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THE EXPERIMENTAL PROPHYLAXIS OF SYPHILIS.
407 Sullivan records a case where a sailor fell into and as he was swimming he was struck by paddle first on one shoulder and then on the other, In Stanley Yeoman’s and a double dislocation resulted. case part of the roof of a coal-mine fell on a man’s back and caused double subcoracoid dislocation. In all the recorded the blow has come cases, however, nearly on the hands or elbows, and a fall is the most usual way in which the blow has been delivered. In Davidson’s case a carpenter fell from a roof and both his elbows touched the ground at once, in Hamilton’s the patient fell from a carriage, and in Lister’s he fell from a tree. In Hennequin’s In Gant’s case one side was case the fall was backwards. first dislocated and then the other : an omnibus was upset and the patient was thrown off ; he fell on the right shoulder and felt that it was dislocated ; the next moment another passenger fell on his left shoulder and he felt that that was ’, In some of the cases there has been a dislocated also. history of earlier displacements of the joints. In most of the instances the same variety of dislocation existed on the two sides, and the subcoracoid is the most common. shoulders. the the
EAST SUSSEX SCHOOL INSPECTION SCHEME.
sea
THE East Sussex education committee and county council combined have changed their plans as regards the medical inspection of school children. Instead of appointing a male superintending medical officer at a salary of f:400 per annum with an allowance of £40 per annum for travelling expenses, and a male assistant medical officer at a salary of R250 per annum with a like allowance for travelling expenses, as was agreed upon in April last, the authorities have decided that the inspection shall be carried out under the supervision of the county medical officer of health, thus per annum :—
Since the April meeting of the county council a conference has been held attended by the education committee and the public health committee of the county council, and it was at this conference that the new scheme was agreed upon, the THE EXPERIMENTAL PROPHYLAXIS OF education committee and the county council ratifying it on SYPHILIS.1 July 28th. The cost is a little more than the original WE noticed recently a valuable book on syphilis written by scheme, but, as will be seen, it provides for two whole-time officers of the Royal Army Medical Corps ; now we have and for making use of the county medical officer before us a book on ’’ The Experimental Prophylaxis of and the inspector of midwives. The time of the latter has Syphilis," written by a Frenchman and translated by not hitherto been fully occupied. A proposal for appointing a surgeon in the navy, who is to be congratulated a whole-time county medical officer of health, having regard on the readable English into which he has turned to the extra work now entailed, is a matter for further conhis author’s interesting chapters. Briefly, the argu- sideration. The new scheme divides the East Sussex area ment is that the virus of syphilis cannot penetrate into two divisions. The number of scholars (about 26,000) unbroken skin, that it must have an abrasion through and schools will remain the same, so it may be taken (176) which to reach its special field of attack in the upper that the appliances required will be as tabulated in these layers of the dermis. But syphilitic lesions have trepo- columns in April last.1 With such a comprehensive scheme nemata swarming in their deeper layers and few on the as this appears it is very evident that the East Sussex surface ; hence a syphilitic lesion rarely infects another authorities fully realise that the medical inspection of school person unless its own surface has been firmly rubbed off children is the foundation-stone upon which all the ’means and its deeper and more infectious area exposed-a for the healthy environment and better physical development fact which is indicated by the comparative rarity of extra- of the rising generation must rest. genital chancre. The disease swiftly becomes generalised, WITHERING SARCOMA OF THE SCALP. consequently excision of the chancre does not prevent infection, although in certain situations the practice is IN the New Zealand Medical Journal for May Dr. P. C. very good, as the wound heals by first intention and Fenwick has published a case of a curious tumour of the the patient is saved some risk of added infections and The scalp. patient was a healthy-looking man, aged possibly much inconvenience. How far is it possible that 38 years, with an excellent family history and no history mercury applied to the area of infection, before or very soon of tuberculosis or venereal disease. He stated that two after infection had occurred, might destroy the virus ? It years previously a small dark spot appeared on his chest and has now been proved by logical treatment. Metchnikoff and slowly grew to the size of a watch-glass. It was firm and Roux have inoculated apes, and so successfully that they can elevated and painless. In the course of a few state that their inoculations will always be followed by months it slowly disappeared. Simultaneously with its chancres unless the inoculated area is rubbed within an disa,ppearance a spot appeared on the right parietal region hour or so after inoculation with a 30 per cent. calomel (the patient was bald) and this slowly grew. He came ointment for five minutes, and this not merely because of the under observation 11 months after the growth on the scalp mechanical removal of the poison by rubbing, as protection The right parietal region showed a curious-looking is not secured if the proportion of calomel in the ointment began. tumour measuring 4 by 3 inches and elevated three-quarters be less than 30 per cent. Dr. Maisonneuve’s book is written of an inch above the scalp. Its colour varied from pink to to show how, guided by this experimental and other clinical It was nodular, very firm and elastic, and paindark red. evidence, the 30 per cent. calomel ointment in lanolin can less, and not moveable over the bone. At every point of be recommended as a certain prophylactic if used before or the circumference small vessels passed into the growth within an hour or two after exposure to infection. It is The patient was shown to a local medical society and stated that this ointment is issued to all men in the French the only diagnosis that could be suggested was a myxoAn ointment is issued to the German army with army. fibroma. The x rays were applied daily for five days, then similar intention. So far as we can learn we are content to three times at intervals of three days, and finally weekly. act in Great Britain as if the evils of syphilis do not exist After the first application the tumour began to shrink rapidly, and we call attention to the work for this reason. a stained area and after the last
inspectors
slightly
Translated by F. L. de Verteuil, M.B. Edin., M.R.C.S. Eng., L.R.C.P. Lond., Surgeon, R.N. Bristol: John Wright and Co.; London : Simpkin, Marshall, and Co. Price 4s.
