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THE DECLINE OF PERSONAL HONESTY.
39
prejudicially on the mind of the victim, and if there is ’* a police court with children instead of adult offenders, but instability it may suffice to upset the mental an aggressive child protecting agency." It is urged that the if it should not go so far as this it may be intelligent acceptance of Mr. Edmond Holmes’s thesis, that or equilibrium ; the function of education is to foster growth," must lead to to the whole life of the sufferer, and to embitter enough render him a much less useful member of society than he a peaceful revolution in our ideas and our common life that would otherwise be. Attempts to cure, to remove, or, at in time will transform our whole criminal procedure and least, to mitigate, all facial deformities must be regarded result in the disappearance of prisons. In two appendices are as a very important part of the work of a surgeon, not so published certain suggestions for penal reform, of which the as the relief of an obstruction of the following seem to be the more important: Inebriates, mental important indeed of defectives, and debtors should not be imprisoned, but treated a malignant growth, but surely as bowel, or the removal important as the remedying of a knock-knee or the excision or cared for ; the replacing of imprisonment by probation of a lipoma. Decorative surgery is not only justifiable but or training for offenders under 23 years, the principle of is really essential for a large number of people if they are probation being better organised and more widely extended ; to pursue effectively the business of their lives, and we have organisation of prison industries with a view to giving only to determine what limits there are, if any, to surgical instruction in methods of gaining a livelihood, clothing practice in this direction. The greatest care should be taken prisoners better, and the training of character ; the establishthat the operations which may be included under the I ment of carefully organised parole or after-care system, and heading of decorative surgery should be conducted with all of prison farms and colonies ; the holding of juvenile courts the precautions that modern science has shown to be quite apart from other courts, in juvenile houses of detention necessary. The fact that these operations are not performed and under special magistrates ; and a change of personnel in with life dependent upon them, and, strictly speaking, need prison administration, in respect of an improved method of not be performed at all, must not persuade the surgeon to selection of officials and a marked improvement in the relax his watchfulness. But the responsibility of assisting conditions of life of prison officers. the public by cosmetic operations is upon the medical pro-
act
the least mental
fession. If surgeons will not undertake the manifold operations belonging to this class the unqualified practitioner will step in and will carry out inefficiently the work neglected by the surgeon. Without training and without due knowledge of the conditions and of the risks that are run in operating and of the precautions that should be taken, unqualified operators do grievous harm. Already they venture to undertake much that is pure surgery, and the evil is growing. It is true that the surgeon is willing to operate on hare-lips and a few of the more striking deformities, but many of the malformations he will not touch. In skilled hands the risk and danger are small, and with practice the results may be very good. The work must be undertaken as a real and important part of surgery, and when carried out with care much misery will be saved and many men and women will be rendered more capable of earning a livelihood. THE DECLINE OF
PERSONAL HONESTY.
THE Penal Reform League, in its fourth annual report which has just been issued, takes up seriously the dictum of the head constable of Liverpool that there is "a general decline of personal honesty in many relations of life." That personal honesty is widely lacking, the report states, is well known, but whether it is generally declining there are no means of knowing. In any case, considering the prevalence of social and economic injustice, the unequal distribution of wealth, party strife in economics, politics, and religion, unfit parents and homes, and the stunting effect of schools, what right, it asks, have we to expect anything else ? As signs of an awaking conscience in these matters, the report refers to the National Conference on the Prevention of Destitution, held last summer, the First International Congress on Children’s Courts, and various other congresses touching cognate subjects. The tours of inspection of the secretary of the league, Captain Arthur J. St. John, lead him to comment on the over centralisation in this country, as compared, for instance, with the methods in vogue in America. He especially urges that children’s places of detention should be under the charge of gentlewomen of exceptional attainments. He reviews the prevailing condis tions in English, Scotch, and Irish prisons, and concludes that "neither the British Public nor their magistrates have yet grasped the whole meaning and possibilities of probation or of the juvenile court," which in his opinion should be not
