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Births, Marriages, and Deaths. BIRTHS.
634 Greenwich Metropolitan Borough.—M.O. for Maternity and Child Welfare Work. £600. Guildford, Royal Surrey County Hospitul.-H.S. £150. Hospital for Sick Children, Great Ormond-street, W.C.—H.S. Each at rate of £100. Also Part-Time Jun. Also H.P. Cas. 0. At rate of 150. Hospital of St. John and St. Elizabeth, 60, Grove E4 nd-road, W.— Ites. H.S. At rate of £75.
Huddersfield Royal Infirmary.-Pathologist. £750. -Infants Hospital, Vincent-square, Westminster.-Med. Reg. £120. Jersey General Hospital and Poor-law Infirmary.-Res. M.O. £200. Leeds, St. James’ Hospital.—H.P. and S. £200. Liverpool, Eye and Ear Infirmary, Myrtle-street.—H.S. £100. Also Hon. Asst. Surgeon to Ear, Nose and Throat
Department.
Liverpool Sanatorium, Delamere Forest, Frodsham.—Asst. to Med. Supt..6250. London Hospital, E.-First Asst. and Registrar to one of the five Surgical Firms. £300. London .Temperance Hospital, Hampstead-road, N.W.—Res M.O.
At rate of £175. Cas.O. At rate of £120. AlsoH.P. Atrate of £100. -Alacclesfield General Infirmary.-Res. H.S..S180. Macclesfield, Parkside Mental Hospital.-Res. Clin. Asst. £75. Maidstone, Kent County Mental Hospital.-Asst. M.O. £300. Manchester, Monsall Hospital.-lst Asst. M.O. £600. Mauritius, Port Louis.-M.O.H. £900. Metropolitan Ear, Nose and Throat Hospital, 2, Fitzroy-square, W. Anæsthetist. Middlesex Hospital, W., Feren’s Institute of Oto-Laryngology.Bernhard Baron Research Scholarship. £300. National Hospital, Queen-square, W.C.-Asst. P. Norwich, Norfolk and Norwich Hospital.-H.S. and Cas. O. Each ,c120. Nuneaton Borough.—Asst. M.O.H. £600. Prince of Wales’s General Hospital, Tottenham, N.-H.S., Special H.S., and H.P. Each at rate of £120. Also Jun. H.S. and Jun. H.P. Each at rate of £90. Public Dispensary, 122, Drury-lane, W.C.—Res. M.O. £120.
Queen’s Hospital for Children, Hackney-road, E.—Physicianin-Charge Skin Department. Royal College of Phvsicians, Pall Mall East.-Milroy Lecturer. Royal Eye Hospital, St. George’s Circus, S.E.—Clinical Assistants. Royal Free Hospital, Gray’s Inn-road, W.C.-Cas. O. £150. St. Mark’s Hospital for Cancer, &c., City-road, E.C.-H.S. At rate of £75. Samaritan Free Hospital for TVomen, Marylebone-road, N.TV.Hon. S. to Out-patients. Southampton, Borough Isolation Hospital.-Res. M.O. £360. Southern Rhodesia Medical Service.-Govt. M.O. £500 to £600. Swansea Hospital.—Two H.S.’s. £150. Warrington, County Mental Hospital, IVin2vick.-Asst. M.O. £350. Willesden General Hospital, Harlesden, N.W.-Res. H.S. At rate of £100. The Chief Inspector of Factories announces a vacancy for a Certifying Factory Surgeon at Pangbourne (Berks.).
Births, Marriages, and Deaths. BIRTHS. BROOKE.—On Sept. 13th, the wife of Ralph Brooke, M.B.,
F.R.C.S., of a daughter. CAMERON.—On Sept. 12th, in a nursing home, Belfast, the wife of Captain W. Moore Cameron, O.B.E., R.A.M.C., of a son. CORNER.-On Sept. 8th, in a nursing home, Bournemouth, the wife of Dr. H. W. Corner, of a daughter. GAUSSEN.-On Sept. 7th, in a nursing home, Herne Bay, the wife of Surgeon Lieut.-Commander J. F. H. Gaussen,
M.B., R.N.,
of
a
daughter.
HARDIE.—On Sept. llth, at King-street, Great Yarmouth, the wife of Ronald W. W. Hardie, M.B., Ch.B., of a daughter. LISTON.—On Sept. 15th, at Milner-street, Cadogan-square, S.W., the wife of Dr. R. Prosper Liston, of a son. PORTER.-On Sept. 13th, at Kidderminster, the wife of Dr. C. Petyin Porter, of a daughter.
