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THE "STICK" " LEG-REST.
334 The Balkan Cockpit, by W. H. CRAWFURD PRICE (London : T. Werner Laurie. Pp. 369. Price 10s. 6d. net), is a pleasantly written chronicle of the war of 1912-13 between the Balkan Alliance (Bulgaria, Greece, Montenegro, Serbia) and Turkey, together with the ensuing war between the Allies-namely, Bulgaria against the other three. The downfall of Turkey in the first instance and the defeat ot Bulgaria in the second are still bearing fruit in the presenf general European conflict. From a medical point of view the most interesting portion of the book is the account which Mr. Price gives of the admirable paper organisation of the Turkish military medical force and its hopeless breakdown in action. Further, although the Turkish Red Crescent organisation worked well the authorities thereof refused to lend a helping hand to their military brethren, whose hospitals were lamentably understaffed and were without food, medical comforts, bandages, or medicines. Miss ETHEL C. HARGROVE went to Portugal on the invitation of the Sociedad Propaganda de Portugal as a member of the British International Association of Journalists, and her book, Progressive Portugal (London : T. Werner Laurie. 1914. Pp. 276. Price 6s. net), is a brightly written, if superficial, account of what she saw and did there. Portugal, which has been Britain’s ally from the time of the Crusades, is a country with a most interesting history. Its climate, architecture, and vegetation are all fascinating and but little known to the majority of British travellers. The recent change of government has apparently been of an awakening nature, and Miss Hargrove points out that the Republic took early steps to reorganise the public institutions, especially the hospitals, which are now being modernised all round. The book is supplied with a map and with numerous illustrations, but we have also noticed an unduly large number of
misprints. Of books for students of the resume class there are two kinds-those that should be unhesitatingly condemned for inherent defects and those that are not dangerous unless improperly used, and may even serve a useful purpose if used merely to systematise knowledge. To the latter class belongs Aids to Pathology, by Dr. HARRY CAMPBELL (London: Bailliere, Tindall, and Cox. 1915. Pp. 228. Price 3s. net; in cloth 3s. 6d. net). The third edition of this book contains much additional matter on immunity. A chapter on diseases of the heart has been added, and there is considerable amplification in other directions. JOURNALS. British Dental Journal.-The first January issue of this journal contains a paper by Mr. W. Hern on Oral Hygiene and Prophylaxis. After recounting the various conditions giving rise to gingivitis Mr. Hern discusses the most efficient He means of keeping the mouth in a state of cleanliness. seems to think that reliance can be placed upon the use of the tooth-brush, and suggests patterns of brushes to be used He discusses as well as the methods for brushing the teeth. briefly the value of tooth powders, and incidentally does not place much reliance upon the use of antiseptic washes. The discussion on the paper is printed, and many of the speakers obviously thought that the question of oral hygiene and prophylaxis should be approached from rather a broader point of view than that suggested by Mr. Hern-viz., on the broad lines of dietetics and efficient mastication.-Mr. W. H. Gilmour reports an interesting case of fractured teeth from a bullet, the bullet having indentations on both upper and lower surfaces.-Mr. Arthur Underwood contributes a very interesting letter on the question of the scarcity of dental practitioners, and thinks that the cause rests in the unsatisfactory condition of dental legislation. -The issue for Jan. 15th contains an article by F. W. Broderick on The Relation between Calcium Metabolism and Dental Diseases. The author discusses the manner in which calcium is found in the body, and describes how the calcium balance is maintained. He considers that caries is the result of a deficient calcium output, which reduces the alkalinity of the saliva, while he regards periodontal disease as due to calcium saturation, the excess salts being deposited around the necks of the teeth and, acting as mechanical irritants, press the gum’s margins away and lay them open to infection. There is a reprint of a lecture by Mr. Howard Mummery on Calcification ; also two letters dealing with the question of shortage of qualified dentists.
