THE RELATIVE HEIGHTS AND WEIGHTS OF BENGAL PRISONERS.

DR. BENNETT: SULPHATE OF QUININE AND THE GRAVID UTERUS.

598

colossal organisms is as well supplied with what it requires if it is to live and perform its vital acts as the minute individual particle free to move, to grow, and to multiply in a medium laden with the substances upon which it lives dissolved in the proportion of water which suits it. It will be found that the same principle holds with regard to the vital actions of living things in every department of nature-every particle of living matter being dependent for its life upon an interstitial circulation which is established and sustained by itself, which begins with its life and ceases at its death. In every particle of living matter, then, we have a laboratory without apparatus and without any visible chemist, where analytical-and synthetical operations are always being conducted in the most perfect manner. Movements and work proceed without any mechanical appliances and in the absence of any tangible designer, constructor, regulator, governor, or conductor. Here atoms are moved about in all directions, and may be placed above one another notwithstanding the influence of gravitation. Transformation of energy is effected in this clear, colourless, structureless substance, consisting largely of water; and movement, heat, light, electricity, and possibly other modes of motion may be evolved. Moreover, this clear, soft, structureless, living matter is capable of endless multiplication. It also differs from matter in every other known state in that it possesses powers unknown elsewhere, which have been derived from pre-existing living matter and are capable of being transmitted to particles of matter which do not yet live, and this without any loss. These wonderful vital powers, according to Lord Kelvin’s most recent computation, have been passing from living to lifeless particles for about 20,000,000 years. If this be so, we may be sure that colourless, structureless, living matter, with its interstitial circulation, has existed for the same period, and that the universal vital characteristics have never ceased or been dormant for a single moment. (To be continued.)

the slight improvement the case was regarded with anxiety. I leave this case at this stage to pass on to the next. CASE 2.-On the day after I had seen Case 1 I was called to attend a primipara, aged twenty-four years, in about the eighth month of pregnancy. There was enormous o3dema of the upper and lower extremities, the labia, the face, &c. The patient was intensely ansemic, with hurried action of the heart and bmmic murmurs and some dyspnœa. The oedema, The urine was scanty was of a recent and acute character. and pale and charged with albumin. There had been no indications of convulsions. Mentally the patient was clear and intelligent. There were no signs of labour. She was, in addition, suffering from intermittent attacks of malarial fever. Treatment on general principles was prescribed, and five-grain powders of sulphate of quinine were given three times daily owing to her attacks of fever. Within fortyeight hours of taking the quinine she was delivered of a stillborn child-a desirable result considering her general

condition.

I ordered and issued six powders of ten grains each, one to be given every fourth hour. I did so with the object of bringing about labour and to test the action of quinine in this direction. I was agreeably surprised at its action. Before the sixth powder was given labour pains had set in, and when I saw the patient she was in the second stage with a normal presentation. In due time she was delivered of a still-born To return to Case 1.

sulphate of quinine of

child, large and well developed. The further clinical progress

of these cases does not come within the scope of this paper. They both did well. Remarks.-That quinine can and may induce uterine con. tractions and thus bring about premature labour or abortion I think there are grounds for believing. This I have before now noted, and it is also the experience of some practitioners with whom I have had opportunities of discussing the subject. I think Case 1 points to this. In treating pregnant women (the subjects of malarial fever) with quinine it is proper always to mention the possibility of abortion or premature labour (more frequently the former) taking place, and to diminish the possibility of such an occurrence one has to administer, and that cautiously, cnly small doses of this drug. Whether quinine acts directly on the gravid uterus or indirectly through the nerve centres is, perhaps, of no immediate importance, though information on In the available this point would be acceptable. literature on cinchona and its compounds little is said as regards the action of quinine on the uterus. Ringer’s Therapeutics"" has the following sentences :"Quinia is sometimes useful in the vomiting of pregnancy." " American writers believe that quinia strengthens the contractions of the womb during delivery and some use it in preference to ergot." " Other writers deny this action to quinia does not induce premature labour, though quinia some writers have asserted the contrary." It must be admitted that many women when pregnant take quinine with no evil results whatever. Considering that this drug is largely used in the colonies further information of its action in the direction here indicated would be interesting and valuable. Trinidad, West Indies.

PUERPERAL ALBUMINURIA AND THE ACTION OF SULPHATE OF QUININE ON THE GRAVID UTERUS. BY R. C.

BENNETT, M.B., C.M. EDIN.,

GOVERNMENT MEDICAL

OFFICER, TRINIDAD.

