RADIUM.

409 of of

opinion, and have English style and

more

than

once

l been found to be considerably radio-active. The view said, that the neglect has words, both toothat the healing power of certain natural medicinal waters

the misuse of classic

is due not as to the waters to

much to the ordinary chemical constituents which apparently most mineral to be regarded as men of science, are a more or less degree possess, becomes fully impede the acceptance of science among the really strengthened also in the light of recent work, while we may literary classes of the community, to whom a verbal solecism have here an explanation as to why natural mineral water is as repugnant as a false quantity, and in whose minds a so far cannot be imitated so as to give the same therapeutic pretentious misuse of Greek or of Latin produces boredom. results. The reginae and treatment enjoined at health resorts A great deal of the prevailing physiological and pathological have a favourable effect on the individual doubtless in most cases because metabolism is improved and it remains to be verbiage might be accurately described as consisting rather of seen what the influence on metabolism may be of a course slang than of technicalities, and it is characteristic of slang of subjection to radium emanations ; one of the points to to be evanescent. May we not, even on this ground alone, urge be determined will be whether any benefit resulting arises upon men of science, and especially upon men of our own simply out of healthy oxidation being promoted by the profession, the advisability of discarding slang in favour of radium emanations or out of much more complex actions. the more abiding elements of language, so that their works, The value to clinical medicine of investigations into radium if the work can be carried on in read by their contemporaries for the sake of the instruction will be much enhanced as well as at the new institute, for in this hospitals general which they afford, may be read also by posterity as examples way the evidence of the comparative value of the treatment of style and as the raw material of history. It were surely a in certain cases can be best arrived at. worthy ambition to seek to leave something so written that VAGINAL EXAMINATIONS BY MIDWIVES. posterity "would not willingly let it die"; and success in often to be encountered in the

of authors who desire conditions which power-

writings

so

radio-activity

endeavour would have the incidental effect of even strictly professional writing may fulfil showing all the conditions necessary to satisfy a sound definition

such

an

THE Central Midwives Board having had its attention drawn to the fact that in certain instances the certificate of attendance on cases (Rules-schedule, Form III.) required of literature. Whether those conditions can also be fulfilled from every candidate for examination has been signed on behalf of those candidates who have not complied with all by medical journalism it is not for us to decide. the conditions imposed by Rule c 1 (i.) has passed the following resolution which must be taken as indicating the minimum requirements of the rule :"— that

Annotations. "Ne quid nimis."

RADIUM.

No case can be counted in which the pupil has not made abdominal and vaginal examinations (that is more than one), and has also personally delivered the head and body of the child ..and the placenta and B.B.A." (born before membranes. This excludes all cases known as arrival), and also all cases in which the labour is too advanced on arrival to make (repeated) abdominal and vaginal examinations possible. It also forbids the same case being counted to more than one person. The fact that medical help becomes necessary to apply forceps or otherwise assist delivery does not prevent the case being counted to the pupil. ‘

THE recent announcement of the formation of an institution in which the physiological and therapeutical effects ofNow, nothing could be more unfortunate than such a rule radium salts or their emanations are to be minutely studiedactually sanctioning and even requiring that "repeated will be received with satisfaction, since it must be reco- vaginal examination " should be made in every case delivered gnised that the remarkable results claimed to have beenin the face of modern experience and teaching. As far obtained in certain quarters have not so far admitted of that back as 1886 Crede wrote: ’’ Even the simplest manipulaexplanation which scientific medicine demands. The applica- tion may cause infection. It should, therefore, be laid down tion of radium emanations in disease has only proceeded onand taught as a fundamental principle that internal exapurely experimental or empirical lines, and no doubt in minations of parturient women should be altogether avoided or restricted within the narrowest possible limits. It can be some cases remarkable results have been achieved, but we To instruct are still left in the dark as to the exact way in very well replaced by external examination. which the emanations act. The lay mind has in many their pupils as thoroughly as possible in this method is the instances jumped to the conclusion that in radium a present and future duty of teaching institutions." At the panacea for cancer has been found, a view which no doubt Rotunda Hospital (the largest maternity hospital in the will be disturbed when the nature of the action of radium on British Empire) and at the New Maternity Hospital in tissues is understood ; for in fact it receives no support from Belfast one of the main points taught to the students and the experiments so far tried, since favourable results have only nurses is to endeavour to avoid vaginal examination in order been recorded in certain conditions. That the action of the to do away with the greatest danger at childbirth of both morIn speaking of the selection of nurses radium emanations is a complex one chemically, physiologic- tality and morbidity. ally, and therapeutically admits of little doubt, but it is Mr. E. H. Tweedy, Master of the Rotunda, writes in his interesting to record that experiment has already shown that"Rotunda Practical Midwifery"(Oxford Medical Publicaradium emanations appreciably increase the rate of autolysistions) : "For ourselves [Mr. Tweedy and Dr. Wrench] we of tissues, especially in the expressed juices from certainalways tell the nurse to refrain from making vaginal carcinomatous growths, and if the power of the emanationsexaminations"" (p. 37); and in one of the most scientific textconsists in encouraging the self-digestion of tissues in the! books of midwifery of the present day Dr. J. Whitridge absence of micro-organisms (which is autolysis) it isWilliams (the head of the great obstetric clinique at the possible that an agency has been found which mayJohns Hopkins Hospital) writes, p. 304 (second edition), reverse the dire progress of certain diseases. In generalunder the headDirections for Obstetrical Nurse " : " Don’t radium would appear to act as an oxidising agent, and it hasi examine patient vaginally under any circumstances." The recently been suggested that the huge beds of nitrate foundIsuggestion of the Central Midwives Board requiring midwives in Chili owe their origin to the action of radium on theto produce evidence of their having made repeated vaginal nitrogen of the air. The soil in those regions, at all events,, examinations " is contrary to much present teaching at home