- Email: [email protected]
THE MEDICAL DEPARTMENT OF THE LOCAL GOVERNMENT BOARD.
415 increase resulted from a more widespread existence of insanity through the general population it could hardly happen that this should be so. But, on the other hand, it is precisely what would happen if the source from which the annual increment is derived were being year by year reduced by the continuous transference from the reserve to the register of penmns of the class under consideration. So far, Mr. Humphreys’ results may be accepted with sincere satisfaction without occasioning any great surprise; or, indeed, producing any marked effect upon public opinion. In this view more importance attaches to the criticism which he passed upon the lunacy returns and other statistics bearing upon the statistics of lunacy. Wefully concur in the views which Mr. Humphreys expressed as to the great desirability of obtaining the fullest and most exact information upon a point of such vital importance. On the other hand, it is impossible not to see that great difficulties have to be encountered in the collection of the requisite materials, and it is easy to believe that the work of criticism is easier than the task of finding a remedy and putting it in use. This notwith. standing, it may be hoped that some improvements in the form and substance of future returns will result from the consideration of Mr. Humphreys’ very carefully elaborated
suggestions.
-
THE FUNDS OF THE ROYAL INFIRMARY, GLASGOW. A
in the Glasgow Herald, commenting on a in the deficiency regular income of this fine institution, thinks the deficiency might be made up in some degree by more liberal church collections. Perhaps so. The Irish make a large portion of the infirmary patients. Thus, of the patients treated 3640 were Scotch and 1159 Irish. The church collections altogether seem somewhat smallf859. But none have been received from the Irish congregations. This must be from oversight, and probably only needs to be pointed out to be altered. In London Cardinal Manning has been one of the foremost promoters of the Hospital Sunday Fund. More than :E25,000 is expended yearly by the managers of the Royal Infirmary. WRITER
THE SUTURE OF ARTERIAL WOUNDS.
the circumference of a large artery, also longioblique wounds, may be successfully sutured if antiseptic precautions can be thoroughly carried out, as was the case in all his experiments, When the vessel lies it is to very deep, however, impossible get at it sufliciently well to practise the delicate manipulation required in the operation. Of course, after a wound has occurred, the sooner operative measures are undertaken the better. He calls attention to the peculiar blowing or rasping systolic murmur always heard over a wounded artery, and the thrill which is perceptible to the touch, which constitute what is known as "Wahl’s phenomenon," a discovery made by the eminent Dorpat professor just deceased, as a valuable diagnostic sign in cases where it is possible that arteries may have
beyond half tudinal and
been wounded. THE MEDICAL DEPARTMENT OF THE LOCAL GOVERNMENT BOARD.
announced last week, Mr. R. D. R. Sweeting, M.R.C.S., L.S.A., medical superintendent of the Western Fever Hospital of the Metropolitan Asylums Board, has been appointed one of the medical inspectors of the Local Government Board. Mr. Sweeting has, during an extended term in the office he now relinquishes, acquired an exceptional knowledge of the various infectious fevers, and his contributions to the annual reports of the Statistical Committee of the Asylums Board have shown that he has used his special opportunities in a way to extend our knowledge of some of the obscurer phases observed in the specific fevers. In 1883 Mr. Sweeting was awarded the Howard Prize for his essay on the Sanitation of Public Institutions; and subsequently, whilst serving as an occasional medical inspector under the Local Government Board, he prepared a number of sanitary reports dealing with the prevalences of He is disease and with the question of river pollution. also treasurer to the Epidemiological Society, whose Transactions contain some excellent papers by him on Vaccination. Mr. Sweeting’s appointment is due to the resignation of Dr. Stevens, who was one of Sir John Simon’s earliest colleagues in the department of public health. We regret to learn that Dr. Stevens has, by reason of ill-health, been compelled, after an active career extending over many years, to seek repose from his official duties. As
we
DR. JASSINOWSKY has published, as a graduation thesis THE "DOUBLE CYANIDE." in Dorpat, a series of experiments made on animals for the A SHORT TIME after Sir Joseph Lister introduced as a purpose of determining the conditions under which it is new antiseptic a "double cyanide of mercury and zinc," possible to stitch successfully wounds in arteries. He operated on horses, calves, and dogs. The plan adopted questions upon its composition were raised. These induced Professor Dunstan and Mr. Bloch to undertake further was to dissect down to the artery, to open the sheath, and, after applying a clamp to the vessel, to stitch the wound investigations at the Research Laboratory of the PharmaTheir results were brought before a with silk, the needle passing through the external and ceutical Society. of the Society on the 12th inst. From the experimiddle coats only ; a reef knot was then tied, and the ends meeting ments Professor Dunstan concluded that there could be no cut off close. When the clamp was removed the vessel was doubt that a double cyanide, with the formula ZnHg(CN)4, compressed, and all the fasciæ and skin incisions carefully exist. He found that while the greater part of the cannot stitched with interrupted sutures. The external wound mercuric was of cyanide was then sealed by means evidently in a free state, and photoxylin, a substance could be therefore dissolved by cold water, a smaller easily first used which, though by photographers, has recently been introduced into surgical practice as an improvement part was not thus removed, in spite of the solubility on collodion for sealing wounds. In all the cases operated of mercuric cyanide. To determine the precise nature of on the wounds healed satisfactorily. When viewed from this smaller proportion was the object of his inquiry. an arterial wound that has been within, recently sewn Is it (1) chemically combined as a double cyanide? or appears as a fissure of the intima filled up with (2) as a compound of hydroxycyanide with zinc cyanide? or (3) as a compound of zinc hydrate (or hydroxyblood-corpuscles, which form a minute thrombus, or is it (4) the sulci of the intima to disappear. Later on a cross cyanide) ? merely occluded by particles of zinc section through the sulci gives the appearance of a cyanide during precipitation, so that in consequence of a funnel-shaped space filled with a homogeneous, horny sub- protective coating of insoluble zinc cyanide the water is stance. The endothelium is much augmented. In time unable to come into contact with the mercuric cyanide’? the whole of the coats at the wounded spot become Of these four hypotheses the last was the only one which thickened, and the elastic membrane is not to be found. stood the test of experimental verification. It may be Dr. Jassinowsky concludes that wounds not extending observed that Professor Dunstan uses the term occluded
causing
suggestions.
