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IMPEDIMENTS OF SPEECH.
257 but when casting about for probabilities of wrong doing, are, on the whole, carefully and rationally put. A statewhy did it not occur to Mr. Stansfeld that an insult might ment that those who suffer in this way should go out in all hare been spared " an honourable profession," and a great weathers with the throat exposed may be accepted as a deal of verbiage avoided by falling back on that favourite general rule, provided that its gradual adoption and a general expression of his, which not only covers what have been soundness of constitution be understood to guard the praceuphemistically called " the two sexes of man," but would tice from abuse. Some valuable hints on the subject of hare included every other class of possible offender, even stammering are also to be found in this little work. We themidwife"and the " any other person " to whom he must say, however, that the reference to treatment of this affection by bromides and belladonna might be excised elegantly alluded ? with advantage. It is a vague and hasty statement resting -
NITRO-GLYCERINE AS A SUBSTITUTE FOR ALCOHOL.
but assuming the confidence of With the reservation above mentioned, If the July number of the Therapeutic Gazette, Dr. we may recommend this paper as conveying some good Joseph B. Burroughs of Manchester, N.Y., recommends the practical advice on self-management to the class for whom employment of nitro-glycerine as a substitute for alcohol. it is intended. He states that some time ago, whilst using nitro-glycerine in HYDROCELE IN THE MALE. a case of angina pectoris, and watching its wonderful stimuTHE Virginia Medical Monthly for July contains an lating effect on the heart and bloodvessels, it occurred to him that it might be advantageously employed in many interesting clinical lecture on Hydrocele in the Male by diseases in place of alcohol. At first he was unwilling to Dr. Fred. S. Dennis, Professor of Surgery in Bellevue Hosrely on it solely, but as he became more fully acquainted pital Medical College, New York. The most noticeable with its effects he began to realise that as a heart stimulant points in it are Dr. Dennis’s argument in favour of always it is far superior to brandy. Alcohol in its effects on the trying the palliative treatment by paracentesis first, on the system is classed with chloroform and ether. All three pro- ground not only of occasional inconvenient results from the duce first a period of excitement, followed by unconscious- radical operation, but of the frequency of cure after simple Dr. Dennis has seen many cases permanently ness. In the case of chloroform and ether the second stage tapping. this cured is quickly reached, so that they are readily available as procedure. In the first series of 100 cases by on anesthetics. With alcohol the first stage is of longer dura- operated by Dr. Dennis, he was surprised to find 25 per cent. cured by a single tapping. Another point of interest tion, the secondary effect not being apparent unless large in Dr. Dennis’s are so that it is as paper is that he shows, on the good authority taken, quantities generally employed of Professor that in some hydroceles the fluid contains, a stimulant to the heart and circulation. Welch, Nitro-glycein addition to albumen and cholesterine, indigo-blue. This is this effect in a rine, possessing pre-eminent stimulating Dr. a new observation Welch. The indigo-blue is supposed adbe with confidence whenever the by degree, may given ministration of brandy is indicated. Its advantages are, to be produced by the decomposition of indican. Dr. Dennis’s in the first place, that a very small quantity is required, favourite operation for radical cure is the excision of a one or two drops of the 1 per cent. solution being equipiece of the sac, or simple incision into the sac, evacuation valent to one ounce or more of brandy; secondly, that it of the contents, and stitching the tunica vaginalis and skin is tasteless, colourless, and practically odourless; thirdly, together, "under strict antiseptic precautions." that it acts immediately and without any appreciable interval; and, finally, that it is not likely to induce a RETURN OF CHOLERA AT MARSEILLES. eraving for alcoholic stimulants. An extensive experience ANYONE who has read the special report we recently pubhas shown that it is of great value in the shock resulting lished 1 on the sanitary condition of Toulon and Marseilles from accidents, in the nausea and faintness following will not be surprised to hear that cholera has again broken surgical operations, in the failure of the heart’s action due out in at least