- Email: [email protected]
COLD BATHS
516
(2) Tensing and relaxing muscles performed without violence exaggeration. This is known to increase the surge of blood through muscles, and its influence upon the digestion and the bowels strongly suggests some form of visceral activity resulted or
from these exercises. (3) Elementary education in the changes and events of pregnancy and parturition, giving confidence and removing most, if not all, anxiety about childbirth. This resulted in general and physical improvement and, by allaying of fears, minimised the constrictor influence of the sympathetic upon the visceral blood vessels.
coordination of all branches of science in the study of faculty and function. GRANTLY DICK READ. Petersfleld, I-Iants.
human
COLD BATHS
-
The value of such measures cannot be estimated with the certainty of laboratory experiments, for obviously they ’may be associated with a variety of causes and effects. Toxaemia and pre-eclamptic symptoms rarely develop under this regime sufficiently to demand active interference. No absolute conclusion can be drawn from these observations but they may emphasise the possibility of a multiple or general origin of toxaemia as opposed to a primary visceral or focal cause. A
of 27, who lost 3 babies between twelve and twenty weeks’ gestation with marked hypertensive pre-eclamptic symptoms, started this regime in part before her fourth pregnancy, and with the exception of limb-moving exercises the whole programme was adopted soon after she missed a period. Her diastolic blood-pressure had remained around 80 mm. Hg, and there was a faint cloud of albumin but no casts in the urine. She was on a minimal NaCl diet and all went well until the thirty-fourth week when albumin and blood-pressure increased and some oedema appeared. On admission to hospital she was treated with confident, companionable encouragement and reassurance and started to improve at once with no other treatment. At thirty-seven weeks she came into labour spontaneously and was delivered calm and relaxed without drugs, analgesics, or episiotomy. She stated she had no discomfort that needed analgesia and refused it when offered. She watched her 4 lb. baby born; it was a toxic premature type, but owing to the nature of her labour cried lustily immediately and adjusted its general metabolism without difficulty. I was fortunate in obtaining, with her consent, a colour film of her labour and delivery, and her breast-fed baby of three weeks old. This was one of several toxaemias of varying intensity which reacted in this way to the same procedures. woman
Later I was travelling in South, Central, and East Africa studying childbirth in the tribes uninfluenced by modern science or European interference. In the two hundred-odd tribes and subtribes of whom I obtained information, I observed that the posture and carriage of women ensures breathing far more efficient than in cultural societies. Relaxation and muscle tension are natural to their way of life. They have no fear of childbirth but welcome pregnancy as a gift from their spiritual ancestors and labour as a joyous achievement though sometimes hard work. Most of them are instructed in childbirth by experienced women teachers who assist and never leave them during labour. Except for one or two quite degenerate tribes and others who had become urbanised by association with Europeans, the African woman appeared to me to be an excellent example of all I had taught as a means of avoiding dysfunction in pregnancy and childbirth. Amongst the African women eclampsia is extremely rare and in some of the Central Congo tribes we found it had never been known to occur. This was equally true at all altitudes and amongst the badly and the wellnourished people, the vegetarians, blood drinkers, and mixed-food eaters. It applied in the same measure to Bantu, Hamitic, Nilotic, and mixed races who live tribal lives in remote areas where the white man does not live or rarely visits. I offer these observations, Sir, as an appreciation of the clinical importance of the work of Dr. Morris and his colleagues upon the circulation of the blood in the wall of the pregnant uterus, but I believe that the final answer to the problem of toxaemia of pregnancy, as well as dysfunction of the uterus, will only be found by the
SiR,-At this school cold baths have up till now been compulsory every morning of the year. It has been suggested that this practice should be changed, and in the course of discussion an important point has arisen on which we felt that it would be wisest to take an impartial outside opinion. We wondered whether any of your readers could suggest, roughly, what would be a suitable lower air-temperature in the bathroom. (There are no considerations of heat or draughts to be taken into account.) Perhaps this lower limit we are looking for might be defined as the point when the various risks from and the unpleasant shock begin to outweigh the exposure " healthiness " and the power of waking one up that is claimed for them. Bedales School, Petersfield, Hants.
