THE PARIS EXHIBITION.

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only able to spare a leaving Bath feeling in every respeot pounds better. This spring, from all accounts, I sciatica appears to have been epidemic. Let me say too with regard to this complaint, having twice suffered from it, that, to my mind, there are two forms, the lower and the can

only

fortnight

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to the treatment I

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am

THE PARIS EXHIBITION. (FROM OUR OWN CORRESPONDENT.)

THE name remains though the substance has gone. The upper. The first time I had the lower form, when the Gallery of Machines is still known by that name though, as sciatic nerve from its notch down the back of the thigh gave the most agonising pain. and the outer leg and ankle were already explained, it no longer contains any machinery, for also very painful. This time I have suffered from the upper in its centre there is the Hall of Festivals and on each side form, when the first point of pain was in the upper part of are arranged alimentary and agricultural products. The the buttock. To name rightly the nerve branch affected I gallery which is parallel and next to this vast and magnificent should have to refer to the anatomical work of my good old iron and glass structure does contain machinery in motion, teacher, Professor Vyner Ellis (so recently dead), which is huge boilers, power-producers, and electrical machinery. at my home. From the buttock the pain has been distributed This is the most backward part of the Exhibition. Here through the groin, and down the iliofemoral band to a chaos reigned supreme long after the Exhibition was opened. short distance below the knee, the knee often being There was bare earth where there should be carpeted particularly painful. boards, some portions were absolutely impassable, and the The lower form, the pain was continuously intense, visitor was constantly turned back, first at one point and only incapacitated me from work for ten days. The upper then at another, by attendants whose duty it was to prevent form of sciatica kept me in bed three weeks and three days, sightseers from incurring the risk of accident. Yet even and then when I tried for some days to work I had to give here, by going upstairs to the galleries, there is a good up, the pain being too severe for me to keep up against ; and deal to be seen, for Class 112 has nearly all its exhibits now after a fortnight’s treatment in Bath, though returning in order. This class deals with poor relief and is situated to work, I am still at times somewhat crippled by the pain. close to the Hall of Festivals, and a portion of it was For these reasons I am of opinion that there are two kinds officially inaugurated last week. Here all private and of sciatica, upper and lower, and that the upper kind is by public organisations and charities for the relief of the far the worse of the two. When the lower form attacked me poor display drawings, charts, maps, models, statistical I do not remember that my leg lost at all in size. In this tables, &c., that may serve to illustrate their work, attack after the first month the upper part of my thigh lost Then, again, in the gardens of the Champ de Mars facing two inches in circumference. the monumental Chateau d’Eau the aspect is that of a I am, Sirs, years faithfully, railway goods station rather than that of pleasure-grounds. PUGIN THORNTON. The railway lines have not been covered up and numerous Pierrepont-street, Bath, May 15th, 1900. railway trucks are still there, though the process of unload. ing them is postponed till after the grounds are closed to M.D. DURHAM FOR PRACTITIONERS. the public. Nor is there any immediate need to clear To the Editors of THE LANCET. this space till the Chateau d’Eau which it faces is itself finished. This, however, is approaching completion. me to answer columns allow SiES,—Kindly through your some questions respecting the above degree. Intending Nearly all the scaffolding has been removed and the candidates who have the files of THE LANCET by them will sculptors are giving their final touches to the nymphs ,find a letter signed "M.D." on Oct. 15th, 1898, containing who are gracefully poised over and about the waterfalls, some sound advice. I, for one, am grateful to him for it. That the largest structure, the principal architectural For those who have not the letter by them I would say: feature, of the Exhibition should consist of a succession of write to Dr. Howden, the courteous secretary of Durham cascades issuing from within a monumental arch is certainly University, for a copy of the last Calendar, which gives the a very original conception. Above and around, the gilding text-books advised and some of the recent papers given. Get and the white statuary, and at night the blaze of electric the latest editions. Either the Latin or Professional may be light, will produce a most impressive effect ; and it is only taken separately or first. Unless Latin is an easy subject I right that in front a vacant space, large enough to hold advise taking it first and alone so as to be free for purely thousands and thousands of people, should have been left professional subjects. Get up thoroughly urine and urinary free of all encumbrance. This space, which at present conmicroscopic and pathological and histological work. If pos- stitutes the principal goods station of the Exhibition, will sible do some clinical work and go over a good museum once soon be clear, and when all is complete it will attract Those near London will get much help in hygiene visitors who may be counted by the million. or twice. On the westerly side of the Eiffel Tower there are still a by going over the Parkes Museum. The examination is fair but and The clinical work must just. good many buildings which are not yet finished, and here perfectly thorough, be done well. Do not go up with the idea that the degree is dust or mud and cobbles and sharp stones still prevail, but .given away or you will regret it. Remember that you are on the opposite side better progress has been made. Indeed, again a student undergoing examination. To those who have the mason and the plasterer and scaffolding and rubbish-carts few opportunities I would advise them to go up eight or nine are now confined to a few corners and localities and genuine days before the examination and attend a special class for this progress towards completion has been made. Every day some degree which is given. They will be taken over all the work, new section or pavilion is finished which very often forms of particularly the pathological and microscopical work, which itself a sufficient motive for a visit to the Exhibition. Thus, is so essential. I wish success to all intending candidates in the Avenue of Nations the vast Italian Pavilion opened and hope they will have as much pleasure in going over the its doors the week before last. Under the gilt cupola reold ground as I had. After an interval of 20 years it was produced from St. Mark’s of Venice and within walls that imitate those of the palace of the Doges the artistic glass.a great treat to be again examined by one of the kindest and most eminent of London surgeons. Operative surgery has work, ceramic arts, sculpture, and mosaics, &c., of Italy are made great strides since the day when last we met. exhibited, while in a gallery running round the building the technical schools, the universities, and the municipalities I am, Sirs, yours faithfully, M.R.C.S. ENG. display drawings, and charts, and specimens that explain May 15th, 1900. what has been done to improve the health and education of the people. Immediately behind this palace BRISTOL LUNATIC AsYLUM.—The thirty-ninth Denmark shows a model middle-class dwelling to which annual report of this institution, which has just been issued, the public are now admitted and which illustrates the home shows that on Dec. 31st, 1899, there were 778 patients- life of that country. The Hungarian Pavilion is also comviz., 379 males and 399 females-in the asylum. The highest pleted and forms a sort of synopsis of the history and number resident at any one time in the year was 799. The avocations of the Hungarian people. On one side there is a extension of the asylum buildings, with the exception of the reconstruction of the Abbey and the Church of Jaak, and on isolation hospital, will shortly be completed and will be the other side the frontage of the Vajda-Hunyad mansion ready for occupation early this summer. The committee, in and the fortress of Koermoeczbanya, together with other concluding the report, expressed their high appreciation of specimens of Hungarian architecture; while inside the arts, the manner in which the medical superintendent and the and sciences, and the industrial progress of that interesting officers and staff of the asylum had performed their respective people are illustrated by numerous exhibits. The Finland Pavilion is also open and here the visitor may appreciate duties during 1899.