New Inventions. VENTILATED ELASTIC STOCKINGS FOR VARICOSE VEINS. THE medical profession will, I think, be glad to have their attention called to a ventilated stocking which I have been employing in cases of varicose veins associated with eczema. In these cases patients often complain bitterly of the almost intolerable itching provoked by the heat inseparable from the use of stockings of solid elastic. The substitution of perforated bandages is but a partial remedy for the drawback, the necessary overlapping of the folds of the bandage neutralising to some extent the effect of the perforation. The intense irritation suffered in an exceptionally severe case of mine prompted me to consult Messrs. Maw, Son, and Sons as to the practicability of constructing aa elastic stocking on the principle of cellular clothing. The attempt was made, and made successfully, for I have tried the stocking in a number of appropriate cases and have found that it admirably fulfils the desired purpose of affording support without heat. The stocking, composed of finely meshed silk and elastic, supports the distended veins not less effectually than does a stocking of solid elastic, while permitting free ventilation. For obvious reasons, in cases in which there is discharge it must not be applied until the exudation has ceased. Where economy is an important consideration cotton can be substituted for silk, and, whether made of the one material or of the other, the stocking can be employed with advantage in cases of uncomplicated varicose veins as well as in those in which there is associated
recently
eczema.
Harley-street, W.
MALCOLM
MORRIS, F.R.C.S. Edin.
THE "STICK" " LEG-REST. THIS ingenious little invention consists of a very stout stick split in halves, the halves being joined by bands of webbing, as shown in the picture. The halves, closed and secured by a thick rubber cap on each end, make a stout walking-stick. When the halves are separated the stick becomes a leg-rest of a very comfortable sort in any position; each half is converted into an adjustable splint, the leg
resting comfortably on the webbing. The length of the stick is 33 inches, so that as a rest the apparatus jjust fits across the seat of a railway train. The removing the caps to open up the stick is simple, and the caps are very substantial, so that they may not be worn out by use as The price of the stick leg-rest is 4s. 6d., ferrules. and all communications should be made to Mr. George
Marshall, Seymour Works, Seymour-place, Bryanston-sqaare, London, W.
BELGIAN REFUGEES UNDER THE INSURANCE ACTS. -A circular of the Local Government Board addressed t. local refugee committees has given explanations as to the position of Belgian refugees towards insurance when they obtain employment in this country. Employers have to pay the same contributions whether they employ their countrymen or Belgians. The refugee in certain circumstances may claim exemption, as may the British subject. The Belgian, if insured, must obtain a card and either join an Approved Society or remain outside, as he may prefer. His benefits from the society will be such as it is in a position to give in return for his contributions. He will, in fact, be in the position of an ordinary foreigner. By joining an Approved Society he will usually become entitled to medical and sanatorium benefits at once, but will not be in the same position as a British subject with regard to other benefits.
THE INVALID AND THE FIGHTING LINE.
At the meeting of the Académie de Medecine of Paris M. Ch. FIESSINGER reported some truly remarkable cases in which the subjects of other forms of heart disease showed as much staying power as those suffering from aortic insufficiency. The declaration of war caused, said M. FIESSINGER, the national energies to manifest themselves in an " elan incomparable," and under the stimulus LONDON: SATURDAY, FEBRUARY 13, 1915. failing organs worked better for a time. Those who Line. had good reason to remain at home ignored medical The Invalid and the advice and went to the frontier like the others. WE called attention recently to a striking mani- M. FIESSINGER referred to 12 cases, in 6 of which festation of patriotism shown by subjects of aortic the patients were retired officers. The remaining & insufficiency who, while quite aware of the nature of were officers in the army, who would no longer their disability, had nevertheless been found in the incur the shame of being considered " infirmes" fighting line of the French army. A recent report and followed their comrades. The diseases to the Académie de Medecine has shown that this present in these 12 cases were as follows ; display of heroism has been widespread, incidentally in 5 affections of the myocardium (myocarditis or proving that compensation in quite serious cardiac renal heart), paroxysmal tachycardia in 1, and vallesions is for a time often very complete. The vular disease in 6 (3 cases of mitral regurgitation, however, that may arise from the success- 1 of mitral obstruction, and 2 of aortic insuffiful attempt upon the part of a physically damaged ciency). The treatment usually followed was man to enrol himself in the army as sound may be administration of 1/lOth of a milligramme of crystalso serious that while we admire we regret such line digitalin for two or three consecutive days as a exploits. And the French army is not singular prophylactic when the heart was not failing, and the in providing examples. The experience of the same dose for 10 consecutive days with intervals of medical men who passed recruits for enlistment four days when there were signs of myocardial in our rapidly created army was, as is known, failure. As might have been foreseen, the subjects satisfactory on the whole : it entirely contradicted of valvular disease stood the campaign better than the more gloomy prognostications of the untiring those who had