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INTRA-OCULAR AFFECTIONS AS SEQUELÆ OF NASAL DISEASES.
378 month of this incarceration, where the atmospheric depres- for consumption, in so far as filtration will do this. And he sion was such as to correspond with that of the Great St. explains that a filter efficient for this purpose can be made Bernard or of Santa-Fe de Bogota (height about 3000 metres), by means of a ilower-pot, partly filled with sand and partly with the rabbit emerged, not very lively indeed, but to some small magnetic oxide of iron or polarite, which may be purchased for degree fatter. On the blood being examined, it was found about ld. per pound. Where the water is very bad he advises that it absorbed 21 cc. per cent. of oxygen-that is to boiling and then filtration ; in other cases headvocatesmere as much as that absorbed by the blood of the Peruvian filtration ; and he records that, as the result of his experiments sheep; while the blood of rabbits kept under normal con- with such means of filtration, purification was effected which ditions in the plain absorbs only 17 cc. It is therefore the amounted to something like 90 per cent. For such purposes atmospheric depression which increases the respiratory capa- as Mr. Carter Bell indicates we concur withj him that subcity of the blood in animals. Regnard’s confirmation of his stantial improvement would be effected, and we are prac. predecessors’ results serves to explain the efficacy of tically content with the scheme which advocates boiling and certain climatic resorts in Switzerland, particularly in then filtration, provided it be distinctly understood that theanaemic and chlorotic patients and in sufferers from neur- measure is adopted as a temporary one. The removal of astheni:1. It is the atmospheric depression which, in con- 90 per cent. of matters which are undesirable unfortunately junction with good hygienic conditions, acts on those invalids leaves a noticeable percentage behind, and unless we could and promotes in their blood the formation of new san- feel assured that the 10 per cent. in question contains nothing guineous globules fit for the assimilation of oxygen. The like the specific material of disease, the practice cannot more abundant nutrition and the augmentation of the appetite possibly be recommended as in any way taking the place of observable in- a sojourn in the mountains are not the cause, the provision of a water-supply which shall not run the risk but a consequence, of the improvement which such sojourn of containing dangerous material. When risky contamination brings. Indeed, even admitting that the haematogenous is involved, filtration is not a remedy ; it is a mere palliati’ve action of elevated sites may owe something to other which serves to diminish not to remove risk. Hence arises the causes, as Viault contends, it is difficult to resist the objection to relying for the purposes of health on domestic induction of Regnard that climatic establishments are in filtration. Water which calls for such filtration by reason of general to be preferred to mineral water resorts-certainly to its being subject to risk of pollution is a water that needs to those whose reputation is chiefly built on fashion, on enter- be replaced by a wholesome supply, and the sanitary autainments, or on the ensemble of adventitious attractions, from thorities of places where such water exists should be pressed which health pure and simple has little or nothing to gain. to adopt the proper remedy. a
say,
VENTRO-FIXATION OF THE UTERUS.
HOSPITAL MONDAY!
IT looks as if every day in the week, on one ground or has now published reports of twenty-five cases in which he has performed the operationanother, would soon become sacred to hospitals. Mr. Edward known as "ventro- fixation of the uterus. " None of the cases White, in the City Press, gravely proposes that a "Hospital proved fatal.. In seventeen permanent anteflexion was Monday Fund " be established with a Metropolitan Hospita] obtained ; in fourteen there was, besides the retroflexion, a Aid League without interfering with either Hospital Sunday diseased condition of the uterine appendages necessitating or Hospital Saturday. It is really difficult to believe that their removal. Of the cases that were not so complicated such a proposal can be meant seriously. It is time to say all except one were successful. Dr. Spaeth rarely fastens that this belief in " days " has been carried far enough and the stump of the broad ligament into the abdominal wound, that what is wanted is a deeper conviction of obligation on usually stitching the fundus uteri directly to the parietal the part of both rich and poor to our hospitals. If Alr. White peritoneum. In the later cases he adopted Schede’s method- will persuade-and few men are more likely to do so—both that is to say, silver sutures were drawn through the rich and poor to crowd the churches and chapels and other whole thickness of the abdominal walls at intervals of meeting-places of the various religious bodies on Hospital about an inch and a half, but they were not at first tied. In Sunday he will do more to help the hospitals than by thethe intervals finer silver sutures were inserted the multiplication of hospital days.
