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A HISTORICO-MEDICAL CALENDAR.
42 of birds. The researches of Ross demonstrated for the first time in the protozoa a complete life-history in which the parasites undergo two distinct cycles of reproduction in two different hosts. The second important discovery mentioned above, that of the Americans Smith and Kilborne, concerns a fatal epidemic disease of cattle and other animals, sometimes termed "red-water." These parasites are transmitted by ticks but not quite in the same way as malaria is transmitted by the mosquito; they are tiny pear-shaped bodies which multiply in the blood corpuscles. The tsetse fly somewhat resembles a common house fly. The disease which follows its bite causes a great mortality among domestic animals by the inoculation of a specific trypanosome which, as already mentioned, was discovered by Colonel Bruce. This tryp3,nosome does not affect the human subject but sleeping sickness, which is caused by a trypanosome of a different kind, carries off a great many native Africans and has proved fatal to a few European visitors.
transmitting the malarial parasites
for
example, in the case of invalids or when the essence is being taken for a long time, even the minutest amount of metallic impurity present is distinctly open to objection. Dr. Schryver suggests that the solvent action on tin is due to the presence of organic acids, such as lactic acid and carnic acid. The metal is first dissolved and then thrown out in the form of an organic salt. The manufacturers have adopted the precaution of stamping the date of manufacture on the wrapper of every tin of meat essence which they issue. It is stated that these changes in the appearance of tinned meat essences are quite unusual in the experience of manufacturers and retailers in this country. In this connexion we have pointed out1 how the action of fruit acids in may be successfully prevented by coating the tin with a lacquer of shellac or similar substance. Otherwise only glass vessels should be permitted for the purpose. The public would do well to be on their guard in this matter and should have nothing to do with meat essences unless they are brilliant in appearance, firm and not liquid, and of a good clear amber colour
preserves
’
THE CHANGES OCCURRING IN MEAT ESSENCES KEPT IN TINS.
A HISTORICO-MEDICAL CALENDAR. So,-iE months ago the Local Government Board was FOR a series of years our German colleagues have had in informed by a firm of manufacturers that a difficulty had Spemann’s Historischer Medicinal-Kalendar"a record of arisen in their business in connexion with the return to the the history of the healing art as embodied in the lives of United Kingdom of tins of beef essence which had been its past masters which is at once an exemplar and a prepared by them several years ago, which, in fact. had stimulus to all members, young and old, of the profession. been sent out to South Africa during the war. A large Day by day the German practitioner, the consultant, the stock of these tins being no longer required for use in the clinician, and the teacher may read, suspended in his library army had been sold and certain consignments of this stock or consulting room, the name, the life, and the work of had recently found their way to this country and the manu- some distinguished surgeon or physician, anatomist or facturers believed that the condition of these essences was university teacher or hospital administrator, physiologist, not satisfactory. Subsequently a large consignment arrived and his morning’s work with the encouragement begin at Southampton from South Africa, 3900 tins in all, valued and the inspiration to be drawn from a noble, often roughly at 700, and Mr. R. E Lauder, the medical officer an epoch-marking career. In a few well-chosen words of the borough and port of Southampton, reported the the said career is impressively told, with the aid, fact to the Local Government Board. Dr. G. S. Buchanan wherever of a portrait reproduced from the best possible, was instructed to confer with Mr. Lauder and to make available likeness of the hero of the day. Side-lights are some inquiries regarding the condition and disposal of the also thrown on the subject by pictures on a small, but vividly articles in question. On examination of some of the tins of effective, scale of the scene of the professional man’s work. beef essence the following points were noted. The sound or of some contemporary incident bearing on his life and its produced by shaking the tins indicated that the contents achievements-the whole, as has been said, constituting in were quite fluid and this was found to be the case in opening daily instalments a history of medical genius and endeavour, the tins. By contrast, new samples at the same temperature inspiring-shall we say sometimes consolatory ? were in the form of jelly. All the fresh samples were clear -to the practitioner or the teacher before facing his patient and amber-coloured, whereas the contents of the tins or his class. German in its inception and its editorshipreturned from South Africa were turbid and their colour it is issued under the of Dr. Julius Pagel, professor auspices might be described as a rather dirty yellow. The appearance of the history of medicine in Berlin, and a highly competent of the surface in the case of the old essences was dull, coadjutor, Dr. J. Schwalbe, of the same university-it gives, whereas that of the new essences was bright. There was no enough, the preference to compatriot heroes, smell indicating decomposition in any of the samples but fair to add, wherever outstanding merit has it is though examined and the inner surface of some of the tins a " claim, no trace of " pan-Germanispaus is visible, but the examined appeared comparatively bright, though in Englishman, the American, the Italian, the Frenchman, or of them dark patches were observed. some Bacteri- the Russian all get their share of recognition and the to be examination contents sterile and ological proved the "Kalendar" at random we alight eulogy. Opening there was no evidence that the gelatin had undergone on excellent portraits and notices of the late Sir degradative changes. Eventually, Dr. Schryver, D.Sc., William Fergusson, of Huxley, of Sir Humphry Davy, found that the material change which had taken place of Monro, and of Charles Murchison, among the British resulted from metallic contamination. The essence had men of light and leading, while no European nationdissolved tin from its receptacle and the turbidity of the can ality complain of being wholly unrepresented. essence was due to the subsequent precipitation of tin in All the same, we think that a similar calendar of purely organic combination. Metallic tin was present in amount British origin and editorship would be a welcome addition to between 0’02 and 0’03 per cent., or roughly between one our professional men’s literary resources, doing for them and a half and two grains per pound of essence. In one what the GermanKalendar"" has done so long and so essence the amount of metal was found to be as much as effectively for the practitioners and teachers of the Father22 grains per pound. This amount of contamination might land. Grand historical figures like those of William Harvey, be expected to occasion symptoms of acute poisoning in of Thomas Sydenham, of Edward Jenner, and of John Dr. Schryver’s opinion, but it is doubtful whether the small Hunter would represent the " Dii Maj orum Gentium" of amount found in the generality of samples would give rise 1 THE to deleterious results. Still, in special circumstances, as, LANCET, Feb. 24th, 1906.
stimulating,
naturally
43 as to lesser but still Sears reports the following case. The patient was a man, constitute a multitude aged 40 years, under the care of Dr. J. L. Morse in the "which no man can number." Preference having been Boston City Hospital. There was effusion into the left given to them wherever a " day " can be found for them chest reaching as high as the third rib. On July 10th in the calendar the intervals might be filled up, as 64 ounces of bloody fluid were removed by aspiration. The in its German counterpart, with names drawn from the symptoms were relieved but the temperature remained continental roll-call-in due homage to the " catholicity of elevated and the fluid re-accumulated. On August lst it medicine" and the "brotherhoodwhich makes the whole was decided to aspirate again. This prospect produced no world of science kin. Such a publication could not but mental perturbation (which has been considered a possible commend itself to the practitioners or teachers in these factor in the fatal cases). The patient did not wince when islands or on the other side of the Atlantic, and we venture to the needle was introduced but he almost immediately The needle was at throw it out as a hint for a "new departure" in medical became cyanotic and pulseless. at stimulation failed and literature for 1908. once withdrawn. Attempts he remained unconscious and died 15 minutes later. OLD VIEWS ON COLDS IN THE HEAD. The necropsy showed several hundred cubic centimetres THE ancient belief that catarrh was caused by a flux from of bloody fluid in the left pleural cavity, and the left lung the brain may be said to have died very hard. As late as collapsed and containing only a little air in the upper lobe. the reign of Queen Anne-a period supposed to mark the It was covered with a membrane from one to two millizenith of what the late Mark Pattison called " The Age of metres in thickness. Scattered through this and over the Reason "-we find James Handley, a popular writer on parietal pleura, which was also