THE ARCHIVES OF INTERNAL MEDICINE.

RECOVERY FROM DISLOCATION OF THE NECK.

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Health was an essential to the proper preventive treatment of such grave problems as this which the association was facing. Mr. W. H. Dickinson, M.P., gave an interesting account of the successful working of large farm colonies in America which afford varied employment and interests to their feebleminded inmates ; he laid stress upon the personal qualities required by the officers owing to the fact that a feebleminded person was practically a child, happy as long as he received proper care and affection. Dr. Robert Jones gave the meeting those national statistics of insanity and imbecility which unhappily our readers have only too often before them, and after dwelling upon their proved consequences made a spirited appeal for the study and practice of eugenics. He supported strongly both the aims and the methods of the association, which had evoked his warm admiration. Finally, Miss Adler spoke of the important after-care work of the association, which she considered should be taken up by local authorities. We were pleased to see that many ladies evidently belonging to the leisured and influential classes were present at this meeting. When such facts are widely known as were told to them in undisguised language concerning the propagation of the unfit the nation will begin to see that the wise and sympathetic control of uncertifiable " border-line mental cases in such settlements as this association seeks to found is demanded in the urgent interests of the nation no less than in those of the afflicted individuals themselves. As the speakers at this meeting suggested, it is personal sympathy which can alone deal with them in the best possible manner. We heartily commend the work of this association in its educational, its charitable, and its national purposes, and we trust that the money may be forthcoming to found the proposed farm colony.

RECOVERY FROM DISLOCATION OF THE NECK.

results. During the reduction the patient complained of much pain, especially in the throat, and said that he felt as if he were about to choke. No immediate sensory or motor improvement was observed upon reduction but there was a. desire to micturate. The neck and head were fixed in (heir normal position with adhesive plaster. The patient was taken home in an ambulance. When he arrived, aboat 11 hours after the accident, the pulse was 76 and the respira-tion was 19. He was placed in bed with the head elevated about eight inches. The plaster on the neck was reinforced with bandages. The temperature never rose above 99.6° F,. On the fourth day the paralysis began to diminish in the left leg and right forearm. On the seventh day he could move the right foot. Gradually the use of the muscles of deglutition, the erector spinæ, the muscularsystem generally, and the sphincters was regained. The dorsal decubitus position was maintained for ten days. Then massage, hot sponging, and faradism were used and the patient could change his position with On the fifteenth day he contracted measles assistance. which ran the usual course. On the thirtie6h day he could sit up and walk a few steps. Massage and faradism were used for five and a half months. At the end of this time theonly evidence of the injury was partial atrophy of the left deltoid muscle. ___

THE ARCHIVES OF INTERNAL MEDICINE.

WE have received a copy of the first number of theArchives of Internal Medicine-a new magazine produced and published by the American Medical Association. It is to appear in monthly parts and the subscription price is. $4 per annum, including postage. It is under the direction of an editorial board consisting of Dr. R. C. Cabot of Boston ; Dr. George Dock of Ann Arbor, Michigan ; Dr. David L. Edsall of Philadelphia ; Dr. Theo. 0. Janeway of New York ; Dr. W. S. Thayer of Baltimore; and Dr. Joseph L. Miller of Chicago. Judged by the first number the American Medical Association is to be congratulated on its new venture. It contains five papers, the first being the Harvey Lecture delivered at the New York Academy of Medicine by Dr. Friedrich Miiller of Munich on the Nervous Affections of the Heart, which is an interesting presentment of this complex subject viewed from the clinical standpoint in the light of the recent advances afforded by the experimental study by scientific physiological methods of the heart’s action and its control by the central nervous system. Dr. Richard Weil of New York City contributes a short paper on the Haemolytic Reactions of the Blood in Dogs affected