DR. SPABTH of
Hamburg
through
sheaths of the recti, the peritoneum and the fundus uteri, and tightened, twisted and cut short, the whole of course being beneath the skin; the thicker sutures were then tightened and twisted and the lips of the wound brought together with superficial catgut sutures. The subcutaneous silver sutures remained, but never gave any trouble. Dr. Schede and Dr. Spaeth are both of opinion that this method is the best for preventing any hernia, and that when it has been employed abdominal binders are unnecessary. Dr. Spaeth does not perform or recommend ventro-fixation in cases of retroflexion unless there is either disease of the appendages or chronic
INTRA-OCULAR AFFECTIONS AS
SEQUELÆ
OF
NASAL DISEASES.
DR. ZIEM of Dantzig publishes in the Münchener Medicinisc7w T17ockenschrift an interesting case in which intraocular symptoms had supervened on nasal disease. A man sixty eight years old was suffering from a tumour which obstructed the nose on both sides, especially the left. An irregular excrescence was felt in the left half of the nose, and the left half of the naso-pharyngeal cavity was almost filled by a similar tumour of irregular shape. The left eyelid was. tumid and hanging down as if paralysed. The eyeball properitonitis. truded downwards and was only very slightly movable. POLLUTED WATERS IN CHESHIRE. The conjunctiva was injected, the pupil dilated and fixed, THE county analyst for Cheshire, Mr. J. Carter Bell,and partial amaurosis was present in the right eye with reports very strongly on some of the water-supplies which arevenous hyperaemia of the retina and considerable shortin use in the county of Cheshire. He says that of twenty- Iening of the focus. The patient, who suffered severe nine samples which he has analysed, only ten could bepains in the left eye, begged for its removal, but regarded as good from the chemical point of view, whilstno operation could have been of any benefit. Injections twelve were bad and seven exceeded in impurity the efliuentsinto the nose helped to remove a large quantity of from the Salford sewage. Having next referred to the causa- badly smelling pus and gave the patient great relief, and tion of disease in connexion with the use of such waters, he continued treatment also restored the focus almost to its deplores the fact that some elementary technical education is normal length. In about ten weeks the patient died from not given to cottagers as to the best way of fitting their water the progress of the malignant tumour. The success of the -
379 treatment made it plain that the case was not one of retro-bulbar neuritis, but that the interior of the eye became congested through the swelling of the nasal mucous membrane. In the words of Dr. Ziem the restoration of normal nasal respiration and increase of the respiratory capacity of the lungs re-establish free circulation in the vascular system of the nose and neighbouring organs as well as in the rest of the body; so that after the depletion of the orbits, the eyeball and ciliary bodies, the current of blood becomes normal again within the retina and the ophthalmic nerve and restores the function of these organs.
THE
DANGERS OF READY-MADE GARMENTS.
No term, perhaps, possesses a ruore familiar meaning than 1the word "parasite." Happy, indeed, would be that animal which, however unconscious of etymology, had not the It seems an almost hopeless most intimate relation with it. task to search for this enviable creature. We should despair of finding it even among the animalcula or in the cell world of histology. " So, naturalists observe, a flea Has smaller fleas that on him prey : And these have smaller still to bite ’em, And so proceed ad infinitum."
It is not numbered with the greater beasts. It is not man, whether of high or low degree. The Scottish poet describes, AT the last meeting of the Académie de Medecine, jin i a humorous poem which is frequently quoted for the Dr. Hervieux, who presides over the Public Vaccination pointed lesson it conveys, the career of one well-known parasite Department at the head-quarters of that learned body (vac-which he observed, "plump and gray," strutting on a cinations from the calf are performed gratuitously at the lady’s bonnet at church. A correspondent, writing in a building in the Rue des Saints-Peres every Tuesday, Thursdaysomewhat similar vein, confesses to a like experience. She and Saturday) read a report by an army surgeon, M. Stroebel, ,dilates upon " some exceptionally dainty and befrilled on the transport of vaccine by carrier-pigeons. It appearshand-made lingerie, snowy, spotless, crisp, and garthat one pigeon is capable of conveying ill’ one journey fromnished with lace," but, she pathetically adds, with "a five to six tubes. The utility of this means of transport in something half hidden under a " tuck." It was, in her times of war is very obvious, and one can imagine the joy of servant’s patois, a "death louse." Need we be surprised the representatives of the Army Medical Department at the that our correspondent adds to her graphic description apparition of a flock of these swift vaccine carriers in a the warning that all bought underclothing should before besieged town. wearing be made to undergo the full laundry process, " the more especially since it appears to be quite customary (may THE FUNCTIONS OF THE PANCREAS. the custom early become extinct !) for firms to send even such THE profession is too apt to regard the pancreas as a mere articles "on approval" to be tried on?? What possibilities secretor of that composite digestive juice-the succus pan- does this practice open up, not only of parasitic migration, creaticus-forgetting that the gland may have other and but of the actual communication of disease. It is a veritable equally important r6les to play in the animal economy. The method of infection and it has doubtless acted as such more part it takes when diseased in the production of diabetes has for often than we