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MILK AND TYPHOID FEVER.
730 will receive the certificate of the Agsociation. The qualities of a really good attendant include morality, suitability, and proficiency, and only those persons who can give evidence of those three requirements will be considered eligible. This scheme will do much to elevate in the public esteem those nurses in charge of mental cases who, up to the present, carry out their arduous and dangerous duties without that sympathy and kindly consideration which have been exhibited towards other branches of the
nursing profession.
-^
MILK AND TYPHOID FEVER. DR. VINCENT, physician to the Geneva Board of Health, has just published a careful report on the typhoid epidemic which raged in that city last spring, particularly in the Quartier des Paquis. He succeeded in tracing the outbreak to the milk with which the people in general, and the inhabitants of that quarter especially, were supplied. The most culpably negligent and untidy system of cleansing the milk cans prevailed ; indeed, in one extensive dairy he saw a milkman spitting on his hands in order to lubricate them for the scouring process to which be presently subjected the insideof those receptacles. Another sourceof the mischief was found in the carelessness with which the watering of the milk was practised-any water, pure or impure, being reckoned suitable. He strenuously urges on all who wish to escape the risk of contracting typhoid to boil their milk, and to see it done themselves. Milk sold as already boiled had not, in many cases, according to his experience, been properly boiled at all. The most perfunctory methods of boiling he found in constant practice. The moment the milk began to stir in the boiler and to bubble a little it was regarded as boiling and taken off the fire ! Even had the boiling-point been adequately reached, he insists that the milk should still be kept on the fire for some minutes, if it is to be made perfectly innocuous. On the present system he thinks the microbes it is sought to destroy have every chance of surviving and of propagating their kind to increased activity. -
ACUTE ANTERIOR POLIOMYELITIS.
OPPORTUNITIES for the examination of the
spinal cord in so infrequent when they do arise. Dr. R. T. Williamson, of the Manchester Royal Infirmary, has published (Medical Chronicle for September) a of
poliomyelitis are comparatively that every advantage should be taken of them
recent
cases
detailed account of such a case, where death occurred suddenly five weeks from the commencement of symptoms. The patient was a young man, twenty-two years old, who first complained of numbness in the light hand, the feeling soon extending to the right leg and the left side, and on the third day being followed by complete paralysis of arms and legs. The knee-jerka were absent. There was no anæsthesia, and the sphincters were not involved. Rapid iiiu-scular atrophy then ensued; but he was commencing to regain somepower whendeath occurred. The lesions found by Dr. Williamson in the spinal cord may be thus summarised: In the lumbar region, a patch of cell infiltation in the outer half of each anterior horn, composed of small round leucocyte bodies and large oval or round nucleated cells. At the periphery of the patch the bloodvessels were greatly distended, and their peri-vascular sheaths full of round cells. There were no true haemorrhages. No nerve-cells were visible in the area wlich corresponded to the region of the antero-lateral, postero-lateral, and central group of ganglion cells. Such cells still existed in the inner part of the cornu, but those bordering on the patch were shrunken and deformed. The network of nerve fibres was destroyed by the infiltration, but in the white matter no degenerate fibres were seen. The contrast between the anterior and pos-
terior
nerve
roots
was
striking.
