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INTERMENSTRUAL DYSMENORRHOEA.
1670 he did not know them or the place. The mother told the police that he was a somnambulist and had left home previously under similar conditions. In the youth’s pocket there was found a diary in which he had entered the details of his daily experience since the time he left home and forgot who or where he was. "His physicians state that his attack of amnesia is gradually passing off, and that while
dirty environment as factors in the etiology of the disease he is right, but to say that these conditions indicate nothing but the accumulation of a large quantity of carbonic acid gas and insufficient quantity of oxygen is to ignore the teachings of modern research and to manifest a lamentable ignorance of the nature of infection.
he shows memory of other events in his past life any reference to himself seems to be the signal for another lapse of his memory." The import of cases such as the above is To the list of candidates for vacancies upon the Council evident both from a medical and medico-legal standpoint, should be added the names of Mr. W. H. Bennett, surgeon to and it is to note their affinities with such neurointeresting St. George’s Hospital, and Mr. R. Clement Lucas, surgeon to pathic conditions as epilepsy and somnambulism. Guy’s Hospital. The full list will be found on p. 1674.
THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.
THE INTERNATIONAL CONGRESS
OF
MEDICINE.
Ix answer to many inquiries which have been addressed to it, it is announced by the Executive Committee of the Thirteenth International Congress of Medicine that it has decided that dentists who are not doctors of medicine, but
I I
UNIVERSITY OF LONDON: PRIZE.
THE ROGERS
AT a meeting of the Senate of the University of London, held on March 28th, 1900, it was resolved that one sum of .S100 be offered as the Rogers Prize open for competition to the members of the medical profession in Great Britain all who nevertheless are registered or possess a diplô’lne d’état, either French or foreign, can register themselves as members and Ireland for an essay under the following regulation as of the Congress in the Section of Stomatology. Names must to the subject and conditions thereof, namely: an essay ,be sent to the Bureaux of the Congress, the address of which by any member of the medical profession in Great Britain and Ireland upon the Production of Immunity in Specific is 21, rue de 1’IoIe de M6decine, Paris. Infective Diseasesgenerally, and with particular reference to anyone disease on which the writer of the essay has LOSS OF MEMORY AND OF SENSE OF made original investigations. The essay is to be sent to the PERSONAL IDENTITY. Registrar, University of London, South Kensington, S.W., CASES of this sort, though decidedly uncommon in on or before June lst, 1901. occurrence, are of considerable medical and legal interest. The record of a specially interesting case is published in INTERMENSTRUAL DYSMENORRHCEA. the Philadelphia Medical Journal (May 19th, 1900) and recalls the occurrence of a similar case recently at Cambridge THE Boston Medical and Surgical ,To7crnat of April 19tb where a young undergraduate disappeared from his contains an important paper by Dr. M. Storer on this rare quarters and was not heard of for several days till and interesting affection. His observations lead him to he was discovered staying at an inn in the country conclude that intermenstrual dysmenorrbcea is not so rare some distance from Cambridge. He seemed to have as has been asserted: he had found it last summer 18 times had no recollection of leaving his rooms in Cambridge in 400 "suitable cases"in which he inquired as to its or of any of the incidents subsequent to that event existence. Analysis of 20 cases under his care and of 25 and until his arrival at the inn, except that he was collected from literature led to the following conclusions. As feeling tired and fatigued and that his boots and clothes regards regularity the pain in all cases appeared practically The undergraduate was a every month. In 22 cases it always occurred on a definite were wayworn and dusty. to epileptic fits at infrequent day from the beginning of the last menstruation; in 13 youth subject occasionally and it that after such a fit he lost there was a variation of two days and in 4 of four days; in intervals, appears his memory and his sense of personal identity and 2 with irregular menstruation it occurred on a definite day wandered about until he came to the inn where, wearied before the next menstruation. As regards day of appearance and worn out, he took lodgings. He had lost all recollec- from the first day of the previous menstruation, out of 41 cases tion of his former life and condition and stayed in the inn it came on in from the twelfth to the sixteenth days in 37. As for some days. Then a second fit occurred after which the to character, in a large number of cases it was described as memory of his former self returned and he was able to paroxysmal, the