- Email: [email protected]
NUSSBAUM'S STEAM ATOMISER.
564 outlawed
leucocyte. The variously named, wandering, amœboid, lymph or pus cell was found to have more extensive and far-reaching functions than its more ruddy and
New Invention.
Its embryonal affinities. pathological neoplasms, once NUSSBAUM’S STEAM ATOMISER. recognised, shed abundant light upon our previously obscure THIS is a simple form of the ordinary spray producer used knowledge of the nature of new growths. Moreover, it was in many hospitals for antiseptic surgery. The instrument found that through the microscope on a warm stage, its could be studied with as much precision consists of a copper spirit lamp and a copper boiler, separated omnivorous tastes as the feeding of gold-fish in an aquarium or the ducks in by a cylindrical framework of perforated tin, to which a the park. Particles of cinnabar, aniline blue, the corpses of handle is attached. On applying the heat to the boiler the defunct red corpuscles were found not to come amiss to the steam is conducted along a tube about an inch and a half ingestion of the living leucocyte, and thus prepared the way for the belief that it would not prove more long, which meets another tube at right angles proceeding fastidious when bacteria were served to it as food. from a glass jar containing some medicated solution. At Metchnikoff claims to have shown that the immunity the point of junction there is an aperture through which of the frog to anthrax under ordinary circumstances is. the steam passes, so small as to produce a fine spray. The due to phagocytic action of its leucocytes. Ruffer main. idea is a good one, although simple, and is at least an tains "that the inflammatory process consecutive to the advance on the ancient tin kettle vaporiser, which many introduction of the bacilli of quarter evil under the guineapig’s skin is a protective process, and serves a useful purpose," owing to the phagocytic action of amœboid cells. more numerous
and
blood relatives.
consequent reference
to
Tchistovitch claims to have demonstrated
a similar action the parts of the lymph cells in the lungs when bacilli were introduced into the air passages. Of course, a wide generalisation has been constructed upon these somewhat restricted premisses, and the daily and weekly press, in accord with that "vulgarisation of medical science" which has received your severe condemnation, have waxed eloquent over the "new battle of life" waged between the defending army of leucocytes and the invading hosts of hostile bacteria. Without accepting unduly the considerations set forth, it may be instructive to inquire whether the means of defence at the command of the animal body against noxious agencies from without do not cut the ground from under the feet of the rigid antisepticist who seeks salvation from without rather than from within, who insists with painful solicitude on the mint and anise, or the thymol and eucalyptus. of antiseptic dressings, while subordinating to a lower place the weightier matters of healthy blood and normal nutrition. It would now appear that " healthy living tissues,"’ "organising blood-clot or lymph," and "normal serum" have powerful anti-bacteric properties ; that the lowly leucocyte can wage a smart single-handed combat against a multitude of bacilli ; and-even " that the inflammation ex. cited by the microbe becomes, through the medium of the leucocytes, the cause of its destruction." Indeed, we may conclude that, considering the successful war daily waged by the living body upon organisms which enter at every breath, are swallowed at every meal and thrive upon thesurface of the skin, it would be fair to accord to living tissue and living blooo, in health states, a high position as a most innocuous antiseptic. The successful, most subtle, spray is accordingly abandoned by its author, since "floatin our surgical ing particles in the air may be work," and its use was based on an assumption of its destruction of air-borne germs which is admittted to be " physically impossible." Why water-borne germs should be deemed to be worthy of more regard is less obvious. Can they more successfully baffle the phagocytes. than the bacterium lurking in unsterilised ligatures 1/30 inch in diameter ? For this is the explanation vouchsafed for aseptic results when non-antiseptic ligatures are used. The more the phagocyte theory and the resistent power of living tissues to putrefaction are emphasised, the more impossible will it be to maintain " antisepticismas apart instead of a part of " asepticism." To maintain that the two differ toto cœlo, while insisting that the former term includes inter alia free ventilation, dependent openings, the dry dressings of MeVail, and "the judicious selection of cases for operation," while it may exclude the spray, carbolic acid, and possibly irrigation of the wound and drainage, is. to sacrifice comprehensibility to comprehensiveness. The flood-tide of cleanly surgery which set in between 1865. and 1875 carried " Listerismon the crest of the wave, and all practical surgeons are grateful for the work its author has done in drawing attention to chemical means of prevention of putrefaction, no less than for his more recent researches, which tend to show how much the living tissues. can perform in the same direction for themselves. I am. Sirs, vours faithfully. W. J. COLLINS, M.S., M.D. Lond. Reform Club, Aug. 21st, 1890. on
practitioners, despite the progress of the age, use at the present day. It is smaller, but, as it requires to be held in a vertical position, it cannot be so accurately adjusted to suit the position of the patient. Two modifications we would also suggest-namely, the addition of some arrangement for extinguishing the spirit lamp when it is not in a means of tightening the safety valve when more is pressure required from the spray producer. On the whole, it will be found a most useful article to both practitioner and patient.
