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CIVILISATION AND THE CORSET.
1705
indicating a well-marked or quasi-acute case of lymphatism, ]large quantities. Either or both the liver and spleen may, or and one in which both respiratory and cardiac centres are ]may not, be enlarged, and to such a variable extent that no ] can be placed on the absence of physical signs of usually affected suddenly and more or less synchronously, reliance with the inevitable result, sudden death. 4. Because the ienlargement, and very little indeed on the presence of the kidneys were a little congested, to me another indication ofsame. The pupils of the eyes also may appear rather 5. Because dilated. The co-existence of 1 and 2 is pathognomonic of a quasi-acute example of the status lymphaticus. i disease. the lungs were congested-a point that I have commented on the before in such cases of sudden death from lymphatism. Lastly, I cannot agree with Dr. Munro when he says, At the inquest no notes were recorded as to whether the No clinical observation has ever been so hopelessly glands in the mesentery were dark or pale pink in colour ;mistaken as that which stated that pregnancy conferred whether they were uniformly large or uniformly small ;immunity from the poisonous effects of chloroform." True, whether there was or was not any general enlargement there are here more factors than one tending to produce an of the smaller peripheral mesenteric glands ; and whether overdose of the vapour, but the anaesthetist is prepared for 1 some groups of glands were larger and paler than others. this. Despite the mechanical embarrassment to respiration, Also the condition of the miliary lymphatics in the stomach,as Dr. Munro says, the heart is stronger than normal, and oesophagus, ahd intestines was not recorded. All these the increased carrying capacity of the red blood corpuscle I points might possibly have thrown further light on the case. would regard as a"virtue"" rather than a "vice." This The cavities of the heart presumably did not contain anyfactor, coupled with the toxaemia from over-metabolism, noticeable quantity of blood, since no mention is made that probably in large measure accounts for the reason that so they did, and I consequently surmise that it is not improbablelittle chloroform isnecessary to produce and maintain an that its action ceased during systole, as it usually does inefficient and safe anæsthesia during parturition. Is it not such cases. In THE LANCET of Dec. 26th, 1908, I drewsometimes advisable to artificially produce a toxaemia by attention to the fact that of deaths occurring while undergiving a hypodermic injection of morphine preparatory to the general anaesthetics from the status lymphaticus the cata-administration of chloroform’? Probably if one had to strophes always happened during light anaesthesia, either maintain surgical anaesthesia or the third stage of narcosis before reaching, or on recovery from, the third stage ofduring parturition it would not be as safe as it would be narcosis. In some instances where chloroform has beenapart from the condition, but surely "light"anæsthesia is administered for an hour or more during a protracted opera- much safer at such a time than it is at any other. I am, Sir, yours faithfully, tion, although no untoward symptoms may have been present at any time during the whole of the administration, neverR. ERNEST HUMPHRY, M.R.C.S. Eng., L.R.C.P. Lond. theless, just as the patient is beginning to come round and the last few skin sutures are being inserted he may Northwood, Middlesex, Nov. 15th, 1909. suddenly die. From this, and also in consideration of the extremely CIVILISATION AND THE CORSET. trivial firing-off causes that may be sufficient to give rise to a fulminating termination resulting in sudden death, I argue To the Editor of THE LANCET. that the effects of shock in such cases are probably of more an impression which Mr. Heather importance than the effect of the narcotic. In Miss SIR,-May Iin correct his communication on the above subject ? Bigg conveys caused of the fear Dalrymple’s case, shock, by cognisance that she might feel faint, subsequently reinforced by theHe seems to think that men in sultry and atonic shock of the cold lotion applied to her head, would be, at acountries "-I wonder what he means by an atonic country ?" with a view of supporting nature’s coincidently critical period, quite a potent enough exciting "gird the loins walls." Some years ago I unabdominal In conclusion, I was sorry that both "incompetent cause of sudden death. Miss Dalrymple’s former medical attendant and the coroner’sexpectedly met in Calcutta a very distinguished London surgeon, an old fellow-student, who was spending his jury should have attributed this sad and unfortunate disastersummer holiday in going to India to personally see a thing to Death from misadventure," when surely the true verdict ’’
