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BRITISH INSTITUTE OF PREVENTIVE MEDICINE.
BRITISH INSTITUTE OF PREVENTIVE MEDICINE.
446
appreciative leading article in the same number calling attention to what may prove to be an epoch-making paper so far as this ’country is concerned. Able, however, as is M. Pinard’s contribution, and fortunate as seems to have been the issue of his’ cases, there are some ’points in it to which I think emphatic attention should be drawn. In the first place, the diameter in none of the thirteen cases was conjugate pelvicinches and a half, and in four it was quite four less inches. It is not stated, moreover, how these measurements were determined ; and anyone who has had much experience in the matter knows that extreme accuracy is not always very easily attained: .Accepting these measurements, however, as accurate, it will be agreed not only that the contraction was not extreme (a point considered in the leading article), but that the measurement in several cases was one involving no insuperable obstacle to an expert obstetrician using forceps or Case 8, further, in which the pelvic conjugate is stated to have been 9’7 cm. (three inches and three-quarters), a large healthy child was born alive at term spontaneously in the first confinement. In the second the vertex presented in the left transverse position, which in this country we should term the I I left occipito-posterior." A male child was easily extracted after symphysiotomy in a condition of suspended animation, but revived. The puerperium was I I pathological," but the mother also recovered. With a diminishing population, no doubt a French obstetrician considers it his duty to emphasise the great importance of a live foetus. In this country I trust no one will accuse us of a want of solicitude in this respect,-but it has always been considered that the tree has a prior claim to the fruit-that the absolute safety of the mother, so far as we can secure it, is our paramount indication and duty. It is because. I fear that the influence of symphysiotomy may be to diminish the cultivation of the highest manipulative and instrumental dexterity, of which none are greater masters than innumerable members of our profession in general practice, and that thus the danger to the mother may be increased, that I have ventured to call attention to these points. That symphysiotomy will acquire a certain definite place in obstetrics I think there can be little doubt ; that it will in England play the rôle which M. Pinard seems to contemplate is, I believe, very doubtful. I trust the subject will be fully discussed in the columns of THE LANCET. As one differentiating from general practice, but not towards obstetrics-in which, however, I can never cease to take an interest, but of which in this age of specialism, so justly condemned by you, I must assume a profound ignorance-permit me to enclose my card and subscribe myself, Sirs, yours truly, M. R. C. P. Feb. 18th, 1893.
than three
turning..In
BRITISH INSTITUTE OF PREVENTIVE MEDICINE. To the Editors of THE LANCET. Tait has contributed to your last Lawson SlRS,—Mr. number a letter in which he states that the skeleton report of the meeting held at Birmingham in support of the British Institute of Preventive Medicine represents but incompletely the meaning he intended to convey in his speech. As I was present at the meeting, will you allow me to say that, in my opinion, the report published by you is perfectly accurate, and represented exactly the impression which Mr. Tait’s words conveyed tothose present at the meeting. Mr. Lawson Tait, in support of his assertion, makes a number of statements which are not correct. In the first place, Mr. Tait did not say. that he "objected altogether to the past record of experiments on animals as delusive," but that "he objected to a certain class of surgical experiments made chiefly to prove that somebody else was wrong." Mr. Tait did not say that bacteriological research had possibly proved of value to animals, but that it had undoubtedly done so. Mr. Tait did not say that in its application to man he could not admit in a single instance the word"proved,’’ so lavishly used by me ; but he said that he did not admitthevalue of M. Pasteur’s treatment for rabies, and he did not refer to any other forms of treatment founded on experimentation on animals...Mr. Tait further added that "a great deal of good has been accomplished by such investigations "--words which were taken down at the time. This is not the first occasion on which Mr. Lawson Tait has denied the fact that, when brought face to face with his fellow-practitioners in Birmingham, he threw over his friends of the Victoria-street Anti-vivisection Society. Mr Victor Horsley, in the Rock (Feb. 10th, 1893), stated
denied..
that he had done so-a fact which Mr. Tait then The matter, however, was referred to Mr. Henry Eales, President of the Midland Medical Society, who presided at the Birmingham meeting and who wrote the following letter, which appeared in the 7.’oc&, Feb. 17th, 1893 :
[Copy.]l 7. Newhall-street. Birmingham, Feb. 12th, 1893.