GENERAL INFECTION WITH THE COLON BACILLUS PRODUCING DOUBLE PNEUMONIA AND PURULENT BRONCHITIS. IN recent years it has been recognised that the colon bacillus may infect various parts of the body, producing inflammation. Infections of the urinary tract are the best recognised and may take the form of nephritis, pyelonephritis, pyelitis, or cystitis. Of lesions in other parts little is yet known. In THE LANCET of Oct. 30th, 1909, p. 1269, Dr. J. Charlton Briscoe reported several cases of matting together of the pelvic viscera by an exudate showing caseous changes and suggesting tuberculosis, but microscopic examination showed that the lesions were due to the colon bacillus, which was also found abundantly in the urine. In the Boston Medical and Surgical Journal of Nov. 30th, 1911, Dr. R. C. Kemp has reported a case of general infection with the colon bacillus in which double pneumonia and purulent A. man, aged 44 years, was bronchitis were produced. in the York on New Hospital for right inguinal operated hernia on March 2nd, 1910. He was in perfect physical condition and his organs were found normal on examination. Though he took much exercise he was subject to constipation, for which he used olive oil and other simple remedies. On the afternoon of the day of operation catheterisation was necessary. On the next day there was some irritation of the bladder, which was washed out. On the following day there was pain in the leftrenal region and the urine contained pus. Pyelitis was diagnosed and urotropine was given. In three or four days the pain disappeared and then the right kidney was affected, but not so severely as the left. The pain on the right side soon disappeared, but pyuria and slight pyrexia continued. On March llth he complained of pains in the right side of the chest, and on the 12th dry pleurisy was found. On the 14th a small pneumonic area was found at the right base. On the 16th there was an alarming attack of heart failure with a fall of Under digitalin, strychnine, hypodermic of camphor in olive oil, hot stupes, and inhalation of oxygen he rallied. On the 24th there was a rigor, and the temperature rose to 104° F. As there was still evidence of pyelitis this suggested infection with the colon bacillus, which was found in the urine in large numbers. Resolution of the lesion in the right lung was very slow. There was little sputum, but in it abundant colon bacilli were found
temperature.
injection
prejudicially on the mind of the victim, and if there is ’* a police court with children instead of adult offenders, but instability it may suffice to upset the mental an aggressive child protecting agency." It is urged that the if it should not go so far as this it may be intelligent acceptance of Mr. Edmond Holmes’s thesis, that or equilibrium ; the function of education is to foster growth," must lead to to the whole life of the sufferer, and to embitter enough render him a much less useful member of society than he a peaceful revolution in our ideas and our common life that would otherwise be. Attempts to cure, to remove, or, at in time will transform our whole criminal procedure and least, to mitigate, all facial deformities must be regarded result in the disappearance of prisons. In two appendices are as a very important part of the work of a surgeon, not so published certain suggestions for penal reform, of which the as the relief of an obstruction of the following seem to be the more important: Inebriates, mental important indeed of defectives, and debtors should not be imprisoned, but treated a malignant growth, but surely as bowel, or the removal important as the remedying of a knock-knee or the excision or cared for ; the replacing of imprisonment by probation of a lipoma. Decorative surgery is not only justifiable but or training for offenders under 23 years, the principle of is really essential for a large number of people if they are probation being better organised and more widely extended ; to pursue effectively the business of their lives, and we have organisation of prison industries with a view to giving only to determine what limits there are, if any, to surgical instruction in methods of gaining a livelihood, clothing practice in this direction. The greatest care should be taken prisoners better, and the training of character ; the establishthat the operations which may be included under the I ment of carefully organised parole or after-care system, and heading of decorative surgery should be conducted with all of prison farms and colonies ; the holding of juvenile courts the precautions that modern science has shown to be quite apart from other courts, in juvenile houses of detention necessary. The fact that these operations are not performed and under special magistrates ; and a change of personnel in with life dependent upon them, and, strictly speaking, need prison administration, in respect of an improved method of not be performed at all, must not persuade the surgeon to selection of officials and a marked improvement in the relax his watchfulness. But the responsibility of assisting conditions of life of prison officers. the public by cosmetic operations is upon the medical pro-
act
the least mental
fession. If surgeons will not undertake the manifold operations belonging to this class the unqualified practitioner will step in and will carry out inefficiently the work neglected by the surgeon. Without training and without due knowledge of the conditions and of the risks that are run in operating and of the precautions that should be taken, unqualified operators do grievous harm. Already they venture to undertake much that is pure surgery, and the evil is growing. It is true that the surgeon is willing to operate on hare-lips and a few of the more striking deformities, but many of the malformations he will not touch. In skilled hands the risk and danger are small, and with practice the results may be very good. The work must be undertaken as a real and important part of surgery, and when carried out with care much misery will be saved and many men and women will be rendered more capable of earning a livelihood. THE DECLINE OF
PERSONAL HONESTY.