I SUBMIT the following cases with the hope that they may be of some interest. CASE 1.—A primipara, aged twenty-two years, had been pregnant about eight months, and had suffered from oedema of the extremities for one month. This was the short history I obtained at midnight on March 13tb, when I was for the first time consulted owing to the sudden onset of severe and frequent convulsive attacks. Half-drachm doses of bromide of potassium somewhat relieved these attacks. On the following morning the patient lay on her back in a stupid half-conscious condition, taking no notice of anything and being unable to answer questions. The tongue was lacerated. There was marked oedema of the extremities, the face, the The abdomen was enlarged, due to the advanced THE RELATIVE HEIGHTS AND WEIGHTS labia, &?. OF BENGAL PRISONERS. stage of pregnancy. There was an entire absence of any indications of commencing labour. The urine was scanty, BY W. J. BUCHANAN, M.B., DIPL. STATE MED. DUB., pale in colour, and contained, roughly estimated, 20 per cent. SURGEON-CAPTAIN, INDIAN MEDICAL SERVICE ; SUPERINTENDENT, of albumin. The bowels were constipated. There was no CENTRAL GAOL, BHAGALPUR. history of recent attacks of intermittent malarial fever. ......

of jalap with elaterium was ordered, diuretic mixture and milk and soda-water No quinine was given. This briefly was the The case, and the prognosis was not favourable. marked absence of any indications of approaching labour and the prospect of having to induce it added to the seriousness of the case. On the following day there was a little improvement: the patient answered questions ; there was no recurrence of the fits ; the urine was less scanty, and the bowels were freely purged, but the oedema was distressing. On the next day there was some further improvement ; the oedema was slightly less, but that of the labia had become painful owing to the appearance of sloughs. There were no symptoms of recurrence of convulsions and there was entire absence of any indications of labour. In spite of

Compound powder

also diet.

IN THE LANCET of

a

Aug. 24th, 1895 (p. 476), I .published giving the relative heights and weights of Bengal prisoners. I have since collected a large number of weights and measurements-viz., 28,863-and the result has been to confirm almost absolutely the accuracy of the formula I then published. This formula runs as follows :-" Taking 100 lb. as a normal average weight for a man of 5 ft. add 31b. for each inch above that weight109 lb." That this formula gives as e.g., 5 ft. 3 in. accurate an average height as can be expected is also shown, I think, by the fact that the results of examining 5000, 8000, 20,000, and the above total practically correspond, and the a

table

=

I

BURG.-CAPTAIN BUCHANAN: HEIGHTS & WEIGHTS 7800 cases in the other large in the Administration Report for 1896 are practically identical with the above formula. I Mr. Havelock have purposely avoided parts of an inch. Ellishas shown this to be useless. I must note that these figures have all been taken from prisoners of the peasant class, chiefly from the Behar portion of the Province of Bengal, and are confined to adult men of the agea of from twenty-five to forty years. They do not apply to hill men, Burmese, aboriginal tribes, or to the tall, well-made Rajputs, but are representative of the average Behar and

results of

gaols

in

a

collection of

OF BENGAL PRISONERS.

599

some

Bengal published

Clinical Notes: MEDICAL, SURGICAL, OBSTETRICAL,

AND

THERAPEUTICAL. A CASE OF ANEURYSM. BY F. W. THURNAM,

M.B., C.M. EDIN.

