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PRISON CLEANLINESS.
235 to them and became F.R.S. and HunterianIcontinuity with the old tissues but the processes in these two 1 A fact not generallytissues are not quite identical, cells with nuclei undergoing lecturer on the strength of them. I noted is that the handwriting of Everard Home and thedivision being found in the new muscles but not in the new had a In the latter the axis cylinder seems to be prolonged Hunter close resemblance. nerves. of John very handwriting It may possibly be that Home not only copied Hunter’sforwards without cell growth. notes into his precious lectures but actually lifted portions THE PREVENTION AND TREATMENT OF of Hunter’s writing into his numerous MSS. Many scraps CANCER. of writing have been found stuck in an old copy of Home’s WE have received the following communication from the paper on whales. They are without water-marks and it may be that they were snipped by Home from some old Hunter committee of the Liverpool Cancer Research :note-book which he afterwards burnt. Hunter also certainly Cancer Research Laboratory, The University, wrote on whales. Liverpool, July, 1904.
reputation
REGENERATION
OF BONE IN TRITONS.
IN a communication published in the fourth part of the 63rd volume of the Arckiv fur Mikrokopische Anatonzie, Professor Wendelstadt of Bonn gives an account of a long series of researches which he has made upon the process of regeneration in the bones of the forearm, after amputation of the limb, in Tritons. Previous experiments on axolotls had satisfied him that in those animals regeneration or reproduction of those bones only takes place when either In the cartilage or the perichondrium is left behind. the first set of the present experiments on Tritons the right forearm was amputated in a considerable number near the elbow-joint. Five days after the operation the arm
In view of the increasing prevalence of cancer the committee of the Liverpool Cancer Research deem it their duty to call attention to what may be done to combat this increase. No specific cure for cancer is yet known, but, as with consumption, the earlier the treatment is commenced the greater is the chance for its success. Unfortunately a large number of people put off seeking the advice of their doctor instead of going to him immediately they notice anything wrong. It may be pointed out that certain organs are more often affected than others. In men cancer of the gullet, stomach, and intestines; in women cancer of the breast and the womb, account for about two-thirds of all cases of cancer. There are, of course, many other only slight ailments of these organs. The committee feel that they cannot too strongly state how important it is that the disease should be recognised at the earliest possible moment. This recognition can only be attained by the patient going to his or her doctor for examination at the very
beginning of
illness.
We endorse heartily the suggestions of the Liverpool Cancer Research Committee that persons with any suspicion of cancer should seek medical advice early but there is the great difficulty that the early manifestations of the disease are often exceedingly slight. It is important, too, that medical men themselves should be on the look out for malignant disease. In this connexion medical men may well bear in mind the value of hospitals as affording opportunities for consultation on cases occurring amongst the poorer classes of the population. This is one of the most legitimate functions of the out-patient department of hospitals and it is not utilised to the extent which it deserves.
removed at the shoulder-joint and in thirty-one others at successively later periods at intervals of 24 hours. In the second set Gf experiments the intervals between the amputation and the removal of the limb at the shoulder was reduced to eight hours for eleven days. The number of sections made and examined was 264. The proceeding adopted was that the limbs with the humerus and upper portions of the radius and the ulna were without loss of time placed in Flemming’s solution, thoroughly PRISON CLEANLINESS. washed, decalcified, and preserved in alcohol. They were " WE hear frequently of the absolute cleanliness which then embedded in paraffin and stained with hasmalum. The first point noticed was that after 16 hours in most, but not is insisted upon by our prison discipline. The buildings, quite in all, cases a considerable production of cells took bedding, clothing, and utensils are kept in a condition place from the edges of the skin forming a protecting bordering on perfection and meals are served in a manner covering to the cut surface, several cells deep. In the to which no one can reasonably object. But the cleanliness is found only in connexion with inanimate objects." Thus course of the next few days an infiltration of small cells, the origin of which Professor Wendelstadt was unable to dis- a writer who has completed recently a term of one month’s cover, occurred in the tissues in the immediate proximity of hard labour in one of His Majesty’s local prisons and who the wound. From these cells the connective tissue in the new has been forced to the conclusion, he says, that so far from structures is developed and they play an important r6le in precautions being taken to insure the prisoner’s personal effecting the absorption of the damaged bone-that is to say, cleanliness regulations of a vexatious nature are laid down the bone in the immediate vicinity of the amputation. which actually compel him to live in a condition of filth. Either singly or in groups they attack the outer surface of The following facts are those upon which he relies to subthe bone and penetrate into the medullary cavity, eroding stantiate his sweeping statement. " Each occupant of a the osseous tissue with such energy that they sometimes prison cell is provided with a set of pewter vessels, termed isolate small fragments which form sequestra. Several cells ’ tins.’ This set comprises, drinking-vessel, plate, water-can, unite together with fusion of their protoplasm and thus form wash-basin, dust-pan, and urinal, the last-named being the giant cells which are first observed at about 60 hours after only one provided with a cover ; but the cover must not be the operation and persist in their erosive action for as long as put on during the day otherwise an inspecting officer would 12 days. The periosteum becomes thickened, the thickening be unable to tell at a glance whether vessel and lid were To keep all these tins bright a bundle of rags and being very marked in sections made on the twenty-first day. In those made a few days later club-shaped bone processes a supply of brick-dust is provided. Now the unfortunate appear which are shown in the drawings to start from or near prisoner cannot tell for what specific purpose his predethe ends of the bones. At the same time small isolated masses cessor has used any individual fragment of cloth. As of cartilage may be seen which are the rudiments of the a consequence he may clean his tableware (wooden spoon fingers. Both the bony processes and the masses of cartilage included) with a rag which has been very differently In the course of a month he may occupy three are small and isolated at first but gradually increase till’ utilised. they attain their normal size. Although these events take different cells, so having to attempt this differentiation three place with great rapidity it is remarkable that it was only in times over. But so long as the tins look bright authority one section that Professor Wendelstadt observed a bone cell does not concern itself with the trivial discomfort alluded presenting the characteristic features -of active mitosis. to. Once a month about half a square yard of,caean rag is New bone is formed by the endosteum as well as by the, provided. As regards daily ablutions, there, is no rule near end The new a of the bone. the periosteum, especially against prisoner washing half a dozen times a day it he muscles and nerves are developedfrom appropriate cells in -V6 so- minded. He is, however, allowed only about half a was
clean.
236 water for both washing and drinking purposes, and all his tins, with the exception of the water-can, must be clean and empty throughout the day. On getting up in the morning he has to wash, dress, and sweep out his cell, being ready to put wash-basin, dustpan, urinal, and water-can on the door sill directly the door is opened. This has all to be done hurriedly and he has generally to content himself with the merestlick and promise’ of hands and face. Experience may teaoh him in time, though that on one morning in the week when bedding is inspected he will get a minute or two more. This brief period gives him his only opportunity in the week of washing any other portion of his anatomy, thus the neck and ears get some attention. Tooth brushes are unknown. Hair brushes are filthy and add another horror to a change of cell. Also, it is enjoined that after having washed the prisoner must scrub his cell ; so that even if his perfunctory dabble in about one and a half pints of water has served to make his hands clean they are not allowed to remain so for ten minutes. A single pail of scrubbing water does duty for more cells than one. Some prisoners are in habits and seem but their anything cleanly to delight in the passing of filth from cell to cell. The treasured fragment of soap with which a man who longs to be clean attempts to wash himself must be used upon the floor in conjunction with the scrubbing brush. True, prisoners have a warm bath once a fortnight, but this is the merest farce. One is not given time to use the soap before there comes a peremptory order toI let that water off and get out.’ Again, as regards the water tin. A prisoner may be rejoiced to find that his plate just serves to cover its wide top and it will seem to him that he may thus keep his only drink to some extent free from dust throughout the day. But this is against the rules. The plate must be set nearly upright so that a glance will reveal any dulness on its surThe water is thus left free to absorb dust and face. impurities throughout the entire 14 hours. Another point may be alluded to as showing how little care is taken to preserve health and cleanliness among prisoners. A diet of brown bread and porridge is, as everyone knows, calculated to induce diarrhoea. Yet the prisoner is supposed to go to the’ He may ring his bell and ask w.c. but once in the 24 hours. leave to go again. The bell may or may not be answered. If it is it matters not how he prefers his request, he is certain, of abuse and by no means sure of the desired permission. OnL his discharge he receives his own linen-unwashed." We give our correspondent’s statement exactly as he sends it.
