ON CERTAIN MENTAL AND NERVOUS DISTURBANCES DUE TO THE USE OF TRIONAL.

1290 to whether if the prayer and the oil had caused cessation of years and he was surprised to find that a very large number pain there would have been evidence of this cessation of of class medallists and demonstrators had gone into the pain discoverable after death (to which he naturally receivedt home and Indian service and that the professional status of doubt genuinelyr the men sent into the medical service of the army was a negative answer), and he was no imbued with a fanatical belief in the righteousness of! quite as good as any corresponding number of men sent into his conduct In the end, however, the jury convictedl any other professional walk in life in the world." A number and a him fine of £20 was imposed and promptly of volunteer medical officers took part in the discussion and while the female prisoner, his wife, was boundI many resolutions were passed, but the little pamphlet paid, over to come up for judgment if called upon, Mr. requires to be read in extenso, for it does not readily lend i itself to analysis and criticism within a reasonable compass. Justice Pbillimore being of opinion that a more severe sentence would introduce an element of religious martyrdom into the proceedings. On the other hand, the danger of THE BIRMINGHAM CONSULTATIVE MEDICAL AND sentences being too light in such cases arises from the fact SURGICAL INSTITUTION. that it is an advantage to some parents to be able to get IN our issue of April 27th, p. 1223, we noted that rid of their children, and that the risk of being fined may the Birmingham Consultative Medical and Surgical Insti. be worth incurring by people who may have no other motive had determined to advertise for two medical tution for being "peculiar" than the desire to diminish their in the place of Dr. H. Ward Irvine. We learn men responsibilities with impunity. Whether an "elder" would from the Birmingham Gazette of April 29th that the detect such a motive and refuse to be called in by converts received a large number of answers from committee of this description we cannot say. At present the children practitioners all over the country. The fully-qualified of the Peculiar People do not constitute a large class, but were not satisfied with this response committee, however, none the less deserve that the to they dangers which they and they are now advertising for a physician, a surgeon, an are exposed should be seriously considered. oculist, an ear and throat specialist, and a gynaecologist. Again we wait with interest the result of the advertisement. r

.

REORGANISATION OF THE MEDICAL SERVICES OF THE AUXILIARY FORCES AND OF THE ARMY MEDICAL RESERVE.

WE have received a copy of the proceedings of the Conference on the Re-organisation of the Medical Services of the Auxiliary Forces and of the Army Medical Reserve, held on Dec. 19th, 1900, under the presidency of Professor Thomas Annandale, F.R.C.S. Edin., in which Professor Chiene and a number of officers of the volunteer forces, yeomanry, and volunteer medical staff corps took part. The conference was arranged by the East of Scotland Tactical Society. We are very glad to see that ’a movement of this kind has been started because the more light that is thrown upon the subject of medical aid in modern warfare and the more people are interested and the matter is discussed the better. The chairman opened the proceedings by adverting to the experience of the South African War and by giving a preliminary sketch of the objects which the society had in view and, as a teacher in an important medical school, he offered some remarks upon the training and position of the members of the Royal Army Medical Corps. He said that the members of that corps and the civil surgeons connected with them had done their duty nobly, and it was not with them that there was any dissatisfaction, there was, however, a general desire to assist the Government by carefully considered suggestions for the improvement and reform of the medical services of the regular army and reserve forces. The report of the Royal Commission on the Hospitals in South Africa not having been published, however, at the time the chairman and those taking part in the conference were labouring under the disadvantage of not knowing how matters stood. Professor Chiene remarked that if the civil surgeons who were to assist in time of war were to be apart from the volunteers then he held "a strong view that it should be an Imperial force, and that in the old country and in the colonies there should be men and women chosen for their special knowledge in the treatment of disease and injury, in the prevention of disease, and in the nursing of the sick. It appears to me that every hospital in the country should be asked to supply men as physicians and surgeons." We are glad to notice that Surgeon-Captain Hepburn, Edinburgh Company, Volunteer Medical Staff men who enter the Army Medical time ago he took the trouble to look up the statistics of Edinburgh University for the last 15

