1000 ASSOCIATION OF GENERAL PRACTITIONERS. To the Editor of THE LANCET.
SiR, We ask leave to inform your readers that active .steps have been taken by the Association to assist general practitioners of this country to give combined and united force to their wishes and interest, especially in relation to - the actions of the various corporations, and to the representation of the general practitioner thereon. We desire especially at this moment to assist the licentiates of the College of Physicians to give organised expression to their
claim to
a
voice in the administration of the affairs of their
College. We believe their claim to be so strong that adequate representations made by a strong body of licentiates duly organised could not fail ultimately to secure for the licentiates of the College of Physicians ajust voice in the management -of their own affairs, and in the government of the profession of which they constitute so large a proportion. We should be glad to hear from licentiates of the College of Physicians on this subject, and have names of those willing to take part in securing for themselves and fellows a less contemptuous and more honourable treatment than they now receive ,at the hands of the self-elected Council of that body. May we be allowed to add that we forwarded yesterday a requisition signed by twenty members of the Metropolitan ’Counties Branch to the secretaries of the branch calling for a meeting of the Metropolitan Branch to consider the action of the College of Physicians and College of Surgeons in respect to the Apothecaries’ Society, which threatens to create a new and competing class of general practitioners throughout the kingdom ? We have every reason to believe that that requisition will be favourably considered, and we trust that general practitioners will largely attend the meeting when summoned. Hoping to hear from all who sympathise with our efforts in the objects we have stated, We remain, Sir, your obedient servants, H. W. VERDON, M.D., F.R.C.S., 410, Brixton-road, S.W.
W. GIBSON BOTT, L.R.C.P. and M.R.C.S, 31.R.C.S, Nov. 18th, 1886.
414, Clapham-road. S.W. Hon. Secs. Sees. Association of General Practitioners.
"DEATH OF A PASTEUR PATIENT." To the Editor
of
THE LA.NCET.
SIR,—Will you kindly allow meto correct a statement in
Dr.
Hime’s letter to you on a Pasteur patient (Wilde), the remarks being made in a postscript that Wilde was not really intentionally bitten by the deceased Oates. I emphatically contradict this hazy piece of information. Wilde was savagely bitten by Oates, and the latter had remarked that he should bite someone if they did not mind. I saw the lacerated teeth-marks. I had Wilde’s own evidence and my own observations bore out the man’s statement. I had several opportunities of questioning Wilde on this point; his statement was always the same. If there had been any doubt in my mind that it was an abrasion only in the struggle, he would never have gone to Paris. This interpolation of Dr. Hime’s letter in your annotation also gives an utter misrepresentation of the facts of the case. I am, Sir, yours obediently, HARRY HARRY O’D. FOOTE, Nov. 1886. FOOTE, M.D.
THE MEETING OF GERMAN NATURALISTS AND MEDICAL MEN IN BERLIN. (Concluded from
p.
847.)
meeting of the Surgical Section Professor showed some interesting and rare cases. One of these was a young man who from a fall received compound fractures of the legs and fractures of both the thigh and the patella. In order to unite the fractured patella, some months after the accident, Professor Bergmann chiselled off the tuberosity of the tibia, and placed it between the two fragments of the patella, after which union took place. The patient can now extend the leg very freely, but the mobility of the knee is yet a good deal impaired. The other AT the first
von
Bergmann
shown were two cases of Actinomycosis. At the second meeting, Krause spoke of the changes in the nerves and in the spina cord after amputation, and afterwards demonstrated his specimens. The changes consist in atrophy of the medullary substance and subsequent atrophy of the axis cylinder in the sensory peripheric nerves; hence the changes spread to the spinal ganglia. As shown before by Dickinson and others, alterations were also seen in the posterior column and in the ganglia cells of the posterolateral group in the anterior horn. The observations were made under the direction of C. Friedlander. Griiufeld showed an Endoscope of simple construction, which enabled him to make out the exact form, surface, and extent of bladdertumours. Madelung introduced the subject of Diffuse Lipomata, and an interesting discussion followed, in which several surgeons spoke of the neuralgic pains associated with these tumours and the recurrence of these tumours after removal. Madelung described an affection of the sole of the foot corresponding to Dupuytren’s palmar contraction, and exhibited some casts. Of the other papers read in this section we wish briefly to notice one by Kiister on Stenosis of the Trachea. The author distinguished between traumatic, diphtheritic, and syphilitic stenosis and the narrowing produced by new growths (sarcomata and carcinomata), &c., and recommended, whenever possible, removal ot the granulations, dissection of bands, &c., and subsequent dilatation by means of instruments. In very severe cases, especially in cases of new growths, he recommends resecttion of the trachea. Baumgärtner spoke of the Cachexia following the removal of Tumours of the Thyroid. The cachexia is not present in all cases of tbyrectomy, and in six cases no cachexia strumipriva