THE Penal Reform League, in its fourth annual report which has just been issued, takes up seriously the dictum of the head constable of Liverpool that there is "a general decline of personal honesty in many relations of life." That personal honesty is widely lacking, the report states, is well known, but whether it is generally declining there are no means of knowing. In any case, considering the prevalence of social and economic injustice, the unequal distribution of wealth, party strife in economics, politics, and religion, unfit parents and homes, and the stunting effect of schools, what right, it asks, have we to expect anything else ? As signs of an awaking conscience in these matters, the report refers to the National Conference on the Prevention of Destitution, held last summer, the First International Congress on Children’s Courts, and various other congresses touching cognate subjects. The tours of inspection of the secretary of the league, Captain Arthur J. St. John, lead him to comment on the over centralisation in this country, as compared, for instance, with the methods in vogue in America. He especially urges that children’s places of detention should be under the charge of gentlewomen of exceptional attainments. He reviews the prevailing condis tions in English, Scotch, and Irish prisons, and concludes that "neither the British Public nor their magistrates have yet grasped the whole meaning and possibilities of probation or of the juvenile court," which in his opinion should be not
GENERAL INFECTION WITH THE COLON BACILLUS PRODUCING DOUBLE PNEUMONIA AND PURULENT BRONCHITIS. IN recent years it has been recognised that the colon bacillus may infect various parts of the body, producing inflammation. Infections of the urinary tract are the best recognised and may take the form of nephritis, pyelonephritis, pyelitis, or cystitis. Of lesions in other parts little is yet known. In THE LANCET of Oct. 30th, 1909, p. 1269, Dr. J. Charlton Briscoe reported several cases of matting together of the pelvic viscera by an exudate showing caseous changes and suggesting tuberculosis, but microscopic examination showed that the lesions were due to the colon bacillus, which was also found abundantly in the urine. In the Boston Medical and Surgical Journal of Nov. 30th, 1911, Dr. R. C. Kemp has reported a case of general infection with the colon bacillus in which double pneumonia and purulent A. man, aged 44 years, was bronchitis were produced. in the York on New Hospital for right inguinal operated hernia on March 2nd, 1910. He was in perfect physical condition and his organs were found normal on examination. Though he took much exercise he was subject to constipation, for which he used olive oil and other simple remedies. On the afternoon of the day of operation catheterisation was necessary. On the next day there was some irritation of the bladder, which was washed out. On the following day there was pain in the leftrenal region and the urine contained pus. Pyelitis was diagnosed and urotropine was given. In three or four days the pain disappeared and then the right kidney was affected, but not so severely as the left. The pain on the right side soon disappeared, but pyuria and slight pyrexia continued. On March llth he complained of pains in the right side of the chest, and on the 12th dry pleurisy was found. On the 14th a small pneumonic area was found at the right base. On the 16th there was an alarming attack of heart failure with a fall of Under digitalin, strychnine, hypodermic of camphor in olive oil, hot stupes, and inhalation of oxygen he rallied. On the 24th there was a rigor, and the temperature rose to 104° F. As there was still evidence of pyelitis this suggested infection with the colon bacillus, which was found in the urine in large numbers. Resolution of the lesion in the right lung was very slow. There was little sputum, but in it abundant colon bacilli were found
temperature.
injection