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THE COLD BATH IN SCARLET FEVER.
1133 occasion, protested 11 against apathy and inactivity where real evil or danger " has existed. Indeed, it is because of this very attitude that we claim alliance with the local paper in its war against such delay and inactivity In March, 1879, as we felt it our duty to refer to. our contemporary gave some prominence to a report on Haslemere. That report referred to insanitary conditions which were only "too notorious," to the lack of proper means of drainage, and to the resulting high mortality; and, significantly heading its comments by the words " Something Wrong Somewhere," it went on to say : "Some months ago, it will be remembered, Messrs. Bailey Denton and Co., the eminent engineers, prepared a scheme of drainage and also of a new water-supply for the town, at the instance of the rural sanitary authority, but the parochial sanitary committee managed to get both put aside." This attitude of apathy and delay is precisely the point to which we adverted, and we hope that, if it has not already been ascertained, some effort will be made to find out with whom rests the " wrong" which was admitted in 1879, and also with whom it has been lying ever since that date. a
cataleptic torpor is itself morbid. It implies, moreover, eithera previous abnormal sensitiveness in the nervous centres of the medium acted on or the employment of an unusual and powerful agent to control those of ordinary stability. Either way the process and its effects are unwholesome, needless, and undesirable. Another consideration is that of after-consequences. As regards these, no definite statistics, indeed, are obtainable, but common experience teaches that, the will mastered, and that not once but often, by another, is less potent for its individual work in life than it was before. What right, then, we would ask, has anyone to subtract thus much from even a unit of human usefulness ? The privilege based on reason, and claimed by the genuine scientific observer, we have already referred to. That of the mere performing conjuror of the entertainment-room neither fashion nor money gain will justify. Such exhibitions as his should be discouraged by all rational persons, and in cases where consent has been actually or virtually forced, should be punishable by law.
to
ALBUMINURIA AS A RESULT OF THE MORPHIA HABIT. THE COLD BATH IN SCARLET FEVER. AT the meeting of the Société Médicale des Hôpitaux on THE good effect of cold immersion in severe scarlet fever May 9th, Dr. Huchard pointed out (L’Union Méd., No. 58), was well illustrated in a case related by M. Dieulafoy at a that the abuse of morphia sometimes causes albuminuria, recent meeting of the Paris Hospitals Medical Society which leads to death by uræmia. Levinstein has published (Bull. et Mem. Soc. M6d. des Hôpitaux, No. 15). The patient, seven such cases, and Dr. Huchard contributed three others, a girl sixteen years of age, was, on the sixth day of the fever, attacked by marked nervous symptoms, excitement, insomnia, suppression of urine, pulse from 120 to 150, and very high temperature. On the eighth day her condition was very grave, the eruption had disappeared, the temperature was 40 9° C. (105.6° F.), pulse irregular and intermittent, and the prostration extreme. In spite of the fact that she was menstruating, he advised the cold bath, and after some delay the friends of the patient permitted the measure. She was placed in a bath at 24° C. (75° F.) which caused severe shivering, cyanosis, and coldness of the extremities. But the pulse rate fell from 150 to 100, and the delirium ceased.
all fatal from uraemia. As to the connexion between the renal disease and morphinism, Dr. Huchard suggested that it might be through the action of the poison on the medulla, or by long-continued diminution of arterial tension ; for he has found that morphine lowers arterial tension considerably, thus favouring passive congestion in the organs, the kidney among others. According to him, whereas excessive arterial tension will ultimately bring about arterio-sclerosis, a persistent lowering of tension can lead to Bright’s disease (obviously Dr. Huchard does not here speak of granular kidney, which is associated with high arterial tension). In conclusion, he pointed out that morphioAt the end of fifteen minutes she was removed from the mania, a cerebral condition, required different management bath, which was repeated three times during the night, at from morphinism. higher temperatures. This treatment was continued up to the eleventh day, when the body temperature became YSTRAD AND NOTIFICATION. normal. M. Dieulafoy advocated the bath in all malignant THE attitude of the Ystrad local board of health towards forms of fever, and its good effects in scarlet fever were the question of the notification of infectious diseases is one endorsed by MM. Johel-Renoy and Duponchel, who had which the passing of the Infectious Diseases (Notification) obtained similar good results. Dr. Huchard advised caffeine Act should have rendered altogether impossible. As far as injections for the collapse. we can there has been an on the -
understand,
-
PUBLIC EXHIBITIONS OF HYPNOTISM. THOUGH but lately introduced to public notice, hypnotism has for many years attracted a share of professional attention. A certain interest doubtless attaches to the subject, but this is of a serious rather than an amusing kind, a fact which is not so fully recognised as it should be. It is of some consequence from a scientific standpoint, for example, to determine the psychical forces concerned in producing this condition. It is, further, somewhat important practically to decide how far the artificial slumber may be utilised for therapeutic purposes, though its occasional success when thus employed will probably never compensate for the time and effort often vainly spent in striving after this result. Up to this point, however, we can at least allow that serious honesty of purpose on the part of those concerned affords
some
show of
justification
for the
peculiar
nervous
change effected by them. When we come to such novelties recreation as the hypnotic séance the case is quite different. There is at any time an element of danger involved in a practice which num os the senses and energies of the nervous system as hypnotism does. The creation of what amounts
attempt
part
of that authority to secure the notification which that Act enforces without making any payment for the information, such as the same statute requires. A deputation of medical men having attended the board, it was intimated that if the authority put the Act in force the medical practitioners would on their part loyally carry it out, and this notwithstanding the views they hold to the effect that its requirements go beyond that which in their opinion the State should properly demand. But, as Dr. Davies pointed out, the medical profession stood in the front ranks of those who gave gratuitous services, and hence where a statute definitely assigns remuneration for a task which it imposes, theauthority had the less right to ask that that duty should be performed and then refuse to pay the fee. Dr. Parry also urged that until the local authority had proved that they were too poor to pay for that which was intended as a boon to the public at large, theie was absolutely no reason why the medical profession should forego its very limited rights in this matter. One member of the local board is reported to have said that the ratepayers felt very strongly on the question, and that if refusal were maintained they would " make their feelings known." Apparently this threat had to do
cataleptic torpor is itself morbid. It implies, moreover, eithera previous abnormal sensitiveness in the nervous centres of the medium acted on or the employment of an unusual and powerful agent to control those of ordinary stability. Either way the process and its effects are unwholesome, needless, and undesirable. Another consideration is that of after-consequences. As regards these, no definite statistics, indeed, are obtainable, but common experience teaches that, the will mastered, and that not once but often, by another, is less potent for its individual work in life than it was before. What right, then, we would ask, has anyone to subtract thus much from even a unit of human usefulness ? The privilege based on reason, and claimed by the genuine scientific observer, we have already referred to. That of the mere performing conjuror of the entertainment-room neither fashion nor money gain will justify. Such exhibitions as his should be discouraged by all rational persons, and in cases where consent has been actually or virtually forced, should be punishable by law.
