ATTEMPTED SUICIDE BY MEANS OF ILLUMINATING GAS.

1294

rising to .eeoo. He was allowed to do other work and held three other important appointments. He resigned in 1902. During this period no report was issued by the medical ,officer. The first report was issued in 1903 by Dr. James Kerr who was appointed in 1902. His salary was Z800 per annum, rising to 1000, and he was not allowed to hold any other appointment. Let us give the Board When it comcredit for what it has accomplished. menced work the prospect was enough to appal the most ardentlover of education. The Board was hampered by a badly drawn Act and by the fatal British love of compromise. As a Board it acted with conspicuous unfairness for years towards the medical profession and was not infrequently extravagant. But within the last few years, owing to wholesome checks administered by the result of Regina v. Oockerton and the refusal of the medical profession to give certificates, the Board was beginning to settle down.

Of the conduct of its individual members we can say nothing but praise. They have ungrudgingly devoted their time and their talents to the service of the children of the poor and they have left the new education authority a sound system upon which to carry on the work which the School Board organised. -

MALARIA AND PREVENTIVE MEASURES. ONE of

our

correspondents

has recently had the oppor-

tunity of meeting some of the invalids from the English regiments quartered temporarily in the hinterland behind Aden during the progress of the Boundary Commission which is working under General Maitland to decide on the frontier which Turkey is to accept. It appears that the Hampshire Regiment landed in Aden in February, 1903, 1100 strong, being actually over strength. 300 men were despatched to take part in the Somaliland campaign, where there are certain obvious risks contingent on active service and a fair chance of a medal for the survivors when the fighting is all over. The rest of the regiment, all presumably in good health after service in India, were marched up to the hills where they left sandy wastes behind them and got into a hilly country where tea and coffee are grown. A few weeks ago, or about a year after the regiment landed from India, the principal medical officer held an inspection and decided that 75 per cent. of the men were unfit for duty. We understand that there have been 32 deaths in this regiment in Aden and that about half of these were due to malaria. The ordinary causes of sickness must have accounted for a few of the 75 per cent. but the great bulk of them are being invalided for malaria with the ordinary symptoms of intermittent fever, sweats and consequent debility, anasmia, and enlarged spleens. There are pools of water in this hinterland near the soldiers’ damping grounds and many mosquitoes and the regiment was paraded daily for a preventive dose of quinine while a non-commissioned officer stood by to see that the men really drank the prescribed dose. But we are informed that there were no mosquito nets provided by the authorities either for officers or men and the officers naturally suffered in a similar proportion, four having been already invalided home and three now being in hospital in Aden. The fever-stricken men blanched as if from prolonged haemorrhage, crawling about like chronic invalids, are now being sent home, and as their mission was a political one they will probably get no medal to compensate them. But is a preventable disease. we now know that malaria

Why

was

this

regiment

not

supplied

with

mosquito

nets

which are now served out even to black soldiers in the Soudan?7 If our information is incorrect we shall be glad to have it authoritatively denied but if it is correct in ,substance we hope that the matter will be inquired into. We have heard it whispered that in India troops in

barracks

even

in malarial stations

are

not

yet supplied with

mosquito netting, though the hospitals are well provided with it. It is only fair to the Indian Government to state that the Dublin Fusiliers who were relieved by the Hampshire and the Buffs"who were sent to Aden last October have both suffered less from malaria than the unfortunate Hampshires.

Regiment

THE

HOUSE

OF COMMONS AND VENTILATION.

appeared in our issue of

Oct. 10th, a select committee of the House of Commons had presented in regard to the ventilation of the House was embodied. This topic has again been disturbing the equanimity of Members without, so far as we can see, any very urgent reason and the animated discussion upon it which on April 28th occupied so large a part of the valuable time of our legislative assembly does not appear to have produced any particular result. As we pointed out at the time there is really very little to find fault with in the ventilation and Mr. T. W. Russell was probably quite correct in saying that a great deal of nonsense was talked about the matter. This opinion seems to have been shared by Sir M. Foster, Sir W. Foster, and Dr. Farquharson, all of whom are well qualified to form a competent judgment on such a point. The only serious defect in the arrangements which the committee’s report brought to light was that the air inlets were placed in the floor and covered by matting over which those who entered the chamber had to pass, so that particles of dust and mud from the boots of the persons concerned were introduced into the air current and so disseminated. This, of course, is by no means a satisfactory system and the We do not suppose that sooner it is amended the better. Members would take kindly to Mr. Weir’s suggestion that they should leave their boots at the door, even though the" assistance ofI I eight Japanese girls in their native costume" was available to this end, but some inexpensive structural alterations overcoming the difficulty should be quite feasible. IN