hr rare cases recovery has taken place after dislocation of the neck. In the New York Medical Journal of April 18th Dr. Lucien Lofton has reported the following remarkable case. A youth, aged 20 years, while adjusting a chain beneath a steam shovel was caught round the neck by it and drawn up against the floor of the machine. The left side of his head was pressed against the under surface of the shovel for several seconds. When released he fell limp to the ground and appeared to be dead to those who removed his body. Within a few seconds he showed signs of recovery. When he regained consciousness he asked for water but after repeated attempts for an hour he could not swallow it. with Transplantable Sarcoma. Having found in a previous Dr. Lofton saw him about three hours after the accident, investigation that hasmolytic substances could be extracted He did not complain of from these tumours in dogs, he now maintains as a result of when he was much improved. pain but only that his neck was sore. On being his experiments that the serum of all the dogs with these offered drink he could with great difficulty use some of tumours is distinctly more hasmolytic than that from normal the muscles of deglutition. The pulse was 58 and the dogs, and further that the corpuscles of the animals with respiration was 14. There was complete sensory and motor tumours are more refractory to the destructive effects of the paralysis below the chin, excepting a slight movement of the h83molytic serum than those of normal dogs. He draws attenright index finger, and loss of control of the sphincters. He tion to the bearing which these results may prove to possess in talked intelligently and could whistle, expectorate, protrude regard to the ansemia associated with new growths. Dr. the tongue, and make any facial contortion requested. The Hugo A. Freund of Detroit contributes an important paper neck was stretched one and a half inches. The ventral arch with the title " Trichomonas Hominis Intestinalis :aStudy of of the atlas rested upon the odontoid process of the axis. its Biology and Pathogenicity." He points out that American Reduction was performed in the following manner. The and English writers have not attached sufficient importance patient was placed flat upon the ground. Two assistants to this organism. He describes its morphology in considerable grasped his lower limbs and two placed their hands on his detail and gives some good plates in illustration. So far it chest to steady the trunk. Dr. Lofton then firmly grasped has been found impossible to cultivate this organism. Dr. the occiput with his right hand and placed his left under the Freund has had the opportunity of showing the clinical chin. By lifting the head backwards, upwards, and forwards course and symptoms of ten cases in which these organisms upon the chest he replaced the atlas in its normal posi- were found in the fasces, and of these cases he gives details. tion. He performed each step of the manipulation deliber- The trichomonad is found in a variety of pathological con. ately and slowly. No anaesthetic was used for fear of direful ditions, in some of which it would appear to be an

PREMATURE BURIAL.-THE MEDICAL SOOIETY OF LONDON.

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while in others it plays a secondary part.they are dead. We say without hesitation that cases of i death are few, and that those in which the careful consideration of his own results and a com-simulated is likeness cannot be effaced do not exist. other Freund conOf the with those of Dr. observers, parison vincel that this organism is the direct cause of certain formsrecorded instances of premature burial the vast majority are of acute, chronic, and recurring enteritis, characterised by wholly devoid of foundation in fact, and the doubtful abdominal pain, diarrhoea, loss of weight and strength, and remainder are wanting in substantiation by the only evidence ansemu. Dr. David Murray Oowie of Ann Arbor and Dr. worthy of credence-that of a qualified medical man. In James Frederick Munson of Sonyea, N.Y., give the results some parts of Germany what are termed funeral chambers of an Experimental Study of the Action of Oil on Gastric are provided for the purpose of watching bodies in order to Acidity and Motility. They find that olive oil and cotton- verify the fact of death. In some of these a bell rope is seed oil, when given in connexion with the usual test break- placed in the hands of the corpse, but as a distinguished fast, decrease the gastric acidity at the end of the hour and authority has pithily remarked, 11 since the institution of retard the evacuation of the stomach, that the secretion these chambers no one has ever heard the bell ring." We of hydrochloric acid is delayed when oil precedes the meal may fittingly close these remarks with the words of Brouardel, and is unchanged when oil follows it, and that the height "Let us say at once that one fact is found to be almost of secretion is lowered when oil precedes the meal and is constantly present-viz., in the immense majority of cases unchanged when given afterwards. They conclude that oil the persons died without having been seen during their is in suitable cases preferable to antacids because of its illness by a physician, and were buried without a physician heat value, and recommend that in hyperchlorhydria it having had the opportunity of verifying their death." should precede the meal, that in hypochlorhydria it should follow the meal, and that its use should be avoided in stasis THE MEDICAL SOCIETY OF LONDON. and persistent slow evacuation. Dr. Hugh A. Stewart of AT a general meeting of the Medical Society of London, Baltimore records his observations on the Pulse and at 11, Chandos-street, Cavendish-square, London, on held Blood Pressure Changes in Aortic Insufficiency. He confirms Henderson’s statement that the cardiac cycle is not May llth, Mr. C. B. Lockwood was elected President and the diphasic but triphasic, consisting of systole, the period of following were elected members of the Council : Mr. Charles ventricular discharge; diastole, the period of ventricular A. Ballance, Dr. Walter Broadbent, Mr. Edred M. Corner, relaxation and filling ; and diastasis, the period of rest. From Dr. Bertrand Dawson, Dr. John H. Drysdale, Mr. Harold

