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DEATH OF SIR FREDERICK ABEL.
755 for
example,
appears
as
a
to
point
out that
an
witness but at the
official who not
presiding judge (himself frequently
a
only
time
advises the
medical
man) upon
same
institution rather novel than desirable. Upon general grounds, however, we would suggest to the County Council, should it be considering the proposals of its public control offices, that medical matters is
likely
the increased number of
to be looked upon
inquests
is not
as
an
necessarily
a cause
for dissatisfaction but is probably the result of the increased vigilance of its officers and of a growing feeling in favour of the
prevention
of avoidable
The view submitted to the
as
take work of this nature at
guinea
per number of
case
on
the
an
all-round fee of say one that a considerable
understanding
cases would be referred to them." the further theories put forth in the text of the reAmong port as distinct from its statistics we observe the suggestion openly made that coroners multiply inquests because their
salaries
mortality. County Council
upon this head appears from the following passage in the report: " It appears probable that a proportion of the inquests held was unnecessary, as in no less than 3935 cases-almost precisely one-half of the inquests held-the verdict of the jury was 6 Death from natural causes.’" We, on the other hand, hold the opinion that no such inference can be drawn from the figures and fact stated, believing as we do
thousands of deaths take place in London as to which no medical man will certify it is for the public safety that all should recognise it as almost inevitable that deaths so uncertified will be followed by inquiry. It is true that the creation of a "medical investigator" is suggested to the County Council as a means by which inquiries may be held without formal inquests, but the essential merit of the inquest, which at present has its admitted defects, lies in its publicity and its formality. A "medical investigator" could only be a practitioner instructed to ascertain as far as possible the .actual cause of death, to which his inquiry would be limited. Even in this he might be regarded as a person holding an inquisitorial position and one from whom information should be withheld ; it would not be right that he should play the part of a detective suggested by the novel and undesirable title of "medical investigator." His inquiry, moreover, would be one of a more or less private nature and might be held without the advantage of the evidence of persons able to impart valuable information. The inquest, on the other hand, is publicly held and publicly reported, so that public opinion is brought to bear upon the matters disclosed and so that those who have anything to say as to relevant facts may at any time learn that it is taking place and come forward to give evidence or may give information afterwards if relevant facts have been suppressed. No inquiry, therefore, by an 11 investigator," medical or otherwise, can in any way take the place of a coroner’s inquest and it that
employed in each district,and being will have been seen, of airing speculative theories he adds : " There are probably many capable young pathologists attached to London hospitals who would be glad to underexaminations should be
fond,
if
are based upon a scale proportionate to the number of inquests held, and this is coupled with the recommendation that they should be paid regular salaries independent of the work done as a means to diminish the number of and the consequent expense to the Council. That coroners should have fixed incomes may be very desirable, but we emphatically protest against the allegation that this should be done on the ground that they now increase their emoluments by corrupt methods. With regard to the report as a whole, it contains interesting figures and statistics and perhaps the germs of useful alterations in the regulations governing the holding of coroners’ inquiries. It will, however, we hope, be long before the County Council is permitted to introduce innovations tending to diminish the number or the thoroughness of inquests, which, whatever their defects may be, undoubtedly play a considerable part in the safeguarding of life in the metropolis and indeed
inquiries
throughout
the
country.
Annotations. "
DEATH
Ne
quid nimis."
