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CONGENITAL HERNIA INTO THE UMBILICAL CORD.
PARENTS AND SCHOOLMASTERS.
1322
in which it appears as broad stripes, as though swollen, or in sible and who apparently failed to deal with the offence In the case of an unhealthy ear death has those in which it exhibits a rod-like structure (first noted by adequately. is not a He followed such regards Browicz), boxing the ears. We fear that, in post-mortem appearance. repeatedly a condition as the initial phase of fragmentation, as a pathothe case of some, if not all, of our large public schools logical change, and as the loosening of the connexion between there is an impression that there is no appeal beyond the the cells forming the muscular cellular tissue. This condition school authorities and that any such appeal fails of its by itself may, in his opinion, exercise an influence upon the object and involves both parent and scholar in such un-functional acth ity of the heart. 2. It is a change which may pleasantness that either the parent drops the case or the lead to a complete separation of the muscle cells, and even to boy has to leave the school. In the case under notice the the complete alteration of the muscular structure of the heart, parent disproved both suppositions, and we hope and inducing the utmost confusion in the grouping of these cells. think that his action will have done much to render this 3. This fragmentation may extend over wide areas of the dangerous and unwarrantable practice altogether obsolete. heart’s substance and is in such cases the cause of enfeeble- At all events, the master and the school have much to thank ment of the function of that organ and of sudden death. 4. him for in his efforts in this direction, as well as for the Fragmentation may also occur in a disseminated mannerreticence which he has shown in keeping names and places ,(7ceerdrveise) and is then the cause of cardiac insufficiency. from the public. In any future instance the i’s could doubt5. It is not by any means a rare phenomenon. 6. It less be dotted and the t’s crossed. be in observed an otherwise normal heart-muscle; may in cases, that is, in which the bloodvessels, interstitial CONGENITAL HERNIA INTO THE UMBILICAL CORD. tissue, and even the muscle-cells exhibit no alteration. 7. It may also, however, be found in association with cloudy DR. COLLINS WARREN of Boston has recorded in the swelling and fatty degeneration, or with changes in the Transactions of the American Surgical Association, 1893, two interstitial tissue of the cardiac walls and papillary muscles. very interesting cases of this somewhat rare malformation. 8. Disseminated fragmentation may, as Robin believes, be In the first case the cord at the umbilicus was greatly disthe cause of rupture of the heart. 9. It may also, like tended, forming an opaque tumour 62 cm. in diameter., arterial vascular changes, be the cause of fibrous degenera- An operation was at once performed, the sac opened, tion of the cardiac muscle. As regards the age at which and the contents found to be the liver-apparentlythis phenomenon is observed, Browicz does not consider the whole of it. The mucous tissue of the cord it to be necessarily a disease of old age, but asserts that was dissected off the liver, the umbilical vessels were He draws a it may be met with in younger subjects. tied and divided, the liver reduced within the abdominal distinction between the undue visibility of the cement joints cavity, and the edges of the opening were united by ( Kittleisten) and the separation of the muscle cells. The sutures. This operation was done when the child was former he regards as the initial pathological condition, and a about twenty-four hours old. He made a good recovery. homogeneous swollen appearance of this substance as a In the second case the sac was transparent and formed further stage, which may be followed by complete separation a pear-shaped tumour seven inches long. It was found of the cells. It is this latter condition or ultimate stage to contain the bowel from near the duodenum to thewhich, in proportion to its general or localised character, descending colon. After enlarging the aperture the bowel exercises an influence upon the functional activity of the was all placed within 1 the abdomen and the edges of the heart. Finally Browicz is of opinion that the fragmentation were closed with sutures. The child was opening of affected cells is brought about by the contraction of very ill for several days, but eventually made a good healthy fibres, as in the case of waxy degeneration of skeletal recovery. These cases illustrate well the conditions and cardiac muscle. He does not discuss the clinical aspects met with in this deformity-the protrusion of the liverof the question, which appears to have been done by Renaut or of a great length of the intestine. When of small and Mollard. of ileum size contain Meckel’s diverticulum and the ____
loop
they
When larger, as in Dr. Warren’s cases, the bowel as low as the sigmoid flexure may be met. with, or the liver in part or as a whole. The complete success, attending Dr. Warren’s operations is a great encouragement to deal with these cases at once in the same way. In a very few instances recovery has followed palliative measures only, even when the thin sac has sloughed. But this exposes thechild to a great danger of general septic peritonitis, and the immediate return of the viscera and closure of the abdominal opening should be considered the appropriate treatment, The operation ought to be carried out with the least possiblsto which it is attached.
