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CHLORETONE IN SEA-SICKNESS.
253 The second theory, to which I think strong objection shouid be made, is that of the nature of the great intestine, which Mr. Stanmore Bishop regards as "the slop stone and drain"to carry ofE the. refuse of the stomach and small intestine. It is not nature’s habit to use seven or eight feet of an elaborate tube furnished with a carpet of glands and lymphoid tissue, supplied most richly with arteries, veins, and lymphatics, with a delicate and easily discrganised nervous mechanism, to play the part of an excretory duct or cloaca. Yet Metchnikoffand Dr. E. Barclay-Smith4 have each concluded that the great intestine, as far as man is concerned, is a useless and dangerous structure and that its presence in man is a blunder on the part of nature which, however, can be obviated by the aid of the surgeon. The Metchnikoffian theory of the great intestine rests on two facts : (1) we do not know the function of the great intestine ; and (2) the health of the body is improved by the removal of a diseased great intestine. There is no evidence that the excision of a healthy or normal great intestine leads to an improvement of the well being of the individual. " My reason for protesting against the " syphon drain-pipe theory of the great intestine is that, were it accepted by a your ger generation, it would retard a much. needed inquiry into the functions of the colon and the normal stimuli whereby its nervous and muscular mechanisms are set in
operation,
4 ought
view of the comparative anatomist it inference to suppose that it would be easier, did we know the functions of the several segments of the alimentary canal, to adapt the human diet to the canal than by surgical interference to modify the canal to suit the artificial diet of civilisation. From the
point of logical
seems a more
T
——
0.’--
—-
A.
t:ttn—
KEITH, M.D. Aberd.
THE BORDERLANDS OF INFECTIOUS DISEASES AND THEIR
MANAGEMENT. To the Editors
hospitals
to be
I am,
Sirs, yours faithfully,
-
CLEMENT DUKES.
CHLORETONE IN SEA-SICKNESS. To the Editors of THE LANCET. SIRS,-As was through the correspondence columns of your valued journal that I was first made acquainted with the efficacy of chloretone in sea-sickness, and as I havejust recently realifed the value of that information, I deem it my duty to contribute through the same medium my grateful testimony in confirmation of your correspondents’ reports. My daughter (aged about 20 years) is so fond of the sea that she always prefers boat to train, notwithstanding the fact that she has (until this last trip) invariably had to undergo the ordeal of at least 24 hours’ sea-sickness. She sailed from London Docks on Dec. 30th per s.s. Avon to Grangemouth and returned by same steamer last Friday morning. On this occasion she took with her a supply of chloretone capsules, five grains each, and for the first time in her life made the sea trip not only without sickness In fact, she but with improved appetite and spirits. partook with relish of fats and vegetables, things that she could not tolerate at home. She attributes (I believe rightly) her immunity to the chloretone capsules, two of which she took before setting out and nturning. She was directed to take one every two hours if threatened with sickness, but fortunately occasion did not arise, although the trip both ways was very rough, the vessel shipping numerous heavy seas and rolling very much. I may also add that I have found the same preparation useful in some cases of insomnia, reflex headache and vomiting, and would very much like if some of your numerous readers could favour THE LANCET with their experience of its effects in these directions and such explanation of its action as may assist in indicating suitable cases and mode of administration. Apologising for the unintended length of this communicaI am, Sirs, yours faithfully, it
tion,
--
JOHN
DUNLOP,
L.R.C.P.
Edin., &c.
of THE LANCET.