"
’of which he heard in connexion with native customs ; if of " Death from natural causes." Mr. Bigg would follow that example he would see personally Since writing the above I have read with great interest thethat girding of the loins " has nothing whatever to do with letter of Dr. Donald J. Munro published in THE LANCET .artificial support. He need not go beyond Aden, where he of Nov. 13th (p. 1468), and I would here like to take ,will see the Arab camel-drivers coming in from the desert, the opportunity of endorsing many of his views. Foramong whom he will see magnificent specimens of activity. practical purposes the first point of paramount importance"Girding of the loins"really means girding of the loin is the question of diagnosis, and in this connexion may I( cloth, which is wrapped round the body, passed through the be allowed to suggest some modifications of Dr. Munro’s and tucked in at the waist, and is no more worn for the legs, In my restrictions of the term "status lymphaticus"? of support than our trousers are so worn ; nor, if it purpose opinion the five following physical signs and symptoms are were conceivably the object, could it be obtained in any the most important and are arranged in order of merit.better 1 degree than by our trousers. It is obvious that 1. Signs of a persistent thymus gland as evidenced by atthe cloth is liable to work loose, being only tucked lowering of the upper border of superficial cardiac dulnessiin, and girding of the loins" means readjusting it in the absence of emphysema of the lungs, or old tuber-and tucking it in again, and the object corresponds culous cavities at its bases, with or without fulness of the to our object in wearing braces. Natives of India, episternal notch, and not by a dulness to percussion behind whether fighting as uniformed Sepoys or in their native the manubrium. This region may even be a little hyperBritishers, whether fighting or engaging in friendly f garb, resonant, and if dulness is present it is probably due do not wear, and do not need, any artificial contests, some new growth, and not to a simple hyperplasia of the support. I do not wish to contend for or against the use of thymus gland. 2. An uniform prominence of all the papillæ corsets, t the women will settle that for themselves apart from of the tongue, especially the circumvallate papillæ, between tcontradictory statements and opinions of the profession, but which and the epiglottis posteriorly there is frequently Ii do wish to correct an impression which may mislead others present a great multiplication, hypertrophy, and hyper-in i supposing that in a country like India-if Mr. Bigg calls plasia of all the lymphatic nodules, giving rise to a verythat t an atonic country, and a visit there will correct him on characteristic picture, many of these sessile nodulesthat t point-men have to wear artificial support for their measuring about 1-8th to 3-16ths of an inch in diameterloins 1 and abdomens. The impression might lead to the at their bases ; the condition cannot be seen without t that it is necessary in this country, though not thought the aid of forehead and laryngoscopic mirrors. 3. A those accustomed to, or knowing anything about, among symmetrical enlargement of the thyroid gland. 4. exercise. Fancy a Marathon runner running in an abdominal Distant and muffled heart sounds, with absence of the1 belt! sharply defined click caused by closure of the valves, assoI may go one point further and say that In ciated with a soft, weak, and ill-sustained pulse, and, as Dr. whichconclusion, is demonstrable-namely, that where the natural Munro states, often abnormally slow and inexcitable. 5. A r muscular support of the loins and abdomen is deficient from greater or less amount of hyperplasia of any or all of the want of tone, the best way of preventing recovery of ton. faucial, pharyngeal, and lingual tonsils, also of the uvula,iis to provide artificial support, and in no cases is this so and the presence of adenoid growths in either very small or 1,lamentably obvious as in the indiscriminate ordering of
should have been
one
.,
to
1706 for spinal cases, and I am constantly engaged in the evil done in such cases, which evil admits of easv demonstration.-I am. Sir. vours faithfullv. H. E. DEANE, Lieut.-Col., R.A.M.C. (retired). Weymouth-street, W., Nov. 29th, 1909.
