STRANGE INCIDENTS IN PRACTICE,

BRITISH INSTITUTE OF PREVENTIVE MEDICINE.

446

appreciative leading article in the same number calling attention to what may prove to be an epoch-making paper so far as this ’country is concerned. Able, however, as is M. Pinard’s contribution, and fortunate as seems to have been the issue of his’ cases, there are some ’points in it to which I think emphatic attention should be drawn. In the first place, the diameter in none of the thirteen cases was conjugate pelvicinches and a half, and in four it was quite four less inches. It is not stated, moreover, how these measurements were determined ; and anyone who has had much experience in the matter knows that extreme accuracy is not always very easily attained: .Accepting these measurements, however, as accurate, it will be agreed not only that the contraction was not extreme (a point considered in the leading article), but that the measurement in several cases was one involving no insuperable obstacle to an expert obstetrician using forceps or Case 8, further, in which the pelvic conjugate is stated to have been 9’7 cm. (three inches and three-quarters), a large healthy child was born alive at term spontaneously in the first confinement. In the second the vertex presented in the left transverse position, which in this country we should term the I I left occipito-posterior." A male child was easily extracted after symphysiotomy in a condition of suspended animation, but revived. The puerperium was I I pathological," but the mother also recovered. With a diminishing population, no doubt a French obstetrician considers it his duty to emphasise the great importance of a live foetus. In this country I trust no one will accuse us of a want of solicitude in this respect,-but it has always been considered that the tree has a prior claim to the fruit-that the absolute safety of the mother, so far as we can secure it, is our paramount indication and duty. It is because. I fear that the influence of symphysiotomy may be to diminish the cultivation of the highest manipulative and instrumental dexterity, of which none are greater masters than innumerable members of our profession in general practice, and that thus the danger to the mother may be increased, that I have ventured to call attention to these points. That symphysiotomy will acquire a certain definite place in obstetrics I think there can be little doubt ; that it will in England play the rôle which M. Pinard seems to contemplate is, I believe, very doubtful. I trust the subject will be fully discussed in the columns of THE LANCET. As one differentiating from general practice, but not towards obstetrics-in which, however, I can never cease to take an interest, but of which in this age of specialism, so justly condemned by you, I must assume a profound ignorance-permit me to enclose my card and subscribe myself, Sirs, yours truly, M. R. C. P. Feb. 18th, 1893.

than three

turning..In

BRITISH INSTITUTE OF PREVENTIVE MEDICINE. To the Editors of THE LANCET. Tait has contributed to your last Lawson SlRS,—Mr. number a letter in which he states that the skeleton report of the meeting held at Birmingham in support of the British Institute of Preventive Medicine represents but incompletely the meaning he intended to convey in his speech. As I was present at the meeting, will you allow me to say that, in my opinion, the report published by you is perfectly accurate, and represented exactly the impression which Mr. Tait’s words conveyed tothose present at the meeting. Mr. Lawson Tait, in support of his assertion, makes a number of statements which are not correct. In the first place, Mr. Tait did not say. that he "objected altogether to the past record of experiments on animals as delusive," but that "he objected to a certain class of surgical experiments made chiefly to prove that somebody else was wrong." Mr. Tait did not say that bacteriological research had possibly proved of value to animals, but that it had undoubtedly done so. Mr. Tait did not say that in its application to man he could not admit in a single instance the word"proved,’’ so lavishly used by me ; but he said that he did not admitthevalue of M. Pasteur’s treatment for rabies, and he did not refer to any other forms of treatment founded on experimentation on animals...Mr. Tait further added that "a great deal of good has been accomplished by such investigations "--words which were taken down at the time. This is not the first occasion on which Mr. Lawson Tait has denied the fact that, when brought face to face with his fellow-practitioners in Birmingham, he threw over his friends of the Victoria-street Anti-vivisection Society. Mr Victor Horsley, in the Rock (Feb. 10th, 1893), stated

denied..

that he had done so-a fact which Mr. Tait then The matter, however, was referred to Mr. Henry Eales, President of the Midland Medical Society, who presided at the Birmingham meeting and who wrote the following letter, which appeared in the 7.’oc&, Feb. 17th, 1893 :

[Copy.]l 7. Newhall-street. Birmingham, Feb. 12th, 1893.

DEAR MR. HORSLEY,-I have read carefully your letter and that of Mr. Tait in the Rock, which you kindly sent me, as chairman of the meeting which took place here on Feb. 2nd, when Dr. Ruffer placed before our profession the claims of the British Institute of Preventive Medicine to our support, and I have no hesitation in saying that your representation of Mr. Tait’s a,ttitude is perfectly correct. I may say that, not wishing to rely entirely on my own memory, I have conferred with three of the leadtra of our profession here and placed Mr. Tait’s. and your letters before them, and they agree with me in this view. Mr. Gilbert Barling, who at the meeting congratulated Mr. Tait on having, however tardily, come to see that his attitude in the past was. untenable and on having had the courage to admit this, waites me, with authority to use his communication, as follows : " I understood Mr. Tait to give a general approval to the objects of the Institute of Preventive Medicine, the chief of these dwelt upon by Dr. Ruffer being the advancement of the science of bacteriology by experimental research. In speaking after Mr. Tait and in his presence, I congratulated him on assuming a position in this matter, so different to that which he previously held, and he did not demur to my interpretation of his remarks." I m,y say that I heard Mr. Tait’s remarks with profound astonishment, which I have since learned was the invariablij feeling they excited in those who heard them, it being auite unexpected that he would have accorded even " a reluctant assent" to the proposition before the meeting, and his speech was the most striking incident of the proceedings. You have my full permission to make what use you think fit of this letter. I am, yours truly, To Victor Horsley, Esq., F.R.S. HENRY EALES.