DEAR MR. HORSLEY,-I have read carefully your letter and that of Mr. Tait in the Rock, which you kindly sent me, as chairman of the meeting which took place here on Feb. 2nd, when Dr. Ruffer placed before our profession the claims of the British Institute of Preventive Medicine to our support, and I have no hesitation in saying that your representation of Mr. Tait’s a,ttitude is perfectly correct. I may say that, not wishing to rely entirely on my own memory, I have conferred with three of the leadtra of our profession here and placed Mr. Tait’s. and your letters before them, and they agree with me in this view. Mr. Gilbert Barling, who at the meeting congratulated Mr. Tait on having, however tardily, come to see that his attitude in the past was. untenable and on having had the courage to admit this, waites me, with authority to use his communication, as follows : " I understood Mr. Tait to give a general approval to the objects of the Institute of Preventive Medicine, the chief of these dwelt upon by Dr. Ruffer being the advancement of the science of bacteriology by experimental research. In speaking after Mr. Tait and in his presence, I congratulated him on assuming a position in this matter, so different to that which he previously held, and he did not demur to my interpretation of his remarks." I m,y say that I heard Mr. Tait’s remarks with profound astonishment, which I have since learned was the invariablij feeling they excited in those who heard them, it being auite unexpected that he would have accorded even " a reluctant assent" to the proposition before the meeting, and his speech was the most striking incident of the proceedings. You have my full permission to make what use you think fit of this letter. I am, yours truly, To Victor Horsley, Esq., F.R.S. HENRY EALES.
With regard to Mr. Lawson Tait leaving the room befora the end of the meeting, I must be excused if I am still of opinion that he did so because, having become the champion, of the Victoria-street Society, at St. James’s Hall, he was. afraid to hear what Mr. Horsley had to say about his conduct and that he therefore took the wisest course and ran away. I am. Sirs. vour obedient servant. M. ARMAND RUFFER.
"ARE DISEASE GERMS IN MILK DESTROYED BY BOILING?" To the Editors
of THE LANCET. doubt that micro-organisms may SIRS,—There escape being killed by boiling for a few minutes, as was, abundantly proved in the experiments by which Pouchet and Bastian sought to found the doctrine of abiogenesis. This is probably due to the presence of solid particles, which afford them some protection from the boiling fluid. But it is a great pity to throw any doubt on the general utility of boiling’ as a means of disinfecting milk, and the opinion that boiled milk is injurious to children is a very foolish and dangerous one. Even if it were proved that boiled milk loses a slight percentage of its nutritive properties, this disadvantage would be more than compensated by the freedom from risk of infection by scarlet fever and diphtheria, which are frequently conveyed in milk, and the probable. dangers from tubercle and from cholera, if the last-named disease should reach our shores during this year. Compared to the danger of kissing a Testament in a court of justicean act which has never been shown to be the source of’ disease in any single instance-this question of disinfecting milk is of the highest importance to the public health, and, until our County Councils can be trusted to provide us with. milk above all suspicion I would advise everyone to have it boiled on delivery and to boil it well. I am. Sirs. vours trulv. ROBERT SAUNDBY. Edmund-street, Birmingham, Feb. 18th, 1893. can
be
no
STRANGE INCIDENTS IN PRACTICE, To the Editors of THE LANCET. SlRS,—The case of the gentleman who for many years did’ not speak, recorded by Sir William Dalby on p. 241 of THE: LANCET of the 4th inst., recalls to my mind the case of another gentleman, which was referred to during the’ recent trial of an action in one of the Superior Courts. It appears that he suddenly ceased to speak, and, although it is. alleged that no other alteration in his, general state,which np
to
the commencement of his silence
was
normal and
446
