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A DIAGNOSTIC SKIN REACTION FOR TYPHOID.
298 presence of fluid in the thorax, when the chest is dull to percussion, since the speech phenomenon is particularly evident under these conditions. In fact, the bulging of the intercostal spaces will coincide with the lower level of the fluid, and if experience bears this out, this will be the only method we possess of separating the dull area due to fluid from the liver or spleen beneath. Dr. Weisz also claims to distinguish between organic and functional disease of the abdomen, since his method is another way of determining the alteration in tone of the muscles overlying an abnormally affected viscus, an alteration which is
ordinarily determined by palpation when a sense of rigidity is experienced. But a warning is necessary here. It is probable that such a means of investigation indicates an abnormal condition of the viscus, but not whether this condition is produced by organic disease, since the viscus which produces the symptoms may react in the same manner both from functional and organic disease. The method may be regarded as a worthy addition to the procedures of clinical investigation, and it has already received considerable attention on the continent, especially in Germany. HISTORY OF AERONAUTICS. THE Royal Society of Medicine held another successful social evening on Feb. lst, when Dr. F. J. Poynton gave an address on the Part Taken by Doctors in the Early Days of Aeronautics. He traced men’s interest in aerial flight back to the earliest recorded times. In the " Book of the Dead," he pointed out, the spirits were shown winged, and there were many stories of men aspiring to the sky drawn by eagles or with wings. The earliest illustration was found in a wood-cut of Daedalus and Icarus, published in 1493. Turning to the particular history of the lighterthan-air machine, the lecturer drew attention to the Roger many celebrated names associated with it. Bacon, Montanus, Leonardo da Vinci, Robert Hook, Cavarro, Swedenborg, Lavoisier, and Priestley had all been bitten by the craze, but, as so often happened, the solution of the problem came from an unexpected In 1782 the two brothers Montgolfier first source. saw a paper sphere filled with heated air float to the ceiling of their room. They gave their first public demonstration in the following year, when a sphere with a capacity of 65 cubic feet was successfully floated with heated air. The importance of their success was realised at once. Two and a half months later hydrogen was first used by Mr. Charles to inflate a balloon of such dimensions that 1125 lb. of iron and 560lb. of sulphuric acid were required to supply it. Fierce controversy ensued as to which of the two methods was the better. Later, in 1783, a cage-balloon carrying a sheep, a duck, and a cock was sent up in the presence of the King, the Queen (llarie Antoinette), and a large and distinguished crowd. Among them were Marat, who was very interested in aeronautics ; Mr. Charles, who was afterwards saved from the guillotine by his eloquent address to the crowd, in which he recalled his aerial experiments and the popular enthusiasm they aroused ; and the famous de Bozier, who began life as a medical student at Metz, but turned to science He became to escape the ordeal of anatomy. director of the first science museum in Paris, and in 1783 made an aerial journey across Paris. Benjamin Franklin was the link between these Parisian ventures and England, through his correspondence with Sir Joseph Banks, in the course of which he wrote : Your philosophy seems to be too bashful ; in this country we are not so ashamed of being laughed at." But it was not long before the " balloon madness of Paris, with its caricatures, toy balloons, stamped handkerchiefs, and even garters, spread to London, and in September, 1783, a balloon was sent up from the Artillery Ground. On Feb. 2nd, ] 7fH, a 5-foot balloon let free at Sandwich floated across to Flanders, and was the first to cross the Channel. Jn Scotland the and ill-fated Dr. Tybler made an ascent in a hot-air balloon on August 25th, but returned to THE
EARLY
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earth with some precipitancy. His later attempts failed. In 1784 the Italian Lunardi arrived in London with letters of introduction to Banks and others, and in September made an ascent in a gas balloon which was filled for the occasion by Dr. George Fordyce, of St. Thomas’s Hospital. Among the spectators on that occasion were Mr. John Sheldon, F.R.S., of Paris, surgeon to the Westminster Infirmary ; Dr. Jeffries, a Boston physician practising in London ; and the These three were the Frenchman, Blanchard. pioneers of early English attempts to fly. The first woman to make an aerial journey was Lunardi’s friend, Mrs. Sage. On both sides of the Channel feverish preparations were being made to cross the water, and after several difficulties Blanchard and Jeffries succeeded in doing so on Jan. 7th, 1785, after a journey of 2 hours and 47 minutes. de Rozier’s effort from Boulogne resulted in the balloon crashing on French soil and killing both him and his companion, de Romain. Dr. Poynton illustrated his lecture by a large series of rare prints and contemporary documents. ____