Corps, speaking

of the

Services, said that

some

SANITATION OF CHURCHES. ACCORDING to the Revue Scientifique of April 27th one of the Italian bishops, Monsignor Franceschini, has sent to the clergy of his diocese a circular enjoining them to adopt sundry sanitary precautions in their churches. Immediately after saints’ days, when the congregations have been large, the paved floors are to be cleansed with sawdust soaked in a solution of corrosive sublimate (1 in 1000). On ordinary occasions the floors are to be frequently swept, after a preliminary sprinkling with water in order to avoid raising dust. Every week or oftener the seats and confessional boxes are to be dusted with damp sponges and cloths. Every week or oftener the grilles of the confessi mal boxes are to be cleansed with alkaline lye and afterwards polished. The holy water fonts are to be emptied every week, or oftener if necessary, and washed either with boiling alkaline lye or with solution of corrosive sublimate (1 in 1000). Our readers will remember that THE LANCET of Jan. 27th, 1900, p. 252, contained a description of a new font for holy water devised by Mr. J. J. Bruns of Arnhem in Holland, and approved by the Archbishop of Utrecht. It is pleasing to find the clergy thus careful of the bodily as well as of the spiritual health of their people. -

ON

CERTAIN

MENTAL AND NERVOUS DISTURBANCES DUE TO THE USE OF TRIONAL.

TRIONAL is now largely used as a hypnotic and cerebral sedative in various forms of nervous and mental ailments and thus the following case, which illustrates certain rare but important sequel following its use, has a special interest. Dr. Stuart Hart of New York refers to it in an article in the American Journal of the Medical Sciences for April. The case was that of a woman, aged 50 years, who for a period of 20 years was a sufferer from nervous depression, gastric dyspeptic troubles, and insomnia. She was apparently free From organic disease. For two months she had been taking trional at the rate of 15 grains every alternate day. At the end of that time (April 20th, 1899) she somewhat suddenly developed symptoms of acute gastro-intestinal irritationviz., severe colicky pain, nausea, and vomiting. She was unable to retain food taken by the mouth, and only rectal feeding was possible. The trional was stopped and morphia was given hypodermically to allay the pain.

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Hmmatoporphyrinuria next followed ; a little albumin and a few granular casts appeared in the urine, and she began to suffer from cardiac disturbance and exhibited systolic and diastolic murmurs. The nervous disturbance took the form of peripheral neuritis leading to foot-drop and wristdrop on the left side, and subsequently on the right side. These symptoms of extensor paralysis were preceded by tingling and pricking sensations about the vulva, the hands, and the feet. The symptoms of hsematolysis and renal disease above referred to were soon followed by those of cerebral toxæmia—viz., periods of delirium, mental confusion, and hallucinations of time and was complicated space. The pain in the extremities " with pains and "girdle-sensations" in the abdomen which became severe. The skin generally was so hypersesthetic that she could not tolerate the pressure of the bedclothes. She lost flesh for the next few weeks, and had slight oedema of the ankles and considerable physical weakness. All these symptoms, however, gradually subsided and The in the course of 12 months she quite recovered. nervous troubles passed away in the order in which they appeared-viz., first the disturbances of the vagus and the heart, next the neuritis affecting the hand and foot on the leftside, and lastly that of the hand and foot on the right side. The heart returned to the normal condition, leaving no trace of valvular disease or enlargement, and the mental condition was unimpaired, all traces of the hallucinations having completely passed away.

utterly neglected and devoid of any scientific manageor control ; finally, it became of world-wide renown at the beginning of the last century, chiefly on account of the scientific labours and able management of Philip Gili, who for a period extending over 30 years was its director. Alter the death, however, of Gili, which occurred in 1821, it. again became quite disorganised. All the instruments and records were dispersed and the observatory itself was entirely was

