- Email: [email protected]
NON-PARASITIC CHYLURIA.
288 of lupus, five of ringworm, and one of numerous lengthy cases of small-pox than by performing with excellent results. These were specially a small operation at almost gratuitous rates. At the end parasitic sycosis, remarkable in two cases of very severe lupus. Dr. Eichoff of fourteen pages of random statements, the need for a is hopeful that this remedy, which may sometimes perhaps Parliamentary Commission is urged in apparent seriousness be applied in the form of subcutaneous injections, may be and good faith, although the report of a Select Committee found useful in psoriasis, parasitic eczema, and even in of the House of Commons is set aside as having been a lepra and syphilis. He, however, warns those who propose to foregone conclusion. The article merits perusal if only to try it that it is a very powerful irritant, and that even for acquaint medical men with the tactics adopted by the outward application a strength of 1 per 1000 is quite enough. opponents of vaccination. The leading idea appears to be to hurl charges of unworthy motives against those whose deductions differ from their own. INFLUENCE OF THE ELECTRIC LIGHT ON THE EYESIGHT. PUBLIC ACCIDENTS AND PROFESSIONAL DR. DUBINSKI of Kronstadt has had an has treated five
cases
opportunity during
the last ten years of observing thirty cases of a peculiar ophthalmic affection occurring in young sailors whose duty had obliged them to remain in the vicinity of electric lights. The symptoms of this affection, which he proposes to denominate "photo-electrical ophthalmia," may occur during sleep. The patient is awakened by profuse lacrymation associated with intense peri-orbital pain. Photophobia is extreme. Nothing, however, can be seen upon examination except palpebral (jedema and peri-corneal injection of a very marked character. With the ophthalmoscope hypei’tBmia of the papilla is found, and sometimes a venous pulse in the retinal vessels. After a time varying from an hour and a half to three hours these symptoms subside and the patient is able to go to sleep, and the next morning he awakes quite well, with the exception of a certain amount of ocular fatigue such as is caused by reading late at night. Sleep appears to be an indispensable condition for the manifestation of photo-electrical ophthalmia. Thus, in the case of men who have been exposed during the morning to the electric light, when they take a midday nap the disagreeable phenomena wake them up at that time, and not during the succeeding night. Although the patient, when awake, suffers slightly from phosphenes, he is quite able to read and write during the evening. The pathological cause of symptoms above described would appear to be a hypercemia of the optic nerve and some lesion of the nervous filaments uf the cornea. ___
THE TRUTH ABOUT VACCINATION.
REMUNERATION." THE North Star of Darlington has some very apt and forcible remarks on the question of the remuneration of medical men summoned to the scene of great calamities.
They
go,
our
contemporary says, impelled by humanity,
and work for hours willingly and under very disagreeable conditions, and get very imperfectly thanked for it after all is over. It is really a public scandal that so much is required of medical men and so little is given. Every community should provide for its emergencies where private means will not avail. There is a tacit contract between a community and its medical men as regards What would be the odium if medical its calamities. men failed to respond to a cry for help at a fire, or a shipwreck, or a colliery explosion, or a railway accident? How the newspapers would ring and yell with deiiunciations of conduct so inhuman. But, as our northern contemporary suggests, there is another side to this question. The public has its debt to the medical profession, and it is a big one. It has been much ignored. We thank our confor temporary raising a question which should be raised and settled in every community. The necessity for medical service in case of an accident in the street is partly met by the power of the police to call for medical aid. But much more perfect provision for the payment of help in emergencies by night and day is needefl. Let us hope that out of our more perfect organisation of local government may arise a provision for medical emergencies and the payment of them. Where private individuals or firms can meet the obligation, well and good; but in the first instance the local authorities should be liable for medical aid as for the help of the Fire Brigade itself.
