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Contemporary Medical Literature.
160 obliterated, and the wound healed without any unpleasant generally desire the continuance of the agent. In these symptoms being noticed. This latter treatment is certainly larger doses, it is true, the drug colours the dejections of a different from the procedure which English surgeons would brown hue, but it does not give rise to the least dyspeptic have employed on the failure of the injections. The incision symptom. It has never caused emesis, and if the child has of the sac and vessel should, however, be recorded, as it shown some dislike to it at first, it takes it afterwards with becomes evident that this operation, though dangerous, may great avidity. Children who were in the extreme stage of be successful. exhaustion, whose stomachs were so irritable that milk and Weshould not omit to say, that M. Petrequin, of Lyons, beef-tea or broth wererejected by them, and cod-liver oil could has just endeavoured to combine injection into the aneurismal not be in the least retained, bore the extract of ox-blood well, sac with Brasdor’s method. The vessel affected with aneurism and throve admirably.’ Here, in Berlin, [Mauthner is at was the right subclavian artery, and the ligature was applied Vienna,] the extractum sanguinis bovini is given with very
at the point where the latter arises under the clavicle. One in- good effect to chlorotic and emaciated girls, and even to jection of the perchloride failed from the canula getting en- phthisical adults. A colleague has found it very efficacious in tangled in the cellular tissue of the sac; another injection of rachitis."-Journ. f. Kinderkkhtn. eight drops was made the next day, careful compression having CURABILITY OF TUBERCULOUS MENINGITIS. - This disease first been effected on the innominata. There was, subsequently, has been too generally regarded as an incurable malady. A of the results were but and the unfavourable; sac, suppuration child affected with tuberculous meningitis is a child nearly as M. Petrequin thinks that by avoiding the cellular tissue, and much condemned in the sight of the parents as in that of phymaking certain modifications in the mode of operating, by sicians. Nevertheless, such an idea, as cheerless as it is false, of the Brasdor’s ligature and the injection perchloride, success is a misfortune, for it depresses courage, paralyzes might eventually be obtained in cases of the desperate kind to energy,great and scarcely permits the evil to be combated with which we have alluded. through the more efficacio-,.is measures. The defeat, too, seems to have nothing humiliating about it, since it is regarded as a necessity: The prejudice which attributes the character of incurability to tuberculous meningitis only serves the purpose Contemporary Medical Literature. of shackling the progress of medical art. But we have sufficiently cleared up this question in the fourth chapter, and we HYGIENE OF EMIGRANT SHIPS. -It is next to impossible to have there shown that the disease is, in a very great number get the emigrants on deck during the passage. Considerate of cases, susceptible of care.-De da Méningite Llube?-cule2ise, and humane masters haveto drive them out by violence. H. IlAHN. Sometimes they resort to smoking them out with burning tar; &c., par CAN IT BE SAID FOR CERTAIN WHETHER AN INFANT HAS but in a great majority of instances it has been found that any attempt at ventilation or the promotion of exercise or cleanli- BREATHED ?-As the final rea2zme of our inquiries, it must be ness amongst them has resulted in a quasi mutiny. Nothing affirmed that, from the anatomic investigation of a new-born is more common than to find that children born on the passage child (if the same has died soon after birth), it cannot be laid down with apoclictic certainty whether it has breathed, or are very conveniently smothered, or lain over, or in some other whether air has been blown into the lungs; nevertheless, in manner disposed of; for instincts of maternity and humanity give way to a desire to be rid of such encumbrances on landing many cases a greater or less degree of probability will incline on a new continent. The whole subject is filled with the to the one or the other circumstance. The result thus iiadicated may have something depressing about it, but is infinitely most loathsome images and associations.—The* Times Jan. to be preferred to a deceitful certainty, which in no branch of CEREBRAL TUMOURS.—The following may be regarded as will induce such melancholy consequences as in the chief symptomatic phenomena of tumours at the base and knowledge forensic medicine.-Untersuchungen, &c., v. HOFRATH S. A. in the vicinity of the protuberance:- Headache, mostly frontal, ELSASSER. same side and not rarely-unilateral upon the as the tumour; palsy, and commonly palsy of the other nerves of the head POOR-LAW EXTRA FEES. upon the same side as the tumour, with paralytic symptoms of the extremities on the opposite side; the latter may be rarely To the Editor of THE LANCET. wanting. The non-epileptiform character of the convuldiscussion has lately arisen between the Board SIR.