an

annotation which

1903, p. 1033, the substance of the report which

ATTEMPTED SUICIDE BY MEANS OF ILLUMINATING GAS. IN the Boston Medioal and Surgical Journal of March 24th Dr. F. Holyoke has published a case of attempted suicide by means of illuminating gas which presents several points of interest. The inhabitants of a tenement house were disturbed by moaning in one of the rooms during the afternoon and evening. At 8 P. M. they knocked at the door but were not answered. The police were called in and on breaking open the door found the windows closed tightly and gas escaping from two jets. The air was unbreathable and a man, aged 44 years, was lying unconscious in an easy chair. He was removed from the room and seen by a medical man within ten minutes. He was perspiring profusely and his clothes were drenched with sweat. The pupils were dilated, the face was cyanotic, the limbs were relaxed, and the pulse was imperceptible at the wrist but a feeble cardiac impulse could be felt at the rate of 140 a minute. Respiration was very slow and gasping and the jaw had dropped. After artificial respiration the breathing became more rapid. Strychnine and nitroglycerine were injected and the pulse was restored. At 9.30 P. M. the skin was pale and cold and the limbs were rigid and convulsed. The pupils were dilated and did not respond to light. There was a naphtha-like odour from the breath which did not disappear until the fourth day. The rectal temperature was 96’ 8° F., the pulse was 142, and the respirations were 32 and shallow. Large mucous rales were heard over the lungs and persisted until the second day. The temperature did not become normal until the third day; then it rose steadily until the sixth day when it reached

1295 100’60. Consciousness was gradually regained on the night of the second day. For the next two days the patient complained of great headache and of numbness in the limbs, which latter lasted for a week. On the second day was noticed a peculiar condition of the parts on which he rested when in the chair-the shoulders, the sacrum, and the buttocks. They were thickened and brawny, bright red, hot, and tender, as though scalded. After a few days the skin became loose, leaving a large denuded surface which healed slowly. The muscles of the left leg were paretic for several weeks. There was also vaso-motor weakness of this leg: when standing was attempted the skin became turgid and purple with distended vessels. The gas was a mixture of two parts of coal gas and one part of water gas.

absence of certain associated signs. A clinical descrip-tion of the phenomenon of astereognosis and of its tests was