though

1469 how much has been done to spread education among the rperforation of the intestine had occurred or not, as Finnish people. Of course, many of the Finnish exhibits t;he symptoms of this condition were very like those of relate to fishing but the man of science will be interested in a ssevere shock. Unconsciousness, vomiting, and weakness of gigantic meteorite which fell at Bjurboele on May 12th last tjhe pulse were symptoms of shock as B’It,1l as of perforation year. Close by also in the Avenue of Nations the specimen c)f the intestines. it was, however, chbrou’eristic of shock houses or palaces of Belgium, Monaco, Sweden, and Spain tthat these symptoms were of short duration, whilst in perhave been completed and opened to the public last week, so fforation of the intestine signs of peritonitis generally made that the majority of these remarkable buildings are now ttheir appearance in a few hours. If the vomiting continued f several hours and became worse perforation was almost accessible. On the opposite side of the river the Social for ( Also the pulse-rate, the respiration, the temperaEconomy Palace is now open, though all the exhibits are not certain. t and the tension of the abdominal muscles must be as yet in their places ; and finally the two permanent stone ture, t into account. The presence of gas in the abdopalaces of the Fine Arts and of the Retrospective Arts were taken i cavity could be ascertained only when a considerable opened to the public on May lst. These palaces, which are !minal situated in the Champs Elysees, are in themselves well worth (quantity of it had penetrated through the intestines. On the whole, though it is still‘With regard to the treatment Professor von Angerer strongly a journey to Paris. to advisable postpone going to Paris for a week or two, if )recommended early operation-laparotomy and suture of this cannot be done conveniently the Exhibition to-day is so 1the intestinal wounds. He had collected histories of 159 c where no operation had been performed, the result far advanced as not to disappoint the visitor. Though the cases 1 that 149 died and 10 had to be operated on eventually, above description of the present condition of the Exhibi- being tion may not be considered altogether favourable it must be 1because an intestinal fistula had developed. The operation borne in mind that we are still only in the middle of theIought to be performed as early as possible, even before the month of May and that the last exhibition held in 1889 wasIsymptoms of shock had quite disappeared, so as to avoid the I not opened before the 6th of that month. complication of peritonitis.-In the discussion Dr. STOLPE Great capital has been made in certain quarters out of everyI(Breslau) showed the difficulty of an exact diagnosis of miscalculation, delay, or accident. Thus the report is veryintestinal perforation by mentioning a case where an injury generally spread abroad that a considerable number of livesof the spinal cord had produced paralysis of the intestines have been lost in the building of the Exhibition, and not aand where the diagnosis of perforation had been made,few Frenchmen go about repeating that at least one life is Professor HAHN said that in traumatic rupture of the inteslost per week through the numerous accidents that occur. tines sutures alone were not sufficient ; he advised that the Fortunately, the chief of the Exhibition medical service injured part should be resected previously to being sutured, (Dr. Gilles de la Tourette, Professor at the Faculty of especially when the intestine was severely contused. Medicine) has kept a careful record of these casualties. Gro7vths of the Omentum. According to his statement there were nine deaths BRAUN Professor (Gottingen) read a paper on Solid due to accident during the process of building in 1896, Growths of the Omentum following abdominal operations. during 1897 there were only two deaths, and in 1898 also only two deaths, while in 1899 there were seven Such growths which sometimes caused severe pain consisted chronic infiltrations of the omentum and might appear deaths, including those of two men who fell into the Seine of and were drowned. This is far from being one death per several months after the operation. They might disappear week. All these men died on the spot or in a few hours, and spontaneously, or suppurate or continue to persist in the They were caused by all those who were injured have recovered under treatment. state