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BENJAMIN BROADBENT.
THE JOHNSTON-LAVIS GEOPHYSICAL BEQUEST. to the sad cases on its books, sweets and books for the children, and money for the elderly. It is at the festive season that the burden of a hard life becomes more bitter, and a small remembrance such as the Guild is able to provide brings a feeling of joy quite disproportionate to the value of the gift. The heavy rentals demanded for single rooms as well as the general increase in cost of living and crowding of the labour market has reduced many of these people to real starvation ; their appeals are almost always for work, but modern conditions afford little hope of livelihood to the untrained or partially-trained and elderly worker. The Guild allows money grants to the aged, the sick, and for special emergencies, such
removal, purchase of surgical appliances, spectacles dentures, holidays, and the acquisition of some
as or means
of livelihood such as a typewriter. The fundamental principle underlying the work is to help people to help themselves. Scarcely more pathetic, but still graver from the point of view of the community, are the young children whose education cannot be completed owing to the death of their father. Much valuable service would be lost to the State if the Guild were not able to save these children from the lives of uncongenial and unproductive labour into which poverty would force them. The attention of practitioners and their wives is drawn to the value of the work being done by this Guild. The Secretary is Miss Thomson, 60, South Molton-street, W. 1. THE
SECRETARYSHIP OF THE ROYAL SOCIETY OF MEDICINE. AT its last meeting the Council of the Royal Society of Medicine selected a successor to Sir John MacAlister from a large number of applicants, the choice falling upon Mr. Geoffrey R. Edwards, B.A. Camb. Mr. Edwards was educated at St. Paul’s School and St. John’s College, Cambridge. He studied in Germany in order to qualify for the Woods and Forests Department of the Indian Civil Service, and continued this work in India. On his return to this country he joined the Royal Air Force as a pilot, was wounded, and had to alight in enemy country, entailing an imprisonment of 14 months in Germany. Subsequently, Mr. Edwards served on the Repatriation Commission in Germany and on the Inter-Allied Aeronautical Commission of Control. When finally demobilised he obtained the appointment of assistant secretary to the National Physical Laboratory, Teddington, where he had considerable experience in library and editorial work, in organisation, and in receiving. Mr. Edwards has travelled in most European countries and speaks French and German. He takes up the duties for which he is so well qualified on Sept. lst next, and we wish him well in a position of great importance and interest. Weare glad to learn that the Society has decided to mark Sir John MacAlister’s retirement by appealing for funds to raise a memorial to his great work for medicine over .a period of 38 years. Fellows of the Society will be glad to have the opportunity of constituting a permanent memorial of the man to whom the very existence of the Society is chiefly due. The proposal is to ask Sir John MacAlister to sit for his portrait, to be rendered in oil or stone. THE JOHNSTON-LAVIS GEOPHYSICAL BEQUEST. THE late Dr. H. J. Johnston-Lavis, who was both a medical man and a distinguished geologist, bequeathed to University College, London, his geophysical collection of some 20,000 specimens and a remarkable library of books and pictures relating to volcanic phenomena. These have been housed at 13-1, Gower-street, a few doors from University College, where the collection was formally opened on June 25th by Sir Henry Miers, F.R.S., Vice-Chancellor Sir John Rose of the University of Manchester. Bradford presided, and among those present was Dr. de Lavis-Trafford, the son of the donor, who is qualified in medicine in France. Johnston-Lavis, who was descended from a Huguenot family, " de
31
Levis," received his primary education at the Grammar School, Iver, Bucks. While there, the story goes, a school-fellow threw a stone at him. Young JohnstonLavis, although in pain, examined the stone with curiosity, and further investigation showed the
missile to be a fossil echinoderm. This event stimulated his interest in geology, and the stone formed the first specimen in his collection. In 1873 he became a student at University College, studied medicine at St. Mary’s Hospital, and qualified with the M.R.C.S. in 1878. While a medical student all his leisure was devoted to geological studies, and at 18 he joined the Geologists’ Association, in the following year became a member of the Geological Society, and at the age of 20 published his first geological paper. The value of geology to medicine was shown in his essay, which gained the Parkin Prize of the Royal College of Physicians of Edinburgh in 1914. This discussed the physics and chemistry of volcanic eruption and the physical effects of eruptions on human beings and animals. For many years Johnston-Lavis was Professor of Vulcanology in the Royal University of Naples and, as Prof. Miers pointed out, he was the very embodiment of the scientific spirit in all the work which he did. The gift forms a permanent expression of the donor’s affection for the College and the University.
