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THE THERAPEUTIC VALUE OF CACTUS GRANDIFLORUS.
753 The average annual rate of natural increase of population, by excess of births over deaths, which was equal to 14’6 per 1000 in 1876-80, showed, however, a steady decline in the four following five-year periods to 11-66 in 1896-1900 ; but it recovered to 12’11 per 1000 in 1901-05, during which period the decline in the death-rate was proportionately greater than the decline in the birth-rate. The actual increase of the English population is, of course, influenced by the balance between immigration and emigration as well as by the balance between births and deaths ; but the effect of this factor was so slight during the ten years 1891-1901 that the difference between the number of the population enumerated in 1901 and the estimate based solely on the excess of births over deaths in the ten years was only equal to 2-3 per 1000. Failing complete record of immigration and emigration, the estimate of the English populaticn in the middle of 1905, adopted by the Registrar-General in his last annual report, is based on the assumption that the rate of increase that prevailed in the last intercensal period has since been maintained. The result of this estimate assumes that the loss to the English population between the date of the last census and the middle of 1905 by excess of emigration over immigration was
105,442,
or
hairs, and scurf
would be directed, for the most part up an exhaust ventilating shaft situated immediately opposite the head of the person who is under operation. Such a measure, too, would secure a supply of fresh air in general in the
room.
nearly 25,000 per annum.
HAIR-BRUSHING
BY
MACHINERY.
THE machine brush, especially if it be driven by electrical means, is one of the proud acquisitions of the modern barber. It is commonly looked upon as a sign that the business of the hairdresser is conducted upon principles abreast of the times. A machine brush electrically propelled, together with some attempt at an aseptic or antiseptic practice in connexion with hair-cutting, shaving, and shampooing, serves to bring the proprietor of such an establishment into some sort of scientific reputation from the point of view of his patrons. Cleanliness is almost as great a sine quâ non in the conduct of the affairs of a barber’s shop as in that of the operating theatre, and therefore the man most deserves success who most endeavours to secure as far as possible the scientific cleanliness of his person and of the instruments used in his business. There is not wanting evidence that the barber’s shop has been the means of spreading disease and it is not difficult to suggest the conditions under which such a distribution of pathogenic materials mav take place. The sterilisation of razors, combs, blushes, and the hands of the operator may, however, avail much but it is conceivable that the good which this may do may be undone by the revolving brush scattering dust, scurf and so forth from the dry scalp. Thus all the care taken to insure antiseptic conditions may be negatived by the whirlwind of particulate matters raised by the machine brush. It should be remembered that the function of the machine brush is not to dress or to arrange the hair but merely to drive out dust and
The hand brush, of course, plays quite it is used to adjust the hair and very frepart; quently during this process the hair is wetted or oil is applied to it. It is a pity that the machine brush presents this objectionable feature, for apart from its usefulness as a remover of dust and hair clippings it undoubtedly exercises a healthy stimulus to the scalp and may even promote, when reasonably used, the nutrition of the hair. For these reasons the apparatus finds a wide circle of patrons. To preach its abolition may be justifiable on strictly hygienic grounds, but that would mean the banishment of a really useful, if not indispensable, instrument connected with the dressing and treatment of the hair. Its application would be rendered futile by moistening the hair and so the suggestion remains that the objection might be met, perhaps, by conducting the machine-brushing operation in such a manner that dust,
hair-cuttings. another
-
EPIDEMIC
CEREBRO-SPINAL
FEVER.
DURING the last six or seven days epidemic cerebro-spinal fever has made its appearance in several fresh localities. In London on March 7th an inquest was held on a girl, aged five months, who had died at Kensal Rise. The medical evidence was to the effect that death was due to cerebro" spinal meningitis and the jury returned a verdict accordingly. The medical officer of health of Poplar reported on March 7th that a fatal case had occurred on the Isle of Dogs, Cases are also said to have occurred at Wealdstone, near
Harrow, Middlesex, at Langley Green, near Oldbury, Worcestershire, at the village of Elson in Shropshire, and at Warrington. An alleged case in St. Helens, near
Liverpool, was at the necropsy found to be tuberculous meningitis. Two fatal cases are reported from Liverpool. In Glasgow the daily announcement of the notified and the deaths has been discontinued since March 4th and in future only a weekly official report will be issued on Fridays. The report for March 8th stated that only 101 cases were under observation. There had then been notified in Glasgow a total of 340 cases with 174 deaths. Since the beginning of March there have been eight or nine deaths from the disease in Leith. In Greenock three patients have recovered and three remain in the hospital. In Paisley there have been 13 cases with nine deaths, and in Govan a total of 26 cases with 14 deaths. In Dundee there havebeen several cases, some of which are described on p. 739 of our present issue, and there has been a case in Dunfermline. In Belfast nine fresh cases and one death There had then been in that were announced on March 12th. city a total of 177 cases and 96 deaths. In Dublin there has been a total of nine deaths but no fresh case has been notified since March 5th.
cases
____
THE THERAPEUTIC VALUE
OF CACTUS
GRANDIFLORUS. THE therapeutic value of Cactus grandiflorus, the nightblooming cereus, in functional disorders of the heart has been considered by some physicians to be such as to warrant the inclusion of the drug in the current edition of the United States Pharmacopoeia. The subcommittee on and its results have the question pharmacognosy investigated been published by Professor L. E. Sayre in a recent number of the Therapeutia Gazette (1906, No.12, pp. 812-16). It was found difficult to obtain a supply of trustworthy material, as the greenhouse varieties were not considered to be of value and the plants growing wild in tropical countries occur in many species and varieties.
