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INTRAVENOUS TREATMENT OF ARTHRITIC PROCESSES.
247 INTRAVENOUS TREATMENT OF ARTHRITIC PROCESSES. THERE are certain positive advantages obvious to the intravenous methods of giving drugs. One is precision and accuracy of dosage with the certainty that the agent used will exert its effect unchanged by the disturbing factors which are necessarily associated with the ordinary absorptive The processes from the gastro-intestinal tract. other is rapidity of action. Advantages accruing from precision of dosage are especially seen in the salvarsan treatment, the necessity for such accuracy being obvious. The advantage of quickness of effect is most conspicuously noted, perhaps, in the intravenous inj ection of strophanthus in urgent cases of heart failure due to auricular fibrillation. It is natural that intravenous medication should have been tried in other conditions, and some success is claimed for this method of giving salicylates for refractory cases of acute rheumatism. Dr. Albert Comstock records the details of this form of treatment in certain articular diseases in the New -York Medical Journal (vol. c., 1914, p. 1113). He uses the
CHADWICK LECTURES AND DISEASE.1
THE
ON
WAR
THE second of three Chadwick lectures was delivered ab. the Royal Society of Arts on Jan. 22nd by Colonel F. M. SANDWiTH, M. D. The chair was occupied by Sir FREDERBCK. TREVES, and there was a large attendance.
Presentation of Chadrviok Prizes and Medals. interesting function preceded the delivery of thelecture-namely, the presentation to Fleet-Surgeon Cleveland Munday and Colonel Heaton Horrocks, R.A.M.C., of theChadwick Medal and Z50 for distinguished services in promoting the health of the men in the navy and army An
respectively.
Sir ARTHUR MAY, in thanking the Chadwick trustees for the honour they had conferred on the navy, said that when he entered the navy in 1878 the rate of sickness was 47 per 1000; to-day it was only 25, and the invalid-rate was now 15 as against 35 in 1878. In the latter year the death-rate in the navy was 6 per 1000, whereas to-day it was 2.. The improvement was due to sanitation and the education of the men, for every sailor in the service attended lectures on.
personal hygiene.
Sir ALFRED KEOGH emphasised the importance of thehealth of the troops in the maintenance of an army’s fighting::’ following prescription :strength, and said that Colonel Horrocks was the officer mos 1): Guaiacolis-sodii salicylatis, ana gr. 640. responsible for the very satisfactory health of our army now’ gr. 640. Glycerin in France, and his record extended back many years, the Aq. destill. et steril....... 2000 c.c. abolition from Malta of undulant fever having been due ten The conditions for which its intravenous use is him. Formerly there were in that island 600 or 700 men indicated are acute articular rheumatism, acute and stricken with that disease ; and hospitalisation alone cost. chronic muscular rheumatism, and acute gouty .,15,000 a year. To-day there was no fever. Colonel: had also much steady work in improving t1’2&bgr;, Horrocks done arthritis. The patient is suitably prepared and an sanitation of camps and barracks. of the at The solution, quantity aperient given. Colonel SANDWITH then delivered a lecture on 100° to 110° F., used is 250 c.c. (sic). The vein is The Smdh African and the Russo-Japanese Campaig?f:1’r. usually dissected out and the fluid slowly allowed I ...............
to flow in. The first subjective sign noted is a He said the Japanese army medical officers held that theretingling sensation, with a coal tar taste in the were three grades of illness : (a) comprising wounds ormouth, due to the guaiacol. The face then becomes disease caused by hardships and exposure incidental to warsuffused and congested and perspiration is free. fare ; (b) diseases, accidents, or injuries to which’ the There is generally slight delirium, which may last soldier might succumb in circumstances beyond his control: The pain, however, is re- and (e) diseases brought about by disobedience to orders, for half an hour. the of unwholesome food. and the
eating lieved in a wonderful manner, and within 24 immorality, of dirty water. The victim of the latter received’ This relief is most drinking hours the patient is better. no sympathy. Before the Russo-Japanese War the indimarked and most permanent -in acute rheumatism ; vidual Japanese soldier was made to understand how largely in 50 cases there has been no bad result. In his health contributed to the fighting efficiency of the army, muscular rheumatism the result is not so good, and this was an important factor in the avoidance by that~ and in the chronic form two or three injections nation of serious epidemic disease during the campaignmay have to be made at intervals of three or foui This lesson had had its good effect on our own army, and’ admired the British troops in this war for theirdays. For cases where salicylates given in the ordi. the French observances. No illness so dogged the steps of an hygienic nary way cannot be tolerated by the stomach or in as did typhoid fever. For years water contaminaarmy particularly obstinate cases this intravenous method tion was thought to be the cause,many but epidemics had occurred’ is recommended. where the water-supply was excellent, and dust and flies____
had
obviously to
be blamed.