etiological factor,

After

a

A. T. Fairbank, Colonel Sir Joseph Fayrer, Bart., R.A.M.C., Dr. James Kingston Fowler, Mr. A. Corrie Keep, Mr. oubic centimetre of blood and that the volume of blood V. Warren Low, Dr. Percy J. F. Lush, Dr. Frederick S. which regurgitates is negligible. The fall of blood pressure Palmer, Dr. J. Porter Parkinson, Dr. J. J. Perkins, Dr. in aortic regurgitation is due to the diminished peripheral Frederick J. Poynton, Mr. Herbert Tilley, Dr. R. Cecil ocesistance brought about by a reflex inhibition of the vaso- Wall, Mr. Charles Gordon Watson, Dr. F. Parkes Weber, motor centre and not to loss of blood by regurgitation. We and Dr. W. Essex Wynter. wish the American Medical Association every success in this endeavour to found a periodical dealing with the scientific THE QUESTIONABLE EFFICIENCY OF ATROPINE aspects of medicine. IN CHLOROFORM POISONING.

experimental investigations he finds that aortic regurgitation increases the systolic output in the dog by only a fraction of a

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PREMATURE BURIAL.

IN the Biochemical Journal of April 16th Dr. W. Webster IN a contemporary journal on April 28th there appeared contributes notes on the action of atropine, hyoscyamine, under the following headlines, " Living Woman in a Coffin- hyoscine, scopolamine, duboisine, and daturine, representing Narrow Escape from being Buried Alive," a detailed account the results of a research which was begun with the primary of an alleged circumstance calculated to strike terror into object of testing the efficiency of atropine as a restorative in the minds of people, and especially those who are unusually poisoning by chloroform, or as a precautionary measure receptive of the marvellous. In a later issue it was stated before its administration. Dr. Webster found as close a relathat there was no foundation for the report. Although tionship between these substances as regards their physiopremature burial cannot be denied absolutely we may say logical action as there is between their chemical structure, with Brouardel, " if a mistake has been made it is a popular no difference being detected between them from a physioblunder and not a medical one." There are many circum- logical point of view. The experiments were performed on stances which cause death to be simulated but the phenomenon dogs and cats and the anæsthetics employed were chloroform, ,can never, at least in this country, give rise to a mistaken ether, or the A.C.E. mixture, and in a few cases curare in belief when properly examined by a qualified medical man. addition. The investigation was restricted to the gross Apparent death, or, as it has been termed, " latent life," effects upon the heart, circulation, and respiration, and is occasionally observed under a variety of conditions. In brought out several points of interest. In dogs atropine, hysteria, catalepsy or trance, and syncope from mental or hyoscine, hyoscyamine, scopolamine, and daturine, whether physical shock the signs of life may be reduced to a in small or large doses, produced a lowering of the blood minimum. The same occurs in many cases of so-called pressure. Dr. Webster considers that although these drugs stillbirth and in supposed deaths from drowning. Pro- eliminate the tonic inhibitory action of the vagus, they have a longed attempts at resuscitation of bodies apparently lifeless simultaneous action on the heart substance, diminishing the at once exemplify the condition and indicate the knowledge output. The frequent administration of increasing doses of that life may be distinguished from the simulacrum of death. these drugs produces a condition of tolerance within one or Short of cadaveric decomposition there is no certain sign of two hours, enabling the animal to withstand, with comparadeath, much less an absolute criterion which can determine tively slight reaction, very many times the dose which would the precise moment of death. In some cases of somatic have been fatal at the beginning of the experiment. In death-e.g., after decapitation-the heart, once termed small doses the respiration is quickened and rendered deeper; "ultimum moriens," has been known to beat for many in large doses it is often paralysed immediately. In so far minutes. It is not our purpose to discuss here the various as they go these experiments do not tend to encourage the signs of death and their relative value but to assail what has use of atropine in chloroform poisoning. Suprarenin, on the become in some degree a popular belief that bodies may be other hand, seems to be of much more, though limited, buried alive because of the supposed inability to prove that utility. Its effect is transitory, so that as a rule small