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ACTION AGAINST A DENTIST FOR MALPRAXIS.
265
ACTION AGAINST A DENTIST FOR MALI’TtANT9.
texture
and contains, as in the normal condition, many Itis not so very long since we heard a good deal about the The epididynua shows no other of epilepsy by correcting errors of refraction, but now connective-tissue cells. most physicians are satisfied that however much such cor- changes than those incident to the first stage. Besides the rection may relieve the epileptic, it very rarely, if ever, is above there is a third change, which is more partial and sufficient to abolish his fits. Probably the same is true much resembles the result of the infiammatory process. It of all peripheral disturbances. The sooner it is clearly is usually observed in the small or shrunken testicles of old recognised that epilepsy depends upon some morbid condition ’, men and afreets both organs. In the altered patches the of the nervous centres the more likely are therapeutic di seminal tubules, in the majority of instances, are completely measures to be crowned with that success which is at once ’ transformed into fibrous rods or cords ; but in some there still remain in the central fissure that represents the original the aim of the physician and the desire of the patients. lumen traces of epithelial cells derived from the degenerated cells of the seminal tubules. The inter-tubular connective ACTION AGAINST A DENTIST FOR MALPRAXIS. tissue is increased in amount and converted into a dense ACTIONS brought against dentists to recover damages for fibrous variety. alleged avoidable injury during an operation are by no means uncommon and are exceedingly difficult to adjudicate upon. THE HEALTH OF ITALY. Such a one occurred recently at Manchester, the plaintiff YEAR by year the statistical reports issued by the Italian alleging that by the negligence of the defendant’s operator Government are gaining in method, in fulness and in scienhe suffered from haemorrhage to such an extent that he had tific precision, and those for which the department of Public to be attended by a medical man. Another dentist subseHealth is responsible are a conspicuous illustration in point. quently extracted a piece of the fang which had been left in One drawback, however, is common to the whole series, and the gum. It was contended for the defendant that the bleedthat is the lateness of their appearance. For instance, we are iag was due to a predisposition on the part of the plaintiff not allowed to know the mortality returns of the first half of to hemorrhage. The plaintiff was awarded E15 damages. 1892 till July of 1893. Still, compared with the old perFrom the meagre report in our hands it is impossible to give functory system, now happily superseded, the superior accuany definite opinion on this particular case, but the operation racy and comprehensiveness of the new are worth waiting for, evidently was not a success as one fang was left, though this with which consolation we must be content and hope for the might have been the fault of the patient. Hemorrhage is further improvement by which the subject-matter dealt the most frequent of all the casualties, and they are many, yet with shall savour less of "ancient history." From a return that may arise from tooth extraction, and cases occur from which we owe to the Public Health Department we can now time to time even in the hands of the most skilful operators. give the number of deaths from infectious diseases in each Many cases have been recorded where death has occurred province of the kingdom from Jan. 1st to June 30th, 1892. from loss of blood after the extraction of a tooth in those These, all told, were 426,604-far too high a figure for a ,6uffeHng from hemophilia, and in some where there has been population of 30,200,000. This is a notable rise on the In cases of hsemopbilia certain no history of this condition. number of deaths for the corresponding six months of 1891, precautions should always be taken-but how often is the which was 402,479. Special causes, however, are cited to operator informed of the fact ?-such as the internal adminis- explain this difference between the two semesters-a differtration of gallic acid for a few weeks prior to the operation as ence which, as will be seenfrom the subjoined table, was most 6uggested by Mr. Smith Turner, and the plugging of the marked in January and February of each year :socket after the extraction. enre
-
dumber of deaths.
___
THE TESTICLES IN AGED PERSONS.
Months.