JOHN VINCENT.
Obituary HENRY WADE Kt., C.M.G., D.S.O., M.D. Edin., F.R.C.S.E. Sir Henry Wade, past president of the Royal College of Surgeons of Edinburgh and an honorary fellow of the English, American, Australasian, and Irish Colleges, died in his Edinburgh home on Feb. 21, at the age of 78. A son of the Rev. George Wade of Falkirk, he was educated in Edinburgh at the Royal High School and the university, where he graduated M.B. with first-class honours in 1898. The following year the South African war broke out and it was not long before his adventuresome spirit prompted him to volunteer for active service as a civil surgeon attached to the British Field Force. After eighteen months, the last eight of which were spent in sole charge of the surgical beds in a military hospital in Pretoria, he returned to Edinburgh where for a year he was demonstrator in anatomy at the university. At this point, however, he broke with tradition, in that when appointed as clinical tutor to F. M. Caird, then regius professor of clinical surgery, he forsook anatomy to study pathology, believing that a wide knowledge of this subject was of paramount
to a surgeon. his reputation as a pathologist, that when he was elected to the fellowship of the Royal College of Surgeons of -Edinburgh in 1903, he was appointed conservator of the college museum the same year; and he continued in this office for seventeen years. He began his pathological researches by studying the aetiology of carcinoma, and he published several papers on this subject in our columns in 1904. In 1907 he was awarded a gold medal for his M.D. thesis on infective sarcoma of the dog. In 1906 he temporarily resigned from clinical work on his appointment as assistant pathologist to the Royal Infirmary, and for the next two years he performed the post-mortem examinations on virtually all cases sent from the surgical wards of the hospital. Wade was appointed assistant surgeon to Leith Hospital in 1908 and to the Royal Infirmary in 1909. At this time the extramural school was flourishing, and from 1906 onwards he was for many years much in demand as a lecturer in surgery and surgical pathology both to students and to postgraduates. Gradually his interest in the pathological and clinical aspects of urology
importance Such
was
(2) Tensing and relaxing muscles performed without violence exaggeration. This is known to increase the surge of blood through muscles, and its influence upon the digestion and the bowels strongly suggests some form of visceral activity resulted or
from these exercises. (3) Elementary education in the changes and events of pregnancy and parturition, giving confidence and removing most, if not all, anxiety about childbirth. This resulted in general and physical improvement and, by allaying of fears, minimised the constrictor influence of the sympathetic upon the visceral blood vessels.
coordination of all branches of science in the study of faculty and function. GRANTLY DICK READ. Petersfleld, I-Iants.
human
COLD BATHS
-
The value of such measures cannot be estimated with the certainty of laboratory experiments, for obviously they ’may be associated with a variety of causes and effects. Toxaemia and pre-eclamptic symptoms rarely develop under this regime sufficiently to demand active interference. No absolute conclusion can be drawn from these observations but they may emphasise the possibility of a multiple or general origin of toxaemia as opposed to a primary visceral or focal cause. A
of 27, who lost 3 babies between twelve and twenty weeks’ gestation with marked hypertensive pre-eclamptic symptoms, started this regime in part before her fourth pregnancy, and with the exception of limb-moving exercises the whole programme was adopted soon after she missed a period. Her diastolic blood-pressure had remained around 80 mm. Hg, and there was a faint cloud of albumin but no casts in the urine. She was on a minimal NaCl diet and all went well until the thirty-fourth week when albumin and blood-pressure increased and some oedema appeared. On admission to hospital she was treated with confident, companionable encouragement and reassurance and started to improve at once with no other treatment. At thirty-seven weeks she came into labour spontaneously and was delivered calm and relaxed without drugs, analgesics, or episiotomy. She stated she had no discomfort that needed analgesia and refused it when offered. She watched her 4 lb. baby born; it was a toxic premature type, but owing to the nature of her labour cried lustily immediately and adjusted its general metabolism without difficulty. I was fortunate in obtaining, with her consent, a colour film of her labour and delivery, and her breast-fed baby of three weeks old. This was one of several toxaemias of varying intensity which reacted in this way to the same procedures. woman
