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COMPANIES AND THE MEDICAL PROFESSION.
915
healthy and pleasant sea-coast resi- intense, neuralgic in character, and continuous. To procure governed by a local body whose relief and to obtain sleep large doses of morphia had to be doings are likely to bring it into notoriety as a place which, subcutaneously injected. The jaundice would usually last sanitarily speaking, is ill managed, and which refuses to from four to six days. There was no accompanying gastric accommodate itself to some of the most elementary require. disturbance; the bowels were on these occasions regular and the stools were clay-coloured. The urine showed ments of modern public’health administration. the presence of bile pigment. The hepatic area during a crisis was acutely tender and sensitive to touch-to COMPANIES AND THE MEDICAL PROFESSION. such an extent that even the pressure of her clothing As will be seen by a reference to our Parliamentary was intolerable ; when the attack was over this tenderIntelligence the Lord Chancellor has introduced into the ness disappeared. The treatment wassuspension," House of Lords a Bill to prohibit the profession or business and this she was able to go through when the of physician, surgeon, dentist, or midwife being carried on hepatic crises were over. However, in spite of treatby a company. We have not yet seen the text of this Bill, ment her ataxy increased; the pupils became myotic but we should hope that it is so drafted as to include and exhibited the characteristic Argyll-Robertson phemedical aid societies. These societies in many cases sweat nomenon. There was no optic atrophy or external ophtheir medical officers in the most disgraceful manner, as we thalmoplegia. She gradually lost strength and wasted bave frequently shown in our columns. perceptibly, the hepatic attacks became more and more intense, and she finally died from wasting and exhaustion. THE ASSOCIATION OF ASYLUM WORKERS. The necropsy revealed a normal condition of the heart, lungs, WE have received the annual report and financial state- and viscera generally, excepting the liver. This organ was ment of the Association of Asylum Workers for the year much congested and of the typical mottled or "nutmeg" 1898. The association was formed to look after the interests appearance. The gall-bladder was normal and free from of those working in asylums, both medical and lay. The gall-stones. The spinal cord on preparation by Weigert’s care of the sick is in all cases very trying work and method presented a " sclerosis of the posterior tracts of the the entire cord." No lesion was most length the care of mental disease is one of the exacting throughout in the abdomen or thorax which found could forms of attendance on the sick. The responsibility is very explain the of the liver and " condition to which could nothing great and the constant association with some form or 11 nutmeg the and be attributed severe crises of paroxysmal hepatic other of mental disturbance is apt to react disastrously and jaundice which Dr. Krauss accordingly ascribes to upon the minds of those who attend upon such patients. pain Hence change of air and scene is very necessary for the morbid process within the spinal cord affecting the asylum workers, and we are glad to see that part of the nerves supplying the liver and gall-bladder. To the various good work of the association under consideration is support- crises tabétiques of Charcot-viz., the gastric, laryngeal, cardiac, and rectal-must now be added the hepatic, which a "home of rest fund" by which nurses or attendants with the rare type of vesical, nephralgic, and urethral, and are granted two or three weeks’ holiday at some suitable health resort free of all expense or trouble. The association including in females the clitoric, complete the list of these also looks after the interests of asylum workers in connexion painful and paroxysmal syndromes which may occur in the with proposed legislation, such as the new Lunacy Bill, and course of tabes dorsalis. upon its reputation as a dential town should be
ing
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also trains attendants and nurses for their duties. The financial position of the association is satisfactory, there being a balance of f.137 14s. 3d. The secretary of the association is Dr. G. E. Shuttleworth who will be happy to receive subscriptions or donations.