A DIAGNOSTIC SKIN REACTION FOR TYPHOID. THE early course of typhoid fever rarely proceeds according to plan and there are many conditions which resemble it closely enough to giverise to anxiety. A reliable test which would exclude typhoid during the first few days of a febrile disease would be distinctly helpful in practice. Dr. G. Rodriguez, of Buenos Aires, has experimented on a skin reaction for typhoid which is analogous to the Schick and Dick reactions. He used Vincent’s vaccine in doses of 100,000 bacilli in a volume of 01 c.cm., injected intradermally, and classified the reactions as weak, true, and strong, according to whether the result was a macule, a slight papule, or a large papule with tumescence. A series of 20 cases of typhoid and other diseases was tried with this dose, but the results suggested that it was too small, and Dr. Rodriguez increased it to 2 millions (in 0 1 c.cm.) for the next group of patients. Altogether the test was tried in 39 cases, of which 26 were typhoid in various stages, 4 were paratyphoid, and 9 were other febrile or bowel conditions. Of the typhoid cases 13 gave positive reactions, 12 negative, and 1 doubtful. All the remainder gave negative reactions. He concludes that early cases of typhoid
give a positive reaction, which becomes negative again in convalescence, but not in the presence of a complication or relapse. Dr. Rodriguez quotes a paper by S. Costa, L. Boyer, and E. Giraud, who investigated a skin reaction produced by the filtrate of broth cultures filtered through a Chamberland candle. They found a negative reaction in 15 cases of typhoid fever, but 12 convalescent or cured cases gave a positive reaction. One normal individual and 11 with diseases other than typhoid also gave a positive reaction. Rodriguez attempted to repeat this work, but obtained only doubtful results. VOLUNTARY HOSPITAL DEVELOPMENTS. THE fourth report of the Somerset Voluntary Hospitals Committee, under the Voluntary Hospitals Commission, has just been issued, and justifies its affirmation of the new hold now obtained by the voluntary system on public sentiment. There is no doubt that during the last five years a real change of public opinion has occurred. The advantages of the voluntary system have become more widely appreciated, while its defects are being removed and some of its financial problems are being solved, and it is the public, of course, who is supplying the solutions. The appointment of the Voluntary Hospitals Commission with local committees in every county and borough was a definite admission, or rather statement, that the public is intimately interested in the existence of the voluntary hospitals. 11’heu, some four years ago, Parliament voted .8500,000 to meet the pliglit in which some of these institutions found themselves, it followed that
ordinarily determined by palpation when a sense of rigidity is experienced. But a warning is necessary here. It is probable that such a means of investigation indicates an abnormal condition of the viscus, but not whether this condition is produced by organic disease, since the viscus which produces the symptoms may react in the same manner both from functional and organic disease. The method may be regarded as a worthy addition to the procedures of clinical investigation, and it has already received considerable attention on the continent, especially in Germany. HISTORY OF AERONAUTICS. THE Royal Society of Medicine held another successful social evening on Feb. lst, when Dr. F. J. Poynton gave an address on the Part Taken by Doctors in the Early Days of Aeronautics. He traced men’s interest in aerial flight back to the earliest recorded times. In the " Book of the Dead," he pointed out, the spirits were shown winged, and there were many stories of men aspiring to the sky drawn by eagles or with wings. The earliest illustration was found in a wood-cut of Daedalus and Icarus, published in 1493. Turning to the particular history of the lighterthan-air machine, the lecturer drew attention to the Roger many celebrated names associated with it. Bacon, Montanus, Leonardo da Vinci, Robert Hook, Cavarro, Swedenborg, Lavoisier, and Priestley had all been bitten by the craze, but, as so often happened, the solution of the problem came from an unexpected In 1782 the two brothers Montgolfier first source. saw a paper sphere filled with heated air float to the ceiling of their room. They gave their first public demonstration in the following year, when a sphere with a capacity of 65 cubic feet was successfully floated with heated air. The importance of their success was realised at once. Two and a half months later hydrogen was first used by Mr. Charles to inflate a balloon of such dimensions that 1125 lb. of iron and 560lb. of sulphuric acid were required to supply it. Fierce controversy ensued as to which of the two methods was the better. Later, in 1783, a cage-balloon carrying a sheep, a duck, and a cock was sent up in the presence of the King, the Queen (llarie