are aware of. The only real remedy of course years been insisted on by that careful pathologist and clinician, consists in its entire discontinuance. Less than this ought Dr. Lancereaux, the correctness of whose opinion can no not to satisfy a wholesome public opinion. Until, however, longer be denied after the positive results obtained experi- the usage of trade in this particular is above suspicion a mentally by M. Hedon of Montpellier. That gentleman has careful examination and free ventilation of all purchased for some time past been studying the effects of grafting the clothing should not be omitted, while such further measures pancreas of the dog under the skin of the abdominal parietes. as "the full laundry process," and, beyond this, antiseptic His method consists in drawing out the greater part of the fumigation, can never be superfluous. gland and fixing it in the subcutaneous tissue, without interfering with the vascular connection between the extruded portion and the part still remaining in situ. After the lapse MEDICAL NARROWNESS IN SWITZERLAND AND FRANCE. of a few days, this pedicle is cut, and the grafted gland
CARRIER-PIGEONS AND VACCINATION.
-
continues to live in its abnormal situation. During the first few days of the extra-abdominal existence, the organ swells up, and a tumour is formed which is filled with a clear colourless liquid-the pancreatic juice, in fact. The sac having been emptied a few times, there only remains a fistula through which the liquid continues to flow. Later on, the fistula closes and the graft continues to live, its secreting powers having been suppressed. When the graft is examined no departure from the normal structure of the pancreas is discernible. In the animal arrived at this stage of the experiment there exist then an intra-abdominal and an extra-abdominal pancreas, of which the former remains in connexion with the intestine, pouring into it its characteristic secretion, the pancreatic juice. The extra-abdominal pancreas has ceased to be a secreting organ and has acquired the functions of a vascular gland. Pushed still further th experiment yields most instructive results. The removal of the intra-abdominal pancreas alone is not at all injurious to the dog’s health, the urine being normal both in quantity and constitution. When, however, the subcutaneous organ is, in addition, removed, the animal becomes quickly diabetic, the quantity of urine passed being greatly augmented and containing a notable proportion of glucose. Death ensues rapidly. These interesting experiments go to provethat over and above its digestive functions the pancreas is useful and even necessary in other ways.
generally
,
IT is lamentable to think how illiberal the law of Switzer land is in reference to foreign medical men. It is said that an English physician has lately been prosecuted or threatened with prosecution for attending his own mother in a hotel in Switzerland. The Republic of France has passed, or is on the point of passing, a law almost as narrow. The hardship of such legislation is the greater to English-speaking people when we consider the fact that they visit the health resorts of France and Switzerland so freely. It is to the medical men of both countries that we have a right to look for some mitigation of this most unsatisfactory state of the law, and it is certainly they who are considered responsible for it. There is nothing so narrow in our own law. A memorandum has lately been prepared by direction of the General Medical Council for submission to foreign governments, showing the conditions under which foreign medical practitioners are allowed to practise in England as determined by the Medical Acts of 1858 and 1886, and with a view to induce these Governments to reconsider the regulations by which English qualified practitioners are excluded from practising on the Continent even among their own countrymen. Foreign practitioners, though they cannot register or hold appointments, can practise here without restriction so long as they use no name or title implying their registration. Hospitals established for foreigners may be attended by foreign practitioners entitled to practise in their own country and not engaged in other medical prac-
say,
VENTRO-FIXATION OF THE UTERUS.
HOSPITAL MONDAY!
IT looks as if every day in the week, on one ground or has now published reports of twenty-five cases in which he has performed the operationanother, would soon become sacred to hospitals. Mr. Edward known as "ventro- fixation of the uterus. " None of the cases White, in the City Press, gravely proposes that a "Hospital proved fatal.. In seventeen permanent anteflexion was Monday Fund " be established with a Metropolitan Hospita] obtained ; in fourteen there was, besides the retroflexion, a Aid League without interfering with either Hospital Sunday diseased condition of the uterine appendages necessitating or Hospital Saturday. It is really difficult to believe that their removal. Of the cases that were not so complicated such a proposal can be meant seriously. It is time to say all except one were successful. Dr. Spaeth rarely fastens that this belief in " days " has been carried far enough and the stump of the broad ligament into the abdominal wound, that what is wanted is a deeper conviction of obligation on usually stitching the fundus uteri directly to the parietal the part of both rich and poor to our hospitals. If Alr. White peritoneum. In the later cases he adopted Schede’s method- will persuade-and few men are more likely to do so—both that is to say, silver sutures were drawn through the rich and poor to crowd the churches and chapels and other whole thickness of the abdominal walls at intervals of meeting-places of the various religious bodies on Hospital about an inch and a half, but they were not at first tied. In Sunday he will do more to help the hospitals than by thethe intervals finer silver sutures were inserted the multiplication of hospital days.
