- Email: [email protected]
OPERATION FOR HYDATID TUMOUR OF THE SPINAL CORD.
THE CHURCH SANITARY ASSOCIATION.
of woman give up using anything which may perhaps enhance her beauty. Ignorance may be an excuse for those who used this preparation before the latest misfortune, although at least two deaths were reported from the use of it in a room with a naked light; but ignorance will not serve now, and yet we have the above startling evidence. As in Casimir de la Vigne’s poem, it is a case of 11 On disait Pauvre Constance,’ " and that is all, and the fashionable world goes on, if not dancing, using all sorts of quack or patent remedies merely because they are fashionable. An occurrence such as this is one more reason for the law as to patent medicines and other preparations being altered. The formula of all these nostrums should be stated on the bottle or package in which they are contained, and meantime we might state that an alcoholic solution of ammonia is quite as efficacious for the cleansing of hair as light petroleum oils, and is not fraught with danger like them. THE IMMEDIATE REDUCTION OF THE DEFORMITY IN POTT’S DISEASE. ON July 24th, at the Royal Southern Hospital, Liverpool, Mr. Robert Jones and Mr. A. H. Tubby demonstrated on a series of cases of Pott’s disease the manipulations for immediate reduction of deformity. The children’s ages varied from three to eight years, and some of the curvatures were very extreme. The deformities were reduced with considerable facility. The forced reduction of the deformity in caries of the spine has been advocated at various times,l but it has always met with much opposition. Recently the practice has been revived by Dr. Calot, of Berck-sur-Mer, who had employed it in thirtyHe claimed seven cases when he wrote his paper.2 that the healing process was much accelerated, and The method that most cases recovered under ten months. employed is as follows : forcible traction is made on the upper and lower parts of the spinal column, while firm pressure is exerted over the prominence. When the deformity is reduced a plaster jacket is put on. We believe that the cases mentioned above are the first that have been treated by Calot’s method in this country. An exact estimate of the value of the treatment is impossible at the present time. -
319
obtained to prevent jerry-builders and all persons interested in businesses leading to air and water pollution from occupying seats on district councils. It is the presence of such men as these which prevents the adoption of proper by-laws, the removal of the smoke which envelops our manufacturing towns, and the cleansing of the water courses which traverse them. At the same time, we fully admit that it is the existence of enterprising men, such as large manufacturers frequently are, which contributes in no small
degree to our national greatness. THE CHURCH SANITARY ASSOCIATION. sermon of the Church Sanitary Association was preaohed on Aug. lst (°t I Sanitation Sunday") in All Saints’ Church, Tufnell Park, London, by the vicar, the Rev. W. J. Hocking. The preacher took for his text the motto of the association, "Iwill, b3 thou clean"(St. Mark i. 41), and in the course of his sf rnon said that two things were beginning to be learned by slow degrees : first, that diseases and paim were not necessarily parts of the economy of human life, but the consequences of imperfect conditions; and secondly, that nine-tenths of the physical ills, diseases, and deformities from which men suffer were traceable to the violation of wise and b3neficent laws, and hence were preventable. Science was making it clearer and clearer every day that not only diseases, but a very large proportion of deaths, were attributable to causes evolved out of conditions for which men were, directly or indirectly, responsible. Mr. Hocking also said that it was one of the phases of the Church’s mission in every parish to be tha teacher of everything that makes for the health of the community-" as well for the body as the soul." Sermons upon the same subject were preached in various peds of the country, the Gospel for the day indicating that concern for the temporal welfare of the people was part of the duty of the Christian ministry. In thus impressing on the masses a sense of the necessity of attending to domestic and personal hygiene the clergy have before them a wide field of usefulness, in which it is possible to benefit their congregations without any excursions into questions of therapeutics. The special feature of the Gospel for last Sunday was the miracle of feeding 4000 persons in the wilderness.. THE annual
HOUSE AGENTS AND RENT COLLECTORS AS SANITARY INSPECTORS. THE sanitary authority of St. James’s, Westminster, has made it a condition for the appointment of sanitary inspector that he shall not deal in house property or act as a rent collector or an agent for absentee property in that district. The authority is to be congratulated on this determination, as it is clearly a difficult matter, with human nature constituted as it is at present, for an officer interested in house property to view that property in an altogether unbiased fashion, or, in cases where he has to collect the rent, to order such as will render it a difficult reconstruction of drains, &c., matter to obtain the rent in question. Dr. J. Edmunds, the medical officer of St. James’s, Westminster, thinks that a restriction of this nature might well find a place among the regulations of the Local Government Board which appertain to sanitary inspectors, and there is certainly much to be said for the proposal. live have ourselves seen instances where sanitary inspectors who acted also as house agents found great difficulty-that is, if the state of the houses in which they were interested can be taken as an index-in carrying out their duties as inspectors. If, however, we are to reduce this position to its logical conclusion it will be necessary for Parliamentary powers to be 1 Hare : Practical Observations on the ment of Curvatures of the Spine, 1838.
