- Email: [email protected]
"A CORONER'S COMMENTS. "
906 the immediate aim of their own body as a steppingstone towards the summum bonum. It is not at all unlikely that a greater measure of success may attend the " comparatively moderate requirements of° semi-teetotalism to efforts of the than has yet met the instigators The consumption of alcohol in Great total abstinence. Britain shows no marked signs of decreasing. The evils wrought by alcoholic excess remain a serious menace to our national welfare and a cause of vice and disease probably unequalled in this country by any other one thing. Any system that may tend to free the country from this widely prevalent and destructive influence must be welcomed by all who have the good of the nation at heart and to the notice of medical men in particular we would recommend for support the "Semi-Teetotal Pledge Association."which has the patronage of Lord Roberts and Lord Alverstone.
regard
____
"A CORONER’S COMMENTS. IN
"
annotation which we published recently under this we remarked upon the proceedings at an inquest held at Bournemouth where an investigation into the cause of death had been undertaken by the medical men in attendance immediately after the death of the patient. We appear to have received a piece of incorrect information or to have derived a wrong impression, as we understood that the patient, who died during the administration of an anaesthetic, had already an abdominal wound, the commencement of an operation, which wound, with the permission of the parents, was afterwards enlarged. The coroner asks us to state that no abdominal wound existed at the time of death and that the abdominal incision was made entirely after death. an
heading1
THE
CLINICAL VALUE OF MEASURING THE BLOOD PRESSURE.
IT is only within recent years that measurement of the blood pressure with the sphygmometer has begun to take the place of vague estimation with the finger, an advance analogous to measuring the temperature with the thermoIn the Boston meter instead of estimating it by the hand. Medical and Sitrgietzl Journal of Feb. 26th Dr. J. M. Jackson has published a number of interesting observations made with Gaertner’s sphygmometer which show the value of measuring He finds that the blood pressure in the blood pressure. young healthy men ranges from 100 to 130 millimetres of mercury but may be as high as 150 millimetres and that in young women it ranges from 90 to 110 millimetres. Elderly persons have, in consequence of arterial changes, almost always a high blood pressure. Thus in a person aged 50 years a pressure of 175 millimetres need not cause disquietude. Low pressures are uncommon and are found principally in cases of shock and collapse. Pressures of 200 millimetres are not infrequent and should be regarded as dangerous, while pressures of 250 millimetres are very dangerous. In the last year five of Dr. Jackson’s patients with pressures of over 190 millimetres have died from apoplexy. Hence he makes it a rule to warn the family in such cases. In kidney disease he has sometimes found very high pressures. Thus a girl complained of headache and dimness of vision. Considerable enlargement of the heart The urine was noticed and there was incipient retinitis. did not contain albumin or casts and there was no dropsy. The sphygmometer registered 250 millimetres, the highest pressure that could be measured. As he was puzzled by the case he admitted the patient to hospital. For a few days nothing more was found until slight hsematuria occurred. A week after admission she died suddenly. 1
THE
LANCET, Dec. 27th, 1902,
p. 1797.
The necropsy showed ureter and the other
the blood pressure
was
tuberculous kidney with occluded kidney hypertrophied. In this case the only danger signal." In another a
"
case a woman, aged about 60 years, with marked arteriosclerosis and interstitial nephritis, had been under treatment for some time. The blood pressure ranged up to about 210 millimetres. One day she complained of headache and the pressure was higher than the sphygmometer registered (250 millimetres). While Dr. Jackson was making a third attempt to take the pressure, in order to be sure that he Death from was correct, she fell on the floor unconscious. cerebral haemorrhage occurred in a few minutes.
