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HENRY MORTON STANLEY.
1367 and proved cases to be 142-viz., coloured persons 123 and whites 19. Since April 23rd 5 deaths have been reported, all being of coloured persons. For the week ending May 7th the total number of fresh cases reported since April 30th is 11, 6 being white persons and 5 coloured ; 19 cases have been found not to be plague, making the present total of suspected and proved cases 134, 22 whites and 112 coloured. The number of deaths for the week is 4, 1 of a white and 3 of coloured patients. In Cape Colony for the week ending April 16th only 1 case of plague was reported-namely, a coloured male at Port Elizabeth. Plague-infected rodents As regards the Mauritius a were also found in the town. Governor received at the Colonial from telegram the Acting Office on May 6th states that for the week ending May 5th there was 1 case of plague which proved fatal.
The discussion is of use in that it draws attention to the possible normal condition of the colon during life. This portion of the bowel is probably in a condition of slight tonic rigidity and in its empty state has practically no lumen. Considerable lengths of the colon may occasionally be seen in a firmly contracted condition during abdominal operations on man and a similar appearance is not infrequently met with after death, especially in the descending, iliac and pelvic sections of the bowel. This is quite comparable with the condition held to obtain in the living empty stomach. We cannot see, however, that any advantage will accrue by discussion of the matter in our columns.
I further
HENRY MORTON STANLEY. By the death of Sir Henry Morton Stanley, which occurred May 10th from pleurisy and pneumonia, the country has lost a typical British explorer. Born in very humble sur roundings in Denbighshire, he raised himself, partly by his own innate talent and partly owing to the kindness of a merchant named Stanley whose name he adopted, to a position on the staff of the New York Herald. The chief incident in his career of interest to our own profession was that he was the discoverer of Livingstone who had for years disappeared within the heart of what was then literally The historic meeting between "the Dark Continent." and Stanley took place at Ujiji in 1871. Livingstone Two years afterwards Livingstone died alone except for the presence of one faithful servant at Ilala and his body being brought home Stanley was one of the pallbearers when it was laid to rest in Westminster Abbey. In 1874 Stanley again left England for Africa to undertake an exploring expedition under the auspices of the Daily Telegraph and the New York Herald and explored a great Of the foundation of the deal of the Congo territory. Independent State and the expedition for the relief of Emin Pasha we have no space to give details, but it may justly be said that Stanley’s explorations put the copingstone to the building raised with such toil and indomitable energy by Denham, Barth, Burton, Speke, Grant, and Baker, to mention only a few of those who have devoted their lives to solving the problems of Africa. on
DOES SYPHONAGE OCCUR IN THE INTESTINE P
LARGE
A LIVELY controversy has been going on lately in our columns as to the way in which the colon propels its contents into the rectum preparatory to their evacuation. Dr. R. W. Leftwich is an advocate of a novel view, for he seeks to explain this action of the colon on purely hydrostatic principles. He considers that hydrostatic pressure is brought to bear on the large bowel by the small intestine at the ileo-oasoal orifice and that the colon, in man at all events, acts after the manner of a syphon of which the descending colon and its continuation form the longer limb. In a small volume in which he has published the results of his speculations and experiments Dr. Leftwich advocates the avoidance of the recumbent position in strictures of the colon, points out that the proper position after the administration of an enema is the erect one, conjectures that intussusceptions are the results of csecal vacua, and states that in typhoid fever the patient should be made to sit up, during the first ten days at all events, for stated intervals. He certainly has the courage of his opinions. His opponent, Dr. A. Keith, has with persistence asserted that this view of the purely hydrostatic action of the colon in emptying itself is erroneous. Dr. Keith’s chief reasons for dissenting from the theories of Dr. Leftwich are the known consistence of the contents which is not such as to favour syphonage ; the impossibility under normal conditions of maintaining a rigid and at the same time freely pervious colon ; the great development of the muscular coats of this part of the bowel; and, lastly, the actual demonstration of peristaltic move. ments in it. Dr. Leftwich, on the other hand, doubts the power of the human colon to propel its contents against gravity and infers that the rigidity of the tube is sufficiently provided for by tonic contraction of its longitudinal bands and the support yielded by the doubling in of the ridges between the saccules. He holds that the failure of saline purges if the patient retires to bed after taking them, the occurrence of morning diarrhoea in some conditions, and the normal morning evacuation all support his contention of syphonage as the active agent in causing the onward passage of the contents of the colon. We think that Dr. Keith has advanced cogent reasons for doubting the presence of such a mechanism as that which Dr. Leftwich invokes and our scepticism is strengthened when we turn to a description of the mechanism as given by Dr. Leftwich in his own book, for at one stage he postulates the following condition of affairs: an inverted rigid U-tube (the colon) with a vacuum at the cseoal end and a faecal column suspended between the cseoum and the rectum, the end which lies in the descending column in some mysterious way supporting the end which lies in the ascending colon. Since the publication of Dr. Keith’s last letter we have received a further communication from Dr. Leftwich in which he still maintains his original position.