DR. SPABTH of
Hamburg
through
sheaths of the recti, the peritoneum and the fundus uteri, and tightened, twisted and cut short, the whole of course being beneath the skin; the thicker sutures were then tightened and twisted and the lips of the wound brought together with superficial catgut sutures. The subcutaneous silver sutures remained, but never gave any trouble. Dr. Schede and Dr. Spaeth are both of opinion that this method is the best for preventing any hernia, and that when it has been employed abdominal binders are unnecessary. Dr. Spaeth does not perform or recommend ventro-fixation in cases of retroflexion unless there is either disease of the appendages or chronic
INTRA-OCULAR AFFECTIONS AS
SEQUELÆ
OF
NASAL DISEASES.
DR. ZIEM of Dantzig publishes in the Münchener Medicinisc7w T17ockenschrift an interesting case in which intraocular symptoms had supervened on nasal disease. A man sixty eight years old was suffering from a tumour which obstructed the nose on both sides, especially the left. An irregular excrescence was felt in the left half of the nose, and the left half of the naso-pharyngeal cavity was almost filled by a similar tumour of irregular shape. The left eyelid was. tumid and hanging down as if paralysed. The eyeball properitonitis. truded downwards and was only very slightly movable. POLLUTED WATERS IN CHESHIRE. The conjunctiva was injected, the pupil dilated and fixed, THE county analyst for Cheshire, Mr. J. Carter Bell,and partial amaurosis was present in the right eye with reports very strongly on some of the water-supplies which arevenous hyperaemia of the retina and considerable shortin use in the county of Cheshire. He says that of twenty- Iening of the focus. The patient, who suffered severe nine samples which he has analysed, only ten could bepains in the left eye, begged for its removal, but regarded as good from the chemical point of view, whilstno operation could have been of any benefit. Injections twelve were bad and seven exceeded in impurity the efliuentsinto the nose helped to remove a large quantity of from the Salford sewage. Having next referred to the causa- badly smelling pus and gave the patient great relief, and tion of disease in connexion with the use of such waters, he continued treatment also restored the focus almost to its deplores the fact that some elementary technical education is normal length. In about ten weeks the patient died from not given to cottagers as to the best way of fitting their water the progress of the malignant tumour. The success of the -
379 treatment made it plain that the case was not one of retro-bulbar neuritis, but that the interior of the eye became congested through the swelling of the nasal mucous membrane. In the words of Dr. Ziem the restoration of normal nasal respiration and increase of the respiratory capacity of the lungs re-establish free circulation in the vascular system of the nose and neighbouring organs as well as in the rest of the body; so that after the depletion of the orbits, the eyeball and ciliary bodies, the current of blood becomes normal again within the retina and the ophthalmic nerve and restores the function of these organs.
THE
DANGERS OF READY-MADE GARMENTS.
No term, perhaps, possesses a ruore familiar meaning than 1the word "parasite." Happy, indeed, would be that animal which, however unconscious of etymology, had not the It seems an almost hopeless most intimate relation with it. task to search for this enviable creature. We should despair of finding it even among the animalcula or in the cell world of histology. " So, naturalists observe, a flea Has smaller fleas that on him prey : And these have smaller still to bite ’em, And so proceed ad infinitum."
