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FREE SHOOTING.
THE BACTERIOLOGICAL EXAMINATION OF THE BLOOD.
1200
pure fluid difficult or impossible. From the calf he obtained from 20 to 60 c.cm. of the fluid contained in the sub-arachnoid space. The fluid was limpid and colourless, of slightly saline taste, and contained neither flocculi nor coagula. Under the microscope isolated red and white blood corpuscles were frequently visible, probably driven in by the needle. The fluid was feebly alkaline and became opalescent on boiling. On the addition of a small quantity of acetic acid On the a finely flocculent precipitate was thrown down. addition of solution of soda and a trace of copper sulphate in seven out of twenty experiments a slight violet coloration In was observed; in the remaining thirteen there was none. all instances a positive result was obtained by the use of Trommer’s test. No response was obtained from Nylander’s test. In the cases in which the phenyl-hydrazin test was applied the results were positive. The doubtful and conflicting statements of writers in respect to the nature of the reducing substance Dr. Nawratzki believes to be due to the small quantity of fluid at their disposal. He accordingly mixed the fluids obtained from no less than 85 calves, and thus collected more than two litres, which were acidified with acetic acid and mingled with a considerable quantity of alcohol. The mixture was then divided into four portions. These were severally tested for a copper-reducing substance and for pyrocatechin, and the results of his experiments were that in opposition to Hoppe Seyler and Ransom he finds that in health a substance is present which in all its properties agrees with grape sugar. The percentage amount is smaller than that in blood, varying in different classes of the animal kingdom from one-tenth part to two-tenth parts per cent., whilst pyrocatechin is entirely absent. A NEW LOCAL ANÆSTHETIC. OF the
making of
new local anesthetics there appears to be The latest claimant rejoices in the name " p amidom-oxy-benzo-methylic ether." The German chemists, Einhorn and Heinz, who have experimented with this substance have adopted for it the more convenient term "orthoform." It is a white crystalline powder and is without odour or taste ; it is but slightly soluble. However, it forms soluble salta with acids which, while they possess distinctly anæsthetic properties, are rather irritating when applied to mucous membranes. The powdered orthoform placed upon the surface of an ulcer or inflamed mucous membrane produces, it is said, insensibility of the part and its anaesthetic action persists for some time. It possesses the advantage of being non-poisonous, and so can be freely applied to the surface of burns and painful cancerous and other ulcers. It has been given internally in gramme doses in cases of gastric carcinoma. Its insolubility appears to be a drawback to its employment as a local anaesthetic for surgical work, but successful results appear to have followed its use at Munich for surgical operations.
no
end.
FREE SHOOTING. MATTERS in the County of London are rapidly approachthe happy state of things which used to exist in California and Australia in the " fifties," when the custom of shooting on sight was looked upon as laudable and justifiable. Four cases of shooting came before the courts on Nov. 2nd, another one on Nov. 3rd, and it has become quite a common thing for gangs of boys aged about fifteen years to perambulate the East End and Clerkenwell armed with revolvers. When thee gangs meet there is trouble. Statements have appeared in the lay press to the effect that ten cases of shooting have been attended to at the Royal Free Hospital within the last ten months. This is a slight exaggeration, the correct number being eight up to Oct. 31st. Unfortunately education as given in elementary
ing
schools where we suppose these enterprising youths have been brought up does not as yet include revolver practice, so’ that harmless passers-by are often hit and sometimes killed. If only members of the gang suffered no one would object. Seriously though the custom must be put down at all costs. A licence to sell pistols or revolvers should be made to cost a large sum and a licence to carry one still The sooner the defunct Pistols Bill is brought in more. again and passed the better, for it is perfectly intolerable that in the greatest city in the world and after nearly thirty years’ working of the Education Act a state of matters should be allowed worthy only of a frontier settlement. The magistrates, also, are much to blame for the ridiculously inadequate penalties they inflict when an offender is brought up for punishment; retribution, heavy and swift, should follow any case of shooting in the streets, except perhaps in the very exceptional case of the use of a revolver by a.
policeman.
