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TUBERCULOSIS SOCIETY.
541 an
insect free from previous animal filarial infection. The geographical distribution of the fly and P. loa was
patients in connexion with the French Hospital at Brighton. Being on the sea-front, it had to be closed
very exact. Intermediary stages of filaria had been found in the muscles of Chrysops and not in the Malpighian tubes. The embryo of -F. loa measured 1/16th inch in the proboscis of the fly, just as in the case of F. bancrofti and the mosquito.
as the results were found to more sheltered conditions at
TUBERCULOSIS SOCIETY. meeting was held at the Margaret-street for Consumption, London, W., on Feb. 28th, Dr. NATHAN RAW, M.P., the President, in the chair. Dr. JOHN SORLEY showed a case of Bilateral Fibroid Phthisis in a girl aged 7, complicated by unusually A
CLINICAL
Hospital
extensive hairy pigmentary nsevus, involving
a
large
of the trunk and thighs. This was followed by a demonstration of X ray plates of tuberculous cases. Dr. WILLIAM GORDON (Exeter) read a paper on Rain-bearing Ifinds and Tuberculosis. The paper dealt in brief with the evidence in favour of two main contentions, that exposure to strong prevalent rain-bearing winds (1) increases the prevalence of phthisis, and (2) has an injurious effect on
part
existing
cases.
be bad.
Transferred to the results have been good. Moral-the,sanatorium should not always be blamed for bad results.-Dr. H. A. ELLIS stated that he had, when at Middlesbrough, to stop sending his patients to Redcar and Saltburn on the Yorkshire coast as the results were so uniformly disastrous, due to the effect of the prevalent north-east wind. He suggested that Ceylon, with its two monsoons, would be an admirable locality for the study of the effects of the winds on phthisis.-Dr. JANE WALKER considered that the fact that the patients in the Norwegian sanatorium, alluded to by the lecturer, were allowed to struggle against driving rain during their walks should be discounted in estimating the evil effects of the treatment.-Dr. F. RUFENACHT WALTERS commented on the exhausting effects of walking against strong winds, and the carrying of wet clothing in the case of ambulant patients, and the tendency to keep windows closed in streets exposed to such winds.-Dr. HORACE WILSON, from personal experience of practice in the Isle of Man, stated that phthisis was much more prevalent south of a ridge which separates the island into two parts than north of it, the latter being more sheltered and protected from the prevailing winds.-Dr. SORLEY pointed out that, despite the continuance of prevailing winds, the death-rate from tuberculosis was rapidly decreasing, and probably the disease itself was also less prevalent nowadays, so that other factors must be involved.
Hastings
The starting-point of the observations was the fact that those rural sanitary districts of Devon which faced south and west-that is, with the aspect then considered ideal for a phthisis health resort-were just those which showed the highest death-rates from the disease. The influence of soil, rainfall, sanitation, and social conditions was excluded and the matter investigated further by taking a series of parishes classed as "I sheltered" or "exposed,"when it was found that the phthisis death-rate was much higher in the SHEFFIELD MEDICO-CHIRURGICAL SOCIETY. latter than in the former. To the obvious objection that small numbers tend to produce large exceptions to any law A MEETING was held on Feb. 17th, Dr. F. T. SADLER, of incidence, could be opposed the fact that exceptions were the President, in the chair. so few as thereby only to increase the cogency of the law. Dr. J. S. FAIRBAIRN (St. Thomas’s Hospital) opened a In the Okehampton rural district the average death-rate in the exposed parishes was nearly five times as great as discussion on the question that in the sheltered, and the disproportion was equally Practice and Teaching ReqIlire Reformastriking in the Barnstaple district, results which have been Does l4Zidzoifeytion on Physiological Lines’? confirmed recently by Dr. J. Brownlee. Equally decisive results were obtained in respect of the sheltered and He said that midwifery was an integral part of medicine, exposed streets of Exeter. By applying to these investi- being part of the larger subject of reproduction, and the gations the principle of " the approximate isolation of influ- importance, so tardily recognised, of the care of the rising ences," by which is denoted the systematic enumeration generation to the national health and welfare, has given it of all the known