BENJAMIN
BROADBENT. Benjamin Broadbent, who died on June 25th at the age of 75, was a younger brother of the late Sir William Broadbent and, like him, a forceful person. He will be remembered as a pioneer in child welfare work. For many years chairman of the Huddersfield Health Committee, he entered with enthusiasm into the efforts of the medical officer of health, Dr. S. G. Moore, to save the lives of infants dying from preventable causes in the borough. In 1904 Mr. Broadbent accepted the civic chair for the definite reason that he believed it would give him greater He offered scope for combating infant mortality. a gift of ;&bgr;l, secured by a promissory note, to every baby born in Longwood (where his woollen mills were situated) during his year of office, who was still alive at the end of 12 months, the object being to ascertain where births had taken place, so that they might be followed up. During the year 112 infants were born in that ward, of whom only four failed to claim their birthday present; at the end of ten years 98 were still alive, and only seven were known to have died. The first promissory note was taken to the house by Miss Broadbent, and thus began a system of voluntary home visiting. In the following year the Huddersfield and District Public Health Union was instituted, with Mr. Broadbent as president. This Union, which secured the help of more than 100 volunteers, worked in close cooperation with the Public Health Department. A fee of 18. offered for any notification of birth received within two days was largely successful, but failed in just those cases where it was most needed, and it was chiefly due to the representations made by Mr. Broadbent and Dr. Moore that in 1906 compulsory notification of births A fundamental was introduced by Act of Parliament. aim of Mr. Broadbent’s work for child welfare was to keep mother and child together in the home, and to give help to both. His influence had much weight in the establishment of the National Association for the Prevention of Infant Mortality, for which he drafted the constitution. Again, it was on Mr. Broadbent’s suggestion that, at a Mansion House Conference in 1917, it was decided to form a small committee to act in conjunction with Lord Rhondda to go into the question of a Ministry of Health. As recently as July, 1924, two striking articles appeared in the Times over the signature of Benjamin Broadbent, showing the results of a careful personal investigation into the Ten Best Towns " for infant life. He was one of the speakers appointed to take part in the International Summer School to be held at Geneva in August of this year, when his subject was to have been Begin"
32
THE TREATMENT OF ABDOMINAL ADHESIONS.
of Infant Welfare in Great Britain. Mr. Broadbent had the satisfaction, not granted to all pioneers, of seeing the fruits of his labour.
nings
Modern Technique in Treatment.
A Series of Special Articles, contributed by DENICOTINISED TOBACCO. invitation, on the Treatment of Medical A NUMBER of people appear to be specially sensitive and Surgical Conditions. to the toxic effects of nicotine and its associated alkaloids contained in tobacco. Some of them are deterred from smoking at all; more of them smoke CXXIX.—THE TREATMENT OF ABDOMINAL ADHESIONS. in excess of what they know to be good for their and THE of this Dealers have endeamental scope paper is limited to a consideration physical efficiency. voured to meet the needs of these people by supplying of abdominal adhesions secondary to inflammatory tobacco from which the nicotine has been removed, processes or to operation, and does not include the in whole or in part. We published not long ago, at various recognised types of colonic adhesions whosethe request of a business firm, some analyses of the sites and appearances are constant-e.g., Jackson’s nicotine-content of tobacco treated with a view to membrane. Inflammatory Adhesions. reducing the percentage of nicotine. While the flavour and smoking quality remained, as far as we could In the first place, we must recognise that the ascertain, unchanged, it was possible to show that formation of adhesions following inflammation of, denicotinisation had taken place to the extent of operation on, abdominal organs is a natural and 10 to 20 per cent. It must not, however, be assumed or when these adhesions life-saving process. It is " tobacco placed interfere with the normal only that every so-called " nicotine-free functions that the patient on the market is in fact such, for a communication seeks advice and treatment. has recently been madel by Dr. L. Frank, scientific Adhesions which result from inflammation may member of the Chief Health Office in Berlin, showing cause severe symptoms of acute or subacute obstructhat the Chemical Institute attached to the Health tion, and these are more liable to occur following Office was unable to confirm the withdrawal of a lesion in the lower abdomen. While in some patients nicotine from a number of tobacco samples so