thickened, were numerous " health, accounting for " the seat of catarrhs and small grey tubercles. Careful examination of the lung "rheumes" quite in the time-honoured manner. "Fernelius." failed to show any tuberculous focus. There was acute It did not seem possible that the says he, "saith, besides serum within the cranium, there’s glomerular nephritis. other excrements gathered in the external parts of the head, needle could have reached the pulmonary branches of the especially under the cutis of the vertex, where the vessels vagus. The moral of such cases is, as pointed out by Dr. Carhave their extremities, which when they grow turgid, with penter, that exploratory puncture of the chest should never too much serum or other humour, they shed forth under be regarded as a trifling operation and never resorted to, as the skin that which they cannot carry off, and there it sometimes is by house physicians and others, until all it remains, because the thickness and looseness of the ordinary methods of examination are exhaastei. During MM permits it not to evaporate ; and there’s sometimes so exploration the pulse and the respiration should be carefully great a collection here, that it causeth a soft swelling, that watched and any signs of failure promptly treated. Brandy manifestly heaves up the p8’l’io’l’anium from the craniitm." may be administered before operation. Dr. Thomas Oliver, This, the writer avers, is assuredly the source oE all external who has observed four cases of fatal puncture of the "distillation," and he marvels that the ancients never chest, advises the avoidance of the sitting posture during noticed what to him is demonstrable truth. "Hence," says operation.’ he, "Rheumes fall into the eyes, cheeks, teeth, neck, shoulder-blades, sides, back, loyns, hips, thighs, and all the "CHRISTIAN SCIENTISTS" AND PRECAUTIONS joynts, and this is certainly the foundation of every external AGAINST INFECTION. pain, particularly in a catarrh." The habit of taking snuff IN commenting upon the case of Mr. Robert Chisholm in was believed by our ancestors to bs a means of clearing the THE LANCET of Dec. 1st, 1906, p. 1535, we spoke of the effect brain of " rheumsand "humours," and it is a question which the attitude of the "Christian Scientist" towards whether some such belief does not linger even at this day medical science might have in the case of dangerous infecamong primitive snuff-taking peasants. tious diseases contracted by members of their families. Our observations appear to have been taken by some members DEATH FROM EXPLORATORY PUNCTURE OF of the sect to imply that they disregard sanitary precautions THE CHEST. and refuse to notify infectious disease or to take steps to IT is not sufficiently recognised that sudden death may prevent it from being spread among their neighbours. One result from paracentesis thoracis or even from exploratory gentleman in addressing us has explained that in his puncture. Attention was first called to this fact in 1893 own case " when our children had measles, although no by Dr. George Carpenter. The American Journal of the doctor was in attendance and no medicine was given, nor Xedical Saienaes for December contains an important paper any attempt made to follow the usual medical treatment, we on the subject by Professor G. G. Sears of the Harvard did consult a doctor to find out whether it was a notifiable Medical School. On analysing ten recorded cases of fatal disease ; we steeped all the dirty clothes in disinfectants and exploratory puncture he found that in at least eight a notified the laundry so that they might keep the things solidified lung was the cause of the ambiguous signs and separate." Our article must have been misread, for if our was punctured by the needle. Seven of the patients were correspondents will refer to it again they will find that we children. In Vol. XXVIII. of the St. Thomas’s Hospital did not say that they refused to notify infectious disease Reports Dr. A. E. Russell reported three cases of fatal or to take precautions against infection. What we did exploratory puncture of the lung and one fatal case of suggest was, that if no medical man is employed an inparacentesis thoracis. From a careful study of these fectious disease may in all probability not be recognised cases and from experiments performed on animals he as such, at any rate at first, and that the persons reconcluded that death was due to reflex inhibition of the sponsible not being " awareof the nature of the illness centres in the medulla from irritation of the pulmonary would incur no penalty for not notifying it. Moreover, filaments of the vagus rendered unduly sensitive by the whatever may be the course pursued by those who have inflammation. In some cases death did not immediately written to correct us, we were not speculating upon what occur but was preceded for several days by unconscioustheir conduct would have been but were commenting upon ness and convulsions which Dr. Russell attributes to cerebral the actual case of Mr. Chisholm who did not call in a anaemia resulting from the fall of blood pressure. In other medical man, with the result that the diphtheria from cases, as shown by Dr. Carpenter, death was due to asphyxia 1 THE resulting from hsemorrhage into the air passages. Professor LANCET, Jan. 2nd, 1904, p. 26,
