- Email: [email protected]
CONFLUENT VARICELLA WITH SECONDARY FEVER.
313 are, in the
main, poisonous substances, and although the remained normal. Desiccation was not complete until effect of very small doses may be inappreciable yet the the 10th, when many of the scabs on the trunk had Their copious exfoliation and the associated presence of a poison in beverages in any quantity at all separated. is highly objectionable. There is convincing evidence to foetor were additional points of resemblance to small-pox. show that saponin is prejudicial to health and therefore its From Nov. 9th to 19th there was pyrexia due to suppuration use for the purpose of causing a beverage to foam is beneath the scabs, which on separation left punched-out forbidden in the provisions of the Sale of Food and Drugs ulcers. By Dec. 4th all the scabs had separated and the Acts. Saponin is prepared from the poisonous corn-cockle child was discharged in good health on the 10th. The skin which is quite a common plant in our fields and often a presented numerous scars showing various degrees of pigsource of considerable trouble to wheat farmers. Even if mentation. Very few cases of confluent varicella have saponin were not poisonous the practice of making things been recorded. The absence of prodromal symptoms, the not what they seem is fraud, and nothing but fraud, and even appearance of fully developed vesicles on the first day, the if perfectly innocuous substances are used for the same successive crops, and the shape of the lesions proved that purpose the intention is obviously again to deceive and to the disease was varicella. The vesicular haemorrhages entitled the case also to be termed hæmorrhagic varicella. produce a wretched imitation of the genuine article. Secondary fever in varicella has been described particularly French writers. ENGLAND. by OF OF SURGEONS ROYAL COLLEGE -
THE following arrangements for the annual course at the College. The lecture hour be delivered to of lectures will be delivered by Dr. lectures Hunterian The is 5 P.M. on the C. G. Seligmann, F.Z.S., Physical Anthropology and New British of Guinea, on Feb. 12th, 14th, and Ethnology Paterson on Gastric Surgery, on H. J. Mr. 16th; by Mr. Arthur’ H. Cheatle on and Feb. 19th, 21st, 23rd; by Some Points in the Surgical Anatomy of the Temporal Bone from Birth to Adult Life, on Feb. 26th and 28th and March 2nd; and by Mr. J. Warrington Haward on Phlebitis and Thrombosis, on March 5th, 7th, and 9th. The Erasmus Wilson lectures will be delivered by Mr. James Sherren on the Distribution and Recovery of Peripheral Nerves Studied from Instances of Division in Man, on March 12th, 14th, and 16th. The Arris and Gale lectures will be delivered by Mr. J. H. Watson on the Viscosity of the Blood, on March 19th and 21st; and by Mr. Sydney W. Curl on the Arterial Pnlse, its Physiology and Pathology, on March 23rd. are
the
THE
MODE
OF PRODUCTION WORM GUT.
OF
SILK-
AN interesting account of the history and mode of production of silkworm gut has been published by M. J. Triollet in the Bitlletin des Sciences Pharmacologiques (1905, No.5). It is obtained from the silk-producing glands of Bombyx mori at the time when the larva commences to spin. It has been known from very early times but was used for fishing purposes only until 1865, when Dr. Passavant of Frankfort-onMain employed it in surgery. His example was later followed in this country by Mr. T. Bryant and Dr. Granville Bantock. Mr. Bryant, in the edition of his " Surgerypublished in 1874, mentioned his experiences in the use of this ligature and recommended it for "quill sutures." Dr. Bantock employed the gut at first as a ligature for arteries and then as a suture. Silkworm gut is tenacious, flexible, and easy to tie in a surgeon’s knot, and does not cut the tissues as is the case with metallic threads. Owing to its smooth surface it can readily CONFLUENT VARICELLA WITH SECONDARY be sterilised and removed from the patient without causing FEVER. undue pain. It is rarely employed, however, as a buried VARICELLA is generally an exceedingly mild disease but ligature, being almost exclusively used as a suture owing to the rule is occasionally broken by the occurrence of serious the impossibility of making with it so tight a knot as with complications, such as nephritis or gangrene. In the silk or catgut. Although Italy produces large quantities of British JOllrnal of Children’s -Diseases for January Dr. J. D. silkworm gut for fishing the surgical thread comes chiefly Rolleston has reported the following very rare case. A from the province of Murcia in Spain. The manufacturers boy, aged five years, was admitted into hospital on Oct. 8th, supply the peasants with boxes containing an ounce of the 1903, with a typical attack of scarlet fever. General eggs, sufficient to produce about 40,000 silkworms. These desquamation followed and the temperature subsided by are hatched during April and May when the mulberry leaves lysis to subnormal on the 18th and remained so until the begin to appear. The incubation occupies seven days at a 26th, when it rose to 990 in the evening. On the next temperature of from 220 to 300 C. The silkworms are micromorning there were numerous papules and vesicles character- scopical at first and