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THE PEKING HOSPITAL.
501 the left hand could be placed on the head, and almost all the movements of the leg were regained. Half an hour after the operation recovery from the paralysis was complete. Other cases of transitory hemiplegia in heart Condisease have been recorded by French writers. stantin Paul in his work on heart disease (1883) mentions the case of a woman, aged 64 years, suffering from chronic myocarditis, who, after an effort, was seized with right hemiplegia, not accompanied with aphasia. The symptoms disappeared in four hours. In 1897 Achard and Levi recorded two cases of the same class. A woman, aged ’64 years, with mitral stenosis and asystole, had first right inferior facial paralysis which lasted four days, and 15 days later paralysis of the opposite side of the face with paresis of the upper limb ; death occurred at the end of two days. In the second case a woman, aged 35 years, with well’compensated mitral stenosis, was seized with complete left facial paralysis, and then with paralysis of the left sixth nerve and transient paresis of the left arm. All the in five Several explanations of days. symptoms disappeared these transitory paralyses have been given. Paul attributes them to cerebral anaemia. Achard and Levi compared them to the transitory paralyses of urasmia and hepatic toxasmia, and ascribe them to the auto-intoxication of heart disease. Later Achard suggested that they are due to circulatory troubles in the brain-cerebral oedema and dropsy of the ventricles. M. Hirtz and M. Beaufume point out that their case shows that the paralysis depends on a mechanical cause-cerebral congestion or oedema-which was relieved by the paracentesis. This view is supported by the fact that in Achard and L6vi’s first case the necropsy showed considerable submeningeal oedema with congestion, most marked in the
At the same time one feels that with such facilities there would be for many a hopeful outlook, for the dry, sunny climate of North China, with its cold, bracing winter, renders it an ideal place for the treatment of tubercle if the patient can be removed from the dust and dirt of towns. Even without such treatment many remarkable instances of natural cure take place-as, for instance, the case of a boy who came to hospital more than a year ago in a desperate condition with a tubercular pyo-pneumothorax, already ruptured, and who is to-day able to do work as a messenger. Venereal diseases, with all their complications, are exceedingly common ; so, again, are fistulæ in ano, for which there is no entirely satisfactory explanation, though undoubtedly many are tuberculous. Ascaris lumbricoides is regarded as part of the natural intestinal fauna. Tumours, both innocent and malignant, are very common, especially at sites of chronic irritation, as, for instance, in scars or beneath a tight prepuce ; but the exact nature of these needs further investigation. Every variety of tumour is met with, but rodent ulcer and epithelioma are the most noticeable. On the medical side there is a conspicuous absence of acute rheumatism, though chronic osteoarthritis is very common. As a sequence mitral disease is not frequent but aortic is common, probably from the frequent association of syphilis. Acute pneumonia is rare. Typhoid, typhus, and the infective exanthemata, though always present, do not ravage the community so severely as one would expect in a large city like Peking, where there is complete absence of sanitary precautions, no proper drainage, and no attempt at isolation. Presumably the inhabitants in the course of centuries have reached a stage of natural immunity unknown to us at home. Diphtheria causes many deaths, Rolandic area. infant mortality is high and tetanus neonatorum common. A list of the more important cases other than tuberculous THE PEKING HOSPITAL. which have been met with in the course of the last year of hospital practice will give a good idea of the scope for THE Peking Hospital is the oldest and one of the biggest medical practice and investigation in North China. On the hospitals in China. It was founded in 1861 by the late medical side were seen : Typhoid fever (one case developed Dr. W. Lockhart, who came to China as a medical double suppurative parotitis and yet recovered) ; typhus, missionary in 1838. It now furnishes the clinical material for the Union Medical College, the leading medical relapsing fever ; cerebro-spinal meningitis, the diplococcus school, native or foreign, of the empire. It is a matter being readily identified by lumbar puncture ; mitral disease of regret that with such a wealth of cases no accurate rare, aortic common ; nephritis common ; osteo-arthritis statistics have been kept, but as the hospital was for many common ; leprosy, nodular and anaesthetic (all from cases years run single handed by a succession of overworked medical imported from South China) ; infantile paralysis frequent ; missionaries such bookkeeping was not found possible. At the rickets very rare; hemiplegia common ; tabes dorsalis ; present time over 19,000 patients pass through it annually. spastic paraplegia ; hypertrophic muscular paralysis ; and In the absence of statistics Dr. H. V. Wenham (who takes a paralysis agitans. On the surgical side : Tumours of all large part in the work of the hospital and college, and who is kinds; hernia, both acquired and congenital, inguinal are clinical tutor to the students) has been good enough to give common (the latter included one interstitial hernia)-we have also seen a case of femoral hernia in a man ; rupture of us the following notes of his general impressions of the work ulnar artery due to acupuncture; fistula and necrosis of undertaken in a locality where there is abundant scope for both bone, exceedingly common ; stricture of urethra, very research as in North China. There are many points of and papillomata of bladder; tetanus calculus of from common; difference in the manifestations disease in China those observed at home, the system of diet and general mode following dirty wounds ; hydrophobia, beyond the reach of of life of the Chinese differing markedly from those of Pasteur treatment ; and gangrene, common in winter Europeans. Epidemics arise and work out their ravages months." The foregoing list is, we are informed by our unchecked, microbic transmission of disease being as yet Peking correspondent, a good résumé of the main lines of nationally unrecognised. Dr. Wenham says : "The great hospital work in China. and outstanding impression is that of the plague of tubercle. OPERATIVE TREATMENT OF FRACTURES. Every form is met with from the most acute to the most chronic ; the various forms of localised tubercle in bones, IN the Surgical Section of the British Medical Association glands, &c., are exceedingly common. This seems strange in at its recent annual meeting there was a discussion on the the li"ht of recently expressed views, since the average Operative Treatment of Fractures.1 It was opened by Mr. Chinaman never uses milk and never eats beef, neither are Arbuthnot Lane, the protagonist of the new method, and children fed on cows’milk. Their food has much opportunity decided many opinions were expressed on both sides of for contamination by dust and flies, and the frequency with the controversy. As a result of the interest felt in this which tubercular disease follows on traumatism is noticeable. important matter the Section passed a resolution requesting The lack of any facilities for open-air or sanatoriumcure’ renders the treatment of these cases peculiarly depressing. 1 THE LANCET, July 30th, 1910, p. 348. ____
