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THE STATE REGULATION OF PROSTITUTION.
1223 one morning and badly sprained his ankle, the being slightly inverted when I saw him the same afternoon. Massage, chiefly squeezing, and movement were the treatment employed. In two days he was walking with a perceptible limp and on the fourth day the limp had disappeared although the parts were a little swollen and
early
foot
the attention of its teachers to the very suggestive naturesuch a collection of I am, Sirs, yours faithfully. faithfullv. W. HEPTINSTALL MILLAR. Streatham-hill, S.W., Oct. 19th, 1902.
I of
I symptoms? am, Sirs,
THE PHYSICAL AND MEDICAL EXAMINATION OF CANDIDATES FOR COMMISSIONS IN THE ARMY.
there was some discolouration left. The other case was one of subglenoid dislocation of the humerus. When the man called on me he was in a faintish condition and as I considered that his muscles would be partially relaxed I immediately tried to reduce the dislocation by rightangle traction and in this I was successful, the bone going in with a grating snap. He immediately experienced great relief. He left me without bandage or sling with instructions to move the joint and not to allow it to get stiff. The patient, who is an engineer, went to his work next morning at 6 o’clock-nine hours after reduction-and worked at his trade all day. When using the hammer he felt some pain in the joint. I have just seen him now-45 hours since reduction-and he can move his joint freely in every direction and says that he feels no pain. He has not been This treatment is apparently a great one hour off his work. improvement on the old treatment when the joint was rendered immoveable for several weeks and the joint was left in a stiff and weakened state. I am Sirs, yours faithfully, WILLIAM DOIG, M. D. Edin. Galashiels, Oct. 17the,1902.
To the Editors of THE LANCET.
SIRS,-Mr. Kenneth Campbell wishes to know the meaning of Vision D. 6 at six metres," which he calls a "crypticsign " and allusion to which, he states, is not to be found in "
=
the text-books.
If Mr.
Campbell
can
find any
ophthalmic
text-book, in any language, in which no allusion is made to Snellen’s test-types I shall be much surprised. "Vision D. 6 at six metres" means, of course, that the sixmetre type is read at six metres-i. e., vision 6/6, or normal. The fractional expression of vision (, 6/12, &c.), though now almost universally employed, might possibly not be understood by every practitioner ; for this reason the War Office regulations amplify it, in the case instanced by Mr. Campbell, =
=
I
THE STATE REGULATION OF PROSTI-
to "D. 6 at six metres." If Mr. Campbell’s letter is meant to be taken seriously it is evident that the War Office elucidation of is by no means uncalled for. I am, Sirs, yours faithfully, T A THE WRITER WRITER OF THE ARTICLE. Oct. 27th, 1902. THE
OF
mrrrn
RTICLE .
A NEW SYSTEM OF TREATMENT PULMONARY PHTHISIS.
TUTION. To the Editors of THE LANCET. member of the recent International Congress SIRS,-As for the Prophylaxis of Syphilis and Venereal Diseases at Brussels and of the one held there three years ago, permit me to draw attention to one point which I think has escaped the writer of the leading article on the conference in THE LANCET of Oct. 18th, p. 1063. He alludes to the necessity of careful and efficient control of the regulated houses, which, he says, will otherwise become virulent sources of infection, but he does not recognise the other horn of the dilemma, which is that wherever the medical control assumes a certain strictness, with greater frequency of inspection, &c., the houses are actually dying out and giving place to houses of accommodation where no inspection is carried out. This question was thrashed out in great detail at the first conference. Strange to say, the houses seem to retain their popularity chiefly where (as in the case of the lower-class houses in Russia) they are conducted with flagrant carelessness and are, as your leading article suggests, virulent I am inclined to attribute this to sources of infection. popular ignorance which does not recognise the danger of houses of this kind. I may add that the general testimony, and especially that of the most advanced experts, was very strong as to the misleading nature of certificates of health given to these A certificate of health is impossible in the case of women. syphilis as the disease is contagious in its latent periods, when no sign of it can be detected ; and on this ground Professor Neisser, Professor Finger, Professor Jadassohn, and others urged that an explanation should be printed on the face of the certificate itself to the effect that it only guaranteed the absence of visible disease. I am, Sirs, yours faithfully, B. LEPPINGTON. Cubbington, Oct. 21st, 1902.
