THE ETYMOLOGY OF ASPHYXIA.

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THE LATE SIR HENRY A. PITMAN: A CENTURY’S RETROSPECT.

a patient dies here in whose case we elder Southey, and Billing, and Aston Key, and Clift, and months used the utmost efforts to cure many more. But Sir Henry Pitman’s life was bound up with or relieve, and make an accurate diagnosis, and then that of the Royal College of Physicians. Of his long years no opportunity is given of proving the correctnessI of service to the College he loved to speak and to tell how of the diagnosis. I am quite satisfied that if patients or he had read through its centuries of Latin annals, how he their friends were informed that people would not be, spent long years upon their index, and how the Grant of Arms admitted into the hospital, except in cases of accident orwas once lost until the precious parchment was discovered by sudden illness, unless permission was previously given to one of the Fellows in a casual shop. Sir Henry Pitman knew inspect the body in the event of death, they would consent 13 successive Presidents of the College, from Halford who to it, and it would be done as a matter of course. Under came to the chair in 1820 down to the distinguished holder the present circumstances, in a large number of instances, of the office to-day. He was indeed examined by Sir Henry when permission is at first refused, it is given as soon as we Halford in Latin for the College Licence. Thus through the offer money. But this is a bad habit, and I seldom yield to life now closed we seem to be brought into touch with the it. Again, in a large number of cases, the persons who refuse courtly figure of that most aristocratic of physicians, the permission are not the immediate relatives, but mere trusted adviser of four successive sovereigns, and the undisacquaintances ; and though the former would consent, the puted head of his profession in London for 20 years from the latter urge them to oppose the measure, for the mere purpose death of Matthew Baillie in 1823. Sir Henry Pitman knew of looking friendly, or exerting influence and being busy. Halford’s successor, Dr. Paris, an accomplished chemist It frequently also happens that patients are never visited rather than a man of extensive practice, whose chief fame while in the hospital by either relatives or acquaintances, so rests on his literary work in pharmacology. It was under long as they are alive, but as soon as they die, ten or twenty Dr. Mayo that Sir Henry Pitman began his work as regispersons come forward to prevent the body from being opened. trar of the College; he found his President keen and I am quite sure that if it were made a rule to admit none intelligent, despite a certain hesitation in his manner. But the ideal President of all his experience was Sir Thomas (except indeed urgent cases) but with the understanding that they should be opened if they died, it would be cheerfully Watson. He was, Sir Henry Pitman would say, a most assented to. I am satisfied that the public feeling would amiable man, with a felicitous manner, the outcome of his change on the subject,-that the world might be brought to own happy nature. III never heard him speak an evil word consider that we had not paid proper respect to the of any one. Any letter he wrote was short and beautifully Sir Roundell Palmer, responding at a Harveian deceased unless we had ascertained by examination after expressed. death, the precise nature and cause of the complaint, and dinner, said that if he wanted happy expressions and good communicated the true state of the inside to the friends. language he would go to the Royal College of Physicians." This is always done in the case of the highest personage of In Sir Henry Pitman’s earlier days the President was still the kingdom ; and every soldier is opened, and whatever may chosen, under statute of Henry VIII., by the eight College be the part of the world in which he may have died, an "elects " from among their own number; it was not until account of the inspection is transmitted to the army medical 1860 that the choice was given to the whole body of Fellows. board at Woolwich. Unfortunately, many do not distinguish At the date of his birth the College was housed in Warwickbetween dissection and inspection-do not know that while lane ; its removal to Pall Mall East was celebrated with dissection means cutting up piece by piece, inspection is much ceremony in 1825. The changes of the century may merely making a cut, looking in, and sewing the cut up be illustrated from the College Pharmacopoeias. That issued in the year after Pitman’s birth introduced chemical nomenagain. Whenever I die I hope to be carefully inspected. clature and admitted arsenic and digitalis for the first time ; quinine, morphia, strychnia, and ergot had to wait until 1836. No attempt can, however, be here made to measure the advances witnessed by our venerable friend during his long life. The stethoscope, the microscope, the thermometer, the "Audi alteram partem." testing of urine and of blood,-all these were brought into use in medicine within that century of life and they have THE LATE SIR HENRY A. PITMAN: A opened up undreamt-of vistas in the science of our art. It may be that therapeusis has not kept pace with diagnosis, CENTURY’S RETROSPECT. yet the age has been so full of expanding medical knowledge To the Editor of THE LANCET. that to pass from 1808 to 1908 seems like going from darkSIR,-The student of historical medicine cannot but note ness into light. What may be looked for in the century to I am, Sir, yours faithfully, the passing away of Sir Henry Pitman. The historic imagina- come2 Fox. R. HINGSTON FOX. tion covets landmarks, and a life which covered a century London, W., Nov. 16th, 1908. and was passed in association with many of the leadersof British medicine may afford us such tokens. By these we THE ETYMOLOGY OF ASPHYXIA. may be helped to discern the march of our art, its periods and its masters, during the last few generations. To the Editor of THE LANCET. Sir Henry Pitman was born in 1808, the year before the birth of Darwin and of Oliver Wendell Holmes. (Many SIR,-The difficulty in explaining how the word asphyxia other men of note were born in 1809-Gladstone and Lincoln, has acquired its present meaning, "suffocation"" or deprivaTennyson and Fitzgerald and Poe, Mendelssohn and Chopin ; tion of air or oxygen, must have occurred to many of your it was a "year of momentous births," like 1769, when readers. the pulse) means Asphyxia (& priv. and is derived of the pulse. Napoleon, Wellington, and other famous men came into the pulselessness or stoppage " world.) When Sir Henry Pitman was born our country was in from o-956pw "to throb. But pulselessness is not a feature the throes of the Great War. He was already seven years old in what we call asphyxia, and under the heading Asphyxia in when that war was closed by the battle of Waterloo, and the Sir James Murray’s "New English Dictionary " the following leaders of medicine and other sciences in our own land and comment on this discrepancy appears:"It indicates a France could once more come together. English savants curious infelicity of etymology that the pulse in asphyxiated were again welcomed by Cuvier and Berthollet, by Dupuytren animals continues to beat long after all signs of respiratory movements have ceased." and Laennec. The possible solution of the difficulty is that the ancients, The period from the death of John Hunter in 1793 until 1820 may be called the Epoch of the Pupils of the Hunters- noticing that the arteries after death contained air and not Baillie and Abernethy and Astley Cooper and the rest-as it blood, believed that during life they were air-ducts ramifying was, perhaps, in the northern capital the epoch of the pupils from the trachea called the arteria aspera."Therefore, the of Cullen and of the Monroes. Young Pitman knew the word artery is probably derived from ’Ap (air) and generation that followed these-the era when in London (I guard) ; and as’’ the pulse-beat itself was attributed to the Lawrence and Brodie, Bright and the younger Babington rebound of air or vital spirit" in the arteries or air carriers were in their prime. He had heard Guthrie lecture ; he it follows that the word asphyxia acquired the double meanwould tell how W. F. Chambers kept the notes of his cases ing, stoppage of the pulse and deprivation of air. In the in Latin, of the mordant eloquence of J. A. Wilson, of the latter sense the term has survived. Thus an ancient error

