CHLORATE OF POTASSIUM IN HABITUAL ABORTION.

1081 when I remonstrated with him for telling me a boy was asking for permission to bury him when as a matter of fact the native was not dead and did not die for some hours. The history of the accident was as follows. A native police boy accused this boy of having taken his wife away. The native denied it and the police boy left the hut, leaving his rifle (a Martini) inside the hut. The native promptly picked it up, put it to his chin, and pulled the trigger with his right toe. A woman inside the hut seeing what he was about to do placed her hand over the barrel, the bullet passing between two of her fingers and inflicting The boy’s no other damage than slight abrasion of the skin. injuries were terrible. The bullet fractured the lower jaw, almost severed the tongue, shattered the right half of the upper jaw, and came out between the inner angle of the orbit and the nose. The eye escaped entirely. The portion of the nose left consisted of skin and the deeper soft structures and, owing to the jaw on the left side also being fractured, was freely moveable. The native was seen inside a dark native hut by the light of a cheap candle. The hut was full of smoke and the atmosphere was extremely painful to one’s eyes. In addition, a good view was obscured by old blood-clots and extremely foul pus, so that the precise nature of the injuries was extremely difficult to ascertain. The outer wall of the nasal fossa on the right side, the floor and septum seemed entirely destroyed and the superior and middle turbinated bones were exposed and bare. The boy’s condition was extremely bad. He had a weak thready pulse, very rapid. He had rapid shallow breathing and me

dead and

and to apply hot fomentations. A week later I was told that the boy was better and a fortnight later, 16 days after the injuries, he walked 15 miles into the hospital. The wound in the tongue had healed and the lower jaw had united. The cavity in the cheek had closed up considerably. The wound now seemed to be covered with healthy red granulations but the interior presented masses of dry brown-looking dead bone which from time to time came away. The native had lived for 16 days almost entirely on Kaffir beer. The photograph reproduced was kindly taken for me by Privai,e Timmins of the British South African police, hospital orderly. It shows the right nasal bone attached to the soft structure at the upper and. outer corner of the wound and several portions of dead bone in the interior of the cavity. The right eye is partially closed by a lacrymal cyst.

Lomagundi, Southern Rhodesia. A CASE OF HERMAPHRODITISM.

BY LIONEL H. MOISER,

M.B. LOND., L.R.C.P. LOND.,

M.R.C.S. ENG., LATE OBSTETRIC HOUSE PHYSICIAN AT

GUY’S HOSPITAL.

patient was 19 years of age and rather appearance. Her voice was lower in tone than THE

masculine in that of most The hair on the women and she had no hair on her face. pubes was normal in amount but it did not extend upwards to the umbilicus. The mons veneris was not well developed. The breasts were small and ill-developed, much the same in appearance as ordinary male breasts, and the nipples were small. The labia majora were normal in appearance but the labia minora were very small. The clitoris was very much hypertrophied, being one and a half inches in length and almost half an inch in diameter ; the glans and prepuce were well developed, as also was the fraenum. There was no meatus at the distal extremity of the clitoris. The meatus urinarius was in the normal position for the female. The vagina was two inches in length and small in circumference, the index finger being inserted with difficulty; the upper end of the vagina was slightly narrowed and blind. The hymen was absent. On examination under an anaesthetic no uterus or ovaries could be felt, neither was there any Fallopian tube. No testicles were felt. Previously to Christmas, 1903, the patient never menstruated at all, but each month since that time she had had epistaxis, the onset being at regular intervals and each attack lasting about five days. Concurrently with these attacks she had an aching pain in the left ovarian region. Shortly after admission to the Royal Hants County Hospital on June 18th, 1904, she had a severe attack of pain in the left ovarian region which lasted eight or nine days; there was also slight epistaxis on one or two days. It was thought that she must have an ovary, either in a cystic condition or degenerated in some other way. A laparotomy was performed to see if anything could be done to relieve the pain ; no ovaries, uterus, Fallopian tube, or testicles were found. The vermiform appendix was about three inches in length and contained seven hard fsecal concretions. This was removed. - Since that time she has not had any recurrence of pain. Her temperature was normal

throughout. For permission to publish these notes I am indebted to Dr. H. E. Wingfield, physician to the Royal Hants County Hospital. Winchester.