English-speaking medicine, while, brilliant lights, they wellnigh
___
--
I
transmitting the malarial parasites
for
example, in the case of invalids or when the essence is being taken for a long time, even the minutest amount of metallic impurity present is distinctly open to objection. Dr. Schryver suggests that the solvent action on tin is due to the presence of organic acids, such as lactic acid and carnic acid. The metal is first dissolved and then thrown out in the form of an organic salt. The manufacturers have adopted the precaution of stamping the date of manufacture on the wrapper of every tin of meat essence which they issue. It is stated that these changes in the appearance of tinned meat essences are quite unusual in the experience of manufacturers and retailers in this country. In this connexion we have pointed out1 how the action of fruit acids in may be successfully prevented by coating the tin with a lacquer of shellac or similar substance. Otherwise only glass vessels should be permitted for the purpose. The public would do well to be on their guard in this matter and should have nothing to do with meat essences unless they are brilliant in appearance, firm and not liquid, and of a good clear amber colour
preserves
’
THE CHANGES OCCURRING IN MEAT ESSENCES KEPT IN TINS.
A HISTORICO-MEDICAL CALENDAR. So,-iE months ago the Local Government Board was FOR a series of years our German colleagues have had in informed by a firm of manufacturers that a difficulty had Spemann’s Historischer Medicinal-Kalendar"a record of arisen in their business in connexion with the return to the the history of the healing art as embodied in the lives of United Kingdom of tins of beef essence which had been its past masters which is at once an exemplar and a prepared by them several years ago, which, in fact. had stimulus to all members, young and old, of the profession. been sent out to South Africa during the war. A large Day by day the German practitioner, the consultant, the stock of these tins being no longer required for use in the clinician, and the teacher may read, suspended in his library army had been sold and certain consignments of this stock or consulting room, the name, the life, and the work of had recently found their way to this country and the manu- some distinguished surgeon or physician, anatomist or facturers believed that the condition of these essences was university teacher or hospital administrator, physiologist, not satisfactory. Subsequently a large consignment arrived and his morning’s work with the encouragement begin at Southampton from South Africa, 3900 tins in all, valued and the inspiration to be drawn from a noble, often roughly at 700, and Mr. R. E Lauder, the medical officer an epoch-marking career. In a few well-chosen words of the borough and port of Southampton, reported the the said career is impressively told, with the aid, fact to the Local Government Board. Dr. G. S. Buchanan wherever of a portrait reproduced from the best possible, was instructed to confer with Mr. Lauder and to make available likeness of the hero of the day. Side-lights are some inquiries regarding the condition and disposal of the also thrown on the subject by pictures on a small, but vividly articles in question. On examination of some of the tins of effective, scale of the scene of the professional man’s work. beef essence the following points were noted. The sound or of some contemporary incident bearing on his life and its produced by shaking the tins indicated that the contents achievements-the whole, as has been said, constituting in were quite fluid and this was found to be the case in opening daily instalments a history of medical genius and endeavour, the tins. By contrast, new samples at the same temperature inspiring-shall we say sometimes consolatory ? were in the form of jelly. All the fresh samples were clear -to the practitioner or the teacher before facing his patient and amber-coloured, whereas the contents of the tins or his class. German in its inception and its editorshipreturned from South Africa were turbid and their colour it is issued under the of Dr. Julius Pagel, professor auspices might be described as a rather dirty yellow. The appearance of the history of medicine in Berlin, and a highly competent of the surface in the case of the old essences was dull, coadjutor, Dr. J. Schwalbe, of