1 By Dr. Paul Maisonneuve.
marked its
application only slightly position. A wax cast and a photograph 1
THE LANCET,
April 18th,
p. 1164.
of the
EAST SUSSEX SCHOOL INSPECTION SCHEME.
sea
THE East Sussex education committee and county council combined have changed their plans as regards the medical inspection of school children. Instead of appointing a male superintending medical officer at a salary of f:400 per annum with an allowance of £40 per annum for travelling expenses, and a male assistant medical officer at a salary of R250 per annum with a like allowance for travelling expenses, as was agreed upon in April last, the authorities have decided that the inspection shall be carried out under the supervision of the county medical officer of health, thus per annum :—
Since the April meeting of the county council a conference has been held attended by the education committee and the public health committee of the county council, and it was at this conference that the new scheme was agreed upon, the THE EXPERIMENTAL PROPHYLAXIS OF education committee and the county council ratifying it on SYPHILIS.1 July 28th. The cost is a little more than the original WE noticed recently a valuable book on syphilis written by scheme, but, as will be seen, it provides for two whole-time officers of the Royal Army Medical Corps ; now we have and for making use of the county medical officer before us a book on ’’ The Experimental Prophylaxis of and the inspector of midwives. The time of the latter has Syphilis," written by a Frenchman and translated by not hitherto been fully occupied. A proposal for appointing a surgeon in the navy, who is to be congratulated a whole-time county medical officer of health, having regard on the readable English into which he has turned to the extra work now entailed, is a matter for further conhis author’s interesting chapters. Briefly, the argu- sideration. The new scheme divides the East Sussex area ment is that the virus of syphilis cannot penetrate into two divisions. The number of scholars (about 26,000) unbroken skin, that it must have an abrasion through and schools will remain the same, so it may be taken (176) which to reach its special field of attack in the upper that the appliances required will be as tabulated in these layers of the dermis. But syphilitic lesions have trepo- columns in April last.1 With such a comprehensive scheme nemata swarming in their deeper layers and few on the as this appears it is very evident that the East Sussex surface ; hence a syphilitic lesion rarely infects another authorities fully realise that the medical inspection of school person unless its own surface has been firmly rubbed off children is the foundation-stone upon which all the ’means and its deeper and more infectious area exposed-a for the healthy environment and better physical development fact which is indicated by the comparative rarity of extra- of the rising generation must rest. genital chancre. The disease swiftly becomes generalised, WITHERING SARCOMA OF THE SCALP. consequently excision of the chancre does not prevent infection, although in certain situations the practice is IN the New Zealand Medical Journal for May Dr. P. C. very good, as the wound heals by first intention and Fenwick has published a case of a curious tumour of the the patient is saved some risk of added infections and The scalp. patient was a healthy-looking man, aged possibly much inconvenience. How far is it possible that 38 years, with an excellent family history and no history mercury applied to the area of infection, before or very soon of tuberculosis or venereal disease. He stated that two after infection had occurred, might destroy the virus ? It years previously a small dark spot appeared on his chest and has now been proved by logical treatment. Metchnikoff and slowly grew to the size of a watch-glass. It was firm and Roux have inoculated apes, and so successfully that they can elevated and painless. In the course of a few state that their inoculations will always be followed by months it slowly disappeared. Simultaneously with its chancres unless the inoculated area is rubbed within an disa,ppearance a spot appeared on the right parietal region hour or so after inoculation with a 30 per cent. calomel (the patient was bald) and this slowly grew. He came ointment for five minutes, and this not merely because of the under observation 11 months after the growth on the scalp mechanical removal of the poison by rubbing, as protection The right parietal region showed a curious-looking is not secured if the proportion of calomel in the ointment began. tumour measuring 4 by 3 inches and elevated three-quarters be less than 30 per cent. Dr. Maisonneuve’s book is written of an inch above the scalp. Its colour varied from pink to to show how, guided by this experimental and other clinical It was nodular, very firm and elastic, and paindark red. evidence, the 30 per cent. calomel ointment in lanolin can less, and not moveable over the bone. At every point of be recommended as a certain prophylactic if used before or the circumference small vessels passed into the growth within an hour or two after exposure to infection. It is The patient was shown to a local medical society and stated that this ointment is issued to all men in the French the only diagnosis that could be suggested was a myxoAn ointment is issued to the German army with army. fibroma. The x rays were applied daily for five days, then similar intention. So far as we can learn we are content to three times at intervals of three days, and finally weekly. act in Great Britain as if the evils of syphilis do not exist After the first application the tumour began to shrink rapidly, and we call attention to the work for this reason. a stained area and after the last
inspectors
slightly
Translated by F. L. de Verteuil, M.B. Edin., M.R.C.S. Eng., L.R.C.P. Lond., Surgeon, R.N. Bristol: John Wright and Co.; London : Simpkin, Marshall, and Co. Price 4s.
1 By Dr. Paul Maisonneuve.
marked its
application only slightly position. A wax cast and a photograph 1
THE LANCET,
April 18th,
p. 1164.
of the