- Email: [email protected]
THE NOTIFICATION OF PULMONARY TUBERCULOSIS.
THE NOTIFICATION OF PULMONARY TUBERCULOSIS.
1333
who died under placenta præsvia. Not at all disposed to undervalue the importance of the post-mortem investigations, confirming, as they do, my original description, I may be to observe that the evidence of what may be calledl "frozen physiology"" cannot be compared with the richL evidence of "living physiology" and clinical experience. Let me conclude this brief explanation of the true significance of the term "ectopic gestation" with a challenge to those who, directly or indirectly, have passed over my claim to originality to make good their conduct. "Litera scripta manet." The following dates bave to be, considered : How does "Barnes’s boundary-line " described in 1847, 1857, and repeatedly since, become the "os internnmof Braune in 1872, Bandl’s ring in 1876, and later still the contraction-ring of Schroeder ? I am. Sirs. vours faithfullv. ROBERT BARNES. 1899. Eastbourne, Nov.
calomel has frequently been used as a diuretic in continentai clinics. When studying under Professor von Ziemssen (Munich) in the eighties" I saw the remedy continually employed in his wards and the professor never missed an opportunity to recommend it to his students. The remedy is also highly lauded by Jendrassik2 and by Bauer3 in his article, "Treatment of the Circulatory Disorders." Bauer says that calomel often produces a regular ’’flood " of urine, not seldom amounting to five, and even to 10, litres during 24 hours. The good effect is even produced in cases in which digitalis has been useless and the increased diuresis generally lasts for some time after the last dose of calomel has been taken. The use of calomel, however, is not without danger as bad effects are always observed in those cases in which the diuresis is not increased by the remedy. Salivation, stomatitis, and diarrhoea, not seldom of a sanguineous type, may occur and shorten the life of the patient, especially in cases in which the heart disease is complicated with nephritis or in cases of extreme degeneration of the myocardium. THE NOTIFICATION OF PULMONARY Calomel should be given in doses of three grains combined with one-sixth of a grain of opium (to prevent. TUBERCULOSIS. diarrhoea) three times daily for at least three days, but it To the Editors of THE LANCET. may be pushed for five, and even for 10, days. The good SIRS,-I should’be grateful if you would kindy insert the effects will seldom be observed before the third day. &houlc5 following letter which I have sent to all the medical practi- diarrhoea or salivation occur the remedy must be stopped tioners in Norwich. immediately ; in any case the mouth should be watched from I am, Sirs, yours faithfully, the beginning of the treatment and a gargle of potassium H. COOPER PATTIN, chlorate used regularly. After the disappearance of the Medical Officer of Health. oedema a course of digitalis or strophanthus will often be useCity of Norwich Municipal Buildings, Nov. 6th, 1899. ful to prevent its re-collection, later on the calomel treatSIR,-At my suggestion the Health Committee of the City ment may be repeated if necessaiy. I may add that I have Council has agreed to make a six months’ experiment, for in many cases followed this course of treatment with State medical purposes, of the value of a voluntary notifica- excellent results, and I am convinced that it will do good tion of phthisis.It is believed that the information which sometimes in cases which have not reacted on digitalis,, will thus be gained will furnish a reliable basis upon which diuretin, and other remedies in general use. I am, Sirs, yours faithfully, to estimate the amount and distribution of the lung form of tuberculous disease which prevails in Norwich, and as the Finsbury-square, Nov. 6th, 1899. Health Committee is advised by me that the information it may look forward to acquiring through the voluntary notificaTHE RAY FUNGUS AND THE ANIMAL tion of the disease will be of value to it as well as to the WORLD : A CORRECTION. medical profession and to preventive medicine it has on its part, as the local public health authority, agreed to pay ls. for To the Editors of THE LANCET. each notification certified to have been received by me. In SIRs,-In your report of my remarks at the last meeting view of the importance of this experiment I do most sinof the Clinical Society of London I am made to say that that will with it meet cordial concerely hope your currence and active It is proposed to com- I thought it doubtful "whether the true ray fungus of support. animals was ever really found in man." I did not say mence the voluntary notification of phthisis in Norwich but expressed a doubt as to whether it was ever this, I on Jan. 1st next. At the end of four months have to report to the Health Committee upon its actual and found except in the animal world and asked if there was any from vegetables to animals. prospective value as an aid to State medicine, and if it meet., real evidence of its conveyance T am. Sirs. yours faithfully. as I fully expect it to meet, with cordial acceptance at the G. R. TURNER. Half Moon-street, Piccadilly, 6th, 1899. hands of the medical profession in Norwich I do not doubt that I shall be able to advise the Health Committee of the City Council to