influences involved and their successive a new and enhanced value. The present-day tendency in elimination as far as possible from the problem, Dr. medicine is to study disease from Ithe physiological side and Gordon considers that the rain-bearing prevalent winds discover the earliest evidence of disturbed function, and this have emerged from this severe test as one of the most tendency ought also to be our attitude towards midwifery powerful of all influences known to affect the death-rate practice. Dr. Fairbairn pointed out that this had not been from the disease. Corroboration of this view has come the case in the past, as shown by the neglect of the from Japan, the Sandwich Islands, the Falklands, the physiological feeding of the infant for the perfecting of Faroe Islands, and Iceland. It explains, as nothing else substitute feeding, at which great success has been can do, the exceptions and difficulties met with by other attained, but along non-physiological lines. Considering investigators who have endeavoured to account for the application of physiology to the conduct of labour, the prevalence of phthisis on the basis of soil, geographical Dr. Fairbairn said we had hitherto concentrated on the distribution, occupation, density of population, or other artificial termination of labour by instrumental aid; the factors. Further, Delepine found, on mapping out the attendant’s biceps had been the substitute for the uterine situation of 1524 farms which supplied Manchester with muscle in cases of indifferent uterine action. We should milk, that great differences existed with regard to the pre- not argue on the sterile question as to when and when not valence of bovine tuberculosis in them. Using the data so to use forceps and the factors that interfere with good ascertained, the lecturer showed that tuberculosis was from uterine action. We should discuss how their use may be twice to five times as prevalent in farms which were exposed, eliminated, forceps delivery being regarded as the result partially or fully, as in those which were similarly sheltered. of a failure to secure normal and physiological parturition. As to the influence of these winds on the course of the The two factors to which most of the cases of delayed disease, evidence, though far from complete, is yet very labour in otherwise normal cases could be ascribed were suggestive. Records from sanatoriums in different localities, emotion and fatigue. The discussion should turn on suggesunder varying conditions of wind and rain, in sheltered and tions as to how these factors could be avoided, and whether exposed situations, and comparison of collective results are the use of sedative drugs to diminish sensitiveness and suggested as the lines on which future inquiry should run. secure rest was less physiological than operative interAlready, however, they point to such an influence being ference. Dr. Fairbairn concluded by a reference to the manifested, while as regards the average duration of fatal future of midwifery practice, to the respective spheres of cases under the contrasted conditions it is found that a the practitioner and the midwife, and to the training and higher proportion of cases of shorter duration (short cases, teaching of students. those lasting 9 months or less; long, 15 months or more) The PRESIDENT emphasised what the speaker had said as occurred in the exposed areas and a higher proportion of to the importance of controlling the emotional factors longer duration in the sheltered areas. Somme has recently which tend to disturb labour.-Mr. MILES PHILLIPS condrawn attention to the evil effects of wind and rain on sidered the pathological aspect of labour as being the one sanatorium patients in Norway, the number of those dis- most calling for practical attention.-Mr. W. W. KING also charged as improved being lessened after exposure to a thought that labour, from the point of view of the practical period of persistently bad weather. The limits of effective obstetrician, was best regarded as pathological.-Dr. SAMSON shelter may be approximately defined in terms that a ridge MATHEWS and Dr. W. E. HOULBROOK also spoke. 100 ft. in height will afford effective shelter to half a mile of flat country level with its base and more or less shelter to Corrigendum.-In our last week’s issue lines 9 and 10 from nearly half a mile further. of first column of p. 488 should read " the total mortality top Dr. CAMPBELL McCLURE cited the fate which befell might be anything from the 15 per cent. given by Sir William the establishment of an annexe for consumptive Hale-White to over 50 per cent."