He
particularised
the
case
of
meeting of the Council of the Royal College Quetta, which had an admirable water-supply. A striking of Surgeons in Ireland held on Jan. 21st, Mr. instance was that which occurred in the camp at ModderF. Conway Dwyer, President, in the chair, Sir River in the South African campaign. The winds covered) Arthur Chance was elected to represent the College the food with grit, and flies multiplied rapidly. The first. case of typhoid fever was recognised on Dec. 18th, 1900’, and! at the meetings of the General Medical Council. by the end of that month 18 cases had been admittedt into hospital. The Highland Brigade camp suffered theDr. George Lovell Gulland, physician to the least because it was in a wind-protected locality.. was also great danger from the handling of’ Edinburgh Royal Infirmary, has been appointed to There the Chair of Medicine in the University of Edinburgh, food by typhoid carriers, some of whom had had) the disease so slightly that it escaped recognition,. vacant through the resignation of Professor John especially in view of the necessary huddling of the men Wyllie. AT
a
.
AT
!
of the Senate of the University of Jan. 27th Dr. Edward BarclaySmith, M.A., M.D., B.C. Camb:, was appointed to theB University Chair of Anatomy at King’s College,’ London, and Dr. Edward Provan Cathcart, MD.,, Ch.B., D.Sc. Glasg., was appointed to the University . Chair of Physiology (as from April lst next)) tenable a
meeting
London held
on
at the London Hospital Medical College..
in quarters during war time. The typhoid death-rate in civil life varies from 5 per cent. to 20 per cent. ;: among armies in war time the rate is much higher, owing tothe absence of the best nursing facilities. In the South African War we lost 8022 from this disease, 19,454 wereinvalided, and 30,208 were either returned to duty or other-wise discharged. The mortality from typhoid fever in the war exceeded in number that of the men killed in action. Each?
together
____
.
1 A
report of the first lecture appeared in
p. 105.
THE LANCET of Jan.
23rd.
CHADWICK LECTURES AND DISEASE.1
THE
ON
WAR
THE second of three Chadwick lectures was delivered ab. the Royal Society of Arts on Jan. 22nd by Colonel F. M. SANDWiTH, M. D. The chair was occupied by Sir FREDERBCK. TREVES, and there was a large attendance.
Presentation of Chadrviok Prizes and Medals. interesting function preceded the delivery of thelecture-namely, the presentation to Fleet-Surgeon Cleveland Munday and Colonel Heaton Horrocks, R.A.M.C., of theChadwick Medal and Z50 for distinguished services in promoting the health of the men in the navy and army An
respectively.
Sir ARTHUR MAY, in thanking the Chadwick trustees for the honour they had conferred on the navy, said that when he entered the navy in 1878 the rate of sickness was 47 per 1000; to-day it was only 25, and the invalid-rate was now 15 as against 35 in 1878. In the latter year the death-rate in the navy was 6 per 1000, whereas to-day it was 2.. The improvement was due to sanitation and the education of the men, for every sailor in the service attended lectures on.
personal hygiene.
