A DELICATE METHOD OF OBTAINING HÆMIN CRYSTALS FROM MINUTE BLOODSTAINS.

1484 one of the most fatal of all docking of extraneous supplies, appear to be extremely seninfective diseases. Since tuberculosis has been made notifi- sible. The two essentials for improvement at the present able it is clear that the public must be regarded as used to the time are, in her opinion, better education of the cooks and idea of the violation of medical confidence involved, and fuller discussion of the subject in all its branches. Dr. that there need be less hesitation in extending the sphere of Mumford regards the midday meal, when the interval is notification to other affections. We hope that the question short, to be "of the nature of a refreshment more than a of such extension throughout the whole country, and apart full-sized meal " ; and he makes no mention of meat as from local predilections, may not be lost sight of by the forming a part of it. We imagine that most parents as well medical advisers of the Government. From an article in as children regard the mid-day meal (at school) as the chief another column it will be seen that this plan is already being meal of the day-a late dinner is not the ideal arrangement Mr. Prosser is for the young for many and obvious reasons. adopted in the new public health legislation of Canada. a Norfolk headmaster of considerable experience, who DIETARY REFORM IN SECONDARY SCHOOLS. carries out Dr. Sim Wallace’s advice of ending meals with a I to clean the teeth ; he has a large garden and makes UNDER the auspices of the National Food Reform Associa-crust tion a conference has lately been held at the Mansion House, full use of vegetables and fruit ; he also uses cheese andat which various speakers of acknowledged experience and nuts in accordance with the latest vogue, and states that authority gave expression to the feeling that our existing these dishes are popular. Eating between meals is promethods of school dieting are in need cf considerable hibited, and as the school is in the country we presume the modification. Probably no one has a better right to speak prohibition is effectual: (]’r16St1Ûa desunt. Dr. Sim Wallace’s address on the main lines of reform in feeding at public, on the subject than Dr. Clement Dukes, of Rugby ; he laid in the of are two demands down that there secondary, and private schools contained some statesupreme feeding ments that seemed designed to excite criticism, He on the of and at school-adequate knowledge part boys girls considers at these schools to be not the both in and of details the the caterer dietary personal supervision kitchen and in the dining hall. He mentioned that one at fault 11except perhaps for its being too highly headmaster’s wife whom he knew invariably walked about nutritious," and, further, he adds that the digestibility the dining hall where over 100 boys dined, personally saw and absorbability of the food supplied leave little room for that every boy was properly served, and learned the reason improvement. He divides foods into the cleansing and the. by inquiry why any boy failed to eat. We can imagine non-cleansing kinds, in regard to their effect on the teeth that this practice may have furnished a strong stimulus and mouth. The latter (farinaceous and sugary food in to appetite, or at any rate to consumption of food ; general, without a fibrous element) should not be eaten undoubtedly such constant supervision would ensure satis- except when followed by food of a cleansing kind (fish, meat, factory cooking and serving of meals. It is failings in these uncooked vegetables and fruit, stale bread, liquids, &c.). respects rather than in the amount and character of the food He particularly recommends raw fruit as a termination for a. itself that Dr. Dukes considers require most attention. He meal, with which opinion everyone will agree. The down as two fundamental rules that a in of lies the The headcourse, lays during youth difficulty, application. larger quantity of all kinds of food is demanded than at master of Abbotsholme, Derbyshire, Dr. Cecil Reddie,. any other time of life, and that a relative excess of proteids gave an interesting account of the hygienic condition, is imperative if the highest condition of growth and develop- and particularly of the attention that is paid to health ment is to be attained. Three meat meals, however, are not matters in the curriculum at this school. This conrequired, the evening supper being preferably of a lighter ference on diet in schools has done good in stimucharacter. We notice that not only Dr. Dukes but other lating public interest in the subject. We believe that speakers also recommend oatmeal porridge as an ideal schools are far better managed in this regard than was the food. So much is said nowadays as to the necessity for case a few years ago. But much still remains to be done in taking food that requires considerable mastication that a soft the education of parents and teachers in the principles of food like porridge is often condemned. Dr. A. A. Mumford, dietetics ; in the exposure of fallacies as to food that may be of Manchester, recommends a crust. with the porridge, but in fashion for the moment; and perhaps most of all in the believes that the danger to boys from insufficient food is bringing of .. experts" together, so that there may be free greater than that from non-masticated food. Mr. Prosser, discussion, and the public may become acquainted with the a headmaster who has given great personal atten- two (or more) sides of the question, in regard to the various tion to school dietetics, also considers porridge a reforms that may be suggested. very good food if properly made. Dr. Dukes maintainsI that, in spite of asseverations to the contrary, boys A DELICATE METHOD OF OBTAINING HÆMIN and girls do care for puddings, sweet things being CRYSTALS FROM MINUTE BLOODSTAINS. the most palatable of all the foods they eat. We should A TEST for blood, first described by Teichmann in 1855, is, hardly have thought this needed emphasising, but with the increased pace of the present day it is not unlikely that this the production of hasmin crystals by heating the suspected taste will diminish, and in time the sight that did Thackeray s substance with glacial acetic acid. If the material is abunheart good to see-a man of 40 eating a jam tart with dant there is no difficulty, and large and characteristic relish-will indeed be a rarity. We are glad to find Dr. crystals are readily formed. But glacial acetic acid when Dukes upholding sugar as a physiological necessity in youth, heated has a tendency to evaporate with explosive violence, and, being more digestible, as preferable to fat; this is in with consequent loss of the crystals if the amount of accordance with the natural tastes of children. He emphati- material is small. In the Boston Medical and S’ugiccy as most of condemns tea the cause Jowrnal of 11th Dr. W. F. Whitney has described acally frequent indigestion April in the young, especially when it is made too strong and new method which appears to have advantages. He sought Miss Robertson, of Hertford, for a solvent a drop of which would evaporate from the allowed to stand too long. also recommends porridge for breakfast, though admitting periphery toward the centre, thus concentrating the soluthat it is unpopular in England ; her two recommendations, tion. He found this in formic acid of specific gravity 1’ 2. that the tuck shop should not be accessible before meals If a drop of this acid is placed on a glass slide and and that rejection of good plain food should be met by the allowed to evaporate at the temperature of the air,