supports undoing
To tie Editor of THE LANCET. read with SIR,-I great interest an article in THE LANCET of Nov. 13th, entitled,"Civilisation in Relation to the Abdominal Viscera," which opens up a subject of wide and ever-increasing importance. During the last year I have made a careful observation of a large number of cases varying in age from 15 to 50 years, having regard to those conditions which are said to result from chronic intestinal stasis, and I am bound to confess the existence of those conditions is confirmed by systematic examination. In hospital work we are able more accurately to estimate the severity and chronicity of constipation, and I should like very briefly to repeat some of the points which have been recorded in your columns and which have struck me most forcibly. The worn and haggard appearance, the absence of muscular tone, the pigmentation of the skin in definite places, and the peculiar odour of auto-intoxication are most characteristic. Pigmentation is an early symptom and this staining may be very marked at a time when signs of degeneration are only just beginning to appear. Most constant and remarkable are the changes in the breasts, which at first feel lumpy and later show cystic degeneration. There is a point in connexion with this which arrests attention, and that is that this cystic degeneration does not take place in married women who are having habitual intercourse. A striking illustration of this pre. sented itself to me a short time ago. A married woman, who had one child, 15 years old, was admitted, having received a slight injury to the right breast a few days before. The patient, who had for many years been subject to chronic constipation, showed extensive cystic changes in both breasts. On inquiry it transpired that she had had no intercourse with her husband for 14 years. Pregnancy has a beneficial effect on constipation ; the enlargement of the uterus so alters the mechanics of the abdomen that the bowel can more easily empty itself. Recently I had a typical instance of this. A woman, aged 39 years, was the mother of 14 children. She had been subject all her life to chronic constipation, except during her pregnancies when there was a daily evacuation and a consequent general improvement in health. The almost universal wasting that follows a long history of stasis is a prominent feature. Frequently these patients will say that up to the age of 19 or 20 they were stout, but that afterwards they gradually began to lose flesh until at the age of 35 to 40 they become very thin and wasted. Enfeebled circulation with cold hands and cold feet is a source of great discomfort to the habitually constipated. Pain is always present, though it varies in position and severity and there are periodical remissions. These people are admitted into a hospital for various reasons. Loss of flesh, loss of appetite, indigestion, abdominal pain, vomiting, displacements of the uterus from loss of fat, sleeplessness, nervous depression are some of the numerous symptoms complained of. With painful monotony it is found that a long history of chronic constipation is given. They show some temporary improvement from treatment in bed, due in a slight measure to a daily purging, but chiefly to the assumption of the recumbent posture. It is surely not difficult to believe that a system whose resisting power is so lowered by auto-intoxication becomes an easy prey to the tubercle bacillus and other organisms. These are some of the effects briefly enumerated which cannot fail to be noticed on methodical examination. I am, Sir, yours faithfully, H. M. H. M. M. M. WOODWARD. WOODWARD. Nov. 1909. 18th, Lewisham,
Irnow
accommodated in a room adjacent to the Hunterian collection; and, secondly, by entertaining the leading members of the profession at a dinner within the precincts of the College. I would venture to suggest that this movement might well be directed towards a more permanent memorial of the Jubilee of the Dental Charter by establishing a research scholarship and demonstratorship in connexion There are already two small with the Dental Museum. endowed prizes, the Tomes and Cartwright prizes, administered by the College, the one awarded every third and the other every fifth year ; but the dental profession is deserving of something of a much wider scope than these for the stimulation of research and for the higher teaching of its scientific branches. My own view favours a far more ambitious scheme than anything in the form of a mere prize, whether awarded after examination or conferred in recognition of original work completed. I would ask for the modest sum of £10,000 to endow a research and teaching demonstratorship in con. In this way not only nection with the Dental Museum. would a scientific worker be secured, but he would by his
r( c
demonstrations attract the students from the various dental hospitals to study in the Dental Museum. Such a sum could, I am sure, be easily collected from among the dental surgeons alone ; but if they were to impress upon their patients the necessity of endowing dental research there need be no hesitation in raising the sum I have suggested to 50,000, whereby not only research and teaching demonstratorships might be established, but travelling scholarships might be founded which would be of great advantage in keeping English dentistry in touch with that of foreign countries. It is some 25 years ago since I first began to advocate the bringing of the dental surgeons back within the pale of the profession and giving them the same opportunities as ophthalmic, aural, and other specialists. One could scarcely have anticipated so encouraging a development as has occurred within so short a period. The dental surgeons have not been slow of late to seize the occasions for better recognition, and by placing the Odontological Society under the Eegis of the Royal Society of Medicine, and by handing over their superb museum to the care of the Royal College of Surgeons they have shown their desire to be associated with the general body of the medical profession. Now I think the time has come for the further development of the scientific side of the branch, in which direction several members have already gained great eminence. Should my suggestion find favour with the dental section of our profession, I should be pleased to cooperate with any interested in this project ; but it must be distinctly understood that I write quite unofficially, though I have little doubt that the Council of the Royal College of Surgeons would give its consent to the administration of such a research demonstratorship as that proposed if the money were forthcoming for its endowment. I am, Sir, yours faithfully, R. CLEMENT LUCAS. Nov. 1909. London, W., 27th,
THE TREATMENT OF MORPHINISM. 10 the Editor
of THE LANCET.
