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DR. EDMUND SMITH'S RETIREMENT.
1223 lesions may appear, subsiding in their turn with the fall of temperature. Œdema of the skin is sometimes a prominent feature, its extent depending on the situation of the indurated lesions. Coarse, flaky desquamation follows the involution of the erythematous plaques. The skin lesions become less numerous and distinct as the disease progresses, and disappear altogether as it subsides spontaneously or is arrested by intravenous injection of neo-arsphenamin, as occurred in one of Dr. O’Leary’s cases. new
Modern Technique
in Treatment.
of Special Articles, contributed by invitation, on the Treatment of Medical and Surgical Conditions.
A Series
LXXV. OF ACUTE GONORRHŒA IN TREATMENT * THE MALE. DR. EDMUND SMITH’S RETIREMENT. GONORRHŒA in the male has an incubation period His colleagues in the public health service will have 3-21 days ; the average is 5, any time after 10 is of of the retirement learned with regret impending The earliest symptom is a slight gumminess through ill-health of Dr. Edmund Smith, medical rare. officer of health for the city of York. Dr. Smith was of the meatus, associated with a sense of chafing. York’s first whole-time medical officer, and the quarter This appears usually on the second day after contact, of a century during which he has held office has been a and, if a smear is -then taken, gonococci are present. time of great progress in public health matters. i This is an important fact not generally known, most During his first year there was an extensive epidemic practitioners waiting until pus shows on the third of typhoid fever in York, which led to the gradual to fifth day. The inflammation at this stage is still abolition of the conservancy system and the improve- confined to the squamous epithelium of the fossa ment of the sewers. Voluntary notification of navicularis, where the gonococcus can lead only a pulmonary tuberculosis was adopted at an early date, precarious life. It has not yet spread to the columnar and a complete scheme for dealing with tuberculosis epithelium of the urethra proper, where the organism has since been built up. An excellent maternity and can speedily burrow between the cells, invade the child welfare scheme has come into being as the result racemose glands of Littre, and establish itself firmly. of whole-hearted cooperation with the York Infants’ The importance of recognising the gonococcus thus Welfare Association. In his report for 1922 Dr. early, and before pus formation, is due to the fact at this stage it is still possible occasionally to Smith told of the opening of the new maternity an attack. I hospital at Acomb Hall, a building admirably adaptedabort for the purpose with accommodation for some 40! Abortive Treatment. patients. One of the principal features of public The most successful method is that of Ballenger. health work in York has been the happy blending of After the patient has urinated, the glans and meatus and in no small due municipal voluntary effort, degree are cleaned with spirit, and 20 minims of 1 per cent. to the tact and enthusiasm of the medical officer of protargol, or 1/2000 collosol silver, is instilled into the health. Comparison between the death-rates in the anterior urethra with an ordinary hypodermic syringe. year of Dr. Smith’s appointment (1900) and the last The of the meatus are then closed, and sealed with lips for available shows that which are (1923) year figures a strand of cotton-wool soaked in collodion flexile. the general death-rate has fallen from 20-3 to 10-3 ; The is then held erect until the seal has dried. the tuberculosis death-rate from 2-10 to 0-86 ; the Afterpenis three hours this seal is removed with acetone, infant mortality-rate from 211 to 51. We are not the meanwhile having been instructed to surprised to learn that the cause of Dr. Smith’s drinkpatient of Contrexev ille or barley water. litres 1 t retirement has aroused deep sympathy on the part of The same manoeuvres are repeated six hours later, and, the citizens whom he has served so faithfully. if pus formation has not started, continued on the two succeeding days. The method probably acts by WE regret that by an oversight the name of Surgeon increasing osmosis. Its success can scarcely be due to In private Rear-Admiral Charles Marsh Beadnell was omitted the strength of the gonococcicide used. from. the list of Birthday Honours in our issue of practice a small proportion of first-attack cases can June 7th. Admiral Beadnell received the C.B., be aborted in this way, and it is therefore worth the attempt, particularly in married patients. In hospital Military Division. cases it seldom succeeds. Carelessly used it aggravates THE annual dinner of the Federation of Medical the attack, especially in relapse cases. The points and Allied Services on June 20th will be held in the to remember are : (1) Not to use more than 20 minims Crown Room at the Connaught Rooms, Great Queen- -the normal capacity of the urethra. (2) Not to use street, W.C. This alteration of place has now become silver nitrate, as is often done-it is a dangerous drug necessary owing to the applications for tickets having to seal up. (3) Never to attempt the method if pus greatly exceeded the accommodation available at the is actually present-damming up the discharge in this way only aggravates the condition. Langham Hotel.