continue it in operation for a very much "THE ORGANISATION OF THE longer time than six months-probably until a general Act PROFESSION." of Parliament include the tuberculous among the compulsorily notified diseases. I propose on the receipt of a To the Editors of THE LANCET. notification of phthisis to visit the indicated dwelling in SIRS,-The list of "medical unions, guilds, and kindred person to satisfy myself as to the existence of overcrowding Members of the associations " published in THE LANCET of Oct. 21st presents or other remediable sanitary defect. medical profession may rest assured that nothing will be an extraordinary omission. While it recounts the local done to disturb the relation between the certifying practi- medical union of every little provincial town in England and tioner and the patient-a small, clearly-printed card, with even mentions the Cork Medical Protection Association, the Irish Medical Association. This. simple directions as to the treatment of expectoration, pro- it entirely ignores has been doing the work of the profession organi-ation I be vision of ventilation, &c., left. shall glad only being if on and after Jan. lst next you will notify to me any case in Ireland for over 60 years and its members are more of phthisis under your actual treatment, particularly if you numerous than those of a score ofs the local English guilds have reason to regard the dwelling and home surroundings and far more numerous than those of all the other medicoas factors of importance. Please make use of the ordinary ethical associations in Ireland put together. As, however, it shares with the British Medical Association notification forms.-Yours truly, the cold shade in which it is placed by this list it need not, H. COOPER PATTIN, complain. I am. Sirs. vours faithfullv. Medical Officer of Health. ARCHIBALD M.D. Dub., F.R.C.S. Irel., of Norwich 1899. City Municipal Buildings, November, -
,
permitted
,
.
6th,
-- - ’
-
I
Nov.
HAMILTON JACOB,
Councillor and ex-President of the Irish Medical Association.
Dublin, Nov. 3rd, 1899.
"THE USE OF MERCURY IN THE TREATMENT OF HEART DISEASE." To the Editors of THE LANCET.
*The
Irish Medical
to communicate
Association ignored our invitation particulars concerning itself.-ED. L.
To the Editors of THE LANCET. to make a few observations on the Commissioner in THE LANCET of
SIRs,-Having read Dr Alexander Morison’s address on the SIRS,-I should like Use of Mercury in the Treatment of Heart Diseasewith great of your Special report interest, I think it might interest your readers to know that 1
THE
LANCET,
Oct.
28th, page 1147.
3
2 Deutsches Archiv für Klinische Medicin, vol. xxxviii. Handbuch der Therapie innerer Krankheiten, second edition, vol. iii.
1333
who died under placenta præsvia. Not at all disposed to undervalue the importance of the post-mortem investigations, confirming, as they do, my original description, I may be to observe that the evidence of what may be calledl "frozen physiology"" cannot be compared with the richL evidence of "living physiology" and clinical experience. Let me conclude this brief explanation of the true significance of the term "ectopic gestation" with a challenge to those who, directly or indirectly, have passed over my claim to originality to make good their conduct. "Litera scripta manet." The following dates bave to be, considered : How does "Barnes’s boundary-line " described in 1847, 1857, and repeatedly since, become the "os internnmof Braune in 1872, Bandl’s ring in 1876, and later still the contraction-ring of Schroeder ? I am. Sirs. vours faithfullv. ROBERT BARNES. 1899. Eastbourne, Nov.
calomel has frequently been used as a diuretic in continentai clinics. When studying under Professor von Ziemssen (Munich) in the eighties" I saw the remedy continually employed in his wards and the professor never missed an opportunity to recommend it to his students. The remedy is also highly lauded by Jendrassik2 and by Bauer3 in his article, "Treatment of the Circulatory Disorders." Bauer says that calomel often produces a regular ’’flood " of urine, not seldom amounting to five, and even to 10, litres during 24 hours. The good effect is even produced in cases in which digitalis has been useless and the increased diuresis generally lasts for some time after the last dose of calomel has been taken. The use of calomel, however, is not without danger as bad effects are always observed in those cases in which the diuresis is not increased by the remedy. Salivation, stomatitis, and diarrhoea, not seldom of a sanguineous type, may occur and shorten the life of the patient, especially in cases in which the heart disease is complicated with nephritis or in cases of extreme degeneration of the myocardium. THE NOTIFICATION OF PULMONARY Calomel should be given in doses of three grains combined with one-sixth of a grain of opium (to prevent. TUBERCULOSIS. diarrhoea) three times daily for at least three days, but it To the Editors of THE LANCET. may be pushed for five, and even for 10, days. The good SIRS,-I should’be grateful if you would kindy insert the effects will seldom be observed before the third day. &houlc5 following letter which I have sent to all the medical practi- diarrhoea or salivation occur the remedy must be stopped tioners in Norwich. immediately ; in any case the mouth should be