attain their full size in 24 days, istic of varicella. At 10 P.M. the lesions numbered 160. At moulting four times in succession. The longest and most 11.30 A.M. next day the vesicles alone numbered 254. On vigorous are then set apart and carefully watched. When the 29th they numbered 794. On the lower part of the back they manifest signs of beginning to spin they are killed by the eruption was confluent and on the limbs it was semi- plunging them in a large tub of water acidulated with confluent. Several of the lesions were multilocular and some vinegar or citric acid, in which they remain from 12 to showed umbilication. Most of the vesicles on the trunk rup- 15 hours. The dead silkworms are then taken one by tured, leaving a bleeding surface. The albumin in the urine, one by women, who make a longitudinal incision along the which had appeared a few days before the onset of the back and carefully withdraw the intestine, stomach, varicella, increased from a trace to a cloud. On the 30th the oesophagus, and probably the greater part of the muscular vesicles numbered 2185 and their distribution resembled that and vascular tissue. They then isolate the two silkThe of confluent small-pox. There were oedema of the face and producing glands and wash them with hot water. the of which are then in increased women skilled this resemblance. swelling fingers glands manipulated by specially The vesicles were distributed as follows : trunk, 574; the work who hold each gland by its ends and draw it out genitals, 30; thighs, 511 ; legs, 197 ; feet, 185 ; arms, 394 ; so as to produce one thread which is placed on a polished hands, 147 ; neck, 93 ; face, 50 ; and scalp, 4. There were marble or granite table. In contact with air the thread several lesions on the hard palate. Haemorrhage took place rapidly dries and acquires a more or less blood-red yellow into a few of the vesicles on the left forearm, the right colour. This crude silkworm gut is then sold to the manuknee, and the left ankle. On the 31st desiccation and facturer and further treated. It is first boiled in alkaline incrustation were commencing. Many of the vesicles had water to remove fat and blood and is then dried in the sun, become pustules, especially on the back. On Nov. 2nd being protected from dust. It is next polished by means of the temperature fell by crisis and for about a week it slightly oiled pumice stone with an apparatus the secret of
main, poisonous substances, and although the remained normal. Desiccation was not complete until effect of very small doses may be inappreciable yet the the 10th, when many of the scabs on the trunk had Their copious exfoliation and the associated presence of a poison in beverages in any quantity at all separated. is highly objectionable. There is convincing evidence to foetor were additional points of resemblance to small-pox. show that saponin is prejudicial to health and therefore its From Nov. 9th to 19th there was pyrexia due to suppuration use for the purpose of causing a beverage to foam is beneath the scabs, which on separation left punched-out forbidden in the provisions of the Sale of Food and Drugs ulcers. By Dec. 4th all the scabs had separated and the Acts. Saponin is prepared from the poisonous corn-cockle child was discharged in good health on the 10th. The skin which is quite a common plant in our fields and often a presented numerous scars showing various degrees of pigsource of considerable trouble to wheat farmers. Even if mentation. Very few cases of confluent varicella have saponin were not poisonous the practice of making things been recorded. The absence of prodromal symptoms, the not what they seem is fraud, and nothing but fraud, and even appearance of fully developed vesicles on the first day, the if perfectly innocuous substances are used for the same successive crops, and the shape of the lesions proved that purpose the intention is obviously again to deceive and to the disease was varicella. The vesicular haemorrhages entitled the case also to be termed hæmorrhagic varicella. produce a wretched imitation of the genuine article. Secondary fever in varicella has been described particularly French writers. ENGLAND. by OF OF SURGEONS ROYAL COLLEGE -
THE following arrangements for the annual course at the College. The lecture hour be delivered to of lectures will be delivered by Dr. lectures Hunterian The is 5 P.M. on the C. G. Seligmann, F.Z.S., Physical Anthropology and New British of Guinea, on Feb. 12th, 14th, and Ethnology Paterson on Gastric Surgery, on H. J. Mr. 16th; by Mr. Arthur’ H. Cheatle on and Feb. 19th, 21st, 23rd; by Some Points in the Surgical Anatomy of the Temporal Bone from Birth to Adult Life, on Feb. 26th and 28th and March 2nd; and by Mr. J. Warrington Haward on Phlebitis and Thrombosis, on March 5th, 7th, and 9th. The Erasmus Wilson lectures will be delivered by Mr. James Sherren on the Distribution and Recovery of Peripheral Nerves Studied from Instances of Division in Man, on March 12th, 14th, and 16th. The Arris and Gale lectures will be delivered by Mr. J. H. Watson on the Viscosity of the Blood, on March 19th and 21st; and by Mr. Sydney W. Curl on the Arterial Pnlse, its Physiology and Pathology, on March 23rd. are
the
THE
MODE
OF PRODUCTION WORM GUT.
