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LARGE FAMILIES AMONG THE POOR.
1567 open to doubt, and there is always the danger of still further hampering respiration and circulation by compressing one or other lung in that posture when the patient is very heavy, especially when emphysema is present. The initial use of gas and ether in this case may be adversely criticised by some but it certainly possessed the advantage-an important one in the present instance-of avoiding the stage of excitement so common when chloroform is used in the induction of anaesthesia. Probably had the development of cyanosis been foreseen the brief operation would have been conducted under nitrous oxide gas mixed with oxygen, which answers well in short cases, although it must be admitted that it is not an ideal anaesthetic for such persons as the patient is described to have been in the case in
question.
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LARGE FAMILIES AMONG THE POOR. an inquest held on Dec. Bethnal-green on the body of
2nd by Dr. Wynn Westcott an infant found dead in bed the mother of the deceased mentioned that she had fifteen children. The coroner remarked that he could not understand how it was that the poor managed to keep such large families, whereupon a juror remarked : "One or two don’t make no difference. Some grow up and help to keep the others." After all, there may be more sound sense in this argument than might at first sight be supposed. Everyone who has any experience of work among poor people knows how kind the poor are in taking in an extra child for nothing very often, and sometimes for a small weekly payment. We do not, of course, refer to baby farmers, but as a matter of fact the charity of the poor to one another is above all praise, and so perhaps the large family may not be so undesirable after all. The great difficulty in connexion with such is not so much clothing or feeding but proper house-room, and to find this with the exorbitant rents which are being daily demanded in London is almost impossible. AT
at
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THE ANNUAL REPORT OF THE ARMY VETERINARY DEPARTMENT. THE usual annual report of the Army Veterinary Departrecently been completed by the Director-General, Veterinary-Colonel Duck, C.B., F.R.C.V.S. It consists of a general summary of the diseases met with amongst the army horses and transport animals at home and abroad. In the Home Department the number of patients amounted to 65-12 per cent. of the average strength, being greatest in the Army Service Corps which has the Young Horse Depot attached to it and lowest in the Military Police. It was noticed, as has been the case before, that the percentage of admissions to treatment was higher in horses about four or five years of age than in those of more mature years. It is a matter of great congratulation to know that glanders is still absent. One suspicious case occurred amongst the animals at Shorncliffe in November, 1897, but a careful post-mortem examination and the use of the mallein test amongst the in-contact horses demonstrated beyond dispute that the disease was not glanders. In Egypt, from which country the report is made by the senior veterinary officer, Veterinary Captain Blenkinsop, the absence of glanders is also noted, although 69 cases of this disease were reported by the Egyptian civil authorities. The Government stables, however, had a narrow escape from becoming a centre of contagion, as a private pony standing in one of them showed suspicious symptoms and after reacting to mallein was destroyed, the necropsy confirming the existence of the disease. All the animals in the same stable were promptly tested, but none reacted and the disease has not again reappeared. Veterinary - Captain remount horses and mules that Blenkinsop suggests as ment has
from Syria, where glanders exists to cor.s’d( rable extent, all animals should be tested before being admitted to the troop stable. In South’Africa out. breaks of glanders occurred at Etchowe or Pietermaritzburg. Mallein was employed and all animals which reacted were destroyed. Every precaution was adopted and the disease appears by the last reports to be stamped out. Mortality from horse sickness " was very heavy and an unusually large number (no less than 119) of animals died from colic due to the ingestion of large quantities of sand. The latter cases occurred at Ladysmith, where the animals were picketted out in the open on a sandy soil which they continually licked, the sand accumulating in the intestine and causing complete obstruction. In the Army Veterinary School the usual classes were held for officers and farriers, examinations being held and certificates granted to those who were successful. From the Vaccine Institute lymph was issued for 71,103 people, the average yield from each calf being sufficient for 4345’25 persons, the total expenses for the year, including cost of calves, instruments, &c., being only .891 9s. 3d. Lymph is now supplied from here to the navy as well as to the army, a request to that effect having been received from the Admiralty. are