OF SIR FREDERICK ABEL.
of Sir Frederick Abel, G *’C.V.0., K.C.B., undoubtedly our greatest authority on the chemistry of explosives. At the outset of his career he was quickly associated with research work into the physics and chemistry of gunpowder and other explosive agents. Indeed, the transition from what may be called the gunpowder period in regard to explosives for military purposes to the nitroexplosives period was due to Abel’s brilliant researches while Professor of Chemistry at the Royal Military Academy and chemist to the War Department. Sir Frederick Abel cannot be said to be the founder of nitro-explosives but undoubtedly he was the first to recognise the value of applying nitro-explosives as the projecting force for He studied very minutely the conditions under guns. which the nitro-compounds could be adapted for the does not seem to us that the "medical investigator purpose. Practically the results of his study of this applica’could properly do more than can now be done by a tion proved the death-knell of gunpowder in favour of Abel’s name will, perhaps, be best remedical practitioner employed in the usual way by the smokeless powder. membered by the public by his connexion with the cordite .coroner to hold a post-mortem examination. case. He was accused by Nobel of having acted in bad It is, however, submitted to the County Council in the ’aith by, as Nobel asserted, having adopted a powder pracreport before us that the general practitioners who now tically of the same composition as the one he had .usually make the post-mortem examinations are rarely quali- nvented (ballastite) for the Government’s exclusive use. fied by experience for the work, and it may be that In other words, Nobel claimed that cordite was a of ballastite. It is almost fresh in our memory a proportion of the post-mortems now made are of piracy ,hat Abel pointed out a very essential difference between little value in determining the cause of death." The writer she two which made the former safe and effective for -of the report having made this statement without adducing tmmunition, while the latter was not trustworthy. The - evidence in support of it goes on to suggest thata well iircumstances of the case were that Abel was appointed qualified pathologist experienced in making post-mortem )y the Government to determine what powders existed "
THE
removes
death
756 could be substituted with advantage for gunand the reply of Abel and his colleague, Professor Dewar, was that at the time of their investigation there existed none. It cannot be gainsaid, however, that through this investigation Abel conceived in what respects nitropowders were unsuitable and his subsequent research upon the subject resulted in an improved powder which fulfilled all the conditions required for an explosive for ordnance use. Thus the charge of bad faith failed. Sir Frederick Abel’s work, however, was not confined to the practical study of explosives. He was appointed to inquire into the safe storage of petroleum oil and at the present time regulations exist as to the sale, storage, and use of petroleum oil which owe their origin to the results of Abel’s inquiry. Amongst other things he invented a flash-point apparatus for the testing of oil, an apparatus Sir which is officially recognised at the present time. Frederick Abel devoted himself also to the investigation of other branches of science, such as, for example, to the improved manufacture of iron and steel, especially in their relation to the requirements of war material. He was, again, student of pure science and communicated a an eager number of papers chiefly to the Chemical Society and the Royal Society embodying scientific research. Sir Frederick Abel during his career occupied the offices of President of the Chemical Society, of the Institute of Chemistry, of the Society of Chemical Industry, and of the British Association. The death of Sir Frederick Abel will be a melancholy fact to his colleague, Professor Dewar, as having taken place on the eve of his presidency of the British Association this Sir Frederick Abel proved a faithful week at Belfast. servant to the Government and his place as official adviser to the War Department will be hard to fill.
which
powder
THE
MEDICAL
LANGUAGE OF ST. LUKE.
