493 material improvement. As to after-results, these should scorbutic treatment was delayed. Probably modern diet be described thus : fit for full work (being the person’s contained sufficient antiscorbutics to prevent actual acute but not to prevent a chronic periodontitis. Pyorrhcea ordinary occupation), fit for light or partial work, scurvy was present because in the mouth there was damaged tissue unfit for any work, died, lost sight of. It was agreed in the shape of inflamed gums, due to pap foods ; bacteria to postpone the question of the symbolic representa- were always present and with a diet deficient in antiscorbutic of and to make no tion recommenda- vitamines pyorrhoea supervened. That many vegetarians physical signs, tion regarding the form of case records. suffered from pyorrhcea was probably explained by the fact The meeting adopted the report of the committee on that they are mostly large consumers of carbohydrates and that their vegetables or fruit are rarely eaten raw. the In Asiatic races caries is rare, but the teeth drop out Training of Nurses, at middle age in those parts of the country where which advises a two years’ training in a tuberculosis the antiscorbutic factor is deficient in the diet. Points institution, followed by an examination conducted by which lead to the conclusion that chronic general an independent examiner and to the satisfaction of periodontitis was really connected with diet were its the College of Nursing. Nurses should be encouraged universality, its development among wild animals brought to proceed to general training, from which a remission into captivity, the fact that no specific bacteria had been and the further fact that some persons who might of six months in a three years’ training should be isolated, be considered food cranks had effected their own cure. allowed to those passing the examination. Dr. Handley-Read then described several cases in which she had found acute pyorrhoea which had completely cleared up on a diet of raw vegetables, salads and fruit, eggs, a little LONDON ASSOCIATION OF THE MEDICAL milk, and very limited carbohydrates. Anintensive vita-
mine " diet such as this would produce astonishingly good results. While firmly believing in the efficacy of such treatment for chronic pyorrhoea, local treatment by drugs, vaccines, and ionisation should not be neglected. In the discussion of the paper Dr. 0. LEWIN, Dr. D. HARE, Dr. E. HARDING, Mrs. FLEMMING, and others
WOMEN’S FEDERATION.
A MEETING was held on Feb. 15th at the Elizabeth Garrett Anderson Hospital, Mrs. E. FLEMMING, M.D., in the chair, when Dr. EVA HANDLEY-READ read a paper on took part. The Influence of Diet CM Dentition (1) on teeth during the pre-natal period, (2) on dental SOCIÉTÉ DE DE PARIS. caries, (3) on pyorrhoea alveolaris. The speaker emphasised the importance of accessory food AT a recent meeting of this society Dr. G. CAUSSADE and factors as absolutely essential to growth, and of the antirachitic fat-soluble A vitamine as a necessity in diet if the Dr. P. CHABPY communicated a paper on the hardest tissue of the body and the one requiring the best Pharmacology, Posology, and Clinical Aspects of Salicylate nourishment-i.e., the enamel of the teeth-is to develop of Soda.
THÉRAPEUTIQUE
Dr. Handley-Read said that the temporary teeth remarked that the toxicity of this drug had been much formed in the jaws before birth. Calcification They While fatal cases had been reported after small the sixteenth week, and continues throughout the disputed. in other instances only transient disturbances had doses, of the it is existence evident that the mother’s teeth ; hence been caused by much stronger doses. Children above mode of living during pregnancy and lactation must influence the age of 7 would very well take the doses ordered for the teeth of the child. Even at the worst war period the on the other hand, above 30 the drug was usually diet of the poorest working women of this country had just adults ; in the first place, acute articular contra-indicated sufficient essential vitamines to produce bone and tooth rheumatism was because, rare after that age ; and secondly, because tissue fairly well calcified, and observations at baby the liver and kidneys were less likely to be healthy then showed that the teeth of all babies erupt fully than in clinics, &c., younger persons. Women showed a special susceptiformed with apparently good enamel, but if the diet to the drug, and it should not be given to alcoholic is poor in the antirachitic vitamine the enamel is found bility or to persons with a nervous taint. Apart from carious within a few months. Dr. Harriette Chick, Mrs. subjects individual susceptibility, the impurity of the product had and others done much Mary Mellanby, important should be considered. Commercial salicylate of research work on the accessory food factors. It had been employed soda contained free salicylic acid, isomeric acids, isophthalic shown that absence of fat-soluble A influences the develop- and creosotic acids. The last two were toxic substances,. ment of teeth and jaw in puppies, causing (1) poor growth and every salicylate should be rejected which was not of bone and alveolar process, the tissue being osteoid ; crystalline, and which was violet or grey in colour and acid of lower incisors; (3) delayed eruption (2) irregularity in reaction. Salicylate of soda was mainly eliminated in in enamel and dentine, the urine in the shedding; (4) delay