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EXTRANEOUS DEPOSITS IN URINE.
825
Germany such a pretender would Dr. Mezger of Amsterdam in 1853, has come to 4e employed the "Faith Healers"and be promptly in medicine only in a well-defined class of cases-employed, suppressed, but the forcible extinction of any sect, however moreover, by persons specially qualified and certified and absurd, would in this country lead to indignant protest acting under the direction of the physician or surgeon in and to a rapid increase in the number of adherents to attendance. In the training of such persons the Swedish the persecuted cause," so easily is the insanity of sanity schools-notably, Stockholm and Upsala-have, greatly brought into evidence. In the present instance, as in the past, to their honour, taken a lead, granting a diploma to aspiring ‘° masseurs " and " masseuses " only after we can but indicate the medical man as being the only means by which Mr. Pigott and his co-delusionists can be thorough examination. So practised and medically controlled medical examination A dealt with. massage is an important adjunct to treatment, thorough by properly experts in the investigation of mental obliquity would steadily, if slowly, living down professional disfavour and probably result in the transference of impostors of this class misgiving, due to such disastrous products as the "massageto the seclusion of an asylum where their vagaries could only kidney" and other such lesions which we hope Hindoos be carried on under restricted conditions. To deal with as well asEuropeans " will ere long know nothing " them as seriously deserving of logical treatment is as about. impossible as is the attempt to argue a general paralytic PTOMAINE POISONING. out of his fool’s paradise. organisations.
In
share the fate of
____
-
I places
CASES of ptomaine poisoning have occurred in several in addition to those which were mentioned in Ix that much-perused romance of the last publishing ’fHE LANCET of Sept. 13th, p. 756, and in each instance season, "Kim," its author, Mr. Rudyard KipliDg. gives an the source can be traced to pork pies purchased from the Six persons were seized at elaborate description of the cure of the said"Kimwhen same pork-butcher at Derby. whom from of one has since died. Several people it would suffering general malaise, induced, appear, Sheffield, were also attacked at one case mental and The in Uttoxeter, Sahiba, proving fatal. by prolonged fatigue, bodily. whose hands he was a half-comatose and wholly unresisting A family of seven persons at Walthamstow were taken ill patient, began the treatment with what seem to have been after having partaken of a pie sent from Derby, and very drastic emetics-" drenches that smelt pestilently and at Cheltenham a number of persons were reported ill Dr. Sheridan Delepine has 1-)retasted worse. She stood over Kim till they went down and from a similar cause. his to sented the had after come ’’ when report Sanitary Committee of the Derby inquired exhaustively they up." Then, the body was cleared, "she called in a sister practitioner- I I a Corporation on the samples of pork pie entrusted to. He had succeeded in isolating a bacillus belongcousin’s widow, skilled in what Europeans, who know him. nothing about it, call massage. Thereupon, the two ing to the colon group, which he considered had proof them, laying him east and west that the mysterious duced the symptoms observed. The full report has not yet. earth-currents, which thrill the clay of our bodies, might been published, but we understand that Dr. Delepine is of help and not hinder, took him to pieces all one long after- opinion that the meat or the jelly, or both, used in the noon-bone by bone, muscle by muscle, ligament by pies became infected in the course of preparation, whilst ligament, nerve by nerve. Kneaded to irresponsible pulp, the flour, lard, and seasoning of the pies were not contamihalf hypnotised by the perpetual flick and readjustment nated. He further shows that animals inoculated with theof the uneasy chudders that veiled their eyes, Kim bacillus have died and the same variety of bacillus has been If these stateslid 10,000 miles into slumber-36 hours of it-sleep that isolated from the blood of those animals. soaked like rain after drought." On emerging from this, the ments have been correctly reported, the present outbreak Sahiba fed him on ’’ fowls, vegetables, spices, milk, and cannot accurately be termed one of "ptomainepoisoning.. onion, with little fish from the brook-anon, limes for The symptoms were caused apparently by the toxins sherbets, quails of the pit, then chicken livers upon a eliminated by the colon bacillus, and their