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ELECTRIC ILLUMINATION OF THE MALE BLADDER AND URETHRA.
ROMŒOPATHY IN THE UNITED STATES.
, 1888.
occurred in the Metropolitan Asylum Hospitals situated possible to doubt that the invaluable sanitary work now outside the boundaries of Registration London. These deaths being done by the Metropolitan Asylum Board affords the were equal to an annual rate of 0’34 per 1000 of the esti- true explanation of the control which was maintained over mated population of the metropolis, against 0’43 from the what threatened to be, but cannot be called a severe epidemic same disease in the twenty-seven large provincial towns of scarlet fever in London last year. dealt with in the Registrar-General’s weekly return, and having an aggregate populaticn somewhat exceeding that of London. The highest death-rates from scarlet fever in those towns during last year were 0’90 in Birkenhead, " Ne quid nimis." 0’96 in Bristol, and 1’36 in Blackburn, each of these HOMŒOPATHY IN THE UNITED STATES. rates being about three times as high as the London rate. If we compare the London rate from scarlet fever IT is an awkward fact in the homoeopathic world that last year with the rates from this disease in the metro- its leading practitioner in London has written a book to show polis in previous years, we find that it showed a con- that contraria contrariis curantur is as much a principle as siderable increase upon the unprecedentedly low rates in similia similibus curantur. There is abundant evidence that other homoeopaths act on this practitioner’s varied prin1885 and 1886, but that it was lower than the rate in ciples in serious circumstances, though they have not the any previous year of which record exists; it was very little same courage of avowal as he. " J. C. B.," Dr. George more than half the mean annual rate during the ten years Johnson, and others, have published in The Times proofs 1871-80, which again was little more than half the mean rate of what everybody knows, that homoeopaths no longer are in the preceding decennium. It being therefore a fact that wedded to infinitesimal doses. When this break down of the death-rate from scarlet fever in London during last year homoeopathy in the hands of its own practitioners is shown, no wonder that it meets with little respect in the was not only below the mean rate in preceding years, but profession, and that in Europe it has practically no recogalso lower than the mean rate during last year in other nition. When the failure of homoeopathy in Europe is large English towns, it becomes interesting to inquire why pressed on its advocates, the unbelievers are referred to the increasing prevalence of the disease in the metropolis the United States. That is a large reference. Medical law gave rise to such exaggerated impressions of the extent and is very easy there, and so is medical education. In fact,the nature of the epidemic. The answer to this inquiry pro- best men in the profession in the States mourn over the rate at which medical men are turned out of the numerous combably also explains why the fatal results of the outbreak peting schools; and we publish a letter to-day showing were confined within such comparatively moderate limits. that homoeopaths in the States are just as little loyal to The number of cases of scarlet fever admitted for isolation Hahnemann as homœopaths here. Dr. Potter is Professor of and treatment into the various hospitals of the Metropolitan the Practice of Physic in the Cooper Medical College, San Asylum Board, which had been 1399 and 1789 in 1885 Francisco, and writes with a complete knowledge of both and 1886, rose to 5933 in 1887. Thus, while the deaths systems and both schools. His letter is far too good, and is quite uncalled for as a refutation of any incorrect statefrom scarlet fever in London in 1887 were only ments about himself in the Homceopathic Reviem meant twice as many as in the previous year, the number to disparage his damaging authority. So regarding it in of cases admitted into these hospitals was more than August, we did not publish it in full, but contented ourthree times as many. It was pointed out in the Registrar- selves with an editorial notice of it. But we think it General’s last annual summary that in 1878 the deaths from well to publish it now, for the light it throws on scarlet fever in the Metropolitan Asylum and the London the homoeopaths of America, whose numbers and practo astonish and stimulate the dull mind Fever Hospitals were equal to but 7 per cent. of all the tice are paraded of Dr. Potter left the homoeopathic school deaths from this cause in London, whereas the proportion because what he saw showed him that no crucial drug rose steadily to 13-2 per cent. in 1883, 17-6 in 1884, 20-2 experimentation conducted under scientific safeguards could in 1885, and 22-7 in 1886. In 1887, of the 1447 deaths meet with any degree of appreciation from the majority of from scarlet fever in London, 500 occurred