to
ALBUMINURIA AS A RESULT OF THE MORPHIA HABIT. THE COLD BATH IN SCARLET FEVER. AT the meeting of the Société Médicale des Hôpitaux on THE good effect of cold immersion in severe scarlet fever May 9th, Dr. Huchard pointed out (L’Union Méd., No. 58), was well illustrated in a case related by M. Dieulafoy at a that the abuse of morphia sometimes causes albuminuria, recent meeting of the Paris Hospitals Medical Society which leads to death by uræmia. Levinstein has published (Bull. et Mem. Soc. M6d. des Hôpitaux, No. 15). The patient, seven such cases, and Dr. Huchard contributed three others, a girl sixteen years of age, was, on the sixth day of the fever, attacked by marked nervous symptoms, excitement, insomnia, suppression of urine, pulse from 120 to 150, and very high temperature. On the eighth day her condition was very grave, the eruption had disappeared, the temperature was 40 9° C. (105.6° F.), pulse irregular and intermittent, and the prostration extreme. In spite of the fact that she was menstruating, he advised the cold bath, and after some delay the friends of the patient permitted the measure. She was placed in a bath at 24° C. (75° F.) which caused severe shivering, cyanosis, and coldness of the extremities. But the pulse rate fell from 150 to 100, and the delirium ceased.
all fatal from uraemia. As to the connexion between the renal disease and morphinism, Dr. Huchard suggested that it might be through the action of the poison on the medulla, or by long-continued diminution of arterial tension ; for he has found that morphine lowers arterial tension considerably, thus favouring passive congestion in the organs, the kidney among others. According to him, whereas excessive arterial tension will ultimately bring about arterio-sclerosis, a persistent lowering of tension can lead to Bright’s disease (obviously Dr. Huchard does not here speak of granular kidney, which is associated with high arterial tension). In conclusion, he pointed out that morphioAt the end of fifteen minutes she was removed from the mania, a cerebral condition, required different management bath, which was repeated three times during the night, at from morphinism. higher temperatures. This treatment was continued up to the eleventh day, when the body temperature became YSTRAD AND NOTIFICATION. normal. M. Dieulafoy advocated the bath in all malignant THE attitude of the Ystrad local board of health towards forms of fever, and its good effects in scarlet fever were the question of the notification of infectious diseases is one endorsed by MM. Johel-Renoy and Duponchel, who had which the passing of the Infectious Diseases (Notification) obtained similar good results. Dr. Huchard advised caffeine Act should have rendered altogether impossible. As far as injections for the collapse. we can there has been an on the -
understand,
-
PUBLIC EXHIBITIONS OF HYPNOTISM. THOUGH but lately introduced to public notice, hypnotism has for many years attracted a share of professional attention. A certain interest doubtless attaches to the subject, but this is of a serious rather than an amusing kind, a fact which is not so fully recognised as it should be. It is of some consequence from a scientific standpoint, for example, to determine the psychical forces concerned in producing this condition. It is, further, somewhat important practically to decide how far the artificial slumber may be utilised for therapeutic purposes, though its occasional success when thus employed will probably never compensate for the time and effort often vainly spent in striving after this result. Up to this point, however, we can at least allow that serious honesty of purpose on the part of those concerned affords
some
show of
justification
for the
peculiar
nervous
change effected by them. When we come to such novelties recreation as the hypnotic séance the case is quite different. There is at any time an element of danger involved in a practice which num os the senses and energies of the nervous system as hypnotism does. The creation of what amounts
attempt
part
of that authority to secure the notification which that Act enforces without making any payment for the information, such as the same statute requires. A deputation of medical men having attended the board, it was intimated that if the authority put the Act in force the medical practitioners would on their part loyally carry it out, and this notwithstanding the views they hold to the effect that its requirements go beyond that which in their opinion the State should properly demand. But, as Dr. Davies pointed out, the medical profession stood in the front ranks of those who gave gratuitous services, and hence where a statute definitely assigns remuneration for a task which it imposes, theauthority had the less right to ask that that duty should be performed and then refuse to pay the fee. Dr. Parry also urged that until the local authority had proved that they were too poor to pay for that which was intended as a boon to the public at large, theie was absolutely no reason why the medical profession should forego its very limited rights in this matter. One member of the local board is reported to have said that the ratepayers felt very strongly on the question, and that if refusal were maintained they would " make their feelings known." Apparently this threat had to do