- Email: [email protected]
THE PRODUCTION OF "BLACK TONGUE" BY HYDROGEN PEROXIDE.
1316
AN ’ARRANGEMENT your OBSERVING
,QPER’.(’IONS.. ,
,
were done energetically with a corresponding risk of a heavy,from the operating table. By meansof opera glasses the fall. In the circumstances the ’broken leg of the one boy most minute details of the operation can be seen. The and the fractured skulland death of the other were acci- enucleation of a cataract or the removal of a gall-bladcer dents for which neither their schoolmasters nor their school- can be seen as plainly as an operation on the foot. By this fellows could conceivably be blamed, but they emphasise method the spectators are in the operating theatre but they the drawbacks which atténd ordinary games " in asphalted are kept at a distance from the table. Both of these devics playgrounds and lend support to our suggestion that other are ingenious and doubtless others will be invented. We feel forms of exercise might be substituted for them. These sure that some such procedure will be a definite gain botn would tend equally or even more certainly to promote bodily to the operating surgeon and to the spectators. activity and healthy physical development and so would form .a useful preparation for the enjoyment of the more familiar APOMORPHINE AS A HYPNOTIC IN ALCOHOLISM. forms of athletic sports at a later age and under more IN the Canadian Practitione7’ for October Dr. A. M. suitable conditions. Rosebrugh, secretary of the Ontario Society for the Reformation of Inebriates, has called attention to the value of AN ARRANGEMENT FOR OBSERVING apomorphine as a hypnotic in alcoholism. The discovery of OPERATIONS. the hypnotic properties of apomorphine was made by Dr. A FEW years ago when any operation was C. J. Douglas of Boston in 1899 but has remained almost performed in a hospital the theatre was crowded with unknown. It is well how promptly the drug acts students, but the large increase in the number of major as an emetic in a doserecognised of one-tenth of a grain administered operations has been followed by a great decrease in the Dr. Rosebrugh finds that it acts with attendance of students at operations. This is not entirely a hypodermically. almost equal promptitude as a hypnotic in alcoholism in matter for regret, for modern surgery does not take kindly doses of one-twentieth or one-thirtieth of a grain. The to the congregation in the theatre of a large number of however wild or noisy, usually sleeps peacefully in spectators. The auditorium of most modern operating patient, or 12 10 minutes after the injection. The sleep may last theatres is much smaller than in those which were builti for 10 or 12 hours, after which he awakens refreshed and ,30 or more years ago. In one theatre in Paris a sober. Dr. Coleman and Dr. Polk of Bellevue Hospital, large glass screen was at one time employed to shut off New have used apomorphine in over 300 cases of York, the spectators completely from the surgeon and his assistants. alcoholism with gratifying results. In Dr. Rosebrugh’s Even in an ordinary operating theatre the spectator sees even the fortieth of a grain is effective in experience comparatively little of the operation unless he be one of the some cases. He thinks that the discovery of this use of favoured few allowed to stand round the operating table. will mark a new era in the management of apomorphine Two methods have recently been described in the Ámerican cases of acute alcoholism and delirium tremens. In many J016’l’nal of Surgery by which spectators at a distance can see in these conditions are far from welcome well even many of the minutiae of an operation. In the hospitals patients but when it becomes known that a safe and prompt hypnotic September number Dr. C. H. Duncan, surgeon to St. is available will be admitted more readily. At the next Gregory’s Volunteer Hospital, New York City, has described session of thethey Ontario Legislature it is proposed to introduce an ingenious arrangement. Over the operating table, at a a a Bill drafted committee of the Ontario Medical height where it cannot interfere with the operator or Association andby thejoint Prisoners’ Aid Association. This Bill his assistants, hangs a glass shield, at the margin of with a view to economy, for the utilisation of the which are many lights, so that the field of operation provides, wards of the general hospitals of the province for the