one of these towns. It would have been surto the administration of chloroform, in opium poisoning, in had Marseilles escaped, considering that nothing asthma, hysterical aphonia, and the collapse of typhoid and prising was done the winter to improve the condition of the other fevers. Dr. Burroughs gives a detailed account of a during town. At the last in it in number of cases which he has employed the manner epidemic it was observed that the streets which were well a The is and will indicated. paved and possessed of sewers were comsuggestion good one, probably from free cholera. There were 225,000 metres of be extensively adopted. paratively streets and only 48,000 metres of sewers in Marseilles. To IMPEDIMENTS OF SPEECH. meet this great dificiency the authorities sanctioned the A SEORT time ago we had occasion to note the importance construction of 3000 additional metres of sewers ; that was of the treatment of deaf-mutism in our educational system. all. The port is infected as usual, and 70,000 cubic metres A pamphlet by the Rev. J. Edgar Foster draws our attention of foul deposit have to be dredged out every year. Thouto the less pressing but important subject of the cause and sands of houses have no closets, and all the filth is emptied cure of impediments of speech. Many of the suggestions into the gutter. The regulation calling upon the proprietors contained in this paper are worthy of general attention, of houses that possess no cesspools to adopt the pail system while others will satisfy some of the special needs of public is not enforced. Our commissioner found that only 44 per speakers. The recommendations as to physical exercise of cent. of the houses at the Capelette were provided with the body as a whole and of the respiratory organs, as well pails, and that, in spite of the terrible havoc wrought by the cholera in this district last year, nothing whatsover had as those relating to the management of breath in speaking been done. Every sanitary defect complained of during are well of Rather too in our aloud, much, worthy perusal. opinion, is made of the evils which may result from a want the last epidemic remained in precisely the same condition of due care in the last-named particular. Congestion of the up to the month of May last, when our commisssioner lung and heart disease do no doubt occur as stated in those visited Marseilles. Contaminated wells, a contaminated who neglect to breathe fully and deeply during de- i brook, houses without any sort of sanitary accommodationciamation, but they are hardly possible without the such was the condition of the Capelette. A little hole dug in co-operation of other causes. The remarks on the causes 1 See THE LANCET of June 20th, 1885, Report of Special Sanitary and treatment of clerical sore-throat and allied affections Commission on Marseilles and Toulon. on
doubtful
therapeutic
empiricism,
law.
I
___
-
NITRO-GLYCERINE AS A SUBSTITUTE FOR ALCOHOL.
but assuming the confidence of With the reservation above mentioned, If the July number of the Therapeutic Gazette, Dr. we may recommend this paper as conveying some good Joseph B. Burroughs of Manchester, N.Y., recommends the practical advice on self-management to the class for whom employment of nitro-glycerine as a substitute for alcohol. it is intended. He states that some time ago, whilst using nitro-glycerine in HYDROCELE IN THE MALE. a case of angina pectoris, and watching its wonderful stimuTHE Virginia Medical Monthly for July contains an lating effect on the heart and bloodvessels, it occurred to him that it might be advantageously employed in many interesting clinical lecture on Hydrocele in the Male by diseases in place of alcohol. At first he was unwilling to Dr. Fred. S. Dennis, Professor of Surgery in Bellevue Hosrely on it solely, but as he became more fully acquainted pital Medical College, New York. The most noticeable with its effects he began to realise that as a heart stimulant points in it are Dr. Dennis’s argument in favour of always it is far superior to brandy. Alcohol in its effects on the trying the palliative treatment by paracentesis first, on the system is classed with chloroform and ether. All three pro- ground not only of occasional inconvenient results from the duce first a period of excitement, followed by unconscious- radical operation, but of the frequency of cure after simple Dr. Dennis has seen many cases permanently ness. In the case of chloroform and ether the second stage tapping. this cured is quickly reached, so that they are readily available as procedure. In the first series of 100 cases by on anesthetics. With alcohol the first stage is of longer dura- operated