EUGENICS AND DESCENT.

960

mainly from the antiserum, not from the albuminous material to the marked increase in the number of cottage and (" homologous proteid ") with which it reacts. The actual isolation hospitals during that period. The fact noted in solid content of precipitating antiserum is increased as com- the Registrar-General’s report that 32,899 deaths were pared with the normal serum from an animal of the same registered during 1905 in the 1833 hospitals included species. At present it is impossible to calculate the quantities in his list affords an entirely inadequate indication of of serum and homologous proteid which take part in the the constantly increasing benefit which these charitable reaction by any simple chemical equation, but the observers institutions confer on the public through the self-denying just quoted see no reason to doubt that a definite chemical and honorary services rendered by their surgical and medical reaction does occur. staffs. It seems impossible to doubt that the steady increase of hospital accommodation and service is at least one of the MEDICAL REFEREES UNDER THE NEW factors in the persistent improvement in public health during WORKMEN’S COMPENSATION ACT. the past 30 years. THE development of the scope of the Workmen’s ComSPARTEINE SULPHATE IN POST-OPERATIVE pensation Act, 1906, which comes into force on July lst SUPPRESSION OF URINE. next, by which it is estimated that 6,000,000 workers will IN the Medical Record of Jan. 19th the value of come under its provisions who were not affected by the Act of 1897, has caused us again to review carefully the sparteine sulphate in the prevention and the treatment Act in the interest of the medical profession. We of post-operative suppression of urine is recorded by Dr. have on several occasions pointed out that the ques- Stuart McGuire. Suppression of urine after an operation is tion of the regulations to be made by the Secretary found in cases where nephritis pre-existed owing to sepsis or of State for the Home Department is one of the cholasmia. As it does not develop until 24 or 36 hours after greatest importance, but the question of the appointment the operation it would appear that it is not due to shock. A of medical referees is, we venture to think, one of certainly patient operated on for retention of urine or jaundice not less moment. The medical referees under the new Act occasionally does well for two or three days and then will be called upon to decide between the conflicting suddenly passes no more urine, becomes listless, restless, views of medical practitioners, to give opinions in and then develops a stupor, rapidly deepening into a obscure and difficult surgical cases, and their decisions coma, and ultimately dies with all the symptoms chaare to be final ; they are therefore to act as judges, racteristic of ursemia. Dr. McGuire has a record of six from whose decisions there is no appeal. In these cases in which sparteine sulphate was the means circumstances it is perfectly clear that the practitioners of saving the patient’s life. The drug increases the blood selected for these posts must be of sufficient recognised pressure, makes the pulse slower and stronger, and acts as standing to possess the confidence of their medical con- a powerful diuretic. Doses of from one to two grains are freres in the several districts. Medical men will willingly given hypodermically and are repeated every three to six meet in consultation and place their considered opinions hours. The action is manifest in 30 minutes after adminisbefore a medical referee for final judgment and award tration and lasts for from four to six hours. Its employment where the medical referee enjoys a high professional position should not be delayed until suppression of urine occurs, since and reputation, but these qualifications are necessary if the it is a prophylactic as well as a curative agent. Dr. McGuire decisions of the referee are to be accepted as satisfactory prefers sparteine sulphate to the drugs of the digitalis type solutions of points in dispute. We trust that the Secretary owing to its rapidity of action and the efficiency of the of State will, in the appointment of medical referees under results. It is noteworthy that the dose recommended is large the Act, meet the wishes and requirements of the profession,as compared with the doses usually given-viz., one-tenth of Dr. McGuire failed to obtain good results with eo that the medical regulations may work smoothly anda grain. without friction. the usual remedies for suppression of urine, including the administration of water bv the mouth and rectum and under DEATHS IN PUBLIC INSTITUTIONS the skin, strychnine and nitro-glycerine, calomel and saline THE recently issued report of the Registrar-General calls Ipurgatives, hot packs, vapour baths, and counter-irritants. attention to the fact that during the year 1905 no fewer EUGENICS AND DESCENT. than 91,597, or 17’6 per cent., of the deaths registered in Mr. Brudenell Carter, in the current number of the England and Wales occurred in public institutions, including < workhouses and workhouse infirmaries, hospitals, and public Cornhill Magazine, writes a suggestive commentary upon It is, moreover, pointed out that the the t lunatic asylums. endeavour of Mr. Francis Galton to establish an ordered < of the conditions of parentage such as might average percentage of these institution deaths in the ten ]knowledge did not exceed 14 ’ 6. The increase t tend 1895-1904 towards the improvement of future generations of men, preceding years in the proportion of deaths in each of the three classes of that t a being sufficiently near definition of the science of institutions has, indeed, been marked and constant during"Eugenics." Mr. Carter’s light but learned essay will In 1875 the proportion of deaths regis- rhardly be regarded by Mr. Galton’s followers as encouraging, the past 30 years. tered in public institutions did not exceed 8’88 per cent., for f he evidently believes that we know as yet so little, at which was but half the percentage in 1905. It must, how- aany rate so little for certain, of the influences of heredity we are not in a position to say what is or what is not an t ever, be borne in mind that the number of these public insti- that ____

