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PROPOSED CONFEDERATION OF THE LONDON MEDICAL SOCIETIES.
874
distributing centres in the town. These methods may no feeling of numbness, and headache was rare. No epileptic to imply such a strict attention to details as to be attack had occurred for over a year and only one was recorded beyond practical application but, as Dr. McCleary points after the operation. The patient was unable to do hard work. out, they are in operation in the city of Rochester in New The special interest of the case lies in the ataxia and the York State. Precise precautions are carried out at this nystagmus in Dr. Dercum’s view. He states that it is known to sterilise not the milk but everything with which it that lesions of the frontal lobe may give rise to ataxia, somedepot the
seem
Another defect of the British milk dep6ts pointed by Dr. McCleary is that practically no the effective individual medical superis made for provision vision of the children. There is no doubt, he thinks, that the value of our dep6ts would be much increased if a regular medical consultation formed part of the work and especially if that consultation were opened to nursing mothers. Finally, Dr. McCleary concludes that (1) municipal milk should not be sterilised milk but clean milk produced under the strictest possible aseptic precautions. For this purpose the cows must be owned by the municipal authorities. 2. Municipal milk should be supplied primarily to three classes of consumers of milk-namely, nursing mothers, children over nine months old (who would not in the natural course of events be breast-fed, or at all events not wholly breast-fed), and infants under nine months for whom breast feeding is impracticable. Lastly, it should be the object of the municipality to increase the number of nursing mothers so as to diminish the number of infants placed in the last
comes into contact. out
category.
-
times bilateral In connexion with the nystagmus it is out that the second frontal gyrus is a centre which pointed stands in direct relation to movements of the eye. But whilst conjugate deviation has been noted in lesions of this region nystagmus has not been previously observed, though reference is made to a similar case of nystagmus reported by Klien at the time of appearance of the above paper. Attention is drawn to the general character of the convulsive seizures although the lesion giving rise to them was limited.
PROPOSED
CONFEDERATION OF THE MEDICAL SOCIETIES.
LONDON
UNDER the above heading we publish in another column a letter from Sir William S. Church drawing attention to a meeting to be held on April 10th at the Royal College of Physicians of London, at 5 P.M., when the question of the desirability of uniting the central medical societies of London will be discussed. At the annual meeting of the Royal Medical and Chirurgical Society held on March lst the project was referred to in the President’s annual address and was well received by those present and, as we reported last week, on the occasion of the anniversary dinner of the Medical Society of London held on March 15th, it was mentioned, by Sir William Church and sympathetically received by his audience. There can be but little doubt, in our opinion, that a confederation of the medical societies of the metropolis would be of great benefit in many ways. We hope that the forthcoming meeting will be largely attended and that a conclusion favourable to confederation may be come to.
A CASE OF TRAUMA OF THE POSTERIOR PART OF THE SECOND FRONTAL CONVOLUTION FOLLOWED BY ATAXIA, NYSTAGMUS, AND EPILEPSY. AN interesting case was reported to the American Neurological Association and was subsequently published in the Journal of Nertozis and Mental Disease for February last by Dr. F. X. Dercum, in which a man; aged 24 years, whose family history was good and who enjoyed good health, received a blow on the head from a baseball bat. He was THE SUPPLY OF ELECTRICITY. stunned and subsequently lay in bed for some weeks with AN analysis of the accounts for the year ended March, delirium passing into mental confusion. Examined two months after the injury the condition was as follows. There 1904, of the electricity supply undertakings established in the County of London, together with miscellaneous statistics were two extensive scars in the frontal region, one on either side of the median line, that on the right side being the relating to the area of supply, capacity, output, and average larger and more serious; there were also present ataxic price obtained, has been published by the London County gait, tremors and ataxic movements of the left hand Council. The most interesting part of this analysis to the and arm, nystagmus on lateral movement of the eyes consumer is that which deals with the various prices charged of an irregular and ataxic kind, difficulty in standing on for current per unit by different companies. The medical either foot, especially on the left, and intense headache. man, too, who has uses for the current other than that of An exploratory operation in the right frontal region was lighting may well consider under what category he ought