Alcoholic tinctures were made from the fresh stems of authentic material and examined physiologically, with the result that the action of the drug on the heart was found to be slight and uncertain, if not practically nil, as shown by tracings taken from the right ventricle and carotid artery of dogs anaesthetised by chloretone and morphine. The subcommittee came to the conclusion that the drug should not be made official, as it is difficult toobtain and to identify ; moreover, it rapidly deteriorates, owing to the presence of an enormous quantity of water, 95 per cent., in the fresh stem, together with mucilage and other easily decomposed bodies. No alkaloid or other definite principle has yet been discovered in the drug ; indeed, if one be present there is reason to suppose that its percentage yield would be remarkably low, amounting to no more than 0’00076 in the tincture. For the present, therefore,.
754 the therapeutic value of Cactus grandiflorus is open to considerable doubt, in spite of many favourable opinions expressed by clinicians.
THE RÔLE OF THE BLOOD PLASMA IN
DISEASE.
---
THE
of Public Health of Queensland in a bulletin dated Jan. 26th states that 6 more cases of plague had occurred and been notified. Of these (the numbering follows the cases reported in the bulletin of Jan. 19th) Case 10, a boy, aged 14 years, was removed to hospital on Jan. 20th and died on the 25th. Case 11, a woman, aged 75 years, was the grandmother of Case 10 and had been nursing him. She was attacked on Jan. 19th and died on the 21st, being too ill to be moved to hospital. Case 12, a boy, aged eight years, was attacked on Jan. 19th, and the case was only reported after death. Cases 13 and 14 a respectively, boy aged eight years and a girl aged nine years, came, as did all the other cases, from the New Farm infected area and had been in constant association with the other cases reported. The boy was attacked on Jan. 19th and the girl on Jan. 23rd. Case 15, a male, aged 40 years, was the father of Cases 6 and 7. He was attacked on Jan. 22nd. A plan is attached to the bulletin showed that the outbreak is a typical example of local infection. All the cases are associated with the general and produce stores known as Garnett’s, in James-street, New Farm. Dead rats were found in and near these stores previously to the outbreak and all the boys had been playing recently in the stores. With regard to Cases 8 and 9 (the suspect cases) they are convalescent. Bacteriological investigation was negative in both. With regard to Port Douglas, 31 cases have been reported and 1 has proved fatal. They all come from a sugar mill eight miles outside the town.
Department
BY HARRY CAMPBELL,
M.D., B.S.LOND., F.R.C.P.LOND.,
PHYSICIAN TO THE NORTH-WEST LONDON HOSPITAL AND TO HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM, WELBECK-STREET.
THE
IV.l INFLUENCE OF THE PLASMIC ENVIRONMENT DEVELOPMENT OF THE ORGANISM.
ON THE
THE fact that the evolution of the individual cell is so under the control of its environment prepares us for the conclusion that the development of the organism as a whole is in great measure determined by the environmental influences operating on its constituent cells and by no means solely by a developmental impulse inherent in these cells. How far this is true of embryonic development cannot here be discussed, but that it is true of post-partum life there can be no shadow of doubt. It is safe to predict that were the individual cell environments to remain, during the entire post-partum life, the same as on the last day of intra-uterine life-were the plasmic environment to remain the same, the nervous system never to be stimulated by external agencies, nor the muscle and gland cells energised through their nerves - supposing life were possible under such conditions, it is, I say, safe to predict that little or no development would take place. Growth there would doubtless be, but it would be growth without development-a mere magnification of the infantile type ; some glimmering of mind there might evolve, but the mental personality would be built up of visceral sensations alone, rising to no higher level than that of the
greatly
proverbial oyster. The structural
..