PARENTS AND SCHOOLMASTERS. Ix Tlte Times of Nov.
paragraph
9th, 1893, appeared the following
:-
" PARENTS AND SCHOOLMASTERs.-Some months ago an assistant master at a large public school administered summary chastisement to a scholar by a series of severe boxes on both ears, with the result that the drum of one of the ears was burst. The parent, after bringing the matter before the governing body, and not considering their reply satisfactory, brought an action against the master in the Court of Queen’s Bench for assault. The master has expressed his deep regret and paid a sum into court, which has been accepted. The case has been more than once referred to in the press, and has excited considerable interest. The boy remains at the school."
The
delay.
-
is identical with one which has been referred THE INVENTION OF LANOLINE. to more than once, the parent being a well-known London physician. It seems to us strange that so dangerous ! A QUESTION of some considerable commercial and scientific a practice should not long since have been severely interest is at present occupying the attention of Mr. Justice stopped at any large public school, and we have no doubt Romer in the Court of Chancery, where an action has been that bad the boy been a scholar at any Board school in the brought by the Benno Jaffe and Darmstatter Lanolin Fabric kingdom the case would have promptly appeared with all against Messrs. J. Richardson and Co. upon the ground of details in a police-court, and the master would have been infringement of the lanoline patent. The defendants aresummarily dismissed. That publicity has been avoided manufacturers of an ointment sold under the name of speaks for the forbearance of the parent both to the master anaspaline, of which purified wool fat is a constituent part. and to the school. The extract does not say what has The plaintiffs claim under their patent grant to be entitled been the fate of the master at the hands of the school to restrain this manufacture upon the ground that it cannot. authorities ; but he is, in any case, less to blame than the be undertaken without producing lanoline, and that in authorities, who have allowed such punishment to be pos- effect anaspaline is a compound of lanoline with some other case
1322
in which it appears as broad stripes, as though swollen, or in sible and who apparently failed to deal with the offence In the case of an unhealthy ear death has those in which it exhibits a rod-like structure (first noted by adequately. is not a He followed such regards Browicz), boxing the ears. We fear that, in post-mortem appearance. repeatedly a condition as the initial phase of fragmentation, as a pathothe case of some, if not all, of our large public schools logical change, and as the loosening of the connexion between there is an impression that there is no appeal beyond the the cells forming the muscular cellular tissue. This condition school authorities and that any such appeal fails of its by itself may, in his opinion, exercise an influence upon the object and involves both parent and scholar in such un-functional acth ity of the heart. 2. It is a change which may pleasantness that either the parent drops the case or the lead to a complete separation of the muscle cells, and even to boy has to leave the school. In the case under notice the the complete alteration of the muscular structure of the heart, parent disproved both suppositions, and we hope and inducing the utmost confusion in the grouping of these cells. think that his action will have done much to render this 3. This fragmentation may extend over wide areas of the dangerous and unwarrantable practice altogether obsolete. heart’s substance and is in such cases the cause of enfeeble- At all events, the master and the school have much to thank ment of the function of that organ and of sudden death. 4. him for in his efforts in this direction, as well as for the Fragmentation may also occur in a disseminated mannerreticence which he has shown in keeping names and places ,(7ceerdrveise) and is then the cause of cardiac insufficiency. from the public. In any future instance the i’s could doubt5. It is not by any means a rare phenomenon. 6. It less be dotted and the t’s crossed. be in observed an otherwise normal heart-muscle; may in cases, that is, in which the bloodvessels, interstitial CONGENITAL HERNIA INTO THE UMBILICAL CORD. tissue, and even the muscle-cells exhibit no alteration. 7. It may also, however, be found in association with cloudy DR. COLLINS WARREN of Boston has recorded in the swelling and fatty degeneration, or with changes in the Transactions of the American Surgical Association, 1893, two interstitial tissue of the cardiac walls and papillary muscles. very interesting cases of this somewhat rare malformation. 8. Disseminated fragmentation may, as Robin believes, be In the first case the cord at the umbilicus was greatly disthe cause of rupture of the heart. 