described. symptoms supervene after the acute attack, shortly In two samples, in fact, the percentage of nicotine was others may enjoy many years of unimpaired health higher in the treated than in the ordinary variety of before symptoms supervene. Cases are frequently tobacco as obtained from the same firm before seen in which the signs strongly suggest cancer of thetreatment. The increase has a possible explanation colon and in which it is difficult to estimate the true in the greater dryness of the treated tobacco. The significance of a history of " a bad attack of inflammaregistered process of denicotinisation in this case tion of the bowels " 15 to 20 years previously. Tuberappears to consist in the exposure of the tobacco, culous adenitis d the mesentery is not an infrequent whether cigars or cigarettes, for a long time to a moist cause of acute or subacute obstruction, either by the atmosphere, succeeded by a rapid rise of temperature formation of bands stretching across the abdominal to 150° C. in an exhaust chamber. Whether the cavity from the infected gland, or by actual attachunsuccess in the samples examined was to be ascribed ment of the bowel to the gland. In cases of the latter to the process itself or to deficient technique in carrying type the prognosis ought to be guarded, because it out Dr. Frank does not pretend to decide, but he frequently the gland is acutely inflamed as the result does warn physicians not to recommend to their of secondary infection from the bowel, and its close patients the use of cigars and cigarettes alleged to be relationship to the large mesenteric vessels makes denicotinised, without further evidence than the the development of thrombosis, embolism, or genermaker’s assurance. infection fairly probable. The development of A RECEPTION will be held at the Royal College of inflammatory adhesions tends to mask the signs and of the original lesion. For example, when Surgeons of England, Lincoln’s Inn-fields, on symptoms a gastric or duodenal ulcer has become adherent to in connexion with the Monday evening, July 13th, Convention of English-speaking Ophthalmological neighbouring organs the regularity of the appearance Societies. Fellows and Members of the College and disappearance of the pain in relation to the taking of food becomes less noticeable and is by a wishing to attend should apply to the Secretary, continual discomfort or dragging pain. replaced The seasonal Mr. S. Forrest Cowell, at the College for cards of invitation before July 10th. The Convention meets remissions from pain also become incomplete or from July 14th to July 16th, under the Presidency of altogether absent. Mr. Treacher Collins, Mr. C. B. Goulden (79, PortlandTraumatic Adhesions. place, W.) being the General Secretary. After every abdominal operation a certain degree of peritoneal adhesions necessarily occurs. In the THE committee of the Torbay Hospital has received majority of cases no signs or symptoms result. In the sum of 100,000 from Mrs. Ella M. Rowcroft for other cases discomfort develops and the surgeon must the erection of the proposed hospital and chapel ati carefully consider whether at the primary operation Hengreave House. The site had already beenLan important lesion had been overlooked or has purchased and this munificent gift will cover the subsequently developed-e.g., a duodenal ulcer or whole cost of building, leaving the committee to’ gall-stones in a case on which appendicectomy has raise only the sums for furnishing and equipment. been performed-or whether in a neurasthenic patient Subscriptions have already been received and the operation has been performed on insufficient evidence donor hopes that the required amount may be com- owing to exaggeration of the original symptoms. : pleted before the hospital is opened, and also that The Adhesions Diathesis," there may be a sufficient surplus to form a substantialL foundation for an endowment fund. The onlyTIn the treatment of adhesions there is no difference conditions of the gift are that the chapel shall be between those of inflammatory or traumatic origin erected in accordance with a plan and specification to of course, that the former call for more urgent except, be approved by the donor and shall contain a special1 treatment of the primary focus, increase the difficulties window chosen by her, and that no vivisection 01r-at and may cause a more prolonged conoperation, cognate treatment shall be permitted on the premises, valescence. A great deal of experimental work has An additional JB6500 are provided to endow the stipendi been done to try to elucidate the causes of postof the chaplain. A special effort is to be made tcJ adhesions and to devise methods for their raise a further sum of jE26,000 for endowment. Th operative but progress has been slow and unsatiseprevention, work is to be put in hand without delay. factory. Sepsis of low virulence, excessive trauma, 1 and incomplete haemostasis are without doubt Deutsch, med. Wochenschr., 1925, i., 484.