to advised but was refused. About a year after the accident an pay-vizwhether that of lighting or of power and heat. In attack of an epileptic nature, succeeded by severe frontal most cases the maximum price which is authorised to be headache, occurred. The patient was re-examined. The grasp charged for each unit is 8d. but in a few instances it is 7d. or of the left hand was found to be defective and he stood with 6d. and in the case of the Chelsea company it is as high as 10d. difficulty on the left foot ; there were persistence of tremor As a matter of fact, in no case in the County of London is in the left hand, ataxia of the left limbs, diminished sensi- the maximum price charged. The methods of charging for bility of the left arm, and diminution of the left knee-jerk. current are two. There is the flat rate system whereby The condition of the eyes was as before. Rather more than a current is charged at a fixed rate per unit whether the year after the accident he was operated upon, an osteoplastic demand has been regular or intermittent. The maximum flap being removed in the right fronto-parietal region from the demand system appears, however, to be generally the most border-line of the hair to just behind the Rolandic fissure. satisfactory so far as the economical working of an underThe dura mater was yellow and adherent to the pia-arach- taking is concerned, though it is difficult, we fancy, to noid over an area of from four to five centimetres. The convince the consumer that this method is an advantage The principle of the maximum demand system cortex on incision was found to be darker and redder than to him. normal and softened. The posterior portion of the second is that the rate charged per unit depends on the regufrontal gyrus was the region specially involved. The patient larity of the demand. The system involves, in addition made a good recovery from the operation and examination to the usual meter, the use of a demand indicator, the from time to time showed improvement in the symptoms. purpose of which is to register the maximum demand made At the final examination, a little over four years after the for current at any one time during the period (usually a accident, the condition was as follows: the ataxia was absent, quarter) of the account. It is thus possible to work out the the patient stood well on either leg, the knee-jerks were equivalent number of hours per day during which the maxiscale normal, the tremor in the left hand was disappearing, there mum demand has been maintained and a was slight awkwardness in movements of this hand, nystagmus of charges is applied accordingly. The public, however, was still present on lateral movement of the eyes, there was in general prefer the fiat rate as being, perhaps, the more
sliding
distributing centres in the town. These methods may no feeling of numbness, and headache was rare. No epileptic to imply such a strict attention to details as to be attack had occurred for over a year and only one was recorded beyond practical application but, as Dr. McCleary points after the operation. The patient was unable to do hard work. out, they are in operation in the city of Rochester in New The special interest of the case lies in the ataxia and the York State. Precise precautions are carried out at this nystagmus in Dr. Dercum’s view. He states that it is known to sterilise not the milk but everything with which it that lesions of the frontal lobe may give rise to ataxia, somedepot the
seem
Another defect of the British milk dep6ts pointed by Dr. McCleary is that practically no the effective individual medical superis made for provision vision of the children. There is no doubt, he thinks, that the value of our dep6ts would be much increased if a regular medical consultation formed part of the work and especially if that consultation were opened to nursing mothers. Finally, Dr. McCleary concludes that (1) municipal milk should not be sterilised milk but clean milk produced under the strictest possible aseptic precautions. For this purpose the cows must be owned by the municipal authorities. 2. Municipal milk should be supplied primarily to three classes of consumers of milk-namely, nursing mothers, children over nine months old (who would not in the natural course of events be breast-fed, or at all events not wholly breast-fed), and infants under nine months for whom breast feeding is impracticable. Lastly, it should be the object of the municipality to increase the number of nursing mothers so as to diminish the number of infants placed in the last
comes into contact. out
category.
-
times bilateral In connexion with the nystagmus it is out that the second frontal gyrus is a centre which pointed stands in direct relation to movements of the eye. But whilst conjugate deviation has been noted in lesions of this region nystagmus has not been previously observed, though reference is made to a similar case of nystagmus reported by Klien at the time of appearance of the above paper. Attention is drawn to the general character of the convulsive seizures although the lesion giving rise to them was limited.
PROPOSED
CONFEDERATION OF THE MEDICAL SOCIETIES.