attacks either coming on at intervals of realise his position and find his way back to the University. several hours and lasting from five to 15 minutes or the pain The case reported in the Philadelphia Medical JOtlrnal is being constant with exacerbations often of the greatest that of a law student, aged 19 years, living in New York, severity and resembling that of labour. As to duration, who suddenly lost his memory and sense of personal identity in 10 it lasted two days ; in 9, three ; in 8, one; and found himself wandering in the streets of what he con- and in 4, four or more. In no case was there a dissidered a strange city. He was so perplexed that he asked charge like that of menstruation, but in two cases people in the street if they could tell him who he was and (one of bleeding fibroids and the other of hsemorrbagic endo. went to the libraries and hotels to search in the newspapers metritis) there was a slightly sanguineous discharge. Hence for stories of missing persons in order that he might get the term "intermenstrual dysmenorrhoea " is inapt. On the some clue to his identity. He lived at a hotel and after other hand, a marked increase of leucorrhoea is spoken of in five in fruitless spending days wanderings and inquiries he 10 cases, which is evidence of temporary congestion. As to entered a finally police station and inquired of the sergeant causation, the pain in most of the books is described as on duty whether he could inform him in what city he was ovarian but it is not always so. In one case it disappeared and requested that search might be made in the record after the removal of a hydrosalpinx ; in another, after the of missing persons. When this was done it was found that uterus was curetted for endometritis ; and in a third, stenosis of there was a description closely tallying with his appearance. the internal os was apparently the only lesion. On the other A detective was sent with the youth to the address given in hand, out of 40 cases in which the local condition is stated the description, where the wanderer was received with great more or less of an inflammatory condition of the appendages joy by his mother and sisters. To their great surprise, how- is described in 30 ("ovaritis," 15 ; "salpingitis," 12; and ever, he thanked them very politely, but assured them that "bydrosalpinx," three). The exact manner in which the
1671
produced is not doubtful explanations, mechanical brought forward.
phenomenon
is
known. More or less and neurotic, have been
___
MORTALITY AMONG SEAMEN.
I
about three weeks the phlebitis of the left lower limb had passed away, when the right was attacked, but less severely. Complete recovery ensued. M. Troiier insisted that in spite of the recovery the intensity of the symptoms established the diagnosis of meningitis which was produced by the typhoid bacillus or by some secondary infection. He quoted M. Dupr6 who has stated in the" Manuel de Medecine de Debove-Achard" that infectious meningitis might become cured. The phlebitis, he thought, was a mere coincidence and but another manifestation of typhoid infection.
IN the issue of the Syren, a paper dealing with mercantile marine matters, for May 30th, appears an article entitled "Deaths on Shipboard"which is particularly interesting from a medical point of view. The Registrar-General of Shipping and Seamen issues monthly mortality returns from which it appears that although the average number of deaths THE INCORPORATED SOCIETY OF MEDICAL in the British Mercantile Marine is about 300, the returns OFFIOERS OF HEALTH. for March show the very high total of 808. Not all THE members of the Yorkshire branch of the above of these deaths, however, actually occurred in March and by far the greater part were due to the heavy society held their annual dinner on May 31st at the gale which swept over the North Sea in the month of Hotel Metropole, Leeds. Mr. T. B. Fairclough of Mirfield, February. Some deaths, too, reported in March were due to the President of the branch, was in the chair, and among the the hurricane which devastated the Bahamas in August, 1899, guests was Professor Clifford Allbutt who proposed the toast and the two together were responsible for the loss of 413 of " Our Society." He referred to the exceedingly valuable lives by drowning in the case of vessels now reported results which had been accomplished within his own recolas 11 missing." Of the other deaths 26 were due to chest lection by the labours of medical officers of health and by, affections and 18 to heart disease. Yellow fever is credited the science of preventive medicine. Malaria, plague, and with 11 and malaria with 10 deaths. Falls from aloft killed typhus fever were extremely rare or even absent in this. 10 seamen and 20 met with other fatal accidents. Only one country and he thought that in time tuberculosis would case of death from typhoid fever is reported. The number become as rare as typhus fever was now. But perhaps theof deaths due to" chest complaints" is very small most interesting portion of the