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ONLY A PAUPER AGAIN.
161 South Africa, China, and Australia. The block of laboratories which had just been erected, being part of the work of rebuilding the school, had cost between Z9000 and £ 10,000. It had been paid for by donations, by a loan from the general funds of the school, and by the share allotted to the school from the Pfeiffer bequest. In memory of Mrs. Pfeiffer the wing would be named after her. After a prayer by the Bishop of London and an anthem by Madame
Antoinette Sterling, the Prince of Wales, for the Princess, declared the building open. In the course of his speech he mentioned how fully the Princess of Wales and he sympathised with the desire of women to become qualified medical practitioners, and he thought that India and China offered an almost unlimited scope for the practice of medicine by women. It might have been thought, he continued, that medical men would resent the invasion of their province by women practitioners, but the presence of his friend, Sir William Broadbent, was sufficient proof that He had inspected several of the no such feeling existed. laboratories a few days before and he had been struck with the way in which they were fitted up. He had also paid a visit to the New Hospital for Women opened by the Princess of Wales about ten years ago, which was, he believed, officered entirely by former students of the school.
OPERATION IN MICROCEPHALY.
formulated by the parish council were true. In his report upon the poorhouse hospital he mentions that the sanitary arrangements were defective; there were no fires in the wards at night; the nurses, an old woman aged seventythree years and a younger woman aged forty years who is epileptic, sleep in the kitchen and can only be summoned at night by the patients knocking on the locked doors of the wards. The hospital dietary is the same as in the ordinary wards except when the medical officer orders special diet. It is satisfactory that Mr. Barclay considered that the governor and the matron did their best with the very limited material which they had at hand. Other portions of the report dealt with the administration of the poorhouse itself and many deficiencies were pointed out. The Old Kilpatrick Parish Council considered this report at a meeting held on May 9th and finally came to the conclusion that the Local Government Board should insist upon the House Committee resigning en bloc, also that the Local Government Board should be requested to at, once make arrangements for carrying out the recommendations made in the report. It is true that the conditions in workhouses and workhouse infirmaries have improved greatly within the last forty years or so, but very much remains to be done. There is still not enough separation between the lazy loafer who enters a workhouse because he does not mean to do any work and the aged and the feeble who enter the same place on account of old age or sickness. The former class deserve no mercy and should be incontinently committed to prison and made to work. But the latter class are in every way pitiable and what, they want is a rest house, not a workhouse. The difficulty of providing each class with its deserts ought not to be insuperable, but in the meantime such scandals as those upon which we have been commenting must not be allowed to recur.
IN the December number of the Ameriean Journal of NC’J"Co1ls and Mental Disease Dr. W. W. Keen contributes some interesting remarks on the advisability of operation in cases of microcephaly. His views are based upon the work and writings of others, but also on an experience of 18 cases of his own in which he had operated. Of these the was the eldest six months old and youngest patient eighteen and a half years. Five died after operation and of the 13 that recovered 6 were slightly improved and 7 were not benefited. So that in Dr. Keen’s experience the prospect of improvement is not great and the improvement which may take place is only slight. The conclusions, therefore, are that in a moderate number of selected cases of a medium degree of microcephaly death will ensue as a result of the operation and in a small number slight improvement will follow, but in the majority no result, good or bad, will result from the operation. He does not think that a child with an average-sized head is a suitable case for operation nor, on the other hand, does he think operation justifiable in cases in which the head is excessively small. In patients of more than seven years of age he is of opinion that improvement is not to be expected and in all cases after operation the greatest attention must be paid to developing the child’s faculties by education.