With regard to Mr. Lawson Tait leaving the room befora the end of the meeting, I must be excused if I am still of opinion that he did so because, having become the champion, of the Victoria-street Society, at St. James’s Hall, he was. afraid to hear what Mr. Horsley had to say about his conduct and that he therefore took the wisest course and ran away. I am. Sirs. vour obedient servant. M. ARMAND RUFFER.

"ARE DISEASE GERMS IN MILK DESTROYED BY BOILING?" To the Editors

of THE LANCET. doubt that micro-organisms may SIRS,—There escape being killed by boiling for a few minutes, as was, abundantly proved in the experiments by which Pouchet and Bastian sought to found the doctrine of abiogenesis. This is probably due to the presence of solid particles, which afford them some protection from the boiling fluid. But it is a great pity to throw any doubt on the general utility of boiling’ as a means of disinfecting milk, and the opinion that boiled milk is injurious to children is a very foolish and dangerous one. Even if it were proved that boiled milk loses a slight percentage of its nutritive properties, this disadvantage would be more than compensated by the freedom from risk of infection by scarlet fever and diphtheria, which are frequently conveyed in milk, and the probable. dangers from tubercle and from cholera, if the last-named disease should reach our shores during this year. Compared to the danger of kissing a Testament in a court of justicean act which has never been shown to be the source of’ disease in any single instance-this question of disinfecting milk is of the highest importance to the public health, and, until our County Councils can be trusted to provide us with. milk above all suspicion I would advise everyone to have it boiled on delivery and to boil it well. I am. Sirs. vours trulv. ROBERT SAUNDBY. Edmund-street, Birmingham, Feb. 18th, 1893. can

be

no

STRANGE INCIDENTS IN PRACTICE, To the Editors of THE LANCET. SlRS,—The case of the gentleman who for many years did’ not speak, recorded by Sir William Dalby on p. 241 of THE: LANCET of the 4th inst., recalls to my mind the case of another gentleman, which was referred to during the’ recent trial of an action in one of the Superior Courts. It appears that he suddenly ceased to speak, and, although it is. alleged that no other alteration in his, general state,which np

to

the commencement of his silence

was

normal and

SENSITIVENESS OF THE PERITONEUM. was, within twelve months, an lunatic asylum, where he remained for severalyears, and the many medical men who saw him during that period could make nothing of his case. At last one day, during the visit to the asylum of a now deceased London to whom the resident medical officer was relating physician, the case of the "dumb gentleman," the "dumb" man spoke. The whole affair can be explained in a few lines. It appears that this gentleman had a home which was the reverse of happy, and a wife whose tongue was long and unruly. He had put up with it for several years ; but eventually, and when smarting under an unusually large amount of nagging and abuse, he suddenly resolved to maintain a rigid silence for five years. The five years were up on the very morning the London physician visited the asylum. I may add that sot only did I know that physician personally, but I heard him tell the story more than once.

healthy,

was

mmate of

a

observed, he

private

T

am

Sirs

vrmrs

t,rnlv.

BERNARD

O’CONNOR.

"SENSITIVENESS OF THE PERITONEUM." To the Editors of THE LANCET. 8ms, -Dr. W. J. Sinclair comes very late into the discusand his contribution to it seems to be intended much less as pertinent to the issue than as a display of what he believes he has discovered as an inconsistency on my own pa.ft. Even if he were correct it would only prove that I am fallible as others are, but it would prove nothing one way or the other about the sensitiveness of the peritoneum. Speaking ua the question of experiments on animals Dr. Sinclair says: ’’He (Mr. Tait) draws largely upon two papers contributed t’) the Transactions of the British

Gynaecological Society by

Mr Bland Sutton and Dr. Arthur W. Johnstone of Kentucky, and he refers to them in terms of extravagant praise. But will it be believed by your readers who may be unfamiliar with this class of subject that the essay so characterised by Mr. Lawson Tait depended for some of its brilliant qualities tfpon the researches of Johnstone on the wombs of animals?" All ihis is perfectly true, for Johnstone did his work under my own eye, the only peculiarity about it being that his observations on the wombs of animals were all made upon specimens obtained from the butcher’s shop. So again, concerning Afr. Bland Sutton’s observations, I cannot discover that any experiment in the vivisection sense was ever used by Mr. Button for any of his conclusions. He certainly has never had a licence for any experiments, and has placed none .such on record. I think you will therefore agree with me that such. oriticism as Dr. Sinclair’s is purely senseless. I q,m. Sirs. vours trulv. LAWSON TAIT.

