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PAIN IN CASES OF TUMOUR OF THE SPINAL CORD.
1508 the seventh and eighth roots. This tumour had given rise to no symptoms, either motor or sensory, and was, indeed, accidentally discovered in the course of a systematic examination. Its character was that of a psammoma. The second case was also that of a female patient, twenty-nine years of age. She had had between 1889 and 1893 several operations for "tumour," but the nature and situation of these could not be discovered. Ever since 1889 she had been troubled with recurring attacks of paralysis and numbness affecting all four extremities. She made a good recovery from several of these, but she was readmitted to the hospital in 1895 with the history of the sudden onset of the state of paralysis in which she was when admitted. There was in all four extremities extensor paralysis with flexor contracture-a condition, indeed, suggesting peripheral neuritis ; but the knee-jerks were active, and there were cystitis and incontinence of urine. She denied ever having been subject to severe pains. The patient died with lung THE HEATH SCHOLARSHIP. symptoms and suppression of urine, and at the necropsy a mass was found on the ventral surface of BY the will of the late George Yeoman Heath, Professor of large quadrilateral the dura mater in the cervical region, involving the first four Surgery in the University of Durham and President of the cervical roots. The dura mater itself was only slightly thickDurham College of Medicine, a sum of f,200 is awarded every ened. The tumour was apparently a degenerated gumma, and second year for a surgical essay. The trustees of the there were considerable changes in the neighbouring vessels scholarship have announced that the second award will be and and descending degenerations in the cord itself. given to the writer of the best essay on "Congenital The ascending writer refers, in conclusion, to a case reported in Brain Deformities, their Pathology and Treatment." All graduates Dr. Michell Clarke, also of spinal tumour without pain, in medicine or in surgery of the University of Durham are by and he is of opinion that the presence or absence of pain, and eligible to compete for this scholarship, and the essay which also the degree of its intensity, may have some relation to must be type-written or printed, should be delivered to the the slowness or rapidity of growth of the tumour. The essay, trustees not later than March 31st, 1898. to that end.
This line of reflection suggests the expeshaping charges of the kind referred to as far as possible in such a way as to bring into strong relief the public mischief which results from any relaxation of the rules regarding registration or the placing of any obstacle in the way of a thorough and efficient working It is, no doubt, possible out of the registration scheme. to show by argument that in this matter the interests of the medical profession and the interests of the public are indistinguishable and that what injures the one injures the other. Hence the wisdom, at any rate until the law has emerged by successive decisions out of the " fog"" and taken shape in clearly defined rules, of submitting to the courts only such instances of encroachment upon the sphere of medical practice as affect in a way too plain for discussion the public interests which it is the object of Medical Acts to protect.
diency of
with any specimens, drawings, casts, microscopical or other means of illustration accompanying it, will become the property of the College, though by permission, the essay may be printed for general circulation by the Heath scholar. This is one of the most valuable surgical prizes in the kingdom, and the competition should be keen.
together
preparations,
" RETURN " CASES OF SCARLET FEVER.
THIS interesting subject seems at irregular intervals to attract the attention of the public and to call for some comments in our columns ; but we are glad to see that the lay press is now approaching the matter in a fair spirit of inquiry and that the occurrence of so-called "returncases is not at once followed by indiscriminate charges of neglect against THE ROYAL INFIRMARY OF NEWCASTLE. The most recent group of cases the hospital authorities. THE prominence and activity of Dr. Philipson in New- which are on thesis of infection being conveyed a explicable castle and its school of medicine-a part of the University from a fever hospital is reported from by discharged patients of Durham-give exceptional interest to the fact of his and there Richmond, certainly appears to have been a very resignation on the score of age. The rule of the infirmary remarkable chronological sequence in some of the cases. requires resignation at sixty years of age-a time of life A patient, after eleven weeks’ isolation in hospital, was when a physician is now often at his best, with the advandischarged presumably free from infection, but five days tages alike of youth and age. The post held for twenty- later a sister was attacked by the same disease and three eight years so honourably by Dr. Philipson is naturally one days after this-i.e., eight days after the first patient’s of the prizes coveted by aspirants to professional fame in discharge-three other children were attacked. All these the city of Newcastle, which has long been noted for men patients were isolated for eleven weeks, but within a week of of strength in the profession. The committee have the their return home the mother of the family was attacked. responsibility of the succession. They will have no excuse It is very strange that this series of cases should occur in for not making a fit appointment. It is understood that the same family, and it would certainly appear probable that Dr. George Redmayne Murray and Dr. Thomas Beattie are some of them were connected with the return of patients candidates for the post. The election will be watched with from the We are not in possession of all the facts hospital. more than local interest. necessary to form a judgment on the merits of this little outbreak, but if the laundryman in whose house the cases PAIN IN CASES OF TUMOUR OF THE SPINAL occurred, and who has doubtless suffered much hardship in CORD. connexion with the outbreak, considers, as apparently PAIN has generally been looked upon as one of the most he does, that he has cause of complaint against