Sir ALFRED KEOGH emphasised the importance of thehealth of the troops in the maintenance of an army’s fighting::’ following prescription :strength, and said that Colonel Horrocks was the officer mos 1): Guaiacolis-sodii salicylatis, ana gr. 640. responsible for the very satisfactory health of our army now’ gr. 640. Glycerin in France, and his record extended back many years, the Aq. destill. et steril....... 2000 c.c. abolition from Malta of undulant fever having been due ten The conditions for which its intravenous use is him. Formerly there were in that island 600 or 700 men indicated are acute articular rheumatism, acute and stricken with that disease ; and hospitalisation alone cost. chronic muscular rheumatism, and acute gouty .,15,000 a year. To-day there was no fever. Colonel: had also much steady work in improving t1’2&bgr;, Horrocks done arthritis. The patient is suitably prepared and an sanitation of camps and barracks. of the at The solution, quantity aperient given. Colonel SANDWITH then delivered a lecture on 100° to 110° F., used is 250 c.c. (sic). The vein is The Smdh African and the Russo-Japanese Campaig?f:1’r. usually dissected out and the fluid slowly allowed I ...............
to flow in. The first subjective sign noted is a He said the Japanese army medical officers held that theretingling sensation, with a coal tar taste in the were three grades of illness : (a) comprising wounds ormouth, due to the guaiacol. The face then becomes disease caused by hardships and exposure incidental to warsuffused and congested and perspiration is free. fare ; (b) diseases, accidents, or injuries to which’ the There is generally slight delirium, which may last soldier might succumb in circumstances beyond his control: The pain, however, is re- and (e) diseases brought about by disobedience to orders, for half an hour. the of unwholesome food. and the
eating lieved in a wonderful manner, and within 24 immorality, of dirty water. The victim of the latter received’ This relief is most drinking hours the patient is better. no sympathy. Before the Russo-Japanese War the indimarked and most permanent -in acute rheumatism ; vidual Japanese soldier was made to understand how largely in 50 cases there has been no bad result. In his health contributed to the fighting efficiency of the army, muscular rheumatism the result is not so good, and this was an important factor in the avoidance by that~ and in the chronic form two or three injections nation of serious epidemic disease during the campaignmay have to be made at intervals of three or foui This lesson had had its good effect on our own army, and’ admired the British troops in this war for theirdays. For cases where salicylates given in the ordi. the French observances. No illness so dogged the steps of an hygienic nary way cannot be tolerated by the stomach or in as did typhoid fever. For years water contaminaarmy particularly obstinate cases this intravenous method tion was thought to be the cause,many but epidemics had occurred’ is recommended. where the water-supply was excellent, and dust and flies____
had
obviously to
be blamed.
He
particularised
the
case
of
meeting of the Council of the Royal College Quetta, which had an admirable water-supply. A striking of Surgeons in Ireland held on Jan. 21st, Mr. instance was that which occurred in the camp at ModderF. Conway Dwyer, President, in the chair, Sir River in the South African campaign. The winds covered) Arthur Chance was elected to represent the College the food with grit, and flies multiplied rapidly. The first. case of typhoid fever was recognised on Dec. 18th, 1900’, and! at the meetings of the General Medical Council. by the end of that month 18 cases had been admittedt into hospital. The Highland Brigade camp suffered theDr. George Lovell Gulland, physician to the least because it was in a wind-protected locality.. was also great danger from the handling of’ Edinburgh Royal Infirmary, has been appointed to There the Chair of Medicine in the University of Edinburgh, food by typhoid carriers, some of whom had had) the disease so slightly that it escaped recognition,. vacant through the resignation of Professor John especially in view of the necessary huddling of the men Wyllie. AT
a
.
AT
!
of the Senate of the University of Jan. 27th Dr. Edward BarclaySmith, M.A., M.D., B.C. Camb:, was appointed to theB University Chair of Anatomy at King’s College,’ London, and Dr. Edward Provan Cathcart, MD.,, Ch.B., D.Sc. Glasg., was appointed to the University . Chair of Physiology (as from April lst next)) tenable a
meeting
London held
on
at the London Hospital Medical College..
in quarters during war time. The typhoid death-rate in civil life varies from 5 per cent. to 20 per cent. ;: among armies in war time the rate is much higher, owing tothe absence of the best nursing facilities. In the South African War we lost 8022 from this disease, 19,454 wereinvalided, and 30,208 were either returned to duty or other-wise discharged. The mortality from typhoid fever in the war exceeded in number that of the men killed in action. Each?
together
____
.
1 A
report of the first lecture appeared in
p. 105.
THE LANCET of Jan.
23rd.