gallon of
HA inf)f)HeR
ns
a,
two his n()fl1.fl, Y7,f7p.,z
Tt is wall-
’
known to us that in many prisons better conditions prevaill but the other side should be shown in the interests of the medical officers who will thus have their hands strengthenedl in attempts at sanitary reform.
MEETING OF THE BRITISH MEDICAL ASSOCIATION: THE PATHOLOGICAL MUSEUM. WE have on previous occasions alluded to the decadence of this museum of late yearsand it is with great pleasure that we call special attention to the exhibition which is promised this year by Dr. James Ritchie, Dr. E. W. Ainley Walker, and the local committee at Oxford. Among the material promised we note specimens,
photographs, and other material illustrating recent advances in medical science ; apparatus for skiagraphy ; colour photography in relation to medical, surgical, and pathological work ; apparatus for photo-micrography; specimens bearing the discussions in the various sections ; and, more useful perhaps to the general mass of the profession who attend the Association, instruments for clinical diagnosis. We are informed that a room will be fitted up with on
1
THE LANCET,
Sept. 6th, 1902, p. 701,
and
August 22nd, 1903,
p. 545.
various recent inventions for clinical diagnosis. The idea of the founders of the pathological museum was that it should form a valuable means of education and interest for the whole profession and particularly for those who were engaged in busy country and provincial practice. Unfortunately, in process of time it failed to keep up to this ideal. We congratulate the local committee on its attempt to restore the museum to the position which it used to occupy and we cordially wish these gentlemen every success.
ANTIMONIAL AND LEAD POISONING FROM THE USE OF THE LINOTYPE MACHINE. IN the British Journal of Dermatology for July Dr. Leslie Roberts has called attention to the fact that though the has greatly reduced the. use of the linotype machine of lead poisoning among compositors such danger danger still exists, as the following case shows. A compositor, aged 29 years, began to fail in health about a year after the introduction of the linotype machine into the works where he was employed. There were pains in the limbs, tenderness of the fingers, constipation, and excessive perspiration. He continued to work for three and a half years after the onset of the symptoms and consulted several medical men but was never suspected to be suffering from metallic poisoning. After absence from work the symptoms abated but on resuming work the patient relapsed. Tenderness of the palms and the fingers increased so much that it compelled him to give up work and he entered a hospital. The hands were damp with excessive perspiration and the palms and fingers were of a faint pink colour. On the thenar and hypothenar eminences were minute pale papules. Dr. Roberts thought that the patient was suffering from arsenical poisoning but the makers of the linotype metal guaranteed that it consisted of tin, antimony, and lead, and was free from arsenic. Microscopic examination of the affected skin showed congestion but no leucocytosis. The poison had spent its force on the epithelium in an irregular manner. The stratum lucidum was remarkably thickened, the rete cells were actively proliferating, and the prickle cell stratum was enlarged. The epithelial ridges were enlarged laterally and there was cavernous dilatation of the intra-epithelial portion of the sudoriparous ducts. Such changes are produced by a metal of the arsenical group and must have been due to the antimony. In addition to the constipation there was evidence of lead poisoning-tremors and lead in the urine. The absence of colic may have been due to modification of the symptoms of lead poisoning by the antimony. This case shows that air shafts and ventilators should be fixed above the trough containing the molten linotype metal for the purpose of carrying off the fumes.