2
Prevention, Causes,
Semaine Médicale, June 23rd, 1896.
and Treat-
OPERATION FOR HYDATID TUMOUR OF THE SPINAL CORD. IN a recent number of the Inter colonial Medical Journal of Australasia Dr. Jeffreys Wood records a case of very great interest. The patient was a child, aged ten years, without anything significant in his personal history until, at six years of age, he began to wake at night complaining of pain in the back. During the day no pain was complained of. In September, 1893, there was loss of power in the right hand and arm, but this gradually passed away, so that he was able once more to use the hand for writing and with a knife to cut up his food. During 1894 and 1895 the patient remained well and fairly active. About Christmas of the latter year he was noticed to drag the feet in walking. The difficulty in walking increased in the early months of 1896, and in March of that year pain in the left arm was complained of, in addition to the pain in the back and in the right arm, which had been frequent during the previous two years. The left arm also began to waste and the difficulty in walking increased, so that from the commencement of April, 1896, until his admission to the Children’s Hospital in May of the same year he was kept in bed, being unable to stand. During this time he lost all power over his legs, bladder, and rectum, and priapism was The pain in the back and arms also very troublesome. increased. On admission to hospital he was found to be a
320
MEDICINE FOR THE MIND.
bright, intelligent boy, with complete motor palsy of the legs, exaggerated knee-jerks, and ankle clonus on both sides. Both much wasted, and the head was drawn towards shoulder, and there was inability to turn it to the There was complete loss of cutaneous sensibility up right. to the level of the second rib and there was also anesthesia over the inner side of each arm. There was ability to flex both arms at the elbow, but extension at the elbow could not be carried out. There was drop-wrist, the fingers were fi’exed at the mid-phalangeal joint and could not be voluntarily moved. The thenar and hypothenar muscles were wasted, more on the right side than on the left, and the muscles of the right hand did not react to Faradaism; those of the left hand did. The triceps and deltoid on each side showed the reaction of degeneration, and the symptoms were taken to indicate some gradually increasing pressure between the level of the nucleus of the fifth The spine was cervical nerve and that of the sixth. the of the fifth cervical at level trephined spine and the laminse of this vertebra and of that below it removed with forceps. The cord was seen to fill the canal, and there was no pulsation. A swelling was seen on the right side of the cord. In separating the dura mater from this it was seen to be a hydatid cyst, and on opening it a small amount of hydatid fluid escaped and a number of daughter cysts quickly followed. Considerable difficulty was experienced in getting rid of the daughter cysts, but in all sixteen were removed, together with the mother cyst. After the operation there was a considerable degree of recovery of voluntary power for a short time, but unfortunately symptoms of cerebral meningitis developed, and the boy died eighteen days after the operation. The unfortunate termination of a case so admirably studied and carefully operated upon is much to be regretted. arms were
the left
theories are ingenious, but it cannot as yet be said that he has discovered the sweet oblivious antidote which Shakespeare’s Thane asked for; nor, for the matter of that, a panacea of any kind for thick-coming fancies.