CHLORATE OF POTASSIUM IN HABITUAL ABORTION. Showing appearance of wound.

painful cough, and his temperature was 1030 F. His tongue was dry and covered with thick brown fur. He appeared to be moribund and if he lasted out the next few hours seemed in great danger of septic pneumonia or septic mischief extending inside the cranium. I gave him one ’chance in a 1000 and advised against his being carried to the nearest hospital, 15 miles away, as I thought that the journey would destroy his only chance. His brothers were feeding him on Kaffir beer only, administered by means of a gourd roughly shaped like an ordinary spouted feeding-cup. The same night I sent him out some boric lotion, instructing his brothers to cleanse the wound frequently with the lotion

BY GEORGE S. S.

HIRST, M.B., C.M. EDIN.

THE following notes may be of interest to the readers of THE LANCET. In May last I was called to see a pregnant woman who 11 times previously had aborted during and after the third month of pregnancy. She and her husband were most anxious to have a living child and with this object she had consulted medical men during each pregnancy after the third-that is to say, she had been under medical treatment during the last pregnancies. Of the 11 abortions three had taken place during the third month, two

eight

during

1082

month, five during the fifth month, and one the seventh month. She could only attribute one abortion to physical causes-viz., one at the fourth month when from a fright she fell down and the abortion followed on the same evening. During the last pregnancy she had taken under the advice of her medical man aletris cordial but she miscarried at the seventh month. She could attribute the miscarriage to no cause. As it was the sincere wish of herself and her husband to have a living child she had the fourth

during

always taken the greatest care of herself during pregnancy. On May 20th I ordered the patient to take two and a half grains of chlorate of potassium three times a day, which she took regularly up to Sept. 4th. On Sept. 6th she was delivered of a full-time living female child. Her labour was easy and the puerperium was unattended by complications. The child, though small, is perfectly healthy. The mother is a perfectly healthy woman suffering from no misplacement of the uterus or other cause likely to produce abortion. Treherbert.

Medical Societies. MEDICAL SOCIETY OF LONDON. President’s Address.- Case of Gigantic Renal Calculus.

in the name of the society and inviting those present to take part in the discussion. Mr. A. MARMADUKE SHEILD read a paper entitled "A Case of Gigantic Renal Calculus, illustrated with Remarks on Cases where Renal Stones form Obvious Tumours," which is reported in extenso at p. 1074 of our present issue.Mr. A. W. MAYO ROBSON congratulated Mr. Sheild on the success of his operation. It was clear that large calculi such as these must give rise to abdominal tumour but its renal origin could be detected by distending the col6n with air. It could be done simply by a Higginson’s syringe. This method, in his experience, had only failed on one occasion, in The x rays had considerable a case of suprarenal tumour. limitations : they would not show up uric acid calculi unless very large. Phosphatic and oxalic calculi were less transparent.-The PRESIDENT concurred in the untrustworthiness of the x rays. Affirmatively they were of value but not negatively. It was a point of some practical importance that the larger the stone and therefore the less its mobility the less acute and the less marked were the symptoms.-Mr. F. SWINFORD EDWARDS had met with calculi of from two ounces to two and a half ounces but never calculi of such a size as that exhibited. He concurred in the remarks of the previous speakers relative to the x rays and the advisability of removing the whole kidney in such cases at the time of the operation.Professor AMBROSE MONPROFIT (Angers), who spoke in French, referred to an interesting case under his care of a young woman in whom was found at the operation a large r ramifying calculus. The kidney was left behind but a fistula r resulted which necessitated a second operation for the removal cof the renal substance.