SIR,-I have been much interested in the letters of Dr, C. J. Douglas and Dr. Oscar Jennings which have appeared in your columns under the above heading. The subject is in reality much larger than the heading might lead one to infer, for the treatment of morphinism is but a chapter in the volume on the treatment of habit, and accordingly the question raised in respect of one drug-the proper method of treatment of its abuse-is of fundamental importance and applicable in the main to all forms of drug abuse, if not to every form of acquired evil custom. Dr. Douglas suppresses the habit, breaks its custom, by the help of hypnotic remedies ; for him ’’I sleep solves the problem the painless withdrawal of morphine...... when the awakes the painful period is passed and all desire patient THE JUBILEE OF THE DENTAL for morphine is gone."1 To the Editor of THE LANCET. Dr. Oscar Jennings also suppresses the habit, breaks its SIR,-The dental surgeons have shown themselves desirous custom, but by the help of the patient’s own good will, in of commemorating the Jubilee of their Charter, and the Royal arduous operation ; his method stepping in to reinforce and College of Surgeons of England, as the first examining body encourage the operation of the will during the withdrawal of to grant degrees in dental surgery, has endeavoured to the drug, and, at the same time, to lessen the arduousness of show its interest in this branch of the profession, first, by 1 THE accepting the trust of the Odontological Museum, which is LANCET, Oct. 2nd, 1909.
of
CHARTER
indicating a well-marked or quasi-acute case of lymphatism, ]large quantities. Either or both the liver and spleen may, or and one in which both respiratory and cardiac centres are ]may not, be enlarged, and to such a variable extent that no ] can be placed on the absence of physical signs of usually affected suddenly and more or less synchronously, reliance with the inevitable result, sudden death. 4. Because the ienlargement, and very little indeed on the presence of the kidneys were a little congested, to me another indication ofsame. The pupils of the eyes also may appear rather 5. Because dilated. The co-existence of 1 and 2 is pathognomonic of a quasi-acute example of the status lymphaticus. i disease. the lungs were congested-a point that I have commented on the before in such cases of sudden death from lymphatism. Lastly, I cannot agree with Dr. Munro when he says, At the inquest no notes were recorded as to whether the No clinical observation has ever been so hopelessly glands in the mesentery were dark or pale pink in colour ;mistaken as that which stated that pregnancy conferred whether they were uniformly large or uniformly small ;immunity from the poisonous effects of chloroform." True, whether there was or was not any general enlargement there are here more factors than one tending to produce an of the smaller peripheral mesenteric glands ; and whether overdose of the vapour, but the anaesthetist is prepared for 1 some groups of glands were larger and paler than others. this. Despite the mechanical embarrassment to respiration, Also the condition of the miliary lymphatics in the stomach,as Dr. Munro says, the heart is stronger than normal, and oesophagus, ahd intestines was not recorded. All these the increased carrying capacity of the red blood corpuscle I points might possibly have thrown further light on the case. would regard as a"virtue"" rather than a "vice." This The cavities of the heart presumably did not contain anyfactor, coupled with the toxaemia from over-metabolism, noticeable quantity of blood, since no mention is made that probably in large measure accounts for the reason that so they did, and I consequently surmise that it is not improbablelittle chloroform isnecessary to produce and maintain an that its action ceased during systole, as it usually does inefficient and safe anæsthesia during parturition. Is it not such cases. In THE LANCET of Dec. 26th, 1908, I drewsometimes advisable to artificially produce a toxaemia by attention to the fact that of deaths occurring while undergiving a hypodermic injection of morphine preparatory to the general anaesthetics from the status lymphaticus the cata-administration of chloroform’? Probably if one had to strophes always happened during light anaesthesia, either maintain surgical anaesthesia or the third stage of narcosis before reaching, or on recovery from, the third stage ofduring parturition it would not be as safe as it would be narcosis. In some instances where chloroform has beenapart from the condition, but surely "light"anæsthesia is administered for an hour or more during a protracted opera- much safer at such a time than it is at any other. I am, Sir, yours faithfully, tion, although no untoward