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THE CENTRAL MIDWIVES BOARD.
THE WORK OF THE IMPERIAL INSTITUTE. instead of 1 were shown in the report for the week ending May 2nd as having been admitted to hospital. The native male discovered on April 30th was the only case admitted to hospital during the week. 1 patient remained in hospital under treatment at the end of the week.) At King William’s Town 3 cases of plague were discovered, namely, 1 native male (found dead) on May 3rd, 1 European female on the 7th, and 1 native male on the 9th. At the Plague Hospital 1 European female died during the At Graaff-Reinet week, leaving 6 cases under treatment. of plague and no plague-infected rats were no cases discovered. At Burghersdorp 1 plague-infected rodent was At Queenstown plague-infected rats were discovered. discovered on the railway station premises. As regards the Mauritius a telegram from the Governor received at the Colonial Office on May 29th states that for the week ending May 28th there was 1 fatal case of plague. cases
THE WORK OF THE
IMPERIAL
vitality on the part of possibly in the future become as great as was establishment took shape.
1605 what is left of the institute and the scope of its operations may hoped for when first the idea of its-
THE CENTRAL
MIDWIVES
BOARD.
Dr. J. Ward Cousins has kindly forwarded to us a copy of the minority report, signed by himself, by Dr. W. J. Sinclair, and by Mr. E. Parker Young, respecting the draft rules framed by the Central Midwives Board. As, however, the draft rules in question have not as yet obtained the approval of the Privy Council, as required by the Midwives Act, they are so far not available for comment and we.consider that without them it is impossible to discuss the modifications proposed by the signatories of the minority report. When the rules have obtained the approval of the Council we shall deal with the whole matter.
Privy
INSTITUTE.
THE ANTI-SYPHILITIC TREATMENT OF TABES FOR ten years we have waited for some evidence that DORSALIS AND GENERAL PARALYSIS. the Imperial Institute would justify its existence. We have IN a contribution published in the Philadelphia Medical watched the fading of that "regally gorgeous"colouring which the ideal of British brotherhood, as realised at South Journal of April 18th, dealing with the most recent developKensington, presented to the astonished gaze of the world ments in the treatment of tabes dorsalis and general paraat large, and we have followed with appropriate concern the lysis of the insane-two diseases hitherto regarded as hopeunsuccessful efforts of those in authority to run the institute lessly incurable-Professor Leredde of Paris brings together as a club or a tea garden. The poetry of the Imperial con- a number of important facts and illustrative cases and ception may be said to have finally disappeared when in indicates briefly the direction in which further development 1900 the Government took possession and handed over to the may be expected in this branch of therapeutics. Professor University of London a large part of the actual buildings. In Renaut of Lyons had recently shown that the pathological January last, through the agency of an Act passed in July, changes in tabes dorsalis and general paralysis may be1902, the institute was transferred to the care of the Board syphilitic without necessarily conforming to the old classical of Trade. With the assistance of an advisory committee, upon description of syphilitic lesions. Nageotte’s recent observawhich are also ’represented India, the colonies, and the tions have shown that tabes is a chronic inflammatory Board of Agriculture, Sir Alfred Bateman, K.C.M.G., now affection of the spinal meninges affecting with peculiar directs its fortunes, and, shorn of its former glories, the intensity the posterior spinal nerve roots. The appearanceinstitute has sunk to the indignity of becoming a mere of the lesion is quite consistent with the syphilitic origin of branch of the commercial, labour, and statistical depart- tabes and the cerebro-spinal fluid shows a moderate or ment. As a result of these proceedings our patience has at marked degree of leucocytosis. By "recovery" in tabes last been rewarded, for there has just appeared the first dorsalis Professor Leredde means the arrest of the de"Bulletin of the Imperial