DENTAL ADVERTISING. To the -Editors of THE LANCET. SIRS, —A movement having been set on foot by dentists to prevent the disgraceful advertising which one so often sees in the newspapers, and even on the walls by the lower class of dentists, I think the medical profession should assist the dentists in calling upon the Medical Council to use their un’doubted powers to prevent it. A large number of dentists now not only have a dental qualification but also hold a !nedical one, and these feel acutely the stigma of being in any way associated with the advertising section on the Dental Register, I hope the time is not far distant when the Medical Council will act in accordance with the petition which Mr. BL’1ndy published in THE LANCET of Feb. llth-i. e., remove the n.’uii.es of the advertising dentists from the Dental Register. I am. Sir. yours triilvWILLIAM E. TRESIDDER, M.B. Lond.

ASCARIDES

AND

To the Editors

EPILEPSY. of THE LANCET.

’5l&bgr;.h. --Thinking that comparative medicine may possibly throw some light on the subject of Dr. Alston’s article on Ascarides Lumbricoides " in your issue of the llth, I beg to draw attention to the fact that epilepsy associated with the presence of ascarides in the intestine is very common, in individuals of the canine, feline and porcine species. More frequently observed in the young, adults are by no means .

447

exempt. The loss of consciousness is sudden and complete, the convulsive movements well marked and the result often fatal. Diarrhoea is often present, but not invariably. Recovery usually follows expulsion of the worms. In some cases of epilepsy the worms found are few ; in some numerous. In a puppy six weeks old I have found 144 large, fully developed ascarides marginatse ; in others of the same litter from six to ten, the whole of the brood having succumbed to epilepsy. Dogs are particularly prone to swallow large, hard, indigestible bodies and to suffer from impacted fasces, but epilepsy, independently of worms, in them is of very rare occurrence. In post-mortem examination of large numbers of dogs suspected (by the uninitiated) of rabies it is very common to meet with the ascaris marginata, and to elicit the information that the dog "died" or " was killed " in a fit. Pigs, and particularly the young, are very subject to epilepsy in association with ascaris suilla in the intestines. The horse is very frequently the host of ascaris megalocephala, but very rarely the subject of epilepsy, though in two instances in my experience their presence has been associated with loss of consciousness and convulsions ; in one of these 480 large ascarides were found in the stomach. I simply offer these clinical facts for record if deemed worthy as bearing on the question. I am. Sirs. vours obedientlv. Royal Veterinary College, JOHN PENBERTHER, F.R.C.V.S., Professor of Surgery, &c. London, N.W. yours obediently,

TIBBITS

&ugr;.

ALABASTER AND OTHERS.

To the Editors of THE LANCET. conduct of the proprietors of the Electrical SIRS,-The Review in the above-named case deserves the gratitude of the public and the profession. It is, however, safe to say that the public will not recognise their obligation or offer any return for the sacrifices made on their behalf. The successful defence of a lawsuit occupying the Court three days always involves large expenses beyond the taxed costs recovered. If a fund can be started to assist to reimburse the proprietors of the Electrical -Revie7v I shall be glad to contribute five I am, Sirs, yours truly, guineas. HENRY SEWILL.

(FROM

LIVERPOOL. CORRESPONDENT.)

OUR OWN

The late ./?*. Marsh, Surgeon and J. P. AT a, special meeting of the city magistrates, held on the 17th inst., the following resolution was unanimously adopted : That the bench of magistrates, in special meeting assembled, desire to place on record their deep sense of the loss which they have sustained by the death of their colleague, Mr. N. K. Marsh, who, though but recently made a magistrate, had during the period since his appointment dealt with the duties allotted to him in an able, conscientious and painstaking manner, and the justices desired to express their sympathy with his family in their sad bereavement." The -Iloz-t Sanitary Authority. No time is being lost by the local sanitary authority in endeavouring to make efficient arrangements for the proper sanitary inspection of all vessels entering the port and for the prompt detection and isolation of any cases of cholera should it be imported here. Advertisements were issued last week for an assistant medical officer, to perform port sanitary duties under the medical.officer of health, and for two inspectors. For the former there were fifty-nine applications, and out of these four have been selected-Dr. Francis W. Clark of Newcastle-on-Tyne; Dr. E. P. Manby, South Dispensary ; Dr. S. G. Moore ; and Dr. P. C. Walker, of the Parkhill Hospital, these last three being all local candidates. There were eighty-one applications for the two inspectorships and six applicants have been selected. At the meeting of the Health Committee on Thursday, Dr. Moore was appointed to the first office. Small-pox and Vaccination. At the last meeting of the Select Vestry, which regulates the affairs of the Liverpool parish, a very satisfactory report was made by the Vestry Clerk as to the efficient manner in which the vaccination of infants under three months was carried out, there being only a very small proportion oft