I
alised
____
.
.
.
-
removal, purchase of surgical appliances, spectacles dentures, holidays, and the acquisition of some
as or means
of livelihood such as a typewriter. The fundamental principle underlying the work is to help people to help themselves. Scarcely more pathetic, but still graver from the point of view of the community, are the young children whose education cannot be completed owing to the death of their father. Much valuable service would be lost to the State if the Guild were not able to save these children from the lives of uncongenial and unproductive labour into which poverty would force them. The attention of practitioners and their wives is drawn to the value of the work being done by this Guild. The Secretary is Miss Thomson, 60, South Molton-street, W. 1. THE
SECRETARYSHIP OF THE ROYAL SOCIETY OF MEDICINE. AT its last meeting the Council of the Royal Society of Medicine selected a successor to Sir John MacAlister from a large number of applicants, the choice falling upon Mr. Geoffrey R. Edwards, B.A. Camb. Mr. Edwards was educated at St. Paul’s School and St. John’s College, Cambridge. He studied in Germany in order to qualify for the Woods and Forests Department of the Indian Civil Service, and continued this work in India. On his return to this country he joined the Royal Air Force as a pilot, was wounded, and had to alight in enemy country, entailing an imprisonment of 14 months in Germany. Subsequently, Mr. Edwards served on the Repatriation Commission in Germany and on the Inter-Allied Aeronautical Commission of Control. When finally demobilised he obtained the appointment of assistant secretary to the National Physical Laboratory, Teddington, where he had considerable experience in library and editorial work, in organisation, and in receiving. Mr. Edwards has travelled in most European countries and speaks French and German. He takes up the duties for which he is so well qualified on Sept. lst next, and we wish him well in a position of great importance and interest. Weare glad to learn that the Society has decided to mark Sir John MacAlister’s retirement by appealing for funds to raise a memorial to his great work for medicine over .a period of 38 years. Fellows of the Society will be glad to have the opportunity of constituting a permanent memorial of the man to whom the very existence of the Society is chiefly due. The proposal is to ask Sir John MacAlister to sit for his portrait, to be rendered in oil or stone. THE JOHNSTON-LAVIS GEOPHYSICAL BEQUEST. THE late Dr. H. J. Johnston-Lavis, who was both a medical man and a distinguished geologist, bequeathed to University College, London, his geophysical collection of some 20,000 specimens and a remarkable library of books and pictures relating to volcanic phenomena. These have been housed at 13-1, Gower-street, a few doors from University College, where the collection was formally opened on June 25th by Sir Henry Miers, F.R.S., Vice-Chancellor Sir John Rose of the University of Manchester. Bradford presided, and among those present was Dr. de Lavis-Trafford, the son of the donor, who is qualified in medicine in France. Johnston-Lavis, who was descended from a Huguenot family, " de
31
Levis," received his primary education at the Grammar School, Iver, Bucks. While there, the story goes, a school-fellow threw a stone at him. Young JohnstonLavis, although in pain, examined the stone with curiosity, and further investigation showed the
missile to be a fossil echinoderm. This event stimulated his interest in geology, and the stone formed the first specimen in his collection. In 1873 he became a student at University College, studied medicine at St. Mary’s Hospital, and qualified with the M.R.C.S. in 1878. While a medical student all his leisure was devoted to geological studies, and at 18 he joined the Geologists’ Association, in the following year became a member of the Geological Society, and at the age of 20 published his first geological paper. The value of geology to medicine was shown in his essay, which gained the Parkin Prize of the Royal College of Physicians of Edinburgh in 1914. This discussed the physics and chemistry of volcanic eruption and the physical effects of eruptions on human beings and animals. For many years Johnston-Lavis was Professor of Vulcanology in the Royal University of Naples and, as Prof. Miers pointed out, he was the very embodiment of the scientific spirit in all the work which he did. The gift forms a permanent expression of the donor’s affection for the College and the University.