myocardial disease. An infantry prophets of our physical decay as a nation, while captain and two lieutenants who had well-comthe summary inspection led to the immediate pensated mitral disease were able with the aid of remedy in many cases of minor evils which in all digitalin to endure the fatigue of the life of probability would have otherwise gone unattended, combat. An officer, aged 23 years, who had inasmuch as their subjects had finished their retired from the army in consequence of aortic school careers before the national system of insufficiency, rejoined and took part in the battle inspection was in effective order. The good of the Marne, but forgetting to take his digitalis his health now maintained in our army is a proof heart dilated. He rested for a fortnight and then that in physique and stamina there has not been returned, but was discharged in spite of his the widespread deterioration which in many protestations. An officer, aged 26 years, who had magazine articles we were asked to face ; while retired from the service in consequence of aortic on the other hand the capacity shown by masses of insufficiency, re-engaged as an aviator. In the men drawn from every class, varying in age by middle of August he fell with his machine from a 20 years, and in many cases not distinguished by height of 20 metres. His shoulder was dislocated external signs of rude health or muscular vigour, and he was covered with bruises. He came to to endure the shocks of actual war as well as the M. FIESSINGER for examination of his heart. He strenuous labour of military training, has been sur- was doing well, and he soon resumed aerial prising. There has, of course, been from time to time work. A major in the medical corps suffersickness in different camps, but by treatment and ing from mitral obstruction remained alone on prevention, by the cooperation of the medical and the field with more than 700 wounded after the sanitary branches with military chiefs who under disaster in Lorraine to the 15th Corps. He stood the importance of hygiene, the health of oui was taken prisoner and afterwards exchanged troops has been conserved in a wonderfu: for a German army surgeon taken prisoner by the manner. But’ undoubtedly a certain numbe] French. He rejoined his corps and passed many of unfit men were accepted. The work of thE ; days and nights at the front until increasing recruiting medical officers in the first dayt3dyspncea vanquished him. To M. FIESSINGER’s advice of stress was done at full speed, and we have ) to take a fortnight’s rest he replied that it was all heard of individual cases of recruits whose impossible. He kept his bed for 48 hours and then disabilities for a military life were manifestec1 rejoined. Two officers-one an "intendant- général" very quickly. And it was quite well known that in the Army Service Corps, on whom depended the enrolment of some of these men was not due the supplies of food of 350,000, the other a major much to the hurry of the recruiting procedure as t, in the veterinary service, who slept on straw for that very spirit of heroism which has been sseveral weeks at a time, treating men more often markedly displayed by cardiac subjects in France. than horses, and giving numerous injections of
THE LANCET. Fighting
situation,
,
335
.
,
,
misprints. Of books for students of the resume class there are two kinds-those that should be unhesitatingly condemned for inherent defects and those that are not dangerous unless improperly used, and may even serve a useful purpose if used merely to systematise knowledge. To the latter class belongs Aids to Pathology, by Dr. HARRY CAMPBELL (London: Bailliere, Tindall, and Cox. 1915. Pp. 228. Price 3s. net; in cloth 3s. 6d. net). The third edition of this book contains much additional matter on immunity. A chapter on diseases of the heart has been added, and there is considerable amplification in other directions. JOURNALS. British Dental Journal.-The first January issue of this journal contains a paper by Mr. W. Hern on Oral Hygiene and Prophylaxis. After recounting the various conditions giving rise to gingivitis Mr. Hern discusses the most efficient He means of keeping the mouth in a state of cleanliness. seems to think that reliance can be placed upon the use of the tooth-brush, and suggests patterns of brushes to be used He discusses as well as the methods for brushing the teeth. briefly the value of tooth powders, and incidentally does not place much reliance upon the use of antiseptic washes. The discussion on the paper is printed, and many of the speakers obviously thought that the question of oral hygiene and prophylaxis should be approached from rather a broader point of view than that suggested by Mr. Hern-viz., on the broad lines of dietetics and efficient mastication.-Mr. W. H. Gilmour reports an interesting case of fractured teeth from a bullet, the bullet having indentations on both upper and lower surfaces.-Mr. Arthur Underwood contributes a very interesting letter on the question of the scarcity of dental practitioners, and thinks that the cause rests in the unsatisfactory condition of dental legislation. -The issue for Jan. 15th contains an article by F. W. Broderick on The Relation between Calcium Metabolism and Dental Diseases. The author discusses the manner in which calcium is found in the body, and describes how the calcium balance is maintained. He considers that caries is the result of a deficient calcium output, which reduces the alkalinity of the saliva, while he regards periodontal disease as due to calcium saturation, the excess salts being deposited around the necks of the teeth and, acting as mechanical irritants, press the gum’s margins away and lay them open to infection. There is a reprint of a lecture by Mr. Howard Mummery on Calcification ; also two letters dealing with the question of shortage of qualified dentists.