THE
recently announced death of the Rev. William Kirk rector of Killanny, co. Louth, removes from the not numerous experts in Greek medical literature one of the
Hobart, too
appears to be known to Dr. Hobart only in the superseded text of Kuhn and not in that of the standard edition executed with masterly skill for the Sydenham Society by Dr. Francis Adams of Banchory (London, 1856). These defects, we repeat, detract from the merit of Dr. Hobart’s treatise ; but when every allowance is made for them that treatise remains a monument of labour almost "Benedictine"in its assiduity and of learning and Its publicaaccumen well worthy of its sacrosanct theme. tion by the press of Dublin University, of which its author was a distinguished graduate, does honour to that seat of learning, but for whose liberality it would probably never have seen the light. Dr. Hobart, indeed, conveys as much in his preface, while his comparatively premature death calls for a renewal on our part of the tribute paid 20 years ago to his ample vindication of the third Gospel and of the Acts of the Apostles as incontestably the work of the "Beloved Physician."" -
PTOMAINE
epidemic of food-poisoning has occurred in and Derby naturally a good deal of alarm is felt. It is that the number of cases has been 150. estimated roughly Fortunately, the type of disease has not been, in Derby at least, very severe and with one or two exceptions all the persons attacked have recovered or are progressing favour. ably. At Taunton, however, the death has occurred with symptoms of ptomaine poisoning of a man, aged 7b years. The deceased returned home on the evening of Sept. 8th from Derby, bringing with him a pork pie purchased there. He, his wife, and a servant all ate of it and the following day all three were taken ill, the man dying at night. The source of the poisoning is suspected to lie in certain pork pies purchased from one of the best-known pork butchers in Derby. This theory is also supported by the fact that a visitor to Derby brought back with her to her home in London a pork pie from the same shop. All the persons who partook of the pie suffered with the,characteristic symptoms of ptomaine poisoning. Samples of the Dr. food have been sent to Delepine for analysis. suspected As in the case of similar epidemics the symptoms have not occurred as the result of eating meat actually "putrefied"— that is, of meat the smell of which would at once give rise It is known from actual experiment that the to suspicion. most toxic products of putrefaction are present in the earlier and not in the later stages of the process. A SERIOUS
ablest and most accomplished of the band-the author of the treatise, familiar to theologian and philologist alike, entitled "The Medical Language of St. Luke: a Proof from Internal Evidence that the Gospel according to St. Luke and the Acts of the Apostles were written by the Same Person and that the Writer was a Medical Man." Appropriately dedicated to that eminently Biblical scholar, the present Primate of Ireland, Dr. Hobart’s work was published 20 years ago, welcomed by THE LANCET at the time in an extended review, and is now secure in an honoured place in the apparat1tS esitic2s of the evangelist whose " I Gospel Renan has call-ed the loveliest book in all literature," and whose "Acts" is pronounced by Professor W. M. Ramsay to be redolent of "genius, skill, and sympathetic historical insight." No doubt, as we indicated in our critical notice,’ Dr. Hobart is, on occasion the victim of his own enthusiasm, apt to find in St. Luke’s phraseology an exclusively medical idiom when there is evidence to show that the word. or words, cited had passed from professional into general currency. Dr. Phlmmer, Master of University College, Durham, in his very scholarly and able commentary on the Gospel, supplies cogent proof of this, while cordially admitting the! value of Dr. Hobart’s labours. Another defect of the treatise is the preference given to Kiihn’s uncritical recension of the Greek medical writers (Leipsic, 1821-30) over the far sounder texts of Hippocrates as constituted by Littre (Paris, 1839-61), and by Ermerins (Utrecht, 1859-65), to say nothing of the still more correct edition now in course of publication by Ktihiewein in Teubner’s "Bibliotheca Scriptorum Graeoorum et Romanorum." Aretaeus, moreover,
GASTRECTOMY. RECURRENCE after removal of a malignant growth from the stomach may occur either locally in the gastric wall or the lymphatic glands. Mikulicz has laid much stress on the frequency of local recurrence and points out that a sufficient portion of the stomach is usually not removed. In our present issue appears a paper by Mr. G. A. Syme of Melbourne on a successful case of gastrectomy for malignant disease, in which he advocates removal of nearly the whole of the stomach for gastric carcinoma, for, he maintains, if operation is advisable at all gastrectomy is indicated, since, as the presence of the stomach is not essential for digestion, the more complete its removal the the probability of immunity from recurrence, while the increase in the risk is not proportional to the amount removed. Mr. Syme considers it wise for ease in operation to leave a small portion of healthy stomach. There is much to be said for this view, for at present an ordinary pylorectomy for a malignant growth is only too frequently followed by a return of the disease in the stomach, showing that too little of that viscus has been removed. In some points a gastrectomy is an easier operation than a pylorectomy,
in
II greater
"
1
THE
LANCET, June 9th, 1883, p. 1002
POISONING.