treatis adequately illuminated. In the centre of this shield is a ment of indigent inebriates of the more hopeful class. large lens through which pass the light rays from the table Dr. Rosebrugh thinks that the discovery of the hypnotic and its surroundings; the rays are totally reflected in a property of apomorphine and the facility with which it brings prism and then they pass horizontally to a screen which is set alcoholic patients under control will help materially in in a partition wall, separating the operating theatre from a to the Bill. obstacles darkened room where many visitors can obtain a view of removing almost every step of an operation as it progresses. By means THE PRODUCTION OF "BLACK TONGUE" BY of other lenses the image is rectified and the rays are made HYDROGEN PEROXIDE. to pass through some coloured solutions, so that the red, u 11 " THE pathological condition known as " black tongue orange, and green rays are intensified. The image on the m appears to be due to various causes, some of which have not screen can be photographed or a kinematograph film The image can be of any can be made from it. lY yet been determined. When found in cases of glycosuria it has been ascribed to the action of parasites, particularly Dr. Duncan suggests that a megaphone desired size. ne can be fixed in the partition and project into. the operatingsaccharomyces linguae pilosas. In a recent number of Les g2Vouveaqtx Remedes it has been shown by M. L. Bizard that aroom, and thus the surgeon can talk to the visitors. Operalo in many cases this phenomenon is caused by the use of tions on such cavities of the body as the nose and rectum do not lend themselves to this method. As the visitors are re hydrogen peroxide as a mouth wash. He cites the case of a smoker who used a mouth wash daily for eight days consisthis from the and assistants the 18 completely separated surgeon dust from m the of ing of a tablespoonful of hydrogen peroxide in half a glassful contaminating operating-room by danger ie ofwarm water. A marked blackening was then found on the street is eliminated ; the distraction caused by the i, the dorsal surface of the tongue, but on ceasing to use the coming and going of visitors is also done away with ; and, air without risk the visitors can have fresh cool moreover, any ik mouth wash the colouration disappeared in a few days. I of chilling the patient. The other method for observing g The patient was in goodhealth, except that an exasmination urgeon n of the tongue showed that the lingual papillae operations is described by Dr. A. Monae Lesser, surgeon 1 :t were to the New York Red Cross Hospital. A mirror five feet hypertrophied. The same effect was produced in < three tt the case of two patients undergoing mercurial treatfeet hangs obliquely over the operating table about by seven and a half feet above- the floor. i It forms an angle of f ment by the injection of grey oil, who were in the about 75 degrees and the spectators can watch the operation n of rinsing the mouth with hydrogen peroxide. It was 1 habit from the seats, the first row of which stands about six,feet, aat first that the colour was due to the action of the ___
important
he
t,
thought
REPORT ON SANITARY MEASURES IN INDIA FOR 1906-07.
1317
hydrogen peroxide on the mercurial saliva, but hydrogen teachers are a hard-worked and ill-paid class,and pan illperoxide alone, as has been shown, may produce the same afford such charity, though they may very ..well help by effect. As hydrogen peroxide has now come into general use superintending the meals. It is gratifying to know that the as a mouthwash these observations are of great interest and Liverpool public has responded so well to the appeals of value. Apart from the blackening of the tongue which may result from too free a use of this preparation the question arises whether the general employment of antiseptic mouth washes and dentifrices is advisable in healthy persons. Where decay is known to exist there is no doubt that a moderate use of antiseptic agents tends to prevent the spread of the invading organisms. But when the mouth is in a healthy condition it would seem preferable to rely upon cleanliness rather than on antiseptics. The bacterial flora of the mouth may contain organisms that naturally tend to preserve it in a healthy condition but the continued use of antiseptics is calculated to destroy favourable as well as harmful bacteria.