of chronic infiltration. mechanical injury of the omentum during the operation. character of some of the work the Considering dangerous and the great height to which many of the scaffoldings were Sometimes they had to be removed by a second operation.raised the number of accidents is below and not above the Dr. FRIEDRICH (Leipsic) said that he had studied changes in animals after ligature of the omental vessels. average. Further, the injured workmen received, not only occurring their insurance money, but half their salaries during the He had found that in guinea-pigs ligature of those vessels whole time of their treatment. There are fully installed produced small necroses in the stomach and the liver, whilst the kidneys and the spleen were left intact. In ambulances, or medical posts, on the Champs de Mars, the rabbits necroses were seldom observed and in dogs Trocadéro, the Invalides, and the Champs Elysées, and a fifth and cats these It was possible that gastric ulcers following never. A and a staff is of about to be surgeon organised. post abdominal contusions were caused also by traumatic lesions trained nurses are always present at these posts. They of the omental vessels. are connected with each other and also with the neighbouring hospitals by telephone. There is a large stock of Osteoplasty of the Tibia. bandages, splints, &c., at hand, and further outside help can Dr. GROSSE (Halle) showed a child with Congenital be immediately obtained by telephone. Full provision has Absence of a Large Portion of the Tibia, for which he had been made, not only to meet the accidents which under performed a successful plastic operation. Taking advantage normal conditions are likely to occur, but also to cope with a of an amputation of the leg which had to be performed on panic or some altogether exceptional disaster. another patient, he removed from the amputated tibia a Thus, in answer to the complaint that the Exhibition is portion corresponding to the deficiency and inserted it into not ready it may be said that no other similar undertaking the abnormal tibia. Skiagraphy showed that the implanted was so far advanced at so early a period of the year. With piece, which was two inches long, had become firmly united, regard to the statement that the Exhibition is dangerous on and presented the appearance of normal bone. The leg account of the number of accidents which occur, it may be thus operated on, although smaller than the other one, was urged that the number of fatal accidents has been below the now a useful’limb. average and that the only casualties in which members Disinfection of the Hands. of the general public suffered occurred outside the Exhibition Dr. stated that absolute sterility of SARVEY (Tübingen) grounds in the Avenue de Suffren, which is under the control the hands of the surgeon was not obtained by any of the of the Municipality and not of the Exhibition authorities. various methods recommended for that purpose. The Paris, May 13th. relatively best results were got by the use of hot water and alcohol (Ahlfeld’s method) or by the use of spirit of soap GERMAN SURGICAL CONGRESS. (Mikulicz’s method). Mere mechanical treatment of the hands with marble soap was not sufficient, disinfection with (FROM OUR BERLIN CORRESPONDENT.) chemical agents bring indispensable.-Dr. VOLLBRECHT (Continuedfrom p. 1402.) (Dusseldorf) recommended a solid compound which contained spirit of soap and might be used in the form of tubes.-The use of indiarubber gloves as employed by Mikulicz was Operations for Contusions of the Abdomen. recommended by Professor SPRENGEL. PROFESSOR VON ANGERER (Munich) read a paper upon this strongly A Disease of Pianists. subject, in the course of which he said that in abdominal contusions the prognosis and treatment differed according as Professor DABLUDOWSKI (Berlin) read a paper on cases of the cases were attended or not attended by perforation of the Nervous and Muscular Affections observed by him in Pianists, intestines. Contusions without injury of the intestines especially in young players. By the excessive stretching scarcely required treatment, because they were usually of the fingers the tendons, joints, and ligaments of the hand It were injured. This condition might become chronic if the recovered from spontaneously within a short time. was, however, sometimes difficult to say whether a patient continued to play, and in course of time the nerves I

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