to be on the verge of obtaining the clear SiRs,-We white light of truth on the second part of this subject, thanks to the manly courage of Dr. H. E. J. Biss in revealing some of the facts. The question of the borderlands of infectious diseases is eclipsed for the moment by the facts disclosed as to the critical state of the Metropolitan Asylums Board’s hospitals and, as a matter of fact, by many medical officers of health as to isolation hospitals generally, as well as notably by Mr. E. D. Marriott of Nottingham. The facts divulged from time to time for some years past have caused some misgiving to many, but no one outside an isolation hospital could credit that they were as serious as stated by Dr. Biss in his last letter. If during five years in the Metropolitan Asylums Board’s hospitals 2562 patients who had been admitted for scarlet fever were attacked with diphtheria during their convalescence in hospital and if about the same number who were admitted into hospital suffering from diphtheria likewise sickened with scarlet fever then I think the strongest case is made out for an immediate inquiry so that the medical staffs of these hospitals may have an opportunity of unburdening their minds, for they must be fulfilling their duties with heavy hearts. The darkest days of ophthalmia in barrack schools pale before such revelations of, at least, some of these miscalled isolation hospitals. If the results made known are only obtainable after isolation hospitals are constructed secundum artem, and under efficient management, then there is only one course openthe doors must be closed. But I am still loth to believe that they cannot be rendered serviceable for their purpose, notwithstanding Dr. Biss’s alarming figures. I therefore join in calling upon those who are answerable for the construction and management of these hospitals to institute a public inquiry by a competent and disinterested commission without delay. Should those in authority burke an inquiry it will become a question of "urgent public importance " in the House of Commons. Meanwhile I would go further and say, seem
not the construction of new isolation
] pending an inquiry ? prohibited
THE LUNG REFLEX OF ABRAMS. To the Editors of THE LANCET. SiRS,—I am again obliged to correct Dr. Campbell’s statement to the effect that I acknowledge the action of the re-piratory muscles "in explaining reflex pulmonary expansion." Yes ; afttrthe expansion has passed a certain point, already frequently pointed out, and safeguarded in my last letter by the words after passive recoil of the chest has done its part." I am afraid I must admit my inability to follow Dr. Campbell in his comparison of the action of an "
entire organ, like the heart, with that of a group of muscles only forming part of a complicated system of machinery, nor shall I venture to entertain the somewhat mystical conception that muscles when relaxing may be at the same time contracting, more especially as this is based on observations which Dr. Campbell has made upon himself. Now in respect of lung contraction in a limited area Dr. Campbell dismisses physiological experiments as valueless, believing, curiously enough, that in such the lungs are necessarily subjected to a positive pressure. By no means. I intended to refer more particularly to portions of lung inclosed in the plethysmograph from which the air had been exhausttd. If, as Dr. Campbell fancies, the effect of bronchiolar constriction is to drive the contained air backwards into the alveoli, how is it that the manometer records an increase of pressure? The vagus acts chiefly on the sm&llest bronchioles and what may be termed the air wave in lung contraction travels from within outwards. If, on the other hand, the air were driven inwards, not only would there be no rise of pressure but the total lung volume would remain constant for the time being. As the reverse of both these conditions occurs the hypothesis of an alveolar inflation is insusceptible of serious consideration. Even clinical observation proves that sudden obstruction of a bronchus cases collapse of the pertaining lurg territory. Finally, the question is put, 3 The Nature of Man. English translation, by P. C. Mitchell. Could a vagus stimulation produce a pulmonary contraction London, 1903. to cause a darkening (i.e., diminished brightness) 4 Proceedings of the Cambridge Philosophical Society, vol. xii., sufficient in the fluoroscopic field and a dulling of the percussion note? Part I., 1903.
operation,
4 ought
view of the comparative anatomist it inference to suppose that it would be easier, did we know the functions of the several segments of the alimentary canal, to adapt the human diet to the canal than by surgical interference to modify the canal to suit the artificial diet of civilisation. From the
point of logical
seems a more
T
——
0.’--
—-
A.
t:ttn—
KEITH, M.D. Aberd.
THE BORDERLANDS OF INFECTIOUS DISEASES AND THEIR
MANAGEMENT. To the Editors
hospitals
to be
I am,
Sirs, yours faithfully,
-
CLEMENT DUKES.
CHLORETONE IN SEA-SICKNESS. To the Editors of THE LANCET. SIRS,-As was through the correspondence columns of your valued journal that I was first made acquainted with the efficacy of chloretone in sea-sickness, and as I havejust recently realifed the value of that information, I deem it my duty to contribute through the same medium my grateful testimony in confirmation of your correspondents’ reports. My daughter (aged about 20 years) is so fond of the sea that she always prefers boat to train, notwithstanding the fact that she has (until this last trip) invariably had to undergo the ordeal of at least 24 hours’ sea-sickness. She sailed from London Docks on Dec. 30th per s.s. Avon to Grangemouth and returned by same steamer last Friday morning. On this occasion she took with her a supply of chloretone capsules, five grains each, and for the first time in her life made the sea trip not only without sickness In fact, she but with improved appetite and spirits. partook with relish of fats and vegetables, things that she could not tolerate at home. She attributes (I believe rightly) her immunity to the chloretone capsules, two of which she took before setting out and nturning. She was directed to take one every two hours if threatened with sickness, but fortunately occasion did not arise, although the trip both ways was very rough, the vessel shipping numerous heavy seas and rolling very much. I may also add that I have found the same preparation useful in some cases of insomnia, reflex headache and vomiting, and would very much like if some of your numerous readers could favour THE LANCET with their experience of its effects in these directions and such explanation of its action as may assist in indicating suitable cases and mode of administration. Apologising for the unintended length of this communicaI am, Sirs, yours faithfully, it
tion,
--
JOHN
DUNLOP,
L.R.C.P.
