THE CHADWICK LECTURES ON WAR AND DISEASE.1

291 (donors, a much-needed improvement in the medical service had lately been added. Hitherto each man had not, like tthe French soldier, carried his own iodine, but now he did cent. HC1. It is thus easy to reconcile the results in a little glass ampoule, put up by English manufacturers. Theso, obtained by physiologists and clinicians. The importance of this provision it was difficult to overrate. initial acidity is 0’5; the final acidity is about a Gangrene had also claimed its victims in this war owing third of this, a degree at which protein digestion in1to the soiling of the wounds, the causal bacillus being that ] for malignant oedema. The work of Pasteur the stomach is most favoured. These facts suggest responsible " an explanation of the rapid emptying of the stomach,and Lister finally disposed of the idea that "wound fever which radiologists note as indications of duodenaland "hospital gangrene"were spontaneously generated. irritation. Many other clinical findings may be In 1868 the mortality after amputations in France was I60 per cent, ; and a well-known surgeon at the Charite illuminated by these useful observations. Hospital said, "When an amputation seems necessary think ten times about it, for, too often, when we decidePARLIAMENT reopened on Tuesday last, the pro- upon an operation we sign the patient’s death-warrant." The bacillus of gas gangrene, being an anaerobe, did not. ceedings being mainly Government business. infect superficial wounds, but multiplied in deep wounds and lacerated tissue. He described the usual course of a case of The Hunterian Oration will be delivered at the gas gangrene and narrated a typical instance. The subjects. it must be strictly isolated from other wounded men. In Royal College of Surgeons of England, Lincoln’s-Inn of the Turkish War of 1877 the Turkish and Greek doctors in Fields, on Monday, Feb. 15th, at 4 o’clock, by the had no disinfectants except a few basins of quicklime. charge President, Sir W. Watson Cheyne, who has chosen Repeated attempts had been made to supply a vaccine to. as his subject The Treatment of Wounds in War. counteract the bacillus of gangrene, but nothing had yet. been achieved to warrant its use on man. Frost-bite was always liable to occur among troops in cold THE CHADWICK LECTURES ON WAR weather, especially when a high wind prevailed ; and if frost-bite did not receive prompt attention it might end in AND DISEASE.1 gangrene; and the patient might not be aware of th& transition because the freezing process was not a one, though that of inducing the blood to return THE last of the three lectures organised by the Chadwick painful to the part was attended with pain. Sudden warmth killed trustees was delivered at the Royal Society of Arts on the tissue and thus precipitated gangrene. In January, 1878, Jan. 29th by Colonel F. M. SANDWITH, M.D., the subjectthe cold was so intense that 18 of Baker Pasha’s sentries being The Great European War." The chair was occupied were frozen to death in one night, and it became necessary by Sir H. TRUEMAN WOOD, secretary of the Royal Society to change the sentries every 15 minutes. Some of the cases. of Arts, and the attendance was again a large one. of frost-bite in the campaign were grotesque in their Colonel SANDIVITH said that every campaign had its Our well-fed and well-clothed soldiers were. ghastliness. peculiar medical dangers, and in such a gigantic war as the not likely to suffer so severely from frost-bite, especially aspresent one the dangers were manifold, depending on the the women of England had shown a veritable passion for climate, the people, and even the soil in the fighting areas. knitting warm articles for the soldiers. The problem as to. Whilst cholera and other diseases were menacing the German the best for the men in the cold, wet trenches. and Russian troops, we could recognise the fact that the would notclothing be solved by supplying waders, for occasions arose attention given to hygiene, besides the value of antityphoid when the soldiers had to move quickly, either in attack or inoculation, saved our troops from great loss due to disease. retreat. Perhaps the rubbing of some kind of grease (which The sick-rate of our troops now at the front was only 3 per would not mix with water) all over the body would be found cent., and among the Indian troops it was said to be even of some avail. This war differed from other campaigns in its lower. The following figures relating to typhoid fever were uninterrupted violence. In other struggles there had been In the first 421 cases of typhoid fever among lulls now issued. which the combatants could rest and recuperate the British troops in this campaign 305 were in men who had after during of excessive strain, for those who had not periods not been inoculated, In the 421 cases there were 35 deaths, been at the firing line could not realise the effect on the 34 of them in men who had not been inoculated within two nerves produced ; and the men could only be ensured years, the other was in a man who had been inoculated once. some respite by organising relays of relief troops. When the One source of trouble in the past had been wound first batch of 230 wounded arrived at one of the London poisoning caused by dirt, and resulting in gangrene and hospitals they were in such an exhausted condition thattetanus. The latter had attacked the wounded of our own little could be done for them beyond getting them to. and the enemy in about equal degree. Generally its spasms very bed quickly. They slept the sleep of utter exhaustion, and were more exhausting than painful ; but there was great next day had to be aroused to be washed. But after the suffering when the patient had an extensive wound, and the first 30 hours they suffered from sleeplessness ; they slept spasms might produce agonising pain. In the worst cases a lightly, and frequently awoke with a start and shouted, fatal end was generally reached on the third day, and the believing they were still being attacked in the trenches. symptoms of the disease usually commenced about ten days They were not lacking in courage, but the nerve strain had this interval was abbreviated the case been after the injury. When though a complaint was practically never seldom recovered. In the Aisnedistrict tetanus was common heard.excessive, Sometimes the shell fire had caused transient. Brilliant results had among the ordinary population. of the lower limbs, loss of sensation to heat and; followed the use of antitetanic serum prophylactically. The paralysis and defective vision. cold, earlier the prophylactic dose was given the more certain was Dr. Sand with spoke of the plague of vermin which attended its good effect, but by the time the symptoms were well established the disease had made great progress. The prac- campaigns. Bugs were bearers of certain tropical diseases, tice now was the following. On the reception of a wound the and lice were believed to convey dread diseases which hacl first field-dressing, consisting of a pad of gauze, was applied by played havoc in camps in the past. The psychic feeling of a surgeon, a comrade, or by the patient himself. On arriving disgust at harbouring these pests in men who had been at the field ambulance this dressing was changed and the accustomed to clean living was a factor to be reckoned with. It was difficult to with the trouble, but instructions. patient removed to the clearing hospital, where the wound had been issued to cope the troops which it was hoped would was cleaned, if possible, and painted freely with a solution of iodine in spirit. Where needed, the dressing was repeated minimise it. fever was a febrile illness due to spirochastas in during the journey to the column or base. Since November theRelapsing The blood. mortality from it was not high, but thea prophylactic injection of antitetanus serum was given to weakness incapacitated the patient for a long all wounded either at the clearing hospital or the field attendant time. Lice had long been suspected as the carriers of ambulance. Thanks to the generosity of two anonymous relapsing and typhus fevers, but an important factor in the 1 process seemed to be the scratching of the irritating lesion. of the first and lectures in THE second LANCET appeared Reports Lice must be regarded as a menace to ultimate victory, and, of Jan. 23rd (p. 105) and 30th (p. 247) respectively,