THE THE
-
EPIDEMIC OF TYPHOID FEVER AT LYNN.
of enteric fever at Lynn still progresses. Already the attacks number about 300, and some ten fresh cases occur daily. There can be but little doubt that the washing of filth into the Gaywood river, whence the corporation derive their water, is the cause of the outbreak,just as it was in 1892. Unfortunately, too, the ratepayers are themselves responsible for the large amount of disease which has occurred, for a majority of them persistently opposed new waterworks, and at last the Local Government Board had to intervene with a peremptory order. The delay occasioned by the the new works being available before townspeople prevented the beginning of this epidemic. Dr. Frederick St. George. Mivart, of the Local Government Board, has been for some days past conducting an inquiry into the causes and means of spread of the disease. Oar Special Sanitary Commissioner is making a detailed report for our readers, the first instalment of which will be found on page 1218. THE
outbreak
BACTERIOLOGICAL EXAMINATION BLOOD.
OF THE
IN recent years bacteriological examination of the blood during life has become more frequent.. The American Jou,rnal of Medical Sciences for October, 1897, contains a summary of the results obtained by Dr. John Slade Ely. As a diagnostic aid such examinations have proved disappointing ; the proportion of cases in which positive results are obtained is very small. As a means of throwing light on pathology, on the contrary, they are very valuable, explaining the occurrence of complications in diseases which usually are localised. Pyogenic germs have been detected in the blood during life in pyasmia, osteomyelitis, puerperal fever, erysipelas, and infective endocarditis ; the pneumococcus in pneumonia and infective endocarditis; the bacillus coli communis in cystitis with a pyasmic condition; the gonococcus in infective endocarditis following gonorrbcea; thetubercle bacillus in tuberculosis ; and the typhoid bacillus in typhoid fever. Some investigations by Kohn published in the present year are of great interest. In pronounced’ sepsis a positive result was always obtained, and in some cases the bacteria were present in large numbers. In a. case of acute ulcerative endocarditis plate cultures of the blood yielded 200 colonies of streptococci and several of staphylococci. In 32 cases of pneumonia a positive result was obtained in 9. Of the latter 7 were fatal, and the 2 which recovered were complicated respectively with pneumococcus empyema and pneumococcus abscesses. Of the 23 negative cases 18 recovered. Of the remaining 5 the fatal result was due in 2 to secondary
1200
pure fluid difficult or impossible. From the calf he obtained from 20 to 60 c.cm. of the fluid contained in the sub-arachnoid space. The fluid was limpid and colourless, of slightly saline taste, and contained neither flocculi nor coagula. Under the microscope isolated red and white blood corpuscles were frequently visible, probably driven in by the needle. The fluid was feebly alkaline and became opalescent on boiling. On the addition of a small quantity of acetic acid On the a finely flocculent precipitate was thrown down. addition of solution of soda and a trace of copper sulphate in seven out of twenty experiments a slight violet coloration In was observed; in the remaining thirteen there was none. all instances a positive result was obtained by the use of Trommer’s test. No response was obtained from Nylander’s test. In the cases in which the phenyl-hydrazin test was applied the results were positive. The doubtful and conflicting statements of writers in respect to the nature of the reducing substance Dr. Nawratzki believes to be due to the small quantity of fluid at their disposal. He accordingly mixed the fluids obtained from no less than 85 calves, and thus collected more than two litres, which were acidified with acetic acid and mingled with a considerable quantity of alcohol. The mixture was then divided into four portions. These were severally tested for a copper-reducing substance and for pyrocatechin, and the results of his experiments were that in opposition to Hoppe Seyler and Ransom he finds that in health a substance is present which in all its properties agrees with grape sugar. The percentage amount is smaller than that in blood, varying in different classes of the animal kingdom from one-tenth part to two-tenth parts per cent., whilst pyrocatechin is entirely absent. A NEW LOCAL ANÆSTHETIC. OF the
making of
new local anesthetics there appears to be The latest claimant rejoices in the name " p amidom-oxy-benzo-methylic ether." The German chemists, Einhorn and Heinz, who have experimented with this substance have adopted for it the more convenient term "orthoform." It is a white crystalline powder and is without odour or taste ; it is but slightly soluble. However, it forms soluble salta with acids which, while they possess distinctly anæsthetic properties, are rather irritating when applied to mucous membranes. The powdered orthoform placed upon the surface of an ulcer or inflamed mucous membrane produces, it is said, insensibility of the part and its anaesthetic action persists for some time. It possesses the advantage of being non-poisonous, and so can be freely applied to the surface of burns and painful cancerous and other ulcers. It has been given internally in gramme doses in cases of gastric carcinoma. Its insolubility appears to be a drawback to its employment as a local anaesthetic for surgical work, but successful results appear to have followed its use at Munich for surgical operations.
no
end.