MARRIAGES. LAWRENCE—BATSON.—On Sept. 7th, at Holy Trinity Church, Brompton, Robert Daniel Lawrence, M.D., to Doreen Nancy (Anne), only daughter of Mr. and Mrs. T. Batson, Overstrand-mansions, Battersea, S.W. MURPHY—MURPHY.—On Sept. 1st, at Brompton Oratory, Major Denys Murphy, M.C., F.R.C.S., I.M.S., to Vera, elder daughter of Mrs. Murphy, Greenleaze, Knowle, Bristol.
DEATHS. CAMPBELL.—On Sept. 13th, at his residence, Shrewsbury-road, Birkenhead, William Macfie Campbell, M.D., J.P., late of
Liverpool, in his 80th year. EDGELOw.-On Sept. 14th, at Braddon Villa, Torquay, William Ford Edgelow, M.D., aged 75. FORBES.—On Sept. 17th, at Cuminestown Turriff, Aberdeenshire, Hugh McGregor Forbes, L.R.C.S., L.R.C.P. Edin. PERKINS.—On Sept. 13th, Joseph John Perkins, M.A., M.B. Camb., F.R.C.P. Lond., aged 65. PHILLIPPS.—On Sept. 12th, suddenly at Seafield, Paignton, William Alfred Phillipps, M.D. WYNDHAM.—On Sept. 7th, in London, Thomas Lancelot Wyndham, L.R.C.S. & P. Fdin.z aged 54. N.B.—A fee of 7s. 6d. is charged for the insertion of Notices of Births. Marriapes. and Deaths. .
’
Notes, Comments, and Abstracts. THE INFLUENCE OF INDUSTRIAL POISONS UPON THE DIFFERENT ORGANS.* BY
SIR THOMAS
OLIVER, M.D., F.R.C.P.
WHEN a poLson has been absorbed and has circulated in the blood, it might be expected that the whole body would more or less suffer simultaneously, but experience shows that certain organs and tissues exercise a selective influence upon some poisons and not upon others. A distinction must be made between acute and chronic forms of industrial poisoning. There.is the opinion that those tissues of the body which are the last to be developed, and therefore the more delicately organised, are less resistant, hence the rapidity of the effects of alcohol upon the higher nerve centres in the brain. While the nervous system is not free from the harmful influences of lead, many research workers regard the blood and the hsemopoietic system as the anatomical elements earliest affected by lead, those bodily units, in fact, which are formed and function in the early stages of embryonic development, and which therefore ought to be the most stable. It is an interesting circumstance that while the blood and blood-making organs. are readily influenced by lead, yet in the blood very little of the metal is found, even while the internal organs may contain it in considerable quantity. Although the blood may show physical and chemical changes due to the influence of lead, it has only slight retentive power upon the metal, possibly because the blood is ever changing and therefore rejuvenating itself, its corpuscles are short-lived, also that it is constantly eliminating the poison, while in the tissues generally, physico-chemical changes are less rapid, and there is therefore given greater opportunity for the metal to become more firmly linked to the cellular constituents. The types of industrial poisoning which have the greatest interest for us are those where the amount of toxin received daily into the system is small, where elimination almost equals absorption, and where therefore poisoning is slowly induced. In many of these cases, symptoms of toxaemia may not arise for several years ; so slowly, in fact, do thesymptoms appear that the individual is not aware of his condition until some change occurs in his metabolism or he is attacked by some minor ailment.
Lead. It is now several years since I remarked upon the storageof lead in a rather insoluble form in the body, also upon the absence of symptoms, until there have occurred chemical changes in the liquor sanguinis and the fluids bathing the tissues, whereby the deposited lead becomes soluble, thus favouring its reabsorption into the circulation. To this subject and the early harmful effects of lead upon the blood, Aub and his co-workers in Harvard University have given close attention, as also have Kehoe and Thamann, of the University of Cincinatti, and P. Schmidt, of Halle, who hold, like many other physicians, that, by a microscopical examination of the blood of lead-workers, plumbism may be detected before symptoms develop, and when, therefore, it is possible for further trouble to be averted. The relation of the blood to poisons passing through it are of a two-fold character ; the blood may be little affected or physico-chemical changes are induced in it which affect its efficiency as an oxygenating and nutritive medium. So far I have dealt mainly with lead, principally because, apart from iron and steel, lead is the metal which is most widely used in the industries, also because it has been the occasion of much ill-health among the workers. lliost of salts, too, have the power of precipitating proteins, as observed on mucous membranes, thereby exercising a protective influence compared with the corrosive effects produced by several other industrial poisons. Absorption of the metal is slow, so that time and opportunity are given for lengthened reaction to take place between the poison and the animal tissues. Industrially, lead poisoning is seldom acute. When large doses of lead acetate have been swallowed by a healthy person, the symptoms which follow are less the result of absorption ofthe metal, than of the local effects of the lead compound upon the stomach and intestine. The intravenous injection of a neutral lead salt precipitates the proteins of the blood and may cause embolism. Harnack found in injecting lead-triethyl into the veins of animals that it became decomposed in the tissues and gave rise to. symptoms of plumbism. Lead intravenously introduced
its
* Abridged from an address delivered to the Fifth International Congress for Industrial Accidents and Occupations in Budapest on Sept. 3rd, 1928.