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Correspondence.

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THE ELECTROLYTIC ADMINISTRATION OF DRUGS. is embalmed in a word in modern use. Artery has also been derived from aelpm (I raise) and from (I leap), but on seems most likely to be the whole its derivation from correct. There is nothing novel, of course, in this supposition, but as far as I know no attempt has hitherto been made to reconcile the apparent discrepancy between the etymology and present meaning of the word asphyxia. I am, Sir, yours faithfully, LEONARD GUTHRIE. Upper Berkeley-street, W., Nov. 16th, 1908.

THE CAUSE AND PREVENTION OF DENTAL CARIES. To the Editor of THE LANCET. SIR,-I have been much interested in reading Dr. J. Sim Wallace’s article on the above subject which appeared in your issue of Sept. 12th. Dr. Wallace and Dr. Campbell have rendered a useful service in bringing this subject prominently before the profession, and nothing but good can arise from following out the principles there set forth. May I, however, be permitted to state that the germ of most of Dr. Wallace’s writings appeared nearly 30 years ago in my father’s work on dental surgery1 (see pages 103, 104, 105, 106, 107), although this germ has not been allowed to develop in present day text-books on dental surgery. For this reason it is all the more gratifying to see that the subject of diet in relation to dental caries and the effect of the former on the hard and soft tissues of the jaws and their surrounding parts has now been placed on a firmer basis, and perhaps this time to take root. I am, Sir, yours faithfully, F. COLEMAN. London, Nov, llth, 1908.

