AN IODISED HYDROGEN WATER FOR USE IN THE URIC ACID DIATHESIS
795 physician is to cure his patient, and that it does not matter what means he employs for this purpose, provided they are such as he can adopt with clean hands and a clear conscience. 5ow, nous avons changé tout cela: no newspaper appears without half-a-dozen advertisements about massage, schools for massage have been started, every hospital has one or two nurses or sisters who practise it, and massage threatens to become the prevailing medical fashion, if not the prevailing medical folly, of
... g medical folly, of the day. No morning passes but some deserving woman leaves her card at my door with " Professional -)IasseLise beautifully printed upon it; and a new "El Dorado seems to have been discovered for women in want of employment. Large works have been written on massage, and a perfectly simple matter has been rendered complex by such terms as " p6ti-issage," "effleurage," and the like--terms which I had never heard of when I first worked at this subject, and of which I am sure not one of the nurses I employ to this day understands the meaning. Lastly, we are now told that it takes two years at least for a woman to become a competent masseuse. Now, I have taken some pains to ascertain how many lessons the women who work for me have had, and 1 find that none of them ever had more than a half-a-dozen, although, of course, they have vastly improved by subsequent practice; and I will venture to say that no one who cannot learn the knack of massage sumciently to start with in six lessons will learn it in two years or twenty, since the thing requires a natural aptitude which very few possess. The plain truth, stripped of verbiage, is, that massage is nothing more than a vicarious way of giving exercise to patients who cannot take it themselves, and if the operator does not produce sufficient waste of tissue to enable the patient (possibly bedridden for years) to eat and assimilate without trouble as much food as I choose to order, and steadily to gain in nutrition, she knows very well that I consider the fault hers, and that she will not be allowed to continue her work. Whether this is done by "pétrissage," or "effleurage," or anything else, is a matter of indifference to me. " By their fruits ye shall know them" is a text thoroughly applicable to this subject, and practically I have myself never seen massage employed and do not care how it is done; and yet I will venture to say that the results I have obtained are quite equal to those secured by anyone else. That massage is capable of doing much good in conditions other than those for which I have employed it is perfectly likely; personally, I have only used it in the regular and systematic treatment of grave functional neuroses, being anxious to avoid the imputation of riding a hobby too hard. Moreover, I have taken pains to show that this is not by any means the most important agent, the striking results being quite as much, if not more, due to removal from unwholesome domestic surroundings, and to personal moral influence brought to bear on the patient. And yet, perhaps because massage is a striking thing, people will insist on caUing this a massage treatment, whereas massage is a mere remedial agent, and only one out of many brought to bear on the case. If I may judge by numerous instances I have lately seen, massage now runs the risk of being employed in cases for which it is perfectly unsuitable, and in which it can do nothing but harm. As a means of depriving rest, voluntary or enforced, of its evils it is invaluable ; as a panacea for all the ills which flesh is heir to, like all such panaceæ, it is sure to lead to failure and disappointment. As I feel that I am unwittingly in some degree responsible for this epidemic of massage, perhaps you will permit me to sound this note of warning. in THE LANCET of October IGth unanswered were they not calculated, under cover of a rebuke addressed to myself, to confuse a very simple issue. In my letter to you I did not, as Dr. Murrell supposes, confound massage with the Weir Mitchell treatment, but, on the contrary, alluded to the refinements which had been imported from the Continent, and quoted Dr. Play fair's oDinion that " massage had been made complex by the absurd way it had been written on abroad, and the divisions I and names given it." Had it been to my purpose, I could, with but little additional trouble, have got together a number of foreign names, "Philippeaux, Gautier, Estradere, and a host of others." But it so happens (and herein is the gist of the whole matter) that, in spite of this host, there. is no other form of massage whatever which has taken root or is commonly practised in this country, save and except that which Dr. Weir Mitchell describes. For years that method, and that method only, has been largely employed in our hospitals and nursing establishments, and always under the name of massage-not out of any love of that word or its associations, but to avoid confusion with the old and useless "medical rubbing." And so, when it was said in THE LANCET of Oct. 2nd that the art of massage required a long education, I venture to think that there was no reader of your journal who did not suppose that reference was made to a process which is now becoming familiar, and of the good effects of which in suitable cases there is unquestionable evidence. To say of this process that it needed two years to learn seemed to me a misleading and injurious statement, to which the wide circulation of THE LANCET would give e general currency. Hence my letter in which I ventured to suggest that weeks should be substituted for years. As for"the true massage, as practised by Professor von Mosengeil, and others on the Continent," I should never pre-. sume to meddle with it; and I feel some confidence that any statement in regard to that practice, whether as to the time it takes to learn or the class of patients it seeks to cure, would be received with but languid interest in Great Britain, where there are so few medical men who feel themselves qualified by their own observation either to confirm or deny any assertion whatever upon the subject. Let me add that I have no wish to interpose between Dr. Murrell and his readers. In writing on behalf of those I am bound to defend-my own hospital sisters and nurses-it was to the statement of THE LANCET that I took exception, avoiding all reference to a book I have neither read nor seen, and which it is not for me to criticise. I am, Sir, your obedient servant, October, 1886. OCTAVIUS STURGES. AN IODISED HYDROGEN WATER FOR USE IN THE URIC ACID DIATHESIS To the Editor of THE LANCET. SIR,—The need of a simple water which may be taken freely by persons suffering from uric acid accumulations, with the effect of washing out the acid and its salts, has been long felt. For myself, I believe the value of " waters," generally, depends much more on their capacity for taking up and washing out excrementitious matter while passing through the blood and the extra-vascular fluids of the organism than upon the specific effect of anything they introduce into the system. I have now to suggest that an excellent and potable water may be made by very slightly iodising distilled water, or dissolving in it a minute quantity of hydriodic acid-not enough of either to render the taste disagreeable,-and then passing well-washed hydrogen gas through it. Water will only dissolve about 2 per cent., by measure, of hydrogen gas, but this is by no means an inconsiderable proportion as compared with that existing in many of the natural waters of high repute; and beyond question it greatly increases the capacity of the water for holding solids in solution. I venture to think the profession will find the use of a simple non-effervescing water of this description of great value, and it can readily be prepared by any competent chemist. It is the measure of the hydrogen, and not the weight, which must by regarded; 100 cubic inches only weigh 2.25 grains. I am, Sir, yours obediently, Hanover square, Oct. 16th, 1886.