the constant symptoms accompanying tumours of the spinal cord. hospital authorities, it will perhaps be better that inquiry In the March number of the Journal of Nervous and Mental should be made as to whether all practicable preDiseases Dr. Pearce Bailey reports two cases which were cautions are taken at the hospital in question, and whether remarkable by reason of the absence of pain which charac- proper disinfection of the house was performed after terised their progress, and while they do not permit any the removal of each case or group of cases-in other general rule to be formulated with reference to this point words, that the question should be investigated from both they are interesting as a valuable contribution to the sides. It would seem improbable that the whole series of symptomatology of an important class of cases. The first cases is to be explained by carelessness on the part of the was that of a woman sixty-five years of age who died from hospital authorities, as after the occurrence of the first nephritis and pneumonia and in whom a tumour was "return"case the authorities would have been especially discovered involving the dorsal region of the cord It is interesting in connexion as to disinfection, &.c. ___
betweencareful
This line of reflection suggests the expeshaping charges of the kind referred to as far as possible in such a way as to bring into strong relief the public mischief which results from any relaxation of the rules regarding registration or the placing of any obstacle in the way of a thorough and efficient working It is, no doubt, possible out of the registration scheme. to show by argument that in this matter the interests of the medical profession and the interests of the public are indistinguishable and that what injures the one injures the other. Hence the wisdom, at any rate until the law has emerged by successive decisions out of the " fog"" and taken shape in clearly defined rules, of submitting to the courts only such instances of encroachment upon the sphere of medical practice as affect in a way too plain for discussion the public interests which it is the object of Medical Acts to protect.
diency of
with any specimens, drawings, casts, microscopical or other means of illustration accompanying it, will become the property of the College, though by permission, the essay may be printed for general circulation by the Heath scholar. This is one of the most valuable surgical prizes in the kingdom, and the competition should be keen.
together
preparations,
" RETURN " CASES OF SCARLET FEVER.
THIS interesting subject seems at irregular intervals to attract the attention of the public and to call for some comments in our columns ; but we are glad to see that the lay press is now approaching the matter in a fair spirit of inquiry and that the occurrence of so-called "returncases is not at once followed by indiscriminate charges of neglect against THE ROYAL INFIRMARY OF NEWCASTLE. The most recent group of cases the hospital authorities. THE prominence and activity of Dr. Philipson in New- which are on thesis of infection being conveyed a explicable castle and its school of medicine-a part of the University from a fever hospital is reported from by discharged patients of Durham-give exceptional interest to the fact of his and there Richmond, certainly appears to have been a very resignation on the score of age. The rule of the infirmary remarkable chronological sequence in some of the cases. requires resignation at sixty years of age-a time of life A patient, after eleven weeks’ isolation in hospital, was when a physician is now often at his best, with the advandischarged presumably free from infection, but five days tages alike of youth and age. The post held for twenty- later a sister was attacked by the same disease and three eight years so honourably by Dr. Philipson is naturally one days after this-i.e., eight days after the first patient’s of the prizes coveted by aspirants to professional fame in discharge-three other children were attacked. All these the city of Newcastle, which has long been noted for men patients were isolated for eleven weeks, but within a week of of strength in the profession. The committee have the their return home the mother of the family was attacked. responsibility of the succession. They will have no excuse It is very strange that this series of cases should occur in for not making a fit appointment. It is understood that the same family, and it would certainly appear probable that Dr. George Redmayne Murray and Dr. Thomas Beattie are some of them were connected with the return of patients candidates for the post. The election will be watched with from the We are not in possession of all the facts hospital. more than local interest. necessary to form a judgment on the merits of this little outbreak, but if the laundryman in whose house the cases PAIN IN CASES OF TUMOUR OF THE SPINAL occurred, and who has doubtless suffered much hardship in CORD. connexion with the outbreak, considers, as apparently PAIN has generally been looked upon as one of the most he does, that he has cause of complaint against the constant symptoms accompanying tumours of the spinal cord. hospital authorities, it will perhaps be better that inquiry In the March number of the Journal of Nervous and Mental should be made as to whether all practicable preDiseases Dr. Pearce Bailey reports two cases which were cautions are taken at the hospital in question, and whether remarkable by reason of the absence of pain which charac- proper disinfection of the house was performed after terised their progress, and while they do not permit any the removal of each case or group of cases-in other general rule to be formulated with reference to this point words, that the question should be investigated from both they are interesting as a valuable contribution to the sides. It would seem improbable that the whole series of symptomatology of an important class of cases. The first cases is to be explained by carelessness on the part of the was that of a woman sixty-five years of age who died from hospital authorities, as after the occurrence of the first nephritis and pneumonia and in whom a tumour was "return"case the authorities would have been especially discovered involving the dorsal region of the cord It is interesting in connexion as to disinfection, &.c. ___
betweencareful