in the Metro- that sect, and because of the impression made on him by politan Asylum Hospitals and 27 in the London FeveI finding that ninety-nine out of every hundred. so-called were in the habit of resorting to Hospital; these 527 deaths were equal to 36-5 per cent. oi homœopathic physicians whenever there was any active therapy the total deaths from the disease, showing a further con- regular therapeutics to be done. So much for the homoeopathy of the United siderable increase upon the steadily increasing proportion: It is as unreal as the homceopathy of Europe. in the nine preceding years. Judged by the hospital returns, the case-mortality of scarlet fever in 1887 did not ELECTRIC ILLUMINATION OF THE MALE BLADDER materially differ from that in the preceding two years. Th< AND URETHRA. mortality of cases of scarlet fever in the Metropolitan TIlE electric urethroscope and vesicoscopes which Mr. Asylum Hospitals was 9’8 and 9’3per cent. of the complete( Hurry Fenwick demonstrated to a large gathering of the I cases in 1885 and 1886, and rose in 1887 to 11’4 per cent. Medical Society on Monday, Jan. 23rd, are indeed triumphs must, however, be borne in mind that these hospitals con of science over grave mechanical difficulties. A reliable index of the progressiveness of the medical profession is tained 2094 cases at the end of last year, against 496 at th by the rapidity with which almost every innovation beginning, and that by far the larger proportion of th afforded or advance in science is laid under contribution and utilised former number were at the close of the year practically to the improvement of the diagnosis and the treatment of convalescent, the discharge of which as recoveries in th disease. As an instance in point, we now find the surgeon first few weeks of this year will reduce the proportion: enabled to pass an incandescent lamp into the male bladder mortality of the cases admitted in 1887. It seems im without pain or danger, and to examine every detail of that
Annotations.
Europe.
States.
185 viscus in as brilliantly illuminated a condition as if it was viewed in direct sunlight. Surely, with such instruments as these at command, we shall now have fewer uncertain diagnoses of "obscure vesical disease." Increased knowledge and improved methods of diagnosis and treatment have greatly influenced the statistics of large calculi. It is not too much to expect that a similar limitation will in future be placed upon benign vesical growths, for by means of the electric
pose, if a true one, is not lost because of an unsuccessful issue, but in some way or other always exerts its force as a co-efficient in the work of progress. Though it do not reach the intended goal, it may find some other-perhaps a better,--and in any case has a place in that long battle of mind and circumstance by which character is formed. " There shall *
What
never
be
one
*
lost
What was, shall live
good !
*
*
*
as
before;
*
shall be
good good. light they may now be diagnosed in their earliest stages. * Mr. Fenwick, in his opening words, regretted, we may add On the earth the broken arcs; in the heaven a perfect round." that the only unsatisfactory feature of this new resource is The value of a high ideal is necessarily recognised in the the fact that its conception and final stage of perfection life which is ruled by this heroic standard, and it is well emanates from our Austrian confreres rather than from an expressed in the following lines :source. was
*
English
EXPERIMENTAL NEPHRITIS.
"
M. GAUCHER recognises many varieties of the large white kidney characterised by different etiologies. Some cases of nephritis are derived from a previous infectious disease; others arise from cold, or cutaneous disturbances secondary to this; yet a third set may be of toxic origin. But apart from saturnine nephritis, which is an interstitial affection of special kind, the mineral poisons may set up an acute nephritis. M. Gaucher has attempted to prove that autochthonous poisoning is a not infrequent cause of the large white kidney. The poison is the result of incomplete oxidation of azotised matters. By introducing subsutaneously in guinea-pigs for a certain number of days an
increasing quantity of creatine, leucine, tyrosine, creatinin, xanthin, or hypoxanthin in aqueous solution, the animal is rendered albuminuric, and eventually dies with (as the necropsy shows) an epithelial nephritis like the large white kidney. The accumulation of extractive matters in the blood may then, by elimination of the same through the kidneys, set up irritation of the secreting epithelium, and so produce parenchymatous nephritis. The idea is eminently reasonable. Hepatic disease may perturb the metabolic arrangements of the body in such a way as to lead to excessive accumulation of these products of imperfect metamorphosis of proteids. -
BROWNING ON
"LIFE."
many persons wnose
*
*
*
" Better have failed in the high aim as I, Than vulgarly in the low aim succeed, As, God be thanked, I do not!
