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THE INFLUENCE OF MATERNAL NUTRITION ON LACTATION.
1008 Feb. 7th, and they lie buried on a height over- to find any recorded cases of callousness on the looking the Sea of Marmora. John Newton, second- part of army surgeons at that time save one. The class staff-surgeon, dies also at Scutari on Jan. 26th, accused in this case was court-martialled for On neglect of the wounded and was condemned to a as does Frederick A. Macartney on Feb. 12th. Feb. 8th we read of the death from fever at term of imprisonment. Before the close of 1855 we Balaclava of Francis Smith, surgeon to the 95th. read that he had died in confinement and that he At the end of the month the sanitary state of was insane. the army at Sebastopol is described as improving, THE SECRETION AND EXCRETION OF SALbut typhus and typhoid are still raging at VARSAN AND NEOSALVARSAN. Scutari and Balaclava. A vast mass of putrefying matters are still said to be lying about the camp IN an interesting paper read before the Society of at Sebastopol. The climate is described as most Public Analysts at a meeting held on May 3rd capricious, alternating between heat and cold, with Mr. John Webster, F.I.C., presented the results of piercing north winds at night which were very some analyses showing the relative amounts of trying to the soldiers. At the same period we read arsenic found in the various organs after injections of mismanagement in the matter of transport of of salvarsan and neosalvarsan. Special attention Ambulances are tried which are was drawn to the relatively very high proportion the wounded. swung on vulcanised indiarubber springs, but prove of arsenic present in the kidneys. In one case a post. to possess an uncomfortable jogging motion. There mortem examination had shown that nephritis was is, at a later period, an account of the trial of a present. Various analyses of urine were made knapsack invented by Berington, which is found showing the variability of the rate of excretion. not to drag on the armpits as does the army Analyses of human milk from two cases of salvarsan knapsack of the time. It had not yet been treatment were referred to and the results indicated adopted in the army, and THE LANCET remarks: that after a dose or repeated doses of salvarsan the " We should have thought that by this time milk of a lactating woman is entirely, or almost the shortcomings of all the arrangements in force entirely, free from arsenic. A minute trace of with respect to the equipments of our troops and arsenic was found in one specimen only. Mr. their influence for good or evil on the health of Webster expresses the opinion that any beneficial the army ought to have been perceived, and the results to the syphilitic child fed on such milk remedies applied where found to be necessary." cannot be due to the presence of salvarsan or On Feb. 16th, 1855, John Grabham, assistant other compound of arsenic present in the milk of surgeon, 71st Regiment of Foot, dies, aged 24, at the mother. Scutari, from malignant fever contracted in the zealous discharge of his duties at the General THE INFLUENCE OF MATERNAL NUTRITION ON LACTATION. Hospital. Dr. Lamont dies from fever before SebasIn in Edward WITH the of food rising and the difficulties March, January. !, topol, aged 22, price Leblanc, surgeon of the 9th Regiment, is shot dead of transport increasing, it is of importance to con. accidentally by a French sentry. On April 4th sider what effect, if any, the nutrition of the mother Ludlow Harvey, aged 29, dies at the British Hos- will have on young infants. Although there pital, Scutari. He was acting assistant staff-surgeon appears to be very little probability of any actual at the time of his death, and had been most shortage of the necessities of life to the civil honourably mentioned for efficiency in charge population of this country, yet the state of refugees of the sick and wounded on board the steamer retreating before invaders and the occurrence of Trent. He was surgeon to the Royal Free sieges elsewhere may give rise to conditions which Hospital and a medical journalist. On April 21st impair the nutrition of the mother to a marked and Dr. Hector Gavin is accidentally shot by his serious degree. The far-reaching effect of malnutribrother when in their tent before Balaclava tion on the mother is obviously a subject of conand dies after great agony. He is described as a siderable importance, but little has been published man of indomitable perseverance and energy. Other concerning it. In this connexion a paper read by names of surgeons who died in the performance of Mr. G. F. Darwall Smith at a meeting of the their duty in the Crimea or at Scutari are Robert Royal Society of Medicine some years ago is very Thomas Simons (April 28th), Alexander Wishert pertinent. The paper was the result of an investi(May 25th), Dr. Walter Simpson (June 3rd), gation made for the Local Government Board and Dr. Ninian Hill (June 22nd), Roy Samuel Millard the full