TUBERCULOSIS (ANIMALS) COMPENSATION BILL. WE have received a copy of "Notes of Evidence"submitted to a select committee of the House of Commons by Dr. Henry O’Neill, consulting surgeon to the Royal Victoria Hospital, Belfast, in reference to the Tuberculosis (Animals) Compensation Bill. Dr. O’Neill explained that in Belfast the meat-supply is carefully inspected by a staff of one superintendent and five properly qualified meat inspectors assisted (when required) by a veterinary surgeon and such other scientific experts as the market committee may consider necessary. These inspectors endeavour to carry out to the best of their judgment the recommendations of the Royal Commission on Tuberculosis. In consequence of this action certain carcasses are condemned and Dr. O’Neill brought forward statistics to show that a heavy financial loss fell upon the butchers, several of whom had consequently been " driven out of trade." Dr. O’Neill considered that this loss should be partly borne by the
reputation
REGENERATION
OF BONE IN TRITONS.
IN a communication published in the fourth part of the 63rd volume of the Arckiv fur Mikrokopische Anatonzie, Professor Wendelstadt of Bonn gives an account of a long series of researches which he has made upon the process of regeneration in the bones of the forearm, after amputation of the limb, in Tritons. Previous experiments on axolotls had satisfied him that in those animals regeneration or reproduction of those bones only takes place when either In the cartilage or the perichondrium is left behind. the first set of the present experiments on Tritons the right forearm was amputated in a considerable number near the elbow-joint. Five days after the operation the arm
In view of the increasing prevalence of cancer the committee of the Liverpool Cancer Research deem it their duty to call attention to what may be done to combat this increase. No specific cure for cancer is yet known, but, as with consumption, the earlier the treatment is commenced the greater is the chance for its success. Unfortunately a large number of people put off seeking the advice of their doctor instead of going to him immediately they notice anything wrong. It may be pointed out that certain organs are more often affected than others. In men cancer of the gullet, stomach, and intestines; in women cancer of the breast and the womb, account for about two-thirds of all cases of cancer. There are, of course, many other only slight ailments of these organs. The committee feel that they cannot too strongly state how important it is that the disease should be recognised at the earliest possible moment. This recognition can only be attained by the patient going to his or her doctor for examination at the very
beginning of
illness.
We endorse heartily the suggestions of the Liverpool Cancer Research Committee that persons with any suspicion of cancer should seek medical advice early but there is the great difficulty that the early manifestations of the disease are often exceedingly slight. It is important, too, that medical men themselves should be on the look out for malignant disease. In this connexion medical men may well bear in mind the value of hospitals as affording opportunities for consultation on cases occurring amongst the poorer classes of the population. This is one of the most legitimate functions of the out-patient department of hospitals and it is not utilised to the extent which it deserves.
removed at the shoulder-joint and in thirty-one others at successively later periods at intervals of 24 hours. In the second set Gf experiments the intervals between the amputation and the removal of the limb at the shoulder was reduced to eight hours for eleven days. The number of sections made and examined was 264. The proceeding adopted was that the limbs with the humerus and upper portions of the radius and the ulna were without loss of time placed in Flemming’s solution, thoroughly PRISON CLEANLINESS. washed, decalcified, and preserved in alcohol. They were " WE hear frequently of the absolute cleanliness which then embedded in paraffin and stained with hasmalum. The first point noticed was that after 16 hours in most, but not is insisted upon by our prison discipline. The buildings, quite in all, cases a considerable production of cells took bedding, clothing, and utensils are kept in a condition place from the edges of the skin forming a protecting bordering on perfection and meals are served in a manner covering to the cut surface, several cells deep. In the to which no one can reasonably object. But the cleanliness is found only in connexion with inanimate objects." Thus course of the next few days an infiltration of small cells, the origin of which Professor Wendelstadt was unable to dis- a writer who has completed recently a term of one month’s cover, occurred in the tissues in the immediate proximity of hard labour in one of His Majesty’s local prisons and who the wound. From these cells the connective tissue in the new has been forced to the conclusion, he says, that so far from structures is developed and they play an important r6le in precautions being taken to insure the prisoner’s personal effecting the absorption of the damaged bone-that is to say, cleanliness regulations of a vexatious nature are laid down the bone in the immediate vicinity of the amputation. which actually compel him to live in a condition of filth. Either singly or in groups they attack the outer surface of The following facts are those upon which he relies to subthe bone and penetrate into the medullary cavity, eroding stantiate his sweeping statement. " Each occupant of a the osseous tissue with such energy that they sometimes prison cell is provided with a set of pewter vessels, termed isolate small fragments which form sequestra. Several cells ’ tins.’ This set comprises, drinking-vessel, plate, water-can, unite together with fusion of their protoplasm and thus form wash-basin, dust-pan, and urinal, the last-named being the giant cells which are first observed at about 60 hours after only one provided with a cover ; but the cover must not be the operation and persist in their erosive action for as long as put on during the day otherwise an inspecting officer would 12 days. The periosteum becomes thickened, the thickening be unable to tell at a glance whether vessel and lid were To keep all these tins bright a bundle of rags and being very marked in sections made on the twenty-first day. In those made a few days later club-shaped bone processes a supply of brick-dust is provided. Now the unfortunate appear which are shown in the drawings to start from or near prisoner cannot tell for what specific purpose his predethe ends of the bones. At the same time small isolated masses cessor has used any individual fragment of cloth. As of cartilage may be seen which are the rudiments of the a consequence he may clean his tableware (wooden spoon fingers. Both the bony processes and the masses of cartilage included) with a rag which has been very differently In the course of a month he may occupy three are small and isolated at first but gradually increase till’ utilised. they attain their normal size. Although these events take different cells, so having to attempt this differentiation three place with great rapidity it is remarkable that it was only in times over. But so long as the tins look bright authority one section that Professor Wendelstadt observed a bone cell does not concern itself with the trivial discomfort alluded presenting the characteristic features -of active mitosis. to. Once a month about half a square yard of,caean rag is New bone is formed by the endosteum as well as by the, provided. As regards daily ablutions, there, is no rule near end The new a of the bone. the periosteum, especially against prisoner washing half a dozen times a day it he muscles and nerves are developedfrom appropriate cells in -V6 so- minded. He is, however, allowed only about half a was
clean.
236 water for both washing and drinking purposes, and all his tins, with the exception of the water-can, must be clean and empty throughout the day. On getting up in the morning he has to wash, dress, and sweep out his cell, being ready to put wash-basin, dustpan, urinal, and water-can on the door sill directly the door is opened. This has all to be done hurriedly and he has generally to content himself with the merestlick and promise’ of hands and face. Experience may teaoh him in time, though that on one morning in the week when bedding is inspected he will get a minute or two more. This brief period gives him his only opportunity in the week of washing any other portion of his anatomy, thus the neck and ears get some attention. Tooth brushes are unknown. Hair brushes are filthy and add another horror to a change of cell. Also, it is enjoined that after having washed the prisoner must scrub his cell ; so that even if his perfunctory dabble in about one and a half pints of water has served to make his hands clean they are not allowed to remain so for ten minutes. A single pail of scrubbing water does duty for more cells than one. Some prisoners are in habits and seem but their anything cleanly to delight in the passing of filth from cell to cell. The treasured fragment of soap with which a man who longs to be clean attempts to wash himself must be used upon the floor in conjunction with the scrubbing brush. True, prisoners have a warm bath once a fortnight, but this is the merest farce. One is not given time to use the soap before there comes a peremptory order toI let that water off and get out.’ Again, as regards the water tin. A prisoner may be rejoiced to find that his plate just serves to cover its wide top and it will seem to him that he may thus keep his only drink to some extent free from dust throughout the day. But this is against the rules. The plate must be set nearly upright so that a glance will reveal any dulness on its surThe water is thus left free to absorb dust and face. impurities throughout the entire 14 hours. Another point may be alluded to as showing how little care is taken to preserve health and cleanliness among prisoners. A diet of brown bread and porridge is, as everyone knows, calculated to induce diarrhoea. Yet the prisoner is supposed to go to the’ He may ring his bell and ask w.c. but once in the 24 hours. leave to go again. The bell may or may not be answered. If it is it matters not how he prefers his request, he is certain, of abuse and by no means sure of the desired permission. OnL his discharge he receives his own linen-unwashed." We give our correspondent’s statement exactly as he sends it.
gallon of
HA inf)f)HeR
ns
a,
two his n()fl1.fl, Y7,f7p.,z
Tt is wall-
’
known to us that in many prisons better conditions prevaill but the other side should be shown in the interests of the medical officers who will thus have their hands strengthenedl in attempts at sanitary reform.