use, and
_____________
THE LEUCOCYTE AS THE SURGEON’S FRIEND. To the Editors of THE LANCET. should SIRS,—It always be agreeable to make an amende honorable to one whom we have unwittingly injured or thought meanly of through ignorance. The humble station of the individual injured should not interfere with the bona fides of our act of reparation. If the researches of Metchnikoff, of Tchistovitcb, and Ruffer, to which Sir Joseph Lister gave such prominence at Berlin, are unambiguous, it would seem that we must learn to think better of the lowly leucocyte, and in the rule of a phagocyte welcome it as the surgeon’s friend. Of late years, it has much exercised the mind of the physiologist, the white corpuscle has encountered mostly obloquy at the hands of the surgeon. As the essential constituent of pus, its presence was accounted undesirable; the tendency to suppuration was proclaimed to be a world-wide baneful epidemic (Hueter), and an elaborate system of precautions was devised to secure deliverance therefrom. How to get rid of pus, to prevent its formation, to evacuate it early, to anticipate routes for its removal, to substitute a simple serous discharge, have been the problems which have engaged some of the best surgical thought of the last twenty years. Meanwhile the physiologist has patiently studied the sources, the habits, the modes of propagation, and even the appetites of the lowly, and the --
though
and most
disregarded
from
surely
leucocyte. The variously named, wandering, amœboid, lymph or pus cell was found to have more extensive and far-reaching functions than its more ruddy and
New Invention.
Its embryonal affinities. pathological neoplasms, once NUSSBAUM’S STEAM ATOMISER. recognised, shed abundant light upon our previously obscure THIS is a simple form of the ordinary spray producer used knowledge of the nature of new growths. Moreover, it was in many hospitals for antiseptic surgery. The instrument found that through the microscope on a warm stage, its could be studied with as much precision consists of a copper spirit lamp and a copper boiler, separated omnivorous tastes as the feeding of gold-fish in an aquarium or the ducks in by a cylindrical framework of perforated tin, to which a the park. Particles of cinnabar, aniline blue, the corpses of handle is attached. On applying the heat to the boiler the defunct red corpuscles were found not to come amiss to the steam is conducted along a tube about an inch and a half ingestion of the living leucocyte, and thus prepared the way for the belief that it would not prove more long, which meets another tube at right angles proceeding fastidious when bacteria were served to it as food. from a glass jar containing some medicated solution. At Metchnikoff claims to have shown that the immunity the point of junction there is an aperture through which of the frog to anthrax under ordinary circumstances is. the steam passes, so small as to produce a fine spray. The due to phagocytic action of its leucocytes. Ruffer main. idea is a good one, although simple, and is at least an tains "that the inflammatory process consecutive to the advance on the ancient tin kettle vaporiser, which many introduction of the bacilli of quarter evil under the guineapig’s skin is a protective process, and serves a useful purpose," owing to the phagocytic action of amœboid cells. more numerous
and
blood relatives.