the same university-it gives, whereas that of the new essences was bright. There was no enough, the preference to compatriot heroes, smell indicating decomposition in any of the samples but fair to add, wherever outstanding merit has it is though examined and the inner surface of some of the tins a " claim, no trace of " pan-Germanispaus is visible, but the examined appeared comparatively bright, though in Englishman, the American, the Italian, the Frenchman, or of them dark patches were observed. some Bacteri- the Russian all get their share of recognition and the to be examination contents sterile and ological proved the "Kalendar" at random we alight eulogy. Opening there was no evidence that the gelatin had undergone on excellent portraits and notices of the late Sir degradative changes. Eventually, Dr. Schryver, D.Sc., William Fergusson, of Huxley, of Sir Humphry Davy, found that the material change which had taken place of Monro, and of Charles Murchison, among the British resulted from metallic contamination. The essence had men of light and leading, while no European nationdissolved tin from its receptacle and the turbidity of the can ality complain of being wholly unrepresented. essence was due to the subsequent precipitation of tin in All the same, we think that a similar calendar of purely organic combination. Metallic tin was present in amount British origin and editorship would be a welcome addition to between 0’02 and 0’03 per cent., or roughly between one our professional men’s literary resources, doing for them and a half and two grains per pound of essence. In one what the GermanKalendar"" has done so long and so essence the amount of metal was found to be as much as effectively for the practitioners and teachers of the Father22 grains per pound. This amount of contamination might land. Grand historical figures like those of William Harvey, be expected to occasion symptoms of acute poisoning in of Thomas Sydenham, of Edward Jenner, and of John Dr. Schryver’s opinion, but it is doubtful whether the small Hunter would represent the " Dii Maj orum Gentium" of amount found in the generality of samples would give rise 1 THE to deleterious results. Still, in special circumstances, as, LANCET, Feb. 24th, 1906.
stimulating,
naturally
43 as to lesser but still Sears reports the following case. The patient was a man, constitute a multitude aged 40 years, under the care of Dr. J. L. Morse in the "which no man can number." Preference having been Boston City Hospital. There was effusion into the left given to them wherever a " day " can be found for them chest reaching as high as the third rib. On July 10th in the calendar the intervals might be filled up, as 64 ounces of bloody fluid were removed by aspiration. The in its German counterpart, with names drawn from the symptoms were relieved but the temperature remained continental roll-call-in due homage to the " catholicity of elevated and the fluid re-accumulated. On August lst it medicine" and the "brotherhoodwhich makes the whole was decided to aspirate again. This prospect produced no world of science kin. Such a publication could not but mental perturbation (which has been considered a possible commend itself to the practitioners or teachers in these factor in the fatal cases). The patient did not wince when islands or on the other side of the Atlantic, and we venture to the needle was introduced but he almost immediately The needle was at throw it out as a hint for a "new departure" in medical became cyanotic and pulseless. at stimulation failed and literature for 1908. once withdrawn. Attempts he remained unconscious and died 15 minutes later. OLD VIEWS ON COLDS IN THE HEAD. The necropsy showed several hundred cubic centimetres THE ancient belief that catarrh was caused by a flux from of bloody fluid in the left pleural cavity, and the left lung the brain may be said to have died very hard. As late as collapsed and containing only a little air in the upper lobe. the reign of Queen Anne-a period supposed to mark the It was covered with a membrane from one to two millizenith of what the late Mark Pattison called " The Age of metres in thickness. Scattered through this and over the Reason "-we find James Handley, a popular writer on parietal pleura, which was also thickened, were numerous " health, accounting for " the seat of catarrhs and small grey tubercles. Careful examination of the lung "rheumes" quite in the time-honoured manner. "Fernelius." failed to show any tuberculous focus. There was acute It did not seem possible that the says he, "saith, besides serum within the cranium, there’s glomerular nephritis. other excrements gathered in the external parts of the head, needle could have reached the pulmonary branches of the especially under the cutis of the vertex, where the vessels vagus. The moral of such