THE SALARY OF MEDICAL OFFICERS. AT a meeting of the Derby education committee held on Oct. 26th the elementary education subcommittee reported that it had resolved to advertise in the medical journals for an assistant medical officer at a salary of R200 per annum. We declined to insert the advertisement in consequence of representations which had been made to us by local medical men and the British Medical Jowrnal also refused to insert it because the British Medical Association considered that the holders of whole-time appointments should have a minimum salary of
the Children’s Meals Committee as to allay anxiety for the immediate future. A pathetic instance is given of a common practice which leads the committee to touch on a very im- portant economic question in connexion with the children of the poor. "A little barefooted child, about five years of age, received her supply’ of bread ’and jam and was followed home through the rain to the cellar in which she lived. The medical officer, on entering the cellar, found two other children who attended other schools who had also arrived with their share of bread and jam, and the three of them were proceeding to divide the meal with two others who were not of school age. The mother stated that they did this when their father was out of work. Latterly he had been in hospital but was returning to work the following day. She also stated that she had had thirteen children, seven of whom had died in infancy or early childhood." Commenting upon this case the committee states that it may feel disposed to dissociate itself from any suggestion that there are less responsibilities in connexion with children below the school age than with those who are attending school." This guarded statement opens out vistas of an important municipal service of hygiene for which’ there is certainly no existing machinery. We shall awaJLt the committee’s final with interest.
report
A SPECIAL
-
THE King has granted to Mr. George Allardice MacDonald, M.B., C.M. Edin., His Majesty’s Royal licence and authority to accept and to wear the Insignia of a Knight of the Order of the Crown of Italy, conferred upon him by His Majesty the
King of Italy
in
recognition
of valuable services rendered
by
him. A TELEGRAM from the Acting Governor of the Mauritius received at the Colonial Office on Oct. 23rd states that for the week ending Oct. 22nd there were 8 cases of plague and 6 deaths from the disease.
___
THE FREE
-
FEEDING OF SCHOOL CHILDREN IN LIVERPOOL. committee appointed by the city council of
Liverpool investigate the subject of the insufficient or improper feeding of school children has issued recently an interim report, with a supplementary preliminary report of Dr. E. W. Hope, medical officer of health of Liverpool. Inquiry has been made into the state of affairs existing at 20 selected schools and the committee asks the approval of the council of the investigation of 12 others before making a final report. Having regard to the voluntary agencies at present providing meals for Liverpool school children, the committee does not feel justified in recommending that the Education (Provision of Meals) Act of 1906 should be put into operation. Dr. Hope in his report gives a summary of the conditions obtaining in the 20 schools visited, and the general trend of observation goes to show that improper, rather than inadequate, feeding accounts for the malnutrition of many children and that parental carelessness or callousness is a more frequent factor than parental poverty in cases where children come breakfastless to school. Dr. Hope is of opinion that education of the poorer classes in proper methods of feeding their children is needed badly. Some suggestions and criticisms are made concerning thei " coupon" system, which prove it to be liable to abuse. The fact that some of the teachers voluntarily supply the children’s wants is noted, and though this reflects great: credit upon their humanity we are of opinion that the system which allows it is wrong, for elementary schooll to
.
’
REPORT ON SANITARY MEASURES IN INDIA FOR 1906-07. THE Report on Sanitary Measures in India for 1906-07 embraces the data relating to the health of the European and -and the jails, and in native armies, the general addition presents us with the facts appertaining to vaccination, the various medical institutions, the lunatic asylums, It concludes with a review of the and medical schools. sanitary works that have been carried out and with some diseases. valuable remarks on the etiology’ of As regards the health of the European army, we find that the year 1906 was an unhealthy one for all classes of people in India and the rates of admission to hospital, of mortality, and of invaliding were all higher than in 1905. On an average strength of 70,272 the admissions were in the ratios of 871 per 1000 as contrasted with 834 per 1000 in 1905. As in the latter year so in the year under review, the European troops in the Rawal Pindi and Lahore divisions enjoyed the best health. The chief causes of sickness were ague, venereal diseases, and simple continued fever, the above-mentioned increase of sickness being chiefly due to a rise in the first-mentioned class of diseases, ague causing an admission of 176 as ’contrasted with 111 per 1000 in 1905. 