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DANGEROUS PERFORMANCES.
1664
THE METHODS OF DISTRIBUTION OF ICE.-DANGEROUS PERFORMANCES.
Association (Dr. W. Collier), and Mr. Plowden, the wellThe toasts of "The Coroners’ known police magistrate. Society," given by Mr. T. H. Openshaw, C.M.G., F.H..C.S.. and responded to by Mr. Butcher in an interesting speech, and "The Officers" were duly pledged, the President culogising the honorary secretary, Mr. Walter Schroder, for his invaluable assistance to the council and to the many members who wrote to him for his opinion in cases of emergency and difficulty. Mr. G. 1’. Wyatt and Mr. Schroder replied. The Arcadian glee singers gave a very good musical programme and a most agreeable evening was spent, the company dispersing about 11 lr.M.
THE METHODS OF DISTRIBUTION OF ICE. THE approach of warmer weather calls attention to the unsatisfactory methods under which ice is distributed in this country. The purity of ice has frequently been referred to in THE LANCET. Everyone is familiar with the method of handling huge blocks of ice from an open lorry to, as is usually the case, an underground cellar. A sack, more often than not filthy by constant dragging along the pavement on which it is placed, is used not so much to keep the ice clean as to break the fall. The blocks of ice are lowered down a ladder or board to the sacking. The ice is then pushed along the pavement to its destination, either a shed at the back of the premises or a cellar. This method of handling ice may be seen every day in any large town. i Huge quantities of ice are used nowadays, especially by butchers and fishmongers, in hotels and restaurants, and for the preparation of " ices " and iced drinks. Bacterial contamination due to ice is bad enough in the case of meat and fish, though the cooking of these foods probably destroys the micro-organisms. In the case of " ices" and iced drinks,
however, any bacteria introduced by impure ice remain unaffected until they reach the mouth and alimentary tract
rendered the laity blind to the dangers of otorrhcea and slow to seek medical advice is that the patient frequently gets well without treatment. This is the origin of the belief that a child " will grow out of the discharge." The by no means infrequent cases of spontaneous cure have also had another result-quacks have seen in ear diseases a likely malady for cultivation. Quacks, in fact, at all times have reaped a rich harvest from the " treatment " of aural diseases, and in England we have witnessed the immense scale upon which the Drouet Institute, assisted by a complacent press, conducted its operations. Even the Drouet Institute, however, hardly achieved the superlative wickedness of a French aurist who killed a large number of people by filling their ears with plaster of Paris in order to "cure the discharge." We have read that this person " received the deserts" but we cannot believe it-the age is too humanitarian. To return, however, to the undoubted neglect of aural disease by medical men in times gone by, the scanty attention given to the teaching of the subject has been responsible in this country for the disregard of aural discharges. We are awake now in the matter and there is one important fact also which has worked in a very practical way for the due recognition by the lay mind of the latent dangers of otorrhoea. This is the fact that life assurance companies with but few exceptions are now declining lives where this condition exists. The public can appreciate the significance of this and see that it means a simple assertion that a discharge of the ear is a danger to life. Careful and skilled attention is necessary for the treatment of these conditions, but this skill and care are no more beyond the range and abilities of the averagely endowed practitioner than are the necessities of midwifery. Happen what will, a large proportion of cases will require operation, either a minor operation, such as removing the ossicles with the remains of the drum, or the more extensive radical operation. Both these are extremely satisfactory in skilled hands and the former finds its chief use in soon enabling the busy man to But it cannot be too firmly impressed resume his labours. on sufferers from suppurative otitis media or those responsible for the well-being of such persons that a chronic otorrhoea is a constant danger.