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tutions in which deaths are recorded has more than doubled atavistic a result, or where or when a " throwback " will occur. I is evident that to bring about a progressive improvement of during the 30 years. The separate workhouse establishments It have increased from 715 in 1875 to 816 in 1905 ; hospitals the t human race by a system of selective marriages would imply and infirmaries from 582 to 1833 ; and public lunatic asylums a total remodelling of our social theories and procedures, and from 83 to 136. The proportion of deaths recorded in work- before b embarking upon such a revolution we have a right to house establishments increased from 5’ 6 per cent. in 1875 ask a those who press it upon us how far they can predict any to 9-4 in 1905; the percentage of deaths in hospitals s surety of results to be obtained by selective mating. 11 into consideration the way that the world now lives, during the 30 years increased from 2’3 to 6’ 3, and in Taking it is beyond the power of prophecy to foretell that the public lunatic asylums from 0’9 to 1-9. The number of it c: of a good or successful man will display the hospitals in England and Wales has, it appears, more than children trebled during the 30 years under notice, owing mainly qualities or virtues which their parents have displayed. q

961 Modern civilisation has produced EO many complications, the rise and fall of commercial fortunes is so much more rapid, the commingling of classes is so much more general and intimate, that the parental influence whether moral or social has not the force that it formerly had. Physically the advocate of selective breeding is upon strong ground, for the whole world joins with the medical profession in condemning the union of the physically unfit. But the whole world also knows that we must not look to the heroes of muscular achievement as the ideal progenitors of a sane and well-balanced stock. We refer our readers to Mr. Carter’s interesting article in which, writing from something this point ofview, he shows that before any method of scientific race production can be considered by the legislature it will at least be necessary, to quote his words "that the laws of inheritance should be as firmly established as those of physics, and that the consequences pro. duced by violations of them should have been brought home to successive generations by the hard teachings of experience." ____

THE

INTERNATIONAL CONGRESS AND DEMOGRAPHY.

OF

HYGIENE

IT is announced that the Fourteenth International Congress of Hygiene and Demography will be held in Berlin from Sept. 23rd to 29th. The meetings will not continue longer than till 2 P.M. each day in order that the afternoons may be devoted to visiting the numerous hygienic institutions of Berlin and its environs. There are more than a hundred -such establishments which can be visited in this way, some of them without any restrictions and some by specially conducted parties. In order that the members of the congress may be able to select those in which they happen to feel most interest a "Hygienic Guide " will be issued containing short descriptions of the various institutes in three languages. Dr. Eilsberger, privy councillor in the Department of Public Worship and Education, is the president of the local committee. The general secretary of the congress is Dr. Nietner, Eichhornstrasse 9, Berlin 9 W.

BRIGHT SUNSHINE. DURING the last fortnight of last month the brilliance of the weather was extraordinary, as will be gauged from the

following figures

:-

*

No

trustworthy

average.

Such a general absence of cloud as is here indicated has not been experienced at the same time of year during the present generation and an excellent example is furnished of what the British climate would often be in early spring if anti-

and not cyclones, were the prevailing weather On the coast fog and mist were practically nonexistent except for a brief time about sunrise, and it was only in London that that unwelcome and belated visitor exercised any appreciable effect on the number of hours of sunshine. Had the atmosphere in the metropolis been as free from smoke and dust as it was in the country there is every reason to suppose that in spite of the almost stagnant air during the latter part of the period, which in the actual circumstances rendered the fog possible, London would have fared nearly as well As it was, the sunshine in as did the resorts on the coast. London (Westminster) for the whole month-152 hours-was much higher than any experienced during March since the automatic records commenced in 1881. While there can scarcely be a doubt as to the healthy influence of the abnormal sunshine it is questionable if the absence of rain which invariably accompanies anticyclonic weather is an unmixed blessing. London and several other districts bad no more than half the usual amount of rain during last month, and what is, perhaps, more serious still, the quantity that has fallen since Jan. lst in the metropolitan area and many other localities in the south and east of England has been only about 50 per cent. of the ordinary amount.

cyclones, systems.

CELLULITIS AND MYOSITIS OF THE ABDOMINAL WALL SIMULATING INTRA-ABDOMINAL DISEASE. IN the Journal of the American Medical Association of March 2nd Dr. J. M. Hitzrot has pointed out the close resemblance which may exist between inflammatory conditions of the abdominal wall and intra-abdominal disease-a subject which has received little attention. He relates the following case. A youth, aged 18 years, was admitted into hospital complaining of pain in the right side of the abdomen. He ate a heavy meal eight days before and awoke next morning with pain in the abdomen, at first diffused but later becoming localised on the right side. It was cramp-like and occurred in paroxysms. It disappeared for about three days, leaving only a dull ache in the right side. On the fourth day it returned in great severity to the right side, which gradually grew tender. At the onset the patient vomited and the vomiting recurred at intervals but was never distressing. The bowels were constipated but acted freely to medication. On examination the face was flushed, the pulse was 104, and the temperature was 103’6° F. The respiratory movements were limited above the umbilicus and were absen below it. The abdomen was slightly distended and everyIn the right iliac region was a hardI where slightly tender. readily defined, very tender mass, extending from the anterior border of the rectus well into the flank and from the level of the umbilicus to an inch from Poupart’s ligament. In this area there was marked muscular rigidity. Gentle percussion over the mass gave a tympanitic note. Acute appendicitis An incision was made with abscess was diagnosed. over the mass through the external oblique muscle. A small quantity of sero-sanguineous, slightly purulent fluid was found on the internal oblique muscle, which was oedematous and rather indurated. On cutting through it considerable oedema and induration were found in the subperitoneal tissue and the peritoneum seemed swollen and cedematous. The peritoneal cavity was opened and the intestines and appendix were found to be normal. As the appendix was very long it was removed. The peritoneum was carefully closed. The muscular and fascial layers were closely approximated, a drain was inserted at each angle of the wound down to the peritoneum, and the wound in the skin was closed with silk. A reddish grumous discharge of pus and muscle cells took place for about 12 days and the wound broke open. The discharge then