pathology would skewer, with sliced ginger between." As the result of this materially differ from previous outbreaks which have been "massage" (which Europeans know nothing about), followed due to alkaloids formed by decomposition of organic subby the strangely-compounded meal (of which they are stances due to putrefactive organisms. equally ignorant), "Kim," we are assured, "sat up and smiled. The terrible weakness had dropped from him EXTRANEOUS DEPOSITS IN URINE. like an old shoe." He had, it is right to say, "youth STRANGE errors occasionally are made in determining th& on his side "-such an allowance of it, in fact, as enabled nature and source of urinary deposits. Quite recently we him to survive first the "massage"" and then the meal." received a communication from a correspondent who stated What, indeed, but I I youth " and a general ’’resisting- that he had been attending a patient suffering from subpower " as abnormal as the treatment can explain the fact acu e muscular rheumatism and who had been taking a that, already semi-comatose with histolytic waste in the of sulphur in milk every night. The urine was teaspoonful system, he could yet find room in his circulation and turbid, and deposited amorphous sulphur. Our excretive energy in his kidneys for the accumula- slightly (correspondent had eliminated the usual sources of accition of still further waste contributed by a kneading (dental contamination such as cleanliness of the collecting process, uninterrupted for a long afternoon, and prac- vessel and purposeful addition and asked for information tised by two sinewy hags who did not leave off till as to whether sulphur could be eliminated by the kidney in a " every tissue in his body was reduced to pulp Kim’s solid form. In a subsequent letter, however, he stated that services to British rule in India were, Mr. Kipling tells us, he had questioned his patient more closely and he found that of signal value. The bequest of his body to the museum of she had been in the habit of using a dusting powder conthe Calcutta Medical College, in the remote sulphur for local irritation. A similar case was also taining of his death, would be of no less value to pathological to our notice in which a specimen of urine was sent science. But, persiflage apart, Mr. Kipling’s claim for the brought f for examination under the supposition that it contained superiority of Hindoo massage, as practised by the Sahiba,‘"amyloid corpuscles," bodies which somewhat resemble over the European massage, as performed by an expert under s starch granules in appearance owing to their concentric duly qualified medical advice, is but another instance of the vvariations. They occur in the semen and hence the loose talk in which even clever men indulge on subjects outside their competence. Massage, in fact, since its revival by 1 THE LANCET, Oct. 2nd, 1897, p. 868.
MASSAGE AND
"MASSAGE."
"
1
"
: ‘
contingencyt
826
practitioner who sent the sample thought that they skin that a snake doth cast off, gotten or gathered when the might occasionally find their way into the urine. moon is in the full, being also in the first part of Aries the In this case, also, questioning the patient showed that Ram, he shall see terrible and fearful dreams. And if he the source of the deposit was a powder containing shall have it under the sole of his foot he shall be acceptable In another instance, in which a urine contained before magistrates and princes." starch. a sediment of "uncertain character," microscopic examination revealed the presence of the threads of leptothrix SCOTTISH POOR-LAW MEDICAL OFFICERS. buccalis together with fragments of meat and vegetable SOME little time ago Mr. Galloway Weir, M.P., asked for fibres, thus plainly indicating that the deposit originally a return of those Scottish Poor-law medical officers who had came from the mouth. Patients occasionally add substances been dismissed by their parish councils: The report is now to the urine for purposes of deception, but the above cases published and shows "the number of medical officers dis. show how important it is not only to make sure that the missed by parish councils in each crofting county during collecting and examining vessels are perfectly clean, but each of the seven years 1895-1901, name of the parish that in doubtful cases the patients themselves should be council, and the cases in which a cause of dismis al was as to possible sources of error. Other extraneous matters also lead to mistakes and we have seen a fragment of pine-wood from the floor mistaken for an epithelial cast ; moreover, particles of silk, cotton, or linen fibres frequently puzzle students who are not conversant with their nature.