example,
appears
as
a
to
point
out that
an
witness but at the
official who not
presiding judge (himself frequently
a
only
time
advises the
medical
man) upon
same
institution rather novel than desirable. Upon general grounds, however, we would suggest to the County Council, should it be considering the proposals of its public control offices, that medical matters is
likely
the increased number of
to be looked upon
inquests
is not
as
an
necessarily
a cause
for dissatisfaction but is probably the result of the increased vigilance of its officers and of a growing feeling in favour of the
prevention
of avoidable
The view submitted to the
as
take work of this nature at
guinea
per number of
case
on
the
an
all-round fee of say one that a considerable
understanding
cases would be referred to them." the further theories put forth in the text of the reAmong port as distinct from its statistics we observe the suggestion openly made that coroners multiply inquests because their
salaries
mortality. County Council
upon this head appears from the following passage in the report: " It appears probable that a proportion of the inquests held was unnecessary, as in no less than 3935 cases-almost precisely one-half of the inquests held-the verdict of the jury was 6 Death from natural causes.’" We, on the other hand, hold the opinion that no such inference can be drawn from the figures and fact stated, believing as we do
thousands of deaths take place in London as to which no medical man will certify it is for the public safety that all should recognise it as almost inevitable that deaths so uncertified will be followed by inquiry. It is true that the creation of a "medical investigator" is suggested to the County Council as a means by which inquiries may be held without formal inquests, but the essential merit of the inquest, which at present has its admitted defects, lies in its publicity and its formality. A "medical investigator" could only be a practitioner instructed to ascertain as far as possible the .actual cause of death, to which his inquiry would be limited. Even in this he might be regarded as a person holding an inquisitorial position and one from whom information should be withheld ; it would not be right that he should play the part of a detective suggested by the novel and undesirable title of "medical investigator." His inquiry, moreover, would be one of a more or less private nature and might be held without the advantage of the evidence of persons able to impart valuable information. The inquest, on the other hand, is publicly held and publicly reported, so that public opinion is brought to bear upon the matters disclosed and so that those who have anything to say as to relevant facts may at any time learn that it is taking place and come forward to give evidence or may give information afterwards if relevant facts have been suppressed. No inquiry, therefore, by an 11 investigator," medical or otherwise, can in any way take the place of a coroner’s inquest and it that
employed in each district,and being will have been seen, of airing speculative theories he adds : " There are probably many capable young pathologists attached to London hospitals who would be glad to underexaminations should be
fond,
if
are based upon a scale proportionate to the number of inquests held, and this is coupled with the recommendation that they should be paid regular salaries independent of the work done as a means to diminish the number of and the consequent expense to the Council. That coroners should have fixed incomes may be very desirable, but we emphatically protest against the allegation that this should be done on the ground that they now increase their emoluments by corrupt methods. With regard to the report as a whole, it contains interesting figures and statistics and perhaps the germs of useful alterations in the regulations governing the holding of coroners’ inquiries. It will, however, we hope, be long before the County Council is permitted to introduce innovations tending to diminish the number or the thoroughness of inquests, which, whatever their defects may be, undoubtedly play a considerable part in the safeguarding of life in the metropolis and indeed
inquiries
throughout
the
country.
Annotations. "
DEATH
Ne
quid nimis."
OF SIR FREDERICK ABEL.