MEETING OF THE BRITISH MEDICAL ASSOCIATION: THE PATHOLOGICAL MUSEUM. WE have on previous occasions alluded to the decadence of this museum of late yearsand it is with great pleasure that we call special attention to the exhibition which is promised this year by Dr. James Ritchie, Dr. E. W. Ainley Walker, and the local committee at Oxford. Among the material promised we note specimens,
photographs, and other material illustrating recent advances in medical science ; apparatus for skiagraphy ; colour photography in relation to medical, surgical, and pathological work ; apparatus for photo-micrography; specimens bearing the discussions in the various sections ; and, more useful perhaps to the general mass of the profession who attend the Association, instruments for clinical diagnosis. We are informed that a room will be fitted up with on
1
THE LANCET,
Sept. 6th, 1902, p. 701,
and
August 22nd, 1903,
p. 545.
various recent inventions for clinical diagnosis. The idea of the founders of the pathological museum was that it should form a valuable means of education and interest for the whole profession and particularly for those who were engaged in busy country and provincial practice. Unfortunately, in process of time it failed to keep up to this ideal. We congratulate the local committee on its attempt to restore the museum to the position which it used to occupy and we cordially wish these gentlemen every success.
ANTIMONIAL AND LEAD POISONING FROM THE USE OF THE LINOTYPE MACHINE. IN the British Journal of Dermatology for July Dr. Leslie Roberts has called attention to the fact that though the has greatly reduced the. use of the linotype machine of lead poisoning among compositors such danger danger still exists, as the following case shows. A compositor, aged 29 years, began to fail in health about a year after the introduction of the linotype machine into the works where he was employed. There were pains in the limbs, tenderness of the fingers, constipation, and excessive perspiration. He continued to work for three and a half years after the onset of the symptoms and consulted several medical men but was never suspected to be suffering from metallic poisoning. After absence from work the symptoms abated but on resuming work the patient relapsed. Tenderness of the palms and the fingers increased so much that it compelled him to give up work and he entered a hospital. The hands were damp with excessive perspiration and the palms and fingers were of a faint pink colour. On the thenar and hypothenar eminences were minute pale papules. Dr. Roberts thought that the patient was suffering from arsenical poisoning but the makers of the linotype metal guaranteed that it consisted of tin, antimony, and lead, and was free from arsenic. Microscopic examination of the affected skin showed congestion but no leucocytosis. The poison had spent its force on the epithelium in an irregular manner. The stratum lucidum was remarkably thickened, the rete cells were actively proliferating, and the prickle cell stratum was enlarged. The epithelial ridges were enlarged laterally and there was cavernous dilatation of the intra-epithelial portion of the sudoriparous ducts. Such changes are produced by a metal of the arsenical group and must have been due to the antimony. In addition to the constipation there was evidence of lead poisoning-tremors and lead in the urine. The absence of colic may have been due to modification of the symptoms of lead poisoning by the antimony. This case shows that air shafts and ventilators should be fixed above the trough containing the molten linotype metal for the purpose of carrying off the fumes.
TUBERCULOSIS (ANIMALS) COMPENSATION BILL. WE have received a copy of "Notes of Evidence"submitted to a select committee of the House of Commons by Dr. Henry O’Neill, consulting surgeon to the Royal Victoria Hospital, Belfast, in reference to the Tuberculosis (Animals) Compensation Bill. Dr. O’Neill explained that in Belfast the meat-supply is carefully inspected by a staff of one superintendent and five properly qualified meat inspectors assisted (when required) by a veterinary surgeon and such other scientific experts as the market committee may consider necessary. These inspectors endeavour to carry out to the best of their judgment the recommendations of the Royal Commission on Tuberculosis. In consequence of this action certain carcasses are condemned and Dr. O’Neill brought forward statistics to show that a heavy financial loss fell upon the butchers, several of whom had consequently been " driven out of trade." Dr. O’Neill considered that this loss should be partly borne by the