THE AUSTRALIAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE. THE seventh session of the above association will comJan. 6th, 1898, the place of meeting being Sydney. The objects of the association are to give a stronger impulse and a more systematic direction to scientific inquiry; to promote the intercourse of those who cultivate science in different parts of the Australasian colonies and in other countries ; to obtain more general attention to the objects of science, and a removal of any disadvantages of a public kind which may impede its progress. The president-elect, who also holds the office of permanent honorary secretary, is Professor A. Liversidge, M.A.,LL.D., F.R.S., who will answer any questions addressed to him as to proceedings, &c., and will furnish a list of hotels, apartments, or boarding houses, with tariffs, to members of the association. Inquirers are state to the nature and amount of particularly requested accommodation they may require. The sections into which the subjects for discussion are divided include nearly every department of science other than medical. The steamship md railway companies give reductions in fares to members upon production of their cards of membership. Besides the general meetings, excursions will be organised to various places of interest in the neighbourhood, and this portion of Ihe Congress will no doubt be by no means the least appreciated of the proceedings, for the scenery of the Blue Mountains is as beautiful as any in the world. mence on
TYPHUS FEVER IN LIVERPOOL DURING 1896. IN these days we hear but little of typhus fever in and it will probably be a matter of surprise to LADY MACBETH’S medical attendant was obliged to confess England, were in Liverhis inability to minister to a mind diseased, but according to many persons to learn that during 1896 there with of as as 305 36 this disease, deaths, cases, many the modern school of psycho-neurologists the cleansing of pool as against 162, with 24 deaths, in the previous year-figures psychically affected brains is by no means beyond which go to show that although this disease was more the range of medical achievement. In a work which has in during 1896 than during 1895 the just been publishedM. de Fleury combats with great prevalentrate Liverpool was lower. The latter fact may be partly seriousness the old-fashioned hypothesis that bodily ills fatality for by the circumstance that during 1896 one of accounted alone are the province of the practitioner. The disorders of the day industrial schools appears to have acted as a centre the half of the human economy are every whit as for disseminating the disease, and that thus the age distrinumerous and important, if not more so, than those affecting bution of the attacks was a favourable one. Dr. Hope tells the somatic half, and everyone reflecting on the havoc they us that the greater number of the attacks occurred in the occasion must acknowledge that systematic efforts should be south end of the city, in parts notable for "drunkenness, made to render them amenable to treatment. Laziness, and filth," circumstances which are almost always grief, and anger are among the mental affections discussed squalour, found to be associated with this terrible disease. Upon by the writer, not only from a curative, but also from a the discovery of a case of typhus fever in Liverpool prophylactic, point of view, but his remarks should be the patient is at once sent to the isolation hospital and perused in the origiral. As might perhaps be expected, an the infected bedding and clothing are destroyed. Furtherentire chapter is devoted to the tender passion under the more, an inspector visits the house from which the heading, La Médecine des Passions. "Love," says M. de patient is removed every day for a fortnight, and Fleury,"is a physiological phenomenon which enters the makes minute inquiries as to any other suspicious cases domain of pathology the moment it assumes the sentiof illness, while regard is also had to all persons who mental form. Do we not habitually say,’So-and-so is may have visited the house prior to the removal of the madly in love’?This passion, which is beyond the control of patient and the disinfection of his belongings. Notwithsense, in face of which reason loses her rights and her standing these precautions, Dr. Hope remarks that the powers, is incontestably a human malady." The symptoms disease at times remains unrecognised until a localised outof l’ Amou’l’-Maladie, we are further told, bear a wonderful break attracts attention. As he observes, typhus fever is by resemblance to those of alcoholism and morphinomania. no means easy of diagnosis even by persons fairly familiar Everyone who inquires into the facts for himself will be with its manifestations, and it is obvious that, owing to the struck with the absolute identity of the pathological proof the disease, especially in London, the majority of The point of departure is different, rarity cesses in each case. the younger generation of medical practitioners must have but the results are precisely similar, and the same treatpassed through their hospital experience without seeing a ment-namely, separation-cures both. M. de Fleury’s case at all. We are accustomed to flatter ourselves that we out" have 1 L’Introduction a la Médecine de Paris: typhus fever from our practically "stamped Alcan, 1897. l’Esprit.