THE annual general meeting of this society was held on Oct. 10th, Dr. F. DE HAVILLAND HALL, the President, being in the chair. The treasurer’s report and balance sheet, as passed by the auditors for the year ending SOCIETY FOR THE STUDY OF INEBRIETY.-A Sept. 30th, were presented and adopted. The retiring President and the retiring honorary secretary, to whom the cquarterly meeting of this society was held on Oct. llth, usual votes of thanks were accorded, then vacated their Dr. I Harry Campbell, the President, being in the chair.l Charles F. Harford delivered an address entitled respective offices and Dr. de Havilland Hall inducted Mr. Dr. ’ "The Drinking Habits of Uncivilised and Semi-civilised John Langton, the incoming President, into office. The first ordinary meeting of the society was afterwards Races " and said that the protection of the weaker races of t the world from demoralisation by the liquor traffic had for held, when Mr. LANGTON delivered his presidential address. The PRESIDENT commenced his address by giving expres- imany years past occupied the attention of a special comi sion to his deep appreciation of the honour which the society mittee, the Native Races and the Liquor Traffic United Comi In the course of these investigations some valuable had conferred upon him and remarked upon the dis- mittee. i had been recorded concerning the drinking habits of cussions which had taken place at the society and which facts often added greatly to the scientific value of the communica- tthese races. These habits differed in each country. Perhaps tions made at the meetings. He referred to the losses whichthe most convenient method of considering this subject was i the society had incurred by death during the past year, to classify the different kinds of drinks commonly used, and the names of T. Dr. Gilbart-Smith noting where possible the way in which they were especially mentioning Sir W. Mitchell Banks. He then directed attention to various used and the effects which they produced. They were problems in pathology. Since the discovery of tubercleas follows :-1. Non-alcoholic beverages.-Water, milk, bacillus great progress had been made and Great Britain palm wine, and cocoanut milk when fresh, tea and coffee, ] now occupied the proud position of having the lowestand drinks made with various kinds of meal and water. death-rate from tuberculosis, Russia having the highest.2. Native fermented drinks.-Various forms of corn beer of Referring to the progress of surgery, he emphasised thevarying alcoholic strength, palm wine, cocoanut milk, and value of aseptic as compared with antiseptic methods. Thethe like which had been allowed to ferment. 3. Distilled pathology of cancer was then referred to and the importanceliquors.-Native spirits (especially such as were prepared in of the discovery of the conjugation of young cancer cells by India), Cape brandy, and potato spirit, prepared especially in Dr. E. F. Bashford was mentioned. The radical cure ofGermany for consumption in West Africa. These classes of hernia, an operation which dated from the time of Celsus,liquor might be taken as samples of the drinks used by the Statistics from hospitalnative races, especially of India and Africa ; the wines, beers, was an important practical matter. practice on the ultimate effects of these operations were and the better forms of spirits manufactured in England and It was necessary to trace cases for two, other European countries were almost left out of account as fallacious. three, or four years before the real results could bethey were in the main too costly for wide use. 1. Nonmeasured. He had operated on 2319 cases, only 19 alcoholic beverages.-Chiefly used by the races concerned of which had been fatal, or less than 1 per cent. with their meals. 2. Native fermented drinks.-Palm wine and The degree of perfection of the results depended very much similar products did not usually contain a large percentage on the details of the operation. Out of 246 cases operated of alcohol but when large quantities were taken intoxication on in private he had ascertained the results in 214. Three might be produced. Sir William MacGregor estimated the cases had been fatal-two from venous embolism and one strongest form of palm wine to contain less than 3 per from acute sepsis. Only 26 of these cases had relapsed. cent. of alcohol. There were many varieties of corn beer. The chief question relating to the radical cure of hernia Mr. Joseph Orpen of Rhodesia had given some valuable before the profession at the present time was the best age at information about different kinds of what were known as which to perform the operation. Some advocated it as Kafir beer ; one form, "leting," he described as an early as possible. The proper time varied with circum- acid refreshing drink of little or no intoxicating quality. stances but the operation was best done in early life. "Joala," on the other hand, more properly known as Hernias in children were apt to disappear from time to time Kafir beer, was generally made with the object of proand the causes of this were considered. Continuous pressure ducing drink of the greatest intoxicating strength attainable never resulted in cure. Strangulation in children was by native manufacture. It was used purposely to produce always acute but with rest and warm baths the hernia its toxic effects and was drunk in large quantities till the It had a stupefying effect could generally be reduced. The operation for the radical stomach was quite distended. and in addition produced violent headaches and indigescure of hernia had taken nearly 2000 years to perfect but the problem had now been solved. In conclusion the Presi- tion, even when not mixed with spirits, which was often dent referred to the visit of the French physicians and done. Probably drugs such as bhang were frequently added surgeons to England, extending to them a cordial welcome to these native drinks for purposes of intoxication