Institute." Professor Wyndham structive process, comparable to the arrest of pulmonary R. Dunstan, F.R.S., the director, was at one time at the tuberculosis. Fournier, in a recent work on para-syphilitic head of the research laboratories of the Pharmaceutical affections (1899), quotes a case of tabes with arrest of sym-Society of Great Britain and we are therefore not surprised ptoms for 16 years after having undergone anti-syphilitic Recent observations by Lemoine of Lille on the to find that although commercial matters receive chief atten- treatment. I I intensive " mercurial treatment of general paralysis and of much in is of medical interest. tion the bulletin there yet Several drugs and allied materials have been subjected to exa- tabes dorsalis, an account of which appeared in an annotation. mination by the scientific workers whom Professor Dunstan in THE LANCET of Sept. 6th, 1902, p. 690, and additional controls, with, it is claimed, results of permanent value. observations made subsequently by Leduc, comprise ten Thus Podophyllzcm Emodi, a plant common in Northern India, cases of tabes dorsalis subjected to the intensive" mercurial has been shown to be chemically very similar to the familiar treatment, with the result that considerable sensory and. Podophyllum peltatum. The therapeutical effects of the drug motor improvement took place in all and some few were cured. As regards general paralysis Professor Leredde, after were studied by members of the St. Thomas’s Hospital staff and they concluded that it constituted an efficient substitute collating a number of cases, carefully observed and recorded, for the latter species. It may be noticed in passing that by various authors-viz., six cases by Lemoine, nine by these opinions are somewhat in conflict with the views of Devay of Lyons, and three by Cassaet, and adding to thesecases under his personal observation, making a total earlier investigators. An examination was also made of an other 26 cases-says that these 26 cases may be considered as Egyptian plant-Hyoseyamc2cs muticus-and this also is said to have been proved to be of service, though in exactly what showing that good prospects of recovery may be entertained capacity is not clear. The chemical composition of certain for general paralysis-a disease hitherto universally regarded oil-yielding nuts from Brazil, Portuguese East Africa, and as hopelessly incurable and fatal. The following two typical British Honduras has been ascertained, while some useful cases may be cited as illustrative of the results of treatment information seems to have been gleaned as to the poisonous for general paralysis. Case 1 was that of a male general effects on horses and cattle of some Indian and Colonial paralytic with weakness of the lower limbs, vertigo and fodder plants. There is also another field in which an ataxia, disturbance of speech and of handwriting, loss He was treated with has been made to further medical progress. of memory, and a grandiose mood. attempt Office room has been provided for the Colonial Nursing three-fourths of a grain of calomel injected weekly into theAfter some months his speech and Association-a body which selects trained hospital and subcutaneous tissue. and other British nurses for the Crown colonies private handwriting improved, his memory returned rapidly, and the dependencies. There are, therefore, not wanting signs of mental-state regained its normalcharacter. At the date
of
THE WORK OF THE
IMPERIAL
vitality on the part of possibly in the future become as great as was establishment took shape.
1605 what is left of the institute and the scope of its operations may hoped for when first the idea of its-
THE CENTRAL
MIDWIVES
BOARD.
Dr. J. Ward Cousins has kindly forwarded to us a copy of the minority report, signed by himself, by Dr. W. J. Sinclair, and by Mr. E. Parker Young, respecting the draft rules framed by the Central Midwives Board. As, however, the draft rules in question have not as yet obtained the approval of the Privy Council, as required by the Midwives Act, they are so far not available for comment and we.consider that without them it is impossible to discuss the modifications proposed by the signatories of the minority report. When the rules have obtained the approval of the Council we shall deal with the whole matter.
Privy
INSTITUTE.