Bengal peasant. A MAN, aged fifty-four years, married, but having no children, decorator, consulted me on Feb. 15th, 1897, complaining of "rheumatic"pains at the back of the head, side of the neck, and towards the right shoulder, There was no history of syphilis, with slight cough and beyond helping to lift a heavy case of goods three months before, which had been followed by an attack of faintness, there was no history of exertion. He was said to have had gout (or rheumatism) many years back. He was ordered a mixture containing salicylate of soda and compound tincture of camphor and a liniment of turpentine and acetic acid. He was allowed to go for a week’s change to Epping Forest during the first week in March. No mention had been made to me of a "sensation of internal tumour behind the collar-bone," neither had any swelling been noticed, though looked for, himself or his wife during the three weeks of its existence. A glance at the second column in the above table will by While away, on the evening of March 9th, his neck, shoulder, show how closely the weights for height correspond with my and upper part of the right chest were rubbed with the liniment formula given above. It will also be seen that one inch a relative, and though there was much pain no enlargement by in height practically means 3 lb. increase in weight. was seen. Next however, a tumour was clearly Lombroso’s rule for Italians, beginning with 5 ft. 110 lb., visible above the morning, sternal end of the right clavicle. On gives an increase of about 5 lb. per inch for his countrymen ; the 12th over the regim of the right sterno-clavicular Allen’s table of heights and weights for Englishmen gives articulation was a swelling the size of a goose’s egg, pulsaalso about 5 lb. per inch above 5 ft. ; that given by Liharzik ting and indistinctly expansile, without bruit over the varies from 3 lb. to 7 lb. These are all the observations of tumour or the vessels ; pain was felt over the site, along this kind I can lay my hands upon at present. The above the neck, and down the arm, which was somewhat table also shows that, taking the Bengal prison population, up the heart’s apex was in the fifth space, displaced oedematous; which fairly represents the peasant classes generally, the out to the line ; the sounds were faint; there were no nipple vast majority of them are of short stature. Taking, with both the radial arteries were atheromatous ; and murmurs ; Mr. Havelock Ellis, heights between 5 ft. 4 in. and 5 ft. 9 in. there was no appreciable difference in their pulses. There to be medium, below that short, and above it tall (these of were a troublesome hacking cough, some difficulty in course are European ideas) we find that from an European and alteration in the voice. My diagnosis swallowing, point of view 51 per cent. would be classed as short, an was aneurysm of tre innominate artery. A mixture conalmost equal number as medium, and almost none as tall. taining iodide of potassium and tincture of opium was for out of 28 863 men measured I could only collect 51 (0’1 given. On the 15th the patient was seen in consultation per cent.) of 5 ft. 10 in. and above. I have frequently had with Dr. H. B. Carter, and, to exclude the possibility of prisoners of this height, but they were generally Rajputs, abscess, disease of the joint or other growth, an exploraor men of better social position than the average prisoner. tory aspiration was made with a hypodermic needle, I have also found that the average weight of this large but it showed no A pus and only withdrew blood. number of men was 109lb. In calculating relative diet red blush over the swollen area, with increased fluctuascales2I took 110lb. as the average, which is now shown to tion in the centre, gave the impression that the skin was be practically correct. T. Lewis, F.R.S,, put the average much thinned. There was exophthalmos of both eyes, more weight of the Bengali as 1051b. The above figures are particularly of the right, the pupil of which was more dilated sufficiently large, I think, to draw safe conclusions from. as compared with the left. The ophthalmoscope showed the It is not meant that these figures can be applied accurately vessels of the right retina to be more distended than those on to every individual case, but they furnish as accurate as the left side. The laryngoscope showed no laryngeal possible a standard for healthy men of this class. Apart paralysis. The cough was due to irritation by compression from their use in gaols they can be used, as has been the case of the right recurrent laryngeal nerve. On the 31st the during this year of famine, to compare the relative health patient was admitted to the London Hospital, under the care and physique of persons of this class in unhealthy or famine, of Mr. Hurry Fenwick, to whom my thanks are specially due years compared with normal conditions. It is much to be for the summary of the notes taken during the patient’s regretted that anthropological figures are not more frequently stay there of one week. " Rapidly growing innominate collected in India. aneurysm; inoperative; doubled its size while in hospital." Buxar, India. On April 7th the patient was discharged from the London Hospital, where an ice-bag had been used which was 1 The Nineteenth Century, July, 1897. continued intermittently, as well as the iodide and opium 2 THE LANCET, May 2nd, 1896. mixture. There was no oedema of the arm at that time. There was slight delirium at night. In May the prominence : and extent of the aneurysm seemed to vary ; it was generally LITERARY INTELLIGENCE.-The American X Ifuller at night ; there were frequent convulsive twitchings Journal is the name of a new monthly journal devoted to the of the arm and leg, more so during sleep. The appetite was and surgical applications of the Roentgen rays. It good, but capricious. As little fluid as possible was is published in St. Louis and is edited by Dr. Heberr allowed in his diet. In June the aneurysm was increasing in size and extending to the left across the episternal notch. Robarts. There were frequent attacks of sickness and diarrhoea, alterDR. J. ASHBURTON President of the nating with constipation. There was more pain in the neck New South Wales Board of Health, has been elected an1 and arm. The patient was confined to bed throughout. In the position of the right clavicle had become much honorary Fellow of the Incorporated Society of Medical Omcers of Health of Great Britain. more nushed downwards than its fellow. and. partlv owing to =

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THOMPSON,

1 July