of Sir Frederick Abel, G *’C.V.0., K.C.B., undoubtedly our greatest authority on the chemistry of explosives. At the outset of his career he was quickly associated with research work into the physics and chemistry of gunpowder and other explosive agents. Indeed, the transition from what may be called the gunpowder period in regard to explosives for military purposes to the nitroexplosives period was due to Abel’s brilliant researches while Professor of Chemistry at the Royal Military Academy and chemist to the War Department. Sir Frederick Abel cannot be said to be the founder of nitro-explosives but undoubtedly he was the first to recognise the value of applying nitro-explosives as the projecting force for He studied very minutely the conditions under guns. which the nitro-compounds could be adapted for the does not seem to us that the "medical investigator purpose. Practically the results of his study of this applica’could properly do more than can now be done by a tion proved the death-knell of gunpowder in favour of Abel’s name will, perhaps, be best remedical practitioner employed in the usual way by the smokeless powder. membered by the public by his connexion with the cordite .coroner to hold a post-mortem examination. case. He was accused by Nobel of having acted in bad It is, however, submitted to the County Council in the ’aith by, as Nobel asserted, having adopted a powder pracreport before us that the general practitioners who now tically of the same composition as the one he had .usually make the post-mortem examinations are rarely quali- nvented (ballastite) for the Government’s exclusive use. fied by experience for the work, and it may be that In other words, Nobel claimed that cordite was a of ballastite. It is almost fresh in our memory a proportion of the post-mortems now made are of piracy ,hat Abel pointed out a very essential difference between little value in determining the cause of death." The writer she two which made the former safe and effective for -of the report having made this statement without adducing tmmunition, while the latter was not trustworthy. The - evidence in support of it goes on to suggest thata well iircumstances of the case were that Abel was appointed qualified pathologist experienced in making post-mortem )y the Government to determine what powders existed "
THE
removes
death
756 could be substituted with advantage for gunand the reply of Abel and his colleague, Professor Dewar, was that at the time of their investigation there existed none. It cannot be gainsaid, however, that through this investigation Abel conceived in what respects nitropowders were unsuitable and his subsequent research upon the subject resulted in an improved powder which fulfilled all the conditions required for an explosive for ordnance use. Thus the charge of bad faith failed. Sir Frederick Abel’s work, however, was not confined to the practical study of explosives. He was appointed to inquire into the safe storage of petroleum oil and at the present time regulations exist as to the sale, storage, and use of petroleum oil which owe their origin to the results of Abel’s inquiry. Amongst other things he invented a flash-point apparatus for the testing of oil, an apparatus Sir which is officially recognised at the present time. Frederick Abel devoted himself also to the investigation of other branches of science, such as, for example, to the improved manufacture of iron and steel, especially in their relation to the requirements of war material. He was, again, student of pure science and communicated a an eager number of papers chiefly to the Chemical Society and the Royal Society embodying scientific research. Sir Frederick Abel during his career occupied the offices of President of the Chemical Society, of the Institute of Chemistry, of the Society of Chemical Industry, and of the British Association. The death of Sir Frederick Abel will be a melancholy fact to his colleague, Professor Dewar, as having taken place on the eve of his presidency of the British Association this Sir Frederick Abel proved a faithful week at Belfast. servant to the Government and his place as official adviser to the War Department will be hard to fill.
which
powder
THE
MEDICAL
LANGUAGE OF ST. LUKE.