appreciative leading article in the same number calling attention to what may prove to be an epoch-making paper so far as this ’country is concerned. Able, however, as is M. Pinard’s contribution, and fortunate as seems to have been the issue of his’ cases, there are some ’points in it to which I think emphatic attention should be drawn. In the first place, the diameter in none of the thirteen cases was conjugate pelvicinches and a half, and in four it was quite four less inches. It is not stated, moreover, how these measurements were determined ; and anyone who has had much experience in the matter knows that extreme accuracy is not always very easily attained: .Accepting these measurements, however, as accurate, it will be agreed not only that the contraction was not extreme (a point considered in the leading article), but that the measurement in several cases was one involving no insuperable obstacle to an expert obstetrician using forceps or Case 8, further, in which the pelvic conjugate is stated to have been 9’7 cm. (three inches and three-quarters), a large healthy child was born alive at term spontaneously in the first confinement. In the second the vertex presented in the left transverse position, which in this country we should term the I I left occipito-posterior." A male child was easily extracted after symphysiotomy in a condition of suspended animation, but revived. The puerperium was I I pathological," but the mother also recovered. With a diminishing population, no doubt a French obstetrician considers it his duty to emphasise the great importance of a live foetus. In this country I trust no one will accuse us of a want of solicitude in this respect,-but it has always been considered that the tree has a prior claim to the fruit-that the absolute safety of the mother, so far as we can secure it, is our paramount indication and duty. It is because. I fear that the influence of symphysiotomy may be to diminish the cultivation of the highest manipulative and instrumental dexterity, of which none are greater masters than innumerable members of our profession in general practice, and that thus the danger to the mother may be increased, that I have ventured to call attention to these points. That symphysiotomy will acquire a certain definite place in obstetrics I think there can be little doubt ; that it will in England play the rôle which M. Pinard seems to contemplate is, I believe, very doubtful. I trust the subject will be fully discussed in the columns of THE LANCET. As one differentiating from general practice, but not towards obstetrics-in which, however, I can never cease to take an interest, but of which in this age of specialism, so justly condemned by you, I must assume a profound ignorance-permit me to enclose my card and subscribe myself, Sirs, yours truly, M. R. C. P. Feb. 18th, 1893.
than three
turning..In
BRITISH INSTITUTE OF PREVENTIVE MEDICINE. To the Editors of THE LANCET. Tait has contributed to your last Lawson SlRS,—Mr. number a letter in which he states that the skeleton report of the meeting held at Birmingham in support of the British Institute of Preventive Medicine represents but incompletely the meaning he intended to convey in his speech. As I was present at the meeting, will you allow me to say that, in my opinion, the report published by you is perfectly accurate, and represented exactly the impression which Mr. Tait’s words conveyed tothose present at the meeting. Mr. Lawson Tait, in support of his assertion, makes a number of statements which are not correct. In the first place, Mr. Tait did not say. that he "objected altogether to the past record of experiments on animals as delusive," but that "he objected to a certain class of surgical experiments made chiefly to prove that somebody else was wrong." Mr. Tait did not say that bacteriological research had possibly proved of value to animals, but that it had undoubtedly done so. Mr. Tait did not say that in its application to man he could not admit in a single instance the word"proved,’’ so lavishly used by me ; but he said that he did not admitthevalue of M. Pasteur’s treatment for rabies, and he did not refer to any other forms of treatment founded on experimentation on animals...Mr. Tait further added that "a great deal of good has been accomplished by such investigations "--words which were taken down at the time. This is not the first occasion on which Mr. Lawson Tait has denied the fact that, when brought face to face with his fellow-practitioners in Birmingham, he threw over his friends of the Victoria-street Anti-vivisection Society. Mr Victor Horsley, in the Rock (Feb. 10th, 1893), stated
denied..
that he had done so-a fact which Mr. Tait then The matter, however, was referred to Mr. Henry Eales, President of the Midland Medical Society, who presided at the Birmingham meeting and who wrote the following letter, which appeared in the 7.’oc&, Feb. 17th, 1893 :
[Copy.]l 7. Newhall-street. Birmingham, Feb. 12th, 1893.