insect free from previous animal filarial infection. The geographical distribution of the fly and P. loa was
patients in connexion with the French Hospital at Brighton. Being on the sea-front, it had to be closed
very exact. Intermediary stages of filaria had been found in the muscles of Chrysops and not in the Malpighian tubes. The embryo of -F. loa measured 1/16th inch in the proboscis of the fly, just as in the case of F. bancrofti and the mosquito.
as the results were found to more sheltered conditions at
TUBERCULOSIS SOCIETY. meeting was held at the Margaret-street for Consumption, London, W., on Feb. 28th, Dr. NATHAN RAW, M.P., the President, in the chair. Dr. JOHN SORLEY showed a case of Bilateral Fibroid Phthisis in a girl aged 7, complicated by unusually A
CLINICAL
Hospital
extensive hairy pigmentary nsevus, involving
a
large
of the trunk and thighs. This was followed by a demonstration of X ray plates of tuberculous cases. Dr. WILLIAM GORDON (Exeter) read a paper on Rain-bearing Ifinds and Tuberculosis. The paper dealt in brief with the evidence in favour of two main contentions, that exposure to strong prevalent rain-bearing winds (1) increases the prevalence of phthisis, and (2) has an injurious effect on
part
existing
cases.
be bad.
Transferred to the results have been good. Moral-the,sanatorium should not always be blamed for bad results.-Dr. H. A. ELLIS stated that he had, when at Middlesbrough, to stop sending his patients to Redcar and Saltburn on the Yorkshire coast as the results were so uniformly disastrous, due to the effect of the prevalent north-east wind. He suggested that Ceylon, with its two monsoons, would be an admirable locality for the study of the effects of the winds on phthisis.-Dr. JANE WALKER considered that the fact that the patients in the Norwegian sanatorium, alluded to by the lecturer, were allowed to struggle against driving rain during their walks should be discounted in estimating the evil effects of the treatment.-Dr. F. RUFENACHT WALTERS commented on the exhausting effects of walking against strong winds, and the carrying of wet clothing in the case of ambulant patients, and the tendency to keep windows closed in streets exposed to such winds.-Dr. HORACE WILSON, from personal experience of practice in the Isle of Man, stated that phthisis was much more prevalent south of a ridge which separates the island into two parts than north of it, the latter being more sheltered and protected from the prevailing winds.-Dr. SORLEY pointed out that, despite the continuance of prevailing winds, the death-rate from tuberculosis was rapidly decreasing, and probably the disease itself was also less prevalent nowadays, so that other factors must be involved.
Hastings
The starting-point of the observations was the fact that those rural sanitary districts of Devon which faced south and west-that is, with the aspect then considered ideal for a phthisis health resort-were just those which showed the highest death-rates from the disease. The influence of soil, rainfall, sanitation, and social conditions was excluded and the matter investigated further by taking a series of parishes classed as "I sheltered" or "exposed,"when it was found that the phthisis death-rate was much higher in the SHEFFIELD MEDICO-CHIRURGICAL SOCIETY. latter than in the former. To the obvious objection that small numbers tend to produce large exceptions to any law A MEETING was held on Feb. 17th, Dr. F. T. SADLER, of incidence, could be opposed the fact that exceptions were the President, in the chair. so few as thereby only to increase the cogency of the law. Dr. J. S. FAIRBAIRN (St. Thomas’s Hospital) opened a In the Okehampton rural district the average death-rate in the exposed parishes was nearly five times as great as discussion on the question that in the sheltered, and the disproportion was equally Practice and Teaching ReqIlire Reformastriking in the Barnstaple district, results which have been Does l4Zidzoifeytion on Physiological Lines’? confirmed recently by Dr. J. Brownlee. Equally decisive results were obtained in respect of the sheltered and He said that midwifery was an integral part of medicine, exposed streets of Exeter. By applying to these investi- being part of the larger subject of reproduction, and the gations the principle of " the approximate isolation of influ- importance, so tardily recognised, of the care of the rising ences," by which is denoted the systematic enumeration generation to the national health and welfare, has given it of all the known influences involved and their successive a