carefully questioned
____
SNAKE-BITE AND SNAKE-LORE. THE subject of snake-bite may occasionally engage the individual practitioner in a moorland country-side where, especially in the summer and autumn, cases are not unknown of infants dying from collapse after being bitten by vipers. We have recently been informed that the " infallible remedy"used by Brusher"Mills, the well-known New Forest snake catcher, for the bite of the adder or viper is the fat of the creature itself melted, bottled, and applied a drop at a time to the wound. The cure, he asserts, is an affair of two minutes. Mills has, of course, had immense experience with snakes, having in his day killed or taken more than 4000 venomous and 27,000 harmless specimens. He has, in fact, practically devastated his own field of operations round Lyndhurst. His belief in his remedy is shared by Wiltshire and Hampshire rustics and is doubtless universal in the country districts of England. The is whether this treatment is a survival of question merely the old savage homoeopathy which ordains a hair of the dog that bit you as a cure for the bite, or whether it is a rude form of serum-therapy. Vipers are exceedingly quarrelsome from the moment they break the egg and unless immune " We publish this return with pleasure. It wil against venom would long ago have ceased to exist as a assigned. serve to show intending applicants for Scottish Poor-law distinct species. Hence their fat may be a kind of It will Of course, all fatty and oily substances are appointments which parishes should be avoided. antitoxin. be that Irish medical remembered and Poor-law English useful against poisons, which they doubtless absorb and isolate. The old-fashioned " London viper catchers," officers have a right of appeal to their respective Local mentioned by White of Selborne and others always Government Boards but the Scottish Poor-law medical otlicer has none. employed hot olive oil as a cure or treatment for snake-bite, and this with ammonia continues to be GENERAL PARALYSIS AND ITS TREATMENT BY recommended. We read of the oil-cure in works on THE MIXED METHOD. natural history but find no mention of the peasants’ use of M. DEVAY of Lyon published in Le Progres Medical of fat. How came it to be used in the first instance? Prob23rd a communication regarding the treatment of August in with the that accordance fat, blood, ably savage theory sputum and so forth, contain the life-principle or "soul" general paralysis of the insane by the "mixed intensive" of men and animals and are therefore a cure for any lesion. method of mercury and the iodides, a method allied to Fat was anciently used to frighten away serpents from the treatment with benzoate of mercury published by gardens and houses. The "suet of deer strewed up and Professor Lemoine and to1 which reference was recently He has treated in all 90 down where they [adders] come will cause them to depart," made in these columns. cases and gives the results obtained in 21 cases, the latter says Agrippa of Nettesheim, whose ideas, despite his scepticism, were often those of the tribal medicine-man. Bacon consisting of patients the course of whose illness was fat, mixed with the brains of a weazel, is recommended by watched for some length of time. The results obtained by him to scare away rats and mice. Drugs and charms obtained M. Devay are summed up by him under the headings of from snakes are, of course, very ancient. The witches in amelioration, remission, and morbification of the symptoms Macbeth make a baleful viper-broth, but the same mix- of general paralysis, and on the whole the issues were Although accepting the theory of the parature was also a medicine and core for many diseases. favourable. The sloughs of snakes had also The sixteenth syphiliticnature of the disease he does not regard the uses. ____
"
singular
century Jerome
saying,
Cardan is quoted in an old chap-book as "If any do sprinkle his head with the powder of
a
1 THE LANCET, Sept. 6th, 1902, p. 690, annotation On the " Intensive " Mercurial Treatment of General Paralysis and Tabes Dorsalis.
Germany such a pretender would Dr. Mezger of Amsterdam in 1853, has come to 4e employed the "Faith Healers"and be promptly in medicine only in a well-defined class of cases-employed, suppressed, but the forcible extinction of any sect, however moreover, by persons specially qualified and certified and absurd, would in this country lead to indignant protest acting under the direction of the physician or surgeon in and to a rapid increase in the number of adherents to attendance. In the training of such persons the Swedish the persecuted cause," so easily is the insanity of sanity schools-notably, Stockholm and Upsala-have, greatly brought into evidence. In the present instance, as in the past, to their honour, taken a lead, granting a diploma to aspiring ‘° masseurs " and " masseuses " only after we can but indicate the medical man as being the only means by which Mr. Pigott and his co-delusionists can be thorough examination. So practised and medically controlled medical examination A dealt with. massage is an important adjunct to treatment, thorough by properly experts in the investigation of mental obliquity would steadily, if slowly, living down professional disfavour and probably result in the transference of impostors of this class misgiving, due to such disastrous products as the "massageto the seclusion of an asylum where their vagaries could only kidney" and other such lesions which we hope Hindoos be carried on under restricted conditions. To deal with as well asEuropeans " will ere long know nothing " them as seriously deserving of logical treatment is as about. impossible as is the attempt to argue a general paralytic PTOMAINE POISONING. out of his fool’s paradise. organisations.