cases is, as pointed out by Dr. Carhave their extremities, which when they grow turgid, with penter, that exploratory puncture of the chest should never too much serum or other humour, they shed forth under be regarded as a trifling operation and never resorted to, as the skin that which they cannot carry off, and there it sometimes is by house physicians and others, until all it remains, because the thickness and looseness of the ordinary methods of examination are exhaastei. During MM permits it not to evaporate ; and there’s sometimes so exploration the pulse and the respiration should be carefully great a collection here, that it causeth a soft swelling, that watched and any signs of failure promptly treated. Brandy manifestly heaves up the p8’l’io’l’anium from the craniitm." may be administered before operation. Dr. Thomas Oliver, This, the writer avers, is assuredly the source oE all external who has observed four cases of fatal puncture of the "distillation," and he marvels that the ancients never chest, advises the avoidance of the sitting posture during noticed what to him is demonstrable truth. "Hence," says operation.’ he, "Rheumes fall into the eyes, cheeks, teeth, neck, shoulder-blades, sides, back, loyns, hips, thighs, and all the "CHRISTIAN SCIENTISTS" AND PRECAUTIONS joynts, and this is certainly the foundation of every external AGAINST INFECTION. pain, particularly in a catarrh." The habit of taking snuff IN commenting upon the case of Mr. Robert Chisholm in was believed by our ancestors to bs a means of clearing the THE LANCET of Dec. 1st, 1906, p. 1535, we spoke of the effect brain of " rheumsand "humours," and it is a question which the attitude of the "Christian Scientist" towards whether some such belief does not linger even at this day medical science might have in the case of dangerous infecamong primitive snuff-taking peasants. tious diseases contracted by members of their families. Our observations appear to have been taken by some members DEATH FROM EXPLORATORY PUNCTURE OF of the sect to imply that they disregard sanitary precautions THE CHEST. and refuse to notify infectious disease or to take steps to IT is not sufficiently recognised that sudden death may prevent it from being spread among their neighbours. One result from paracentesis thoracis or even from exploratory gentleman in addressing us has explained that in his puncture. Attention was first called to this fact in 1893 own case " when our children had measles, although no by Dr. George Carpenter. The American Journal of the doctor was in attendance and no medicine was given, nor Xedical Saienaes for December contains an important paper any attempt made to follow the usual medical treatment, we on the subject by Professor G. G. Sears of the Harvard did consult a doctor to find out whether it was a notifiable Medical School. On analysing ten recorded cases of fatal disease ; we steeped all the dirty clothes in disinfectants and exploratory puncture he found that in at least eight a notified the laundry so that they might keep the things solidified lung was the cause of the ambiguous signs and separate." Our article must have been misread, for if our was punctured by the needle. Seven of the patients were correspondents will refer to it again they will find that we children. In Vol. XXVIII. of the St. Thomas’s Hospital did not say that they refused to notify infectious disease Reports Dr. A. E. Russell reported three cases of fatal or to take precautions against infection. What we did exploratory puncture of the lung and one fatal case of suggest was, that if no medical man is employed an inparacentesis thoracis. From a careful study of these fectious disease may in all probability not be recognised cases and from experiments performed on animals he as such, at any rate at first, and that the persons reconcluded that death was due to reflex inhibition of the sponsible not being " awareof the nature of the illness centres in the medulla from irritation of the pulmonary would incur no penalty for not notifying it. Moreover, filaments of the vagus rendered unduly sensitive by the whatever may be the course pursued by those who have inflammation. In some cases death did not immediately written to correct us, we were not speculating upon what occur but was preceded for several days by unconscioustheir conduct would have been but were commenting upon ness and convulsions which Dr. Russell attributes to cerebral the actual case of Mr. Chisholm who did not call in a anaemia resulting from the fall of blood pressure. In other medical man, with the result that the diphtheria from cases, as shown by Dr. Carpenter, death was due to asphyxia 1 THE resulting from hsemorrhage into the air passages. Professor LANCET, Jan. 2nd, 1904, p. 26,
English-speaking medicine, while, brilliant lights, they wellnigh
___
--
I