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SPARTEINE SULPHATE IN POST-OPERATIVE SUPPRESSION OF URINE.
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
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 ____
-
____
‘
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