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ABACTERIAL PYURIA
PSYCHIATRIC VIEW OF NATIONAL BEHAVIOUR.——CHELSEA PHYSIC GARDEN
PSYCHIATRIC VIEW OF NATIONAL BEHAVIOUR
IN our mentally sick world there is a new pleasure for some of us in accounting for the other man’s motives in the technical language of modern psychiatry. Strengthen this new weapon by a knowledge of crowd psychology and we may begin to acquire an understanding of the mental processes, or forces, that threaten civilisation, an understanding that can be useful, however, only when we have enough insight to apply to ourselves, personally and nationally, the technical knowledge we are so ready to use on the other man. Prof. Edward A. Strecker of Pennsylvania, in presenting this function of mental hygiene in his new book/ uses the tried and accepted postulates of psychiatry as guides to the study of man’s behaviour in what we still hopefully regard as the world of sanity-a sanity which he quescomtions when he makes a hypothetical There are pare his own fantasies with our realities. many reminders of our immediate problems in this book -for example, the note that, if symbols used in crowd and mob making could be desensitised by even a small leaven of thought, propaganda would lose much of its effectiveness, followed by the remark that counterpropaganda, unless it is willing to abandon ethical scruples, is rarely successful. Yet there is a thread of optimism in it all. As the productive need for hygiene and sanitation was born from the plagues of the Middle Ages, so, Prof. Strecker hopes, the plagues of our civilisation will stimulate a wider dissemination of the teachings of mental hygiene.
schizophrenic
237
been recognised for many years, but urologists differ as to its frequency and even more as to its significance. Is it a true clinical entity, to be diagnosed only by the exclusion of all other causes, or is it merely an indication that investigation has failed to reveal the underlying lesion ? Moore believes that it is a disease in itself. His view is supported chiefly by the results of treatment. The disappearance of all symptoms and the pyuria after the intravenous injection of neoarsphenamine has been the outstanding feature of similar cases published in the past, and in Moore’s 6 cases, all of whom had failed to respond to ordinary therapeutic measures, a few injections of Novarsenobenzol led to rapid and permanent relief. This remedy has been widely and successfully used in the treatment of chronic staphylococcal infections of the urinary tract. When it is injected both formaldehyde and organic arsenical compounds appear in the urine, and both havebeen credited with the resultant cure. It has also been shown that its injection may turn an alkaline urine acid, and it would be interesting to know what is the pH of the urine in cases of " abacterial pyuria," and whether ammoniacal decomposition of the urine is present in this condition. However this may be, it seems that the injection of neoarsphenamine presents a safe and valuable therapeutic test. CHELSEA PHYSIC GARDEN
THE physic garden at Chelsea, of rather less than four acres in area, has for more than 260 years been devoted to the promotion of scientific pharmacology. The garden, at first leased to the Apothecaries Company in 1673 by Lord Cheyne, was in 1722 generously conveyed to that ABACTERIAL PYURIA body by Sir Hans Sloane, who had acquired the Manor ANY patient whose urine contains pus but remains of Chelsea. Under the management of the Apothecaries sterile on culture must be suspected of having tuberculosis it won the commendation of John Evelyn and was visited of the urinary tract. It should be remembered, however, by Professor Herman of Leyden during the XVIIth that where a patient with an acute or chronic urinary century. It was the attraction of this garden that drew infection is being given a course of a urinary antiseptic the great Linnagus to England in 1736. Among its illusthe urine may be sterile on culture because bacterial.trious curators were Watts, Philip Miller, Forsyth, Fairgrowth has been inhibited by the antiseptic either in the bairn, Fortune and Moore; while among its directors or bladder or the specimen bottle, and examination several lecturers were the well-known names of Curtis, Wheeler, days after the drug has been stopped may then reveal a Ward and Lindley. After passing through many vicissiflourishing growth of organisms. On the other hand, tudes, and in 1893 being on the verge of collapse, the patients with urinary tuberculosis often have both pus Apothecaries Company relinquished their trust to the and coliform organisms in their urine, and the true The Royal Society and the Charity Commissioners. nature of their disease may then only be suspected