quantity accumulates which

is

of

bringingtheacidity to the level of about0’15 perIt sufficient

capable

I

292 could not contemplate defeat by.disease any more than by armies ; hence every soldier should be impressed with the necessity of ridding himself of these pests. This lecture was also illustrated by some very interesting slides, and the thanks of the audience, voiced by the chairman, were very warmly accorded to Dr. Sandwith. we

ROYAL COLLEGE OF PHYSICIANS OF LONDON. MEETING

OF

COMITIA.

A COMITIA was held on Jan. 28th, Sir THOMAS BARLOW, Bart., K.C.V.O., the President, being in the chair. The following gentlemen having passed the required

examination

were

admitted Members of the

College : Jivraj

Narayan Mehta, M.D. Lond., L.R.C.P., John Tattersall, M.D. Lond., L.R.C.P., and William Wilkinson Uttley, M.B., Ch.B. Vict., L.R.O.P. (Lymm, Cheshire). Licences to practise physic were granted to 114 gentlemen who had

THE SERVICES. ROYAL NAVY MEDICAL SERVICE.

Fleet-Surgeon William Ernest Marshall has been placed on the Retired List (dated Jan. 20th). The following appointments are notified :-Fleet-Surgeon: W. H. 0. Garde to the Revenge. Surgeon : M. F. Caldwell to the Vivid, additional, for disposal. Temporary Surgeons: W. H. W. Cheyne to the Soudan Hospital Ship; J. S. Jobson to the Chin(t Hospital Ship; W. L. Anderson to the Pernbroke III. for R.N. Air Service ; and F. A. Williamson to the Pembroke, additional, for disposal. The undermentioned have been granted temporary commissions as Surgeons in His Majesty’s Fleet :-David Revell Bedell-Sivright and George Stivala Aspinall. ROYAL NAVAL RESERVE. The undermentioned Acting Sub-Lieutenant has been promoted to the rank of Sub-Lieutenant:-Dated Dec. 2nd, 1914: Nigel Adrian Macqueen. The undermentioned have been granted temporary commissions as Surgeons in His Majesty’s Fleet :-Dated Jan. 26th : Weir Burns Cunningham and William Little Glegg. Dated Jan. 27th: Alfred George Stewart and Dundas

Simpson MacKnight.

passed the necessary examinations. ROYAL NAVAL VOLUNTEER RESERVE. Diplomas in Public Health were granted jointly with the Surgeon: T. Turner to the Pembroke, additional, for Royal College of Surgeons of England : Kishori Ldl Chandry, Chatham Hospital. M.B., B.S. Punjab, Punjab and University College; NoormaARMY MEDICAL SERVICE. homed Kasembhai Chohan, L.M. & S. Bombay, Bombay and Colonel Robert Porter is retained on the Active List under Cambridge; Herbert William Fankhauser, M.B., Ch.B. Article 120 Royal Warrant for Pay and Promotion, and to be Melb., Melbourne and R.I. Pub. Health; Thomas Marlin, Supernumerary (dated Jan. 31st). ROYAL ARMY MEDICAL CORPS. M.D., Ch.B. Glasg., Glasgow and University College ; The undermentioned Captains to be Majors:-Dated Lucy MacBean Ross, M.B., Ch.B. Glasg., Glasgow and University College ; and Andrew James Shinnie, M.D., Ch.B. Jan. 31st: Albert E. B. Wood, James B. Meldon, Charles Bramhall, and Henry T. Stack. Aberd., Aberdeen and University College. The undermentioned Lieutenants to be Captains :-Dated The PRESIDENT announced that he had appointed Dr. William B. Jan. 28th : Basil H. H. Robert

to be the Harveian orator for 1915, and Dr. J. Michell Clarke to be the Bradshaw lecturer for 1915. Also that the Council had appointed Dr. Samson G. Moore (medical officer of health of Huddersfield) to be the Milroy lecturer for 1916. The following communications were received. From the Secretary of the Royal College of Surgeons of England, dated Dec. 12th, 1914, and Jan. 15th, 1915, reporting proceedings of the Council of that College on Dec. 10th, 1914, and on Jan. 14th, 1915, respectively. Dr. A. G. Barrs, Dr. H. G. Turney, Dr. H. Morley Fletcher, and Dr. L. Humphry were elected councillors. Sir Francis Champneys, Bart., was elected a Representative of the College on the Central Midwives Board for one year from April lst next. Mr. Mark Lemon Romer, K.C., was elected a senior standing counsel to the College in the place of Lord Parmoor. Sir Dyce Duckworth, Bart., was re-elected as Representative Member of the Court of the University of Liverpool. Dr. S. H. West was re-elected a Representative Member of the Court of Governors of the University of

Sidney Coupland

Birmingham. A report was received and adopted from the representative of the College on the General Medical Council. After some further formal business the PRESIDENT dissolved the Comitia.