pneumonia, which remains

,

1485 after gentle heating, it will disappear gradually from the yearly average, which seems to indicate that more general On the other hand, attention is being paid to systematic preparation than was the periphery to the centre. acid does not hold together, formerly the case. Allied to examinations is the question of a drop of glacial acetic but spreads over the slide and evaporates instantly. With the interchange of certificates of qualification between the these facts in mind Dr. Whitney worked out the following recognised pharmaceutical authorities within the British method. A minute fragment of the suspected substance-a Empire, and the President mentioned that the first reciprocal scraping from a stain or a bit of stained fibre-is placed on agreements with colonial pharmaceutical authorities, in pura slide and a small drop of formic acid of specific gravity 1’ 2 suance of the new by-law relating thereto, had already been is applied with a glass rod. 0 ver the drop is inverted a decided upon, so that the Council can now accept, under small watch glass, which should not touch it or project certain equitable conditions, the pharmaceutical graduates of beyond the edge of the slide. Gentle heat is applied Victoria and of Queensland, while negotiations are going In addition to these matters beneath the drop, and the moment condensation is seen on with other colonies. inside the watch-glass the heat is discontinued, the watch- the annual report, which was adopted by the meeting, glass is removed, and the remainder of the fluid is dealt at some length with the policy of the Council in regard When dry the spot to the National Insurance Act, and stated that the pharmaallowed to evaporate in air. can be examined microscopically and mounted in Canada cists of Great Britain have reason to congratulate themselves The crystals are very small, requiring a high on the outcome of their struggle for recognition. The quesbalsam. power objective to see them well, but they are so tion of dispensing by medical men under the Act was numerous that they cannot be overlooked. A second appli- adversely commented on. cation of acid does not seem to make them any larger. The fact that they are so small shows that only a minute THE BACTERIOLOGY OF THE RENAL FORM OF TYPHOID FEVER. quantity of blood is necessary for their formation. The addition of a little hydrobromic acid (34 per cent.) in the THERE is a very rare form of typhoid fever which begins proportion of one drop to 4 cubic centimetres of the formic an acute nephritis, the cause of which is not recognised acid gives darker and more numerous crystals than formic until the appearance of the rose spots several days later.’acid alone. The delicacy of the test is so great that crystals At a meeting of the Socie’e M6dicale des H6pitaux of Paris have been obtained occasionally from a small drop of a on March 15th M. Marcel Garnier and M. Joseph Thiers mixture of blood with 200 times as much water, while from reported a case in which, apparently for the first time, the a mixture of 1 to 50 they can always be obtained. Further, bacteriology of this form was investigated. A domestic the ease and rapidity with which this test can be performed servant, aged 22 years, was admitted into the Lariboisiere is an advantage. It can be directly applied to the suspected Hospital on Nov. 25th, 1911. On the 21st she was seized substance, and the whole procedure takes less than a minute. with in the lumbar and back. and acute or