results have not yet been published so far (June 9th), Lawrence Ormerod (June 20th), as we are aware. For the purpose of the investigation A. Sibbald (June 26th), John Horsley White over 6000 consecutive cases were taken from the (July 3rd), John Longmore (August 22nd), Edward notes of lying-in hospitals in London and Dublin. John Complin (Oct. 29th). Fever is in almost all The nutrition of the mother was estimated by taking cases the cause of death; none fell, as now, before her height and weight ratio, the report of the the bullets of the enemy. In October, just before medical officer made especially for the purpose, and the last-recorded death of a surgeon in 1855, the patient’s own history as to any difficulty that THE LANCET heads a vigorous leading article she may have had in obtaining adequate nourish" Mr. Bracebridge’s Abuse of Crimean Doctors." ment. Based on these three criteria, the 6000 cases He had been to the front and lectured in Coventry were divided into three groups of bad, average, and on his return to England on what he deemed the good nutrition. All sources of error, as far as possible, inhumanity and backwardness of the English army having been excluded, the results and statistical surgeons. He compared them unfavourably with tables were presented with great care. Regarding the French surgeons, who were then held, with the the mother’s capability for suckling, it appears Austrians, to be in the van of military surgery. that a poor state of nutrition causes a definite THE LANCET writes of Mr. Bracebridge in a way diminution in the patient’s ability to suckle. For that would to-day be highly dangerous, though example, of a thousand unclassified patients over every syllable and insinuation were true. Clearly 99 per cent. were able to feed their babies entirely the exposure was merited, for it is not possible on the breast, but taking patients in a bad state of ___
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1009 was found that under 73 per cent. able to suckle successfully. Contrary to what might be expected, the state of nutrition of the mother at the time of labour did not have much effect on the progress of breast-fed babies who, survived the ten days that they were under observation. It must be remembered, however, that during the puerperium all patients were inmates of a hospital, and so were presumably receiving an ample diet. Mr. Darwall Smith’s conclusions were that the figures obtained seemed to suggest that a state of bad nutrition of the mother at the time of labour due to insufficient food (a) greatly increases the percentage of premature and also of dead-born babies; (b) slightly decreases the weight of the fullterm child at birth; (c) decreases the ability of the mother to feed the child; and (d) greatly increases the post-natal infantile mortality during the first week of life.
nutrition only it
were
THE DUBLIN RISING. (FROM OUR OWN CORRESPONDENT.) YoUR readers
are
by
now
familiar with the
principal
events of the Dublin rebellion of Easter week which have
been graphically and, on the whole, accurately recorded in I am therefore Mr. John E. Healy’s letters to the Times. concerned merely with the medical aspects of the rising. A considerable number of casualties occurred on Easter Monday in the first few hours of the rising, as the rebels did not hesitate to shoot anyone-soldier or civilian-who hampered them in their activities. The civil population, however, soon learned that the rebels were in earnest, and as long as no active interference was offered the rebels do not seem to have molested civilians to any great extent. Moreover, it was not until Wednesday that the military began any serious attack on the rebel strongholds. It was, therefore, in the latter half of the week, from Wednesday afternoon, when the military began their work seriously, to Saturday afternoon, when the principal rebels surrendered, that the number of casualties was greatest. estimate of Casualties. A NEW GREEK MEDICAL PAPYRUS. Of the total number of casualties any estimate is only THE eleventh volume of the " Oxyrhynchus loosely approximate. The Irish Times of May 6th gave a compiled from the records of the city hospitals and from Papyri," which are stored at Oxford, has recently list, other trustworthy sources, of 160 civilians who had been been edited by Dr. B. P. Grenfell and Dr. A. S. Hunt, killed. There must have been many more whose deaths and published by the Egypt Exploration Fund. It have not been reported, and 200 in all is a conservative contains one medical manuscript, a Greek recipe estimate. The number of soldiers killed is probably somefor a purge. The ingredients do not present any what less.1 Of the rebels no figure can be given. In only a novelty to scholars acquainted with those commonly few cases were dead bodies in rebel uniform brought to the to be found in the so-called h.iera (mixtures) of city hospitals, though, as many of the rebels wore no The text runs as follows: uniform and carried no equipment other than a bandolier Grseco-Roman times. a rifle, it is possible that some of those returned as "Ingredients of a purging draught : Cummin and were in truth rebels shot while carrying arms. Of civilians 4 drachmae, fennel 2 dr., parsly 4 dr., costus 4 dr., Jervis-street Hospital, which is in the centre of mastich 4 dr., coriander 7 dr., 21 laurel berries, wounds, close to the General Post Office, treated some 400 Dublin, nut dr., ham (?) dr., pennyroyal dr., silphium (?), cases. Mercer’s Hospital, which is close to the Roval College salt, vinegar." The number of drachmae for a few of Surgeons, treated 130 cases of shot wounds. The City of of the constituents has become obliterated. The Dublin Hospital and Sir Patrick Dun’s Hospital, which are word 7rÉpva. rendered " ham," has probably some near the Northumberland-road and Mount-street Bridge area, other meaning indicating a herb, but a com- also treated large numbers, and all the city hospitals, as well as Cross Hospital and the King George V. parison with the lists of ingredients in similar the Dublin Castle Red their share. The total may have received Hospital Military far to so failed which suggest Greek recipes has been anything between 1000 and 2000. The great majority plant it refers to. The word rendered here were, of course, civilians, including a large number of women silphium is p6xNop, which was a title at this period and children. This is, perhaps, inevitable in street fighting, for silphium from Cyrene. Classic medical authors especially when the locality is strange to both troops and sometimes used (t6XNop to indicate betel-nut. officers. The presence of a few rebels, or even of one Silphium (asafoetida) is almost certainly the correct sniper in a particular house or court, endangered the lives of interpretation. This papyrus also contains two notes several score innocent persons, and in many cases those innocent suffered for the guilty. Civilians were ako shot by upon the healing art as follows : " For strangury, to the rebels, chiefly in the first hours of the outbreak. take the seed of heal the sufferer, dry basil-thyme, As the arms varied greatly, so also did the character of crumble it with wine of Ascalon, then drink it hot." the wounds. The wounds produced by military rifles were The Ascalon wine was celebrated above all thesuch as the war has accustomed surgeons to, but the number vintages of Syria. The second says : "For of head wounds was notably large. Most of these were wounds, take the fruit of a cypress and boil it andIreceived by civilians who incautiously looked through their apply." The remainder of this fragmentary manu-1windows while the military were being fired at by rebel script is occupied with some partly legible portionssnipers in their neighbourhood. The firearms possessed by of what appears to be an apocryphal gospel con-1the rebels seem to have varied within the widest limits. of them apparently had serviceable rifles, such as cerning healing of the sick, not only humanMany Mausers and Winchesters, but all sorts of arms were used. sufferers, but angelic ones, the latter being affectedMany round bullets have been picked up, and it is probable with ocular disease. These sentences are quitethat they were fired from shot-guns, the bullets being obscure. substituted for shot in the cartridges. It is said that the rebels were possessed of a few machine-guns. It is too soon to judge of the effects of treatment, but one CHILDREN’S COUNTRY HOLIDAY FUND.-Mr. A. F. may hope that the results will be better than have been Chairman of the sends us London Buxton, County Council, generally seen in military operations in France. In the first a letter pleading for money and voluntary workers on behalf of the Children’s Country Holiday Fund, and asking the place, treatment was given speedily, and in the second the public to spare a thought for the thousands of elementary clothes of the wounded were fairly clean, and were not, as in school children whose only escape from London and their France, sodden with infective mud. own stuffy crowded quarters is the fortnight in the country Hospital and Ambicktnee Arrangements. organised by the Fund. At no previous time in the history of the nation has it been so necessary that the health of Some of the hospitals which gave most attention to the children should be preserved in every possible way, and the vounded have already been mentioned, but as fighting was Children’s Country Holiday is a very helpful factor in this ,aking place simultaneously in several quarters of Dublin, direction. It is hoped that about 16,000 of the most suitable L]l the city hospitals were kept busy. In some instances the little cases may be sent this year to gather fresh stores of vounded could not, on account of danger in the street, gain health in the country, and donations and offers of help should be sent to the Secretary of the Fund, or to Mr. 1 The Government casualties have been announced as 124 killed, Buxton, at 18, Buckingham-street, Strand. W.C. 388 wounded.
treading
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____
1009 was found that under 73 per cent. able to suckle successfully. Contrary to what might be expected, the state of nutrition of the mother at the time of labour did not have much effect on the progress of breast-fed babies who, survived the ten days that they were under observation. It must be remembered, however, that during the puerperium all patients were inmates of a hospital, and so were presumably receiving an ample diet. Mr. Darwall Smith’s conclusions were that the figures obtained seemed to suggest that a state of bad nutrition of the mother at the time of labour due to insufficient food (a) greatly increases the percentage of premature and also of dead-born babies; (b) slightly decreases the weight of the fullterm child at birth; (c) decreases the ability of the mother to feed the child; and (d) greatly increases the post-natal infantile mortality during the first week of life.
nutrition only it
were
THE DUBLIN RISING. (FROM OUR OWN CORRESPONDENT.) YoUR readers
are
by
now
familiar with the
principal
events of the Dublin rebellion of Easter week which have
been graphically and, on the whole, accurately recorded in I am therefore Mr. John E. Healy’s letters to the Times. concerned merely with the medical aspects of the rising. A considerable number of casualties occurred on Easter Monday in the first few hours of the rising, as the rebels did not hesitate to shoot anyone-soldier or civilian-who hampered them in their activities. The civil population, however, soon learned that the rebels were in earnest, and as long as no active interference was offered the rebels do not seem to have molested civilians to any great extent. Moreover, it was not until Wednesday that the military began any serious attack on the rebel strongholds. It was, therefore, in the latter half of the week, from Wednesday afternoon, when the military began their work seriously, to Saturday afternoon, when the principal rebels surrendered, that the number of casualties was greatest. estimate of Casualties. A NEW GREEK MEDICAL PAPYRUS. Of the total number of casualties any estimate is only THE eleventh volume of the " Oxyrhynchus loosely approximate. The Irish Times of May 6th gave a compiled from the records of the city hospitals and from Papyri," which are stored at Oxford, has recently list, other trustworthy sources, of 160 civilians who had been been edited by Dr. B. P. Grenfell and Dr. A. S. Hunt, killed. There must have been many more whose deaths and published by the Egypt Exploration Fund. It have not been reported, and 200 in all is a conservative contains one medical manuscript, a Greek recipe estimate. The number of soldiers killed is probably somefor a purge. The ingredients do not present any what less.1 Of the rebels no figure can be given. In only a novelty to scholars acquainted with those commonly few cases were dead bodies in rebel uniform brought to the to be found in the so-called h.iera (mixtures) of city hospitals, though, as many of the rebels wore no The text runs as follows: uniform and carried no equipment other than a bandolier Grseco-Roman times. a rifle, it is possible that some of those returned as "Ingredients of a purging draught : Cummin and were in truth rebels shot while carrying arms. Of civilians 4 drachmae, fennel 2 dr., parsly 4 dr., costus 4 dr., Jervis-street Hospital, which is in the centre of mastich 4 dr., coriander 7 dr., 21 laurel berries, wounds, close to the General Post Office, treated some 400 Dublin, nut dr., ham (?) dr., pennyroyal dr., silphium (?), cases. Mercer’s Hospital, which is close to the Roval College salt, vinegar." The number of drachmae for a few of Surgeons, treated 130 cases of shot wounds. The City of of the constituents has become obliterated. The Dublin Hospital and Sir Patrick Dun’s Hospital, which are word 7rÉpva. rendered " ham," has probably some near the Northumberland-road and Mount-street Bridge area, other meaning indicating a herb, but a com- also treated large numbers, and all the city hospitals, as well as Cross Hospital and the King George V. parison with the lists of ingredients in similar the Dublin Castle Red their share. The total may have received Hospital Military far to so failed which suggest Greek recipes has been anything between 1000 and 2000. The great majority plant it refers to. The word rendered here were, of course, civilians, including a large number of women silphium is p6xNop, which was a title at this period and children. This is, perhaps, inevitable in street fighting, for silphium from Cyrene. Classic medical authors especially when the locality is strange to both troops and sometimes used (t6XNop to indicate betel-nut. officers. The presence of a few rebels, or even of one Silphium (asafoetida) is almost certainly the correct sniper in a particular house or court, endangered the lives of interpretation. This papyrus also contains two notes several score innocent persons, and in many cases those innocent suffered for the guilty. Civilians were ako shot by upon the healing art as follows : " For strangury, to the rebels, chiefly in the first hours of the outbreak. take the seed of heal the sufferer, dry basil-thyme, As the arms varied greatly, so also did the character of crumble it with wine of Ascalon, then drink it hot." the wounds. The wounds produced by military rifles were The Ascalon wine was celebrated above all thesuch as the war has accustomed surgeons to, but the number vintages of Syria. The second says : "For of head wounds was notably large. Most of these were wounds, take the fruit of a cypress and boil it andIreceived by civilians who incautiously looked through their apply." The remainder of this fragmentary manu-1windows while the military were being fired at by rebel script is occupied with some partly legible portionssnipers in their neighbourhood. The firearms possessed by of what appears to be an apocryphal gospel con-1the rebels seem to have varied within the widest limits. of them apparently had serviceable rifles, such as cerning healing of the sick, not only humanMany Mausers and Winchesters, but all sorts of arms were used. sufferers, but angelic ones, the latter being affectedMany round bullets have been picked up, and it is probable with ocular disease. These sentences are quitethat they were fired from shot-guns, the bullets being obscure. substituted for shot in the cartridges. It is said that the rebels were possessed of a few machine-guns. It is too soon to judge of the effects of treatment, but one CHILDREN’S COUNTRY HOLIDAY FUND.-Mr. A. F. may hope that the results will be better than have been Chairman of the sends us London Buxton, County Council, generally seen in military operations in France. In the first a letter pleading for money and voluntary workers on behalf of the Children’s Country Holiday Fund, and asking the place, treatment was given speedily, and in the second the public to spare a thought for the thousands of elementary clothes of the wounded were fairly clean, and were not, as in school children whose only escape from London and their France, sodden with infective mud. own stuffy crowded quarters is the fortnight in the country Hospital and Ambicktnee Arrangements. organised by the Fund. At no previous time in the history of the nation has it been so necessary that the health of Some of the hospitals which gave most attention to the children should be preserved in every possible way, and the vounded have already been mentioned, but as fighting was Children’s Country Holiday is a very helpful factor in this ,aking place simultaneously in several quarters of Dublin, direction. It is hoped that about 16,000 of the most suitable L]l the city hospitals were kept busy. In some instances the little cases may be sent this year to gather fresh stores of vounded could not, on account of danger in the street, gain health in the country, and donations and offers of help should be sent to the Secretary of the Fund, or to Mr. 1 The Government casualties have been announced as 124 killed, Buxton, at 18, Buckingham-street, Strand. W.C. 388 wounded.
treading
t1