TYPHUS FEVER IN DERRY.-An outbreak of typhus fever has occurred in Derry to the extent of nine cases in the lower-lying badly drained parts of that city where there are many dry closets. It is hoped that the .epidemic is now over. THE WOMEN’S IMPERIAL HEALTH ASSOCIATION.The annual meeting of this association was held at the offices at 7, Hanover-square, W., on Jan. 20th, when Dr. R. Murray Leslie took the chair. He reviewed the year’s work of the association, the last five months of which had been war. Among many other activities the association had undertaken the organisation of the Health and Social Section of the Women’s Emergency Corps, and had registered over 1900 voluntary workers and placed 1364 of these in useful work. The association had also started a Women’s Club. The chairman referred also to the many other branches of work, all of which had been proceeding satisfactorily. The annual report can be had on application to the secretary.

largely influenced by the

Spence, Laird, Davidson, Herbert S. Blackmore, James M. Elliott, Francis R. B. Skrimshire, Douglas W. Bruce, Thomas E. Osmond, Richard T. Vivian, Edward G. H. Cowen, Leonard Buckley, William L. Webster, Edward B. Allnutt, Stanley P. Sykes, Harry C. Todd, Henry J. G. Wells, Ernest C. Deane, Frank S. Tamplin, Ivor R. Hudleston, William Stewart, Alexander G. J. Macllwaine, and Arthur S. Heale. The undermentioned officers, Home Hospitals Reserve, are granted the temporary rank of Captain :-Dated August 6th, 1914 : J. E. Moorhouse. Dated August 14th, 1914 : D. M. Barry. Dated Jan. 4th : A. B. Leakey. The undermentioned to be temporary Captains :-Dated Dec. 28th, 1914: Temporary Lieutenant Robert Higham Cooper. Dated Jan. 6th: Charles Ravenscroft Stewart. Dated Jan. 15th : Henry Wynyard Kaye.

The undermentioned to be temporary Lieutenants whilst with the Red Cross Hospital, Netley:-Dated Jan. 19th: Donovan Blaise Pascall and Walter Gibson Marsden. The undermentioned to be temporary Lieutenants:-Dated Oct. 12th, 1914: Alfred Squire Taylor. Dated Dec. 18th, 1914: Edward Forbes. Dated Jan. 1st: Robert Hilton Hutchinson, William Herbert Clements, and James Douglas Driberg. Dated Jan. 2nd: Ernest Leon Maunsell Hackett, Conwy Llewellyn Morgan, and Anthony Hagarty Corley. Dated Jan. 4th: Ralph Anderson Hughes. Dated Jan. 7th : Harold Benjamin Day, Harold Kempsey, Thomas Burns Marshall, Daniel Brough, Edward Verdon Russell Fooks, Thomas Langton Butler, George Fitzjames Darker, Herbert Eustace Clarke, Robert Wilkinson Greatorex, and Howard George Pesel. Dated Jan. 9th: Robert Cecil Leonard, Jerome O’Flynn, and Bernard Charles Tennent. Dated Jan. 10th : Arthur Riley, Frederick Harris, William Edgsworth David, Walter Timothy James, Robert Kay Nisbet, and Thomas Marron. Dated Jan. llth: Henry Speldewinde de Boer, George Alexander Connell Gordon, and David Heron. Dated Jan. 12th: Humphrey Rivers Pollock, Cyril Aubrey Smallhorn, Bernard Ernest Wall, Robert James D’Arcy Irvine, Finbar John Hunt, Albert Jones, Robert Francis Jones, Robert Yelverton Stones, and George Oliver Maw. Dated Jan. 14th: Arthur Hines. Dated Jan. 15th : Walter Winslow, Douglas Green, Arthur Charles Douglas Firth, Cecil Banting, Claude Hollingworth Philips, Thomas Joseph Kelly, Clive Justin Hicks Sharp, Charles Francis Orr White, Robert Campbell Begg, Ernest Stewart Dixon, and Maurice Mackenzie. The undermentioned relinquish their temporary commissions with the Allied Forces Base Hospital :-Dated Feb. 1st: Captain Norman Duggan, Captain Sidney B. Radley, Lieutenant Douglas E. Derry, and Lieutenant

serving

Robert

Henry Liscombe.

SPECIAL RESERVE OF OFFICERS. Royal Army Medical Corps. Lieutenant William 0. Lodge resigns his commission.