speech of the Regius Professor and shows that diseases of this kind are due, not so of Medicine of the University of Cambridge was that passage much, as is popularly believed, to cold and wet as to wherein he referred to cancer. He urged his hearers to losedust and the various other abominations which are found in no opportunity of tracing out the distribution of cancer the atmosphere of great cities. Many forecastles and much and said that when he reflected what had been done within. sleeping accommodation in the mercantile marine are still the lifetime of one man towards the extinction of typhus. far from being what they should be, but there is always fever and that plague and malaria had been absolutely plenty of fresh and dust-free air on deck. The tale of deaths abolished in this country he was confident in thinking that. from " missing" is, however, a terrible one, and these even cancer might be wiped off the slate. They did not know, apparently occurred mainly among fishing craft and coasters. much about cancer, but the weight of evidence was on the The latter class of vessel is in many cases, we fancy, by no side of its being an infectious disease. Optimism in means too well found, and a glance at any wreck chart will medicine is undoubtedly a thing to be cultivated, but we show how dangerous are our own coasts to this kind of fear that it may be long before cancer is " wiped off theslate." Still, the labours of Mr. Alfred Haviland and Mr. vessel. D’Arcy Power with regard to the geographical feature of cancer distribution, to say nothing of the pathological and RECOVERY FROM MENINGITIS IN TYPHOID FEVER. physiological researches of many other workers, even if no. definite results have as yet been arrived at, are at any rateTHE following case, described at the meeting of the an earnest that the problem is being steadily attacked. Société Medicale des Hôpitaux of Paris by M. Troisier, is interesting as an example of recovery from typhoid meningMEDICAL GRADUATES’ COLLEGE AND itis. A patient, aged 24 years, had typhoid fever of the POLYCLINIC. adynamic form. The disease ran a regular course and the THE first annual dinner of this institution was held only peculiarity was the intensity of the headache which began with the prodromal period and its persistence, though at the Trocadero Restaurant on May 31st. The Right Hon.. in less degree, throughout the whole of the febrile period. Lord Strathcona and Mount Royal was in the chair and The temperature commenced to fall on the twenty-first day, and the large number present testified to the interest which on the twenty-fourth day, when defervescence was complete, is extended to the youngest of London’s medical colleges. the patient, who had never ceased to suffer from her head, The gathering was a most successful one and the committee complained of violent headache and photophobia. There responsible for the proceedings may congratulate themselves The Royal toasts were were painful contracture of the cervical muscles, which on the results of their labours. rendered flexion of the head impossible, and repeated vomit- received with the enthusiasm which characterises all ing which took place without effort. The pulse was small references to the Queen and all members of the Royal and irregular and had become slowed from 90 on the previous Family at the present time. Sir Henry Burdett proday to 65. The meningeal streak was well marked. Kernig’s poses 11 The Imperial Forces," referring more particularly sign was absent. These symptoms persisted without fever to the services rendered by the chairman and other reprefor four days. The patient was in a state of torpor sentatives of the colonies to the mother country. Surgeonaccompanied by agitation and slight nocturnal delirium. Captain Kingscote and the Hon. R. H. Lyttelton responded, She comprehended what was said to her, but answered the latter thanking those present for the manner in which slowly and had an absent air. On the twenty-ninth they had received the mention of the name of bis brother, day the vomiting ceased and all the other symptoms General Lyttelton, now serving in South Africa. Lord improved, the headache and stupor diminished, the stiftness Strathcona, in proposing the principal toast, " The Medical of the neck disappeared, and the pulse became regular. On Graduates’ College and Polyclinic," briefly explained the the thirty-seventh day phlebitis with marked oedema of the objects of the institution, the main one being to enable whole left lower limb appeared. On the following day the qualified men who had left the hospitals and entered on meningeal symptoms had completely disappeared. In the practice of their profession to keep themselves ___
dirty environment as factors in the etiology of the disease he is right, but to say that these conditions indicate nothing but the accumulation of a large quantity of carbonic acid gas and insufficient quantity of oxygen is to ignore the teachings of modern research and to manifest a lamentable ignorance of the nature of infection.