resulted. In the discussion which followed, Semon of London gave an interesting account of Myxoedema, of the cases observed in England, and of Horsley’s researches. This disease seems as yet to have escaped the notice of German observers. Bardeleben stated that in more than a dozen cases where the thyroid was removed no symptoms of cretinism followed. Others, however, such as Kiister, were less sceptical, and advocated only partial removal of the thyroid, except in cases of malignant tumours. Buker related a case of Enchondroma springing from the cricoid cartilage, for the removal of which he extirpated this cartilage, with successful results. The case, which seems unique, has since been published in the Deutsche Med. Wochenschrift, No. 43. In the Medical Section several interesting communications were given. Of these the more important ones were: Runeberg on Pernicious Anavmia produced by Bothriocephalus Latus; Fmkler on the Principles of the Pathology and Therapeutics of Fever; and Immerman on Rheumatism. Lenhartz spoke of the antagonism between Morphia and Atropia. His observations and experiments did not lead him to look favourably upon the administration of atropia In 173 cases of opium in cases of morphia poisoning. poisoning 59 cases treated with atropia showed a mortality of 28 per cent., whilst in 73 cases not so treated the mortality only amounted to 15 per cent. In the discussion Freimuth and Lewin spoke in favour of atropia as an antidote in these cases, an opinion which agrees well with the results seen in English hospital practice, many of which are not published, and thus render the statistics of Lenhartz untrustworthy. Penzoldt reviewed the use of Digitalis in various diseases; this drug acts best in simple muscular insufficiency of the heart and in valvular heart disease, and in insufficiency of the right ventricle in emphysema; its effect is more doubtful in nephritis and in the acute diseases associated with weakness from the heart’s action; it has little effect alsowhen there is much fatty degeneration of the heart. Cantani gave an interesting communication on the poisonous properties of the Cholera Bacilli. Experiments on dogs showed that if pure cultivations of cholera bacilli in peptone gelatine after having been heated to 100° C. were injected into the peritoneal cavity, symptoms of cholera poisoning appeared; and he argued that the dead cholera bacilli, if absorbed, have a poisonous effect. As therapeutic agents he recommends enteroclysis with hot solution of gallic acid (which destroys the bacilli rapidly), and large hypodermic injections to increase the elimination of the absorbed poison. Strümpell spoke of Compression-myelitis, and expressed the opinion that in these cases there is simple compression of the cord and no myelitis, and often no descending degeneration. In the Gynaecological Section a number of interesting specimens (preparations of Extra-uterine Foetation, Ovarian Tumours, and Diseased Fallopian Tubes) were shown, and cases
1001 many interesting papers were read, such as the one by Rydygier on Vesico-vaginal Fistulæ (twenty-one cases, all but one cured), and E. Frankel (Breslau) on the Mechanical Treatment of Retro-deviation of the Uterus.
This author is Alexander’s operation, where, out of 118 reported cases, three deaths occurred; in fourteen cases no results ; in others a pessary had to be permanently worn after the operation; and in many cases sufficient time had not elapsed to speak of a definite cure of the ailment by the operation. Several papers were read on Castration for Epilepsy, for Neuroses, and for Diseases of the Fallopian Tubes. These led to a long discussion, in which the best known German gynaecologists took part, and several (Freund, Olshausen, Schatz) were either opposed to castration for pure neuroses, or advised the operation only in those cases where all other means failed. In many of the other special sections, such as those of Neurology, Laryngology, Diseases of Children, Forensic Medicine, and Hygiene, excellent work was done; but it is impossible to do justice to the communications in this short report. The most important papers will be published separately in the special journals, as the Association only publishes short abstracts. In conclusion, a brief reference may be made to the exhibition of scientific instruments and drugs. Besides the usual collection of microscopes, microtomes, electrical apparatus-all by the best German makers,-the exhibition contained numerous physical and physiological instruments, geological charts, and collections of preserved animals, showing the value of new methods of preservation for museum purposes. The specimens exhibited by Prof. Semper (Wurzburg), were beautifully preserved, and the method seemed specially useful for class demonstrations. The exhibition, besides a practical, had thus also an ed ucational value, and we can only recommend the adoption of a similar arrangement to the exhibitions held annually with our Association meeting. An excellent catalogue was prepared and edited by Dr. Lassar, of Berlin, who worked indefatigably for the museum, and took a conspicuous part in the arrangement of the social gatherings and amusements which passed off so successfully. The English visitors are especially indebted to him for the very cordial recEption they received, and thb assistance he rendered them.
this resignation Dr. Thomas R. Glynn, Professor of Physic at the Liverpool University College, becomes senior phy-sician. Dr. Caton is at present the only candidate for thevacant office.
against
THE VICTORIA UNIVERSITY.