-
THE FUNDS OF THE ROYAL INFIRMARY, GLASGOW. A
in the Glasgow Herald, commenting on a in the deficiency regular income of this fine institution, thinks the deficiency might be made up in some degree by more liberal church collections. Perhaps so. The Irish make a large portion of the infirmary patients. Thus, of the patients treated 3640 were Scotch and 1159 Irish. The church collections altogether seem somewhat smallf859. But none have been received from the Irish congregations. This must be from oversight, and probably only needs to be pointed out to be altered. In London Cardinal Manning has been one of the foremost promoters of the Hospital Sunday Fund. More than :E25,000 is expended yearly by the managers of the Royal Infirmary. WRITER
THE SUTURE OF ARTERIAL WOUNDS.
the circumference of a large artery, also longioblique wounds, may be successfully sutured if antiseptic precautions can be thoroughly carried out, as was the case in all his experiments, When the vessel lies it is to very deep, however, impossible get at it sufliciently well to practise the delicate manipulation required in the operation. Of course, after a wound has occurred, the sooner operative measures are undertaken the better. He calls attention to the peculiar blowing or rasping systolic murmur always heard over a wounded artery, and the thrill which is perceptible to the touch, which constitute what is known as "Wahl’s phenomenon," a discovery made by the eminent Dorpat professor just deceased, as a valuable diagnostic sign in cases where it is possible that arteries may have
beyond half tudinal and
been wounded. THE MEDICAL DEPARTMENT OF THE LOCAL GOVERNMENT BOARD.
announced last week, Mr. R. D. R. Sweeting, M.R.C.S., L.S.A., medical superintendent of the Western Fever Hospital of the Metropolitan Asylums Board, has been appointed one of the medical inspectors of the Local Government Board. Mr. Sweeting has, during an extended term in the office he now relinquishes, acquired an exceptional knowledge of the various infectious fevers, and his contributions to the annual reports of the Statistical Committee of the Asylums Board have shown that he has used his special opportunities in a way to extend our knowledge of some of the obscurer phases observed in the specific fevers. In 1883 Mr. Sweeting was awarded the Howard Prize for his essay on the Sanitation of Public Institutions; and subsequently, whilst serving as an occasional medical inspector under the Local Government Board, he prepared a number of sanitary reports dealing with the prevalences of He is disease and with the question of river pollution. also treasurer to the Epidemiological Society, whose Transactions contain some excellent papers by him on Vaccination. Mr. Sweeting’s appointment is due to the resignation of Dr. Stevens, who was one of Sir John Simon’s earliest colleagues in the department of public health. We regret to learn that Dr. Stevens has, by reason of ill-health, been compelled, after an active career extending over many years, to seek repose from his official duties. As
we
DR. JASSINOWSKY has published, as a graduation thesis THE "DOUBLE CYANIDE." in Dorpat, a series of experiments made on animals for the A SHORT TIME after Sir Joseph Lister introduced as a purpose of determining the conditions under which it is new antiseptic a "double cyanide of mercury and zinc," possible to stitch successfully wounds in arteries. He operated on horses, calves, and dogs. The plan adopted questions upon its composition were raised. These induced Professor Dunstan and Mr. Bloch to undertake further was to dissect down to the artery, to open the sheath, and, after applying a clamp to the vessel, to stitch the wound investigations at the Research Laboratory of the PharmaTheir results were brought before a with silk, the needle passing through the external and ceutical Society. of the Society on the 12th inst. From the experimiddle coats only ; a reef knot was then tied, and the ends meeting ments Professor Dunstan concluded that there could be no cut off close. When the clamp was removed the vessel was doubt that a double cyanide, with the formula ZnHg(CN)4, compressed, and all the fasciæ and skin incisions carefully exist. He found that while the greater part of the cannot stitched with interrupted sutures. The external wound mercuric was of cyanide was then sealed by means evidently in a free state, and photoxylin, a substance could be therefore dissolved by cold water, a smaller easily first used which, though by photographers, has recently been introduced into surgical practice as an improvement part was not thus removed, in spite of the solubility on collodion for sealing wounds. In all the cases operated of mercuric cyanide. To determine the precise nature of on the wounds healed satisfactorily. When viewed from this smaller proportion was the object of his inquiry. an arterial wound that has been within, recently sewn Is it (1) chemically combined as a double cyanide? or appears as a fissure of the intima filled up with (2) as a compound of hydroxycyanide with zinc cyanide? or (3) as a compound of zinc hydrate (or hydroxyblood-corpuscles, which form a minute thrombus, or is it (4) the sulci of the intima to disappear. Later on a cross cyanide) ? merely occluded by particles of zinc section through the sulci gives the appearance of a cyanide during precipitation, so that in consequence of a funnel-shaped space filled with a homogeneous, horny sub- protective coating of insoluble zinc cyanide the water is stance. The endothelium is much augmented. In time unable to come into contact with the mercuric cyanide’? the whole of the coats at the wounded spot become Of these four hypotheses the last was the only one which thickened, and the elastic membrane is not to be found. stood the test of experimental verification. It may be Dr. Jassinowsky concludes that wounds not extending observed that Professor Dunstan uses the term occluded
causing