In the former the fibres
scanty, separated by cells and their myelin broken up into fragments, whilst the latter exhibited very slight were
dorsal region of the cord showed only and vascular distension in the outer of anterior the horns, where a few nerve cells were part shrunken. In the cervical region the changes were much The infiltration, as in the lumbar, but less pronounced. rather further in a here extended however, posterior direc. tion ; and, moreover, the lesions were slightly more marked in the left than in the right half. In the filum teiminale the vessels were dilated in the anterior horns, and a few nerve cells in the outer part bad their processes somewhat obscured. In all parts the changes were most marked at the point of entrance of the antero-lateral artery. Micro. organisms were sought for, but not found. Some degenerate fibres were found in the trunks of the ulnar and sciatic
changes indeed. The slight cell infiltration
nerves. __
__
THE ACCUSED IN THE DOCK. OUR contemporary, the St. James’s Gazette, has recently published an article dealing with the case of Hargan, the soldier, and commenting inter alia on the harshness of the law which requires prisoners to stand during the whole of their trial, however long it may last. But our contemporary must here be in error. Our experience is that in all trials, which are in any degree protracted the prisoner is allowed to be seated. More especially is this the case when the prisoner is a female, or when there is any physical infirmity, such as lameness. We should be the last to suggest harshness towards anyone, even prisoners, but we fail to see any great harshness in a soldier being required to stand some hours, seeing that this is an exercise to which from usage he must be inured. Are there no other persons besides the accused in the dock who have to stand eight hours a day, or even longer, with only a very short interval for the midday meal ? It is only very recently that poor shop girls have been allowed seats, and there is still room for improvement in this respect. It would be interesting to know how many hours a day dis. pensers at hospitals, at dispensaries, and in shops have to stand, almost without intermission. Learned counsel, too" who are fortunate in being frequently briefed have much standing, and do not complain of it. On the whole, it appears that the grievance alluded to is imaginary rathe-c than real. ___
AMOUNT OF SUGAR IN BLOOD IN DISEASE. DR. N. P. TRINKLER recently read before the Kharkoff Medical Society a paper on the Diagnostic Significance of the Quantity of Sugar and Reducing Substances in the Blood, in which he detailed a number of observations he had carried out on patients in Professor Grube’s surgical clinic, the majority of whom were suffering from cancer. The blood of some was taken for examination during an operation, that of the rest being only obtained after death.. The examination was in all cases made by means of two processes, that of Febling and Soxhlet and that of Knapp (Knapp’s solution consists of cyanide of mercury dissolved in caustic alkali), the mean of the two results being taken. He fonnd that the blood during life always contains less sugar than after death, and that that of persons siiffering from cancer contains a larger proportion of sugar and reducingsubb stances than that of healthy persons or of persons suffering from other diseases. Affections of internal organs appeared to be accompanied by a greater percentage of sugar in the blood than diseases of the skin or of external parts. The degree of emaciation produced by cancer did not seem to have any direct effect upon the quantity of sugar in the blood. There did not seem to be any real correspondence:
nursing profession.
-^
MILK AND TYPHOID FEVER. DR. VINCENT, physician to the Geneva Board of Health, has just published a careful report on the typhoid epidemic which raged in that city last spring, particularly in the Quartier des Paquis. He succeeded in tracing the outbreak to the milk with which the people in general, and the inhabitants of that quarter especially, were supplied. The most culpably negligent and untidy system of cleansing the milk cans prevailed ; indeed, in one extensive dairy he saw a milkman spitting on his hands in order to lubricate them for the scouring process to which be presently subjected the insideof those receptacles. Another sourceof the mischief was found in the carelessness with which the watering of the milk was practised-any water, pure or impure, being reckoned suitable. He strenuously urges on all who wish to escape the risk of contracting typhoid to boil their milk, and to see it done themselves. Milk sold as already boiled had not, in many cases, according to his experience, been properly boiled at all. The most perfunctory methods of boiling he found in constant practice. The moment the milk began to stir in the boiler and to bubble a little it was regarded as boiling and taken off the fire ! Even had the boiling-point been adequately reached, he insists that the milk should still be kept on the fire for some minutes, if it is to be made perfectly innocuous. On the present system he thinks the microbes it is sought to destroy have every chance of surviving and of propagating their kind to increased activity. -
ACUTE ANTERIOR POLIOMYELITIS.