Antoinette), and a large and distinguished crowd. Among them were Marat, who was very interested in aeronautics ; Mr. Charles, who was afterwards saved from the guillotine by his eloquent address to the crowd, in which he recalled his aerial experiments and the popular enthusiasm they aroused ; and the famous de Bozier, who began life as a medical student at Metz, but turned to science He became to escape the ordeal of anatomy. director of the first science museum in Paris, and in 1783 made an aerial journey across Paris. Benjamin Franklin was the link between these Parisian ventures and England, through his correspondence with Sir Joseph Banks, in the course of which he wrote : Your philosophy seems to be too bashful ; in this country we are not so ashamed of being laughed at." But it was not long before the " balloon madness of Paris, with its caricatures, toy balloons, stamped handkerchiefs, and even garters, spread to London, and in September, 1783, a balloon was sent up from the Artillery Ground. On Feb. 2nd, ] 7fH, a 5-foot balloon let free at Sandwich floated across to Flanders, and was the first to cross the Channel. Jn Scotland the and ill-fated Dr. Tybler made an ascent in a hot-air balloon on August 25th, but returned to THE
EARLY
"
"
earth with some precipitancy. His later attempts failed. In 1784 the Italian Lunardi arrived in London with letters of introduction to Banks and others, and in September made an ascent in a gas balloon which was filled for the occasion by Dr. George Fordyce, of St. Thomas’s Hospital. Among the spectators on that occasion were Mr. John Sheldon, F.R.S., of Paris, surgeon to the Westminster Infirmary ; Dr. Jeffries, a Boston physician practising in London ; and the These three were the Frenchman, Blanchard. pioneers of early English attempts to fly. The first woman to make an aerial journey was Lunardi’s friend, Mrs. Sage. On both sides of the Channel feverish preparations were being made to cross the water, and after several difficulties Blanchard and Jeffries succeeded in doing so on Jan. 7th, 1785, after a journey of 2 hours and 47 minutes. de Rozier’s effort from Boulogne resulted in the balloon crashing on French soil and killing both him and his companion, de Romain. Dr. Poynton illustrated his lecture by a large series of rare prints and contemporary documents. ____
A DIAGNOSTIC SKIN REACTION FOR TYPHOID. THE early course of typhoid fever rarely proceeds according to plan and there are many conditions which resemble it closely enough to giverise to anxiety. A reliable test which would exclude typhoid during the first few days of a febrile disease would be distinctly helpful in practice. Dr. G. Rodriguez, of Buenos Aires, has experimented on a skin reaction for typhoid which is analogous to the Schick and Dick reactions. He used Vincent’s vaccine in doses of 100,000 bacilli in a volume of 01 c.cm., injected intradermally, and classified the reactions as weak, true, and strong, according to whether the result was a macule, a slight papule, or a large papule with tumescence. A series of 20 cases of typhoid and other diseases was tried with this dose, but the results suggested that it was too small, and Dr. Rodriguez increased it to 2 millions (in 0 1 c.cm.) for the next group of patients. Altogether the test was tried in 39 cases, of which 26 were typhoid in various stages, 4 were paratyphoid, and 9 were other febrile or bowel conditions. Of the typhoid cases 13 gave positive reactions, 12 negative, and 1 doubtful. All the remainder gave negative reactions. He concludes that early cases of typhoid
give a positive reaction, which becomes negative again in convalescence, but not in the presence of a complication or relapse. Dr. Rodriguez quotes a paper by S. Costa, L. Boyer, and E. Giraud, who investigated a skin reaction produced by the filtrate of broth cultures filtered through a Chamberland candle. They found a negative reaction in 15 cases of typhoid fever, but 12 convalescent or cured cases gave a positive reaction. One normal individual and 11 with diseases other than typhoid also gave a positive reaction. Rodriguez attempted to repeat this work, but obtained only doubtful results. VOLUNTARY HOSPITAL DEVELOPMENTS. THE fourth report of the Somerset Voluntary Hospitals Committee, under the Voluntary Hospitals Commission, has just been issued, and justifies its affirmation of the new hold now obtained by the voluntary system on public sentiment. There is no doubt that during the last five years a real change of public opinion has occurred. The advantages of the voluntary system have become more widely appreciated, while its defects are being removed and some of its financial problems are being solved, and it is the public, of course, who is supplying the solutions. The appointment of the Voluntary Hospitals Commission with local committees in every county and borough was a definite admission, or rather statement, that the public is intimately interested in the existence of the voluntary hospitals. 11’heu, some four years ago, Parliament voted .8500,000 to meet the pliglit in which some of these institutions found themselves, it followed that