watched from I am, Sirs, yours faithfully, the beginning of the treatment and a gargle of potassium H. COOPER PATTIN, chlorate used regularly. After the disappearance of the Medical Officer of Health. oedema a course of digitalis or strophanthus will often be useCity of Norwich Municipal Buildings, Nov. 6th, 1899. ful to prevent its re-collection, later on the calomel treatSIR,-At my suggestion the Health Committee of the City ment may be repeated if necessaiy. I may add that I have Council has agreed to make a six months’ experiment, for in many cases followed this course of treatment with State medical purposes, of the value of a voluntary notifica- excellent results, and I am convinced that it will do good tion of phthisis.It is believed that the information which sometimes in cases which have not reacted on digitalis,, will thus be gained will furnish a reliable basis upon which diuretin, and other remedies in general use. I am, Sirs, yours faithfully, to estimate the amount and distribution of the lung form of tuberculous disease which prevails in Norwich, and as the Finsbury-square, Nov. 6th, 1899. Health Committee is advised by me that the information it may look forward to acquiring through the voluntary notificaTHE RAY FUNGUS AND THE ANIMAL tion of the disease will be of value to it as well as to the WORLD : A CORRECTION. medical profession and to preventive medicine it has on its part, as the local public health authority, agreed to pay ls. for To the Editors of THE LANCET. each notification certified to have been received by me. In SIRs,-In your report of my remarks at the last meeting view of the importance of this experiment I do most sinof the Clinical Society of London I am made to say that that will with it meet cordial concerely hope your currence and active It is proposed to com- I thought it doubtful "whether the true ray fungus of support. animals was ever really found in man." I did not say mence the voluntary notification of phthisis in Norwich but expressed a doubt as to whether it was ever this, I on Jan. 1st next. At the end of four months have to report to the Health Committee upon its actual and found except in the animal world and asked if there was any from vegetables to animals. prospective value as an aid to State medicine, and if it meet., real evidence of its conveyance T am. Sirs. yours faithfully. as I fully expect it to meet, with cordial acceptance at the G. R. TURNER. Half Moon-street, Piccadilly, 6th, 1899. hands of the medical profession in Norwich I do not doubt that I shall be able to advise the Health Committee of the City Council to continue it in operation for a very much "THE ORGANISATION OF THE longer time than six months-probably until a general Act PROFESSION." of Parliament include the tuberculous among the compulsorily notified diseases. I propose on the receipt of a To the Editors of THE LANCET. notification of phthisis to visit the indicated dwelling in SIRS,-The list of "medical unions, guilds, and kindred person to satisfy myself as to the existence of overcrowding Members of the associations " published in THE LANCET of Oct. 21st presents or other remediable sanitary defect. medical profession may rest assured that nothing will be an extraordinary omission. While it recounts the local done to disturb the relation between the certifying practi- medical union of every little provincial town in England and tioner and the patient-a small, clearly-printed card, with even mentions the Cork Medical Protection Association, the Irish Medical Association. This. simple directions as to the treatment of expectoration, pro- it entirely ignores has been doing the work of the profession organi-ation I be vision of ventilation, &c., left. shall glad only being if on and after Jan. lst next you will notify to me any case in Ireland for over 60 years and its members are more of phthisis under your actual treatment, particularly if you numerous than those of a score ofs the local English guilds have reason to regard the dwelling and home surroundings and far more numerous than those of all the other medicoas factors of importance. Please make use of the ordinary ethical associations in Ireland put together. As, however, it shares with the British Medical Association notification forms.-Yours truly, the cold shade in which it is placed by this list it need not, H. COOPER PATTIN, complain. I am. Sirs. vours faithfullv. Medical Officer of Health. ARCHIBALD M.D. Dub., F.R.C.S. Irel., of Norwich 1899. City Municipal Buildings, November, -
,
permitted
,
.
6th,
-- - ’
-
I
Nov.
HAMILTON JACOB,
Councillor and ex-President of the Irish Medical Association.
Dublin, Nov. 3rd, 1899.
"THE USE OF MERCURY IN THE TREATMENT OF HEART DISEASE." To the Editors of THE LANCET.
*The
Irish Medical
to communicate
Association ignored our invitation particulars concerning itself.-ED. L.
To the Editors of THE LANCET. to make a few observations on the Commissioner in THE LANCET of
SIRs,-Having read Dr Alexander Morison’s address on the SIRS,-I should like Use of Mercury in the Treatment of Heart Diseasewith great of your Special report interest, I think it might interest your readers to know that 1
THE
LANCET,
Oct.
28th, page 1147.
3
2 Deutsches Archiv für Klinische Medicin, vol. xxxviii. Handbuch der Therapie innerer Krankheiten, second edition, vol. iii.