of the consumer where their activity may be aroused. It is therefore of the highest importance that care should be taken not only to obtain ice from pure sources but to maintain it by all possible means in a state of purity. As to the source of ice, there can be no doubt that the purest ice is obtainable from pure water that has been boiled, cooled, and then artificially frozen, but on the whole the natural ice obtained from the Norwegian fields is excellent in quality and any superficial impurity can easily be removed by DANGEROUS PERFORMANCES. rinsing. But the use of stout wooden tubs fitted with AT Hastings, on the Saturday before the recent bank linings of pure tin and mounted on runners would form a distinct advance on the rude method of its distribution at holiday, a man named Davidson gave an exhibition at a public recreation ground, consisting in balancing present in vogue. feats of a not unfamiliar character, executed on a rope or cable stretched 40 feet above the ground. In the THE NECESSITY OF ATTENDING TO AURAL of his performance the pole with the help of which DISCHARGES. he was maintaining his equilibrium slipped from him and PERSISTENT discharge from the ear has not until compara- as he failed in an attempt to grasp the rope he fell to tively recent years been recognised in its true significance by the ground and was killed. A large crowd had assembled the profession and it is only amongst the more cultured and to see him and some of these, no doubt, went home intelligent of the laity that any real appreciation of its sobered and saddened by the catastrophe. At the same time, potential dangers exists. The reasons for this are not hard of others of those present it must be said that they were to find, for although Sir William Wilde, the famous Irish influenced to a large extent by a morbid desire to see a aural surgeon, in 1840 pointed out the dangers accruing from dangerous performance and on this occasion the dangerous neglected aural discharge, yet unfortunately his words did element produced a fatal result before their eyes. Tightnot make a due impression upon the medical profession. rope performances are not particularly attractive in themWilde lamented the fact that it was considered dangerous to selves and if Davidson had advertised his feats as check the discharge of otorrhcea as being a fruitful source of about to take place three feet above the ground or as trouble but we find that this idea persists even now amongst rendered perfectly safe by means of a net he would have the public, while until recently many practitioners of been without an audience, although the skill exhibited medicine failed to see the possible dangers implied in an would have been the same. Some of those who flock to aural discharge. An aural discharge frequently ceases at exhibitions such as his may say in their own defence that it the onset of intracranial complications, so that the symptom is the exhibition of courage displayed by the performer that no longer exists just as the seriousness of the condi- they go to see but they must be perfectly aware that the tion becomes manifest. Another circumstance which has performance is to the chief actor in it a work of routine -
midst
VACCINATION : THE DURATION OF IMMUNITY.
1665
and that he has long ago lost the nervous feeling which that if all his patients took longer over the mastication affects some of us when we look down from what is known and insalivation of their food his labours in safeguarding Davidson was no more likely their bodily health would be lightened in a large degree. as a "giddy height.’’ to be affected by the fact that he was 40 feet above the Unfortunately, the constant tendency of civilisation and of ground than an ordinary person is alarmed when he looks social arrangements is to minimise the time given to mastiThe cook and the conversaout of a second-floor window. Nor was his loss of the pole cation and to insalivation. in any way due to it. The element of danger, however, was tionalist are allied against mastication. The one prepares in order that he be able to a attract crowd food that calls and that offers for mastication necessary might hardly and so to earn his living and he pursued his calling to its little or no resistance to the grindings of the teeth, The Daily Telegraph, in an interesting note the other employs his art to stimulate movements of fatal end. appended to the report of his death, reminds us of some of the tongue entirely unconcerned with the preparation for his more famous predecessors in this particular form of deglutition of food. A man cannot in polite circles at once exhibition. Of these, Mademoiselle Saqui lived to be 80 years talk and eat. Whereas dinner time should be devoted to old, dying in 1866, and Blondin, who also died "in his eating we constantly sacrifice the precious moments to bed"in 1897, was 73 years of age. Many others whose speech and risk a dyspepsia rather than fail to let loose a names are not chronicled have perished in attempting bo7a -mot. The labours of Mr. Horace Fletcher and of Mr. E. H. to attain the skill necessary to become renowned public van Someren may effect a permanent change in our table performers, but our contemporary mentions two women, customs. Perhaps we shall see started a " society for the Miss Young, who died a cripple from injuries sustained at a propagation of poltophagy"and shall recognise its adherents public performance, and the "Female Blondin"who was when we see a silent but healthy-looking dinner party of killed on the Aston Park recreation ground at Birmingham quietly-chewing folk. We do not maintain that the more in August, 1863. It was on this occasion that Her late spiritual side of conviviality will be enhanced but there can Majesty Queen Victoria evinced that sympathy with her be no question of the desirability of chewing or poltophagy subjects which always distinguished her, combined with the from a purely physical and gastronomic aspect. sterling good sense no less conspicuous in her character, for she wrote to the Mayor of Birmingham expressing her horror VACCINATION: THE DURATION OF IMMUNITY. that one of her subjects, and a woman, should have been AT the meeting of the Société Medicale des Hopitaux of "sacrificed to the gratification of a demoralising taste"" on May 5th M. Sevestre brought forward some evidence Paris in a public playground which she and the Prince Consort had opened in the hope that it might be showing that the duration of the immunity after vaccinafor " the healthy exercise and rational recreation of tion is shorter than is generally supposed. A child, aged the people." As a matter of fact, the ground in question three years, was admitted to the measles pavilion of the Bretonneau Hospital with an eruption which was supposed was outside the jurisdiction of the official to whom Her Majesty’s letter was addressed and the stopping of a per- to be of that disease but which turned out to be a prodromal formance of a grown-up person on the score of danger is not rash of variola. All the patients in the pavilion, who numbered 27, were immediately vaccinated. Three left two easy to effect. The best safeguard for the performer is in a healthy public opinion when it can be roused; and of per- days later before the result of the vaccination could be formances upon the tight or slack wire it may also be said ascertained. Of the 24 others, two, aged 11 and 13 years, that they are so dull and monotonous, even with the element showed two and three well-developed vaccination vesicles of danger, that their season of popularity, at its height in respectively. The former child had no vaccination scar and the latter had been unsuccessfully vaccinated in infancy. the days of Blondin, has long been over. In addition well-developed vesicles were obtained in two children who had well-marked vaccination scars and THE PROPER WAY TO EAT. whose ages were two and four years respectively. The THE two articles which we published dealing with the child who suffered from variola was only three years old and showed one vaccination cicatrix. Thus out of the manner in which swallowing is effected by the human being interest and on a of constant touch importance. 25 children one, who showed a vaccination scar, was subject Dietetics and all that relates thereto form a branch of attacked with variola at the age of three years and in medical science that appeals to the general mind as perhaps two others, aged two and four years respectively, vaccinano other branch can hope to do. Every man, be he tion was successfully performed in spite of the existence of must eat to and to the one, even well-marked vaccination scars. M. Sevestre, therefore, conor live, gourmand ascetic, cludes that in the case of an epidemic of variola or of as much as to the other, there is an interest and an importance about the details of the way in which this feeding process exposure to infection from a sporadic case children should is accomplished that few other natural processes entail to an be vaccinated, even those only a few years old and showing equal extent. Whether because he wishes to get the largest well-marked vaccination scars. In the discussion that amount of pleasure at a minimum risk of dyspepsia in followed cases were mentioned in which recruits were the case of the gourmand, or because he wishes to get successfully vaccinated, although the same result had been achieved a short time before. M. Roger stated a maximum amount of nutrition with a minimum expenditure of time and energy, as with the ascetic, man in that he had successfully vaccinated in 1897 six children either case wishes to know how he eats, what becomes of his at ages varying from 16 months to five years who bore food, and why these things are just as they are and not the scars, sometimes multiple, of primary vaccination. otherwise. Mr. Hubert Higgins has opened up an inter- M. Joseph Belin mentioned the case of a woman who esting side of the question in his discussion of the polto- was successfully vaccinated in infancy and had conphagic and psomophagic capabilities of mankind. He has fluent variola in 1868 at the age of 28 years. In 1870 From 1871 to 1881 Professor shown how both anatomically and functionally man can she had discrete variola. vaccinated her Brouardel The every year successfully. choose at will which method of swallowing he will employ allied but distinct of the duration the of question and we believe with Mr. Higgins that much would be gained proif all could resolve,upon, and adhere to, the more trouble- tection against variola conferred by vaccination does not some but more hygienic method. No medical man doubts seem to have engaged the attention of the society. We may point out that the Registrar-General’s statistics of 1 THE LANCET, the small-pox epidemic in London in 1901-02 showed May 20th (p. 1334) and 27th (p. 1417), 1905.
