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PREVENTION OF FROST-BITES.
463
Correspondence. ..
Audi alteram
partem."
URGENCY CASES HOSPITAL FOR FRANCE. To the Editor of THE LANCET.
PREVENTION OF FROST-BITES. To the Editor of THE LANCET.
SIR,-In the short article which appeared in THE LANCET on Feb. 6th I have stated briefly the results of some experiments which I had made with oiled silk bags. Several inquiries which I have received since that date have made me realise that the principles which had guided me had not been understood. I propose, therefore, to give shortly a fuller account of my experiments. Meanwhile, I would like to make it clear that the oiled silk was not used by me on account of its low thermo-conductivity or of its superiority to indiarubber as a waterproofing agent. My object was to use the air space between the bag and the skin as the protective agent on account of its low conductivity. The thick wcollen sock or pair of socks between the skin and the bag act as a support for the bag, and the knitted wool, which is itself a bad heat conductor, holds the air in its meshes. The thin sock placed outside the bag is intended to protect the bag against injury. It is obvious that to obtain the best results the boots must not be tight or laced tightly. Any waterproof material would act in the same way as oiled silk, the object of which is to prevent the penetration of water in the air space and the soaking of the skin. The oiled silk was selected by me on account of its cheapness, of its softness and adaptability, and of the ease with which damages to it can be repaired. This method of prevention is based upon wellknown physical and pathological principles, which I did not think it necessary to discuss in a pre-
us put before statement. The arrangeCases Hospital are so that the committee hope to be nearly complete able to send out the hospital early in March. Its services have been accepted by the French Ministry of War, and the arrangements made have received the approval of the Anglo-French Hospitals Committee. The French military authorities have promised to provide a suitable building or buildings for 60 patients and for the staff. It will be the special work of this to treat severe urgent surgical cases hospital among the French wounded on the lines of communication between the firing line and the base hospitals. The burden already put on French army surgeons in attendance on such cases is wellnigh overwhelming, and it is likely to become not lighter but heavier. The Urgency Cases Hospital, placed some 15 miles behind the firing line, will greatly relieve the present strain on the care of the severely wounded among the French army. The hospital staff has been appointed as follows :Consulting surgeon: Major A. W. Mayo-Robson, ,C.V.0. (who has been kindly permitted by the War Office to go out with the hospital for liminary communication. I am, Sir, yours faithfully, the first month of its work). Surgeons: Dr. SHERIDAN DELÉPINE, DELEFINE, J. A. Cairns Forsyth and Dr. K. E. Leveson Director, Public Health Laboratory. Gower Gunn. Assistant surgeons: Dr. A. S. Manchester, Feb. 23rd, 1915. Anoesthetist : Robinson and Dr. W. H. Ogilvie. Dr. R. W. W. Vaughan. Radiographer and electrician : Mr. J. G. Everitt. Secretary: Mr. Harry CAN EXOPHTHALMIC GOITRE BE SPREAD BY CONTACT? Eyres (late Consul General at Constantinople). To the Editor of THE LANCET. Nursing and domestic staff:—Matron : Miss Curtis I (late superintendent, Hammersmith District Nursing SiR,-Exophthalmic goitre is presumably due to Association). 17 nurses, quartermaster, and 14 a toxaemia, and there is at the present time an orderlies; superintendent of laundry and one increasing belief that this is the result of some assistant; and one cook and three assistants. infective condition, probably of intestinal origin. The hospital has received promises of five or six Such a view is strengthened by analogy with motor-cars and motor ambulances, to be driven by McCarrison’s work on endemic goitre in India, English chauffeurs. It will take out a complete for there seems little doubt that some intestinal a theatre equipment, instruments, sterilisers, &c.; excitant is at the bottom of this condition.1 There complete X ray apparatus, with dynamo, which is no doubt about the fact that exophthalmic goitre will also be used for electric lighting; beds and tends to run in families. This is generally explained bedding for 60 patients ; complete ward equipment; as being due to a peculiar susceptibility for the large stores of dressings, anaesthetics, and drugs ; disease in certain families. But is there any and large household stores. Generous support has evidence that the disease can also be spread by been given to the hospital, but it still appeals, not contact from one person to another ? My attention only for money to maintain its work, but also for has lately been drawn to this latter possibility by gifts of clothing, bed linen, dressings, and drugs. All two cases of the disease in women, both of whom donations should be sent to the honorary secretary, had intimate friends, not relations, suffering from Mr. James Baird (cheques crossed Messrs. Cox and the same complaint. Co.), 50A, Curzon-street, W. All gifts in kind should The first, Case A, was a patient of the late Sir be sent to 10, Stratford-place, W., marked " Urgency W. Broadbent, and she discovered she had Graves’s ’Cases Hospital." disease through comparing her symptoms with We earnestly hope that many members of the those of a friend whom she saw constantly, and medical profession in this country will help, to the who was from it in an advanced stage. suffering best of their power, the good work of this hospital In the second, Case B, more details are available. in France. The patient, a married woman, had a friend who We are, Sir, yours faithfully, Graves’s disease in the spring of 1911. LAUDER BRUNTON. E. L. C. C. EDEN. EDEN. She saw this friend once a week pretty regularly W. ARBUTHNOT ARBUTHNOT LANE. HERBERT POWELL. for about two years, and in addition the two used A. W. MAYO-ROBSON. JAMES BAIRD, BAIRD, to stay in the same house together for a few dayss Hon. Hon. Secretary. Secretary. STEPHEN PAGET. 1 THE LANCET, 1913, vol. i., pp. 147, 219, 365. L7- jOi, Curzon-street, W., Feb. 22nd, 1915.
SIR,-We hope that you will let
your readers the ments for the
following Urgency
developed
Correspondence. ..