Huddersfield Royal Infirmary.-Pathologist. £750. -Infants Hospital, Vincent-square, Westminster.-Med. Reg. £120. Jersey General Hospital and Poor-law Infirmary.-Res. M.O. £200. Leeds, St. James’ Hospital.—H.P. and S. £200. Liverpool, Eye and Ear Infirmary, Myrtle-street.—H.S. £100. Also Hon. Asst. Surgeon to Ear, Nose and Throat
Department.
Liverpool Sanatorium, Delamere Forest, Frodsham.—Asst. to Med. Supt..6250. London Hospital, E.-First Asst. and Registrar to one of the five Surgical Firms. £300. London .Temperance Hospital, Hampstead-road, N.W.—Res M.O.
At rate of £175. Cas.O. At rate of £120. AlsoH.P. Atrate of £100. -Alacclesfield General Infirmary.-Res. H.S..S180. Macclesfield, Parkside Mental Hospital.-Res. Clin. Asst. £75. Maidstone, Kent County Mental Hospital.-Asst. M.O. £300. Manchester, Monsall Hospital.-lst Asst. M.O. £600. Mauritius, Port Louis.-M.O.H. £900. Metropolitan Ear, Nose and Throat Hospital, 2, Fitzroy-square, W. Anæsthetist. Middlesex Hospital, W., Feren’s Institute of Oto-Laryngology.Bernhard Baron Research Scholarship. £300. National Hospital, Queen-square, W.C.-Asst. P. Norwich, Norfolk and Norwich Hospital.-H.S. and Cas. O. Each ,c120. Nuneaton Borough.—Asst. M.O.H. £600. Prince of Wales’s General Hospital, Tottenham, N.-H.S., Special H.S., and H.P. Each at rate of £120. Also Jun. H.S. and Jun. H.P. Each at rate of £90. Public Dispensary, 122, Drury-lane, W.C.—Res. M.O. £120.
Queen’s Hospital for Children, Hackney-road, E.—Physicianin-Charge Skin Department. Royal College of Phvsicians, Pall Mall East.-Milroy Lecturer. Royal Eye Hospital, St. George’s Circus, S.E.—Clinical Assistants. Royal Free Hospital, Gray’s Inn-road, W.C.-Cas. O. £150. St. Mark’s Hospital for Cancer, &c., City-road, E.C.-H.S. At rate of £75. Samaritan Free Hospital for TVomen, Marylebone-road, N.TV.Hon. S. to Out-patients. Southampton, Borough Isolation Hospital.-Res. M.O. £360. Southern Rhodesia Medical Service.-Govt. M.O. £500 to £600. Swansea Hospital.—Two H.S.’s. £150. Warrington, County Mental Hospital, IVin2vick.-Asst. M.O. £350. Willesden General Hospital, Harlesden, N.W.-Res. H.S. At rate of £100. The Chief Inspector of Factories announces a vacancy for a Certifying Factory Surgeon at Pangbourne (Berks.).
Births, Marriages, and Deaths. BIRTHS. BROOKE.—On Sept. 13th, the wife of Ralph Brooke, M.B.,
F.R.C.S., of a daughter. CAMERON.—On Sept. 12th, in a nursing home, Belfast, the wife of Captain W. Moore Cameron, O.B.E., R.A.M.C., of a son. CORNER.-On Sept. 8th, in a nursing home, Bournemouth, the wife of Dr. H. W. Corner, of a daughter. GAUSSEN.-On Sept. 7th, in a nursing home, Herne Bay, the wife of Surgeon Lieut.-Commander J. F. H. Gaussen,
M.B., R.N.,
of
a
daughter.
HARDIE.—On Sept. llth, at King-street, Great Yarmouth, the wife of Ronald W. W. Hardie, M.B., Ch.B., of a daughter. LISTON.—On Sept. 15th, at Milner-street, Cadogan-square, S.W., the wife of Dr. R. Prosper Liston, of a son. PORTER.-On Sept. 13th, at Kidderminster, the wife of Dr. C. Petyin Porter, of a daughter.
MARRIAGES. LAWRENCE—BATSON.—On Sept. 7th, at Holy Trinity Church, Brompton, Robert Daniel Lawrence, M.D., to Doreen Nancy (Anne), only daughter of Mr. and Mrs. T. Batson, Overstrand-mansions, Battersea, S.W. MURPHY—MURPHY.—On Sept. 1st, at Brompton Oratory, Major Denys Murphy, M.C., F.R.C.S., I.M.S., to Vera, elder daughter of Mrs. Murphy, Greenleaze, Knowle, Bristol.