9. It may also, like tended, forming an opaque tumour 62 cm. in diameter., arterial vascular changes, be the cause of fibrous degenera- An operation was at once performed, the sac opened, tion of the cardiac muscle. As regards the age at which and the contents found to be the liver-apparentlythis phenomenon is observed, Browicz does not consider the whole of it. The mucous tissue of the cord it to be necessarily a disease of old age, but asserts that was dissected off the liver, the umbilical vessels were He draws a it may be met with in younger subjects. tied and divided, the liver reduced within the abdominal distinction between the undue visibility of the cement joints cavity, and the edges of the opening were united by ( Kittleisten) and the separation of the muscle cells. The sutures. This operation was done when the child was former he regards as the initial pathological condition, and a about twenty-four hours old. He made a good recovery. homogeneous swollen appearance of this substance as a In the second case the sac was transparent and formed further stage, which may be followed by complete separation a pear-shaped tumour seven inches long. It was found of the cells. It is this latter condition or ultimate stage to contain the bowel from near the duodenum to thewhich, in proportion to its general or localised character, descending colon. After enlarging the aperture the bowel exercises an influence upon the functional activity of the was all placed within 1 the abdomen and the edges of the heart. Finally Browicz is of opinion that the fragmentation were closed with sutures. The child was opening of affected cells is brought about by the contraction of very ill for several days, but eventually made a good healthy fibres, as in the case of waxy degeneration of skeletal recovery. These cases illustrate well the conditions and cardiac muscle. He does not discuss the clinical aspects met with in this deformity-the protrusion of the liverof the question, which appears to have been done by Renaut or of a great length of the intestine. When of small and Mollard. of ileum size contain Meckel’s diverticulum and the ____
loop
they
When larger, as in Dr. Warren’s cases, the bowel as low as the sigmoid flexure may be met. with, or the liver in part or as a whole. The complete success, attending Dr. Warren’s operations is a great encouragement to deal with these cases at once in the same way. In a very few instances recovery has followed palliative measures only, even when the thin sac has sloughed. But this exposes thechild to a great danger of general septic peritonitis, and the immediate return of the viscera and closure of the abdominal opening should be considered the appropriate treatment, The operation ought to be carried out with the least possiblsto which it is attached.
PARENTS AND SCHOOLMASTERS. Ix Tlte Times of Nov.
paragraph
9th, 1893, appeared the following
:-
" PARENTS AND SCHOOLMASTERs.-Some months ago an assistant master at a large public school administered summary chastisement to a scholar by a series of severe boxes on both ears, with the result that the drum of one of the ears was burst. The parent, after bringing the matter before the governing body, and not considering their reply satisfactory, brought an action against the master in the Court of Queen’s Bench for assault. The master has expressed his deep regret and paid a sum into court, which has been accepted. The case has been more than once referred to in the press, and has excited considerable interest. The boy remains at the school."
The
delay.
-
is identical with one which has been referred THE INVENTION OF LANOLINE. to more than once, the parent being a well-known London physician. It seems to us strange that so dangerous ! A QUESTION of some considerable commercial and scientific a practice should not long since have been severely interest is at present occupying the attention of Mr. Justice stopped at any large public school, and we have no doubt Romer in the Court of Chancery, where an action has been that bad the boy been a scholar at any Board school in the brought by the Benno Jaffe and Darmstatter Lanolin Fabric kingdom the case would have promptly appeared with all against Messrs. J. Richardson and Co. upon the ground of details in a police-court, and the master would have been infringement of the lanoline patent. The defendants aresummarily dismissed. That publicity has been avoided manufacturers of an ointment sold under the name of speaks for the forbearance of the parent both to the master anaspaline, of which purified wool fat is a constituent part. and to the school. The extract does not say what has The plaintiffs claim under their patent grant to be entitled been the fate of the master at the hands of the school to restrain this manufacture upon the ground that it cannot. authorities ; but he is, in any case, less to blame than the be undertaken without producing lanoline, and that in authorities, who have allowed such punishment to be pos- effect anaspaline is a compound of lanoline with some other case