WITHOUT making any comment upon the correspondence upon vaccination which has recently appeared in our columns, it is a duty to refer to an article which is placed in the Independent Section of the tYestzinstcr -I’ evieit7. NON-PARASITIC CHYLURIA. In popular form it endeavours to answer the question, " What is the truth about vaccination’!" by what the author A SOMEWHAT anomalous case of ha’ll1ato-chyluria of a is good enough to consider " examples of the disastrous non-parasitic character is reported in / UlinÏrlllC as having consequences" arising from the practice, and by an attempt been in Prof. Desmeth’s wards in the St. Jean Hospital, to " expose some of the sophistries and fallacies by which it Brussels. The patient was a young man of thirty, who is supported." The editorial note which precedes the article attributed the commencement of his disorder to a chill. serves as some consolation to those who feel that the soAt first lie suffered from pain in the epigastrium; this was called arguments are at variance with experience, while its followed by some tenesmus of the bladder, causing him to tone of the article is likely to win sympathy for those whom pass urine thirty or forty times a day, the urine being The medical profession is broadly charged milky, and forming a solid clot on standing. This was the it attacks. with the" fraudulent intent of whitewashing vaccination third attack of the same affection from which he had through thick and thin," and the reasons for this supposed suffered. His general health was very fair. After admission action are thus given : " Vaccination has been extolled as a it was found that the character of the urine passed was masterpiece of scientific medical induction, and as thesubject to considerable variations, being at times red and greatest discovery in the history of medicine"; and it has forming a coagulum en bloc at other times milky with been singled out as the " only prescription worthy to belittle or no red tinge, and occasionally of a normal appearuniversally enforced by legislative authority.... It is obvious,ance. Sometimes these different types followed one another therefore, that the prestige of the profession, no lessin regular order, but not always. Under the microscope the than its interest, is closely associated with its perpetua-Iepithelial elements were found to be no more than normal; tion." Somewhat later it is urged that all who profit by aithere were never any casts, and, what was more remarkable, i system whichthey defend are biassed in their judgments andnever any white corpuscles, the opacity being due to the of red corpuscles and to that of fat in the form of untrustworthy, in entire forgetfulness of the fact that the presence ] I medical profession might make far larger sums by attendingexceedingly fine granules. Diet appeared to have no effect, -
289 bear no relation a in some respects similar to this, where a fismlous communication existed between the lacteals and the bladder, but, as no white corpuscles were found in this case, there may not be any real analogy between the two, though they agreed in an entire absence of filaria sanguinis or any other parasite. The only drug which appeared to exert even a slight effect was copaiba. and the "attacks of
to meal-times.
cbyluria" seemed to has reported
-
THE WORKING MEN’S CLUB AND UNION.
THE principles of self-help
INSTITUTE
and combination for mutual
benefit, characteristic of the co-operative movement, are well illustrated in the procedure of the Working Men’s Our and Institute Union. This association professes to combine and direct the energies of nearly 400 clubs throughout the country. It is supported by the subscriptions of these bodies, and managed by a council elected by them. Its functions are the following : To form a common rallying point for the members of local clubs of various kinds every where, to organise for all such a common medium of education after the school period, to encourage athletic exercise on the same system, to provide Saturday afternoon amusement in the form of visits to places of interest, to afford legal advice on club matters when required, to maintain for the use of members a circulating and a reference library, and to watch over the interests of the club movement generally. Its educational work is carried out in connexion with the Working Men’s Colle ge, and covers the more advanced subjects of a course of English reading, with others of a more technical kind. Ambulance work is not forgotten, and the number of pupils examined and passed affords encouraging evidence of the interest taken in this branch of study. Not least among the facilities afforded by the Union is the means of communication with the Emigrants’ Information office. It is thus in a position both to clieck unwise emigration and to guide workmen to colonies where there is a demand fotheir labour. The published financial statement of the Union is satisfactory. The Association, indeed, appears to be throughout in a healthy condition, and well worthy the support of industrious and enterprising workmen. In its last report there is a complaint that recent accessions to its numbers have added somewhat too much of an elem ent which cares little for its primary design of mutual help in comparison with benefit. This was only to be expected, but mere there is reason to hope that the influence of the more earnest members will not allow the old ideal to be forgotten, but will r ather train their self-seeking fellows in habits of orderly combination. The success of their efforts in this direction is clearly most desirable, and failure cannot but greatly injure the whole movement.
personal
NATURE AND TREATMENT OF DIABETIC COMA.