New Inventions. VENTILATED ELASTIC STOCKINGS FOR VARICOSE VEINS. THE medical profession will, I think, be glad to have their attention called to a ventilated stocking which I have been employing in cases of varicose veins associated with eczema. In these cases patients often complain bitterly of the almost intolerable itching provoked by the heat inseparable from the use of stockings of solid elastic. The substitution of perforated bandages is but a partial remedy for the drawback, the necessary overlapping of the folds of the bandage neutralising to some extent the effect of the perforation. The intense irritation suffered in an exceptionally severe case of mine prompted me to consult Messrs. Maw, Son, and Sons as to the practicability of constructing aa elastic stocking on the principle of cellular clothing. The attempt was made, and made successfully, for I have tried the stocking in a number of appropriate cases and have found that it admirably fulfils the desired purpose of affording support without heat. The stocking, composed of finely meshed silk and elastic, supports the distended veins not less effectually than does a stocking of solid elastic, while permitting free ventilation. For obvious reasons, in cases in which there is discharge it must not be applied until the exudation has ceased. Where economy is an important consideration cotton can be substituted for silk, and, whether made of the one material or of the other, the stocking can be employed with advantage in cases of uncomplicated varicose veins as well as in those in which there is associated
recently
eczema.
Harley-street, W.
MALCOLM
MORRIS, F.R.C.S. Edin.
THE "STICK" " LEG-REST. THIS ingenious little invention consists of a very stout stick split in halves, the halves being joined by bands of webbing, as shown in the picture. The halves, closed and secured by a thick rubber cap on each end, make a stout walking-stick. When the halves are separated the stick becomes a leg-rest of a very comfortable sort in any position; each half is converted into an adjustable splint, the leg
resting comfortably on the webbing. The length of the stick is 33 inches, so that as a rest the apparatus jjust fits across the seat of a railway train. The removing the caps to open up the stick is simple, and the caps are very substantial, so that they may not be worn out by use as The price of the stick leg-rest is 4s. 6d., ferrules. and all communications should be made to Mr. George
Marshall, Seymour Works, Seymour-place, Bryanston-sqaare, London, W.
BELGIAN REFUGEES UNDER THE INSURANCE ACTS. -A circular of the Local Government Board addressed t. local refugee committees has given explanations as to the position of Belgian refugees towards insurance when they obtain employment in this country. Employers have to pay the same contributions whether they employ their countrymen or Belgians. The refugee in certain circumstances may claim exemption, as may the British subject. The Belgian, if insured, must obtain a card and either join an Approved Society or remain outside, as he may prefer. His benefits from the society will be such as it is in a position to give in return for his contributions. He will, in fact, be in the position of an ordinary foreigner. By joining an Approved Society he will usually become entitled to medical and sanatorium benefits at once, but will not be in the same position as a British subject with regard to other benefits.
THE INVALID AND THE FIGHTING LINE.