TABES DORSALIS WITH HEPATIC CRISES. IT is well known that in the course of tabes dorsalis patients are liable to suffer periodically from paroxysmal pains affecting various parts and organs of the body. In the Journal of Nervous and Mental Disease (February, 1899) Dr. W. Krauss of Buffalo records a case of special interest in which the patient suffered from characteristic attacks of hepatic crises-a condition, it would appear, hitherto un!recorded-the importance of which lies in the fact that ehis syndrome" might have been easily mistaken for a separate and independent ailment of the liver were it not that the associated symptoms served to indicate its tabetic origin. The case was that of a woman, aged 44 years, who had hitherto enjoyed good health and was free from syphilitic taint, hereditary or acquired. She menstruated in her fourteenth year and was married at the age of 23 years, At 36 years of age she began to suffer from shooting pains in her legs occurring at intervals and disappearing without obvious cause. Locomotion became gradually difficult and necessitated the use of crutches eventually. Later she suffered from excruciating pains over theI
right hypochondrium, accompanied by a pronounced jaundiced tinge of the skin and mucous membranes; these attacks recurred every four or five weeks and then slowly passed away, leaving her weak and exhausted in bed for several days. The pains were deep-seated, very
THE CREMATION SOCIETY. AT the general meeting of the members of this society held at Grosvenor House on March 15th Sir Henry Thompson who was in the chair moved the adoption of the report and gave an address upon the progress made by the society since its inception in 1874. After detailing the various legal difficulties which the society had to overcome Sir Henry Thompson mentioned that the first body cremated in the society’s crematorium at Woking was that of a lady on March 26th, 1885. In that year the number of bodies cremated was three. In 1898 the number had risen to 240. Sir Henry Thompson then spoke of the efforts made by the society to bring about reforms in the present very loose system of death registration. The report of a Select Committee published in 1893 fully agreed as to the necessity for such reforms, but up to the present nothing has been done to bring such reform about. Besides the ciema. torium at Woking others have been erected at Manchester, Liverpool, Glasgow, and Hull. With reference to examinations into the cause of death which are so necessary before the cremation of a body it was mentioned that Dr. Sidney Martin had accepted the post of pathologist to the society. Sir Henry Thompson concluded by referring to the question as to whether cremation should not sooner or later be made compnJscry in all cases of death caused by acute infectious disease. There are strong arguments in favour of cremation jpplacing earth burial, or rather coffin burial, in all centres of population, but even in rural districts we are of opinion that there is every room for improvement in the method of burial as at present carried out. Perishable coffins should be used and graves should
healthy and pleasant sea-coast resi- intense, neuralgic in character, and continuous. To procure governed by a local body whose relief and to obtain sleep large doses of morphia had to be doings are likely to bring it into notoriety as a place which, subcutaneously injected. The jaundice would usually last sanitarily speaking, is ill managed, and which refuses to from four to six days. There was no accompanying gastric accommodate itself to some of the most elementary require. disturbance; the bowels were on these occasions regular and the stools were clay-coloured. The urine showed ments of modern public’health administration. the presence of bile pigment. The hepatic area during a crisis was acutely tender and sensitive to touch-to COMPANIES AND THE MEDICAL PROFESSION. such an extent that even the pressure of her clothing As will be seen by a reference to our Parliamentary was intolerable ; when the attack was over this tenderIntelligence the Lord Chancellor has introduced into the ness disappeared. The treatment wassuspension," House of Lords a Bill to prohibit the profession or business and this she was able to go through when the of physician, surgeon, dentist, or midwife being carried on hepatic crises were over. However, in spite of treatby a company. We have not yet seen the text of this Bill, ment her ataxy increased; the pupils became myotic but we should hope that it is so drafted as to include and exhibited the characteristic Argyll-Robertson phemedical aid societies. These societies in many cases sweat nomenon. There was no optic atrophy or external ophtheir medical officers in the most disgraceful manner, as we thalmoplegia. She gradually lost strength and wasted bave frequently shown in our columns. perceptibly, the hepatic attacks became more and more intense, and she finally died from wasting and exhaustion. THE ASSOCIATION OF ASYLUM WORKERS. The necropsy revealed a normal condition of the heart, lungs, WE have received the annual report and financial state- and viscera generally, excepting the liver. This organ was ment of the Association of Asylum Workers for the year much congested and of the