consequent reference
to
Tchistovitch claims to have demonstrated
a similar action the parts of the lymph cells in the lungs when bacilli were introduced into the air passages. Of course, a wide generalisation has been constructed upon these somewhat restricted premisses, and the daily and weekly press, in accord with that "vulgarisation of medical science" which has received your severe condemnation, have waxed eloquent over the "new battle of life" waged between the defending army of leucocytes and the invading hosts of hostile bacteria. Without accepting unduly the considerations set forth, it may be instructive to inquire whether the means of defence at the command of the animal body against noxious agencies from without do not cut the ground from under the feet of the rigid antisepticist who seeks salvation from without rather than from within, who insists with painful solicitude on the mint and anise, or the thymol and eucalyptus. of antiseptic dressings, while subordinating to a lower place the weightier matters of healthy blood and normal nutrition. It would now appear that " healthy living tissues,"’ "organising blood-clot or lymph," and "normal serum" have powerful anti-bacteric properties ; that the lowly leucocyte can wage a smart single-handed combat against a multitude of bacilli ; and-even " that the inflammation ex. cited by the microbe becomes, through the medium of the leucocytes, the cause of its destruction." Indeed, we may conclude that, considering the successful war daily waged by the living body upon organisms which enter at every breath, are swallowed at every meal and thrive upon thesurface of the skin, it would be fair to accord to living tissue and living blooo, in health states, a high position as a most innocuous antiseptic. The successful, most subtle, spray is accordingly abandoned by its author, since "floatin our surgical ing particles in the air may be work," and its use was based on an assumption of its destruction of air-borne germs which is admittted to be " physically impossible." Why water-borne germs should be deemed to be worthy of more regard is less obvious. Can they more successfully baffle the phagocytes. than the bacterium lurking in unsterilised ligatures 1/30 inch in diameter ? For this is the explanation vouchsafed for aseptic results when non-antiseptic ligatures are used. The more the phagocyte theory and the resistent power of living tissues to putrefaction are emphasised, the more impossible will it be to maintain " antisepticismas apart instead of a part of " asepticism." To maintain that the two differ toto cœlo, while insisting that the former term includes inter alia free ventilation, dependent openings, the dry dressings of MeVail, and "the judicious selection of cases for operation," while it may exclude the spray, carbolic acid, and possibly irrigation of the wound and drainage, is. to sacrifice comprehensibility to comprehensiveness. The flood-tide of cleanly surgery which set in between 1865. and 1875 carried " Listerismon the crest of the wave, and all practical surgeons are grateful for the work its author has done in drawing attention to chemical means of prevention of putrefaction, no less than for his more recent researches, which tend to show how much the living tissues. can perform in the same direction for themselves. I am. Sirs, vours faithfully. W. J. COLLINS, M.S., M.D. Lond. Reform Club, Aug. 21st, 1890. on
practitioners, despite the progress of the age, use at the present day. It is smaller, but, as it requires to be held in a vertical position, it cannot be so accurately adjusted to suit the position of the patient. Two modifications we would also suggest-namely, the addition of some arrangement for extinguishing the spirit lamp when it is not in a means of tightening the safety valve when more is pressure required from the spray producer. On the whole, it will be found a most useful article to both practitioner and patient.
use, and
_____________
THE LEUCOCYTE AS THE SURGEON’S FRIEND. To the Editors of THE LANCET. should SIRS,—It always be agreeable to make an amende honorable to one whom we have unwittingly injured or thought meanly of through ignorance. The humble station of the individual injured should not interfere with the bona fides of our act of reparation. If the researches of Metchnikoff, of Tchistovitcb, and Ruffer, to which Sir Joseph Lister gave such prominence at Berlin, are unambiguous, it would seem that we must learn to think better of the lowly leucocyte, and in the rule of a phagocyte welcome it as the surgeon’s friend. Of late years, it has much exercised the mind of the physiologist, the white corpuscle has encountered mostly obloquy at the hands of the surgeon. As the essential constituent of pus, its presence was accounted undesirable; the tendency to suppuration was proclaimed to be a world-wide baneful epidemic (Hueter), and an elaborate system of precautions was devised to secure deliverance therefrom. How to get rid of pus, to prevent its formation, to evacuate it early, to anticipate routes for its removal, to substitute a simple serous discharge, have been the problems which have engaged some of the best surgical thought of the last twenty years. Meanwhile the physiologist has patiently studied the sources, the habits, the modes of propagation, and even the appetites of the lowly, and the --
though
and most
disregarded
from
surely