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COLLEGE OF DENTISTS OF ENGLAND.
POOR-LAW MEDICAL
SERVICE.
To the Editor of THE LANCET. SIR,-AS you have always advocated the cause of the Poorlaw Medical Officers, I ventare to ask you to do so now that a Poor-law Medical Reform Bill is about to be introduced into Parliament. I would suggest that they should be better paid, and that they should he allowed to retire on a certain portion of their salary after a number of years’ service ; after which they might employ themselves in private practice. I would recommend that, after fifteen years’ service, they should retire on five-tenths of their salary; after twenty years, on six-tenths; and after twenty-five years, on seven-tenths. I would also suggest, that the drugs should be provided by Government, and a dispenser appointed to make them up; indeed, I think it a disgrace to the medical practitioners of this country that they should combine the trade of a shopkeeper with an honourable profession, which places usfarbehind other European states; and that, I believe, is the main reason why the public respect
central, that sedative treatment is best, and that any severely painful local measures during the time of the hysterical diathesis cannot relieve, but can and do increase the mischief. In conclusion, Dr. Richardson observed that if in this lecture he had introduced matters which, as systematized facts and facts to be taught, were new, he made no apology, for the facts were in nature, and were to be learned in the stucly of naturethe more reason, therefore, that they should be both learned and tausht.
THE CATTLE SHOW. AND THE FEEDING OF ANIMALS FOR HUMAN CONSUMPTION.
IT cannot be denied that the subject of the rearing and feedof cattle is eminently sanitary, and therefore one which cannot fail to interest the medical man. Our attention is directed to it at the present time by the recarrence of the Prize Cattle Show of the Smithfield u so little. Hoping that you will be induced to give your support to ; That the feedingof the prize animals is conducted on a wrong the measure, and that the medical officers may have something principle in one respect is notorious. The tendency, and into look forward to as a reward for their unremitting toil, for deed the great object aimed at by the system of feeding now which they are neither paid nor thanked, adopted, is to produce an animal as large and as fat as pesI am, Sir, your obedient servant, sible ; bulk is sought rather than quality, and this bulk is obMEDICUS, December, 1858. tained chiefly by an extraordinary development of the fatty tissues, and this at the expense of the muscular, nitrogenous,
COLLEGE OF DENTISTS OF ENGLAND. Dp. RICHARDSON’S fourth Lecture, delivered at the College OB the evening of the 30th ultimo, was on "Hysteria and Allied Conditions, in reference to some forms of Dental Affections"--a subject of very great practical interest, but one offering much difficulty to the lecturer. These difficulties were met on this occasion by a carefully-studied mode of arrangement in the subject-matter of the lecture ; the result being, that each new point, as it arose, had a basis on something which had preceded it, so that the mind was carried along in the course of what to many was a novel train, with an attention which from first to last was unbroken. The first points considered related to the nature of hysteria and its causes. Two facts were here impressed-that all the hysterical phenomena are developed though the nervous centres, but that the nervous centres themselves are not the prime seat of the disorder, there being, during the period when these centres are so easily subjected to modification of function, a preceding and originating cause in the general system, due to a depraved nutrition. The symptoms of the hysterical disorder were then described, and it was brought out in the end that, all the extraneous phenomena being removed, the elementary symptoms were but two in number: exalted sensibility, or pain, and exalted irritability of muscle-involuntary motion. The results of hysteria in its influence on the muscular system were now briefly explained, and the difference in the terms convulsion and spasm was defined. In illustration of the hysteric spasm, a case of hysterical trismus was sketched out. Next, pain as a symptom of hysteria came under notice, and the various hysterical pains, and the diagnostic marks of such pains, were recounted. This led to a description of the hysteric pain as simulating tic douloureux and toothache, the toothache of pregnancy being classed under the latter head. Having considered with much minuteness the diagnosis of the hysterical toothache, Dr. Richardson changed the subject slightly, to consider the effects of certain diseased conditions of the teeth in exciting the hysterical paroxysm in persons in whom the hysterical diathesis is strongly marked. He gave illustrations of hysteria assuming the epileptiform type in the instances of children during the time of the second dentition, and in young women during the cutting of the wisdom teeth. He showed also the influence of carious teeth in the production of the hysterical paroxysm, and the similar influence, in some cases, of the pivot of an artificial tooth and the compressing amalgam stopping. Referring, finally, to the points of practice to be followed in the various affections which had been discussed, the lecturer confined himself mainly to such details as came within the legitimate range of the dental practitioner. Thus the treatment of hysterical trismus was brought under notice, and of hysterical neuralgia and of hysterical toothache. In all these affections, it should be borne steadily in mind that the proximate cause of the local phenomena is
ing
Club.
