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SUNBURN AND SNOW.
456 The solutions employed
covered
by the clothing ; but this is only a consequence of and prolonged hyperæmmia. On the other hand, repeated parts halations were used very frequently. When given by the effect of sunlight, even without direct exposure, in the mouth or rectum, Dr. Flint adopted the use of an rendering pre-existing ephelides and similar pigmentations emulsion composed of forty parts of cod-liver oil and sixty more prominent and in developing fresh ones is well known. parts of mucilage of acacia, each drachm containing two The sun also produces pigmentary disturbance indirectly minims of creasote. When possible the creasote emulsion was through the nervous system, as may be seen in melanoderma, administered in milk, being thoroughly mixed with the latter and leucoderma, in which there is excess followed by deficiency, by means of energetic shaking. More of the drug could be which may in some cases be shown to follow sun exposure. given in this manner, without exciting gastric symptoms, On the whole, then, while the actinic rays play a certain than by any other method. For enemata, one or two drachms part in the process of sunburn and subsequent pigmentation, of the emulsion, containing respectively from two to four it must be admitted that the heat rays play a large, and minims of creasote, may be shaken up with four ounces of probably the largest, part in producing the unpleasant results milk, and such an enema may be given every five or six hours. of direct sun exposure. The conclusions arrived at by Dr. Flint are-(1) That intraOVERCROWDING OF RIVER STEAMERS. pulmonary and intra-tracheal injections of creasote are of doubtful utility, and may be positively injurious; MANY pleasure seekers will feel a certain sympathy with (2) that, for administration by mouth or rectum, one of the officers employed by the Victoria Steamship solutions and emulsions of creasote are preferable in Company who was lately convicted of having allowed his most cases to capsules, pills, or wafers; (3) that milk is vessel to be greatly overcrowded. The particular circum. an excellent vehicle for the administration of creasote in stances of the case were such as fortunately do not occur solution or in emulsion; (4) that each method, by inhala- very often. Fine weather had rendered the summer Bank tion, by mouth or rectum alone, or by both these channels holiday particularly attractive, and the boat, the last for the simultaneously, is useful, and may each be particularly day, was regularly boarded by a swarm of excursionists adapted to individual cases ; (5) that the best results for gathered on the pier at Southend. These considerations, each individual attend the administration of the maximum however, merely qualify, they do not excuse, the fact that quantity of creasote which this patient will bear ; (6) that on reaching London she was overloaded by more than half the average patient will not easily tolerate more than ten her allowed passenger freight. It is true that she dis. or fifteen minims of creasote per diem for any great length charged her burthen safely, but this does not justify the risk of time, and that many will only bear two or three drops incurred. One must in all such cases allow for possible per diem cautiously given ; (7) that it is very important accidents. The condition of a small, belated, and deeply that the treatment be uniform and uninterrupted; (8) that, laden vessel on a narrow river traversed by moving craft, consequently, an effort should always be made, if intoler- certainly does not impress one with an idea of safe navigaance of creasote is shown by any one mucous surface, to tion. It is highly probable, moreover, that river boats in employ some other channel of introduction, in order that general, no less than trains and tram-cars, are liable to the continuity of the treatment be not interrupted. frequent accessions of passenger congestion. The need and the prudence of adopting exemplary measures of correction of
were
always those containing equal
creasote, alcohol, and chloroform.