40 per cent. of the total sickness was due to the above three diseases. The chief causes of mortality were enteric fever and hepatic abscess, 31 per cent. of the total deaths being due to enteric fever and 15 per cent. to hepatic abscess. The number of men sent home for syphilis rose from 75 in 1905 to 120 in 1906. With respect to malarial fevers, these were -most rife in the Peshawar and Mhow divisions*-
population,
certain
AN ’ARRANGEMENT your OBSERVING
,QPER’.(’IONS.. ,
,
were done energetically with a corresponding risk of a heavy,from the operating table. By meansof opera glasses the fall. In the circumstances the ’broken leg of the one boy most minute details of the operation can be seen. The and the fractured skulland death of the other were acci- enucleation of a cataract or the removal of a gall-bladcer dents for which neither their schoolmasters nor their school- can be seen as plainly as an operation on the foot. By this fellows could conceivably be blamed, but they emphasise method the spectators are in the operating theatre but they the drawbacks which atténd ordinary games " in asphalted are kept at a distance from the table. Both of these devics playgrounds and lend support to our suggestion that other are ingenious and doubtless others will be invented. We feel forms of exercise might be substituted for them. These sure that some such procedure will be a definite gain botn would tend equally or even more certainly to promote bodily to the operating surgeon and to the spectators. activity and healthy physical development and so would form .a useful preparation for the enjoyment of the more familiar APOMORPHINE AS A HYPNOTIC IN ALCOHOLISM. forms of athletic sports at a later age and under more IN the Canadian Practitione7’ for October Dr. A. M. suitable conditions. Rosebrugh, secretary of the Ontario Society for the Reformation of Inebriates, has called attention to the value of AN ARRANGEMENT FOR OBSERVING apomorphine as a hypnotic in alcoholism. The discovery of OPERATIONS. the hypnotic properties of apomorphine was made by Dr. A FEW years ago when any operation was C. J. Douglas of Boston in 1899 but has remained almost performed in a hospital the theatre was crowded with unknown. It is well how promptly the drug acts students, but the large increase in the number of major as an emetic in a doserecognised of one-tenth of a grain administered operations has been followed by a great decrease in the Dr. Rosebrugh finds that it acts with attendance of students at operations. This is not entirely a hypodermically. almost equal promptitude as a hypnotic in alcoholism in matter for regret, for modern surgery does not take kindly doses of one-twentieth or one-thirtieth of a grain. The to the congregation in the theatre of a large number of however wild or noisy, usually sleeps peacefully in spectators. The auditorium of most modern operating patient, or 12 10 minutes after the injection. The sleep may last theatres is much smaller than in those which were builti for 10 or 12 hours, after which he awakens refreshed and ,30 or more years ago. In one theatre in Paris a sober. Dr. Coleman and Dr. Polk of Bellevue Hospital, large glass screen was at one time employed to shut off New have used apomorphine in over 300 cases of York, the spectators completely from the surgeon and his assistants. alcoholism with gratifying results. In Dr. Rosebrugh’s Even in an ordinary operating theatre the spectator sees even the fortieth of a grain is effective in experience comparatively little of the operation unless he be one of the some cases. He thinks that the discovery of this use of favoured few allowed to stand round the operating table. will mark a new era in the management of apomorphine Two methods have recently been described in the Ámerican cases of acute alcoholism and delirium tremens. In many J016’l’nal of Surgery by which spectators at a distance can see in these conditions are far from welcome well even many of the minutiae of an operation. In the hospitals patients but when it becomes known that a safe and prompt hypnotic September number Dr. C. H. Duncan, surgeon to St. is available will be admitted more readily. At the next Gregory’s Volunteer Hospital, New York City, has described session of thethey Ontario Legislature it is proposed to introduce an ingenious arrangement. Over the operating