-
IN all times tnere nave been
*
Some, who are easily satisfied with a minimum of profitable exertion, would do well to cultivate this spirit of courageous
enterptise.
THE VAGINAL AND UTERINE LOCHIÆ. DR. ALBERT D6DERLEIN of Leipsig has published some researches on the bacteriology of the lochial discharges of women in both normal and diseased puerperal states. He finds that the vaginal discharge must be examined separately from that which originates within the uterus, the clinical importance of micro-organisms being very different in the two cases. The vaginal lochia always contains a multitude of germs of various kinds, and if introduced into the bodies of animals is capable of producing abscesses. The uterine lochia, on the other hand, contains in the normal puerperal condition no germs whatever. When these appear, or at least soon after their appearance, a rise of temperature occurs, and when this latter has fallen the lochia is again found free from germs. Its removal appears to be due to increased secretion and separation of pus cells. Healthy uterine lochia may be introduced into the bodies of animals without causing any harm, but when there is fever and it contains germs septic symptoms in the animals are produced. In some cases not merely germs but streptococci have been found in the uterine discharges of patients with puerperal
fever.
tenaency
in calculating the purposes and results of human life was to strike the balance unfairly, and to make the most of losses while gains were but little considered. We are all, indeed, occasionally prone to recite the preacher’s saying that " all is vanity," forgetful that this is regarded even by him as an inconclusive statement, and applicable mainly to his own experience. It is therefore all the more refreshing to find that some who have also made the world their school have arrived at an opposite opinion. Among these is Mr. Robert Browning. He is, as regards the course of human nature, an optimist. This fact, indeed, may explain his unpopularity with a certain class of readers. It is probable, at all events, that the lack of appreciation displayed by some critics of his works is partly due to a want of his firm and deep conviction that there is a needful struggle between good and evil, which must certainly end in the
-
___
FEVER IN LONDON. ALTOGETHER 134 patients were admitted into the hospitals of the Metropolitan Asylums Board during the week ending Jan. 20th. Of these, 119 were suffering from scarlet fever, 12 from enteric fever, 2 from small-pox, and in one the nature of the illness was doubtful. The small-pox cases were received from the parishes of Bethnal-green and St. Pancras. In the week ending Jan. 14th the total deaths in the metropolis from scarlet fever were 25, the corrected average for the same week during the preceding ten years being 42.7.
CLUB PRACTICE IN LEIPSIG.
THE Amalgamated Mutual Benefit Societies of Leipsig have issued an intimation that, owing to the unsatisfactory state of their finances, they are obliged to cut down the meditriumph of the former. Life, according to the poet, cal fees to little more than half what they have hitherto is worth living even when it ends in honest failure. been-that is to say, in place of Is. per visit the medical officers will now receive only about 6¼d. The fee for advice This world’s no blot for us, Nor blank; it means intensely, and means good." at the doctor’s house will be about 3 3/4d. The members of the We are pleased to find this fact brought out with ampla force societies, who are shrewd enough to see the extreme folly of illustration in a paper read by Mr. Edward Berdoe, M.R.C.S., of such a miserable cheeseparing policy, have met in large at University College, and entitled " Browning’s Estimate numbers, and passed resolutions strongly protesting against of Life." The theme of all the poet’s work, as here explained, the indignity offered to the medical officers, and the absurdity is" that no factors in our life (however unpromising they of supposing that adequate medical attendance can be obmay appear) can be spared consistently with our develop- tained for such a miserable sum. This episode may be ment and progress." Life, though in one sense a vapour commended to the attention of some dispensary doctors and and a shadow, is in another much more than this. Its pur- their patients.