ment

deserted both as regards the scientific and social interests attached to it. In 1888 the Vatican Observatory commenced. a new epoch in its history. In that year, as already mentioned, the commemoration of the fiftieth anniversary of the priesthood of Pope Leo XIII. took place, and on that occasion all the instruments and apparatus given by members of the Roman Catholic Church interested in celestial and terrestrial physics were brought together, and it then occurred to the organisers of the science section of the Vatican Exposition that they would find a. suitable home in the old Gregorian tower. The suggestion was warmly approved and soon carried into effect and Father Denza, a great friend of Secchi, was now called. upon to undertake the management of the revived observatory. He began his work in 1889 with a very interesting and varied programme which he and his able assistantshave well carried out. The investigations which were thusintroduced there relate to meteorology, terrestrial magnetism,. astronomy, and lastly geodynamics. In addition, the building is well situated for meteorological researches andobservations; moreover, it is well equipped with the most modern instruments necessary for the continuous record of ASTRONOMY AT THE VATICAN. meteorological data. Since 1889 it has always kept well IT is reported that an American citizenand a member apace with the times and would now bear comparison with of the Roman Catholic Church, who is much interested any observatory in Europe. in celestial and terrestrial physics, has made what he, calls a humble offering to the Pope in the shape of a OTITIS AND CEREBRO-SPINAL MENINGITIS. telescope which is said to exceed greatly in size even the MORE or less localised meningitis has long been a wellHis one shown at the Paris Exhibition of last year. Holiness is stated to have accepted the gift, which is now recognised sequel of otitis media, but diffuse affection of the destined to find a prominent place amongst the many cerebral and spinal meninges-cerebro-spinal meningitisvaluable instruments of research of the Vatican Observatory has not received much attention. At the meeting of the which was presented just over a century ago by Cardinal Société Médical des Hôpitaux of Paris on Feb. lst M. Zelada with the then famous Dollond’s telescope. In Lermoyez reported two cases which showed that aural infecconnexion with this statement it may be of interest tion, even when slight, might give rise to cerebro-spinal to note that a very erroneous notion generally prevails meningitis by creating a means of entry for the meningowith regard to the original development of the Vatican coccus. More recently, at the meeting on March 8th, Observatory and that usually a quite recent date is assigned M. Vaquez and M. Ribierre described the following A woman, aged 37 years, entered hospital on to it, though it would appear to be the oldest of its kind, case. Three weeks before, while in good with the exception, probably, of the one at Peking. It is Feb. 13th, 1901. true that the Vatican Observatory in its present outward health, she commenced to feel acute pains in the occipital appearance and constitution only dates back to 1888, the region which for three or four days were without year in which Pope Leo XIII. celebrated the fiftieth respite. Then the pains in the head diminished and pains anniversary of his priesthood. But there seems to be in the lumbar spine, which radiated into the buttocks, scarcely any doubt that an observatory tower was erected the lower part of the abdomen, and the upper part of Since June, 1900, she had had in Rome as far back as some time previous to 1582 and, as the thighs, appeared. it would appear, chiefly in connexion with the reform right purulent otitis which followed influenza. For several of the Calendar. According to B. Crescenzi, the author weeks there had been mental symptoms-depression amountof the important work which is entitled "Nautica ing almost to melancholia, defective attention, and slight. Mediterranea," and which was published in Rome in 1607, amnesia. On admission the discharge was slight but very Pope Gregory XIII. was mainly responsible for its erection. foetid. The temperature was 104° F. and the pulse was 118. It is recorded that the tower was intended exclusively for The occipital region was tender and was also the seat of astronomical observations and researches, and there is, from spontaneous pains which constantly recurred. The patient. had much difficulty in sitting up in bed and the movement an historical point of view, every reason to suppose that it was the first celestial watch-tower ever built in Rome. Since aroused or increased the lumbar pains. Kernig’s sign was. its erection, however, and partial endowment by Pope well marked. Investigation of the knee-jerks was. rendered difficult flexor contracture. Intense delirium, it so and so XIII., by Gregory highly passed through many complicated vicissitudes that it now forms for the astro- the hydrocephalic cry, and rigidity of the neck followed. nomical student a large and interesting field of historical Lumbar puncture gave exit to pus containing a. speculation. We are, therefore, not surprised to observe micrococcus which usually presented itself in the form Examinathat while it was at one time most anxiously cared for of a diplococcus and took Gram’s stain. and the scientific work done there may be termed to tion of the ear showed a polypus descending from have been of the utmost importance, at another time it the attic to the lower part of the middle ear. Death took -