I that
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_____
Dr. Arthur Hurst will deliver the Savill (Memorial) Lecture at the house of the Royal Society of Medicine, 1, Wimpole-street, W., on Thursday, July 3rd, at 5 P.M. Dr. Hurst has chosen Migraine as his subject, and the chair will be taken by Sir William Hale-White, President of the Royal Society of Medicine. These lectures were founded in connexion with the West End Hospital for Nervous Diseases. Any member of the medical profession will be admitted on presentation of his card.
Treatment of an Established Case. When definite pus develops, the patient should be given a saline purge, and the bowels regulated throughThis appreciably diminishes the out the attack. A suspensory bandage chance of posterior spread. should be worn, and the penis carried in a bag containing medicated cotton-wool to catch the discharge. Riding, cycling, dancing should be interdicted, all alcohol prohibited, spicy foods and coffee deleted from the diet. Urinary antiseptics are of no value in the Sod. bicarb., gr. xx. AT a meeting of the Board of Governors of the acute stage of the disease. McGill University, Montreal, on Thursday, June 5th, quartis horis, to reduce acidity, may be required if Bromides by the mouth and it was announced that the sum of half a million micturition is painful. dollars had been granted by the Rockefeller Founda-suppositories of atropine, gr. 1/75, should be prescribed tion to the Medical Faculty of the University for the if painful erections occur. The purulent discharge is attacked in three establishment of a university medical clinic in (1) (2) ways : by by vaccines, (3) by chemotherapy, the Victoria with We cooperation Hospital. Royal also learn that Dr. J. C. Meakins, Christison professorirrigations. of therapeutics at the University of Edinburgh, has * An article in this series on Acute Gonorrhœa in the Female been appointed director of the clinic. will appear in the next issue of THE LANCET. _____
,
Modern Technique
in Treatment.
of Special Articles, contributed by invitation, on the Treatment of Medical and Surgical Conditions.
A Series
LXXV. OF ACUTE GONORRHŒA IN TREATMENT * THE MALE. DR. EDMUND SMITH’S RETIREMENT. GONORRHŒA in the male has an incubation period His colleagues in the public health service will have 3-21 days ; the average is 5, any time after 10 is of of the retirement learned with regret impending The earliest symptom is a slight gumminess through ill-health of Dr. Edmund Smith, medical rare. officer of health for the city of York. Dr. Smith was of the meatus, associated with a sense of chafing. York’s first whole-time medical officer, and the quarter This appears usually on the second day after contact, of a century during which he has held office has been a and, if a smear is -then taken, gonococci are present. time of great progress in public health matters. i This is an important fact not generally known, most During his first year there was an extensive epidemic practitioners waiting until pus shows on the third of typhoid fever in York, which led to the gradual to fifth day. The inflammation at this stage is still abolition of the conservancy system and the improve- confined to the squamous epithelium of the fossa ment of the sewers. Voluntary notification of navicularis, where the gonococcus can lead only a pulmonary tuberculosis was adopted at an early date, precarious life. It has not yet spread to the columnar and a complete scheme for dealing with tuberculosis epithelium of the urethra proper, where the organism has since been built up. An excellent maternity and can speedily burrow between the cells, invade the child welfare scheme has come into being as the result racemose glands of Littre, and establish itself firmly. of whole-hearted cooperation with the York Infants’ The importance of recognising the gonococcus thus Welfare Association. In his report for 1922 Dr. early, and before pus formation, is due to the fact at this stage it is still possible occasionally to Smith told of the opening of the new maternity an attack. I hospital at Acomb Hall, a building admirably adaptedabort for the purpose with accommodation for some 40! Abortive Treatment. patients. One of the principal features of public The most successful method is that of Ballenger. health work in York has been the happy blending of After the patient has