It is not numbered with the greater beasts. It is not man, whether of high or low degree. The Scottish poet describes, AT the last meeting of the Académie de Medecine, jin i a humorous poem which is frequently quoted for the Dr. Hervieux, who presides over the Public Vaccination pointed lesson it conveys, the career of one well-known parasite Department at the head-quarters of that learned body (vac-which he observed, "plump and gray," strutting on a cinations from the calf are performed gratuitously at the lady’s bonnet at church. A correspondent, writing in a building in the Rue des Saints-Peres every Tuesday, Thursdaysomewhat similar vein, confesses to a like experience. She and Saturday) read a report by an army surgeon, M. Stroebel, ,dilates upon " some exceptionally dainty and befrilled on the transport of vaccine by carrier-pigeons. It appearshand-made lingerie, snowy, spotless, crisp, and garthat one pigeon is capable of conveying ill’ one journey fromnished with lace," but, she pathetically adds, with "a five to six tubes. The utility of this means of transport in something half hidden under a " tuck." It was, in her times of war is very obvious, and one can imagine the joy of servant’s patois, a "death louse." Need we be surprised the representatives of the Army Medical Department at the that our correspondent adds to her graphic description apparition of a flock of these swift vaccine carriers in a the warning that all bought underclothing should before besieged town. wearing be made to undergo the full laundry process, " the more especially since it appears to be quite customary (may THE FUNCTIONS OF THE PANCREAS. the custom early become extinct !) for firms to send even such THE profession is too apt to regard the pancreas as a mere articles "on approval" to be tried on?? What possibilities secretor of that composite digestive juice-the succus pan- does this practice open up, not only of parasitic migration, creaticus-forgetting that the gland may have other and but of the actual communication of disease. It is a veritable equally important r6les to play in the animal economy. The method of infection and it has doubtless acted as such more part it takes when diseased in the production of diabetes has for often than we are aware of. The only real remedy of course years been insisted on by that careful pathologist and clinician, consists in its entire discontinuance. Less than this ought Dr. Lancereaux, the correctness of whose opinion can no not to satisfy a wholesome public opinion. Until, however, longer be denied after the positive results obtained experi- the usage of trade in this particular is above suspicion a mentally by M. Hedon of Montpellier. That gentleman has careful examination and free ventilation of all purchased for some time past been studying the effects of grafting the clothing should not be omitted, while such further measures pancreas of the dog under the skin of the abdominal parietes. as "the full laundry process," and, beyond this, antiseptic His method consists in drawing out the greater part of the fumigation, can never be superfluous. gland and fixing it in the subcutaneous tissue, without interfering with the vascular connection between the extruded portion and the part still remaining in situ. After the lapse MEDICAL NARROWNESS IN SWITZERLAND AND FRANCE. of a few days, this pedicle is cut, and the grafted gland
CARRIER-PIGEONS AND VACCINATION.
-
continues to live in its abnormal situation. During the first few days of the extra-abdominal existence, the organ swells up, and a tumour is formed which is filled with a clear colourless liquid-the pancreatic juice, in fact. The sac having been emptied a few times, there only remains a fistula through which the liquid continues to flow. Later on, the fistula closes and the graft continues to live, its secreting powers having been suppressed. When the graft is examined no departure from the normal structure of the pancreas is discernible. In the animal arrived at this stage of the experiment there exist then an intra-abdominal and an extra-abdominal pancreas, of which the former remains in connexion with the intestine, pouring into it its characteristic secretion, the pancreatic juice. The extra-abdominal pancreas has ceased to be a secreting organ and has acquired the functions of a vascular gland. Pushed still further th experiment yields most instructive results. The removal of the intra-abdominal pancreas alone is not at all injurious to the dog’s health, the urine being normal both in quantity and constitution. When, however, the subcutaneous organ is, in addition, removed, the animal becomes quickly diabetic, the quantity of urine passed being greatly augmented and containing a notable proportion of glucose. Death ensues rapidly. These interesting experiments go to provethat over and above its digestive functions the pancreas is useful and even necessary in other ways.
generally
,
IT is lamentable to think how illiberal the law of Switzer land is in reference to foreign medical men. It is said that an English physician has lately been prosecuted or threatened with prosecution for attending his own mother in a hotel in Switzerland. The Republic of France has passed, or is on the point of passing, a law almost as narrow. The hardship of such legislation is the greater to English-speaking people when we consider the fact that they visit the health resorts of France and Switzerland so freely. It is to the medical men of both countries that we have a right to look for some mitigation of this most unsatisfactory state of the law, and it is certainly they who are considered responsible for it. There is nothing so narrow in our own law. A memorandum has lately been prepared by direction of the General Medical Council for submission to foreign governments, showing the conditions under which foreign medical practitioners are allowed to practise in England as determined by the Medical Acts of 1858 and 1886, and with a view to induce these Governments to reconsider the regulations by which English qualified practitioners are excluded from practising on the Continent even among their own countrymen. Foreign practitioners, though they cannot register or hold appointments, can practise here without restriction so long as they use no name or title implying their registration. Hospitals established for foreigners may be attended by foreign practitioners entitled to practise in their own country and not engaged in other medical prac-