Now more nutritive tissues, especially the muscular. object of a correct system of feeding should be the very reverse-namely, to produce a large development of muscle, and the
and but a moderate one of fat. In the exhibition of the Smithfield Cattle Club the correctness of this principle is to some small extent recognised, but not nearly sufficiently so : the pigs are so fat that they still require their heads to be supported with pillows, to prevent death by apoplexy or suffocation. It should by clearly impressed on the mind that this excessive formation of fat constitutes a disease-that an animal thus fattened is in an 2cr2sontttci and diseased state, and therefore not in a fit conditionfor human food. The accuracy of this view was clearly shown by Mr. Gant in his researches on the condition of the prize cattle exhibited at the last Show, and which researches should be known to all interested in the rearing and feeding of cattle. Mr. Gant’s investigations proved, also, that the actual condition of foreign cattle, as respects the healthy state of their flesh, can only be accurately determined by a evident that the system of choosing the foreign animals from external examination only is incorrect, and that the decision should be based fully as much upon the internal appearance as post-mortem examination of the bodies. We trust that the Smithfield Cattle Club will speedily be brought to recognise practically the soundness of the views here expressed.
THE REGISTRATION FEE. WE are requested by Dr. Francis Hawkins to state that the registration fee will not, and cannot, be raised from £2to £5, in the case of any person now qualified, or who may beThe larger fee of come qualified before the end of the year. £5will be required only from gentlemen who may be admitted into the profession, for the first time, subsequently to the end of this year.
TOOTH EXTRACTION
AND OTHER
OPERATIONS
RENDERED
MEANS OF ELECTRICITY.-M. Morel Lavallee, Surgeon to the St. Antoine Hospital at Paris, has lately experimented upon the power of the electric current in overcoming the sensation of pain in the extraction of teeth. The Gazette des Hopitaux states, that on the 19th of November, six avulsions of teeth were performed upon various patients, amongst whom were a dresser to the hospital, and a clerk at the office of the institution. No pain was felt in any case, and the two latter patients were induced to submit to the trial by seeing the four others operated upon without experiencing pain. Incisions of different kinds were also made by M. lLorel, to open abscesses, remove sequestra, &c., and no pain was complained of by the patients. The current was always of moderate intensity, one conductor being held by the patient, and the other fixed to the forceps used for the removal of the tooth. The report altogether comprises seventeen cases, with only one
PAINLESS
BY
failure.
621
SERVICE.
To the Editor of THE LANCET. SIR,-AS you have always advocated the cause of the Poorlaw Medical Officers, I ventare to ask you to do so now that a Poor-law Medical Reform Bill is about to be introduced into Parliament. I would suggest that they should be better paid, and that they should he allowed to retire on a certain portion of their salary after a number of years’ service ; after which they might employ themselves in private practice. I would recommend that, after fifteen years’ service, they should retire on five-tenths of their salary; after twenty years, on six-tenths; and after twenty-five years, on seven-tenths. I would also suggest, that the drugs should be provided by Government, and a dispenser appointed to make them up; indeed, I think it a disgrace to the medical practitioners of this country that they should combine the trade of a shopkeeper with an honourable profession, which places usfarbehind other European states; and that, I believe, is the main reason why the public respect
central, that sedative treatment is best, and that any severely painful local measures during the time of the hysterical diathesis cannot relieve, but can and do increase the mischief. In conclusion, Dr. Richardson observed that if in this lecture he had introduced matters which, as systematized facts and facts to be taught, were new, he made no apology, for the facts were in nature, and were to be learned in the stucly of naturethe more reason, therefore, that they should be both learned and tausht.
THE CATTLE SHOW. AND THE FEEDING OF ANIMALS FOR HUMAN CONSUMPTION.