THE WEST LONDON MEDICO-CHIRURGICAL SOCIETY. THE twenty-second anniversary dinner of the West London Medico-Chirurgical Society was held on May 4th at the Empire Hall of the Trocadero Restaurant, Piccadillycircus, London, W., Dr. Seymour Taylor, the president, being in the chair. After the usual loyal toasts had been honoured Colonel T. H. Hendley, I.M.S., in responding to the toast of "The Imperial Forces," which was proposed by Mr. C. R. B. Keetley, referred to the serious misgivings caused by the determination of the authorities to omit from the Army Council the head of the Army Medical Service. If the Medical Service of the army was expected to show successful results in war there should be full preparation in time of peace and that could only be secured by continuity of administration and by full representation. The Indian Medical Service had no official representation on the supreme or provincial legislative councils. However, the good sense and courtesy of lieutenant-governors and other officials minimised this want of representation in the Indian Medical Service. Few realised perhaps in how many ways the men in the Indian Medical Service were in touch with the history and daily work of the empire. Boughton and Hamilton were among the founders of the Indian Empire and Holwell, the hero of the Black Hole of Calcutta, was for a time Acting Governor of Bengal. Continuing, Colonel Hendley pointed out that two officers who had recently served under him
The discussion is of use in that it draws attention to the possible normal condition of the colon during life. This portion of the bowel is probably in a condition of slight tonic rigidity and in its empty state has practically no lumen. Considerable lengths of the colon may occasionally be seen in a firmly contracted condition during abdominal operations on man and a similar appearance is not infrequently met with after death, especially in the descending, iliac and pelvic sections of the bowel. This is quite comparable with the condition held to obtain in the living empty stomach. We cannot see, however, that any advantage will accrue by discussion of the matter in our columns.