typical mottled or "nutmeg" 1898. The association was formed to look after the interests appearance. The gall-bladder was normal and free from of those working in asylums, both medical and lay. The gall-stones. The spinal cord on preparation by Weigert’s care of the sick is in all cases very trying work and method presented a " sclerosis of the posterior tracts of the the entire cord." No lesion was most length the care of mental disease is one of the exacting throughout in the abdomen or thorax which found could forms of attendance on the sick. The responsibility is very explain the of the liver and " condition to which could nothing great and the constant association with some form or 11 nutmeg the and be attributed severe crises of paroxysmal hepatic other of mental disturbance is apt to react disastrously and jaundice which Dr. Krauss accordingly ascribes to upon the minds of those who attend upon such patients. pain Hence change of air and scene is very necessary for the morbid process within the spinal cord affecting the asylum workers, and we are glad to see that part of the nerves supplying the liver and gall-bladder. To the various good work of the association under consideration is support- crises tabétiques of Charcot-viz., the gastric, laryngeal, cardiac, and rectal-must now be added the hepatic, which a "home of rest fund" by which nurses or attendants with the rare type of vesical, nephralgic, and urethral, and are granted two or three weeks’ holiday at some suitable health resort free of all expense or trouble. The association including in females the clitoric, complete the list of these also looks after the interests of asylum workers in connexion painful and paroxysmal syndromes which may occur in the with proposed legislation, such as the new Lunacy Bill, and course of tabes dorsalis. upon its reputation as a dential town should be
ing
___
also trains attendants and nurses for their duties. The financial position of the association is satisfactory, there being a balance of f.137 14s. 3d. The secretary of the association is Dr. G. E. Shuttleworth who will be happy to receive subscriptions or donations.
TABES DORSALIS WITH HEPATIC CRISES. IT is well known that in the course of tabes dorsalis patients are liable to suffer periodically from paroxysmal pains affecting various parts and organs of the body. In the Journal of Nervous and Mental Disease (February, 1899) Dr. W. Krauss of Buffalo records a case of special interest in which the patient suffered from characteristic attacks of hepatic crises-a condition, it would appear, hitherto un!recorded-the importance of which lies in the fact that ehis syndrome" might have been easily mistaken for a separate and independent ailment of the liver were it not that the associated symptoms served to indicate its tabetic origin. The case was that of a woman, aged 44 years, who had hitherto enjoyed good health and was free from syphilitic taint, hereditary or acquired. She menstruated in her fourteenth year and was married at the age of 23 years, At 36 years of age she began to suffer from shooting pains in her legs occurring at intervals and disappearing without obvious cause. Locomotion became gradually difficult and necessitated the use of crutches eventually. Later she suffered from excruciating pains over theI
right hypochondrium, accompanied by a pronounced jaundiced tinge of the skin and mucous membranes; these attacks recurred every four or five weeks and then slowly passed away, leaving her weak and exhausted in bed for several days. The pains were deep-seated, very
THE CREMATION SOCIETY. AT the general meeting of the members of this society held at Grosvenor House on March 15th Sir Henry Thompson who was in the chair moved the adoption of the report and gave an address upon the progress made by the society since its inception in 1874. After detailing the various legal difficulties which the society had to overcome Sir Henry Thompson mentioned that the first body cremated in the society’s crematorium at Woking was that of a lady on March 26th, 1885. In that year the number of bodies cremated was three. In 1898 the number had risen to 240. Sir Henry Thompson then spoke of the efforts made by the society to bring about reforms in the present very loose system of death registration. The report of a Select Committee published in 1893 fully agreed as to the necessity for such reforms, but up to the present nothing has been done to bring such reform about. Besides the ciema. torium at Woking others have been erected at Manchester, Liverpool, Glasgow, and Hull. With reference to examinations into the cause of death which are so necessary before the cremation of a body it was mentioned that Dr. Sidney Martin had accepted the post of pathologist to the society. Sir Henry Thompson concluded by referring to the question as to whether cremation should not sooner or later be made compnJscry in all cases of death caused by acute infectious disease. There are strong arguments in favour of cremation jpplacing earth burial, or rather coffin burial, in all centres of population, but even in rural districts we are of opinion that there is every room for improvement in the method of burial as at present carried out. Perishable coffins should be used and graves should