THE ANTI-SYPHILITIC TREATMENT OF TABES FOR ten years we have waited for some evidence that DORSALIS AND GENERAL PARALYSIS. the Imperial Institute would justify its existence. We have IN a contribution published in the Philadelphia Medical watched the fading of that "regally gorgeous"colouring which the ideal of British brotherhood, as realised at South Journal of April 18th, dealing with the most recent developKensington, presented to the astonished gaze of the world ments in the treatment of tabes dorsalis and general paraat large, and we have followed with appropriate concern the lysis of the insane-two diseases hitherto regarded as hopeunsuccessful efforts of those in authority to run the institute lessly incurable-Professor Leredde of Paris brings together as a club or a tea garden. The poetry of the Imperial con- a number of important facts and illustrative cases and ception may be said to have finally disappeared when in indicates briefly the direction in which further development 1900 the Government took possession and handed over to the may be expected in this branch of therapeutics. Professor University of London a large part of the actual buildings. In Renaut of Lyons had recently shown that the pathological January last, through the agency of an Act passed in July, changes in tabes dorsalis and general paralysis may be1902, the institute was transferred to the care of the Board syphilitic without necessarily conforming to the old classical of Trade. With the assistance of an advisory committee, upon description of syphilitic lesions. Nageotte’s recent observawhich are also ’represented India, the colonies, and the tions have shown that tabes is a chronic inflammatory Board of Agriculture, Sir Alfred Bateman, K.C.M.G., now affection of the spinal meninges affecting with peculiar directs its fortunes, and, shorn of its former glories, the intensity the posterior spinal nerve roots. The appearanceinstitute has sunk to the indignity of becoming a mere of the lesion is quite consistent with the syphilitic origin of branch of the commercial, labour, and statistical depart- tabes and the cerebro-spinal fluid shows a moderate or ment. As a result of these proceedings our patience has at marked degree of leucocytosis. By "recovery" in tabes last been rewarded, for there has just appeared the first dorsalis Professor Leredde means the arrest of the de"Bulletin of the Imperial Institute." Professor Wyndham structive process, comparable to the arrest of pulmonary R. Dunstan, F.R.S., the director, was at one time at the tuberculosis. Fournier, in a recent work on para-syphilitic head of the research laboratories of the Pharmaceutical affections (1899), quotes a case of tabes with arrest of sym-Society of Great Britain and we are therefore not surprised ptoms for 16 years after having undergone anti-syphilitic Recent observations by Lemoine of Lille on the to find that although commercial matters receive chief atten- treatment. I I intensive " mercurial treatment of general paralysis and of much in is of medical interest. tion the bulletin there yet Several drugs and allied materials have been subjected to exa- tabes dorsalis, an account of which appeared in an annotation. mination by the scientific workers whom Professor Dunstan in THE LANCET of Sept. 6th, 1902, p. 690, and additional controls, with, it is claimed, results of permanent value. observations made subsequently by Leduc, comprise ten Thus Podophyllzcm Emodi, a plant common in Northern India, cases of tabes dorsalis subjected to the intensive" mercurial has been shown to be chemically very similar to the familiar treatment, with the result that considerable sensory and. Podophyllum peltatum. The therapeutical effects of the drug motor improvement took place in all and some few were cured. As regards general paralysis Professor Leredde, after were studied by members of the St. Thomas’s Hospital staff and they concluded that it constituted an efficient substitute collating a number of cases, carefully observed and recorded, for the latter species. It may be noticed in passing that by various authors-viz., six cases by Lemoine, nine by these opinions are somewhat in conflict with the views of Devay of Lyons, and three by Cassaet, and adding to thesecases under his personal observation, making a total earlier investigators. An examination was also made of an other 26 cases-says that these 26 cases may be considered as Egyptian plant-Hyoseyamc2cs muticus-and this also is said to have been proved to be of service, though in exactly what showing that good prospects of recovery may be entertained capacity is not clear. The chemical composition of certain for general paralysis-a disease hitherto universally regarded oil-yielding nuts from Brazil, Portuguese East Africa, and as hopelessly incurable and fatal. The following two typical British Honduras has been ascertained, while some useful cases may be cited as illustrative of the results of treatment information seems to have been gleaned as to the poisonous for general paralysis. Case 1 was that of a male general effects on horses and cattle of some Indian and Colonial paralytic with weakness of the lower limbs, vertigo and fodder plants. There is also another field in which an ataxia, disturbance of speech and of handwriting, loss He was treated with has been made to further medical progress. of memory, and a grandiose mood. attempt Office room has been provided for the Colonial Nursing three-fourths of a grain of calomel injected weekly into theAfter some months his speech and Association-a body which selects trained hospital and subcutaneous tissue. and other British nurses for the Crown colonies private handwriting improved, his memory returned rapidly, and the dependencies. There are, therefore, not wanting signs of mental-state regained its normalcharacter. At the date
of