urinated, the glans and meatus and in no small due municipal voluntary effort, degree are cleaned with spirit, and 20 minims of 1 per cent. to the tact and enthusiasm of the medical officer of protargol, or 1/2000 collosol silver, is instilled into the health. Comparison between the death-rates in the anterior urethra with an ordinary hypodermic syringe. year of Dr. Smith’s appointment (1900) and the last The of the meatus are then closed, and sealed with lips for available shows that which are (1923) year figures a strand of cotton-wool soaked in collodion flexile. the general death-rate has fallen from 20-3 to 10-3 ; The is then held erect until the seal has dried. the tuberculosis death-rate from 2-10 to 0-86 ; the Afterpenis three hours this seal is removed with acetone, infant mortality-rate from 211 to 51. We are not the meanwhile having been instructed to surprised to learn that the cause of Dr. Smith’s drinkpatient of Contrexev ille or barley water. litres 1 t retirement has aroused deep sympathy on the part of The same manoeuvres are repeated six hours later, and, the citizens whom he has served so faithfully. if pus formation has not started, continued on the two succeeding days. The method probably acts by WE regret that by an oversight the name of Surgeon increasing osmosis. Its success can scarcely be due to In private Rear-Admiral Charles Marsh Beadnell was omitted the strength of the gonococcicide used. from. the list of Birthday Honours in our issue of practice a small proportion of first-attack cases can June 7th. Admiral Beadnell received the C.B., be aborted in this way, and it is therefore worth the attempt, particularly in married patients. In hospital Military Division. cases it seldom succeeds. Carelessly used it aggravates THE annual dinner of the Federation of Medical the attack, especially in relapse cases. The points and Allied Services on June 20th will be held in the to remember are : (1) Not to use more than 20 minims Crown Room at the Connaught Rooms, Great Queen- -the normal capacity of the urethra. (2) Not to use street, W.C. This alteration of place has now become silver nitrate, as is often done-it is a dangerous drug necessary owing to the applications for tickets having to seal up. (3) Never to attempt the method if pus greatly exceeded the accommodation available at the is actually present-damming up the discharge in this way only aggravates the condition. Langham Hotel.
I that
_____
_____
Dr. Arthur Hurst will deliver the Savill (Memorial) Lecture at the house of the Royal Society of Medicine, 1, Wimpole-street, W., on Thursday, July 3rd, at 5 P.M. Dr. Hurst has chosen Migraine as his subject, and the chair will be taken by Sir William Hale-White, President of the Royal Society of Medicine. These lectures were founded in connexion with the West End Hospital for Nervous Diseases. Any member of the medical profession will be admitted on presentation of his card.
Treatment of an Established Case. When definite pus develops, the patient should be given a saline purge, and the bowels regulated throughThis appreciably diminishes the out the attack. A suspensory bandage chance of posterior spread. should be worn, and the penis carried in a bag containing medicated cotton-wool to catch the discharge. Riding, cycling, dancing should be interdicted, all alcohol prohibited, spicy foods and coffee deleted from the diet. Urinary antiseptics are of no value in the Sod. bicarb., gr. xx. AT a meeting of the Board of Governors of the acute stage of the disease. McGill University, Montreal, on Thursday, June 5th, quartis horis, to reduce acidity, may be required if Bromides by the mouth and it was announced that the sum of half a million micturition is painful. dollars had been granted by the Rockefeller Founda-suppositories of atropine, gr. 1/75, should be prescribed tion to the Medical Faculty of the University for the if painful erections occur. The purulent discharge is attacked in three establishment of a university medical clinic in (1) (2) ways : by by vaccines, (3) by chemotherapy, the Victoria with We cooperation Hospital. Royal also learn that Dr. J. C. Meakins, Christison professorirrigations. of therapeutics at the University of Edinburgh, has * An article in this series on Acute Gonorrhœa in the Female been appointed director of the clinic. will appear in the next issue of THE LANCET. _____
,