IT cannot be denied that the subject of the rearing and feedof cattle is eminently sanitary, and therefore one which cannot fail to interest the medical man. Our attention is directed to it at the present time by the recarrence of the Prize Cattle Show of the Smithfield u so little. Hoping that you will be induced to give your support to ; That the feedingof the prize animals is conducted on a wrong the measure, and that the medical officers may have something principle in one respect is notorious. The tendency, and into look forward to as a reward for their unremitting toil, for deed the great object aimed at by the system of feeding now which they are neither paid nor thanked, adopted, is to produce an animal as large and as fat as pesI am, Sir, your obedient servant, sible ; bulk is sought rather than quality, and this bulk is obMEDICUS, December, 1858. tained chiefly by an extraordinary development of the fatty tissues, and this at the expense of the muscular, nitrogenous,
COLLEGE OF DENTISTS OF ENGLAND. Dp. RICHARDSON’S fourth Lecture, delivered at the College OB the evening of the 30th ultimo, was on "Hysteria and Allied Conditions, in reference to some forms of Dental Affections"--a subject of very great practical interest, but one offering much difficulty to the lecturer. These difficulties were met on this occasion by a carefully-studied mode of arrangement in the subject-matter of the lecture ; the result being, that each new point, as it arose, had a basis on something which had preceded it, so that the mind was carried along in the course of what to many was a novel train, with an attention which from first to last was unbroken. The first points considered related to the nature of hysteria and its causes. Two facts were here impressed-that all the hysterical phenomena are developed though the nervous centres, but that the nervous centres themselves are not the prime seat of the disorder, there being, during the period when these centres are so easily subjected to modification of function, a preceding and originating cause in the general system, due to a depraved nutrition. The symptoms of the hysterical disorder were then described, and it was brought out in the end that, all the extraneous phenomena being removed, the elementary symptoms were but two in number: exalted sensibility, or pain, and exalted irritability of muscle-involuntary motion. The results of hysteria in its influence on the muscular system were now briefly explained, and the difference in the terms convulsion and spasm was defined. In illustration of the hysteric spasm, a case of hysterical trismus was sketched out. Next, pain as a symptom of hysteria came under notice, and the various hysterical pains, and the diagnostic marks of such pains, were recounted. This led to a description of the hysteric pain as simulating tic douloureux and toothache, the toothache of pregnancy being classed under the latter head. Having considered with much minuteness the diagnosis of the hysterical toothache, Dr. Richardson changed the subject slightly, to consider the effects of certain diseased conditions of the teeth in exciting the hysterical paroxysm in persons in whom the hysterical diathesis is strongly marked. He gave illustrations of hysteria assuming the epileptiform type in the instances of children during the time of the second dentition, and in young women during the cutting of the wisdom teeth. He showed also the influence of carious teeth in the production of the hysterical paroxysm, and the similar influence, in some cases, of the pivot of an artificial tooth and the compressing amalgam stopping. Referring, finally, to the points of practice to be followed in the various affections which had been discussed, the lecturer confined himself mainly to such details as came within the legitimate range of the dental practitioner. Thus the treatment of hysterical trismus was brought under notice, and of hysterical neuralgia and of hysterical toothache. In all these affections, it should be borne steadily in mind that the proximate cause of the local phenomena is
ing
Club.
Now more nutritive tissues, especially the muscular. object of a correct system of feeding should be the very reverse-namely, to produce a large development of muscle, and the
and but a moderate one of fat. In the exhibition of the Smithfield Cattle Club the correctness of this principle is to some small extent recognised, but not nearly sufficiently so : the pigs are so fat that they still require their heads to be supported with pillows, to prevent death by apoplexy or suffocation. It should by clearly impressed on the mind that this excessive formation of fat constitutes a disease-that an animal thus fattened is in an 2cr2sontttci and diseased state, and therefore not in a fit conditionfor human food. The accuracy of this view was clearly shown by Mr. Gant in his researches on the condition of the prize cattle exhibited at the last Show, and which researches should be known to all interested in the rearing and feeding of cattle. Mr. Gant’s investigations proved, also, that the actual condition of foreign cattle, as respects the healthy state of their flesh, can only be accurately determined by a evident that the system of choosing the foreign animals from external examination only is incorrect, and that the decision should be based fully as much upon the internal appearance as post-mortem examination of the bodies. We trust that the Smithfield Cattle Club will speedily be brought to recognise practically the soundness of the views here expressed.
THE REGISTRATION FEE. WE are requested by Dr. Francis Hawkins to state that the registration fee will not, and cannot, be raised from £2to £5, in the case of any person now qualified, or who may beThe larger fee of come qualified before the end of the year. £5will be required only from gentlemen who may be admitted into the profession, for the first time, subsequently to the end of this year.
TOOTH EXTRACTION
AND OTHER
OPERATIONS
RENDERED
MEANS OF ELECTRICITY.-M. Morel Lavallee, Surgeon to the St. Antoine Hospital at Paris, has lately experimented upon the power of the electric current in overcoming the sensation of pain in the extraction of teeth. The Gazette des Hopitaux states, that on the 19th of November, six avulsions of teeth were performed upon various patients, amongst whom were a dresser to the hospital, and a clerk at the office of the institution. No pain was felt in any case, and the two latter patients were induced to submit to the trial by seeing the four others operated upon without experiencing pain. Incisions of different kinds were also made by M. lLorel, to open abscesses, remove sequestra, &c., and no pain was complained of by the patients. The current was always of moderate intensity, one conductor being held by the patient, and the other fixed to the forceps used for the removal of the tooth. The report altogether comprises seventeen cases, with only one
PAINLESS
BY
failure.
621