Audi alteram
partem."
URGENCY CASES HOSPITAL FOR FRANCE. To the Editor of THE LANCET.
PREVENTION OF FROST-BITES. To the Editor of THE LANCET.
SIR,-In the short article which appeared in THE LANCET on Feb. 6th I have stated briefly the results of some experiments which I had made with oiled silk bags. Several inquiries which I have received since that date have made me realise that the principles which had guided me had not been understood. I propose, therefore, to give shortly a fuller account of my experiments. Meanwhile, I would like to make it clear that the oiled silk was not used by me on account of its low thermo-conductivity or of its superiority to indiarubber as a waterproofing agent. My object was to use the air space between the bag and the skin as the protective agent on account of its low conductivity. The thick wcollen sock or pair of socks between the skin and the bag act as a support for the bag, and the knitted wool, which is itself a bad heat conductor, holds the air in its meshes. The thin sock placed outside the bag is intended to protect the bag against injury. It is obvious that to obtain the best results the boots must not be tight or laced tightly. Any waterproof material would act in the same way as oiled silk, the object of which is to prevent the penetration of water in the air space and the soaking of the skin. The oiled silk was selected by me on account of its cheapness, of its softness and adaptability, and of the ease with which damages to it can be repaired. This method of prevention is based upon wellknown physical and pathological principles, which I did not think it necessary to discuss in a pre-
us put before statement. The arrangeCases Hospital are so that the committee hope to be nearly complete able to send out the hospital early in March. Its services have been accepted by the French Ministry of War, and the arrangements made have received the approval of the Anglo-French Hospitals Committee. The French military authorities have promised to provide a suitable building or buildings for 60 patients and for the staff. It will be the special work of this to treat severe urgent surgical cases hospital among the French wounded on the lines of communication between the firing line and the base hospitals. The burden already put on French army surgeons in attendance on such cases is wellnigh overwhelming, and it is likely to become not lighter but heavier. The Urgency Cases Hospital, placed some 15 miles behind the firing line, will greatly relieve the present strain on the care of the severely wounded among the French army. The hospital staff has been appointed as follows :Consulting surgeon: Major A. W. Mayo-Robson, ,C.V.0. (who has been kindly permitted by the War Office to go out with the hospital for liminary communication. I am, Sir, yours faithfully, the first month of its work). Surgeons: Dr. SHERIDAN DELÉPINE, DELEFINE, J. A. Cairns Forsyth and Dr. K. E. Leveson Director, Public Health Laboratory. Gower Gunn. Assistant surgeons: Dr. A. S. Manchester, Feb. 23rd, 1915. Anoesthetist : Robinson and Dr. W. H. Ogilvie. Dr. R. W. W. Vaughan. Radiographer and electrician : Mr. J. G. Everitt. Secretary: Mr. Harry CAN EXOPHTHALMIC GOITRE BE SPREAD BY CONTACT? Eyres (late Consul General at Constantinople). To the Editor of THE LANCET. Nursing and domestic staff:—Matron : Miss Curtis I (late superintendent, Hammersmith District Nursing SiR,-Exophthalmic goitre is presumably due to Association). 17 nurses, quartermaster, and 14 a toxaemia, and there is at the present time an orderlies; superintendent of laundry and one increasing belief that this is the result of some assistant; and one cook and three assistants. infective condition, probably of intestinal origin. The hospital has received promises of five or six Such a view is strengthened by analogy with motor-cars and motor ambulances, to be driven by McCarrison’s work on endemic goitre in India, English chauffeurs. It will take out a complete for there seems little doubt that some intestinal a theatre equipment, instruments, sterilisers, &c.; excitant is at the bottom of this condition.1 There complete X ray apparatus, with dynamo, which is no doubt about the fact that exophthalmic goitre will also be used for electric lighting; beds and tends to run in families. This is generally explained bedding for 60 patients ; complete ward equipment; as being due to a peculiar susceptibility for the large stores of dressings, anaesthetics, and drugs ; disease in certain families. But is there any and large household stores. Generous support has evidence that the disease can also be spread by been given to the hospital, but it still appeals, not contact from one person to another ? My attention only for money to maintain its work, but also for has lately been drawn to this latter possibility by gifts of clothing, bed linen, dressings, and drugs. All two cases of the disease in women, both of whom donations should be sent to the honorary secretary, had intimate friends, not relations, suffering from Mr. James Baird (cheques crossed Messrs. Cox and the same complaint. Co.), 50A, Curzon-street, W. All gifts in kind should The first, Case A, was a patient of the late Sir be sent to 10, Stratford-place, W., marked " Urgency W. Broadbent, and she discovered she had Graves’s ’Cases Hospital." disease through comparing her symptoms with We earnestly hope that many members of the those of a friend whom she saw constantly, and medical profession in this country will help, to the who was from it in an advanced stage. suffering best of their power, the good work of this hospital In the second, Case B, more details are available. in France. The patient, a married woman, had a friend who We are, Sir, yours faithfully, Graves’s disease in the spring of 1911. LAUDER BRUNTON. E. L. C. C. EDEN. EDEN. She saw this friend once a week pretty regularly W. ARBUTHNOT ARBUTHNOT LANE. HERBERT POWELL. for about two years, and in addition the two used A. W. MAYO-ROBSON. JAMES BAIRD, BAIRD, to stay in the same house together for a few dayss Hon. Hon. Secretary. Secretary. STEPHEN PAGET. 1 THE LANCET, 1913, vol. i., pp. 147, 219, 365. L7- jOi, Curzon-street, W., Feb. 22nd, 1915.
SIR,-We hope that you will let
your readers the ments for the
following Urgency
developed