MEDICINE FOR THE MIND.
psychic
of woman give up using anything which may perhaps enhance her beauty. Ignorance may be an excuse for those who used this preparation before the latest misfortune, although at least two deaths were reported from the use of it in a room with a naked light; but ignorance will not serve now, and yet we have the above startling evidence. As in Casimir de la Vigne’s poem, it is a case of 11 On disait Pauvre Constance,’ " and that is all, and the fashionable world goes on, if not dancing, using all sorts of quack or patent remedies merely because they are fashionable. An occurrence such as this is one more reason for the law as to patent medicines and other preparations being altered. The formula of all these nostrums should be stated on the bottle or package in which they are contained, and meantime we might state that an alcoholic solution of ammonia is quite as efficacious for the cleansing of hair as light petroleum oils, and is not fraught with danger like them. THE IMMEDIATE REDUCTION OF THE DEFORMITY IN POTT’S DISEASE. ON July 24th, at the Royal Southern Hospital, Liverpool, Mr. Robert Jones and Mr. A. H. Tubby demonstrated on a series of cases of Pott’s disease the manipulations for immediate reduction of deformity. The children’s ages varied from three to eight years, and some of the curvatures were very extreme. The deformities were reduced with considerable facility. The forced reduction of the deformity in caries of the spine has been advocated at various times,l but it has always met with much opposition. Recently the practice has been revived by Dr. Calot, of Berck-sur-Mer, who had employed it in thirtyHe claimed seven cases when he wrote his paper.2 that the healing process was much accelerated, and The method that most cases recovered under ten months. employed is as follows : forcible traction is made on the upper and lower parts of the spinal column, while firm pressure is exerted over the prominence. When the deformity is reduced a plaster jacket is put on. We believe that the cases mentioned above are the first that have been treated by Calot’s method in this country. An exact estimate of the value of the treatment is impossible at the present time. -
319
obtained to prevent jerry-builders and all persons interested in businesses leading to air and water pollution from occupying seats on district councils. It is the presence of such men as these which prevents the adoption of proper by-laws, the removal of the smoke which envelops our manufacturing towns, and the cleansing of the water courses which traverse them. At the same time, we fully admit that it is the existence of enterprising men, such as large manufacturers frequently are, which contributes in no small
degree to our national greatness. THE CHURCH SANITARY ASSOCIATION. sermon of the Church Sanitary Association was preaohed on Aug. lst (°t I Sanitation Sunday") in All Saints’ Church, Tufnell Park, London, by the vicar, the Rev. W. J. Hocking. The preacher took for his text the motto of the association, "Iwill, b3 thou clean"(St. Mark i. 41), and in the course of his sf rnon said that two things were beginning to be learned by slow degrees : first, that diseases and paim were not necessarily parts of the economy of human life, but the consequences of imperfect conditions; and secondly, that nine-tenths of the physical ills, diseases, and deformities from which men suffer were traceable to the violation of wise and b3neficent laws, and hence were preventable. Science was making it clearer and clearer every day that not only diseases, but a very large proportion of deaths, were attributable to causes evolved out of conditions for which men were, directly or indirectly, responsible. Mr. Hocking also said that it was one of the phases of the Church’s mission in every parish to be tha teacher of everything that makes for the health of the community-" as well for the body as the soul." Sermons upon the same subject were preached in various peds of the country, the Gospel for the day indicating that concern for the temporal welfare of the people was part of the duty of the Christian ministry. In thus impressing on the masses a sense of the necessity of attending to domestic and personal hygiene the clergy have before them a wide field of usefulness, in which it is possible to benefit their congregations without any excursions into questions of therapeutics. The special feature of the Gospel for last Sunday was the miracle of feeding 4000 persons in the wilderness.. THE annual
HOUSE AGENTS AND RENT COLLECTORS AS SANITARY INSPECTORS. THE sanitary authority of St. James’s, Westminster, has made it a condition for the appointment of sanitary inspector that he shall not deal in house property or act as a rent collector or an agent for absentee property in that district. The authority is to be congratulated on this determination, as it is clearly a difficult matter, with human nature constituted as it is at present, for an officer interested in house property to view that property in an altogether unbiased fashion, or, in cases where he has to collect the rent, to order such as will render it a difficult reconstruction of drains, &c., matter to obtain the rent in question. Dr. J. Edmunds, the medical officer of St. James’s, Westminster, thinks that a restriction of this nature might well find a place among the regulations of the Local Government Board which appertain to sanitary inspectors, and there is certainly much to be said for the proposal. live have ourselves seen instances where sanitary inspectors who acted also as house agents found great difficulty-that is, if the state of the houses in which they were interested can be taken as an index-in carrying out their duties as inspectors. If, however, we are to reduce this position to its logical conclusion it will be necessary for Parliamentary powers to be 1 Hare : Practical Observations on the ment of Curvatures of the Spine, 1838.