IN an interesting paper on the structural changes observed z, in the testicles of aged persons, which appears in the ’ recently issued number of the Journal of Anatomy and PAyAology, Dr. Joseph Griffiths of Cambridge gives the Miowiag results of his observations : In the testicles of ’I the aged two distinct stages may be recognised in the process of involution or decay to which they are liable. Either of these may be apparent although the organs may present their usual appearance and nearly natural size. In the one the epithelium of the seminal tubules and also that of the tubules of the globus major of the epididymis undergoes more or less complete fatty de- di generation and partly disappears; the tunica propria of the tubules of the testicle becomes somewhat thickened, but the intervening inter-tubular connective tissue remains practically unaltered. In the epididymis the muscular cvall of the tubule is replaced by fibrous connective tissue, and the inter-tubular connective tissue is increased, dense and fibrous. In the other, or second, stage the seminal tubules are much reduced in size, the epithelium having in great part disappeared, leaving only, in many instances, a single layer of long, tapering, columnar cells, lining and filling the tubule, the central spermatozoa-producing cells having completely disappeared, whilst the tunica propria is greatly thickened from proliferation of its own connective-tissue cells and the formation of a fibrous matrix. The inter-tubular connective tissue is in this second stage relatively increased, owing perhaps to the diminution in the size of the seminal tubules, but it still remains of loose
If
I,
18n i.
April......... May .........
79942 73.548 73.136 66 742 55 592
June
54,040
January......... February......... March.........
.........
1892. ......
......
......
......
......
......
91.689 82.208
79,314 61,254 57,381 54,758
The principal causes of the severe mortality registered in the first months of 1892 were the diffusion and the gravity of the influenza epidemic. In fact, owing to this malady there died in the first semester of 1892 no fewer than 19,508 individuals, whilst in the corresponding period of 1891 the deaths due to the same cause were only 118. On the other hand, there was a great diminution of the mortality from other infectious maladies in the first half of 1892 as compared with that of 1891. We cannot transcribe the parallel columns given in the official return before us for the two years, but we may select a few prominent heads, as, for instance, that of small-pox, which for the first half of 1892 numbered 659 victims, as against 1360 for the corresponding half of 1891. Measles in the former period caused 6458 deaths and in the latter 11,430 ; erysipelas 1756 in the one and 2110 in the other; miliary fever 98, as against 144, and typhoid fever 5105, as against 6792. The deduction from these figures is the eminently satisfactory one that in preventable zymotic disease the effect of improved hygiene and sanitary precautions is steadily making itself felt. Malaria, in spite of all that has been done for its etiology, its pathognomonic signs (particularly in the circulation) and its treatment, remains a pretty "constant quantity" so far as its victims are concerned-the deaths from it in the first half of 1891 having
ACTION AGAINST A DENTIST FOR MALI’TtANT9.
texture
and contains, as in the normal condition, many Itis not so very long since we heard a good deal about the The epididynua shows no other of epilepsy by correcting errors of refraction, but now connective-tissue cells. most physicians are satisfied that however much such cor- changes than those incident to the first stage. Besides the rection may relieve the epileptic, it very rarely, if ever, is above there is a third change, which is more partial and sufficient to abolish his fits. Probably the same is true much resembles the result of the infiammatory process. It of all peripheral disturbances. The sooner it is clearly is usually observed in the small or shrunken testicles of old recognised that epilepsy depends upon some morbid condition ’, men and afreets both organs. In the altered patches the of the nervous centres the more likely are therapeutic di seminal tubules, in the majority of instances, are completely measures to be crowned with that success which is at once ’ transformed into fibrous rods or cords ; but in some there still remain in the central fissure that represents the original the aim of the physician and the desire of the patients. lumen traces of epithelial cells derived from the degenerated cells of the seminal tubules. The inter-tubular connective ACTION AGAINST A DENTIST FOR MALPRAXIS. tissue is increased in amount and converted into a dense ACTIONS brought against dentists to recover damages for fibrous variety. alleged avoidable injury during an operation are by no means uncommon and are exceedingly difficult to adjudicate upon. THE HEALTH OF ITALY. Such a one occurred recently at Manchester, the plaintiff YEAR by year the statistical reports issued by the Italian alleging that by the negligence of the defendant’s operator Government are gaining in method, in fulness and in scienhe suffered from haemorrhage to such an extent that he had tific precision, and those for which the department of Public to be attended by a medical man. Another dentist subseHealth is responsible are a conspicuous illustration in point. quently extracted a piece of the fang which had been left in One drawback, however, is common to the whole series, and the gum. It was contended for the defendant that the bleedthat is the lateness of their appearance. For instance, we are iag was due to a predisposition on the part of the plaintiff not allowed to know the mortality returns of the first half of to hemorrhage. The plaintiff was awarded E15 damages. 