Later I was travelling in South, Central, and East Africa studying childbirth in the tribes uninfluenced by modern science or European interference. In the two hundred-odd tribes and subtribes of whom I obtained information, I observed that the posture and carriage of women ensures breathing far more efficient than in cultural societies. Relaxation and muscle tension are natural to their way of life. They have no fear of childbirth but welcome pregnancy as a gift from their spiritual ancestors and labour as a joyous achievement though sometimes hard work. Most of them are instructed in childbirth by experienced women teachers who assist and never leave them during labour. Except for one or two quite degenerate tribes and others who had become urbanised by association with Europeans, the African woman appeared to me to be an excellent example of all I had taught as a means of avoiding dysfunction in pregnancy and childbirth. Amongst the African women eclampsia is extremely rare and in some of the Central Congo tribes we found it had never been known to occur. This was equally true at all altitudes and amongst the badly and the wellnourished people, the vegetarians, blood drinkers, and mixed-food eaters. It applied in the same measure to Bantu, Hamitic, Nilotic, and mixed races who live tribal lives in remote areas where the white man does not live or rarely visits. I offer these observations, Sir, as an appreciation of the clinical importance of the work of Dr. Morris and his colleagues upon the circulation of the blood in the wall of the pregnant uterus, but I believe that the final answer to the problem of toxaemia of pregnancy, as well as dysfunction of the uterus, will only be found by the
SiR,-At this school cold baths have up till now been compulsory every morning of the year. It has been suggested that this practice should be changed, and in the course of discussion an important point has arisen on which we felt that it would be wisest to take an impartial outside opinion. We wondered whether any of your readers could suggest, roughly, what would be a suitable lower air-temperature in the bathroom. (There are no considerations of heat or draughts to be taken into account.) Perhaps this lower limit we are looking for might be defined as the point when the various risks from and the unpleasant shock begin to outweigh the exposure " healthiness " and the power of waking one up that is claimed for them. Bedales School, Petersfield, Hants.
JOHN VINCENT.
Obituary HENRY WADE Kt., C.M.G., D.S.O., M.D. Edin., F.R.C.S.E. Sir Henry Wade, past president of the Royal College of Surgeons of Edinburgh and an honorary fellow of the English, American, Australasian, and Irish Colleges, died in his Edinburgh home on Feb. 21, at the age of 78. A son of the Rev. George Wade of Falkirk, he was educated in Edinburgh at the Royal High School and the university, where he graduated M.B. with first-class honours in 1898. The following year the South African war broke out and it was not long before his adventuresome spirit prompted him to volunteer for active service as a civil surgeon attached to the British Field Force. After eighteen months, the last eight of which were spent in sole charge of the surgical beds in a military hospital in Pretoria, he returned to Edinburgh where for a year he was demonstrator in anatomy at the university. At this point, however, he broke with tradition, in that when appointed as clinical tutor to F. M. Caird, then regius professor of clinical surgery, he forsook anatomy to study pathology, believing that a wide knowledge of this subject was of paramount
to a surgeon. his reputation as a pathologist, that when he was elected to the fellowship of the Royal College of Surgeons of -Edinburgh in 1903, he was appointed conservator of the college museum the same year; and he continued in this office for seventeen years. He began his pathological researches by studying the aetiology of carcinoma, and he published several papers on this subject in our columns in 1904. In 1907 he was awarded a gold medal for his M.D. thesis on infective sarcoma of the dog. In 1906 he temporarily resigned from clinical work on his appointment as assistant pathologist to the Royal Infirmary, and for the next two years he performed the post-mortem examinations on virtually all cases sent from the surgical wards of the hospital. Wade was appointed assistant surgeon to Leith Hospital in 1908 and to the Royal Infirmary in 1909. At this time the extramural school was flourishing, and from 1906 onwards he was for many years much in demand as a lecturer in surgery and surgical pathology both to students and to postgraduates. Gradually his interest in the pathological and clinical aspects of urology
importance Such
was