2
Prevention, Causes,
Semaine Médicale, June 23rd, 1896.
and Treat-
OPERATION FOR HYDATID TUMOUR OF THE SPINAL CORD. IN a recent number of the Inter colonial Medical Journal of Australasia Dr. Jeffreys Wood records a case of very great interest. The patient was a child, aged ten years, without anything significant in his personal history until, at six years of age, he began to wake at night complaining of pain in the back. During the day no pain was complained of. In September, 1893, there was loss of power in the right hand and arm, but this gradually passed away, so that he was able once more to use the hand for writing and with a knife to cut up his food. During 1894 and 1895 the patient remained well and fairly active. About Christmas of the latter year he was noticed to drag the feet in walking. The difficulty in walking increased in the early months of 1896, and in March of that year pain in the left arm was complained of, in addition to the pain in the back and in the right arm, which had been frequent during the previous two years. The left arm also began to waste and the difficulty in walking increased, so that from the commencement of April, 1896, until his admission to the Children’s Hospital in May of the same year he was kept in bed, being unable to stand. During this time he lost all power over his legs, bladder, and rectum, and priapism was The pain in the back and arms also very troublesome. increased. On admission to hospital he was found to be a
320
MEDICINE FOR THE MIND.
bright, intelligent boy, with complete motor palsy of the legs, exaggerated knee-jerks, and ankle clonus on both sides. Both much wasted, and the head was drawn towards shoulder, and there was inability to turn it to the There was complete loss of cutaneous sensibility up right. to the level of the second rib and there was also anesthesia over the inner side of each arm. There was ability to flex both arms at the elbow, but extension at the elbow could not be carried out. There was drop-wrist, the fingers were fi’exed at the mid-phalangeal joint and could not be voluntarily moved. The thenar and hypothenar muscles were wasted, more on the right side than on the left, and the muscles of the right hand did not react to Faradaism; those of the left hand did. The triceps and deltoid on each side showed the reaction of degeneration, and the symptoms were taken to indicate some gradually increasing pressure between the level of the nucleus of the fifth The spine was cervical nerve and that of the sixth. the of the fifth cervical at level trephined spine and the laminse of this vertebra and of that below it removed with forceps. The cord was seen to fill the canal, and there was no pulsation. A swelling was seen on the right side of the cord. In separating the dura mater from this it was seen to be a hydatid cyst, and on opening it a small amount of hydatid fluid escaped and a number of daughter cysts quickly followed. Considerable difficulty was experienced in getting rid of the daughter cysts, but in all sixteen were removed, together with the mother cyst. After the operation there was a considerable degree of recovery of voluntary power for a short time, but unfortunately symptoms of cerebral meningitis developed, and the boy died eighteen days after the operation. The unfortunate termination of a case so admirably studied and carefully operated upon is much to be regretted. arms were
the left
theories are ingenious, but it cannot as yet be said that he has discovered the sweet oblivious antidote which Shakespeare’s Thane asked for; nor, for the matter of that, a panacea of any kind for thick-coming fancies.