DEAR MR. HORSLEY,-I have read carefully your letter and that of Mr. Tait in the Rock, which you kindly sent me, as chairman of the meeting which took place here on Feb. 2nd, when Dr. Ruffer placed before our profession the claims of the British Institute of Preventive Medicine to our support, and I have no hesitation in saying that your representation of Mr. Tait’s a,ttitude is perfectly correct. I may say that, not wishing to rely entirely on my own memory, I have conferred with three of the leadtra of our profession here and placed Mr. Tait’s. and your letters before them, and they agree with me in this view. Mr. Gilbert Barling, who at the meeting congratulated Mr. Tait on having, however tardily, come to see that his attitude in the past was. untenable and on having had the courage to admit this, waites me, with authority to use his communication, as follows : " I understood Mr. Tait to give a general approval to the objects of the Institute of Preventive Medicine, the chief of these dwelt upon by Dr. Ruffer being the advancement of the science of bacteriology by experimental research. In speaking after Mr. Tait and in his presence, I congratulated him on assuming a position in this matter, so different to that which he previously held, and he did not demur to my interpretation of his remarks." I m,y say that I heard Mr. Tait’s remarks with profound astonishment, which I have since learned was the invariablij feeling they excited in those who heard them, it being auite unexpected that he would have accorded even " a reluctant assent" to the proposition before the meeting, and his speech was the most striking incident of the proceedings. You have my full permission to make what use you think fit of this letter. I am, yours truly, To Victor Horsley, Esq., F.R.S. HENRY EALES.
With regard to Mr. Lawson Tait leaving the room befora the end of the meeting, I must be excused if I am still of opinion that he did so because, having become the champion, of the Victoria-street Society, at St. James’s Hall, he was. afraid to hear what Mr. Horsley had to say about his conduct and that he therefore took the wisest course and ran away. I am. Sirs. vour obedient servant. M. ARMAND RUFFER.
"ARE DISEASE GERMS IN MILK DESTROYED BY BOILING?" To the Editors
of THE LANCET. doubt that micro-organisms may SIRS,—There escape being killed by boiling for a few minutes, as was, abundantly proved in the experiments by which Pouchet and Bastian sought to found the doctrine of abiogenesis. This is probably due to the presence of solid particles, which afford them some protection from the boiling fluid. But it is a great pity to throw any doubt on the general utility of boiling’ as a means of disinfecting milk, and the opinion that boiled milk is injurious to children is a very foolish and dangerous one. Even if it were proved that boiled milk loses a slight percentage of its nutritive properties, this disadvantage would be more than compensated by the freedom from risk of infection by scarlet fever and diphtheria, which are frequently conveyed in milk, and the probable. dangers from tubercle and from cholera, if the last-named disease should reach our shores during this year. Compared to the danger of kissing a Testament in a court of justicean act which has never been shown to be the source of’ disease in any single instance-this question of disinfecting milk is of the highest importance to the public health, and, until our County Councils can be trusted to provide us with. milk above all suspicion I would advise everyone to have it boiled on delivery and to boil it well. I am. Sirs. vours trulv. ROBERT SAUNDBY. Edmund-street, Birmingham, Feb. 18th, 1893. can
be
no
STRANGE INCIDENTS IN PRACTICE, To the Editors of THE LANCET. SlRS,—The case of the gentleman who for many years did’ not speak, recorded by Sir William Dalby on p. 241 of THE: LANCET of the 4th inst., recalls to my mind the case of another gentleman, which was referred to during the’ recent trial of an action in one of the Superior Courts. It appears that he suddenly ceased to speak, and, although it is. alleged that no other alteration in his, general state,which np
to
the commencement of his silence
was
normal and