In
share the fate of
____
-
I places
CASES of ptomaine poisoning have occurred in several in addition to those which were mentioned in Ix that much-perused romance of the last publishing ’fHE LANCET of Sept. 13th, p. 756, and in each instance season, "Kim," its author, Mr. Rudyard KipliDg. gives an the source can be traced to pork pies purchased from the Six persons were seized at elaborate description of the cure of the said"Kimwhen same pork-butcher at Derby. whom from of one has since died. Several people it would suffering general malaise, induced, appear, Sheffield, were also attacked at one case mental and The in Uttoxeter, Sahiba, proving fatal. by prolonged fatigue, bodily. whose hands he was a half-comatose and wholly unresisting A family of seven persons at Walthamstow were taken ill patient, began the treatment with what seem to have been after having partaken of a pie sent from Derby, and very drastic emetics-" drenches that smelt pestilently and at Cheltenham a number of persons were reported ill Dr. Sheridan Delepine has 1-)retasted worse. She stood over Kim till they went down and from a similar cause. his to sented the had after come ’’ when report Sanitary Committee of the Derby inquired exhaustively they up." Then, the body was cleared, "she called in a sister practitioner- I I a Corporation on the samples of pork pie entrusted to. He had succeeded in isolating a bacillus belongcousin’s widow, skilled in what Europeans, who know him. nothing about it, call massage. Thereupon, the two ing to the colon group, which he considered had proof them, laying him east and west that the mysterious duced the symptoms observed. The full report has not yet. earth-currents, which thrill the clay of our bodies, might been published, but we understand that Dr. Delepine is of help and not hinder, took him to pieces all one long after- opinion that the meat or the jelly, or both, used in the noon-bone by bone, muscle by muscle, ligament by pies became infected in the course of preparation, whilst ligament, nerve by nerve. Kneaded to irresponsible pulp, the flour, lard, and seasoning of the pies were not contamihalf hypnotised by the perpetual flick and readjustment nated. He further shows that animals inoculated with theof the uneasy chudders that veiled their eyes, Kim bacillus have died and the same variety of bacillus has been If these stateslid 10,000 miles into slumber-36 hours of it-sleep that isolated from the blood of those animals. soaked like rain after drought." On emerging from this, the ments have been correctly reported, the present outbreak Sahiba fed him on ’’ fowls, vegetables, spices, milk, and cannot accurately be termed one of "ptomainepoisoning.. onion, with little fish from the brook-anon, limes for The symptoms were caused apparently by the toxins sherbets, quails of the pit, then chicken livers upon a eliminated by the colon bacillus, and their pathology would skewer, with sliced ginger between." As the result of this materially differ from previous outbreaks which have been "massage" (which Europeans know nothing about), followed due to alkaloids formed by decomposition of organic subby the strangely-compounded meal (of which they are stances due to putrefactive organisms. equally ignorant), "Kim," we are assured, "sat up and smiled. The terrible weakness had dropped from him EXTRANEOUS DEPOSITS IN URINE. like an old shoe." He had, it is right to say, "youth STRANGE errors occasionally are made in determining th& on his side "-such an allowance of it, in fact, as enabled nature and source of urinary deposits. Quite recently we him to survive first the "massage"" and then the meal." received a communication from a correspondent who stated What, indeed, but I I youth " and a general ’’resisting- that he had been attending a patient suffering from subpower " as abnormal as the treatment can explain the fact acu e muscular rheumatism and who had been taking a that, already semi-comatose with histolytic waste in the of sulphur in milk every night. The urine was teaspoonful system, he could yet find room in his circulation and turbid, and deposited amorphous sulphur. Our excretive energy in his kidneys for the accumula- slightly (correspondent had eliminated the usual sources of accition of still further waste contributed by a kneading (dental contamination such as cleanliness of the collecting process, uninterrupted for a long afternoon, and prac- vessel and purposeful addition and asked for information tised by two sinewy hags who did not leave off till as to whether sulphur could be eliminated by the kidney in a " every tissue in his body was reduced to pulp Kim’s solid form. In a subsequent letter, however, he stated that services to British rule in India were, Mr. Kipling tells us, he had questioned his patient more closely and he found that of signal value. The bequest of his body to the museum of she had been in the habit of using a dusting powder conthe Calcutta Medical College, in the remote sulphur for local irritation. A similar case was also taining of his death, would be of no less value to pathological to our notice in which a specimen of urine was sent science. But, persiflage apart, Mr. Kipling’s claim for the brought f for examination under the supposition that it contained superiority of Hindoo massage, as practised by the Sahiba,‘"amyloid corpuscles," bodies which somewhat resemble over the European massage, as performed by an expert under s starch granules in appearance owing to their concentric duly qualified medical advice, is but another instance of the vvariations. They occur in the semen and hence the loose talk in which even clever men indulge on subjects outside their competence. Massage, in fact, since its revival by 1 THE LANCET, Oct. 2nd, 1897, p. 868.
MASSAGE AND
"MASSAGE."