IN
the Editors of THE LANCET. THE LANCET of Oct. 18th, p. 1047, certain figures and "cases"are given as results (obtained by Mr. Duncan Turner at Mount Macedon, Australia) of rubbing cod oil with creasote into the body of tuberculous subjects. If from half to one ounce be rubbed in daily for a year some 24 pounds of oil at the most will beused and possibly absorbed. The patients are in a sanatorium and treated therefore, presumably, in other respects. with generous diet, rest, exercise, and abundant fresh air. On these, the ordinary sanatorium lines, 24 patients gain each in the year from four to five stones, bringing their total bodyweight to, say, 12 to 14 stones-a very respectable average fora healthy person. Other 24 patients with cod oil massage in. addition put on from 14 to 15 stones, bringing their individual weights to a total of from 22 to 24 stones-a still more respectable, if not awful, figure. Even in these days of "remarkableresults " from many various I I methods " these latter figures, seeing that the patients survived the treatment as well as the disease, seem, up to date, the most remarkable. Mr.. Turner would seem to have indeed struck oil " and mightTo
a
SIRS,-In
one thinks, ’’ stop boring." Any stray bacillus still in the field must feel itself " trembling in the balance" and the accommodation per head, or rather per body, at Mount Macedon must be getting small by degrees and beautifully less," as surely, if slowly, the cubic solid contents wax fatter-perhaps after a year a waning process sets in ? Unless the fact of the figures being placed in a footnoteindicates your own doubts of their exactness the credit of our old friend cod oil which was first "taken," later"injected"with creasote also, and is now "massaged"(a "new"method this is styled) into the tuberculous body, emerges from a partial eclipse. Ought not all this, if true, to stimulate still further inquiry into the vexed question of its chemical composition and "specific"" or mere "general" "’ (nutritive) physiological action ? Does it kill the bacillus in Can it as a solvent. pure culture as urea is stated to do ? of fat act on the bacillus in situ7 Derived as it is from the liver, where in man urea is formed, has it any connexion with urea or its metabolites ? Or does it leave the bacillus severely alone and simply fortify the phagocyte? Such. questions only show how interesting the subject is. I am, Sirs, yours faithfully, ADMIRANS. Oct. 21st, 1902.
almost,
HOW DISEASE IS SPREAD.
To the Editors of THE LANCET. SIRS,-The spread of infectious diseases by attendance at ’, school is a matter of such moment that possibly the following I, facts may be of some interest as showing one of the causes I at work. Yesterday I was called to a case of scarlet fever and was informed by the mother that the patient, aged nine I years, attends the local board school. On the day previously I, to my seeing her the child was suffering during morning I school from vomiting, headache, and sore-throat, and was I, NOTES FROM INDIA. unable to do any work. Nevertheless, the teacher strongly (FROM OUR SPECIAL CORRESPONDENT.) urged her to attend again in the afternoon in order to qualify for an attendance medal, and the child did so attend, quite unable to do any work, but reting her head upon the desk The Increasing Plague Mortality.-The New Army Bearer Corps.-The Use of Poisons in India. and, doubtless, infecting her companions. With scarlet fever THE weekly mortality from plague has now to be recorded again prevalent could not the London School Board draw ,
I
,
early
foot
the attention of its teachers to the very suggestive naturesuch a collection of I am, Sirs, yours faithfully. faithfullv. W. HEPTINSTALL MILLAR. Streatham-hill, S.W., Oct. 19th, 1902.
I of
I symptoms? am, Sirs,
THE PHYSICAL AND MEDICAL EXAMINATION OF CANDIDATES FOR COMMISSIONS IN THE ARMY.
there was some discolouration left. The other case was one of subglenoid dislocation of the humerus. When the man called on me he was in a faintish condition and as I considered that his muscles would be partially relaxed I immediately tried to reduce the dislocation by rightangle traction and in this I was successful, the bone going in with a grating snap. He immediately experienced great relief. He left me without bandage or sling with instructions to move the joint and not to allow it to get stiff. The patient, who is an engineer, went to his work next morning at 6 o’clock-nine hours after reduction-and worked at his trade all day. When using the hammer he felt some pain in the joint. I have just seen him now-45 hours since reduction-and he can move his joint freely in every direction and says that he feels no pain. He has not been This treatment is apparently a great one hour off his work. improvement on the old treatment when the joint was rendered immoveable for several weeks and the joint was left in a stiff and weakened state. I am Sirs, yours faithfully, WILLIAM DOIG, M. D. Edin. Galashiels, Oct. 17the,1902.
To the Editors of THE LANCET.
SIRS,-Mr. Kenneth Campbell wishes to know the meaning of Vision D. 6 at six metres," which he calls a "crypticsign " and allusion to which, he states, is not to be found in "
=
the text-books.
If Mr.
Campbell
can
find any
ophthalmic
text-book, in any language, in which no allusion is made to Snellen’s test-types I shall be much surprised. "Vision D. 6 at six metres" means, of course, that the sixmetre type is read at six metres-i. e., vision 6/6, or normal. The fractional expression of vision (, 6/12, &c.), though now almost universally employed, might possibly not be understood by every practitioner ; for this reason the War Office regulations amplify it, in the case instanced by Mr. Campbell, =
=
I
THE STATE REGULATION OF PROSTI-
to "D. 6 at six metres." If Mr. Campbell’s letter is meant to be taken seriously it is evident that the War Office elucidation of is by no means uncalled for. I am, Sirs, yours faithfully, T A THE WRITER WRITER OF THE ARTICLE. Oct. 27th, 1902. THE
OF
mrrrn
RTICLE .