The in-
-
SUNBURN AND SNOW. DR. ROBERT BOWLES’ observations on sunburn in the presence of snow is a good illustration of the way in which It was a holiday may be utilised by a man of science. already known that the effects on the skin of exposure to the sun were aggravated whilst travelling over snow. He found, in addition, that these effects were still more pronounced if the snow had recently fallen. This may be accounted for by the reflection being greater with recent snow, as the crystalline structure would be more perfectly preserved. Dr. Bowles also found that when mountaineering he escaped sunburn by painting his face brown, while all his companions suffered considerably. The natives of many tropical places have found this fact out for themselves. Thus, the inhabitants of Morocco and of the Sikkim hills blacken the skin round the eyes to protect themselves from the glare of the sun on the sand on the one hand, and on the newly fallen snow on the other. The Fijians also, when fishing on the reef, exchange their red and white stripes for black for a similar reason. From his own observations and the above considerations, Dr. Bowles concludes that sunburn is due to the actinic rays rather than to the heat of the sun. This, however, cannot be altogether correct, as while the actinic effect may be almost as powerful from objects not directly in the sun’s rays, as may be seen by their effect on the photographic plate, no one suffers from sunburn except when exposed to the sun’s direct rays. Moreover, a similar dermatitis may be excited in puddlers, stokers, blacksmitbs, and others exposed to artificial heat. With regard to pigmentation, the case is somewhat different ; it may also be produced locally in those abovementioned whose occupations expose them for long periods to great heat, and that, too, in parts
in the instance above mentioned must therefore be admitted in spite of any so-called extenuation of the offence. Such measures are sure to prove useful, not only by compelling some limitation of the holiday throng on landing stages, but also by promoting such increase of the river boat service as will meet any probable emergency.
DEATH UNDER CHLOROFORM AT ST. HELENS. A CASE of death occurring under chloroform, reported by the Liverpool Mercury, is deplorable for more than one reason. The facts as stated by our contemporary are as follows :A female patient aged sixty, the wife of a glassblower’9 labourer, sought advice from Mr. Pennington, a surgeon practising in Liverpool. The woman had suffered, it appears, for nine weeks from whitlow, which had progressed so far as to necessitate amputation of the finger. With a view to this operation, Mr. Pennington had the woman admitted into the St. Helens Cottage Hospital, telling the husband that the operation would necessitate the attendance of a, "specialist" to administer chloroform, and that a fee of two guineas would be requisite for him. To this the husband seems to have assented, saying he would try to obtain the fee. The operation was to have taken place on the Thursday, but, as no formal consent was. given by the husband, Mr. Pennington did not operate or see the patient upon that day, although in his evidence at the inquest he stated he was prepared to do so had he received the consent of the patient’s husband, and would have arranged the chloroform fee himself. He considered it necessary to have a skilled anaesthetist for operation cases. The husband, however, called in Dr. Casey, of St. Helens, who upon the Thursday evening went Sutton, see the patient in the hospital, directing the husband
to
covered
by the clothing ; but this is only a consequence of and prolonged hyperæmmia. On the other hand, repeated parts halations were used very frequently. When given by the effect of sunlight, even without direct exposure, in the mouth or rectum, Dr. Flint adopted the use of an rendering pre-existing ephelides and similar pigmentations emulsion composed of forty parts of cod-liver oil and sixty more prominent and in developing fresh ones is well known. parts of mucilage of acacia, each drachm containing two The sun also produces pigmentary disturbance indirectly minims of creasote. When possible the creasote emulsion was through the nervous system, as may be seen in melanoderma, administered in milk, being thoroughly mixed with the latter and leucoderma, in which there is excess followed by deficiency, by means of energetic shaking. More of the drug could be which may in some cases be shown to follow sun exposure. given in this manner, without exciting gastric symptoms, On the whole, then, while the actinic rays play a certain than by any other method. For enemata, one or two drachms part in the process of sunburn and subsequent pigmentation, of the emulsion, containing respectively from two to four it must be admitted that the heat rays play a large, and minims of creasote, may be shaken up with four ounces of probably the largest, part in producing the unpleasant results milk, and such an enema may be given every five or six hours. of direct sun exposure. The conclusions arrived at by Dr. Flint are-(1) That intraOVERCROWDING OF RIVER STEAMERS. pulmonary and intra-tracheal injections of creasote are of doubtful utility, and may be positively injurious; MANY pleasure seekers will feel a certain sympathy with (2) that, for administration by mouth or rectum, one of the officers employed by the Victoria Steamship solutions and emulsions of creasote are preferable in Company who was lately convicted of having allowed his most cases to capsules, pills, or wafers; (3) that milk is vessel to be greatly overcrowded. The particular circum. an excellent vehicle for the administration of creasote in stances of the case were such as fortunately do not occur solution or in emulsion; (4) that each method, by inhala- very often. Fine weather had rendered the summer Bank tion, by mouth or rectum alone, or by both these channels holiday particularly attractive, and the boat, the last for the simultaneously, is useful, and may each be particularly day, was regularly boarded by a swarm of excursionists adapted to individual cases ; (5) that the best results for gathered on the pier at Southend. These considerations, each individual attend the administration of the maximum however, merely qualify, they do not excuse, the fact that quantity of creasote which this patient will bear ; (6) that on reaching London she was overloaded by more than half the average patient will not easily tolerate more than ten her allowed passenger freight. It is true that she dis. or fifteen minims of creasote per diem for any great length charged her burthen safely, but this does not justify the risk of time, and that many will only bear two or three drops incurred. One must in all such cases allow for possible per diem cautiously given ; (7) that it is very important accidents. The condition of a small, belated, and deeply that the treatment be uniform and uninterrupted; (8) that, laden vessel on a narrow river traversed by moving craft, consequently, an effort should always be made, if intoler- certainly does not impress one with an idea of safe navigaance of creasote is shown by any one mucous surface, to tion. It is highly probable, moreover, that river boats in employ some other channel of introduction, in order that general, no less than trains and tram-cars, are liable to the continuity of the treatment be not interrupted. frequent accessions of passenger congestion. The need and the prudence of adopting exemplary measures of correction of
were
always those containing equal
creasote, alcohol, and chloroform.