symptoms may have been present at any time during the whole of the administration, neverR. ERNEST HUMPHRY, M.R.C.S. Eng., L.R.C.P. Lond. theless, just as the patient is beginning to come round and the last few skin sutures are being inserted he may Northwood, Middlesex, Nov. 15th, 1909. suddenly die. From this, and also in consideration of the extremely CIVILISATION AND THE CORSET. trivial firing-off causes that may be sufficient to give rise to a fulminating termination resulting in sudden death, I argue To the Editor of THE LANCET. that the effects of shock in such cases are probably of more an impression which Mr. Heather importance than the effect of the narcotic. In Miss SIR,-May Iin correct his communication on the above subject ? Bigg conveys caused of the fear Dalrymple’s case, shock, by cognisance that she might feel faint, subsequently reinforced by theHe seems to think that men in sultry and atonic shock of the cold lotion applied to her head, would be, at acountries "-I wonder what he means by an atonic country ?" with a view of supporting nature’s coincidently critical period, quite a potent enough exciting "gird the loins walls." Some years ago I unabdominal In conclusion, I was sorry that both "incompetent cause of sudden death. Miss Dalrymple’s former medical attendant and the coroner’sexpectedly met in Calcutta a very distinguished London surgeon, an old fellow-student, who was spending his jury should have attributed this sad and unfortunate disastersummer holiday in going to India to personally see a thing to Death from misadventure," when surely the true verdict ’’
"
’of which he heard in connexion with native customs ; if of " Death from natural causes." Mr. Bigg would follow that example he would see personally Since writing the above I have read with great interest thethat girding of the loins " has nothing whatever to do with letter of Dr. Donald J. Munro published in THE LANCET .artificial support. He need not go beyond Aden, where he of Nov. 13th (p. 1468), and I would here like to take ,will see the Arab camel-drivers coming in from the desert, the opportunity of endorsing many of his views. Foramong whom he will see magnificent specimens of activity. practical purposes the first point of paramount importance"Girding of the loins"really means girding of the loin is the question of diagnosis, and in this connexion may I( cloth, which is wrapped round the body, passed through the be allowed to suggest some modifications of Dr. Munro’s and tucked in at the waist, and is no more worn for the legs, In my restrictions of the term "status lymphaticus"? of support than our trousers are so worn ; nor, if it purpose opinion the five following physical signs and symptoms are were conceivably the object, could it be obtained in any the most important and are arranged in order of merit.better 1 degree than by our trousers. It is obvious that 1. Signs of a persistent thymus gland as evidenced by atthe cloth is liable to work loose, being only tucked lowering of the upper border of superficial cardiac dulnessiin, and girding of the loins" means readjusting it in the absence of emphysema of the lungs, or old tuber-and tucking it in again, and the object corresponds culous cavities at its bases, with or without fulness of the to our object in wearing braces. Natives of India, episternal notch, and not by a dulness to percussion behind whether fighting as uniformed Sepoys or in their native the manubrium. This region may even be a little hyperBritishers, whether fighting or engaging in friendly f garb, resonant, and if dulness is present it is probably due do not wear, and do not need, any artificial contests, some new growth, and not to a simple hyperplasia of the support. I do not wish to contend for or against the use of thymus gland. 2. An uniform prominence of all the papillæ corsets, t the women will settle that for themselves apart from of the tongue, especially the circumvallate papillæ, between tcontradictory statements and opinions of the profession, but which and the epiglottis posteriorly there is frequently Ii do wish to correct an impression which may mislead others present a great multiplication, hypertrophy, and hyper-in i supposing that in a country like India-if Mr. Bigg calls plasia of all the lymphatic nodules, giving rise to a verythat t an atonic country, and a visit there will correct him on characteristic picture, many of these sessile nodulesthat t point-men have to wear artificial support for their measuring about 1-8th to 3-16ths of an inch in diameterloins 1 and abdomens. The impression might lead to the at their bases ; the condition cannot be seen without t that it is necessary in this country, though not thought the aid of forehead and laryngoscopic mirrors. 