he shows memory of other events in his past life any reference to himself seems to be the signal for another lapse of his memory." The import of cases such as the above is To the list of candidates for vacancies upon the Council evident both from a medical and medico-legal standpoint, should be added the names of Mr. W. H. Bennett, surgeon to and it is to note their affinities with such neurointeresting St. George’s Hospital, and Mr. R. Clement Lucas, surgeon to pathic conditions as epilepsy and somnambulism. Guy’s Hospital. The full list will be found on p. 1674.
THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.
THE INTERNATIONAL CONGRESS
OF
MEDICINE.
Ix answer to many inquiries which have been addressed to it, it is announced by the Executive Committee of the Thirteenth International Congress of Medicine that it has decided that dentists who are not doctors of medicine, but
I I
UNIVERSITY OF LONDON: PRIZE.
THE ROGERS
AT a meeting of the Senate of the University of London, held on March 28th, 1900, it was resolved that one sum of .S100 be offered as the Rogers Prize open for competition to the members of the medical profession in Great Britain all who nevertheless are registered or possess a diplô’lne d’état, either French or foreign, can register themselves as members and Ireland for an essay under the following regulation as of the Congress in the Section of Stomatology. Names must to the subject and conditions thereof, namely: an essay ,be sent to the Bureaux of the Congress, the address of which by any member of the medical profession in Great Britain and Ireland upon the Production of Immunity in Specific is 21, rue de 1’IoIe de M6decine, Paris. Infective Diseasesgenerally, and with particular reference to anyone disease on which the writer of the essay has LOSS OF MEMORY AND OF SENSE OF made original investigations. The essay is to be sent to the PERSONAL IDENTITY. Registrar, University of London, South Kensington, S.W., CASES of this sort, though decidedly uncommon in on or before June lst, 1901. occurrence, are of considerable medical and legal interest. The record of a specially interesting case is published in INTERMENSTRUAL DYSMENORRHCEA. the Philadelphia Medical Journal (May 19th, 1900) and recalls the occurrence of a similar case recently at Cambridge THE Boston Medical and Surgical ,To7crnat of April 19tb where a young undergraduate disappeared from his contains an important paper by Dr. M. Storer on this rare quarters and was not heard of for several days till and interesting affection. His observations lead him to he was discovered staying at an inn in the country conclude that intermenstrual dysmenorrbcea is not so rare some distance from Cambridge. He seemed to have as has been asserted: he had found it last summer 18 times had no recollection of leaving his rooms in Cambridge in 400 "suitable cases"in which he inquired as to its or of any of the incidents subsequent to that event existence. Analysis of 20 cases under his care and of 25 and until his arrival at the inn, except that he was collected from literature led to the following conclusions. As feeling tired and fatigued and that his boots and clothes regards regularity the pain in all cases appeared practically The undergraduate was a every month. In 22 cases it always occurred on a definite were wayworn and dusty. to epileptic fits at infrequent day from the beginning of the last menstruation; in 13 youth subject occasionally and it that after such a fit he lost there was a variation of two days and in 4 of four days; in intervals, appears his memory and his sense of personal identity and 2 with irregular menstruation it occurred on a definite day wandered about until he came to the inn where, wearied before the next menstruation. As regards day of appearance and worn out, he took lodgings. He had lost all recollec- from the first day of the previous menstruation, out of 41 cases tion of his former life and condition and stayed in the inn it came on in from the twelfth to the sixteenth days in 37. As for some days. Then a second fit occurred after which the to character, in a large number of cases it was described as memory of his former self returned and he was able to paroxysmal, the attacks either coming on at intervals of realise his position and find his way back to the University. several hours and lasting from five to 15 minutes or the pain The case reported in the Philadelphia Medical JOtlrnal is being constant with exacerbations often of the greatest that of a law student, aged 19 years, living in New York, severity and resembling that of labour. As to duration, who suddenly lost his memory and sense of