—Some are not of the which sions, frequent occurrence; multiplicity of the abnormal states of the senses, with the tendency of the of Guardians and the medical officers of this union on the subject visual disturbance to become double, are also to be recollected of extras." Among other cases, the guardians refuse to pay as symptoms of importance. Derangements of the intellectual for fractures of the clavicle, alleging as a reason, that fractures faculties are somewhat less so, as being rather diagnostic of of the clavicle are not mentioned in the list of extras in the tumours within the cranial cavity generally, than of their order of the Poor-law Commissioners, and therefore are included particular seat. Bitrage zur Lehre v. d. Gezchülsten in the general contracts. On the other hand, I contend that the clavicle is one of the bones of the upper extremity; that a innerhalb der Schädelhöle, v. Dr. N. PRIEDERICH. TREATMENT or HÆMORRHAGE FROM THE NAVEL OF NEW- fracture of it requires as much treatment, and is as difficult to reduce as the fracture of any other bone of the arm, and thereBORN CHILDREN.-Ordinary remedies are insufficient to arrest the bleeding. Kolophonian, alum, the various styptic fluids, fore that it ought to be paid for as an extra. My object in this letter is to ask your opinion on this point, turpentine, ice, amadou, compression, &c., have been employed "
-
in vain. Cauterization has been several times tried, both with the nitrate of silver and the actual cautery. In fact the use of the ligature appears to be the only means worth dependence upon as capable of restraining the bleeding, and the mode of its application eii anczsse, as advised by Dubois, is to be preferred. But in the best manuals and treatises we find no advice given as to the method of securing immediately the umbilical arteries, and, so far as we know, it has never been accomplished, from the many difficulties attendant upon its performance. It has therefore been proposed to secure all the three vessels together, by pulling the navel-knot forward, and passing around it a ligature with the help of hare-lip pins. At first sight this operation seems to have much in its favour, though experience does not confirm it. Nevertheless up to the present time it has been of most service.-ROGEF, iza Jour2i. f. K inderkkhtn. USE OF EXTRACT OF BULLOCK’S BLOOD. -Dr. Behrend thus writes:-"Dr. Mauthner, to whom we are indebted for the introduction of this remedy answers a request of mine as follows :’Inow gi--e it to children in larger doses than before, to the extent of half an ounce in the day, dissolved in water. In many anaemic states the favourable result is so striking that the parents, perceiving the improvement of their child,
and to
request that medical officers in other unions will be
good enough also to express their opinion, and to inform us as to the general practice in other parts of the country.
It would be of great service to medical officers, and spare much heart-burning, if the Poor-law Board would revise their list of fees for attendance in "extra" cases, and would look a little more carefully into the subject, for there are many diseases, such as cases of retention of urine, requirin- repeated use of the catheter, which, in the country districts, are a serious tax on the time and energiesof the surgeon, but which are not included in the list of extras, and, therefore, are not paid for as such. , I am, Sir, your obedient servant, WILLIAM ATKINSON. Medical Officer to the Eton Union. Iver, Jan. 27th, 1854. I # There can be no question that in equity the treatment a fractured clavicle should be paid for as "an extra". The Poor-law Board can scarcely sanction the withholding of a fee for such attendance merely because the accident is not specifically mentioned in the orders issued by them. We believe that in many unions the accident in question is regarded as falling within the order.-SUB. ED. L.
of
at the point where the latter arises under the clavicle. One in- good effect to chlorotic and emaciated girls, and even to jection of the perchloride failed from the canula getting en- phthisical adults. A colleague has found it very efficacious in tangled in the cellular tissue of the sac; another injection of rachitis."-Journ. f. Kinderkkhtn. eight drops was made the next day, careful compression having CURABILITY OF TUBERCULOUS MENINGITIS. - This disease first been effected on the innominata. There was, subsequently, has been too generally regarded as an incurable malady. A of the results were but and the unfavourable; sac, suppuration child affected with tuberculous meningitis is a child nearly as M. Petrequin thinks that by avoiding the cellular tissue, and much condemned in the sight of the parents as in that of phymaking certain modifications in the mode of operating, by sicians. Nevertheless, such an idea, as cheerless as it is false, of the Brasdor’s ligature and the injection perchloride, success is a misfortune, for it depresses courage, paralyzes might eventually be obtained in cases of the desperate kind to energy,great and scarcely permits the evil to be combated with which we have alluded. through the more efficacio-,.is measures. The defeat, too, seems to have nothing humiliating about it, since it is regarded as a necessity: The prejudice which attributes the character of incurability to tuberculous meningitis only serves the purpose Contemporary Medical Literature. of shackling the progress of medical art. But we have sufficiently cleared up this question in the fourth chapter, and we HYGIENE OF EMIGRANT SHIPS. -It is next to impossible to have there shown that the disease is, in a very great number get the emigrants on deck during the passage. Considerate of cases, susceptible of care.-De da Méningite Llube?-cule2ise, and humane masters haveto drive them out by violence. H. IlAHN. Sometimes they resort to smoking them out with burning tar; &c., par CAN IT BE SAID FOR CERTAIN WHETHER AN INFANT HAS but in a great majority of instances it has been found that any attempt at ventilation or the promotion of exercise or cleanli- BREATHED ?