I further
HENRY MORTON STANLEY. By the death of Sir Henry Morton Stanley, which occurred May 10th from pleurisy and pneumonia, the country has lost a typical British explorer. Born in very humble sur roundings in Denbighshire, he raised himself, partly by his own innate talent and partly owing to the kindness of a merchant named Stanley whose name he adopted, to a position on the staff of the New York Herald. The chief incident in his career of interest to our own profession was that he was the discoverer of Livingstone who had for years disappeared within the heart of what was then literally The historic meeting between "the Dark Continent." and Stanley took place at Ujiji in 1871. Livingstone Two years afterwards Livingstone died alone except for the presence of one faithful servant at Ilala and his body being brought home Stanley was one of the pallbearers when it was laid to rest in Westminster Abbey. In 1874 Stanley again left England for Africa to undertake an exploring expedition under the auspices of the Daily Telegraph and the New York Herald and explored a great Of the foundation of the deal of the Congo territory. Independent State and the expedition for the relief of Emin Pasha we have no space to give details, but it may justly be said that Stanley’s explorations put the copingstone to the building raised with such toil and indomitable energy by Denham, Barth, Burton, Speke, Grant, and Baker, to mention only a few of those who have devoted their lives to solving the problems of Africa. on
DOES SYPHONAGE OCCUR IN THE INTESTINE P
LARGE
A LIVELY controversy has been going on lately in our columns as to the way in which the colon propels its contents into the rectum preparatory to their evacuation. Dr. R. W. Leftwich is an advocate of a novel view, for he seeks to explain this action of the colon on purely hydrostatic principles. He considers that hydrostatic pressure is brought to bear on the large bowel by the small intestine at the ileo-oasoal orifice and that the colon, in man at all events, acts after the manner of a syphon of which the descending colon and its continuation form the longer limb. In a small volume in which he has published the results of his speculations and experiments Dr. Leftwich advocates the avoidance of the recumbent position in strictures of the colon, points out that the proper position after the administration of an enema is the erect one, conjectures that intussusceptions are the results of csecal vacua, and states that in typhoid fever the patient should be made to sit up, during the first ten days at all events, for stated intervals. He certainly has the courage of his opinions. His opponent, Dr. A. Keith, has with persistence asserted that this view of the purely hydrostatic action of the colon in emptying itself is erroneous. Dr. Keith’s chief reasons for dissenting from the theories of Dr. Leftwich are the known consistence of the contents which is not such as to favour syphonage ; the impossibility under normal conditions of maintaining a rigid and at the same time freely pervious colon ; the great development of the muscular coats of this part of the bowel; and, lastly, the actual demonstration of peristaltic move. ments in it. Dr. Leftwich, on the other hand, doubts the power of the human colon to propel its contents against gravity and infers that the rigidity of the tube is sufficiently provided for by tonic contraction of its longitudinal bands and the support yielded by the doubling in of the ridges between the saccules. He holds that the failure of saline purges if the patient retires to bed after taking them, the occurrence of morning diarrhoea in some conditions, and the normal morning evacuation all support his contention of syphonage as the active agent in causing the onward passage of the contents of the colon. We think that Dr. Keith has advanced cogent reasons for doubting the presence of such a mechanism as that which Dr. Leftwich invokes and our scepticism is strengthened when we turn to a description of the mechanism as given by Dr. Leftwich in his own book, for at one stage he postulates the following condition of affairs: an inverted rigid U-tube (the colon) with a vacuum at the cseoal end and a faecal column suspended between the cseoum and the rectum, the end which lies in the descending column in some mysterious way supporting the end which lies in the ascending colon. Since the publication of Dr. Keith’s last letter we have received a further communication from Dr. Leftwich in which he still maintains his original position.
THE WEST LONDON MEDICO-CHIRURGICAL SOCIETY. THE twenty-second anniversary dinner of the West London Medico-Chirurgical Society was held on May 4th at the Empire Hall of the Trocadero Restaurant, Piccadillycircus, London, W., Dr. Seymour Taylor, the president, being in the chair. After the usual loyal toasts had been honoured Colonel T. H. Hendley, I.M.S., in responding to the toast of "The Imperial Forces," which was proposed by Mr. C. R. B. Keetley, referred to the serious misgivings caused by the determination of the authorities to omit from the Army Council the head of the Army Medical Service. If the Medical Service of the army was expected to show successful results in war there should be full preparation in time of peace and that could only be secured by continuity of administration and by full representation. The Indian Medical Service had no official representation on the supreme or provincial legislative councils. However, the good sense and courtesy of lieutenant-governors and other officials minimised this want of representation in the Indian Medical Service. Few realised perhaps in how many ways the men in the Indian Medical Service were in touch with the history and daily work of the empire. Boughton and Hamilton were among the founders of the Indian Empire and Holwell, the hero of the Black Hole of Calcutta, was for a time Acting Governor of Bengal. Continuing, Colonel Hendley pointed out that two officers who had recently served under him