1892 till July of 1893. Still, compared with the old perFrom the meagre report in our hands it is impossible to give functory system, now happily superseded, the superior accuany definite opinion on this particular case, but the operation racy and comprehensiveness of the new are worth waiting for, evidently was not a success as one fang was left, though this with which consolation we must be content and hope for the might have been the fault of the patient. Hemorrhage is further improvement by which the subject-matter dealt the most frequent of all the casualties, and they are many, yet with shall savour less of "ancient history." From a return that may arise from tooth extraction, and cases occur from which we owe to the Public Health Department we can now time to time even in the hands of the most skilful operators. give the number of deaths from infectious diseases in each Many cases have been recorded where death has occurred province of the kingdom from Jan. 1st to June 30th, 1892. from loss of blood after the extraction of a tooth in those These, all told, were 426,604-far too high a figure for a ,6uffeHng from hemophilia, and in some where there has been population of 30,200,000. This is a notable rise on the In cases of hsemopbilia certain no history of this condition. number of deaths for the corresponding six months of 1891, precautions should always be taken-but how often is the which was 402,479. Special causes, however, are cited to operator informed of the fact ?-such as the internal adminis- explain this difference between the two semesters-a differtration of gallic acid for a few weeks prior to the operation as ence which, as will be seenfrom the subjoined table, was most 6uggested by Mr. Smith Turner, and the plugging of the marked in January and February of each year :socket after the extraction. enre
-
dumber of deaths.
___
THE TESTICLES IN AGED PERSONS.
Months.
IN an interesting paper on the structural changes observed z, in the testicles of aged persons, which appears in the ’ recently issued number of the Journal of Anatomy and PAyAology, Dr. Joseph Griffiths of Cambridge gives the Miowiag results of his observations : In the testicles of ’I the aged two distinct stages may be recognised in the process of involution or decay to which they are liable. Either of these may be apparent although the organs may present their usual appearance and nearly natural size. In the one the epithelium of the seminal tubules and also that of the tubules of the globus major of the epididymis undergoes more or less complete fatty de- di generation and partly disappears; the tunica propria of the tubules of the testicle becomes somewhat thickened, but the intervening inter-tubular connective tissue remains practically unaltered. In the epididymis the muscular cvall of the tubule is replaced by fibrous connective tissue, and the inter-tubular connective tissue is increased, dense and fibrous. In the other, or second, stage the seminal tubules are much reduced in size, the epithelium having in great part disappeared, leaving only, in many instances, a single layer of long, tapering, columnar cells, lining and filling the tubule, the central spermatozoa-producing cells having completely disappeared, whilst the tunica propria is greatly thickened from proliferation of its own connective-tissue cells and the formation of a fibrous matrix. The inter-tubular connective tissue is in this second stage relatively increased, owing perhaps to the diminution in the size of the seminal tubules, but it still remains of loose
If
I,
18n i.
April......... May .........
79942 73.548 73.136 66 742 55 592
June
54,040
January......... February......... March.........
.........
1892. ......
......
......
......
......
......
91.689 82.208
79,314 61,254 57,381 54,758
The principal causes of the severe mortality registered in the first months of 1892 were the diffusion and the gravity of the influenza epidemic. In fact, owing to this malady there died in the first semester of 1892 no fewer than 19,508 individuals, whilst in the corresponding period of 1891 the deaths due to the same cause were only 118. On the other hand, there was a great diminution of the mortality from other infectious maladies in the first half of 1892 as compared with that of 1891. We cannot transcribe the parallel columns given in the official return before us for the two years, but we may select a few prominent heads, as, for instance, that of small-pox, which for the first half of 1892 numbered 659 victims, as against 1360 for the corresponding half of 1891. Measles in the former period caused 6458 deaths and in the latter 11,430 ; erysipelas 1756 in the one and 2110 in the other; miliary fever 98, as against 144, and typhoid fever 5105, as against 6792. The deduction from these figures is the eminently satisfactory one that in preventable zymotic disease the effect of improved hygiene and sanitary precautions is steadily making itself felt. Malaria, in spite of all that has been done for its etiology, its pathognomonic signs (particularly in the circulation) and its treatment, remains a pretty "constant quantity" so far as its victims are concerned-the deaths from it in the first half of 1891 having