Sigmund
DR. 5’rnnrl,MnNN of Dorpat, in a recent article in the St. 7’MrA’c/tC JFor/’/’rAr/y7, points out the great similarity which seems to exist between the coma of diabetes and the condition produced in herbivorous animals by inducing acid intoxication. Amongst other points, he refers to some analyses by Minkowski, of the gaseous contents of the blood. In the normal condition, the blood of the rabbit contains 25 per cent. of carbonic acid; but when tlie animal is suffering from artificially induced acid intoxication, the carbonic acid is diminished. Thus in one instance Minkowski found it 1C’4 per cent. with a moderate degree of intoxication ; when the latter was increased, the percentage of carbonic acid fell further, first to 8’3 and linally to 2’9 per cent. In order to compare this with the gaseous changes in the blood of diabetics, he examined the blood of a patient before and during coma, the carbonic acid being respectively 17-0 and 3-34 per cent. In order to ascertain whether this diminution of the carbonic acid in the blood was merely due to comp. as such without to its cause, lie examined the blood of a comatose patient, not a diabetic, whose condition was due to meningitis. Here the carbonic acid amounted to 28’2 per cent. The acid existing in diabetes appears to be oxybutyric acid, which in some cases appears in the urine to the extent of something like three ounces per diem. Some years ago Dr. Stadelmann found a new acid, which he believed to be crotonic acid, in considerable quantity in certain cases. He now, however, considers it merely a substitution product from oxybutyric acid. The indications for treatment supplied by these views are of course to combat the acid by large quantities of alkali. Several attempts have been made to treat diabetic coma by injecting into the veins from one to four ounces of carbonate of soda dissolved in about pints of water, with a little chloride of sodium. In one instance, however, has this proved successful, and only unless it is done very early no good result can be fairly expected of it. It is found that the urine in twelve hours after the injection is intensely acid. Better results are to be obtained in attempting to ward ofl’ coma by giving alkalies freely. Thus Dr. Stadelmann prescribes about an ounce of tartrate or citrate of soda dissolved in about half a pint of soda-water two or three times a day, and has found great reason to be satisfied with this line of treatment. Of course, if coma should come on, lie would have recourse to alkaline intravenous injections without loss of time.
reference
four
THE I
ELECTROPATHIC AND ZANDER INSTITUTE A PROTEST. ’
WE have received another letter from " The Medical Battery "Company, Limited; C. B. Harness, Managing Director. We decline to publish any further communications from this source, and we repeat that we SINGULAR CASUALTY FROM TOOTH absolutely refuse to permit the Company in question, or EXTRACTION. its manager either, to republish or to reproduce verbatim, To the record of the numerous casualties which may or to quote from, or refer to, either of the articles which follow tooth extraction Mr. Ackery, at the Odontological have appeared in THE LANCET with reference to Dr. Zander’s Society of Great Britain, has added another probably unique system, all rights in which articles we reserve. case. A molar was extracted from a patient whilst under the influence of nitrous oxide gas; the apex of one root, ARTIFICIAL MATURATION OF CATARACT. however, was left behind. A sinus subsequently appeared, and this did not heal upon the removal of the remaining Du. PARISOTTI of hotne, in a lecture published in the portion of the tooth. Eight years after the original opera- Riforma lVTccdac;ca, describes two cases in which success tion a substance was discharged from the sinus, wl’ich appeared to follow attempts to induce artificial maturaproved upon examination to be the point of one of the jaws tion of cataract by a procedure dill’(-,ring somewhat from of a tooth forceps, which had doubtless been broken and the operations proposed by other ophthalmologists for this left in the alveolar. process at the time of the endeavour to purpose. Having produced local anesthesia by means of extract the tooth. cocaine, and having washed the eye with an antiseptic
cases
opportunity during
the last ten years of observing thirty cases of a peculiar ophthalmic affection occurring in young sailors whose duty had obliged them to remain in the vicinity of electric lights. The symptoms of this affection, which he proposes to denominate "photo-electrical ophthalmia," may occur during sleep. The patient is awakened by profuse lacrymation associated with intense peri-orbital pain. Photophobia is extreme. Nothing, however, can be seen upon examination except palpebral (jedema and peri-corneal injection of a very marked character. With the ophthalmoscope hypei’tBmia of the papilla is found, and sometimes a venous pulse in the retinal vessels. After a time varying from an hour and a half to three hours these symptoms subside and the patient is able to go to sleep, and the next morning he awakes quite well, with the exception of a certain amount of ocular fatigue such as is caused by reading late at night. Sleep appears to be an indispensable condition for the manifestation of photo-electrical ophthalmia. Thus, in the case of men who have been exposed during the morning to the electric light, when they take a midday nap the disagreeable phenomena wake them up at that time, and not during the succeeding night. Although the patient, when awake, suffers slightly from phosphenes, he is quite able to read and write during the evening. The pathological cause of symptoms above described would appear to be a hypercemia of the optic nerve and some lesion of the nervous filaments uf the cornea. ___
THE TRUTH ABOUT VACCINATION.
REMUNERATION." THE North Star of Darlington has some very apt and forcible remarks on the question of the remuneration of medical men summoned to the scene of great calamities.