I
THE METHODS OF DISTRIBUTION OF ICE.-DANGEROUS PERFORMANCES.
Association (Dr. W. Collier), and Mr. Plowden, the wellThe toasts of "The Coroners’ known police magistrate. Society," given by Mr. T. H. Openshaw, C.M.G., F.H..C.S.. and responded to by Mr. Butcher in an interesting speech, and "The Officers" were duly pledged, the President culogising the honorary secretary, Mr. Walter Schroder, for his invaluable assistance to the council and to the many members who wrote to him for his opinion in cases of emergency and difficulty. Mr. G. 1’. Wyatt and Mr. Schroder replied. The Arcadian glee singers gave a very good musical programme and a most agreeable evening was spent, the company dispersing about 11 lr.M.
THE METHODS OF DISTRIBUTION OF ICE. THE approach of warmer weather calls attention to the unsatisfactory methods under which ice is distributed in this country. The purity of ice has frequently been referred to in THE LANCET. Everyone is familiar with the method of handling huge blocks of ice from an open lorry to, as is usually the case, an underground cellar. A sack, more often than not filthy by constant dragging along the pavement on which it is placed, is used not so much to keep the ice clean as to break the fall. The blocks of ice are lowered down a ladder or board to the sacking. The ice is then pushed along the pavement to its destination, either a shed at the back of the premises or a cellar. This method of handling ice may be seen every day in any large town. i Huge quantities of ice are used nowadays, especially by butchers and fishmongers, in hotels and restaurants, and for the preparation of " ices " and iced drinks. Bacterial contamination due to ice is bad enough in the case of meat and fish, though the cooking of these foods probably destroys the micro-organisms. In the case of " ices" and iced drinks,
however, any bacteria introduced by impure ice remain unaffected until they reach the mouth and alimentary tract
rendered the laity blind to the dangers of otorrhcea and slow to seek medical advice is that the patient frequently gets well without treatment. This is the origin of the belief that a child " will grow out of the discharge." The by no means infrequent cases of spontaneous cure have also had another result-quacks have seen in ear diseases a likely malady for cultivation. Quacks, in fact, at all times have reaped a rich harvest from the " treatment " of aural diseases, and in England we have witnessed the immense scale upon which the Drouet Institute, assisted by a complacent press, conducted its operations. Even the Drouet Institute, however, hardly achieved the superlative wickedness of a French aurist who killed a large number of people by filling their ears with plaster of Paris in order to "cure the discharge." We have read that this person " received the deserts" but we cannot believe it-the age is too humanitarian. To return, however, to the undoubted neglect of aural disease by medical men in times gone by, the scanty attention given to the teaching of the subject has been responsible in this country for the disregard of aural discharges. We are awake now in the matter and there is one important fact also which has worked in a very practical way for the due recognition by the lay mind of the latent dangers of otorrhoea. This is the fact that life assurance companies with but few exceptions are now declining lives where this condition exists. The public can appreciate the significance of this and see that it means a simple assertion that a discharge of the ear is a danger to life. Careful and skilled attention is necessary for the treatment of these conditions, but this skill and care are no more beyond the range and abilities of the averagely endowed practitioner than are the necessities of midwifery. Happen what will, a large proportion of cases will require operation, either a minor operation, such as removing the ossicles with the remains of the drum, or the more extensive radical operation. Both these are extremely satisfactory in skilled hands and the former finds its chief use in soon enabling the busy man to But it cannot be too firmly impressed resume his labours. on sufferers from suppurative otitis media or those responsible for the well-being of such persons that a chronic otorrhoea is a constant danger.