ONLY A PAUPER AGAIN. IN THE LANCET of June 25th we commented severely upon the disgraceful neglect of proper provision for the nursing of sick paupers at the St. Marylebone Infirmary Workhouse. England, it appears, is not alone in the crime of committing the most indefensible form of cruelty. There has recently been a Local Government Board inquiry into the administration of the Dumbarton Poorhouse which revealed a most scandalous state of things. The inquiry was undertaken at the request of the Old Kilpatrick Parish Council and the gentleman appointed to inquire was Mr. R. B. Barclay, who, curiously enough, is not only outside visiting officer for supervising outdoor relief but also has for the past twelve years acted as Inspector of Poorhouses and Poorhouse Hospitals, so that the Local Government Board in ’appointing Mr. Barclay set him to inquire into the efficacy of his own inspection, and we must compliment him warmly on the fact that he found that most of the charges
___
MUMPS
WITHOUT INFLAMMATION SALIVARY GLANDS.
OF THE
IT is gradually becoming more and more evident that the only essential element of an infectious disease is the invasion of the body by a specific microbe. The resulting symptoms and lesions are indefinitely variable. Of late years, partly from clinical observations, but mainly from bacteriological researches, the limits of these variations have been considerably extended. Lesions once supposed to be so characteristic that they entered into the definition of the disease may be entirely absent. Thus typhoid fever is not necessarily enteric; there may be no intestinal lesions. The pneumococcus, the most usual cause of acute pneumonia and the presence of which in other tissues causes the so-called complications of that disease, may attack these tissues and exempt the
lung, producing
a
primary pneumococcic arthritis, pericar
At a recent meeting of the Societe Medicale de ditis, Dr. M. A. Beclere read a case which showed. Hopitaux without doubt that mumps may manifest itself by orchiti& without parotitis or inflammation of the other salivary glands. This has already been stated by M. Laveran and seems to be well known in France, but it does not appear to have been observed in this country, though Dr. Eustace; Smith states that the orchitis may exceptionally appear before the parotitis. A boy, aged fifteen years, was suddenly seized with violent headache, pyrexia, and repeated vomiting.. On the fifth day the right testicle became painful. On thefollowing day he was seen by a distinguished surgeon who, finding orchitis with predominating epididymitis thought,. as there was no urethritis, that the case was one of acutetuberculous orchitis, although the temperature was 104° FDr. Beclere saw the boy on the eighth day. He ascertained that three of his school-fellows had mumps and diagnosed the orchitis accordingly. Resolution was complete on the &c.
Antoinette Sterling, the Prince of Wales, for the Princess, declared the building open. In the course of his speech he mentioned how fully the Princess of Wales and he sympathised with the desire of women to become qualified medical practitioners, and he thought that India and China offered an almost unlimited scope for the practice of medicine by women. It might have been thought, he continued, that medical men would resent the invasion of their province by women practitioners, but the presence of his friend, Sir William Broadbent, was sufficient proof that He had inspected several of the no such feeling existed. laboratories a few days before and he had been struck with the way in which they were fitted up. He had also paid a visit to the New Hospital for Women opened by the Princess of Wales about ten years ago, which was, he believed, officered entirely by former students of the school.
OPERATION IN MICROCEPHALY.
formulated by the parish council were true. In his report upon the poorhouse hospital he mentions that the sanitary arrangements were defective; there were no fires in the wards at night; the nurses, an old woman aged seventythree years and a younger woman aged forty years who is epileptic, sleep in the kitchen and can only be summoned at night by the patients knocking on the locked doors of the wards. The hospital dietary is the same as in the ordinary wards except when the medical officer orders special diet. It is satisfactory that Mr. Barclay considered that the governor and the matron did their best with the very limited material which they had at hand. Other portions of the report dealt with the administration of the poorhouse itself and many deficiencies were pointed out. The Old Kilpatrick Parish Council considered this report at a meeting held on May 9th and finally came to the conclusion that the Local Government Board should insist upon the House Committee resigning en bloc, also that the Local Government Board should be requested to at, once make arrangements for carrying out the recommendations made in the report. It is true that the conditions in workhouses and workhouse infirmaries have improved greatly within the last forty years or so, but very much remains to be done. There is still not enough separation between the lazy loafer who enters a workhouse because he does not mean to do any work and the aged and the feeble who enter the same place on account of old age or sickness. The former class deserve no mercy and should be incontinently committed to prison and made to work. But the latter class are in every way pitiable and what, they want is a rest house, not a workhouse. The difficulty of providing each class with its deserts ought not to be insuperable, but in the meantime such scandals as those upon which we have been commenting must not be allowed to recur.