FREE SHOOTING. MATTERS in the County of London are rapidly approachthe happy state of things which used to exist in California and Australia in the " fifties," when the custom of shooting on sight was looked upon as laudable and justifiable. Four cases of shooting came before the courts on Nov. 2nd, another one on Nov. 3rd, and it has become quite a common thing for gangs of boys aged about fifteen years to perambulate the East End and Clerkenwell armed with revolvers. When thee gangs meet there is trouble. Statements have appeared in the lay press to the effect that ten cases of shooting have been attended to at the Royal Free Hospital within the last ten months. This is a slight exaggeration, the correct number being eight up to Oct. 31st. Unfortunately education as given in elementary
ing
schools where we suppose these enterprising youths have been brought up does not as yet include revolver practice, so’ that harmless passers-by are often hit and sometimes killed. If only members of the gang suffered no one would object. Seriously though the custom must be put down at all costs. A licence to sell pistols or revolvers should be made to cost a large sum and a licence to carry one still The sooner the defunct Pistols Bill is brought in more. again and passed the better, for it is perfectly intolerable that in the greatest city in the world and after nearly thirty years’ working of the Education Act a state of matters should be allowed worthy only of a frontier settlement. The magistrates, also, are much to blame for the ridiculously inadequate penalties they inflict when an offender is brought up for punishment; retribution, heavy and swift, should follow any case of shooting in the streets, except perhaps in the very exceptional case of the use of a revolver by a.
policeman.
THE THE
-
EPIDEMIC OF TYPHOID FEVER AT LYNN.
of enteric fever at Lynn still progresses. Already the attacks number about 300, and some ten fresh cases occur daily. There can be but little doubt that the washing of filth into the Gaywood river, whence the corporation derive their water, is the cause of the outbreak,just as it was in 1892. Unfortunately, too, the ratepayers are themselves responsible for the large amount of disease which has occurred, for a majority of them persistently opposed new waterworks, and at last the Local Government Board had to intervene with a peremptory order. The delay occasioned by the the new works being available before townspeople prevented the beginning of this epidemic. Dr. Frederick St. George. Mivart, of the Local Government Board, has been for some days past conducting an inquiry into the causes and means of spread of the disease. Oar Special Sanitary Commissioner is making a detailed report for our readers, the first instalment of which will be found on page 1218. THE
outbreak
BACTERIOLOGICAL EXAMINATION BLOOD.
OF THE
IN recent years bacteriological examination of the blood during life has become more frequent.. The American Jou,rnal of Medical Sciences for October, 1897, contains a summary of the results obtained by Dr. John Slade Ely. As a diagnostic aid such examinations have proved disappointing ; the proportion of cases in which positive results are obtained is very small. As a means of throwing light on pathology, on the contrary, they are very valuable, explaining the occurrence of complications in diseases which usually are localised. Pyogenic germs have been detected in the blood during life in pyasmia, osteomyelitis, puerperal fever, erysipelas, and infective endocarditis ; the pneumococcus in pneumonia and infective endocarditis; the bacillus coli communis in cystitis with a pyasmic condition; the gonococcus in infective endocarditis following gonorrbcea; thetubercle bacillus in tuberculosis ; and the typhoid bacillus in typhoid fever. Some investigations by Kohn published in the present year are of great interest. In pronounced’ sepsis a positive result was always obtained, and in some cases the bacteria were present in large numbers. In a. case of acute ulcerative endocarditis plate cultures of the blood yielded 200 colonies of streptococci and several of staphylococci. In 32 cases of pneumonia a positive result was obtained in 9. Of the latter 7 were fatal, and the 2 which recovered were complicated respectively with pneumococcus empyema and pneumococcus abscesses. Of the 23 negative cases 18 recovered. Of the remaining 5 the fatal result was due in 2 to secondary