DISCOVERY 



157 



practical certainty that they will live in their new 

 surroundings. Absolute freedom from germs is a 

 sine qua non, especially in bone-surger\', and it requires 

 " surgically clean " surroundings for its success ; but 

 these conditions are attainable, and the method is 

 frtquently applicable to the repair of fractures. 

 Whether dead bone will succeed as a graft as well as 

 live bone is a point requiring investigation ; certain 

 facts point to the purpose of the transplanted bone as 

 no more than a scaffolding for the ingrowth of neigh- 

 bouring live bone, in which case boiled pieces of bone 

 derived from a sheep should be as successful as live 

 bone from the shin of the patient. A curious fact 

 has come to light, however ; a bone-graft is aliv-e 

 three months after transplantation, a date which 

 seems early for the ingrowth into it from its surround- 

 ings of live bone-cells. Yet such a graft undergoes 

 active repair at this date, after fracture, as only live 

 bone can do. The explanation of such facts and the 

 possible sources of such ingrowing bone-cells, if any, 

 provide much scope for further investigation. 



The subject of bone-grafting, so highly developed 

 as a surgical technique by Albee in America, with his 

 twin motor saws, etc., cannot be dismissed without 

 reference to his treatment of spinal tuberculosis. 

 Here absolute immobility is the goal of all methods of 

 treatment, in the hope that the disease will then 

 become quiescent. Plaster-jackets and the recumbent 

 position in bed have long been tried, without complete 

 satisfaction. But it would seem that the bone-graft, 

 long enough when adherent to the spine to make it a 

 rigid column, will help to solve the problem, which is, 

 it must be said, one of the most difficult in orthopaedic 

 work. With the mention of the " plaster bed," a 

 " bed " accurately moulded on to the patient's back, 

 and in which he can lie without disturbance for a 

 month at a time without danger of pressure-sores 

 forming such as occur so easily in a bed-ridden 

 patient, we must dismiss spinal tuberculosis. Its 

 importance and its difficulties are not to be measured 

 by such brief consideration as ours. 



Difficulties also surround the provision of suitable 

 artificial limbs for amputation stumps prepared by 

 the brilliant kineplastic methods of the Italian surgeons. 

 Movable nobs and pulleys are prepared from the live 

 tissues themselves, the puU of an individual muscle 

 being " harnessed " to the nob and so rendered capable 

 of transmission, for example, to the thumb of an 

 artificial hand. These are more successful when a 

 small piece of bone can be incorporated in the " nob," 

 to render it more substantial, but the gravest limita- 

 tion lies in the difficulty of designing suitable artificial 

 appliances. 



The value of baths of different temperatures, of 

 whirlpool baths, must be mentioned when effects upon 



the circulation are desired or when either stimulating 

 or sedative effects are required. They form a useful 

 preliminary to the administration of massage. Exten- 

 sions in the employment of electricity in various 

 forms must be similarly passed over without further 

 consideration. 



The rise of orthopaedic surgery, as we have seen it, 

 has been the outcome of anatomical studies of the 

 exact arrangement of parts, of experimental investi- 

 gations as to the behaviour of muscle, bone, and other 

 tissues under normal and abnormal conditions, and 

 the application of knowledge so gained to the treatment 

 of an increasing variety of disabilities. Exact diagnosis 

 precedes surgical treatment just as education in the 

 use of restored or reconstructed parts must follow it. 



Solid foundations are being laid where once there 

 was a house built upon sand ; but the building of the 

 superstructure has scarcely yet begun. 



BOOKS OF REFEREXCE OR FOR FURTHER RE.\DING 

 (i) Treatment of Joint and Muscle Injuries. By \\'. Rowley 

 Bristow. (Oxford University Press, 1917, 64.) 



(2) Menders of the Maimed. By A. Keith, M.D., F.R.C.S., 



F.R.S. (Oxford University Press, 1919, i6s.) 



(3) The After-Treatment of Wounds and Injuries. By R. C. 



Elmslie, M.S., F.R.C.S. (J. & A. Churchill, 1919./ 



Rising and Falling Prices— 

 and a Remedy 



By Arthur R. Burns, B.Sc. (Econ.) 



I 



Economics, the science that treats of the facts and 

 conditions of the material side of daily life, seems 

 a somewhat unpromising direction in which to seek 

 discovery with all the essential suddenness of advent 

 and revolutionary effect with which it is associated in 

 the physical sciences. In spite of this, something very 

 much akin to discovery, or perhaps, more properly, 

 invention, has been made by Professor Irving Fisher, 

 who has been working for some years at the Yale 

 University on the problem of money and the devising 

 of a scheme to eliminate the serious inconveniences of 

 rising and falling prices. 



The organisation of society is to-day so vastly more 

 complicated than in the days when money was first 

 invented that, before we can fully appreciate either 

 the problem Professor Fisher has been attacking, or 

 the merits of his invention, it will be well to look back 

 to those early days. We shall then be better able to 

 realise how much has now come to depend upon the 