THE WATER-SUPPLIES OF GLAMORGAN. WE have received a copy of a report by Dr. W. Williams, the medical officer of health of the Glamorgan county council, dealing with the water-supplies of that county. The report appears to us to be very complete and presents a good deal of information that will be valuable in regard to existing supplies and possible new sources. It is shown that an enormous increase is taking place in the population of Glamorgan owing to the rapid growth of its industrial centres, and that is a fact which justifies giving the subject careful attention. Dr. Williams deals with this question of the increase of population and then, after a section devoted to the physical aspects of the county, refers to rainfall, watersheds, sources of the water-supplies, and concludes with the results of the examination of the public water supplies based upon chemical analyses undertaken by Dr. W. G. Savage and Mr. J. H. Sugden, B.Sc., F.I.C. Appended to the report are four interesting and instructive maps dealing with (1) the existing and prospective waterworks, gathering grounds and pumping stations and their relation to the South Wales coal field ; (2) the physical configuration of Glamorgan and the adjacent counties ; (3) the rivers of Glamorgan and adjacent counties ; and (4) the rainfall for the year 1901 in Glamorgan and the adjacent counties. We congratulate the Glamorgan county council on the possession of such an admirable report. It is certainly desirable that the county councils and other authorities throughout the country should take steps to gain similarly complete information as to the character and extent of the water-supplies of their own districts. ____
ACUTE
LEUKÆMIA
WITH
HUGE
HÆMATOMA.
AT the meeting of the Societ6 Medicale des H6pitaux of Paris on Feb. 20th M. Ernest Bari6 and M. Salmon related a case of acute leuksemia in which the rare complication of a huge hasmatoma of rapid formation was observed. A man, aged 35 years, who had been ill for six weeks came under observation. He was extremely pale and complained of weakness, visual troubles, epistaxis, and diarrhoea. The lower limbs were oedematous, the spleen was enormous, and the liver was enlarged. The lymphatic glands were not affected. The blood was pale and watery. The red amounted millimetre and to cubic 2,015,000 corpuscles per The leucocytes were of unequal sizes and deformed. were greatly increased in number, being in the proportion of one to every two red corpuscles, and varied much in size, small leucocytes and very large ones being found. Arsenic was given. Some days after admission subcutaneous ecchymoses were found on the arms, legs, and abdomen and a tumour of the size of a walnut appeared below the inferior angle of the right scapula. It was painless and fluctuated. In the evening of the same day it had increased to the size of a Tangerine orange. On the following day it was larger than a fist and on the third day it was of the size of the head of As extension could not be checked a newly born infant. either by compression or by hasmostatics and the patient was rapidly becoming worse the tumour was opened in order to
regard
____
"A CORONER’S COMMENTS. IN
"
annotation which we published recently under this we remarked upon the proceedings at an inquest held at Bournemouth where an investigation into the cause of death had been undertaken by the medical men in attendance immediately after the death of the patient. We appear to have received a piece of incorrect information or to have derived a wrong impression, as we understood that the patient, who died during the administration of an anaesthetic, had already an abdominal wound, the commencement of an operation, which wound, with the permission of the parents, was afterwards enlarged. The coroner asks us to state that no abdominal wound existed at the time of death and that the abdominal incision was made entirely after death. an
heading1
THE
CLINICAL VALUE OF MEASURING THE BLOOD PRESSURE.
IT is only within recent years that measurement of the blood pressure with the sphygmometer has begun to take the place of vague estimation with the finger, an advance analogous to measuring the temperature with the thermoIn the Boston meter instead of estimating it by the hand. Medical and Sitrgietzl Journal of Feb. 26th Dr. J. M. Jackson has published a number of interesting observations made with Gaertner’s sphygmometer which show the value of measuring He finds that the blood pressure in the blood pressure. young healthy men ranges from 100 to 130 millimetres of mercury but may be as high as 150 millimetres and that in young women it ranges from 90 to 110 millimetres. Elderly persons have, in consequence of arterial changes, almost always a high blood pressure. Thus in a person aged 50 years a pressure of 175 millimetres need not cause disquietude. Low pressures are uncommon and are found principally in cases of shock and collapse. Pressures of 200 millimetres are not infrequent and should be regarded as dangerous, while pressures of 250 millimetres are very dangerous. In the last year five of Dr. Jackson’s patients with pressures of over 190 millimetres have died from apoplexy. Hence he makes it a rule to warn the family in such cases. In kidney disease he has sometimes found very high pressures. Thus a girl complained of headache and dimness of vision. Considerable enlargement of the heart The urine was noticed and there was incipient retinitis. did not contain albumin or casts and there was no dropsy. The sphygmometer registered 250 millimetres, the highest pressure that could be measured. As he was puzzled by the case he admitted the patient to hospital. For a few days nothing more was found until slight hsematuria occurred. A week after admission she died suddenly. 1
THE
LANCET, Dec. 27th, 1902,
p. 1797.