calcification, poor form of salicyl-uric acid, a combination and lessened resistance to diseases such as distemper and of salicylic acid and glycocoll. Its elimination should be broncho-pneumonia. Pregnant and nursing mothers should hastened by putting all patients taking the drug on a vegethus have a liberal supply of fat-soluble A in the diet as well tarian diet, since by that means a more abundant formation as the other vitamines. of glycocoll was effected, the suppression of which might Dr. Handley-Read referred to the work of Dr. Sims rise to serious symptoms. The most frequent, if not Wallace, Sir F. Colyer, and Dr. J. Wheatley on the import- give the most serious, symptom of salicylate intoxication was. ance of stone-ground flour in diet owing to its antidelirium. It fairly soon after the commencement neuritic vitamine, to cellulose content, and to its need of of treatment. appeared Its onset might be sudden, occurring at theattrition. Vigorous mastication stimulates the flow of saliva same time as the pains in the joints disappeared. When essential for proper cleansing of the mouth and for the it developed less suddenly it was characterised by talkativeneutralisation of acids. Speaking of the infant’s diet after restlessness, and a freedom of movements in striking weaning, she said that the transition from milk to solid ness, with the functional impotence of the previous days. food should not be via pap food as this is bolted without contrast Dr. GASTON DURAND read a paper on if proper mastication or insalivation. By 1 years of age, dentition is normal, a child should be able to masticate an Migraine and Auto-hœmotherapy, apple, while from 2-5 years a normal child should be, in which he reported the case of a woman who at the age capable of masticating any hard food. The County Council of 50 began to suffer from attacks of migraine accompanied classes in their syllabus advised a diet which was almost; by urticaria, which became worse in the course of six entirely confined to pap food and yet insisted on the import- months until she had only a few days’ respite. After other ance of efficient mastication. It was interesting to note! methods had failed Durand decided to make use of autothat between 1919 and 1920, according to Dr. Wheatley’s! hsemotherapy which he had found successful in several report from Shropshire, children of 5 years of age showedl cases of urticaria. A subcutaneous injection of 10, c.cm. of an an average 1’9 decayed teeth per child, as against 6’4 per the patient’s blood was given during an attack, and four child between 1910 and 1914. This seemed to be explainedl days later at the onset of an attack, with the result that the largely by the restriction in the purchase of carbohydrates,, patient for the first time for three months was a whole and by the fact that new bread was prohibited and crusts ofE fortnight without having another attack. The next attack coarse bread had to be eaten. In poor districts 4
properly. are fully begins in
and
,
.
494 hiccough,
and for that
reason
he
was
inclined to
regard the
condition, not as a manifestation of influenza, as had been done by Logre and Heuyer, nor of epidemic encephalitis, as maintained by Sicard and Paraf and Achard and Rovillard, but as a rheumatoid or rheumatismal manifestation. Dr. G. LEVEN, in his paper on
Reviews and Notices TRUTH
of
Books.
ABOUT VENEREAL DISEASE.
Syrnptomatic Aerophagia, By MARIE CARMICHAEL STOPES, D.Sc., Ph.D. London : G. P. Putnam’s Sons, Ltd. 1921. Pip. 52. stated that although the diagnosis of aerophagia was an ls. 6d. should realise the that the most easy matter, practitioner typical aerophagia might sometimes accompany an organic unfortunately, is a relative term. In regard lesion, and that the most careful and complete treatment of to TRUTH, venereal diseases it has suffered very greatly aerophagia might fail because the symptoms masked a more at the hands of its most eager disciples. Mrs. Stopes serious disease. He recorded three typical cases of aerophagia which were associated with descending goitre, has visited both warring camps-she acknowledges stricture of the oesophagus, and cardiac hypertrophy respec- indebtedness for much information from Mrs. A. C. tively, these three diseases being to a certain extent Gotto and also from Mr. H. Wansey Bayly-and has responsible for aggravating the aerophagia. discovered as common to both the National Council for Combating Venereal Diseases and the Society for the Prevention of Venereal Disease a body of DEVON AND EXETER MEDICO-CHIRURGICAL ascertainable facts, some simple deductions from these facts, and campaigning principles based on SOCIETY. these deductions. These are set forth with great skill and persuasiveness in a little pamphlet literary Exhibition of Cases and Specimens. of 50 pages, which, she states, was written at the A MEETING was held at the Royal Devon and Exeter request or with the approval of Professor W. M. Hospital on Feb. 17th, Mr. A. C. ROPER being in the Bayliss, Sir James Crichton-Browne, and others. The book is divided into nine sections, of which the chair. Mr. A. L. CANDLER showed: (a) X ray plate of a case of headings are : Germs Generate Disease ; The Deadliest Perthes or Legg’s Disease of Hip in a girl aged 17, who also Germs; Pure and Happy Marriage is the Only True gave evidence of deficiency of endocrine glands; (b) Myoma Safeguard of the Race; The Characteristics of the of Uterus weighing 10 lb. with pregnancy