3. A those accustomed to, or knowing anything about, among symmetrical enlargement of the thyroid gland. 4. exercise. Fancy a Marathon runner running in an abdominal Distant and muffled heart sounds, with absence of the1 belt! sharply defined click caused by closure of the valves, assoI may go one point further and say that In ciated with a soft, weak, and ill-sustained pulse, and, as Dr. whichconclusion, is demonstrable-namely, that where the natural Munro states, often abnormally slow and inexcitable. 5. A r muscular support of the loins and abdomen is deficient from greater or less amount of hyperplasia of any or all of the want of tone, the best way of preventing recovery of ton. faucial, pharyngeal, and lingual tonsils, also of the uvula,iis to provide artificial support, and in no cases is this so and the presence of adenoid growths in either very small or 1,lamentably obvious as in the indiscriminate ordering of
should have been
one
.,
to
1706 for spinal cases, and I am constantly engaged in the evil done in such cases, which evil admits of easv demonstration.-I am. Sir. vours faithfullv. H. E. DEANE, Lieut.-Col., R.A.M.C. (retired). Weymouth-street, W., Nov. 29th, 1909.
supports undoing
To tie Editor of THE LANCET. read with SIR,-I great interest an article in THE LANCET of Nov. 13th, entitled,"Civilisation in Relation to the Abdominal Viscera," which opens up a subject of wide and ever-increasing importance. During the last year I have made a careful observation of a large number of cases varying in age from 15 to 50 years, having regard to those conditions which are said to result from chronic intestinal stasis, and I am bound to confess the existence of those conditions is confirmed by systematic examination. In hospital work we are able more accurately to estimate the severity and chronicity of constipation, and I should like very briefly to repeat some of the points which have been recorded in your columns and which have struck me most forcibly. The worn and haggard appearance, the absence of muscular tone, the pigmentation of the skin in definite places, and the peculiar odour of auto-intoxication are most characteristic. Pigmentation is an early symptom and this staining may be very marked at a time when signs of degeneration are only just beginning to appear. Most constant and remarkable are the changes in the breasts, which at first feel lumpy and later show cystic degeneration. There is a point in connexion with this which arrests attention, and that is that this cystic degeneration does not take place in married women who are having habitual intercourse. A striking illustration of this pre. sented itself to me a short time ago. A married woman, who had one child, 15 years old, was admitted, having received a slight injury to the right breast a few days before. The patient, who had for many years been subject to chronic constipation, showed extensive cystic changes in both breasts. On inquiry it transpired that she had had no intercourse with her husband for 14 years. Pregnancy has a beneficial effect on constipation ; the enlargement of the uterus so alters the mechanics of the abdomen that the bowel can more easily empty itself. Recently I had a typical instance of this. A woman, aged 39 years, was the mother of 14 children. She had been subject all her life to chronic constipation, except during her pregnancies when there was a daily evacuation and a consequent general improvement in health. The almost universal wasting that follows a long history of stasis is a prominent feature. Frequently these patients will say that up to the age of 19 or 20 they were stout, but that afterwards they gradually began to lose flesh until at the age of 35 to 40 they become very thin and wasted. Enfeebled circulation with cold hands and cold feet is a source of great discomfort to the habitually constipated. Pain is always present, though it varies in position and severity and there are periodical remissions. These people are admitted into a hospital for various reasons. Loss of flesh, loss of appetite, indigestion, abdominal pain, vomiting, displacements of the uterus from loss of fat, sleeplessness, nervous depression are some of the numerous symptoms complained of. With painful monotony it is found that a long history of chronic constipation is given. They show some temporary improvement from treatment in bed, due in a slight measure to a daily purging, but chiefly to the assumption of the recumbent posture. It is surely not difficult to believe that a system whose resisting power is so lowered by auto-intoxication becomes an easy prey to the tubercle bacillus and other organisms. These are some of the effects briefly enumerated which cannot fail to be noticed on methodical examination. I am, Sir, yours faithfully, H. M. H. M. M. M. WOODWARD. WOODWARD. Nov. 1909. 18th, Lewisham,