OPPORTUNITIES for the examination of the
spinal cord in so infrequent when they do arise. Dr. R. T. Williamson, of the Manchester Royal Infirmary, has published (Medical Chronicle for September) a of
poliomyelitis are comparatively that every advantage should be taken of them
recent
cases
detailed account of such a case, where death occurred suddenly five weeks from the commencement of symptoms. The patient was a young man, twenty-two years old, who first complained of numbness in the light hand, the feeling soon extending to the right leg and the left side, and on the third day being followed by complete paralysis of arms and legs. The knee-jerka were absent. There was no anæsthesia, and the sphincters were not involved. Rapid iiiu-scular atrophy then ensued; but he was commencing to regain somepower whendeath occurred. The lesions found by Dr. Williamson in the spinal cord may be thus summarised: In the lumbar region, a patch of cell infiltation in the outer half of each anterior horn, composed of small round leucocyte bodies and large oval or round nucleated cells. At the periphery of the patch the bloodvessels were greatly distended, and their peri-vascular sheaths full of round cells. There were no true haemorrhages. No nerve-cells were visible in the area wlich corresponded to the region of the antero-lateral, postero-lateral, and central group of ganglion cells. Such cells still existed in the inner part of the cornu, but those bordering on the patch were shrunken and deformed. The network of nerve fibres was destroyed by the infiltration, but in the white matter no degenerate fibres were seen. The contrast between the anterior and pos-
terior
nerve
roots
was
striking.
In the former the fibres
scanty, separated by cells and their myelin broken up into fragments, whilst the latter exhibited very slight were
dorsal region of the cord showed only and vascular distension in the outer of anterior the horns, where a few nerve cells were part shrunken. In the cervical region the changes were much The infiltration, as in the lumbar, but less pronounced. rather further in a here extended however, posterior direc. tion ; and, moreover, the lesions were slightly more marked in the left than in the right half. In the filum teiminale the vessels were dilated in the anterior horns, and a few nerve cells in the outer part bad their processes somewhat obscured. In all parts the changes were most marked at the point of entrance of the antero-lateral artery. Micro. organisms were sought for, but not found. Some degenerate fibres were found in the trunks of the ulnar and sciatic
changes indeed. The slight cell infiltration
nerves. __
__
THE ACCUSED IN THE DOCK. OUR contemporary, the St. James’s Gazette, has recently published an article dealing with the case of Hargan, the soldier, and commenting inter alia on the harshness of the law which requires prisoners to stand during the whole of their trial, however long it may last. But our contemporary must here be in error. Our experience is that in all trials, which are in any degree protracted the prisoner is allowed to be seated. More especially is this the case when the prisoner is a female, or when there is any physical infirmity, such as lameness. We should be the last to suggest harshness towards anyone, even prisoners, but we fail to see any great harshness in a soldier being required to stand some hours, seeing that this is an exercise to which from usage he must be inured. Are there no other persons besides the accused in the dock who have to stand eight hours a day, or even longer, with only a very short interval for the midday meal ? It is only very recently that poor shop girls have been allowed seats, and there is still room for improvement in this respect. It would be interesting to know how many hours a day dis. pensers at hospitals, at dispensaries, and in shops have to stand, almost without intermission. Learned counsel, too" who are fortunate in being frequently briefed have much standing, and do not complain of it. On the whole, it appears that the grievance alluded to is imaginary rathe-c than real. ___
AMOUNT OF SUGAR IN BLOOD IN DISEASE. DR. N. P. TRINKLER recently read before the Kharkoff Medical Society a paper on the Diagnostic Significance of the Quantity of Sugar and Reducing Substances in the Blood, in which he detailed a number of observations he had carried out on patients in Professor Grube’s surgical clinic, the majority of whom were suffering from cancer. The blood of some was taken for examination during an operation, that of the rest being only obtained after death.. The examination was in all cases made by means of two processes, that of Febling and Soxhlet and that of Knapp (Knapp’s solution consists of cyanide of mercury dissolved in caustic alkali), the mean of the two results being taken. He fonnd that the blood during life always contains less sugar than after death, and that that of persons siiffering from cancer contains a larger proportion of sugar and reducingsubb stances than that of healthy persons or of persons suffering from other diseases. Affections of internal organs appeared to be accompanied by a greater percentage of sugar in the blood than diseases of the skin or of external parts. The degree of emaciation produced by cancer did not seem to have any direct effect upon the quantity of sugar in the blood. There did not seem to be any real correspondence: