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THE HEALTH OF SIR J. RUSSELL REYNOLDS.
1374 instance, in the vagus the inhibitory nerves of the heart died THE HEALTH OF SIR J. RUSSELL REYNOLDS. first, next the motor nerves for the oesophagus and larynx, THE news which was announced at the beginning of while the accelerator fibres for the heart lost their excitability the week of the serious illness of Sir J. Russell Reynolds and last of all to die was a
peculiar bundle,
distinctly later,
excitation of which brought about arrest of the heart in systole. This is the bundle which Arloing has already described as the "ordinary motor nerve of the heart
muscle." ____
SIR JOHN MILLAIS. IN view of the many unfounded rumours which are rife concerning the condition of Sir John Millais we think it right to state that the condition of affairs is as follows. On the night of Saturday, May 9th, urgent dyspnoea set in. This gradually increased, and early on Sunday morning Mr. Treves, assisted by Mr. G. H. Hames, considered it necessary to perform a tracheotomy. Sir John Millais was much relieved by the operation and has since gone on well. He(’, sleeps well. and there are no chest complications. In addition to Mr. Treves and Mr. Hames, Sir Richard Quain is in attenclance. ____
came as a surprise to all but a few who were very well informed. His request that he should not be re-elected as President of the Royal College of Physicians of London might have been taken as a preparation for the bad tidings, for he was not the man to escape rpsponsibi1l ties that he had once accepted until it had become clear to him that to burden himself further with them would be wrong. But his indisposition was so ill defined and the absence of important indications of any organic mischief so entire that the serious symptoms which set in last Saturday night were as unexpected as alarming. But they were not without a definite cause. Sir J. Russell Reynolds had improved under rest, care, and change of air, but on April 23rd, after seeing some patients at home, he returned from a drive, and in alighting from his carriage slipped on his own doorstep. This accident, unfortunately, caused him to be confined to bed, and conserluent on the shock and increasing weak-
pulmonary complications supervened. We are very announce that a slight improvement, glad shown by the abatement of temperature and the diminished frequency of respiration, which took place on Monday has been maintained ; and although the patient’s condition is still one to cause the deepest anxiety, his medical advisers now allow us to hope that the rally is perhaps not temporary but the commencement of a return to strength. ness
to be able to
THE MEDICAL OFFICER OF THE ADMINISTRATIVE COUNTY OF LONDON. THE average ratepayer is apt, and with good reason, to kick against the constantly increasing expenditure of the London County Council. But we fancy that the increase in the salary of the medical officer, Mr. Shirley Murphy, from £1000 to L1250 will meet with nothing but approval. The medical and hygienic work of the London County Council is enormous, and the admirable way in which Mr. Shirley Murphy and his assistants direct it is well known. We are glad to see that an amendment to increase the salary to £1200 by an annual rise of E50 was negatived and the committee’s original recommendation carried by 70 votes to 31.
PREVENTION OF HÆMORRHAGE IN DISARTICULATION AT THE HIP-JOINT.
Barlow and Dr. Buzzard have seen Sir J. Russell Reynolds regularly with Mr. Cooper Bentham, who has been in constant and assiduous attention. Dr. Wilks and Dr. Gowers have also seen Sir J. Russell Reynolds in consultation. Dr.
____
THE annual general meeting of the Pathological Society of London for the election of officers and council, and other business, will be held at 20, Hanover-square on May 19th, at 8.30 P.M. Mr. Stanley Boyd will propose the following resolution :That in the opinion of this meeting it is expedient that ladies, who are duly qualified medical practitioners, should be eligible for the membership of this society." The result of the voting on this motion will be awaited by the profession with no little interest and curiosity. By the why do not the ladies unite to form a medical society of their own!1 Some doubt seems to be felt as to whether the medical societies will follow the example set them by the British Medical Association.
hip-joint has always been accompanied by very high mortality, and two causes especially can be assigned to this great death.rate-namely, infection and shock The deaths due to infection are now much less frequent than they were in the pro-antiseptic days, but shock still remains responsible for a very large proportion of deaths. A great part of this shock is caused by the large amount of blood which is so often lost at this operation, and many attempts have been MR. CHAMBERLAIN has been informed by telegram from made to diminish the h2.morrhage. One of the most recent the Governor of Hong-Kong that seventy-four fresh cases of methods was brought forward by Dr. V. Chalot, Professor bubonic plague occurred in the colony in the week ending of Clinical Surgery at the Faculty of Medicine of Toulouse, 12th, and that the number of deaths from the plague in at the Huitieme Congres de Chirurgie, held at Lyons. May the same period was sixty-four. He suggests that a slightly curved incision, four or five centimetres in length, should be made about two centimetres DR. GEORGM OLIVER will deliver the Croonian Lecturesinternal to the anterior superior iliac spine, and the anterior abdominal muscles then divided, so that the peritoneum can A Contribution to the Study of the Blood and of the be gently raised from the iliac fossa. When this is done the Circulation -at the Royal College of Physicians of London, common iliac artery can be felt on the inner border of the Pall Mull East, on June 2nd, 4th, 9th, and llth. The lectures psoas muscle. An assistant places on the artery the tips will commence at 5 P.M. of the middle and ring fingers of the left hand for the right DR. JOHN ANDERSON, C.I.E., M.D.St. And., F.R.C’.P. side of the patient, and of the right hand for the left side, at the same time grasping the iliac crest with the forefinger Lond., Physician to the Seamen’s Dreadnought Hospital, has and the thumb, while the little finger rests on the abdominal been appointed Lecturer on Diseases of Tropical Climates wall. The compression is made against the ala of the at St. Mary’s Hospital Medical School. sacrum, and its efficacy is judged by the cessation of the femoral pulsation. The amputation is then proceeded with MR. A. PEARCE GOULD has been appointed Surgeon to in the ordinary way. Dr. Chalot quoted a case in which he the Middlesex Hospital. had employed this methocl with success, and with only a small amount of haemorrhage. ) TUE annual dinner of old students of King’s College, AMPUTATION at the a
’.
____
--
1375 London, will be held at the Holborn Restaurant on Monday, June 29th, Sir Benjamin Baker, K.C.M.G., LL.D., F.R.S., President of the Institution of Civil chair.
Engineers,
in the
seem to be any distinct contra-indications to its use and it does not produce any unpleasant head or lung symptoms. It may, however, sometimes cause diarrhoea or increase it if already existing.
not
POISONING WITH PIPERAZINB.
__
Pharmacology and Therapeutics.
In the American -3ledical Nen’s Dr. Slaughter of Philadelphia relates the case of a young married woman aged
thirty-two who. through a druggist’s blunder, received one dose of piperazine of twenty grains. Some hours later, when the patient was seen by Dr. Slaughter, she was much cyanosed PHARMACY IN JERSEY. and in a serious comatose condition. The pupils were WE have received a copy of the proposed Bill to Regulate much contracted, the pulse gave 50 beats to the minute, and the Practice of Pharmacy and the Sale of Poisons in Jersey, the temperature was 97’4° F. The respirations also were slow and there was low muttering delirium. The tips of the fingers and cordially welcome it as an effort to put the work of the were cyanotic and there was loss of motion but not of druggist there more in line with the conditions which control sensation in the lower limbs. Cardiac and other stimulants the practice of pharmacy in this country. The Bill provides were at once energetically used, while the limbs were. for the proper qualification of those acting as chemists or elevated and external heat was applied. A stimulating rectal was also given and the catheter was used. Thereclruggists, but the qualifications recognised include those of injection was paraplegia, afterwards treated by massage and large the Schools of Pharmacy of the University of France in doses of strychnia. Recovery was perfect. addition to those granted by the Pharmaceutical Society of APOCYNUM CANNABINUM. Great Britain or the Pharmaceutical Society of Ireland. A which in America is called Indian cannabinum, be Apocynum is to of all those to to whom register kept permission has long been used as a diuretic and indeed is included hemp, has been and it is the title to state practise granted, in the United States pharmacopoeia. Its value in general or qualification in each case. To prevent hardship dropsy due to renal disease gained for it the name of "the the new Act will not apply in these respects to vegetable trocar" from Dr. Rush.l Its physiological prothose chemists and druggists who are already prac- perties have recently been investigated by Dr. Dortschewski, with American observers that the most active tising in Jersey. A further act of grace enables the who agrees of the portion plant, from a pharmacological point of view, legal representatives of a chemist or druggist who has is the cortex of the root. An extract was from practised his profession in the island to continue the busi- this and diluted with from ten to twenty timesprepared its volume of ness after his death, but it necessitates the employment of water. Less than 100 cubic centimetres of this diluted extract an assistant who is in all respects qualified and authorised The effect was to was sufficient to kill a medium-sized dog. to act as a chemist and druggist. Provisions which closely increase the blood pressure and to cause the heart’s beat to follow those in force in this country safeguard the sale of become at first slower, stronger, and reduplicated, but subrapid and irregular until the animal died. The poisons, whether wholesale or retail, and the Bill includes sequently effects were due to the action of the drug on the motor a list of poisons, and the usual precautions are taken to centres of the brain and spinal cord, the slowing of the prevent the sale of the more active and dangerous poisons pulse being caused by the stimulation and its rapidity by The increased to minors aged less than sixteen years or to persons un- paralysis of the pneumogastric centres. known to the vendor. It is satisfactory to find that pre- blood pressure, too, was due to the contraction of the peri-arteries from central action. In clinical practice it parations used or sold for the destruction of vermin are pheral was found that patients with cardiac mischief could take included in this list. Medicines containing a poison or from five to ten drops three times daily with marked advanpoisons prepared by a medical man, or by a chemist or tage. Larger doses were apt to cause nausea and vomiting. druggist when prepared after a medical prescription, are ESSENTIAL OIL OF GARLIC IN PHTHISIS. exempt from the restrictions ordinarily affecting the Dr. Sejournet of Revin communicates to the Union Medecczle sale of poisons, provided that a copy of the prean Nora-Est some account of the effects he has obtained by scription is kept by the vendor. Nothing is said in this treating phthisical patients with garlic. The preparation he connexion of the importance of marking the prescription used was the essential oil of garlic, that is to say, the sulphide with a date each time it is brought to the druggist, a small of allyl, which he mixed with 200 times its weight of sterilised oil, the mixture being called by him ’’ scoradine." A precaution which would be for the public safety in dealings olive with poisons. The concluding articles of the Bill refer to cubic centimetre of this was injected under the skin below the spine of the scapula, at first at intervals of some days and the penalties incurred by contraventions of the regulations. afterwards when the patients were able to tolerate it every The proposed Act is so liberal in dealing with vested in- day. Under this treatment the general condition improved terests and so essential for the protection of the druggist and in a marked degree and the local signs of the disease becameSixteen patients have been treated in this way the public that it should meet with no opposition and but modified. few amendments. ELDER BARK AS A DIURETIC.
M. Lemoine, Professor of Clinical Medicine in the Medical Faculty of Lille, has recently revived the practice of employing the elder (sambucus niger) as a diuretic. Some years ago he was much struck with the efficacy of a decoction of elder bark in a case of general anasarca with pulmonary oedema and ascites due to subacute nephritis in which several ordinary diuretics had failed. The first day of the treatment by elder the urine, which had been very scanty, rose to 400 grammes, the next to 1500 grammes, and at the end of a week’s treatment to 3500 grammes. Since that time M. Lemoine has had occasion to use this remedy frequently for cedema or ascites due to heart or kidney troubles, and it has almost invariably been successful in increasing the quantity of urine passed. At his request Dr. Combermale has made a series ofexperiments on animals. He finds that infusions and decoctions of the inner bark are more active than those of the outer bark. Latterly M. Lemoine has employed an alcoholic extract of the inner bark, sometimes prescribing it alone, sometimes alternately with digitalis or caffein, the effects of whbh it serves to prolong and increase. There dc
with excellent results. 1
See
THE LANCET, March 13th, 1886, p.
508.
THE HEALTH SECTION AT THE CARDIFF EXHIBITION.—The Cardiff Exhibition, which was opened by Lord Windsor on May 2nd, contains an interesting health section, the exhibits of which have been so numerous that the committee have had to nearly double the extent of the It contains several sanitary appliances, accommodation. and amongst other features may be mentioned the various processes adopted for freezing meat and the destructive distillation of wood. A model hospital is fitted up and the daily working and routine is shown. It is proposed to give a series of lectures on]’irst-aid"in connexion with the St. John Ambulance Association. In another section scientific instruments are shown, and although the space is very limited the committee, of which Mr. E. T. Collins, M.R C’.S.Eng., is secretary, have succeeded in bringing together an interesting collection. The profits of the exhibition, on which R100.000 has been expended, will be divided between the Cardiff Free Museum, the Free Library, and the charities of the town.
peculiar bundle,
distinctly later,
excitation of which brought about arrest of the heart in systole. This is the bundle which Arloing has already described as the "ordinary motor nerve of the heart
muscle." ____
SIR JOHN MILLAIS. IN view of the many unfounded rumours which are rife concerning the condition of Sir John Millais we think it right to state that the condition of affairs is as follows. On the night of Saturday, May 9th, urgent dyspnoea set in. This gradually increased, and early on Sunday morning Mr. Treves, assisted by Mr. G. H. Hames, considered it necessary to perform a tracheotomy. Sir John Millais was much relieved by the operation and has since gone on well. He(’, sleeps well. and there are no chest complications. In addition to Mr. Treves and Mr. Hames, Sir Richard Quain is in attenclance. ____
came as a surprise to all but a few who were very well informed. His request that he should not be re-elected as President of the Royal College of Physicians of London might have been taken as a preparation for the bad tidings, for he was not the man to escape rpsponsibi1l ties that he had once accepted until it had become clear to him that to burden himself further with them would be wrong. But his indisposition was so ill defined and the absence of important indications of any organic mischief so entire that the serious symptoms which set in last Saturday night were as unexpected as alarming. But they were not without a definite cause. Sir J. Russell Reynolds had improved under rest, care, and change of air, but on April 23rd, after seeing some patients at home, he returned from a drive, and in alighting from his carriage slipped on his own doorstep. This accident, unfortunately, caused him to be confined to bed, and conserluent on the shock and increasing weak-
pulmonary complications supervened. We are very announce that a slight improvement, glad shown by the abatement of temperature and the diminished frequency of respiration, which took place on Monday has been maintained ; and although the patient’s condition is still one to cause the deepest anxiety, his medical advisers now allow us to hope that the rally is perhaps not temporary but the commencement of a return to strength. ness
to be able to
THE MEDICAL OFFICER OF THE ADMINISTRATIVE COUNTY OF LONDON. THE average ratepayer is apt, and with good reason, to kick against the constantly increasing expenditure of the London County Council. But we fancy that the increase in the salary of the medical officer, Mr. Shirley Murphy, from £1000 to L1250 will meet with nothing but approval. The medical and hygienic work of the London County Council is enormous, and the admirable way in which Mr. Shirley Murphy and his assistants direct it is well known. We are glad to see that an amendment to increase the salary to £1200 by an annual rise of E50 was negatived and the committee’s original recommendation carried by 70 votes to 31.
PREVENTION OF HÆMORRHAGE IN DISARTICULATION AT THE HIP-JOINT.
Barlow and Dr. Buzzard have seen Sir J. Russell Reynolds regularly with Mr. Cooper Bentham, who has been in constant and assiduous attention. Dr. Wilks and Dr. Gowers have also seen Sir J. Russell Reynolds in consultation. Dr.
____
THE annual general meeting of the Pathological Society of London for the election of officers and council, and other business, will be held at 20, Hanover-square on May 19th, at 8.30 P.M. Mr. Stanley Boyd will propose the following resolution :That in the opinion of this meeting it is expedient that ladies, who are duly qualified medical practitioners, should be eligible for the membership of this society." The result of the voting on this motion will be awaited by the profession with no little interest and curiosity. By the why do not the ladies unite to form a medical society of their own!1 Some doubt seems to be felt as to whether the medical societies will follow the example set them by the British Medical Association.
hip-joint has always been accompanied by very high mortality, and two causes especially can be assigned to this great death.rate-namely, infection and shock The deaths due to infection are now much less frequent than they were in the pro-antiseptic days, but shock still remains responsible for a very large proportion of deaths. A great part of this shock is caused by the large amount of blood which is so often lost at this operation, and many attempts have been MR. CHAMBERLAIN has been informed by telegram from made to diminish the h2.morrhage. One of the most recent the Governor of Hong-Kong that seventy-four fresh cases of methods was brought forward by Dr. V. Chalot, Professor bubonic plague occurred in the colony in the week ending of Clinical Surgery at the Faculty of Medicine of Toulouse, 12th, and that the number of deaths from the plague in at the Huitieme Congres de Chirurgie, held at Lyons. May the same period was sixty-four. He suggests that a slightly curved incision, four or five centimetres in length, should be made about two centimetres DR. GEORGM OLIVER will deliver the Croonian Lecturesinternal to the anterior superior iliac spine, and the anterior abdominal muscles then divided, so that the peritoneum can A Contribution to the Study of the Blood and of the be gently raised from the iliac fossa. When this is done the Circulation -at the Royal College of Physicians of London, common iliac artery can be felt on the inner border of the Pall Mull East, on June 2nd, 4th, 9th, and llth. The lectures psoas muscle. An assistant places on the artery the tips will commence at 5 P.M. of the middle and ring fingers of the left hand for the right DR. JOHN ANDERSON, C.I.E., M.D.St. And., F.R.C’.P. side of the patient, and of the right hand for the left side, at the same time grasping the iliac crest with the forefinger Lond., Physician to the Seamen’s Dreadnought Hospital, has and the thumb, while the little finger rests on the abdominal been appointed Lecturer on Diseases of Tropical Climates wall. The compression is made against the ala of the at St. Mary’s Hospital Medical School. sacrum, and its efficacy is judged by the cessation of the femoral pulsation. The amputation is then proceeded with MR. A. PEARCE GOULD has been appointed Surgeon to in the ordinary way. Dr. Chalot quoted a case in which he the Middlesex Hospital. had employed this methocl with success, and with only a small amount of haemorrhage. ) TUE annual dinner of old students of King’s College, AMPUTATION at the a
’.
____
--
1375 London, will be held at the Holborn Restaurant on Monday, June 29th, Sir Benjamin Baker, K.C.M.G., LL.D., F.R.S., President of the Institution of Civil chair.
Engineers,
in the
seem to be any distinct contra-indications to its use and it does not produce any unpleasant head or lung symptoms. It may, however, sometimes cause diarrhoea or increase it if already existing.
not
POISONING WITH PIPERAZINB.
__
Pharmacology and Therapeutics.
In the American -3ledical Nen’s Dr. Slaughter of Philadelphia relates the case of a young married woman aged
thirty-two who. through a druggist’s blunder, received one dose of piperazine of twenty grains. Some hours later, when the patient was seen by Dr. Slaughter, she was much cyanosed PHARMACY IN JERSEY. and in a serious comatose condition. The pupils were WE have received a copy of the proposed Bill to Regulate much contracted, the pulse gave 50 beats to the minute, and the Practice of Pharmacy and the Sale of Poisons in Jersey, the temperature was 97’4° F. The respirations also were slow and there was low muttering delirium. The tips of the fingers and cordially welcome it as an effort to put the work of the were cyanotic and there was loss of motion but not of druggist there more in line with the conditions which control sensation in the lower limbs. Cardiac and other stimulants the practice of pharmacy in this country. The Bill provides were at once energetically used, while the limbs were. for the proper qualification of those acting as chemists or elevated and external heat was applied. A stimulating rectal was also given and the catheter was used. Thereclruggists, but the qualifications recognised include those of injection was paraplegia, afterwards treated by massage and large the Schools of Pharmacy of the University of France in doses of strychnia. Recovery was perfect. addition to those granted by the Pharmaceutical Society of APOCYNUM CANNABINUM. Great Britain or the Pharmaceutical Society of Ireland. A which in America is called Indian cannabinum, be Apocynum is to of all those to to whom register kept permission has long been used as a diuretic and indeed is included hemp, has been and it is the title to state practise granted, in the United States pharmacopoeia. Its value in general or qualification in each case. To prevent hardship dropsy due to renal disease gained for it the name of "the the new Act will not apply in these respects to vegetable trocar" from Dr. Rush.l Its physiological prothose chemists and druggists who are already prac- perties have recently been investigated by Dr. Dortschewski, with American observers that the most active tising in Jersey. A further act of grace enables the who agrees of the portion plant, from a pharmacological point of view, legal representatives of a chemist or druggist who has is the cortex of the root. An extract was from practised his profession in the island to continue the busi- this and diluted with from ten to twenty timesprepared its volume of ness after his death, but it necessitates the employment of water. Less than 100 cubic centimetres of this diluted extract an assistant who is in all respects qualified and authorised The effect was to was sufficient to kill a medium-sized dog. to act as a chemist and druggist. Provisions which closely increase the blood pressure and to cause the heart’s beat to follow those in force in this country safeguard the sale of become at first slower, stronger, and reduplicated, but subrapid and irregular until the animal died. The poisons, whether wholesale or retail, and the Bill includes sequently effects were due to the action of the drug on the motor a list of poisons, and the usual precautions are taken to centres of the brain and spinal cord, the slowing of the prevent the sale of the more active and dangerous poisons pulse being caused by the stimulation and its rapidity by The increased to minors aged less than sixteen years or to persons un- paralysis of the pneumogastric centres. known to the vendor. It is satisfactory to find that pre- blood pressure, too, was due to the contraction of the peri-arteries from central action. In clinical practice it parations used or sold for the destruction of vermin are pheral was found that patients with cardiac mischief could take included in this list. Medicines containing a poison or from five to ten drops three times daily with marked advanpoisons prepared by a medical man, or by a chemist or tage. Larger doses were apt to cause nausea and vomiting. druggist when prepared after a medical prescription, are ESSENTIAL OIL OF GARLIC IN PHTHISIS. exempt from the restrictions ordinarily affecting the Dr. Sejournet of Revin communicates to the Union Medecczle sale of poisons, provided that a copy of the prean Nora-Est some account of the effects he has obtained by scription is kept by the vendor. Nothing is said in this treating phthisical patients with garlic. The preparation he connexion of the importance of marking the prescription used was the essential oil of garlic, that is to say, the sulphide with a date each time it is brought to the druggist, a small of allyl, which he mixed with 200 times its weight of sterilised oil, the mixture being called by him ’’ scoradine." A precaution which would be for the public safety in dealings olive with poisons. The concluding articles of the Bill refer to cubic centimetre of this was injected under the skin below the spine of the scapula, at first at intervals of some days and the penalties incurred by contraventions of the regulations. afterwards when the patients were able to tolerate it every The proposed Act is so liberal in dealing with vested in- day. Under this treatment the general condition improved terests and so essential for the protection of the druggist and in a marked degree and the local signs of the disease becameSixteen patients have been treated in this way the public that it should meet with no opposition and but modified. few amendments. ELDER BARK AS A DIURETIC.
M. Lemoine, Professor of Clinical Medicine in the Medical Faculty of Lille, has recently revived the practice of employing the elder (sambucus niger) as a diuretic. Some years ago he was much struck with the efficacy of a decoction of elder bark in a case of general anasarca with pulmonary oedema and ascites due to subacute nephritis in which several ordinary diuretics had failed. The first day of the treatment by elder the urine, which had been very scanty, rose to 400 grammes, the next to 1500 grammes, and at the end of a week’s treatment to 3500 grammes. Since that time M. Lemoine has had occasion to use this remedy frequently for cedema or ascites due to heart or kidney troubles, and it has almost invariably been successful in increasing the quantity of urine passed. At his request Dr. Combermale has made a series ofexperiments on animals. He finds that infusions and decoctions of the inner bark are more active than those of the outer bark. Latterly M. Lemoine has employed an alcoholic extract of the inner bark, sometimes prescribing it alone, sometimes alternately with digitalis or caffein, the effects of whbh it serves to prolong and increase. There dc
with excellent results. 1
See
THE LANCET, March 13th, 1886, p.
508.
THE HEALTH SECTION AT THE CARDIFF EXHIBITION.—The Cardiff Exhibition, which was opened by Lord Windsor on May 2nd, contains an interesting health section, the exhibits of which have been so numerous that the committee have had to nearly double the extent of the It contains several sanitary appliances, accommodation. and amongst other features may be mentioned the various processes adopted for freezing meat and the destructive distillation of wood. A model hospital is fitted up and the daily working and routine is shown. It is proposed to give a series of lectures on]’irst-aid"in connexion with the St. John Ambulance Association. In another section scientific instruments are shown, and although the space is very limited the committee, of which Mr. E. T. Collins, M.R C’.S.Eng., is secretary, have succeeded in bringing together an interesting collection. The profits of the exhibition, on which R100.000 has been expended, will be divided between the Cardiff Free Museum, the Free Library, and the charities of the town.