BENJAMIN
BROADBENT. Benjamin Broadbent, who died on June 25th at the age of 75, was a younger brother of the late Sir William Broadbent and, like him, a forceful person. He will be remembered as a pioneer in child welfare work. For many years chairman of the Huddersfield Health Committee, he entered with enthusiasm into the efforts of the medical officer of health, Dr. S. G. Moore, to save the lives of infants dying from preventable causes in the borough. In 1904 Mr. Broadbent accepted the civic chair for the definite reason that he believed it would give him greater He offered scope for combating infant mortality. a gift of ;&bgr;l, secured by a promissory note, to every baby born in Longwood (where his woollen mills were situated) during his year of office, who was still alive at the end of 12 months, the object being to ascertain where births had taken place, so that they might be followed up. During the year 112 infants were born in that ward, of whom only four failed to claim their birthday present; at the end of ten years 98 were still alive, and only seven were known to have died. The first promissory note was taken to the house by Miss Broadbent, and thus began a system of voluntary home visiting. In the following year the Huddersfield and District Public Health Union was instituted, with Mr. Broadbent as president. This Union, which secured the help of more than 100 volunteers, worked in close cooperation with the Public Health Department. A fee of 18. offered for any notification of birth received within two days was largely successful, but failed in just those cases where it was most needed, and it was chiefly due to the representations made by Mr. Broadbent and Dr. Moore that in 1906 compulsory notification of births A fundamental was introduced by Act of Parliament. aim of Mr. Broadbent’s work for child welfare was to keep mother and child together in the home, and to give help to both. His influence had much weight in the establishment of the National Association for the Prevention of Infant Mortality, for which he drafted the constitution. Again, it was on Mr. Broadbent’s suggestion that, at a Mansion House Conference in 1917, it was decided to form a small committee to act in conjunction with Lord Rhondda to go into the question of a Ministry of Health. As recently as July, 1924, two striking articles appeared in the Times over the signature of Benjamin Broadbent, showing the results of a careful personal investigation into the Ten Best Towns " for infant life. He was one of the speakers appointed to take part in the International Summer School to be held at Geneva in August of this year, when his subject was to have been Begin"
32
THE TREATMENT OF ABDOMINAL ADHESIONS.
of Infant Welfare in Great Britain. Mr. Broadbent had the satisfaction, not granted to all pioneers, of seeing the fruits of his labour.
nings
Modern Technique in Treatment.
A Series of Special Articles, contributed by DENICOTINISED TOBACCO. invitation, on the Treatment of Medical A NUMBER of people appear to be specially sensitive and Surgical Conditions. to the toxic effects of nicotine and its associated alkaloids contained in tobacco. Some of them are deterred from smoking at all; more of them smoke CXXIX.—THE TREATMENT OF ABDOMINAL ADHESIONS. in excess of what they know to be good for their and THE of this Dealers have endeamental scope paper is limited to a consideration physical efficiency. voured to meet the needs of these people by supplying of abdominal adhesions secondary to inflammatory tobacco from which the nicotine has been removed, processes or to operation, and does not include the in whole or in part. We published not long ago, at various recognised types of colonic adhesions whosethe request of a business firm, some analyses of the sites and appearances are constant-e.g., Jackson’s nicotine-content of tobacco treated with a view to membrane. Inflammatory Adhesions. reducing the percentage of nicotine. While the flavour and smoking quality remained, as far as we could In the first place, we must recognise that the ascertain, unchanged, it was possible to show that formation of adhesions following inflammation of, denicotinisation had taken place to the extent of operation on, abdominal organs is a natural and 10 to 20 per cent. It must not, however, be assumed or when these adhesions life-saving process. It is " tobacco placed interfere with the normal only that every so-called " nicotine-free functions that the patient on the market is in fact such, for a communication seeks advice and treatment. has recently been madel by Dr. L. Frank, scientific Adhesions which result from inflammation may member of the Chief Health Office in Berlin, showing cause severe symptoms of acute or subacute obstructhat the Chemical Institute attached to the Health tion, and these are more liable to occur following Office was unable to confirm the withdrawal of a lesion in the lower abdomen. While in some patients nicotine from a number of tobacco samples so described. symptoms