new and enhanced value. The present-day tendency in elimination as far as possible from the problem, Dr. medicine is to study disease from Ithe physiological side and Gordon considers that the rain-bearing prevalent winds discover the earliest evidence of disturbed function, and this have emerged from this severe test as one of the most tendency ought also to be our attitude towards midwifery powerful of all influences known to affect the death-rate practice. Dr. Fairbairn pointed out that this had not been from the disease. Corroboration of this view has come the case in the past, as shown by the neglect of the from Japan, the Sandwich Islands, the Falklands, the physiological feeding of the infant for the perfecting of Faroe Islands, and Iceland. It explains, as nothing else substitute feeding, at which great success has been can do, the exceptions and difficulties met with by other attained, but along non-physiological lines. Considering investigators who have endeavoured to account for the application of physiology to the conduct of labour, the prevalence of phthisis on the basis of soil, geographical Dr. Fairbairn said we had hitherto concentrated on the distribution, occupation, density of population, or other artificial termination of labour by instrumental aid; the factors. Further, Delepine found, on mapping out the attendant’s biceps had been the substitute for the uterine situation of 1524 farms which supplied Manchester with muscle in cases of indifferent uterine action. We should milk, that great differences existed with regard to the pre- not argue on the sterile question as to when and when not valence of bovine tuberculosis in them. Using the data so to use forceps and the factors that interfere with good ascertained, the lecturer showed that tuberculosis was from uterine action. We should discuss how their use may be twice to five times as prevalent in farms which were exposed, eliminated, forceps delivery being regarded as the result partially or fully, as in those which were similarly sheltered. of a failure to secure normal and physiological parturition. As to the influence of these winds on the course of the The two factors to which most of the cases of delayed disease, evidence, though far from complete, is yet very labour in otherwise normal cases could be ascribed were suggestive. Records from sanatoriums in different localities, emotion and fatigue. The discussion should turn on suggesunder varying conditions of wind and rain, in sheltered and tions as to how these factors could be avoided, and whether exposed situations, and comparison of collective results are the use of sedative drugs to diminish sensitiveness and suggested as the lines on which future inquiry should run. secure rest was less physiological than operative interAlready, however, they point to such an influence being ference. Dr. Fairbairn concluded by a reference to the manifested, while as regards the average duration of fatal future of midwifery practice, to the respective spheres of cases under the contrasted conditions it is found that a the practitioner and the midwife, and to the training and higher proportion of cases of shorter duration (short cases, teaching of students. those lasting 9 months or less; long, 15 months or more) The PRESIDENT emphasised what the speaker had said as occurred in the exposed areas and a higher proportion of to the importance of controlling the emotional factors longer duration in the sheltered areas. Somme has recently which tend to disturb labour.-Mr. MILES PHILLIPS condrawn attention to the evil effects of wind and rain on sidered the pathological aspect of labour as being the one sanatorium patients in Norway, the number of those dis- most calling for practical attention.-Mr. W. W. KING also charged as improved being lessened after exposure to a thought that labour, from the point of view of the practical period of persistently bad weather. The limits of effective obstetrician, was best regarded as pathological.-Dr. SAMSON shelter may be approximately defined in terms that a ridge MATHEWS and Dr. W. E. HOULBROOK also spoke. 100 ft. in height will afford effective shelter to half a mile of flat country level with its base and more or less shelter to Corrigendum.-In our last week’s issue lines 9 and 10 from nearly half a mile further. of first column of p. 488 should read " the total mortality top Dr. CAMPBELL McCLURE cited the fate which befell might be anything from the 15 per cent. given by Sir William the establishment of an annexe for consumptive Hale-White to over 50 per cent."