The election of Mr. W. Mitchell Banks as the representative of the Victoria University on the Medical Council has given general satisfaction here. Mr. Banks is well known as one who is deeply interested in all that relates to medical’ education, in which he has had considerable experience. He is essentially a practical man, and will make a valuable.addition to the Council. FALSE CHARGES AGAINST MEDICAL STUDENTS.
A report was published in the local papers that the medical; students of the Liverpool School of Medicine had contributed to a disturbance at the Exhibition on the night of its. closure. Mr. Paul, the Vice-Dean of the Medical Faculty,. University College, made it his business to investigate the. matter, and found that the statement was erroneous. Only three students were present during the and they all left before the disorder commenced. in a letter which also appeared in the daily papers, alluded to the fact that the title of medical student is often assumed by youngmen who have no claim to it, and he describes the local medical students as being as well conducted as any other body of young men. Mr. Paul deserves the thanks of aU for thus disproving a charge easily made and not always so.
evening, Mr. Paul,
easily disproved. INFECTIOUS
DISEASES IN LIVERPOOL.
A temporary hospital has been erected on ground adjoining the Netherfield-road Hospital for infectious diseases. The structure which has just been completed is admirably adapted for a fever hospital. It contains two commodioussick wards for six patients each, a room for nurses, and other accommodation. It is heated by two large ventilating stoves, and will be lighted by a new system of gas illumination. The hospital has been put up in a remarkably short time, and its erection has been superintended by Mr. Gerson Trier, manager of the English branch of the Daecker Hospital and Hut Factory. It has been officially visited by the citysurveyor, Mr. Shelmerdine, and Mr. Thompson, clerk of works. Liverpool, Nov. 16th.
NORTHERN
LIVERPOOL.
COUNTIES
NOTES.
(From our own Correspondent.) HOSPITAL SUNDAY AND SATURDAY IN LIVERPOOL.
CHILDREN’S HOSPITAL. of of the Gateshead Children’s the Committee meeting at the Town Hall on Friday last, it was held Hospital, determined to advertise for tenders, and to proceed with the erection of the building as soon as possible, so as to make it at the same time a Jubilee memorial. The hospital is to be constructed on the pavilion principle, on a site of two acres generously given by Lady Northbourne as a freegift to the hospital. GATESHEAD
AT
a
THE annual meeting in connexion with the Hospital Sunday and Saturday collections was held in the Town-hall on the 5th inst., the late Mayor, Sir David Radcliffe, presiding. As next January will witness the seventeenth anniversary of this movement in Liverpool, it may be regarded as a well-established institution. In further proof of this it may be stated that although the weather last Hospital Sunday was as unfavourable as it could be, and in THE NEWCASTLE HOSPITAL SUNDAY FUND. spite of the depression of trade being then at its worst, the collections realised the total of £6217. In addition to this The collections for the hospitals were taken on the 24tb there were donations amounting to £158; while the Hos- and 25th of last month, and so far it would appear from pital Saturday boxes yielded a total of .63149, an increase of the lists of subscriptions published that there has been an .6500 over last year—a most gratifying proof of the increased increased interest taken, as shown by the amounts as cominterest taken in the hospitals by the working men. It pared with last year’s. was suggested by Sir William Forwood that the Committee THE VOTING IN THE NORTH. should consider the advisability of changing the Sunday A considerable number of practitioners in the north from January to May. There was a much larger meeting than usual, and considerable interest was taken in the received their voting papers on last Saturday, most of which. are as promptly returned to the offices of the Medical proceedings. Council. I am no "prophet," but still we are "clannish" in the= THE ROYAL INFIRMARY: RESIGNATION OF DR. WATERS. and very few scattered votes will be given; fully north, Dr. Waters, the senior physician to the Royal Infirmary, 75 cent. of the voters are in favour of three candidates. per has resigned the office of physician, which he has held for a NEWCASTLE NATURAL HISTORY SOCIETY. period of fifteen years, having been elected in 1871 in place of the latp Dr. Inman, who resigned in that year. It is A very extensive, valuable, and important collection of hoped, however, that the infirmary will not lose Dr. Waters’ land shells, Helices, Bulimi, &c., has lately been presented services entirely, but that he will, as consulting physician, to this museum by Mrs. Anga,s, Norland-square, Nottinghe enahled to givethe acting staff, students, and patients the hill, London, collected in various parts of the world by her benefi of his large experience. There is a growing feeling late husband, Mr. George French Angas, who was a native in favour of making the offices of cnnsulting physician and Newcastle, but. chiefly raided abroad, and was wen consulting surgeon really useful, and not merely ornamental, known as a natnralist and a scientist. Mr. Angas’s sketches’ the natural history and inhabitants of Australia and New as it must be confessed they have too frequently been. By
ofof