The in-
-
SUNBURN AND SNOW. DR. ROBERT BOWLES’ observations on sunburn in the presence of snow is a good illustration of the way in which It was a holiday may be utilised by a man of science. already known that the effects on the skin of exposure to the sun were aggravated whilst travelling over snow. He found, in addition, that these effects were still more pronounced if the snow had recently fallen. This may be accounted for by the reflection being greater with recent snow, as the crystalline structure would be more perfectly preserved. Dr. Bowles also found that when mountaineering he escaped sunburn by painting his face brown, while all his companions suffered considerably. The natives of many tropical places have found this fact out for themselves. Thus, the inhabitants of Morocco and of the Sikkim hills blacken the skin round the eyes to protect themselves from the glare of the sun on the sand on the one hand, and on the newly fallen snow on the other. The Fijians also, when fishing on the reef, exchange their red and white stripes for black for a similar reason. From his own observations and the above considerations, Dr. Bowles concludes that sunburn is due to the actinic rays rather than to the heat of the sun. This, however, cannot be altogether correct, as while the actinic effect may be almost as powerful from objects not directly in the sun’s rays, as may be seen by their effect on the photographic plate, no one suffers from sunburn except when exposed to the sun’s direct rays. Moreover, a similar dermatitis may be excited in puddlers, stokers, blacksmitbs, and others exposed to artificial heat. With regard to pigmentation, the case is somewhat different ; it may also be produced locally in those abovementioned whose occupations expose them for long periods to great heat, and that, too, in parts
in the instance above mentioned must therefore be admitted in spite of any so-called extenuation of the offence. Such measures are sure to prove useful, not only by compelling some limitation of the holiday throng on landing stages, but also by promoting such increase of the river boat service as will meet any probable emergency.
DEATH UNDER CHLOROFORM AT ST. HELENS. A CASE of death occurring under chloroform, reported by the Liverpool Mercury, is deplorable for more than one reason. The facts as stated by our contemporary are as follows :A female patient aged sixty, the wife of a glassblower’9 labourer, sought advice from Mr. Pennington, a surgeon practising in Liverpool. The woman had suffered, it appears, for nine weeks from whitlow, which had progressed so far as to necessitate amputation of the finger. With a view to this operation, Mr. Pennington had the woman admitted into the St. Helens Cottage Hospital, telling the husband that the operation would necessitate the attendance of a, "specialist" to administer chloroform, and that a fee of two guineas would be requisite for him. To this the husband seems to have assented, saying he would try to obtain the fee. The operation was to have taken place on the Thursday, but, as no formal consent was. given by the husband, Mr. Pennington did not operate or see the patient upon that day, although in his evidence at the inquest he stated he was prepared to do so had he received the consent of the patient’s husband, and would have arranged the chloroform fee himself. He considered it necessary to have a skilled anaesthetist for operation cases. The husband, however, called in Dr. Casey, of St. Helens, who upon the Thursday evening went Sutton, see the patient in the hospital, directing the husband
to