when Royal College of Physicians having refused the reversion the organisms disappear under treatment while the of the garden to them a scheme was established on Feb. symptoms and pyuria persist. Of 78 cases of sterile 21, 1899, by the Commission whereby the administration pyuria reviewed by Moore a resolving urinary infection of the garden was vested in the City Parochial FoundaIn 20 was the cause in 11, and 24 were tuberculous. tion, its management being entrusted to a representative patients the pyuria was associated with a stone, though in committee. Generous annual subventions are made by In the Trustees of the Foundation for the maintenance of many such cases there is a superadded infection. acute and chronic nephritis pus cells are rarely plentiful the garden, its laboratory, library and houses, while conin the urine, but in chronic or healed pyelonephritis tributions are also received from the Board of Education, pyuria is of great diagnostic significance, and some of the the University of London, the College of Physicians and 9 cases of " toxic nephritis " in Moore’s series were The objects of the the Society of Apothecaries. Another of of this condition. probably examples type garden, as originally prescribed, were "for the lesion which may lead to sterile pyuria is infection in manifestation of the glory of God in the works of structures adjacent to the bladder, such as a cervicitis or creation"" and to enable students to distinguish between subacute prostatitis; in the latter prostatic massage may those plants which are useful and those that are harmful. reveal the causative organism. In the more prosaic language of the scheme of 1899 the When all these common causes of sterile pyuria have objects of the garden are defined as " scientific instruction been excluded there remain a few cases which have come and research in botany including vegetable physiology to be regarded as true abacterial pyuria. Moore reports and instruction in technical pharmacology as far as the 5 such cases, in all of whom symptoms of urinary infecValuable culture of medicinal plants is concerned." tion were present but no organism could be grown from researches are carried on chiefly by students of the the urine by any recognised technique. Urological investiImperial College of Science and living specimens are gation in 2 of these patients suggested infection of supplied to medical schools and colleges for the teaching the upper urinary tract, in 1 the bladder was involved, of botany and materia medica. In plots arranged accordand in the other 2 there was evidence of prostatitis. ing to their orders are to be found aconite, belladonna, The occurrence of a non-tuberculous sterile pyuria has hyoscyamus, digitalis, datura, conium, cannabis, jalap, castor and croton oil, opium, coca, mezereon, gentian, 1. Beyond the Clinical Frontiers. By Edward A. Strecker, Sc.D., M.D., professor of psychiatry in the schools of medicine, podophyllin, senega, ipecacuanha and all the medicinal University of Pennsylvania. London: Chapman and Hall. of the British Pharmacopoeia. Since the outbreak plants 1940. Pp. 210. 9s. 6d. of war attention has been directed to belladonna, digi2. Moore, T. Proc. R. Soc. Med. July, 1940, p. 593.
PSYCHIATRIC VIEW OF NATIONAL BEHAVIOUR
IN our mentally sick world there is a new pleasure for some of us in accounting for the other man’s motives in the technical language of modern psychiatry. Strengthen this new weapon by a knowledge of crowd psychology and we may begin to acquire an understanding of the mental processes, or forces, that threaten civilisation, an understanding that can be useful, however, only when we have enough insight to apply to ourselves, personally and nationally, the technical knowledge we are so ready to use on the other man. Prof. Edward A. Strecker of Pennsylvania, in presenting this function of mental hygiene in his new book/ uses the tried and accepted postulates of psychiatry as guides to the study of man’s behaviour in what we still hopefully regard as the world of sanity-a sanity which he quescomtions when he makes a hypothetical There are pare his own fantasies with our realities. many reminders of our immediate problems in this book -for example, the note that, if symbols used in crowd and mob making could be desensitised by even a small leaven of thought, propaganda would lose much of its effectiveness, followed by the remark that counterpropaganda, unless it is willing to abandon ethical scruples, is rarely successful. Yet there is a thread of optimism in it all. As the productive need for hygiene and sanitation was born from the plagues of the Middle Ages, so, Prof. Strecker hopes, the plagues of our civilisation will stimulate a wider dissemination of the teachings of mental hygiene.