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THE
At the same time one feels that with such facilities there would be for many a hopeful outlook, for the dry, sunny climate of North China, with its cold, bracing winter, renders it an ideal place for the treatment of tubercle if the patient can be removed from the dust and dirt of towns. Even without such treatment many remarkable instances of natural cure take place-as, for instance, the case of a boy who came to hospital more than a year ago in a desperate condition with a tubercular pyo-pneumothorax, already ruptured, and who is to-day able to do work as a messenger. Venereal diseases, with all their complications, are exceedingly common ; so, again, are fistulæ in ano, for which there is no entirely satisfactory explanation, though undoubtedly many are tuberculous. Ascaris lumbricoides is regarded as part of the natural intestinal fauna. Tumours, both innocent and malignant, are very common, especially at sites of chronic irritation, as, for instance, in scars or beneath a tight prepuce ; but the exact nature of these needs further investigation. Every variety of tumour is met with, but rodent ulcer and epithelioma are the most noticeable. On the medical side there is a conspicuous absence of acute rheumatism, though chronic osteoarthritis is very common. As a sequence mitral disease is not frequent but aortic is common, probably from the frequent association of syphilis. Acute pneumonia is rare. Typhoid, typhus, and the infective exanthemata, though always present, do not ravage the community so severely as one would expect in a large city like Peking, where there is complete absence of sanitary precautions, no proper drainage, and no attempt at isolation. Presumably the inhabitants in the course of centuries have reached a stage of natural immunity unknown to us at home. Diphtheria causes many deaths, Rolandic area. infant mortality is high and tetanus neonatorum common. A list of the more important cases other than tuberculous THE PEKING HOSPITAL. which have been met with in the course of the last year of hospital practice will give a good idea of the scope for THE Peking Hospital is the oldest and one of the biggest medical practice and investigation in North China. On the hospitals in China. It was founded in 1861 by the late medical side were seen : Typhoid fever (one case developed Dr. W. Lockhart, who came to China as a medical double suppurative parotitis and yet recovered) ; typhus, missionary in 1838. It now furnishes the clinical material for the Union Medical College, the leading medical relapsing fever ; cerebro-spinal meningitis, the diplococcus school, native or foreign, of the empire. It is a matter being readily identified by lumbar puncture ; mitral disease of regret that with such a wealth of cases no accurate rare, aortic common ; nephritis common ; osteo-arthritis statistics have been kept, but as the hospital was for many common ; leprosy, nodular and anaesthetic (all from cases years run single handed by a succession of overworked medical imported from South China) ; infantile paralysis frequent ; missionaries such bookkeeping was not found possible. At the rickets very rare; hemiplegia common ; tabes dorsalis ; present time over 19,000 patients pass through it annually. spastic paraplegia ; hypertrophic muscular paralysis ; and In the absence of statistics Dr. H. V. Wenham (who takes a paralysis agitans. On the surgical side : Tumours of all large part in the work of the hospital and college, and who is kinds; hernia, both acquired and congenital, inguinal are clinical tutor to the students) has been good enough to give common (the latter included one interstitial hernia)-we have also seen a case of femoral hernia in a man ; rupture of us the following notes of his general impressions of the work ulnar artery due to acupuncture; fistula and necrosis of undertaken in a locality where there is abundant scope for both bone, exceedingly common ; stricture of urethra, very research as in North China. There are many points of and papillomata of bladder; tetanus calculus of from common; difference in the manifestations disease in China those observed at home, the system of diet and general mode following dirty wounds ; hydrophobia, beyond the reach of of life of the Chinese differing markedly from those of Pasteur treatment ; and gangrene, common in winter Europeans. Epidemics arise and work out their ravages months." The foregoing list is, we are informed by our unchecked, microbic transmission of disease being as yet Peking correspondent, a good résumé of the main lines of nationally unrecognised. Dr. Wenham says : "The great hospital work in China. and outstanding impression is that of the plague of tubercle. OPERATIVE TREATMENT OF FRACTURES. Every form is met with from the most acute to the most chronic ; the various forms of localised tubercle in bones, IN the Surgical Section of the British Medical Association glands, &c., are exceedingly common. This seems strange in at its recent annual meeting there was a discussion on the the li"ht of recently expressed views, since the average Operative Treatment of Fractures.1 It was opened by Mr. Chinaman never uses milk and never eats beef, neither are Arbuthnot Lane, the protagonist of the new method, and children fed on cows’milk. Their food has much opportunity decided many opinions were expressed on both sides of for contamination by dust and flies, and the frequency with the controversy. As a result of the interest felt in this which tubercular disease follows on traumatism is noticeable. important matter the Section passed a resolution requesting The lack of any facilities for open-air or sanatoriumcure’ renders the treatment of these cases peculiarly depressing. 1 THE LANCET, July 30th, 1910, p. 348. ____
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THE