-As the final rea2zme of our inquiries, it must be ness amongst them has resulted in a quasi mutiny. Nothing affirmed that, from the anatomic investigation of a new-born is more common than to find that children born on the passage child (if the same has died soon after birth), it cannot be laid down with apoclictic certainty whether it has breathed, or are very conveniently smothered, or lain over, or in some other whether air has been blown into the lungs; nevertheless, in manner disposed of; for instincts of maternity and humanity give way to a desire to be rid of such encumbrances on landing many cases a greater or less degree of probability will incline on a new continent. The whole subject is filled with the to the one or the other circumstance. The result thus iiadicated may have something depressing about it, but is infinitely most loathsome images and associations.—The* Times Jan. to be preferred to a deceitful certainty, which in no branch of CEREBRAL TUMOURS.—The following may be regarded as will induce such melancholy consequences as in the chief symptomatic phenomena of tumours at the base and knowledge forensic medicine.-Untersuchungen, &c., v. HOFRATH S. A. in the vicinity of the protuberance:- Headache, mostly frontal, ELSASSER. same side and not rarely-unilateral upon the as the tumour; palsy, and commonly palsy of the other nerves of the head POOR-LAW EXTRA FEES. upon the same side as the tumour, with paralytic symptoms of the extremities on the opposite side; the latter may be rarely To the Editor of THE LANCET. wanting. The non-epileptiform character of the convuldiscussion has lately arisen between the Board SIR.—Some are not of the which sions, frequent occurrence; multiplicity of the abnormal states of the senses, with the tendency of the of Guardians and the medical officers of this union on the subject visual disturbance to become double, are also to be recollected of extras." Among other cases, the guardians refuse to pay as symptoms of importance. Derangements of the intellectual for fractures of the clavicle, alleging as a reason, that fractures faculties are somewhat less so, as being rather diagnostic of of the clavicle are not mentioned in the list of extras in the tumours within the cranial cavity generally, than of their order of the Poor-law Commissioners, and therefore are included particular seat. Bitrage zur Lehre v. d. Gezchülsten in the general contracts. On the other hand, I contend that the clavicle is one of the bones of the upper extremity; that a innerhalb der Schädelhöle, v. Dr. N. PRIEDERICH. TREATMENT or HÆMORRHAGE FROM THE NAVEL OF NEW- fracture of it requires as much treatment, and is as difficult to reduce as the fracture of any other bone of the arm, and thereBORN CHILDREN.-Ordinary remedies are insufficient to arrest the bleeding. Kolophonian, alum, the various styptic fluids, fore that it ought to be paid for as an extra. My object in this letter is to ask your opinion on this point, turpentine, ice, amadou, compression, &c., have been employed "
-
in vain. Cauterization has been several times tried, both with the nitrate of silver and the actual cautery. In fact the use of the ligature appears to be the only means worth dependence upon as capable of restraining the bleeding, and the mode of its application eii anczsse, as advised by Dubois, is to be preferred. But in the best manuals and treatises we find no advice given as to the method of securing immediately the umbilical arteries, and, so far as we know, it has never been accomplished, from the many difficulties attendant upon its performance. It has therefore been proposed to secure all the three vessels together, by pulling the navel-knot forward, and passing around it a ligature with the help of hare-lip pins. At first sight this operation seems to have much in its favour, though experience does not confirm it. Nevertheless up to the present time it has been of most service.-ROGEF, iza Jour2i. f. K inderkkhtn. USE OF EXTRACT OF BULLOCK’S BLOOD. -Dr. Behrend thus writes:-"Dr. Mauthner, to whom we are indebted for the introduction of this remedy answers a request of mine as follows :’Inow gi--e it to children in larger doses than before, to the extent of half an ounce in the day, dissolved in water. In many anaemic states the favourable result is so striking that the parents, perceiving the improvement of their child,
and to
request that medical officers in other unions will be
good enough also to express their opinion, and to inform us as to the general practice in other parts of the country.
It would be of great service to medical officers, and spare much heart-burning, if the Poor-law Board would revise their list of fees for attendance in "extra" cases, and would look a little more carefully into the subject, for there are many diseases, such as cases of retention of urine, requirin- repeated use of the catheter, which, in the country districts, are a serious tax on the time and energiesof the surgeon, but which are not included in the list of extras, and, therefore, are not paid for as such. , I am, Sir, your obedient servant, WILLIAM ATKINSON. Medical Officer to the Eton Union. Iver, Jan. 27th, 1854. I # There can be no question that in equity the treatment a fractured clavicle should be paid for as "an extra". The Poor-law Board can scarcely sanction the withholding of a fee for such attendance merely because the accident is not specifically mentioned in the orders issued by them. We believe that in many unions the accident in question is regarded as falling within the order.-SUB. ED. L.
of