The necropsy showed ureter and the other
the blood pressure
was
tuberculous kidney with occluded kidney hypertrophied. In this case the only danger signal." In another a
"
case a woman, aged about 60 years, with marked arteriosclerosis and interstitial nephritis, had been under treatment for some time. The blood pressure ranged up to about 210 millimetres. One day she complained of headache and the pressure was higher than the sphygmometer registered (250 millimetres). While Dr. Jackson was making a third attempt to take the pressure, in order to be sure that he Death from was correct, she fell on the floor unconscious. cerebral haemorrhage occurred in a few minutes.
THE WATER-SUPPLIES OF GLAMORGAN. WE have received a copy of a report by Dr. W. Williams, the medical officer of health of the Glamorgan county council, dealing with the water-supplies of that county. The report appears to us to be very complete and presents a good deal of information that will be valuable in regard to existing supplies and possible new sources. It is shown that an enormous increase is taking place in the population of Glamorgan owing to the rapid growth of its industrial centres, and that is a fact which justifies giving the subject careful attention. Dr. Williams deals with this question of the increase of population and then, after a section devoted to the physical aspects of the county, refers to rainfall, watersheds, sources of the water-supplies, and concludes with the results of the examination of the public water supplies based upon chemical analyses undertaken by Dr. W. G. Savage and Mr. J. H. Sugden, B.Sc., F.I.C. Appended to the report are four interesting and instructive maps dealing with (1) the existing and prospective waterworks, gathering grounds and pumping stations and their relation to the South Wales coal field ; (2) the physical configuration of Glamorgan and the adjacent counties ; (3) the rivers of Glamorgan and adjacent counties ; and (4) the rainfall for the year 1901 in Glamorgan and the adjacent counties. We congratulate the Glamorgan county council on the possession of such an admirable report. It is certainly desirable that the county councils and other authorities throughout the country should take steps to gain similarly complete information as to the character and extent of the water-supplies of their own districts. ____
ACUTE
LEUKÆMIA
WITH
HUGE
HÆMATOMA.
AT the meeting of the Societ6 Medicale des H6pitaux of Paris on Feb. 20th M. Ernest Bari6 and M. Salmon related a case of acute leuksemia in which the rare complication of a huge hasmatoma of rapid formation was observed. A man, aged 35 years, who had been ill for six weeks came under observation. He was extremely pale and complained of weakness, visual troubles, epistaxis, and diarrhoea. The lower limbs were oedematous, the spleen was enormous, and the liver was enlarged. The lymphatic glands were not affected. The blood was pale and watery. The red amounted millimetre and to cubic 2,015,000 corpuscles per The leucocytes were of unequal sizes and deformed. were greatly increased in number, being in the proportion of one to every two red corpuscles, and varied much in size, small leucocytes and very large ones being found. Arsenic was given. Some days after admission subcutaneous ecchymoses were found on the arms, legs, and abdomen and a tumour of the size of a walnut appeared below the inferior angle of the right scapula. It was painless and fluctuated. In the evening of the same day it had increased to the size of a Tangerine orange. On the following day it was larger than a fist and on the third day it was of the size of the head of As extension could not be checked a newly born infant. either by compression or by hasmostatics and the patient was rapidly becoming worse the tumour was opened in order to