largely obtained
some
BILATERAL ACUTE LABYRINTHITIS. IN the Intercolonial Medical Journal of A1tstralasia of Oct. 20th Dr. Percy Webster relates a case of this very rare disease. A healthy lad, aged ten years, one day looked pale and ill. He vomited, became delirious and complained of pain in the head ; he had to be held down in the bed. The acute delirium lasted 11 hours, after which he was quiet but lay muttering. He called out with pain when touched; moving the limbs seemed to cause great suffering. At times he would lie with his back arched and his head retracted. He He had was ill for about two months and became very thin. at times and after his recovery staggered giddiness especially in the dark. Deafness was noticed before he recovered from the delirium and remained permanent ; it was total both for bone and aerial conduction. He complained of pain and constant buzzing in his ears. The fundi were normal, the knee-jerks were active, and there was neither ankle clonus nor paralysis. As the history was only obtained from his friends it was impossible to say whether the labyrinthitis was primary, or associated with meningitis, pneumonia, typhoid fever, or one of the exanthems, or whether it was secondary to otitis media. -
THE PURPURA OF CHILDHOOD, AT the recent Congress on Gynaecology, Obstetrics, and Diseases of Children, held in Marseilles, Dr. Leon Perrin discussed the pathological significance of purpura in children. This term, he reminds us, no longer stands for the name of a disease but of a symptom. The condition of blood-stasis which it denotes, whether merely an intense congestion with capillaries unruptured or a true extravasa" tion, is in the great majority of cases due to an infective process-a toxaemia. Even the rheumatic variety, he maintains, ought to be relegated to the same series as those of obviously septic origin as being also toxic, though by means of a different toxin. Purpuras associated with syphilis, with the eruptive and other infectious fevers, with septic pleurisies and pneumonias, are necessarily of this character. In the same connexion a reference to two cases in which the presence of staphylococci was demonstrated in the blood is interesting. Dr. Perrin also quotes the observations of de Boeck-Renher, Hutinel, Le Gendre, and others to prove the frequency with which the tonsil serves as the chief point of entrance for the germs of disease. But whether this gland, or the skin, or the gastro-intestinal canal provides ^ the nidus, the later action of toxic products
question.
-
LARGE FAMILIES AMONG THE POOR. an inquest held on Dec. Bethnal-green on the body of
2nd by Dr. Wynn Westcott an infant found dead in bed the mother of the deceased mentioned that she had fifteen children. The coroner remarked that he could not understand how it was that the poor managed to keep such large families, whereupon a juror remarked : "One or two don’t make no difference. Some grow up and help to keep the others." After all, there may be more sound sense in this argument than might at first sight be supposed. Everyone who has any experience of work among poor people knows how kind the poor are in taking in an extra child for nothing very often, and sometimes for a small weekly payment. We do not, of course, refer to baby farmers, but as a matter of fact the charity of the poor to one another is above all praise, and so perhaps the large family may not be so undesirable after all. The great difficulty in connexion with such is not so much clothing or feeding but proper house-room, and to find this with the exorbitant rents which are being daily demanded in London is almost impossible. AT
at
-
THE ANNUAL REPORT OF THE ARMY VETERINARY DEPARTMENT. THE usual annual report of the Army Veterinary Departrecently been completed by the Director-General, Veterinary-Colonel Duck, C.B., F.R.C.V.S. It consists of a general summary of the diseases met with amongst the army horses and transport animals at home and abroad. In the Home Department the number of patients amounted to 65-12 per cent. of the average strength, being greatest in the Army Service Corps which has the Young Horse Depot attached to it and lowest in the Military Police. It was noticed, as has been the case before, that the percentage of admissions to treatment was higher in horses about four or five years of age than in those of more mature years. It is a matter of great congratulation to know