of four months’ Deadliest of all Germs; Contact is the Source duration; (c) three specimens of Ectopic Gestation-viz., of Infection; Disinfectants do Disinfect; Disinfecttubal, ovarian, and secondary abdominal pregnancies. ants Only Disinfect; Disinfectants Disinfect, They Mr. NORMAN LOCK showed: (a) Two Ribs with Chondrodo not Cure; Humanity can be Entirely Freed sarcoma on the Inner Side removed successfully some this Terror. While the first eight sections are from months previously; (b) Large Stones in Kidney; (c) a instructive it is to the ninth that the informed reader, greatly. Thickened Gall-bladder containing a Gall-stone. Dr. RANSOM PICKARD exhibited Eyes removed for Sarcoma sick of controversy, will naturally turn. Mrs. Stopes of Choroid and Sarcoma of the Ciliary Region respectively. holds that if we only dealt with the subject energetically Dr. G. P. HAWKER showed a patient with Embolism of enough we should stamp out the diseases in this Retinal Artery. more quickly and easily than plague, smallDr. R. V. SOLLY showed: microscopic slides of (1) Cattle and country or leprosy. To this end she is assured of the pox, other Ringworms ; (2) Basal-celled Carcinoma ; (3) Cerebral Tumour in Brain secondary to Sarcoma of Eye in a case necessity of a complete survey of everyone in the where no other secondary growths could be found elsewhere country, although it may be many years before the at the autopsy. public demands it. Sex diseases, she thinks, would Dr. SOLLY also showed for Mr. B. DYBALL: (1) Myeloma of never have saddled themselves on humanity had not all Fibula; (2) Hypernephroma. sex knowledge been befouled by prudery. "No one Dr. F. A. ROPER showed X ray photographs of: (1) Osteitis would with a case of small-pox or the willingly sleep Deformans with commencing Sarcoma; (2) Hernia of plague." She believes that a new and overwhelming Stomach into Left Side of Thorax following G.S.W. spiritual power is even now entering upon the earth, but that immediately to stem the onrush of contamination some new factor of health and cleanliness NORTH OF ENGLAND OBSTETRICAL AND must be brought into play during the hiatus, until the GYNÆCOLOGICAL SOCIETY. young generation grows to maturity. The concluding paragraph of the book runs: Exhibition of Cases and Specimens. It is the duty of the Churches to win the people by moral precepts and teaching to a right view of life and pure living; it is A MEETING was held at Liverpool on Feb. 18th, Mr. the duty of the doctor to see that people are decently clean ; it is CARLTON OLDFIELD, the President, in the chair. the duty of the reformer to see that people know facts essential to their In this respect the moralist and the doctor Dr. J. E. GEMMELL and Dr. LEYLAND ROBINSON showed have life and progress. essentially the same message to teach. three specimens of Uterine Fibroids, complicated in two We believe that the chief merit of Dr. Stopes’s book cases by a coexisting carcinoma of the body of the uterus. In the third specimen a left haamatosalpinx was present and lies in the fact that after reading it every right-minded citizen will enlist according to his strength and ability was evidently produced by torsion, as there was no evidence of ectopic pregnancy. in the campaign against venereal diseases, and will be Dr. J. H. WILLETT and Dr. R. A. HENDRY (Liverpool) unlikely to embarrass the high command by violent showed a specimen of Hydatidiform Mole with a Well- adhesion to a particular battalion. Four and a Months’ Fcetus and Placenta. Half developed were of that this was of a case twin pregnancy They opinion in which one ovum had undergone vesicular degeneration. LECTURES ON DISEASES OF CHILDREN. Dr. W. W. KING (Sheffield) described a case where acute Fourth edition. symptoms arose during pregnancy from the rupture of a By ROBERT HUTCHISON, M.D., vein on the surface of a subperitoneal myoma of the uterus. F.R.C.P. London: Edward Arnold. 1920. IllusAt the operation a large quantity of free blood was found in trated. Pp. 416. 21s. the peritoneal cavity. The tumour was removed by myomecAN author who publishes in book form a series of and the left undisturbed. pregnancy tomy A discussion took place on Dr. F. H. Lacey’s paper on lectures prescribes for himself definite limitations, by Induction of Labour for Moderate Contraction of the Pelvis, which the writer of a text-book is unfettered. Each lecture read at the last meeting of the society and reported in must be a composite whole, even though the teaching THE LANCET, Feb. 12th. The opinion of the majority of the be in accordance with consecutive tenets or theories, speakers was that, although excellent results could, no doubt, and the subject-matter of its title must stand out in relief. be obtained in hospital, as Dr. Lacey’s figures showed, the Though necessarily hampered by these restrictions, method was extremely tedious in practice and apt to Dr. Hutchison has contrived to embody in his lectures cause a good deal of anxiety to the patient and her attendant. of information of first-rate importance conCsesarean section should be the operation of choice where a great deal there was any reason to fear that delivery of a healthy full- cerning the diseases of children, and it is not to be term child by the natural passag.es was going to be wondered at that a fourth edition has already been called for. The author has rewritten the lectures impossible.
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