"
1
"
: ‘
contingencyt
826
practitioner who sent the sample thought that they skin that a snake doth cast off, gotten or gathered when the might occasionally find their way into the urine. moon is in the full, being also in the first part of Aries the In this case, also, questioning the patient showed that Ram, he shall see terrible and fearful dreams. And if he the source of the deposit was a powder containing shall have it under the sole of his foot he shall be acceptable In another instance, in which a urine contained before magistrates and princes." starch. a sediment of "uncertain character," microscopic examination revealed the presence of the threads of leptothrix SCOTTISH POOR-LAW MEDICAL OFFICERS. buccalis together with fragments of meat and vegetable SOME little time ago Mr. Galloway Weir, M.P., asked for fibres, thus plainly indicating that the deposit originally a return of those Scottish Poor-law medical officers who had came from the mouth. Patients occasionally add substances been dismissed by their parish councils: The report is now to the urine for purposes of deception, but the above cases published and shows "the number of medical officers dis. show how important it is not only to make sure that the missed by parish councils in each crofting county during collecting and examining vessels are perfectly clean, but each of the seven years 1895-1901, name of the parish that in doubtful cases the patients themselves should be council, and the cases in which a cause of dismis al was as to possible sources of error. Other extraneous matters also lead to mistakes and we have seen a fragment of pine-wood from the floor mistaken for an epithelial cast ; moreover, particles of silk, cotton, or linen fibres frequently puzzle students who are not conversant with their nature.
carefully questioned
____
SNAKE-BITE AND SNAKE-LORE. THE subject of snake-bite may occasionally engage the individual practitioner in a moorland country-side where, especially in the summer and autumn, cases are not unknown of infants dying from collapse after being bitten by vipers. We have recently been informed that the " infallible remedy"used by Brusher"Mills, the well-known New Forest snake catcher, for the bite of the adder or viper is the fat of the creature itself melted, bottled, and applied a drop at a time to the wound. The cure, he asserts, is an affair of two minutes. Mills has, of course, had immense experience with snakes, having in his day killed or taken more than 4000 venomous and 27,000 harmless specimens. He has, in fact, practically devastated his own field of operations round Lyndhurst. His belief in his remedy is shared by Wiltshire and Hampshire rustics and is doubtless universal in the country districts of England. The is whether this treatment is a survival of question merely the old savage homoeopathy which ordains a hair of the dog that bit you as a cure for the bite, or whether it is a rude form of serum-therapy. Vipers are exceedingly quarrelsome from the moment they break the egg and unless immune " We publish this return with pleasure. It wil against venom would long ago have ceased to exist as a assigned. serve to show intending applicants for Scottish Poor-law distinct species. Hence their fat may be a kind of It will Of course, all fatty and oily substances are appointments which parishes should be avoided. antitoxin. be that Irish medical remembered and Poor-law English useful against poisons, which they doubtless absorb and isolate. The old-fashioned " London viper catchers," officers have a right of appeal to their respective Local mentioned by White of Selborne and others always Government Boards but the Scottish Poor-law medical otlicer has none. employed hot olive oil as a cure or treatment for snake-bite, and this with ammonia continues to be GENERAL PARALYSIS AND ITS TREATMENT BY recommended. We read of the oil-cure in works on THE MIXED METHOD. natural history but find no mention of the peasants’ use of M. DEVAY of Lyon published in Le Progres Medical of fat. How came it to be used in the first instance? Prob23rd a communication regarding the treatment of August in with the that accordance fat, blood, ably savage theory sputum and so forth, contain the life-principle or "soul" general paralysis of the insane by the "mixed intensive" of men and animals and are therefore a cure for any lesion. method of mercury and the iodides, a method allied to Fat was anciently used to frighten away serpents from the treatment with benzoate of mercury published by gardens and houses. The "suet of deer strewed up and Professor Lemoine and to1 which reference was recently He has treated in all 90 down where they [adders] come will cause them to depart," made in these columns. cases and gives the results obtained in 21 cases, the latter says Agrippa of Nettesheim, whose ideas, despite his scepticism, were often those of the tribal medicine-man. Bacon consisting of patients the course of whose illness was fat, mixed with the brains of a weazel, is recommended by watched for some length of time. The results obtained by him to scare away rats and mice. Drugs and charms obtained M. Devay are summed up by him under the headings of from snakes are, of course, very ancient. The witches in amelioration, remission, and morbification of the symptoms Macbeth make a baleful viper-broth, but the same mix- of general paralysis, and on the whole the issues were Although accepting the theory of the parature was also a medicine and core for many diseases. favourable. The sloughs of snakes had also The sixteenth syphiliticnature of the disease he does not regard the uses. ____
"
singular
century Jerome
saying,
Cardan is quoted in an old chap-book as "If any do sprinkle his head with the powder of
a
1 THE LANCET, Sept. 6th, 1902, p. 690, annotation On the " Intensive " Mercurial Treatment of General Paralysis and Tabes Dorsalis.