DEATHS. CAMPBELL.—On Sept. 13th, at his residence, Shrewsbury-road, Birkenhead, William Macfie Campbell, M.D., J.P., late of
Liverpool, in his 80th year. EDGELOw.-On Sept. 14th, at Braddon Villa, Torquay, William Ford Edgelow, M.D., aged 75. FORBES.—On Sept. 17th, at Cuminestown Turriff, Aberdeenshire, Hugh McGregor Forbes, L.R.C.S., L.R.C.P. Edin. PERKINS.—On Sept. 13th, Joseph John Perkins, M.A., M.B. Camb., F.R.C.P. Lond., aged 65. PHILLIPPS.—On Sept. 12th, suddenly at Seafield, Paignton, William Alfred Phillipps, M.D. WYNDHAM.—On Sept. 7th, in London, Thomas Lancelot Wyndham, L.R.C.S. & P. Fdin.z aged 54. N.B.—A fee of 7s. 6d. is charged for the insertion of Notices of Births. Marriapes. and Deaths. .
’
Notes, Comments, and Abstracts. THE INFLUENCE OF INDUSTRIAL POISONS UPON THE DIFFERENT ORGANS.* BY
SIR THOMAS
OLIVER, M.D., F.R.C.P.
WHEN a poLson has been absorbed and has circulated in the blood, it might be expected that the whole body would more or less suffer simultaneously, but experience shows that certain organs and tissues exercise a selective influence upon some poisons and not upon others. A distinction must be made between acute and chronic forms of industrial poisoning. There.is the opinion that those tissues of the body which are the last to be developed, and therefore the more delicately organised, are less resistant, hence the rapidity of the effects of alcohol upon the higher nerve centres in the brain. While the nervous system is not free from the harmful influences of lead, many research workers regard the blood and the hsemopoietic system as the anatomical elements earliest affected by lead, those bodily units, in fact, which are formed and function in the early stages of embryonic development, and which therefore ought to be the most stable. It is an interesting circumstance that while the blood and blood-making organs. are readily influenced by lead, yet in the blood very little of the metal is found, even while the internal organs may contain it in considerable quantity. Although the blood may show physical and chemical changes due to the influence of lead, it has only slight retentive power upon the metal, possibly because the blood is ever changing and therefore rejuvenating itself, its corpuscles are short-lived, also that it is constantly eliminating the poison, while in the tissues generally, physico-chemical changes are less rapid, and there is therefore given greater opportunity for the metal to become more firmly linked to the cellular constituents. The types of industrial poisoning which have the greatest interest for us are those where the amount of toxin received daily into the system is small, where elimination almost equals absorption, and where therefore poisoning is slowly induced. In many of these cases, symptoms of toxaemia may not arise for several years ; so slowly, in fact, do thesymptoms appear that the individual is not aware of his condition until some change occurs in his metabolism or he is attacked by some minor ailment.
Lead. It is now several years since I remarked upon the storageof lead in a rather insoluble form in the body, also upon the absence of symptoms, until there have occurred chemical changes in the liquor sanguinis and the fluids bathing the tissues, whereby the deposited lead becomes soluble, thus favouring its reabsorption into the circulation. To this subject and the early harmful effects of lead upon the blood, Aub and his co-workers in Harvard University have given close attention, as also have Kehoe and Thamann, of the University of Cincinatti, and P. Schmidt, of Halle, who hold, like many other physicians, that, by a microscopical examination of the blood of lead-workers, plumbism may be detected before symptoms develop, and when, therefore, it is possible for further trouble to be averted. The relation of the blood to poisons passing through it are of a two-fold character ; the blood may be little affected or physico-chemical changes are induced in it which affect its efficiency as an oxygenating and nutritive medium. So far I have dealt mainly with lead, principally because, apart from iron and steel, lead is the metal which is most widely used in the industries, also because it has been the occasion of much ill-health among the workers. lliost of salts, too, have the power of precipitating proteins, as observed on mucous membranes, thereby exercising a protective influence compared with the corrosive effects produced by several other industrial poisons. Absorption of the metal is slow, so that time and opportunity are given for lengthened reaction to take place between the poison and the animal tissues. Industrially, lead poisoning is seldom acute. When large doses of lead acetate have been swallowed by a healthy person, the symptoms which follow are less the result of absorption ofthe metal, than of the local effects of the lead compound upon the stomach and intestine. The intravenous injection of a neutral lead salt precipitates the proteins of the blood and may cause embolism. Harnack found in injecting lead-triethyl into the veins of animals that it became decomposed in the tissues and gave rise to. symptoms of plumbism. Lead intravenously introduced
its
* Abridged from an address delivered to the Fifth International Congress for Industrial Accidents and Occupations in Budapest on Sept. 3rd, 1928.