LONDON
UNDER the above heading we publish in another column a letter from Sir William S. Church drawing attention to a meeting to be held on April 10th at the Royal College of Physicians of London, at 5 P.M., when the question of the desirability of uniting the central medical societies of London will be discussed. At the annual meeting of the Royal Medical and Chirurgical Society held on March lst the project was referred to in the President’s annual address and was well received by those present and, as we reported last week, on the occasion of the anniversary dinner of the Medical Society of London held on March 15th, it was mentioned, by Sir William Church and sympathetically received by his audience. There can be but little doubt, in our opinion, that a confederation of the medical societies of the metropolis would be of great benefit in many ways. We hope that the forthcoming meeting will be largely attended and that a conclusion favourable to confederation may be come to.
A CASE OF TRAUMA OF THE POSTERIOR PART OF THE SECOND FRONTAL CONVOLUTION FOLLOWED BY ATAXIA, NYSTAGMUS, AND EPILEPSY. AN interesting case was reported to the American Neurological Association and was subsequently published in the Journal of Nertozis and Mental Disease for February last by Dr. F. X. Dercum, in which a man; aged 24 years, whose family history was good and who enjoyed good health, received a blow on the head from a baseball bat. He was THE SUPPLY OF ELECTRICITY. stunned and subsequently lay in bed for some weeks with AN analysis of the accounts for the year ended March, delirium passing into mental confusion. Examined two months after the injury the condition was as follows. There 1904, of the electricity supply undertakings established in the County of London, together with miscellaneous statistics were two extensive scars in the frontal region, one on either side of the median line, that on the right side being the relating to the area of supply, capacity, output, and average larger and more serious; there were also present ataxic price obtained, has been published by the London County gait, tremors and ataxic movements of the left hand Council. The most interesting part of this analysis to the and arm, nystagmus on lateral movement of the eyes consumer is that which deals with the various prices charged of an irregular and ataxic kind, difficulty in standing on for current per unit by different companies. The medical either foot, especially on the left, and intense headache. man, too, who has uses for the current other than that of An exploratory operation in the right frontal region was lighting may well consider under what category he ought to advised but was refused. About a year after the accident an pay-vizwhether that of lighting or of power and heat. In attack of an epileptic nature, succeeded by severe frontal most cases the maximum price which is authorised to be headache, occurred. The patient was re-examined. The grasp charged for each unit is 8d. but in a few instances it is 7d. or of the left hand was found to be defective and he stood with 6d. and in the case of the Chelsea company it is as high as 10d. difficulty on the left foot ; there were persistence of tremor As a matter of fact, in no case in the County of London is in the left hand, ataxia of the left limbs, diminished sensi- the maximum price charged. The methods of charging for bility of the left arm, and diminution of the left knee-jerk. current are two. There is the flat rate system whereby The condition of the eyes was as before. Rather more than a current is charged at a fixed rate per unit whether the year after the accident he was operated upon, an osteoplastic demand has been regular or intermittent. The maximum flap being removed in the right fronto-parietal region from the demand system appears, however, to be generally the most border-line of the hair to just behind the Rolandic fissure. satisfactory so far as the economical working of an underThe dura mater was yellow and adherent to the pia-arach- taking is concerned, though it is difficult, we fancy, to noid over an area of from four to five centimetres. The convince the consumer that this method is an advantage The principle of the maximum demand system cortex on incision was found to be darker and redder than to him. normal and softened. The posterior portion of the second is that the rate charged per unit depends on the regufrontal gyrus was the region specially involved. The patient larity of the demand. The system involves, in addition made a good recovery from the operation and examination to the usual meter, the use of a demand indicator, the from time to time showed improvement in the symptoms. purpose of which is to register the maximum demand made At the final examination, a little over four years after the for current at any one time during the period (usually a accident, the condition was as follows: the ataxia was absent, quarter) of the account. It is thus possible to work out the the patient stood well on either leg, the knee-jerks were equivalent number of hours per day during which the maxiscale normal, the tremor in the left hand was disappearing, there mum demand has been maintained and a was slight awkwardness in movements of this hand, nystagmus of charges is applied accordingly. The public, however, was still present on lateral movement of the eyes, there was in general prefer the fiat rate as being, perhaps, the more
sliding