A NEW SYSTEM OF TREATMENT PULMONARY PHTHISIS.
TUTION. To the Editors of THE LANCET. member of the recent International Congress SIRS,-As for the Prophylaxis of Syphilis and Venereal Diseases at Brussels and of the one held there three years ago, permit me to draw attention to one point which I think has escaped the writer of the leading article on the conference in THE LANCET of Oct. 18th, p. 1063. He alludes to the necessity of careful and efficient control of the regulated houses, which, he says, will otherwise become virulent sources of infection, but he does not recognise the other horn of the dilemma, which is that wherever the medical control assumes a certain strictness, with greater frequency of inspection, &c., the houses are actually dying out and giving place to houses of accommodation where no inspection is carried out. This question was thrashed out in great detail at the first conference. Strange to say, the houses seem to retain their popularity chiefly where (as in the case of the lower-class houses in Russia) they are conducted with flagrant carelessness and are, as your leading article suggests, virulent I am inclined to attribute this to sources of infection. popular ignorance which does not recognise the danger of houses of this kind. I may add that the general testimony, and especially that of the most advanced experts, was very strong as to the misleading nature of certificates of health given to these A certificate of health is impossible in the case of women. syphilis as the disease is contagious in its latent periods, when no sign of it can be detected ; and on this ground Professor Neisser, Professor Finger, Professor Jadassohn, and others urged that an explanation should be printed on the face of the certificate itself to the effect that it only guaranteed the absence of visible disease. I am, Sirs, yours faithfully, B. LEPPINGTON. Cubbington, Oct. 21st, 1902.
IN
the Editors of THE LANCET. THE LANCET of Oct. 18th, p. 1047, certain figures and "cases"are given as results (obtained by Mr. Duncan Turner at Mount Macedon, Australia) of rubbing cod oil with creasote into the body of tuberculous subjects. If from half to one ounce be rubbed in daily for a year some 24 pounds of oil at the most will beused and possibly absorbed. The patients are in a sanatorium and treated therefore, presumably, in other respects. with generous diet, rest, exercise, and abundant fresh air. On these, the ordinary sanatorium lines, 24 patients gain each in the year from four to five stones, bringing their total bodyweight to, say, 12 to 14 stones-a very respectable average fora healthy person. Other 24 patients with cod oil massage in. addition put on from 14 to 15 stones, bringing their individual weights to a total of from 22 to 24 stones-a still more respectable, if not awful, figure. Even in these days of "remarkableresults " from many various I I methods " these latter figures, seeing that the patients survived the treatment as well as the disease, seem, up to date, the most remarkable. Mr.. Turner would seem to have indeed struck oil " and mightTo
a
SIRS,-In
one thinks, ’’ stop boring." Any stray bacillus still in the field must feel itself " trembling in the balance" and the accommodation per head, or rather per body, at Mount Macedon must be getting small by degrees and beautifully less," as surely, if slowly, the cubic solid contents wax fatter-perhaps after a year a waning process sets in ? Unless the fact of the figures being placed in a footnoteindicates your own doubts of their exactness the credit of our old friend cod oil which was first "taken," later"injected"with creasote also, and is now "massaged"(a "new"method this is styled) into the tuberculous body, emerges from a partial eclipse. Ought not all this, if true, to stimulate still further inquiry into the vexed question of its chemical composition and "specific"" or mere "general" "’ (nutritive) physiological action ? Does it kill the bacillus in Can it as a solvent. pure culture as urea is stated to do ? of fat act on the bacillus in situ7 Derived as it is from the liver, where in man urea is formed, has it any connexion with urea or its metabolites ? Or does it leave the bacillus severely alone and simply fortify the phagocyte? Such. questions only show how interesting the subject is. I am, Sirs, yours faithfully, ADMIRANS. Oct. 21st, 1902.
almost,
HOW DISEASE IS SPREAD.
To the Editors of THE LANCET. SIRS,-The spread of infectious diseases by attendance at ’, school is a matter of such moment that possibly the following I, facts may be of some interest as showing one of the causes I at work. Yesterday I was called to a case of scarlet fever and was informed by the mother that the patient, aged nine I years, attends the local board school. On the day previously I, to my seeing her the child was suffering during morning I school from vomiting, headache, and sore-throat, and was I, NOTES FROM INDIA. unable to do any work. Nevertheless, the teacher strongly (FROM OUR SPECIAL CORRESPONDENT.) urged her to attend again in the afternoon in order to qualify for an attendance medal, and the child did so attend, quite unable to do any work, but reting her head upon the desk The Increasing Plague Mortality.-The New Army Bearer Corps.-The Use of Poisons in India. and, doubtless, infecting her companions. With scarlet fever THE weekly mortality from plague has now to be recorded again prevalent could not the London School Board draw ,
I
,