of the consumer where their activity may be aroused. It is therefore of the highest importance that care should be taken not only to obtain ice from pure sources but to maintain it by all possible means in a state of purity. As to the source of ice, there can be no doubt that the purest ice is obtainable from pure water that has been boiled, cooled, and then artificially frozen, but on the whole the natural ice obtained from the Norwegian fields is excellent in quality and any superficial impurity can easily be removed by DANGEROUS PERFORMANCES. rinsing. But the use of stout wooden tubs fitted with AT Hastings, on the Saturday before the recent bank linings of pure tin and mounted on runners would form a distinct advance on the rude method of its distribution at holiday, a man named Davidson gave an exhibition at a public recreation ground, consisting in balancing present in vogue. feats of a not unfamiliar character, executed on a rope or cable stretched 40 feet above the ground. In the THE NECESSITY OF ATTENDING TO AURAL of his performance the pole with the help of which DISCHARGES. he was maintaining his equilibrium slipped from him and PERSISTENT discharge from the ear has not until compara- as he failed in an attempt to grasp the rope he fell to tively recent years been recognised in its true significance by the ground and was killed. A large crowd had assembled the profession and it is only amongst the more cultured and to see him and some of these, no doubt, went home intelligent of the laity that any real appreciation of its sobered and saddened by the catastrophe. At the same time, potential dangers exists. The reasons for this are not hard of others of those present it must be said that they were to find, for although Sir William Wilde, the famous Irish influenced to a large extent by a morbid desire to see a aural surgeon, in 1840 pointed out the dangers accruing from dangerous performance and on this occasion the dangerous neglected aural discharge, yet unfortunately his words did element produced a fatal result before their eyes. Tightnot make a due impression upon the medical profession. rope performances are not particularly attractive in themWilde lamented the fact that it was considered dangerous to selves and if Davidson had advertised his feats as check the discharge of otorrhcea as being a fruitful source of about to take place three feet above the ground or as trouble but we find that this idea persists even now amongst rendered perfectly safe by means of a net he would have the public, while until recently many practitioners of been without an audience, although the skill exhibited medicine failed to see the possible dangers implied in an would have been the same. Some of those who flock to aural discharge. An aural discharge frequently ceases at exhibitions such as his may say in their own defence that it the onset of intracranial complications, so that the symptom is the exhibition of courage displayed by the performer that no longer exists just as the seriousness of the condi- they go to see but they must be perfectly aware that the tion becomes manifest. Another circumstance which has performance is to the chief actor in it a work of routine -
midst
VACCINATION : THE DURATION OF IMMUNITY.
1665
and that he has long ago lost the nervous feeling which that if all his patients took longer over the mastication affects some of us when we look down from what is known and insalivation of their food his labours in safeguarding Davidson was no more likely their bodily health would be lightened in a large degree. as a "giddy height.’’ to be affected by the fact that he was 40 feet above the Unfortunately, the constant tendency of civilisation and of ground than an ordinary person is alarmed when he looks social arrangements is to minimise the time given to mastiThe cook and the conversaout of a second-floor window. Nor was his loss of the pole cation and to insalivation. in any way due to it. The element of danger, however, was tionalist are allied against mastication. The one prepares in order that he be able to a attract crowd food that calls and that offers for mastication necessary might hardly and so to earn his living and he pursued his calling to its little or no resistance to the grindings of the teeth, The Daily Telegraph, in an interesting note the other employs his art to stimulate movements of fatal end. appended to the report of his death, reminds us of some of the tongue entirely unconcerned with the preparation for his more famous predecessors in this particular form of deglutition of food. A man cannot in polite circles at once exhibition. Of these, Mademoiselle Saqui lived to be 80 years talk and eat. Whereas dinner time should be devoted to old, dying in 1866, and Blondin, who also died "in his eating we constantly sacrifice the precious moments to bed"in 1897, was 73 years of age. Many others whose speech and risk a dyspepsia rather than fail to let loose a names are not chronicled have perished in attempting bo7a -mot. The labours of Mr. Horace Fletcher and of Mr. E. H. to attain the skill necessary to become renowned public van Someren may effect a permanent change in our table performers, but our contemporary mentions two women, customs. Perhaps we shall see started a " society for the Miss Young, who died a cripple from injuries sustained at a propagation of poltophagy"and shall recognise its adherents public performance, and the "Female Blondin"who was when we see a silent but healthy-looking dinner party of killed on the Aston Park recreation ground at Birmingham quietly-chewing folk. We do not maintain that the more in August, 1863. It was on this occasion that Her late spiritual side of conviviality will be enhanced but there can Majesty Queen Victoria evinced that sympathy with her be no question of the desirability of chewing or poltophagy subjects which always distinguished her, combined with the from a purely physical and gastronomic aspect. sterling good sense no less conspicuous in her character, for she wrote to the Mayor of Birmingham expressing her horror VACCINATION: THE DURATION OF IMMUNITY. that one of her subjects, and a woman, should have been AT the meeting of the Société Medicale des Hopitaux of "sacrificed to the gratification of a demoralising taste"" on May 5th M. Sevestre brought forward some evidence Paris in a public playground which she and the Prince Consort had opened in the hope that it might be showing that the duration of the immunity after vaccinafor " the healthy exercise and rational recreation of tion is shorter than is generally supposed. A child, aged the people." As a matter of fact, the ground in question three years, was admitted to the measles pavilion of the Bretonneau Hospital with an eruption which was supposed was outside the jurisdiction of the official to whom Her Majesty’s letter was addressed and the stopping of a per- to be of that disease but which turned out to be a prodromal formance of a grown-up person on the score of danger is not rash of variola. All the patients in the pavilion, who numbered 27, were immediately vaccinated. Three left two easy to effect. The best safeguard for the performer is in a healthy public opinion when it can be roused; and of per- days later before the result of the vaccination could be formances upon the tight or slack wire it may also be said ascertained. Of the 24 others, two, aged 11 and 13 years, that they are so dull and monotonous, even with the element showed two and three well-developed vaccination vesicles of danger, that their season of popularity, at its height in respectively. The former child had no vaccination scar and the latter had been unsuccessfully vaccinated in infancy. the days of Blondin, has long been over. In addition well-developed vesicles were obtained in two children who had well-marked vaccination scars and THE PROPER WAY TO EAT. whose ages were two and four years respectively. The THE two articles which we published dealing with the child who suffered from variola was only three years old and showed one vaccination cicatrix. Thus out of the manner in which swallowing is effected by the human being interest and on a of constant touch importance. 25 children one, who showed a vaccination scar, was subject Dietetics and all that relates thereto form a branch of attacked with variola at the age of three years and in medical science that appeals to the general mind as perhaps two others, aged two and four years respectively, vaccinano other branch can hope to do. Every man, be he tion was successfully performed in spite of the existence of must eat to and to the one, even well-marked vaccination scars. M. Sevestre, therefore, conor live, gourmand ascetic, cludes that in the case of an epidemic of variola or of as much as to the other, there is an interest and an importance about the details of the way in which this feeding process exposure to infection from a sporadic case children should is accomplished that few other natural processes entail to an be vaccinated, even those only a few years old and showing equal extent. Whether because he wishes to get the largest well-marked vaccination scars. In the discussion that amount of pleasure at a minimum risk of dyspepsia in followed cases were mentioned in which recruits were the case of the gourmand, or because he wishes to get successfully vaccinated, although the same result had been achieved a short time before. M. Roger stated a maximum amount of nutrition with a minimum expenditure of time and energy, as with the ascetic, man in that he had successfully vaccinated in 1897 six children either case wishes to know how he eats, what becomes of his at ages varying from 16 months to five years who bore food, and why these things are just as they are and not the scars, sometimes multiple, of primary vaccination. otherwise. Mr. Hubert Higgins has opened up an inter- M. Joseph Belin mentioned the case of a woman who esting side of the question in his discussion of the polto- was successfully vaccinated in infancy and had conphagic and psomophagic capabilities of mankind. He has fluent variola in 1868 at the age of 28 years. In 1870 From 1871 to 1881 Professor shown how both anatomically and functionally man can she had discrete variola. vaccinated her Brouardel The every year successfully. choose at will which method of swallowing he will employ allied but distinct of the duration the of question and we believe with Mr. Higgins that much would be gained proif all could resolve,upon, and adhere to, the more trouble- tection against variola conferred by vaccination does not some but more hygienic method. No medical man doubts seem to have engaged the attention of the society. We may point out that the Registrar-General’s statistics of 1 THE LANCET, the small-pox epidemic in London in 1901-02 showed May 20th (p. 1334) and 27th (p. 1417), 1905.
I