THE ELECTROLYTIC ADMINISTRATION OF DRUGS. To the Editor of THE LANCET. SIR,-Your interesting annotation on the above subject in THE LANCET of Oct. 31st, p. 1314, is evidence of the recrudescence of interest in cataphoric medication. In your number for Oct. 25th, 1890, p. 869, i.e., just 18 years ago, you did me the honour to publish a short paper on Cataphoric Medication and Cocaine as a Local Anaesthetic," and I then endeavoured to show that the method there described had already passed beyond the stage of experiment into that of routine practice, at any rate in my own hands. Subsequently (March 13th, 1891), at the Society of Arts, under the distinguished presidency of Mr. (now Sir) William H. Preece, F.R.S., I demonstrated _practioallg some of the powers of the cataphoric method ; and again in a paper on Some Therapeutical Applications of Continuous Currentread at the opening sessional meeting of the Therapeutical Society in October, 1904, I referred to some portions of the work I had done in connexion with the cataphoric and other powers of continuous current. (I am inclosing herewith a marked copy of this paper.) For some 20 years, therefore, as shown, I have used cataphoric medication in my everyday practice, and I am somewhat amused, though interested, to note that the subject is now treated as nem by Leduc, Jones; and others, presumably on the assumption that no work on the subject has previously been done. May I here say that the new ’, term "ionisation"is scarcely comprehensive, and there are weighty objections to its use-except in so far as it implies a part of a process‘! In connexion with recent papers I note that the writers have not yet grasped the necessity for paying regard to antecedent soakage (as demonstrated by the late Mr. Lant Carpenter, Dr. W. H. Stone, and others), or to relative area of contact of the respective electrodes.2 Too much stress has been laid upon "ionisation," which, though an essential part of cataphoric medication, is, after all, only a part3 and does not include the whole of the processes concerned. Verily, there is nothing new under the sun Long before I attempted to employ medication by cataphoresis the late Sir Benjamin Ward Richardson and others in Germany and 1

Manual of Dental

Surgery and Pathology, by A. Coleman, F.R.C.S.,

L.D.S. 1881. 2 See Journal Institution of Electrical Engineers, vol. xix., No. 86. 3 See Journal of the Society of Arts, No, 1999, vol, xxxiv., pp. 316-325.

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America had already carried their investigations into an advanced experimental stage. With regrets for trespassing so far on your valuable space and my best thanks in anticipation, I am, Sir, yours faithfully, ARTHUR HARRIES. St. James’s-square, Pall Mall, S.W., Nov. 7th, 1908. *We remember our correspondent’s interesting paper. We do not see that our annotation implied that either Leduc or Jones considers that cataphoresis is ’’ new." Dr. Lewis Jones was using cataphoric medication by cocaine in 1899 at St. Bartholomew’s Hospital. The originator of electrical medication was Fabre Palaprat, who wrote in 1833 on the introduction of iodine into the tissues by means of currents. In a bibliography of the subject given in 1900 by Professor Leduc, Dr. Harries’s paper is mentioned and occupies the twenty-fourth place in chronological order.-ED. L.

A SERUM TREATMENT FOR CARCINOMA IN MICE. lb the Editom of THE LANCET.

SIR,-My attention has been called to Mr. C. E. Walker’s letter in THE LANCET of Nov. 14th. I, too, would have hoped -had I given the matter a thought-that the discussion should have begun and ended with the meeting of the Liverpool Medical Institution (at which the paper in question was read by him) and the subsequent reports in those journals which thought the matter of sufficient importance to publish. It is contrary to the usual procedure to carry on a discussion in the medical press after a meeting unless material facts or arguments are wrongfully supplemented later in the report of that meeting. This did not occur. I must deny any intention in my remarks other than that of impartial criticism of an important subject in which I am, as most of the profession are, much interested. Further, I have always held that to anyone who has a good case, knows his subject, and has the opportunity to reply, criticism should be welcome, in that it helps him to make good the weak points in that case. Mr. Walker failed in his reply to make a single point. He has since, I take it, worked the subject up ; hence his letter. Since he has alluded to the courtesy of the Medical Institution, which is justly proverbial, I presume he thinks my remarks were discourteous. I hasten to disclaim any intention of discourtesy at all. I would remind Mr. Walker that since he asked to be -enzited to read his paper he could not consider himself in the light of a distinguished guest. Had such been his position my remarks would have been in bad taste and uncalled for. While we are on this matter I must say also that in any circumstances I think the position of the Liverpool Medical Institution is suéh that he was ill-advised to read before it a paper which he had published in THE LANCET only a few weeks previously-it was hardly I feel it necessary to say a compliment to the institution. this much, and also to deny the insinuation that I abused the hospitality of the Cancer Laboratory. I was never Mr. Walker’s guest, nor did he ever give me any mice. I grafted myself what mice I had from one kindly given to me by the director of the laboratory. These are personal details I am sorry Mr. Walker has dragged in. I have no wish in regard to the work of that laboratory but that some good should come out of it, and that the indefatigable energy of the workers there should meet with some reward. If he considers my remarks a "reflection"" on the laboratory I can only reply that my intention was to save it from what happened recently on the publication of work done there in connexion with liquid air-work which was criticised in a similar manner by Dr. E. F. Bashford.l Mainly my complaint was, then, that no reference at all was made by Mr. Walker to the work of others on similar lines (with the exception of a small experiment of Griinbaum done in the same laboratory). I carefully mentioned in my remarks that there was a difference in technique in some of the work but that there was no essential difference. The few remarks made in reply showed that with the exception of some of Borrel’s work he was unfamiliar with, or ignorant 1

See THE LANCET, Feb. 1st, 1908, p.

394.