They
go,
our
contemporary says, impelled by humanity,
and work for hours willingly and under very disagreeable conditions, and get very imperfectly thanked for it after all is over. It is really a public scandal that so much is required of medical men and so little is given. Every community should provide for its emergencies where private means will not avail. There is a tacit contract between a community and its medical men as regards What would be the odium if medical its calamities. men failed to respond to a cry for help at a fire, or a shipwreck, or a colliery explosion, or a railway accident? How the newspapers would ring and yell with deiiunciations of conduct so inhuman. But, as our northern contemporary suggests, there is another side to this question. The public has its debt to the medical profession, and it is a big one. It has been much ignored. We thank our confor temporary raising a question which should be raised and settled in every community. The necessity for medical service in case of an accident in the street is partly met by the power of the police to call for medical aid. But much more perfect provision for the payment of help in emergencies by night and day is needefl. Let us hope that out of our more perfect organisation of local government may arise a provision for medical emergencies and the payment of them. Where private individuals or firms can meet the obligation, well and good; but in the first instance the local authorities should be liable for medical aid as for the help of the Fire Brigade itself.
WITHOUT making any comment upon the correspondence upon vaccination which has recently appeared in our columns, it is a duty to refer to an article which is placed in the Independent Section of the tYestzinstcr -I’ evieit7. NON-PARASITIC CHYLURIA. In popular form it endeavours to answer the question, " What is the truth about vaccination’!" by what the author A SOMEWHAT anomalous case of ha’ll1ato-chyluria of a is good enough to consider " examples of the disastrous non-parasitic character is reported in / UlinÏrlllC as having consequences" arising from the practice, and by an attempt been in Prof. Desmeth’s wards in the St. Jean Hospital, to " expose some of the sophistries and fallacies by which it Brussels. The patient was a young man of thirty, who is supported." The editorial note which precedes the article attributed the commencement of his disorder to a chill. serves as some consolation to those who feel that the soAt first lie suffered from pain in the epigastrium; this was called arguments are at variance with experience, while its followed by some tenesmus of the bladder, causing him to tone of the article is likely to win sympathy for those whom pass urine thirty or forty times a day, the urine being The medical profession is broadly charged milky, and forming a solid clot on standing. This was the it attacks. with the" fraudulent intent of whitewashing vaccination third attack of the same affection from which he had through thick and thin," and the reasons for this supposed suffered. His general health was very fair. After admission action are thus given : " Vaccination has been extolled as a it was found that the character of the urine passed was masterpiece of scientific medical induction, and as thesubject to considerable variations, being at times red and greatest discovery in the history of medicine"; and it has forming a coagulum en bloc at other times milky with been singled out as the " only prescription worthy to belittle or no red tinge, and occasionally of a normal appearuniversally enforced by legislative authority.... It is obvious,ance. Sometimes these different types followed one another therefore, that the prestige of the profession, no lessin regular order, but not always. Under the microscope the than its interest, is closely associated with its perpetua-Iepithelial elements were found to be no more than normal; tion." Somewhat later it is urged that all who profit by aithere were never any casts, and, what was more remarkable, i system whichthey defend are biassed in their judgments andnever any white corpuscles, the opacity being due to the of red corpuscles and to that of fat in the form of untrustworthy, in entire forgetfulness of the fact that the presence ] I medical profession might make far larger sums by attendingexceedingly fine granules. Diet appeared to have no effect, -
289 bear no relation a in some respects similar to this, where a fismlous communication existed between the lacteals and the bladder, but, as no white corpuscles were found in this case, there may not be any real analogy between the two, though they agreed in an entire absence of filaria sanguinis or any other parasite. The only drug which appeared to exert even a slight effect was copaiba. and the "attacks of
to meal-times.
cbyluria" seemed to has reported
-
THE WORKING MEN’S CLUB AND UNION.
THE principles of self-help
INSTITUTE
and combination for mutual
benefit, characteristic of the co-operative movement, are well illustrated in the procedure of the Working Men’s Our and Institute Union. This association professes to combine and direct the energies of nearly 400 clubs throughout the country. It is supported by the subscriptions of these bodies, and managed by a council elected by them. Its functions are the following : To form a common rallying point for the members of local clubs of various kinds every where, to organise for all such a common medium of education after the school period, to encourage athletic exercise on the same system, to provide Saturday afternoon amusement in the form of visits to places of interest, to afford legal advice on club matters when required, to maintain for the use of members a circulating and a reference library, and to watch over the interests of the club movement generally. Its educational work is carried out in connexion with the Working Men’s Colle ge, and covers the more advanced subjects of a course of English reading, with others of a more technical kind. Ambulance work is not forgotten, and the number of pupils examined and passed affords encouraging evidence of the interest taken in this branch of study. Not least among the facilities afforded by the Union is the means of communication with the Emigrants’ Information office. It is thus in a position both to clieck unwise emigration and to guide workmen to colonies where there is a demand fotheir labour. The published financial statement of the Union is satisfactory. The Association, indeed, appears to be throughout in a healthy condition, and well worthy the support of industrious and enterprising workmen. In its last report there is a complaint that recent accessions to its numbers have added somewhat too much of an elem ent which cares little for its primary design of mutual help in comparison with benefit. This was only to be expected, but mere there is reason to hope that the influence of the more earnest members will not allow the old ideal to be forgotten, but will r ather train their self-seeking fellows in habits of orderly combination. The success of their efforts in this direction is clearly most desirable, and failure cannot but greatly injure the whole movement.