that glanders is still absent. One suspicious case occurred amongst the animals at Shorncliffe in November, 1897, but a careful post-mortem examination and the use of the mallein test amongst the in-contact horses demonstrated beyond dispute that the disease was not glanders. In Egypt, from which country the report is made by the senior veterinary officer, Veterinary Captain Blenkinsop, the absence of glanders is also noted, although 69 cases of this disease were reported by the Egyptian civil authorities. The Government stables, however, had a narrow escape from becoming a centre of contagion, as a private pony standing in one of them showed suspicious symptoms and after reacting to mallein was destroyed, the necropsy confirming the existence of the disease. All the animals in the same stable were promptly tested, but none reacted and the disease has not again reappeared. Veterinary - Captain remount horses and mules that Blenkinsop suggests as ment has
from Syria, where glanders exists to cor.s’d( rable extent, all animals should be tested before being admitted to the troop stable. In South’Africa out. breaks of glanders occurred at Etchowe or Pietermaritzburg. Mallein was employed and all animals which reacted were destroyed. Every precaution was adopted and the disease appears by the last reports to be stamped out. Mortality from horse sickness " was very heavy and an unusually large number (no less than 119) of animals died from colic due to the ingestion of large quantities of sand. The latter cases occurred at Ladysmith, where the animals were picketted out in the open on a sandy soil which they continually licked, the sand accumulating in the intestine and causing complete obstruction. In the Army Veterinary School the usual classes were held for officers and farriers, examinations being held and certificates granted to those who were successful. From the Vaccine Institute lymph was issued for 71,103 people, the average yield from each calf being sufficient for 4345’25 persons, the total expenses for the year, including cost of calves, instruments, &c., being only .891 9s. 3d. Lymph is now supplied from here to the navy as well as to the army, a request to that effect having been received from the Admiralty. are
largely obtained
some
BILATERAL ACUTE LABYRINTHITIS. IN the Intercolonial Medical Journal of A1tstralasia of Oct. 20th Dr. Percy Webster relates a case of this very rare disease. A healthy lad, aged ten years, one day looked pale and ill. He vomited, became delirious and complained of pain in the head ; he had to be held down in the bed. The acute delirium lasted 11 hours, after which he was quiet but lay muttering. He called out with pain when touched; moving the limbs seemed to cause great suffering. At times he would lie with his back arched and his head retracted. He He had was ill for about two months and became very thin. at times and after his recovery staggered giddiness especially in the dark. Deafness was noticed before he recovered from the delirium and remained permanent ; it was total both for bone and aerial conduction. He complained of pain and constant buzzing in his ears. The fundi were normal, the knee-jerks were active, and there was neither ankle clonus nor paralysis. As the history was only obtained from his friends it was impossible to say whether the labyrinthitis was primary, or associated with meningitis, pneumonia, typhoid fever, or one of the exanthems, or whether it was secondary to otitis media. -
THE PURPURA OF CHILDHOOD, AT the recent Congress on Gynaecology, Obstetrics, and Diseases of Children, held in Marseilles, Dr. Leon Perrin discussed the pathological significance of purpura in children. This term, he reminds us, no longer stands for the name of a disease but of a symptom. The condition of blood-stasis which it denotes, whether merely an intense congestion with capillaries unruptured or a true extravasa" tion, is in the great majority of cases due to an infective process-a toxaemia. Even the rheumatic variety, he maintains, ought to be relegated to the same series as those of obviously septic origin as being also toxic, though by means of a different toxin. Purpuras associated with syphilis, with the eruptive and other infectious fevers, with septic pleurisies and pneumonias, are necessarily of this character. In the same connexion a reference to two cases in which the presence of staphylococci was demonstrated in the blood is interesting. Dr. Perrin also quotes the observations of de Boeck-Renher, Hutinel, Le Gendre, and others to prove the frequency with which the tonsil serves as the chief point of entrance for the germs of disease. But whether this gland, or the skin, or the gastro-intestinal canal provides ^ the nidus, the later action of toxic products