, 1888.
occurred in the Metropolitan Asylum Hospitals situated possible to doubt that the invaluable sanitary work now outside the boundaries of Registration London. These deaths being done by the Metropolitan Asylum Board affords the were equal to an annual rate of 0’34 per 1000 of the esti- true explanation of the control which was maintained over mated population of the metropolis, against 0’43 from the what threatened to be, but cannot be called a severe epidemic same disease in the twenty-seven large provincial towns of scarlet fever in London last year. dealt with in the Registrar-General’s weekly return, and having an aggregate populaticn somewhat exceeding that of London. The highest death-rates from scarlet fever in those towns during last year were 0’90 in Birkenhead, " Ne quid nimis." 0’96 in Bristol, and 1’36 in Blackburn, each of these HOMŒOPATHY IN THE UNITED STATES. rates being about three times as high as the London rate. If we compare the London rate from scarlet fever IT is an awkward fact in the homoeopathic world that last year with the rates from this disease in the metro- its leading practitioner in London has written a book to show polis in previous years, we find that it showed a con- that contraria contrariis curantur is as much a principle as siderable increase upon the unprecedentedly low rates in similia similibus curantur. There is abundant evidence that other homoeopaths act on this practitioner’s varied prin1885 and 1886, but that it was lower than the rate in ciples in serious circumstances, though they have not the any previous year of which record exists; it was very little same courage of avowal as he. " J. C. B.," Dr. George more than half the mean annual rate during the ten years Johnson, and others, have published in The Times proofs 1871-80, which again was little more than half the mean rate of what everybody knows, that homoeopaths no longer are in the preceding decennium. It being therefore a fact that wedded to infinitesimal doses. When this break down of the death-rate from scarlet fever in London during last year homoeopathy in the hands of its own practitioners is shown, no wonder that it meets with little respect in the was not only below the mean rate in preceding years, but profession, and that in Europe it has practically no recogalso lower than the mean rate during last year in other nition. When the failure of homoeopathy in Europe is large English towns, it becomes interesting to inquire why pressed on its advocates, the unbelievers are referred to the increasing prevalence of the disease in the metropolis the United States. That is a large reference. Medical law gave rise to such exaggerated impressions of the extent and is very easy there, and so is medical education. In fact,the nature of the epidemic. The answer to this inquiry pro- best men in the profession in the States mourn over the rate at which medical men are turned out of the numerous combably also explains why the fatal results of the outbreak peting schools; and we publish a letter to-day showing were confined within such comparatively moderate limits. that homoeopaths in the States are just as little loyal to The number of cases of scarlet fever admitted for isolation Hahnemann as homœopaths here. Dr. Potter is Professor of and treatment into the various hospitals of the Metropolitan the Practice of Physic in the Cooper Medical College, San Asylum Board, which had been 1399 and 1789 in 1885 Francisco, and writes with a complete knowledge of both and 1886, rose to 5933 in 1887. Thus, while the deaths systems and both schools. His letter is far too good, and is quite uncalled for as a refutation of any incorrect statefrom scarlet fever in London in 1887 were only ments about himself in the Homceopathic Reviem meant twice as many as in the previous year, the number to disparage his damaging authority. So regarding it in of cases admitted into these hospitals was more than August, we did not publish it in full, but contented ourthree times as many. It was pointed out in the Registrar- selves with an editorial notice of it. But we think it General’s last annual summary that in 1878 the deaths from well to publish it now, for the light it throws on scarlet fever in the Metropolitan Asylum and the London the homoeopaths of America, whose numbers and practo astonish and stimulate the dull mind Fever Hospitals were equal to but 7 per cent. of all the tice are paraded of Dr. Potter left the homoeopathic school deaths from this cause in London, whereas the proportion because what he saw showed him that no crucial drug rose steadily to 13-2 per cent. in 1883, 17-6 in 1884, 20-2 experimentation conducted under scientific safeguards could in 1885, and 22-7 in 1886. In 1887, of the 1447 deaths meet with any degree of appreciation from the majority of from scarlet fever in London, 500 occurred in the Metro- that sect, and because of the impression made on him by