfortunately turned out too well founded, that the Royal Agricultural
Society would not on this occasion escape the fate which had visited
them so often. The corn stood ripe and upright in the various plots into
which the fields had been divided, and the ground was level and dry. The
published list of the competitors contained twenty entries, not by as
many firms, however, for many names appeared more than once; but the
rules of the society, which objects to different machines being used for
different kinds of corn in these trials, together with non-attendance
for unknown reasons, had reduced the actual list of competing machines
to seven. These were as follows: Mr. W. A. Wood, the McCormick
Harvesting Machine Company, the Johnston Harvester Company, Messrs.
Samuelson & Company, Messrs. J. & F. Howard, Messrs. Aultman & Company,
and Mr. H.J.H. King. All these machines were to be seen at the show,
except the second named, which was delayed by the stranding of
the steamship Britannic, and had only lately arrived in rather a
weather-beaten condition. The trials were to be made upon oats, barley,
and wheat, and the plots for the preliminary trials were about half an
acre in extent. Shortly after half-past nine o'clock, the judges and
engineers of the society having arrived upon the ground, a start was
made upon the oats by the three machines belonging to Mr. Wood, Messrs.
Samuelson & Co., and the Johnston Harvester Company. It should, perhaps,
be mentioned that the strength of this crop of oats varied a good deal
in different parts of the field. These three machines all belong to the
class which has the automatic trip--that is, the binding gear is thrown
into action by the pressure of the straw accumulated arriving at a
certain value, independently of any special action on the part of the
driver. The sheaves from Messrs. Samuelson's machines were extremely
neat and well separated from each other, a point to which farmers attach
great importance.

It would appear that it is impossible to secure the binding of every
single sheaf. Here and there, even with the best binders, an occasional
miss will occur, in which the corn is thrown out unbound. However, with
Messrs Samuelson's machine this was extremely rare, and the neatness of
the sheaves produced was remarkable. No doubt the shortness of the crop
in the portion allotted to this machine may have had something to do
with this, as a longer straw is more likely than a shorter one to
connect two sheaves and produce that hanging together which in other
machines is so often observed to precede a miss in the binding. Mr.
Wood's machine had a stronger crop and longer straw to deal with, and
the hanging together of the sheaves occurred far too frequently, and was
almost always followed by a loose sheaf. The Johnston harvester went
through a very fair performance; there was no hanging except at turning
the corners, and the piece of work was finished in a shorter time than
with the other machines. Notwithstanding the automatic character of the
gear for binding, we believe it will be found that the sheaves produced
in these machines vary very much in weight.

At about 10:20 the next lot of machines started. They were those of
the McCormick Harvesting Machine Company, Messrs. Howard, and Messrs.
Aultman & Co. Of these, the first-named only has the automatic trip. We
believe it made no miss in binding during this trial, and the sheaves
were neat, though, perhaps, rather too tightly bound. There was no
hanging together or check in this run. The machine of Messrs. Aultman &
Co. was not so successful in separating the sheaves, though this was
not so often followed by an unbound sheaf as in some other machines.
Sometimes as many as three sheaves, clinging closely together, were
ejected at one time. To avoid this a man walked by the machine, and
assisted the delivery of the sheaf. The tension of the string which
binds the sheaves varies a good deal in this machine, some of the
sheaves being rather too loosely held together, while at other times the
fault is in the other direction. In Messrs. Howard's machine there is a
tendency in the sheaves to cling together, but this is not accompanied
to any extent with missing the binding. Mr. King attempted a run after
the three last had finished their plots; but his machinery had not been
fully adjusted, and after one course the trial stopped. As far as one
could judge from this short performance, the chief fault in the sheaf
produced was the uncertain position of the string upon it. Sometimes
this was near the bottom of the straw, and sometimes among the corn.
Unfortunately at 11:25 the rain began, and experiments were stopped till
the afternoon. It was no light shower which could give a check to the
ardor of the judges and other officers of the society, but a heavy
downpour of some hours' duration, which soaked the crop through and
through. Indeed, we think it a pity that the experiments should have
been continued at all under circumstances in which practical harvesting
would have been out of the question. However, after a short lull in the
rain, the machines of Mr. Wood, Messrs. Samuelson, and the McCormick
Harvesting Company went into the wet barley. The machine of Mr. Wood
worked most rapidly, but the clinging of the sheaves and the failure to
bind were again very apparent. The stubble left by this machine was the
shortest and most even of the three. The machines of Messrs. Samuelson
and the McCormick Company left a very ragged, long, and uneven stubble
in this trial, though the delivery and binding of the sheaves seemed to
be as good as in the oats trial. The binding in the former was rather
too tight.

The remaining machines, with the exception of that of Mr. King, then
attempted a trial; but Messrs. Howard's machine having too smooth a
face to the driving wheel, was unable to drive all the gear in the wet
condition of the ground. The damp weather had no doubt tightened up the
canvas carriers, and thereby added to the work to be done; but this was
the only machine that was found incapacitated through the action of
the rain. Unfortunately the plots assigned to this machine and to the
Johnston harvester were in juxtaposition, so that the latter machine
was blocked by the former, and could not proceed, and that of Messrs.
Aultman alone went through with its work. There was no improvement in
the separation of the sheaves, and the misses were rather more frequent
than in the trials among the oats. The sheaves, too, that issued singly
were somewhat wanting in neatness. The whole of these barley trials must
be looked upon as unsatisfactory, on account of the condition of the
crop, and it is to be hoped that before the investigations are brought
to a conclusion all these machines may have a more favorable opportunity
of demonstrating the advantages which are claimed for them. It may be
here said that throughout these trials there has been as yet no wind
at all, which, as the investigations are in other respects to be so
thoroughly carried out, is a matter of regret. Probably Messrs. Howard's
machine was as well protected from the wind as any other of the seven
competitors.

The following are the awards of the judges, which were made known
on Wednesday evening: Gold medal--Messrs. McCormick & Co. Silver
medals--Messrs. Samuelson, Messrs. Johnston & Co. Highly commended--Mr.
H. J. King, for principle of tying and separating sheaves. The only
gleaning binding machine which entered the field was that of Mr. J. G.
Walker, made by the Notts Fork Company, but no official trials of this
were made.--_The Engineer_.

* * * * *

THE CULTURE OF STRAWBERRIES.

Messrs. Ellwanger & Barry, of the Mount Hope Nurseries, at Rochester,
give the following directions for setting out and cultivating
strawberries, the result of long and successful experience, in their
recently issued Strawberry Catalogue:

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