personal identity in 10 it lasted two days ; in 9, three ; in 8, one; and found himself wandering in the streets of what he con- and in 4, four or more. In no case was there a dissidered a strange city. He was so perplexed that he asked charge like that of menstruation, but in two cases people in the street if they could tell him who he was and (one of bleeding fibroids and the other of hsemorrbagic endo. went to the libraries and hotels to search in the newspapers metritis) there was a slightly sanguineous discharge. Hence for stories of missing persons in order that he might get the term "intermenstrual dysmenorrhoea " is inapt. On the some clue to his identity. He lived at a hotel and after other hand, a marked increase of leucorrhoea is spoken of in five in fruitless spending days wanderings and inquiries he 10 cases, which is evidence of temporary congestion. As to entered a finally police station and inquired of the sergeant causation, the pain in most of the books is described as on duty whether he could inform him in what city he was ovarian but it is not always so. In one case it disappeared and requested that search might be made in the record after the removal of a hydrosalpinx ; in another, after the of missing persons. When this was done it was found that uterus was curetted for endometritis ; and in a third, stenosis of there was a description closely tallying with his appearance. the internal os was apparently the only lesion. On the other A detective was sent with the youth to the address given in hand, out of 40 cases in which the local condition is stated the description, where the wanderer was received with great more or less of an inflammatory condition of the appendages joy by his mother and sisters. To their great surprise, how- is described in 30 ("ovaritis," 15 ; "salpingitis," 12; and ever, he thanked them very politely, but assured them that "bydrosalpinx," three). The exact manner in which the
1671
produced is not doubtful explanations, mechanical brought forward.
phenomenon
is
known. More or less and neurotic, have been
___
MORTALITY AMONG SEAMEN.
I
about three weeks the phlebitis of the left lower limb had passed away, when the right was attacked, but less severely. Complete recovery ensued. M. Troiier insisted that in spite of the recovery the intensity of the symptoms established the diagnosis of meningitis which was produced by the typhoid bacillus or by some secondary infection. He quoted M. Dupr6 who has stated in the" Manuel de Medecine de Debove-Achard" that infectious meningitis might become cured. The phlebitis, he thought, was a mere coincidence and but another manifestation of typhoid infection.
IN the issue of the Syren, a paper dealing with mercantile marine matters, for May 30th, appears an article entitled "Deaths on Shipboard"which is particularly interesting from a medical point of view. The Registrar-General of Shipping and Seamen issues monthly mortality returns from which it appears that although the average number of deaths THE INCORPORATED SOCIETY OF MEDICAL in the British Mercantile Marine is about 300, the returns OFFIOERS OF HEALTH. for March show the very high total of 808. Not all THE members of the Yorkshire branch of the above of these deaths, however, actually occurred in March and by far the greater part were due to the heavy society held their annual dinner on May 31st at the gale which swept over the North Sea in the month of Hotel Metropole, Leeds. Mr. T. B. Fairclough of Mirfield, February. Some deaths, too, reported in March were due to the President of the branch, was in the chair, and among the the hurricane which devastated the Bahamas in August, 1899, guests was Professor Clifford Allbutt who proposed the toast and the two together were responsible for the loss of 413 of " Our Society." He referred to the exceedingly valuable lives by drowning in the case of vessels now reported results which had been accomplished within his own recolas 11 missing." Of the other deaths 26 were due to chest lection by the labours of medical officers of health and by, affections and 18 to heart disease. Yellow fever is credited the science of preventive medicine. Malaria, plague, and with 11 and malaria with 10 deaths. Falls from aloft killed typhus fever were extremely rare or even absent in this. 10 seamen and 20 met with other fatal accidents. Only one country and he thought that in time tuberculosis would case of death from typhoid fever is reported. The number become as rare as typhus fever was now. But perhaps theof deaths due to" chest complaints" is very small most interesting portion of the speech of the Regius Professor and shows that diseases of this kind are due, not so of Medicine of the University of Cambridge was that passage much, as is popularly believed, to cold and wet as to wherein he referred to cancer. He urged his hearers to losedust and the various other abominations which are found in no opportunity of tracing out the distribution of cancer the atmosphere of great cities. Many forecastles and much and said that when he reflected what had been done within. sleeping accommodation in the mercantile marine are still the lifetime of one man towards the extinction of typhus. far from being what they should be, but there is always fever and that plague and malaria had been absolutely plenty of fresh and dust-free air on deck. The tale of deaths abolished in this country he was confident in thinking that. from " missing" is, however, a terrible one, and these even cancer might be wiped off the slate. They did not know, apparently occurred mainly among fishing craft and coasters. much about cancer, but the weight of evidence was on the The latter class of vessel is in many cases, we fancy, by no side of its being an infectious disease. Optimism in means too well found, and a glance at any wreck chart will medicine is undoubtedly a thing to be cultivated, but we show how dangerous are our own coasts to this kind of fear that it may be long before cancer is " wiped off theslate." Still, the labours of Mr. Alfred Haviland and Mr. vessel. D’Arcy Power with regard to the geographical feature of cancer distribution, to say nothing of the pathological and RECOVERY FROM MENINGITIS IN TYPHOID FEVER. physiological researches of many other workers, even if no. definite results have as yet been arrived at, are at any rateTHE following case, described at the meeting of the an earnest that the problem is being steadily attacked. Société Medicale des Hôpitaux of Paris by M. Troisier, is interesting as an example of recovery from typhoid meningMEDICAL GRADUATES’ COLLEGE AND itis. A patient, aged 24 years, had typhoid fever of the POLYCLINIC. adynamic form. The disease ran a regular course and the THE first annual dinner of this institution was held only peculiarity was the intensity of the headache which began with the prodromal period and its persistence, though at the Trocadero Restaurant on May 31st. The Right Hon.. in less degree, throughout the whole of the febrile period. Lord Strathcona and Mount Royal was in the chair and The temperature commenced to fall on the twenty-first day, and the large number present testified to the interest which on the twenty-fourth day, when defervescence was complete, is extended to the youngest of London’s medical colleges. the patient, who had never ceased to suffer from her head, The gathering was a most successful one and the committee complained of violent headache and photophobia. There responsible for the proceedings may congratulate themselves The Royal toasts were were painful contracture of the cervical muscles, which on the results of their labours. rendered flexion of the head impossible, and repeated vomit- received with the enthusiasm which characterises all ing which took place without effort. The pulse was small references to the Queen and all members of the Royal and irregular and had become slowed from 90 on the previous Family at the present time. Sir Henry Burdett proday to 65. The meningeal streak was well marked. Kernig’s poses 11 The Imperial Forces," referring more particularly sign was absent. These symptoms persisted without fever to the services rendered by the chairman and other reprefor four days. The patient was in a state of torpor sentatives of the colonies to the mother country. Surgeonaccompanied by agitation and slight nocturnal delirium. Captain Kingscote and the Hon. R. H. Lyttelton responded, She comprehended what was said to her, but answered the latter thanking those present for the manner in which slowly and had an absent air. On the twenty-ninth they had received the mention of the name of bis brother, day the vomiting ceased and all the other symptoms General Lyttelton, now serving in South Africa. Lord improved, the headache and stupor diminished, the stiftness Strathcona, in proposing the principal toast, " The Medical of the neck disappeared, and the pulse became regular. On Graduates’ College and Polyclinic," briefly explained the the thirty-seventh day phlebitis with marked oedema of the objects of the institution, the main one being to enable whole left lower limb appeared. On the following day the qualified men who had left the hospitals and entered on meningeal symptoms had completely disappeared. In the practice of their profession to keep themselves ___