schizophrenic
237
been recognised for many years, but urologists differ as to its frequency and even more as to its significance. Is it a true clinical entity, to be diagnosed only by the exclusion of all other causes, or is it merely an indication that investigation has failed to reveal the underlying lesion ? Moore believes that it is a disease in itself. His view is supported chiefly by the results of treatment. The disappearance of all symptoms and the pyuria after the intravenous injection of neoarsphenamine has been the outstanding feature of similar cases published in the past, and in Moore’s 6 cases, all of whom had failed to respond to ordinary therapeutic measures, a few injections of Novarsenobenzol led to rapid and permanent relief. This remedy has been widely and successfully used in the treatment of chronic staphylococcal infections of the urinary tract. When it is injected both formaldehyde and organic arsenical compounds appear in the urine, and both havebeen credited with the resultant cure. It has also been shown that its injection may turn an alkaline urine acid, and it would be interesting to know what is the pH of the urine in cases of " abacterial pyuria," and whether ammoniacal decomposition of the urine is present in this condition. However this may be, it seems that the injection of neoarsphenamine presents a safe and valuable therapeutic test. CHELSEA PHYSIC GARDEN
THE physic garden at Chelsea, of rather less than four acres in area, has for more than 260 years been devoted to the promotion of scientific pharmacology. The garden, at first leased to the Apothecaries Company in 1673 by Lord Cheyne, was in 1722 generously conveyed to that ABACTERIAL PYURIA body by Sir Hans Sloane, who had acquired the Manor ANY patient whose urine contains pus but remains of Chelsea. Under the management of the Apothecaries sterile on culture must be suspected of having tuberculosis it won the commendation of John Evelyn and was visited of the urinary tract. It should be remembered, however, by Professor Herman of Leyden during the XVIIth that where a patient with an acute or chronic urinary century. It was the attraction of this garden that drew infection is being given a course of a urinary antiseptic the great Linnagus to England in 1736. Among its illusthe urine may be sterile on culture because bacterial.trious curators were Watts, Philip Miller, Forsyth, Fairgrowth has been inhibited by the antiseptic either in the bairn, Fortune and Moore; while among its directors or bladder or the specimen bottle, and examination several lecturers were the well-known names of Curtis, Wheeler, days after the drug has been stopped may then reveal a Ward and Lindley. After passing through many vicissiflourishing growth of organisms. On the other hand, tudes, and in 1893 being on the verge of collapse, the patients with urinary tuberculosis often have both pus Apothecaries Company relinquished their trust to the and coliform organisms in their urine, and the true The Royal Society and the Charity Commissioners. nature of their disease may then only be suspected when Royal College of Physicians having refused the reversion the organisms disappear under treatment while the of the garden to them a scheme was established on Feb. symptoms and pyuria persist. Of 78 cases of sterile 21, 1899, by the Commission whereby the administration pyuria reviewed by Moore a resolving urinary infection of the garden was vested in the City Parochial FoundaIn 20 was the cause in 11, and 24 were tuberculous. tion, its management being entrusted to a representative patients the pyuria was associated with a stone, though in committee. Generous annual subventions are made by In the Trustees of the Foundation for the maintenance of many such cases there is a superadded infection. acute and chronic nephritis pus cells are rarely plentiful the garden, its laboratory, library and houses, while conin the urine, but in chronic or healed pyelonephritis tributions are also received from the Board of Education, pyuria is of great diagnostic significance, and some of the the University of London, the College of Physicians and 9 cases of " toxic nephritis " in Moore’s series were The objects of the the Society of Apothecaries. Another of of this condition. probably examples type garden, as originally prescribed, were "for the lesion which may lead to sterile pyuria is infection in manifestation of the glory of God in the works of structures adjacent to the bladder, such as a cervicitis or creation"" and to enable students to distinguish between subacute prostatitis; in the latter prostatic massage may those plants which are useful and those that are harmful. reveal the causative organism. In the more prosaic language of the scheme of 1899 the When all these common causes of sterile pyuria have objects of the garden are defined as " scientific instruction been excluded there remain a few cases which have come and research in botany including vegetable physiology to be regarded as true abacterial pyuria. Moore reports and instruction in technical pharmacology as far as the 5 such cases, in all of whom symptoms of urinary infecValuable culture of medicinal plants is concerned." tion were present but no organism could be grown from researches are carried on chiefly by students of the the urine by any recognised technique. Urological investiImperial College of Science and living specimens are gation in 2 of these patients suggested infection of supplied to medical schools and colleges for the teaching the upper urinary tract, in 1 the bladder was involved, of botany and materia medica. In plots arranged accordand in the other 2 there was evidence of prostatitis. ing to their orders are to be found aconite, belladonna, The occurrence of a non-tuberculous sterile pyuria has hyoscyamus, digitalis, datura, conium, cannabis, jalap, castor and croton oil, opium, coca, mezereon, gentian, 1. Beyond the Clinical Frontiers. By Edward A. Strecker, Sc.D., M.D., professor of psychiatry in the schools of medicine, podophyllin, senega, ipecacuanha and all the medicinal University of Pennsylvania. London: Chapman and Hall. of the British Pharmacopoeia. Since the outbreak plants 1940. Pp. 210. 9s. 6d. of war attention has been directed to belladonna, digi2. Moore, T. Proc. R. Soc. Med. July, 1940, p. 593.