THE AUSTRALIAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE. THE seventh session of the above association will comJan. 6th, 1898, the place of meeting being Sydney. The objects of the association are to give a stronger impulse and a more systematic direction to scientific inquiry; to promote the intercourse of those who cultivate science in different parts of the Australasian colonies and in other countries ; to obtain more general attention to the objects of science, and a removal of any disadvantages of a public kind which may impede its progress. The president-elect, who also holds the office of permanent honorary secretary, is Professor A. Liversidge, M.A.,LL.D., F.R.S., who will answer any questions addressed to him as to proceedings, &c., and will furnish a list of hotels, apartments, or boarding houses, with tariffs, to members of the association. Inquirers are state to the nature and amount of particularly requested accommodation they may require. The sections into which the subjects for discussion are divided include nearly every department of science other than medical. The steamship md railway companies give reductions in fares to members upon production of their cards of membership. Besides the general meetings, excursions will be organised to various places of interest in the neighbourhood, and this portion of Ihe Congress will no doubt be by no means the least appreciated of the proceedings, for the scenery of the Blue Mountains is as beautiful as any in the world. mence on
TYPHUS FEVER IN LIVERPOOL DURING 1896. IN these days we hear but little of typhus fever in and it will probably be a matter of surprise to LADY MACBETH’S medical attendant was obliged to confess England, were in Liverhis inability to minister to a mind diseased, but according to many persons to learn that during 1896 there with of as as 305 36 this disease, deaths, cases, many the modern school of psycho-neurologists the cleansing of pool as against 162, with 24 deaths, in the previous year-figures psychically affected brains is by no means beyond which go to show that although this disease was more the range of medical achievement. In a work which has in during 1896 than during 1895 the just been publishedM. de Fleury combats with great prevalentrate Liverpool was lower. The latter fact may be partly seriousness the old-fashioned hypothesis that bodily ills fatality for by the circumstance that during 1896 one of accounted alone are the province of the practitioner. The disorders of the day industrial schools appears to have acted as a centre the half of the human economy are every whit as for disseminating the disease, and that thus the age distrinumerous and important, if not more so, than those affecting bution of the attacks was a favourable one. Dr. Hope tells the somatic half, and everyone reflecting on the havoc they us that the greater number of the attacks occurred in the occasion must acknowledge that systematic efforts should be south end of the city, in parts notable for "drunkenness, made to render them amenable to treatment. Laziness, and filth," circumstances which are almost always grief, and anger are among the mental affections discussed squalour, found to be associated with this terrible disease. Upon by the writer, not only from a curative, but also from a the discovery of a case of typhus fever in Liverpool prophylactic, point of view, but his remarks should be the patient is at once sent to the isolation hospital and perused in the origiral. As might perhaps be expected, an the infected bedding and clothing are destroyed. Furtherentire chapter is devoted to the tender passion under the more, an inspector visits the house from which the heading, La Médecine des Passions. "Love," says M. de patient is removed every day for a fortnight, and Fleury,"is a physiological phenomenon which enters the makes minute inquiries as to any other suspicious cases domain of pathology the moment it assumes the sentiof illness, while regard is also had to all persons who mental form. Do we not habitually say,’So-and-so is may have visited the house prior to the removal of the madly in love’?This passion, which is beyond the control of patient and the disinfection of his belongings. Notwithsense, in face of which reason loses her rights and her standing these precautions, Dr. Hope remarks that the powers, is incontestably a human malady." The symptoms disease at times remains unrecognised until a localised outof l’ Amou’l’-Maladie, we are further told, bear a wonderful break attracts attention. As he observes, typhus fever is by resemblance to those of alcoholism and morphinomania. no means easy of diagnosis even by persons fairly familiar Everyone who inquires into the facts for himself will be with its manifestations, and it is obvious that, owing to the struck with the absolute identity of the pathological proof the disease, especially in London, the majority of The point of departure is different, rarity cesses in each case. the younger generation of medical practitioners must have but the results are precisely similar, and the same treatpassed through their hospital experience without seeing a ment-namely, separation-cures both. M. de Fleury’s case at all. We are accustomed to flatter ourselves that we out" have 1 L’Introduction a la Médecine de Paris: typhus fever from our practically "stamped Alcan, 1897. l’Esprit.
MEDICINE FOR THE MIND.
psychic