politan Asylum Hospitals and 27 in the London FeveI finding that ninety-nine out of every hundred. so-called were in the habit of resorting to Hospital; these 527 deaths were equal to 36-5 per cent. oi homœopathic physicians whenever there was any active therapy the total deaths from the disease, showing a further con- regular therapeutics to be done. So much for the homoeopathy of the United siderable increase upon the steadily increasing proportion: It is as unreal as the homceopathy of Europe. in the nine preceding years. Judged by the hospital returns, the case-mortality of scarlet fever in 1887 did not ELECTRIC ILLUMINATION OF THE MALE BLADDER materially differ from that in the preceding two years. Th< AND URETHRA. mortality of cases of scarlet fever in the Metropolitan TIlE electric urethroscope and vesicoscopes which Mr. Asylum Hospitals was 9’8 and 9’3per cent. of the complete( Hurry Fenwick demonstrated to a large gathering of the I cases in 1885 and 1886, and rose in 1887 to 11’4 per cent. Medical Society on Monday, Jan. 23rd, are indeed triumphs must, however, be borne in mind that these hospitals con of science over grave mechanical difficulties. A reliable index of the progressiveness of the medical profession is tained 2094 cases at the end of last year, against 496 at th by the rapidity with which almost every innovation beginning, and that by far the larger proportion of th afforded or advance in science is laid under contribution and utilised former number were at the close of the year practically to the improvement of the diagnosis and the treatment of convalescent, the discharge of which as recoveries in th disease. As an instance in point, we now find the surgeon first few weeks of this year will reduce the proportion: enabled to pass an incandescent lamp into the male bladder mortality of the cases admitted in 1887. It seems im without pain or danger, and to examine every detail of that
Annotations.
Europe.
States.
185 viscus in as brilliantly illuminated a condition as if it was viewed in direct sunlight. Surely, with such instruments as these at command, we shall now have fewer uncertain diagnoses of "obscure vesical disease." Increased knowledge and improved methods of diagnosis and treatment have greatly influenced the statistics of large calculi. It is not too much to expect that a similar limitation will in future be placed upon benign vesical growths, for by means of the electric
pose, if a true one, is not lost because of an unsuccessful issue, but in some way or other always exerts its force as a co-efficient in the work of progress. Though it do not reach the intended goal, it may find some other-perhaps a better,--and in any case has a place in that long battle of mind and circumstance by which character is formed. " There shall *
What
never
be
one
*
lost
What was, shall live
good !
*
*
*
as
before;
*
shall be
good good. light they may now be diagnosed in their earliest stages. * Mr. Fenwick, in his opening words, regretted, we may add On the earth the broken arcs; in the heaven a perfect round." that the only unsatisfactory feature of this new resource is The value of a high ideal is necessarily recognised in the the fact that its conception and final stage of perfection life which is ruled by this heroic standard, and it is well emanates from our Austrian confreres rather than from an expressed in the following lines :source. was
*
English
EXPERIMENTAL NEPHRITIS.
"
M. GAUCHER recognises many varieties of the large white kidney characterised by different etiologies. Some cases of nephritis are derived from a previous infectious disease; others arise from cold, or cutaneous disturbances secondary to this; yet a third set may be of toxic origin. But apart from saturnine nephritis, which is an interstitial affection of special kind, the mineral poisons may set up an acute nephritis. M. Gaucher has attempted to prove that autochthonous poisoning is a not infrequent cause of the large white kidney. The poison is the result of incomplete oxidation of azotised matters. By introducing subsutaneously in guinea-pigs for a certain number of days an
increasing quantity of creatine, leucine, tyrosine, creatinin, xanthin, or hypoxanthin in aqueous solution, the animal is rendered albuminuric, and eventually dies with (as the necropsy shows) an epithelial nephritis like the large white kidney. The accumulation of extractive matters in the blood may then, by elimination of the same through the kidneys, set up irritation of the secreting epithelium, and so produce parenchymatous nephritis. The idea is eminently reasonable. Hepatic disease may perturb the metabolic arrangements of the body in such a way as to lead to excessive accumulation of these products of imperfect metamorphosis of proteids. -
BROWNING ON
"LIFE."
many persons wnose
*
*
*
" Better have failed in the high aim as I, Than vulgarly in the low aim succeed, As, God be thanked, I do not!