Irnow
accommodated in a room adjacent to the Hunterian collection; and, secondly, by entertaining the leading members of the profession at a dinner within the precincts of the College. I would venture to suggest that this movement might well be directed towards a more permanent memorial of the Jubilee of the Dental Charter by establishing a research scholarship and demonstratorship in connexion There are already two small with the Dental Museum. endowed prizes, the Tomes and Cartwright prizes, administered by the College, the one awarded every third and the other every fifth year ; but the dental profession is deserving of something of a much wider scope than these for the stimulation of research and for the higher teaching of its scientific branches. My own view favours a far more ambitious scheme than anything in the form of a mere prize, whether awarded after examination or conferred in recognition of original work completed. I would ask for the modest sum of £10,000 to endow a research and teaching demonstratorship in con. In this way not only nection with the Dental Museum. would a scientific worker be secured, but he would by his
r( c
demonstrations attract the students from the various dental hospitals to study in the Dental Museum. Such a sum could, I am sure, be easily collected from among the dental surgeons alone ; but if they were to impress upon their patients the necessity of endowing dental research there need be no hesitation in raising the sum I have suggested to 50,000, whereby not only research and teaching demonstratorships might be established, but travelling scholarships might be founded which would be of great advantage in keeping English dentistry in touch with that of foreign countries. It is some 25 years ago since I first began to advocate the bringing of the dental surgeons back within the pale of the profession and giving them the same opportunities as ophthalmic, aural, and other specialists. One could scarcely have anticipated so encouraging a development as has occurred within so short a period. The dental surgeons have not been slow of late to seize the occasions for better recognition, and by placing the Odontological Society under the Eegis of the Royal Society of Medicine, and by handing over their superb museum to the care of the Royal College of Surgeons they have shown their desire to be associated with the general body of the medical profession. Now I think the time has come for the further development of the scientific side of the branch, in which direction several members have already gained great eminence. Should my suggestion find favour with the dental section of our profession, I should be pleased to cooperate with any interested in this project ; but it must be distinctly understood that I write quite unofficially, though I have little doubt that the Council of the Royal College of Surgeons would give its consent to the administration of such a research demonstratorship as that proposed if the money were forthcoming for its endowment. I am, Sir, yours faithfully, R. CLEMENT LUCAS. Nov. 1909. London, W., 27th,
THE TREATMENT OF MORPHINISM. 10 the Editor
of THE LANCET.
SIR,-I have been much interested in the letters of Dr, C. J. Douglas and Dr. Oscar Jennings which have appeared in your columns under the above heading. The subject is in reality much larger than the heading might lead one to infer, for the treatment of morphinism is but a chapter in the volume on the treatment of habit, and accordingly the question raised in respect of one drug-the proper method of treatment of its abuse-is of fundamental importance and applicable in the main to all forms of drug abuse, if not to every form of acquired evil custom. Dr. Douglas suppresses the habit, breaks its custom, by the help of hypnotic remedies ; for him ’’I sleep solves the problem the painless withdrawal of morphine...... when the awakes the painful period is passed and all desire patient THE JUBILEE OF THE DENTAL for morphine is gone."1 To the Editor of THE LANCET. Dr. Oscar Jennings also suppresses the habit, breaks its SIR,-The dental surgeons have shown themselves desirous custom, but by the help of the patient’s own good will, in of commemorating the Jubilee of their Charter, and the Royal arduous operation ; his method stepping in to reinforce and College of Surgeons of England, as the first examining body encourage the operation of the will during the withdrawal of to grant degrees in dental surgery, has endeavoured to the drug, and, at the same time, to lessen the arduousness of show its interest in this branch of the profession, first, by 1 THE accepting the trust of the Odontological Museum, which is LANCET, Oct. 2nd, 1909.
of
CHARTER