At the meeting of the Académie de Medecine of Paris M. Ch. FIESSINGER reported some truly remarkable cases in which the subjects of other forms of heart disease showed as much staying power as those suffering from aortic insufficiency. The declaration of war caused, said M. FIESSINGER, the national energies to manifest themselves in an " elan incomparable," and under the stimulus LONDON: SATURDAY, FEBRUARY 13, 1915. failing organs worked better for a time. Those who Line. had good reason to remain at home ignored medical The Invalid and the advice and went to the frontier like the others. WE called attention recently to a striking mani- M. FIESSINGER referred to 12 cases, in 6 of which festation of patriotism shown by subjects of aortic the patients were retired officers. The remaining & insufficiency who, while quite aware of the nature of were officers in the army, who would no longer their disability, had nevertheless been found in the incur the shame of being considered " infirmes" fighting line of the French army. A recent report and followed their comrades. The diseases to the Académie de Medecine has shown that this present in these 12 cases were as follows ; display of heroism has been widespread, incidentally in 5 affections of the myocardium (myocarditis or proving that compensation in quite serious cardiac renal heart), paroxysmal tachycardia in 1, and vallesions is for a time often very complete. The vular disease in 6 (3 cases of mitral regurgitation, however, that may arise from the success- 1 of mitral obstruction, and 2 of aortic insuffiful attempt upon the part of a physically damaged ciency). The treatment usually followed was man to enrol himself in the army as sound may be administration of 1/lOth of a milligramme of crystalso serious that while we admire we regret such line digitalin for two or three consecutive days as a exploits. And the French army is not singular prophylactic when the heart was not failing, and the in providing examples. The experience of the same dose for 10 consecutive days with intervals of medical men who passed recruits for enlistment four days when there were signs of myocardial in our rapidly created army was, as is known, failure. As might have been foreseen, the subjects satisfactory on the whole : it entirely contradicted of valvular disease stood the campaign better than the more gloomy prognostications of the untiring those who had myocardial disease. An infantry prophets of our physical decay as a nation, while captain and two lieutenants who had well-comthe summary inspection led to the immediate pensated mitral disease were able with the aid of remedy in many cases of minor evils which in all digitalin to endure the fatigue of the life of probability would have otherwise gone unattended, combat. An officer, aged 23 years, who had inasmuch as their subjects had finished their retired from the army in consequence of aortic school careers before the national system of insufficiency, rejoined and took part in the battle inspection was in effective order. The good of the Marne, but forgetting to take his digitalis his health now maintained in our army is a proof heart dilated. He rested for a fortnight and then that in physique and stamina there has not been returned, but was discharged in spite of his the widespread deterioration which in many protestations. An officer, aged 26 years, who had magazine articles we were asked to face ; while retired from the service in consequence of aortic on the other hand the capacity shown by masses of insufficiency, re-engaged as an aviator. In the men drawn from every class, varying in age by middle of August he fell with his machine from a 20 years, and in many cases not distinguished by height of 20 metres. His shoulder was dislocated external signs of rude health or muscular vigour, and he was covered with bruises. He came to to endure the shocks of actual war as well as the M. FIESSINGER for examination of his heart. He strenuous labour of military training, has been sur- was doing well, and he soon resumed aerial prising. There has, of course, been from time to time work. A major in the medical corps suffersickness in different camps, but by treatment and ing from mitral obstruction remained alone on prevention, by the cooperation of the medical and the field with more than 700 wounded after the sanitary branches with military chiefs who under disaster in Lorraine to the 15th Corps. He stood the importance of hygiene, the health of oui was taken prisoner and afterwards exchanged troops has been conserved in a wonderfu: for a German army surgeon taken prisoner by the manner. But’ undoubtedly a certain numbe] French. He rejoined his corps and passed many of unfit men were accepted. The work of thE ; days and nights at the front until increasing recruiting medical officers in the first dayt3dyspncea vanquished him. To M. FIESSINGER’s advice of stress was done at full speed, and we have ) to take a fortnight’s rest he replied that it was all heard of individual cases of recruits whose impossible. He kept his bed for 48 hours and then disabilities for a military life were manifestec1 rejoined. Two officers-one an "intendant- général" very quickly. And it was quite well known that in the Army Service Corps, on whom depended the enrolment of some of these men was not due the supplies of food of 350,000, the other a major much to the hurry of the recruiting procedure as t, in the veterinary service, who slept on straw for that very spirit of heroism which has been sseveral weeks at a time, treating men more often markedly displayed by cardiac subjects in France. than horses, and giving numerous injections of
THE LANCET. Fighting
situation,
,
335
.
,
,