Edin., &c.
of THE LANCET.
to be on the verge of obtaining the clear SiRs,-We white light of truth on the second part of this subject, thanks to the manly courage of Dr. H. E. J. Biss in revealing some of the facts. The question of the borderlands of infectious diseases is eclipsed for the moment by the facts disclosed as to the critical state of the Metropolitan Asylums Board’s hospitals and, as a matter of fact, by many medical officers of health as to isolation hospitals generally, as well as notably by Mr. E. D. Marriott of Nottingham. The facts divulged from time to time for some years past have caused some misgiving to many, but no one outside an isolation hospital could credit that they were as serious as stated by Dr. Biss in his last letter. If during five years in the Metropolitan Asylums Board’s hospitals 2562 patients who had been admitted for scarlet fever were attacked with diphtheria during their convalescence in hospital and if about the same number who were admitted into hospital suffering from diphtheria likewise sickened with scarlet fever then I think the strongest case is made out for an immediate inquiry so that the medical staffs of these hospitals may have an opportunity of unburdening their minds, for they must be fulfilling their duties with heavy hearts. The darkest days of ophthalmia in barrack schools pale before such revelations of, at least, some of these miscalled isolation hospitals. If the results made known are only obtainable after isolation hospitals are constructed secundum artem, and under efficient management, then there is only one course openthe doors must be closed. But I am still loth to believe that they cannot be rendered serviceable for their purpose, notwithstanding Dr. Biss’s alarming figures. I therefore join in calling upon those who are answerable for the construction and management of these hospitals to institute a public inquiry by a competent and disinterested commission without delay. Should those in authority burke an inquiry it will become a question of "urgent public importance " in the House of Commons. Meanwhile I would go further and say, seem
not the construction of new isolation
] pending an inquiry ? prohibited
THE LUNG REFLEX OF ABRAMS. To the Editors of THE LANCET. SiRS,—I am again obliged to correct Dr. Campbell’s statement to the effect that I acknowledge the action of the re-piratory muscles "in explaining reflex pulmonary expansion." Yes ; afttrthe expansion has passed a certain point, already frequently pointed out, and safeguarded in my last letter by the words after passive recoil of the chest has done its part." I am afraid I must admit my inability to follow Dr. Campbell in his comparison of the action of an "
entire organ, like the heart, with that of a group of muscles only forming part of a complicated system of machinery, nor shall I venture to entertain the somewhat mystical conception that muscles when relaxing may be at the same time contracting, more especially as this is based on observations which Dr. Campbell has made upon himself. Now in respect of lung contraction in a limited area Dr. Campbell dismisses physiological experiments as valueless, believing, curiously enough, that in such the lungs are necessarily subjected to a positive pressure. By no means. I intended to refer more particularly to portions of lung inclosed in the plethysmograph from which the air had been exhausttd. If, as Dr. Campbell fancies, the effect of bronchiolar constriction is to drive the contained air backwards into the alveoli, how is it that the manometer records an increase of pressure? The vagus acts chiefly on the sm&llest bronchioles and what may be termed the air wave in lung contraction travels from within outwards. If, on the other hand, the air were driven inwards, not only would there be no rise of pressure but the total lung volume would remain constant for the time being. As the reverse of both these conditions occurs the hypothesis of an alveolar inflation is insusceptible of serious consideration. Even clinical observation proves that sudden obstruction of a bronchus cases collapse of the pertaining lurg territory. Finally, the question is put, 3 The Nature of Man. English translation, by P. C. Mitchell. Could a vagus stimulation produce a pulmonary contraction London, 1903. to cause a darkening (i.e., diminished brightness) 4 Proceedings of the Cambridge Philosophical Society, vol. xii., sufficient in the fluoroscopic field and a dulling of the percussion note? Part I., 1903.