supervene after the acute attack, shortly In two samples, in fact, the percentage of nicotine was others may enjoy many years of unimpaired health higher in the treated than in the ordinary variety of before symptoms supervene. Cases are frequently tobacco as obtained from the same firm before seen in which the signs strongly suggest cancer of thetreatment. The increase has a possible explanation colon and in which it is difficult to estimate the true in the greater dryness of the treated tobacco. The significance of a history of " a bad attack of inflammaregistered process of denicotinisation in this case tion of the bowels " 15 to 20 years previously. Tuberappears to consist in the exposure of the tobacco, culous adenitis d the mesentery is not an infrequent whether cigars or cigarettes, for a long time to a moist cause of acute or subacute obstruction, either by the atmosphere, succeeded by a rapid rise of temperature formation of bands stretching across the abdominal to 150° C. in an exhaust chamber. Whether the cavity from the infected gland, or by actual attachunsuccess in the samples examined was to be ascribed ment of the bowel to the gland. In cases of the latter to the process itself or to deficient technique in carrying type the prognosis ought to be guarded, because it out Dr. Frank does not pretend to decide, but he frequently the gland is acutely inflamed as the result does warn physicians not to recommend to their of secondary infection from the bowel, and its close patients the use of cigars and cigarettes alleged to be relationship to the large mesenteric vessels makes denicotinised, without further evidence than the the development of thrombosis, embolism, or genermaker’s assurance. infection fairly probable. The development of A RECEPTION will be held at the Royal College of inflammatory adhesions tends to mask the signs and of the original lesion. For example, when Surgeons of England, Lincoln’s Inn-fields, on symptoms a gastric or duodenal ulcer has become adherent to in connexion with the Monday evening, July 13th, Convention of English-speaking Ophthalmological neighbouring organs the regularity of the appearance Societies. Fellows and Members of the College and disappearance of the pain in relation to the taking of food becomes less noticeable and is by a wishing to attend should apply to the Secretary, continual discomfort or dragging pain. replaced The seasonal Mr. S. Forrest Cowell, at the College for cards of invitation before July 10th. The Convention meets remissions from pain also become incomplete or from July 14th to July 16th, under the Presidency of altogether absent. Mr. Treacher Collins, Mr. C. B. Goulden (79, PortlandTraumatic Adhesions. place, W.) being the General Secretary. After every abdominal operation a certain degree of peritoneal adhesions necessarily occurs. In the THE committee of the Torbay Hospital has received majority of cases no signs or symptoms result. In the sum of 100,000 from Mrs. Ella M. Rowcroft for other cases discomfort develops and the surgeon must the erection of the proposed hospital and chapel ati carefully consider whether at the primary operation Hengreave House. The site had already beenLan important lesion had been overlooked or has purchased and this munificent gift will cover the subsequently developed-e.g., a duodenal ulcer or whole cost of building, leaving the committee to’ gall-stones in a case on which appendicectomy has raise only the sums for furnishing and equipment. been performed-or whether in a neurasthenic patient Subscriptions have already been received and the operation has been performed on insufficient evidence donor hopes that the required amount may be com- owing to exaggeration of the original symptoms. : pleted before the hospital is opened, and also that The Adhesions Diathesis," there may be a sufficient surplus to form a substantialL foundation for an endowment fund. The onlyTIn the treatment of adhesions there is no difference conditions of the gift are that the chapel shall be between those of inflammatory or traumatic origin erected in accordance with a plan and specification to of course, that the former call for more urgent except, be approved by the donor and shall contain a special1 treatment of the primary focus, increase the difficulties window chosen by her, and that no vivisection 01r-at and may cause a more prolonged conoperation, cognate treatment shall be permitted on the premises, valescence. A great deal of experimental work has An additional JB6500 are provided to endow the stipendi been done to try to elucidate the causes of postof the chaplain. A special effort is to be made tcJ adhesions and to devise methods for their raise a further sum of jE26,000 for endowment. Th operative but progress has been slow and unsatiseprevention, work is to be put in hand without delay. factory. Sepsis of low virulence, excessive trauma, 1 and incomplete haemostasis are without doubt Deutsch, med. Wochenschr., 1925, i., 484.
I
alised
____
.
.
.
-