THE
recently announced death of the Rev. William Kirk rector of Killanny, co. Louth, removes from the not numerous experts in Greek medical literature one of the
Hobart, too
appears to be known to Dr. Hobart only in the superseded text of Kuhn and not in that of the standard edition executed with masterly skill for the Sydenham Society by Dr. Francis Adams of Banchory (London, 1856). These defects, we repeat, detract from the merit of Dr. Hobart’s treatise ; but when every allowance is made for them that treatise remains a monument of labour almost "Benedictine"in its assiduity and of learning and Its publicaaccumen well worthy of its sacrosanct theme. tion by the press of Dublin University, of which its author was a distinguished graduate, does honour to that seat of learning, but for whose liberality it would probably never have seen the light. Dr. Hobart, indeed, conveys as much in his preface, while his comparatively premature death calls for a renewal on our part of the tribute paid 20 years ago to his ample vindication of the third Gospel and of the Acts of the Apostles as incontestably the work of the "Beloved Physician."" -
PTOMAINE
epidemic of food-poisoning has occurred in and Derby naturally a good deal of alarm is felt. It is that the number of cases has been 150. estimated roughly Fortunately, the type of disease has not been, in Derby at least, very severe and with one or two exceptions all the persons attacked have recovered or are progressing favour. ably. At Taunton, however, the death has occurred with symptoms of ptomaine poisoning of a man, aged 7b years. The deceased returned home on the evening of Sept. 8th from Derby, bringing with him a pork pie purchased there. He, his wife, and a servant all ate of it and the following day all three were taken ill, the man dying at night. The source of the poisoning is suspected to lie in certain pork pies purchased from one of the best-known pork butchers in Derby. This theory is also supported by the fact that a visitor to Derby brought back with her to her home in London a pork pie from the same shop. All the persons who partook of the pie suffered with the,characteristic symptoms of ptomaine poisoning. Samples of the Dr. food have been sent to Delepine for analysis. suspected As in the case of similar epidemics the symptoms have not occurred as the result of eating meat actually "putrefied"— that is, of meat the smell of which would at once give rise It is known from actual experiment that the to suspicion. most toxic products of putrefaction are present in the earlier and not in the later stages of the process. A SERIOUS
ablest and most accomplished of the band-the author of the treatise, familiar to theologian and philologist alike, entitled "The Medical Language of St. Luke: a Proof from Internal Evidence that the Gospel according to St. Luke and the Acts of the Apostles were written by the Same Person and that the Writer was a Medical Man." Appropriately dedicated to that eminently Biblical scholar, the present Primate of Ireland, Dr. Hobart’s work was published 20 years ago, welcomed by THE LANCET at the time in an extended review, and is now secure in an honoured place in the apparat1tS esitic2s of the evangelist whose " I Gospel Renan has call-ed the loveliest book in all literature," and whose "Acts" is pronounced by Professor W. M. Ramsay to be redolent of "genius, skill, and sympathetic historical insight." No doubt, as we indicated in our critical notice,’ Dr. Hobart is, on occasion the victim of his own enthusiasm, apt to find in St. Luke’s phraseology an exclusively medical idiom when there is evidence to show that the word. or words, cited had passed from professional into general currency. Dr. Phlmmer, Master of University College, Durham, in his very scholarly and able commentary on the Gospel, supplies cogent proof of this, while cordially admitting the! value of Dr. Hobart’s labours. Another defect of the treatise is the preference given to Kiihn’s uncritical recension of the Greek medical writers (Leipsic, 1821-30) over the far sounder texts of Hippocrates as constituted by Littre (Paris, 1839-61), and by Ermerins (Utrecht, 1859-65), to say nothing of the still more correct edition now in course of publication by Ktihiewein in Teubner’s "Bibliotheca Scriptorum Graeoorum et Romanorum." Aretaeus, moreover,
GASTRECTOMY. RECURRENCE after removal of a malignant growth from the stomach may occur either locally in the gastric wall or the lymphatic glands. Mikulicz has laid much stress on the frequency of local recurrence and points out that a sufficient portion of the stomach is usually not removed. In our present issue appears a paper by Mr. G. A. Syme of Melbourne on a successful case of gastrectomy for malignant disease, in which he advocates removal of nearly the whole of the stomach for gastric carcinoma, for, he maintains, if operation is advisable at all gastrectomy is indicated, since, as the presence of the stomach is not essential for digestion, the more complete its removal the the probability of immunity from recurrence, while the increase in the risk is not proportional to the amount removed. Mr. Syme considers it wise for ease in operation to leave a small portion of healthy stomach. There is much to be said for this view, for at present an ordinary pylorectomy for a malignant growth is only too frequently followed by a return of the disease in the stomach, showing that too little of that viscus has been removed. In some points a gastrectomy is an easier operation than a pylorectomy,
in
II greater
"
1
THE
LANCET, June 9th, 1883, p. 1002
POISONING.