ago in THE LANCETand illustrative recorded. The balance of clinical and pathological evidence which has been accumulated since then shows that lesions of the parietal area of the cortex close to the rearof the genu of the fissure of Rolando are very frequently associated with varying degrees of astereognosis. There is also strong clinical evidence that subcortical lesions in this situation may produce the same symptom. Verger has reported several cases of cortical lesions in which astereognosis was present but only one in which there was proof by operation of the site of the lesion. The case was that of a man with a haemorrhagic clot which had destroyed a part of the brain cortex. On removal of the former after trephining (by Lannelongue of Paris) the cortex was seen THE TAX UPON A CUP OF TEA AND A to be destroyed in the region of the middle third of theGLASS OF BEER. Rolandic area (ascending frontal and parietal convolutions),. while the subjacent white substance was softened and friable. the WITH regard to the proposal of the Chancellor of Exchequer to raise the duty on tea to 8d. per pound a little Isolated cases have been reported of lesions in the middle calculation will show that when this tax is realised the part of the ascending parietal convolution and the adjacent indirect duty paid upon a glass of beer will still be higher part of the inferior parietal lobe by various observers than that paid on a cup of tea. Of course, as Mr. Austen (Raymond, Walton and Paul, Dana, Mills, and Verger) which the accuracy of the localisation of the "stereognostic Ohamberlain said, everything depends upon the lightness confirm " of the hand and fingers in this region, while the now sense of the beer and the strength of the tea. The question classical case of Mills and Keen has shown that a single put to him in the House of Commons was : " What circumscribed lesion of the corona radiata lying deeply and* is approximately the amount of indirect taxation carried close to the optic thalamus may produce astereognosis as an by a glass of light beer and a half-pint cup of tea of moderate strength ?" There is no difficulty in esti- early and prominent symptom. Dr. Bullard’s own case is that of a man aged 58 years, who had been addicted to mating the indirect taxation upon a glass (half-pint) of alcohol. In May, 1902, he began to suffer from numbness light beer, for the duty upon such beer, the wort of which of the left arm and leg; his lower extremities "often felt as does not exceed a gravity of 1055, is 8s. per 36 gallons, which if were they asleep." He was often unable at night to deteris equivalent to one-sixth of a penny on the half-pint glass. mine the position of his legs among the bed-clothes. Six Coming to tea we may fairly assume for the purpose of later weeks he consulted a physician who found that astereocalculation that on the average one teaspoonful of tea is of the left hand was the most prominent symptom. used for making a half-pint of tea (a breakfast-cupful) and gnosis There was some lack of "muscular sense " in this hand but the mean weight of one ordinary teaspoonful of tea is, we find, 40 grains. There are 7000 grains in the pound, so muscular power (grip on the dynamometer) was unimpaired.. that the indirect taxation upon a teaspoonful of tea or No Romberg’s symptom of ataxia was present, though the In gait was a little awkward owing to a slightdragging" " of upon a cup of tea made from it would be ’1B;å. other words, the indirect taxation on 22 cups of tea the left foot in walking. There was marked exaggeration of would be one penny, while the taxation on six half- the knee-jerks. He grew feeble and early in July developed neuritis and some of anaestheaia over the lowerpint glasses of light beer would come to the same sum. opticof the face on the degree side. Sensation to temperature right The indirect taxation, therefore, is nearly four times heavier part and normal in both hands but. remain touch, pain The changes, on the glass of beer than it is on the cup of tea. marked in the left hand and on the astereognosis persisted taxation of strong beer is, however, proportionately heavier. left forearm. A diagnosis of cerebral tumour was made. The The question raised is of importance and it is interesting to worse and died about the middle of find that on calculation the beer-drinker pays more taxation patient gradually grew in the meantime lost all power of the left. having September, than does the tea-drinker. Total abstainers therefore can hand, and foot. The necropsy disclosed some degree hardly prefer the charge against the Chancellor of the arm, of arterio-sclerosis and diffuse nephritis. A tumour was Exchequer that as compared with tea-drinking beer-drinking found deeply imbedded in the brain substance of the right is encouraged. cerebral hemisphere. It was ill defined externally and in places approached the cortex; internally it reached the STEREOGNOSIS AS A LOCALISING FACTOR IN surface of the ventricle. The structures involved by this CEREBRAL AFFECTIONS. large growth included (together with adjacent parts of the THE value of stereognosis as a sign in the diagnosis of I corona radiata) the subcortical radiations distributed upaffections of the brain may now be said to be established wards to the parietal area of stereognosis as before defined firmly by clinical evidence of indisputable character. In the and seemed therefore to support the correctness of the Journal of Nervous and Mental Disease for April Dr. William doctrine of the localisation of the stereognostic function. Bullard of Boston, U.S.A., states that astereognosis-the inability to recognise the character and identity of small solid THE SANITARY INSTITUTE. objects placed in the hands-"may be caused by affections Dr. Robert Farquharson, M.P., vice-president of the of the cerebral cortex, by subcortical lesions, or by lesions in Sanitary Institute, occupied the chair at the dinner or near the optic thalamus," and occasionally by lesions of held on May 2nd at the Hotel M6tropole, London. the pons and bulb. These various points constitute the After the usual loyal toasts Sir R. M. Hensley, chaircomplex pathway of sensations which, proceeding from the man of the Metropolitan Asylums Board, in proposing stimulus of the object grasped and manipulated in the of "The toast Navy, Army, and Auxiliary Forces," the hand, are conducted to the cerebral cortex, and hence of the work that had been done testified to value the the exact localisation of a lesion at any one point of this pathway is not always possible to be made in the 1 THE LANCET, May 25th, 1901, p. 1483. -

published three years cases were