IN the December number of the Ameriean Journal of NC’J"Co1ls and Mental Disease Dr. W. W. Keen contributes some interesting remarks on the advisability of operation in cases of microcephaly. His views are based upon the work and writings of others, but also on an experience of 18 cases of his own in which he had operated. Of these the was the eldest six months old and youngest patient eighteen and a half years. Five died after operation and of the 13 that recovered 6 were slightly improved and 7 were not benefited. So that in Dr. Keen’s experience the prospect of improvement is not great and the improvement which may take place is only slight. The conclusions, therefore, are that in a moderate number of selected cases of a medium degree of microcephaly death will ensue as a result of the operation and in a small number slight improvement will follow, but in the majority no result, good or bad, will result from the operation. He does not think that a child with an average-sized head is a suitable case for operation nor, on the other hand, does he think operation justifiable in cases in which the head is excessively small. In patients of more than seven years of age he is of opinion that improvement is not to be expected and in all cases after operation the greatest attention must be paid to developing the child’s faculties by education.
ONLY A PAUPER AGAIN. IN THE LANCET of June 25th we commented severely upon the disgraceful neglect of proper provision for the nursing of sick paupers at the St. Marylebone Infirmary Workhouse. England, it appears, is not alone in the crime of committing the most indefensible form of cruelty. There has recently been a Local Government Board inquiry into the administration of the Dumbarton Poorhouse which revealed a most scandalous state of things. The inquiry was undertaken at the request of the Old Kilpatrick Parish Council and the gentleman appointed to inquire was Mr. R. B. Barclay, who, curiously enough, is not only outside visiting officer for supervising outdoor relief but also has for the past twelve years acted as Inspector of Poorhouses and Poorhouse Hospitals, so that the Local Government Board in ’appointing Mr. Barclay set him to inquire into the efficacy of his own inspection, and we must compliment him warmly on the fact that he found that most of the charges
___
MUMPS
WITHOUT INFLAMMATION SALIVARY GLANDS.
OF THE
IT is gradually becoming more and more evident that the only essential element of an infectious disease is the invasion of the body by a specific microbe. The resulting symptoms and lesions are indefinitely variable. Of late years, partly from clinical observations, but mainly from bacteriological researches, the limits of these variations have been considerably extended. Lesions once supposed to be so characteristic that they entered into the definition of the disease may be entirely absent. Thus typhoid fever is not necessarily enteric; there may be no intestinal lesions. The pneumococcus, the most usual cause of acute pneumonia and the presence of which in other tissues causes the so-called complications of that disease, may attack these tissues and exempt the
lung, producing
a
primary pneumococcic arthritis, pericar
At a recent meeting of the Societe Medicale de ditis, Dr. M. A. Beclere read a case which showed. Hopitaux without doubt that mumps may manifest itself by orchiti& without parotitis or inflammation of the other salivary glands. This has already been stated by M. Laveran and seems to be well known in France, but it does not appear to have been observed in this country, though Dr. Eustace; Smith states that the orchitis may exceptionally appear before the parotitis. A boy, aged fifteen years, was suddenly seized with violent headache, pyrexia, and repeated vomiting.. On the fifth day the right testicle became painful. On thefollowing day he was seen by a distinguished surgeon who, finding orchitis with predominating epididymitis thought,. as there was no urethritis, that the case was one of acutetuberculous orchitis, although the temperature was 104° FDr. Beclere saw the boy on the eighth day. He ascertained that three of his school-fellows had mumps and diagnosed the orchitis accordingly. Resolution was complete on the &c.