table, at a a a Bill drafted committee of the Ontario Medical height where it cannot interfere with the operator or Association andby thejoint Prisoners’ Aid Association. This Bill his assistants, hangs a glass shield, at the margin of with a view to economy, for the utilisation of the which are many lights, so that the field of operation provides, wards of the general hospitals of the province for the treatis adequately illuminated. In the centre of this shield is a ment of indigent inebriates of the more hopeful class. large lens through which pass the light rays from the table Dr. Rosebrugh thinks that the discovery of the hypnotic and its surroundings; the rays are totally reflected in a property of apomorphine and the facility with which it brings prism and then they pass horizontally to a screen which is set alcoholic patients under control will help materially in in a partition wall, separating the operating theatre from a to the Bill. obstacles darkened room where many visitors can obtain a view of removing almost every step of an operation as it progresses. By means THE PRODUCTION OF "BLACK TONGUE" BY of other lenses the image is rectified and the rays are made HYDROGEN PEROXIDE. to pass through some coloured solutions, so that the red, u 11 " THE pathological condition known as " black tongue orange, and green rays are intensified. The image on the m appears to be due to various causes, some of which have not screen can be photographed or a kinematograph film The image can be of any can be made from it. lY yet been determined. When found in cases of glycosuria it has been ascribed to the action of parasites, particularly Dr. Duncan suggests that a megaphone desired size. ne can be fixed in the partition and project into. the operatingsaccharomyces linguae pilosas. In a recent number of Les g2Vouveaqtx Remedes it has been shown by M. L. Bizard that aroom, and thus the surgeon can talk to the visitors. Operalo in many cases this phenomenon is caused by the use of tions on such cavities of the body as the nose and rectum do not lend themselves to this method. As the visitors are re hydrogen peroxide as a mouth wash. He cites the case of a smoker who used a mouth wash daily for eight days consisthis from the and assistants the 18 completely separated surgeon dust from m the of ing of a tablespoonful of hydrogen peroxide in half a glassful contaminating operating-room by danger ie ofwarm water. A marked blackening was then found on the street is eliminated ; the distraction caused by the i, the dorsal surface of the tongue, but on ceasing to use the coming and going of visitors is also done away with ; and, air without risk the visitors can have fresh cool moreover, any ik mouth wash the colouration disappeared in a few days. I of chilling the patient. The other method for observing g The patient was in goodhealth, except that an exasmination urgeon n of the tongue showed that the lingual papillae operations is described by Dr. A. Monae Lesser, surgeon 1 :t were to the New York Red Cross Hospital. A mirror five feet hypertrophied. The same effect was produced in < three tt the case of two patients undergoing mercurial treatfeet hangs obliquely over the operating table about by seven and a half feet above- the floor. i It forms an angle of f ment by the injection of grey oil, who were in the about 75 degrees and the spectators can watch the operation n of rinsing the mouth with hydrogen peroxide. It was 1 habit from the seats, the first row of which stands about six,feet, aat first that the colour was due to the action of the ___
important
he
t,
thought
REPORT ON SANITARY MEASURES IN INDIA FOR 1906-07.
1317
hydrogen peroxide on the mercurial saliva, but hydrogen teachers are a hard-worked and ill-paid class,and pan illperoxide alone, as has been shown, may produce the same afford such charity, though they may very ..well help by effect. As hydrogen peroxide has now come into general use superintending the meals. It is gratifying to know that the as a mouthwash these observations are of great interest and Liverpool public has responded so well to the appeals of value. Apart from the blackening of the tongue which may result from too free a use of this preparation the question arises whether the general employment of antiseptic mouth washes and dentifrices is advisable in healthy persons. Where decay is known to exist there is no doubt that a moderate use of antiseptic agents tends to prevent the spread of the invading organisms. But when the mouth is in a healthy condition it would seem preferable to rely upon cleanliness rather than on antiseptics. The bacterial flora of the mouth may contain organisms that naturally tend to preserve it in a healthy condition but the continued use of antiseptics is calculated to destroy favourable as well as harmful bacteria.