-
IN all times tnere nave been
*
Some, who are easily satisfied with a minimum of profitable exertion, would do well to cultivate this spirit of courageous
enterptise.
THE VAGINAL AND UTERINE LOCHIÆ. DR. ALBERT D6DERLEIN of Leipsig has published some researches on the bacteriology of the lochial discharges of women in both normal and diseased puerperal states. He finds that the vaginal discharge must be examined separately from that which originates within the uterus, the clinical importance of micro-organisms being very different in the two cases. The vaginal lochia always contains a multitude of germs of various kinds, and if introduced into the bodies of animals is capable of producing abscesses. The uterine lochia, on the other hand, contains in the normal puerperal condition no germs whatever. When these appear, or at least soon after their appearance, a rise of temperature occurs, and when this latter has fallen the lochia is again found free from germs. Its removal appears to be due to increased secretion and separation of pus cells. Healthy uterine lochia may be introduced into the bodies of animals without causing any harm, but when there is fever and it contains germs septic symptoms in the animals are produced. In some cases not merely germs but streptococci have been found in the uterine discharges of patients with puerperal
fever.
tenaency
in calculating the purposes and results of human life was to strike the balance unfairly, and to make the most of losses while gains were but little considered. We are all, indeed, occasionally prone to recite the preacher’s saying that " all is vanity," forgetful that this is regarded even by him as an inconclusive statement, and applicable mainly to his own experience. It is therefore all the more refreshing to find that some who have also made the world their school have arrived at an opposite opinion. Among these is Mr. Robert Browning. He is, as regards the course of human nature, an optimist. This fact, indeed, may explain his unpopularity with a certain class of readers. It is probable, at all events, that the lack of appreciation displayed by some critics of his works is partly due to a want of his firm and deep conviction that there is a needful struggle between good and evil, which must certainly end in the
-
___
FEVER IN LONDON. ALTOGETHER 134 patients were admitted into the hospitals of the Metropolitan Asylums Board during the week ending Jan. 20th. Of these, 119 were suffering from scarlet fever, 12 from enteric fever, 2 from small-pox, and in one the nature of the illness was doubtful. The small-pox cases were received from the parishes of Bethnal-green and St. Pancras. In the week ending Jan. 14th the total deaths in the metropolis from scarlet fever were 25, the corrected average for the same week during the preceding ten years being 42.7.
CLUB PRACTICE IN LEIPSIG.
THE Amalgamated Mutual Benefit Societies of Leipsig have issued an intimation that, owing to the unsatisfactory state of their finances, they are obliged to cut down the meditriumph of the former. Life, according to the poet, cal fees to little more than half what they have hitherto is worth living even when it ends in honest failure. been-that is to say, in place of Is. per visit the medical officers will now receive only about 6¼d. The fee for advice This world’s no blot for us, Nor blank; it means intensely, and means good." at the doctor’s house will be about 3 3/4d. The members of the We are pleased to find this fact brought out with ampla force societies, who are shrewd enough to see the extreme folly of illustration in a paper read by Mr. Edward Berdoe, M.R.C.S., of such a miserable cheeseparing policy, have met in large at University College, and entitled " Browning’s Estimate numbers, and passed resolutions strongly protesting against of Life." The theme of all the poet’s work, as here explained, the indignity offered to the medical officers, and the absurdity is" that no factors in our life (however unpromising they of supposing that adequate medical attendance can be obmay appear) can be spared consistently with our develop- tained for such a miserable sum. This episode may be ment and progress." Life, though in one sense a vapour commended to the attention of some dispensary doctors and and a shadow, is in another much more than this. Its pur- their patients.