by Dr. Dennis, he was surprised to find 25 per cent. cured by a single tapping. Another point of interest tion, the secondary effect not being apparent unless large in Dr. Dennis’s are so that it is as paper is that he shows, on the good authority taken, quantities generally employed of Professor that in some hydroceles the fluid contains, a stimulant to the heart and circulation. Welch, Nitro-glycein addition to albumen and cholesterine, indigo-blue. This is this effect in a rine, possessing pre-eminent stimulating Dr. a new observation Welch. The indigo-blue is supposed adbe with confidence whenever the by degree, may given ministration of brandy is indicated. Its advantages are, to be produced by the decomposition of indican. Dr. Dennis’s in the first place, that a very small quantity is required, favourite operation for radical cure is the excision of a one or two drops of the 1 per cent. solution being equipiece of the sac, or simple incision into the sac, evacuation valent to one ounce or more of brandy; secondly, that it of the contents, and stitching the tunica vaginalis and skin is tasteless, colourless, and practically odourless; thirdly, together, "under strict antiseptic precautions." that it acts immediately and without any appreciable interval; and, finally, that it is not likely to induce a RETURN OF CHOLERA AT MARSEILLES. eraving for alcoholic stimulants. An extensive experience ANYONE who has read the special report we recently pubhas shown that it is of great value in the shock resulting lished 1 on the sanitary condition of Toulon and Marseilles from accidents, in the nausea and faintness following will not be surprised to hear that cholera has again broken surgical operations, in the failure of the heart’s action due out in at least one of these towns. It would have been surto the administration of chloroform, in opium poisoning, in had Marseilles escaped, considering that nothing asthma, hysterical aphonia, and the collapse of typhoid and prising was done the winter to improve the condition of the other fevers. Dr. Burroughs gives a detailed account of a during town. At the last in it in number of cases which he has employed the manner epidemic it was observed that the streets which were well a The is and will indicated. paved and possessed of sewers were comsuggestion good one, probably from free cholera. There were 225,000 metres of be extensively adopted. paratively streets and only 48,000 metres of sewers in Marseilles. To IMPEDIMENTS OF SPEECH. meet this great dificiency the authorities sanctioned the A SEORT time ago we had occasion to note the importance construction of 3000 additional metres of sewers ; that was of the treatment of deaf-mutism in our educational system. all. The port is infected as usual, and 70,000 cubic metres A pamphlet by the Rev. J. Edgar Foster draws our attention of foul deposit have to be dredged out every year. Thouto the less pressing but important subject of the cause and sands of houses have no closets, and all the filth is emptied cure of impediments of speech. Many of the suggestions into the gutter. The regulation calling upon the proprietors contained in this paper are worthy of general attention, of houses that possess no cesspools to adopt the pail system while others will satisfy some of the special needs of public is not enforced. Our commissioner found that only 44 per speakers. The recommendations as to physical exercise of cent. of the houses at the Capelette were provided with the body as a whole and of the respiratory organs, as well pails, and that, in spite of the terrible havoc wrought by the cholera in this district last year, nothing whatsover had as those relating to the management of breath in speaking been done. Every sanitary defect complained of during are well of Rather too in our aloud, much, worthy perusal. opinion, is made of the evils which may result from a want the last epidemic remained in precisely the same condition of due care in the last-named particular. Congestion of the up to the month of May last, when our commisssioner lung and heart disease do no doubt occur as stated in those visited Marseilles. Contaminated wells, a contaminated who neglect to breathe fully and deeply during de- i brook, houses without any sort of sanitary accommodationciamation, but they are hardly possible without the such was the condition of the Capelette. A little hole dug in co-operation of other causes. The remarks on the causes 1 See THE LANCET of June 20th, 1885, Report of Special Sanitary and treatment of clerical sore-throat and allied affections Commission on Marseilles and Toulon. on
doubtful
therapeutic
empiricism,
law.
I
___
-