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There She also suffered from headache and insomnia. THE WORK OF THE PHARMACEUTICAL SOCIETY. was neither epistaxis nor diarrhoea, but the urine was did not take to bed. She OF the various statutory duties of the Pharmaceutical diminished in quantity. She had borne two children, and examination of the urine is from more important the public point of Society none On exaview than the administration of the penal clauses of the had never revealed the presence of albumin. but mination she to be of robust constitution appeared Pharmacy Acts, and some interesting details of this and was was 104° F. and the The very prostrated. temperature other departments of the society’s work were given at its 120. She complained of violent pains in the lumbar seventy-first annual meeting held in May. Reference pulse has already been made in these columns1 to the statistics region, especially on the right side, which was very tender. - of this part of the society’s work as detailed in the registrar’s The urine amounted to only 250 cubic centimetres in the 24 hours and was of a dark red colour and contained much report. But while the cases taken up were equivalent to so albumin. Acute hasmorrhagic nephritis was diagnosed and many arrests of public dangers, it is unfortunate that the "lactose water " and warm baths were prescribed. On the has no control over the sale of a number of society drugs following day the urine had increased in quantity to in to character of those that many equally dangerous may only a litre, but was still markedly bloody. On the 27th be sold subject to the conditions imposed on the sale of the same symptoms persisted, and tenderness and gurgling scheduled poisons. The President in his address commented were found in the right iliac fossa. Typhoid fever upon the danger to the public arising out of the sale, without From the urine the warning of the poison label, of substances like veronal, of renal onset was then suspected. and mentioned that the Council on March 6th had sent to settled an abundant deposit containing numerous more the Privy Council Office a resolution recommending that this or less deformed red corpuscles, leucocytes, epithelial and certain other substances should be added to the Poison casts, and numerous bacilli which did not retain Gram’s Schedule. No intimation, however, had yet been received stain. On the 28th many rose spots were found on the that the Lords of the Council had confirmed the resolution. abdomen, and the spleen was distinctly enlarged. Widal’s While there can be little doubt that the requisite acquiescence reaction was positive. On Dec. 2nd improvement began, will in due course be intimated, it is difficult to understand and on the llth the temperature fell to normal, but the urine still contained blood and albumin ; it amounted to 1600 cubic why it should be delayed so long. After the administration of the law relating to the sale of poisons, the next in import- centimetres in the 24 hours. On the 17th the urine amounted to two litres and did not appear to contain blood, but there ance of the duties of the society is the conducting of the the 21st the number of bacilli in pharmaceutical examinations, the object of which is to was still albuminuria. On the urine was much diminished, and on the 22nd the albuensure that persons who keep open shops for the sale of was uninterrupted. poisons shall be qualified by training to be entrusted with minuria had disappeared. Recovery was obtained five times by the urine the disease the compounding and distribution of potent drugs. While During examination. On for catheterisation bacteriological aseptic the number of candidates for the qualifying examination last year was less by 153 than that examined in the previous each occasion it was found to contain the typhoid bacillus. of the rose spots, the year, the percentage of passes was considerably higher than On Nov. 27th, before the appearance 1

THE

LANCET, Feb. 17th, p. 445.

1

THE LANCET, Jan.

21st, 1911, p. 180.