THE SALARY OF MEDICAL OFFICERS. AT a meeting of the Derby education committee held on Oct. 26th the elementary education subcommittee reported that it had resolved to advertise in the medical journals for an assistant medical officer at a salary of R200 per annum. We declined to insert the advertisement in consequence of representations which had been made to us by local medical men and the British Medical Jowrnal also refused to insert it because the British Medical Association considered that the holders of whole-time appointments should have a minimum salary of
the Children’s Meals Committee as to allay anxiety for the immediate future. A pathetic instance is given of a common practice which leads the committee to touch on a very im- portant economic question in connexion with the children of the poor. "A little barefooted child, about five years of age, received her supply’ of bread ’and jam and was followed home through the rain to the cellar in which she lived. The medical officer, on entering the cellar, found two other children who attended other schools who had also arrived with their share of bread and jam, and the three of them were proceeding to divide the meal with two others who were not of school age. The mother stated that they did this when their father was out of work. Latterly he had been in hospital but was returning to work the following day. She also stated that she had had thirteen children, seven of whom had died in infancy or early childhood." Commenting upon this case the committee states that it may feel disposed to dissociate itself from any suggestion that there are less responsibilities in connexion with children below the school age than with those who are attending school." This guarded statement opens out vistas of an important municipal service of hygiene for which’ there is certainly no existing machinery. We shall awaJLt the committee’s final with interest.
report
A SPECIAL
-
THE King has granted to Mr. George Allardice MacDonald, M.B., C.M. Edin., His Majesty’s Royal licence and authority to accept and to wear the Insignia of a Knight of the Order of the Crown of Italy, conferred upon him by His Majesty the
King of Italy
in
recognition
of valuable services rendered
by
him. A TELEGRAM from the Acting Governor of the Mauritius received at the Colonial Office on Oct. 23rd states that for the week ending Oct. 22nd there were 8 cases of plague and 6 deaths from the disease.
___
THE FREE
-
FEEDING OF SCHOOL CHILDREN IN LIVERPOOL. committee appointed by the city council of
Liverpool investigate the subject of the insufficient or improper feeding of school children has issued recently an interim report, with a supplementary preliminary report of Dr. E. W. Hope, medical officer of health of Liverpool. Inquiry has been made into the state of affairs existing at 20 selected schools and the committee asks the approval of the council of the investigation of 12 others before making a final report. Having regard to the voluntary agencies at present providing meals for Liverpool school children, the committee does not feel justified in recommending that the Education (Provision of Meals) Act of 1906 should be put into operation. Dr. Hope in his report gives a summary of the conditions obtaining in the 20 schools visited, and the general trend of observation goes to show that improper, rather than inadequate, feeding accounts for the malnutrition of many children and that parental carelessness or callousness is a more frequent factor than parental poverty in cases where children come breakfastless to school. Dr. Hope is of opinion that education of the poorer classes in proper methods of feeding their children is needed badly. Some suggestions and criticisms are made concerning thei " coupon" system, which prove it to be liable to abuse. The fact that some of the teachers voluntarily supply the children’s wants is noted, and though this reflects great: credit upon their humanity we are of opinion that the system which allows it is wrong, for elementary schooll to
.
’
REPORT ON SANITARY MEASURES IN INDIA FOR 1906-07. THE Report on Sanitary Measures in India for 1906-07 embraces the data relating to the health of the European and -and the jails, and in native armies, the general addition presents us with the facts appertaining to vaccination, the various medical institutions, the lunatic asylums, It concludes with a review of the and medical schools. sanitary works that have been carried out and with some diseases. valuable remarks on the etiology’ of As regards the health of the European army, we find that the year 1906 was an unhealthy one for all classes of people in India and the rates of admission to hospital, of mortality, and of invaliding were all higher than in 1905. On an average strength of 70,272 the admissions were in the ratios of 871 per 1000 as contrasted with 834 per 1000 in 1905. As in the latter year so in the year under review, the European troops in the Rawal Pindi and Lahore divisions enjoyed the best health. The chief causes of sickness were ague, venereal diseases, and simple continued fever, the above-mentioned increase of sickness being chiefly due to a rise in the first-mentioned class of diseases, ague causing an admission of 176 as ’contrasted with 111 per 1000 in 1905. 40 per cent. of the total sickness was due to the above three diseases. The chief causes of mortality were enteric fever and hepatic abscess, 31 per cent. of the total deaths being due to enteric fever and 15 per cent. to hepatic abscess. The number of men sent home for syphilis rose from 75 in 1905 to 120 in 1906. With respect to malarial fevers, these were -most rife in the Peshawar and Mhow divisions*-
population,
certain