personal
NATURE AND TREATMENT OF DIABETIC COMA.
Sigmund
DR. 5’rnnrl,MnNN of Dorpat, in a recent article in the St. 7’MrA’c/tC JFor/’/’rAr/y7, points out the great similarity which seems to exist between the coma of diabetes and the condition produced in herbivorous animals by inducing acid intoxication. Amongst other points, he refers to some analyses by Minkowski, of the gaseous contents of the blood. In the normal condition, the blood of the rabbit contains 25 per cent. of carbonic acid; but when tlie animal is suffering from artificially induced acid intoxication, the carbonic acid is diminished. Thus in one instance Minkowski found it 1C’4 per cent. with a moderate degree of intoxication ; when the latter was increased, the percentage of carbonic acid fell further, first to 8’3 and linally to 2’9 per cent. In order to compare this with the gaseous changes in the blood of diabetics, he examined the blood of a patient before and during coma, the carbonic acid being respectively 17-0 and 3-34 per cent. In order to ascertain whether this diminution of the carbonic acid in the blood was merely due to comp. as such without to its cause, lie examined the blood of a comatose patient, not a diabetic, whose condition was due to meningitis. Here the carbonic acid amounted to 28’2 per cent. The acid existing in diabetes appears to be oxybutyric acid, which in some cases appears in the urine to the extent of something like three ounces per diem. Some years ago Dr. Stadelmann found a new acid, which he believed to be crotonic acid, in considerable quantity in certain cases. He now, however, considers it merely a substitution product from oxybutyric acid. The indications for treatment supplied by these views are of course to combat the acid by large quantities of alkali. Several attempts have been made to treat diabetic coma by injecting into the veins from one to four ounces of carbonate of soda dissolved in about pints of water, with a little chloride of sodium. In one instance, however, has this proved successful, and only unless it is done very early no good result can be fairly expected of it. It is found that the urine in twelve hours after the injection is intensely acid. Better results are to be obtained in attempting to ward ofl’ coma by giving alkalies freely. Thus Dr. Stadelmann prescribes about an ounce of tartrate or citrate of soda dissolved in about half a pint of soda-water two or three times a day, and has found great reason to be satisfied with this line of treatment. Of course, if coma should come on, lie would have recourse to alkaline intravenous injections without loss of time.
reference
four
THE I
ELECTROPATHIC AND ZANDER INSTITUTE A PROTEST. ’
WE have received another letter from " The Medical Battery "Company, Limited; C. B. Harness, Managing Director. We decline to publish any further communications from this source, and we repeat that we SINGULAR CASUALTY FROM TOOTH absolutely refuse to permit the Company in question, or EXTRACTION. its manager either, to republish or to reproduce verbatim, To the record of the numerous casualties which may or to quote from, or refer to, either of the articles which follow tooth extraction Mr. Ackery, at the Odontological have appeared in THE LANCET with reference to Dr. Zander’s Society of Great Britain, has added another probably unique system, all rights in which articles we reserve. case. A molar was extracted from a patient whilst under the influence of nitrous oxide gas; the apex of one root, ARTIFICIAL MATURATION OF CATARACT. however, was left behind. A sinus subsequently appeared, and this did not heal upon the removal of the remaining Du. PARISOTTI of hotne, in a lecture published in the portion of the tooth. Eight years after the original opera- Riforma lVTccdac;ca, describes two cases in which success tion a substance was discharged from the sinus, wl’ich appeared to follow attempts to induce artificial maturaproved upon examination to be the point of one of the jaws tion of cataract by a procedure dill’(-,ring somewhat from of a tooth forceps, which had doubtless been broken and the operations proposed by other ophthalmologists for this left in the alveolar. process at the time of the endeavour to purpose. Having produced local anesthesia by means of extract the tooth. cocaine, and having washed the eye with an antiseptic