OF
SILK-
AN interesting account of the history and mode of production of silkworm gut has been published by M. J. Triollet in the Bitlletin des Sciences Pharmacologiques (1905, No.5). It is obtained from the silk-producing glands of Bombyx mori at the time when the larva commences to spin. It has been known from very early times but was used for fishing purposes only until 1865, when Dr. Passavant of Frankfort-onMain employed it in surgery. His example was later followed in this country by Mr. T. Bryant and Dr. Granville Bantock. Mr. Bryant, in the edition of his " Surgerypublished in 1874, mentioned his experiences in the use of this ligature and recommended it for "quill sutures." Dr. Bantock employed the gut at first as a ligature for arteries and then as a suture. Silkworm gut is tenacious, flexible, and easy to tie in a surgeon’s knot, and does not cut the tissues as is the case with metallic threads. Owing to its smooth surface it can readily CONFLUENT VARICELLA WITH SECONDARY be sterilised and removed from the patient without causing FEVER. undue pain. It is rarely employed, however, as a buried VARICELLA is generally an exceedingly mild disease but ligature, being almost exclusively used as a suture owing to the rule is occasionally broken by the occurrence of serious the impossibility of making with it so tight a knot as with complications, such as nephritis or gangrene. In the silk or catgut. Although Italy produces large quantities of British JOllrnal of Children’s -Diseases for January Dr. J. D. silkworm gut for fishing the surgical thread comes chiefly Rolleston has reported the following very rare case. A from the province of Murcia in Spain. The manufacturers boy, aged five years, was admitted into hospital on Oct. 8th, supply the peasants with boxes containing an ounce of the 1903, with a typical attack of scarlet fever. General eggs, sufficient to produce about 40,000 silkworms. These desquamation followed and the temperature subsided by are hatched during April and May when the mulberry leaves lysis to subnormal on the 18th and remained so until the begin to appear. The incubation occupies seven days at a 26th, when it rose to 990 in the evening. On the next temperature of from 220 to 300 C. The silkworms are micromorning there were numerous papules and vesicles character- scopical at first and attain their full size in 24 days, istic of varicella. At 10 P.M. the lesions numbered 160. At moulting four times in succession. The longest and most 11.30 A.M. next day the vesicles alone numbered 254. On vigorous are then set apart and carefully watched. When the 29th they numbered 794. On the lower part of the back they manifest signs of beginning to spin they are killed by the eruption was confluent and on the limbs it was semi- plunging them in a large tub of water acidulated with confluent. Several of the lesions were multilocular and some vinegar or citric acid, in which they remain from 12 to showed umbilication. Most of the vesicles on the trunk rup- 15 hours. The dead silkworms are then taken one by tured, leaving a bleeding surface. The albumin in the urine, one by women, who make a longitudinal incision along the which had appeared a few days before the onset of the back and carefully withdraw the intestine, stomach, varicella, increased from a trace to a cloud. On the 30th the oesophagus, and probably the greater part of the muscular vesicles numbered 2185 and their distribution resembled that and vascular tissue. They then isolate the two silkThe of confluent small-pox. There were oedema of the face and producing glands and wash them with hot water. the of which are then in increased women skilled this resemblance. swelling fingers glands manipulated by specially The vesicles were distributed as follows : trunk, 574; the work who hold each gland by its ends and draw it out genitals, 30; thighs, 511 ; legs, 197 ; feet, 185 ; arms, 394 ; so as to produce one thread which is placed on a polished hands, 147 ; neck, 93 ; face, 50 ; and scalp, 4. There were marble or granite table. In contact with air the thread several lesions on the hard palate. Haemorrhage took place rapidly dries and acquires a more or less blood-red yellow into a few of the vesicles on the left forearm, the right colour. This crude silkworm gut is then sold to the manuknee, and the left ankle. On the 31st desiccation and facturer and further treated. It is first boiled in alkaline incrustation were commencing. Many of the vesicles had water to remove fat and blood and is then dried in the sun, become pustules, especially on the back. On Nov. 2nd being protected from dust. It is next polished by means of the temperature fell by crisis and for about a week it slightly oiled pumice stone with an apparatus the secret of