changes
-
which
characterise the various
stages in the vital cycle-infancy, childhood, puberty, adolescence, maturity, and old age-are all in large measure determined by the plasma, as also are the changes which take place in the pregnant woman. The composition of the plasma varies with each of these vital stages. As each is AN ordinary meeting of the Royal Meteorological Society reached a particular spring is as it were touched, and the will be held at the Institution of Civil Engineers, Great plasma changed in such wise as to induce the structural changes characteristic of the stage attained ; during the George-street, Westminster, S.W., on Wednesday, March 20th, developmental period the tissues are urged by specific plasmic at 7.30 P.M., when a lecture will be delivered on the Explora- stimuli to develop along definite lines, in the absence of tion of the Air, by Major B. F. S. Baden-Powell. The which stimuli they tend to remain in statu quowhile in the lecture will be illustrated by models and lantern-slides. The final stage they suffer senile decay not so much because they annual dinner will be held at the Trocadero Restaurant, wear out as because decay is deliberately thrust upon them by specific plasmic influences, which thus check that Piccadilly-circus, W., on Tuesday, June 18th, at7 P.M. tendency to corporeal immortality which is innate in all
living things, and set a definite term to the length of life : the organism commits, in fact, slow suicide through the plasma.2 A MEETING will be held at the Mansion House on Wednes. That the various stages of post-partum development are day, March 20th, at 3 P.M., with the permission of the Lord brought about by specific plasmic stimuli is proved by the that development may cease at any one of them, if the Mayor, to promote the interests of the Second International fact needed hormonic stimulus be wanting, and by the further on to be School held in in London Congress Hygiene fact that in some cases, at all events, it may be made to August next. The following are announced as speakers : Sir proceed normally by supplying the plasma with the inLauder Brunton, Sir John Cockburn, Dr. T. J. Macnamara, gredient which it lacks. Thus in certain cases of infantilism the administration of pancreatic extract is known to have M.P., Sir Richard Martin, and Sir Edward Brabrook. Dr. L. E. Hill and Dr. H. A. Caley have been nominated candidates for the two vacancies upon the Senate of the University of London. The election will resolve itself into a contest between those who do and those who do not believe in the necessity for the erection and foundation of an Institute of Medical Sciences in connexion with the University of London.
as
-
THE death is announced, on March 10th, at Bournemouth, of Dr. A. E. Sansom, consulting physician to the
London Hospital. Dr. Sansom had written much upon diseases of the heart. We hope to give details of his career in a future issue. ____
A PAPER by Mr. Noel A. Humphreys, LS 0., entitled The Alleged Increase of Insanity," will be read before the Royal Statistical Society at 9, Adelphi Terrace, Strand, London, W.C., on Tuesday, March 19tb, at 5 P.M.
this remarkable influence, and there can be little doubt that the pancreatic hormone which produces this effect is only one among many similar hormones operating during early life. Absence of the thyroid implies, as we know, impeded development, which can to some extent be advanced by the administration of thyroid extract, and the fact that the thymus gland atrophies soon after birth strongly suggests that it also plays a necessary part in development, especially during its earlier phases. Its persistence in cases of Graves’s disease is of interest in this connexion. The influence of the plasma on development is also shown by the phenomena of puberty. It is now known that the secondary sexual characters, both mental and physical, are induced by the presence in the blood of specific hormones derived from the ovaries and testes. Possibly these or kindred hormones begin to be formed in small quantities quite early in life and are responsible for such secondary sexual characters as are observed before puberty, for the boy 1
Articles I., II., and III. were published in THE LANCET of Feb. 2nd 9th (p. 375), and 23rd (p. 535), 1907, respectively. I have elsewhere given my reasons for concluding that senility is essentially a process of slow suicide, committed through the medium of the plasma. See THE LANCET of August 5th, 1905, p. 403
(p.2 313),
105,442,
or
hairs, and scurf
would be directed, for the most part up an exhaust ventilating shaft situated immediately opposite the head of the person who is under operation. Such a measure, too, would secure a supply of fresh air in general in the
room.
nearly 25,000 per annum.
HAIR-BRUSHING
BY
MACHINERY.
THE machine brush, especially if it be driven by electrical means, is one of the proud acquisitions of the modern barber. It is commonly looked upon as a sign that the business of the hairdresser is conducted upon principles abreast of the times. A machine brush electrically propelled, together with some attempt at an aseptic or antiseptic practice in connexion with hair-cutting, shaving, and shampooing, serves to bring the proprietor of such an establishment into some sort of scientific reputation from the point of view of his patrons. Cleanliness is almost as great a sine quâ non in the conduct of the affairs of a barber’s shop as in that of the operating theatre, and therefore the man most deserves success who most endeavours to secure as far as possible the scientific cleanliness of his person and of the instruments used in his business. There is not wanting evidence that the barber’s shop has been the means of spreading disease and it is not difficult to suggest the conditions under which such a distribution of pathogenic materials mav take place. The sterilisation of razors, combs, blushes, and the hands of the operator may, however, avail much but it is conceivable that the good which this may do may be undone by the revolving brush scattering dust, scurf and so forth from the dry scalp. Thus all the care taken to insure antiseptic conditions may be negatived by the whirlwind of particulate matters raised by the machine brush. It should be remembered that the function of the machine brush is not to dress or to arrange the hair but merely to drive out dust and
The hand brush, of course, plays quite it is used to adjust the hair and very frepart; quently during this process the hair is wetted or oil is applied to it. It is a pity that the machine brush presents this objectionable feature, for apart from its usefulness as a remover of dust and hair clippings it undoubtedly exercises a healthy stimulus to the scalp and may even promote, when reasonably used, the nutrition of the hair. For these reasons the apparatus finds a wide circle of patrons. To preach its abolition may be justifiable on strictly hygienic grounds, but that would mean the banishment of a really useful, if not indispensable, instrument connected with the dressing and treatment of the hair. Its application would be rendered futile by moistening the hair and so the suggestion remains that the objection might be met, perhaps, by conducting the machine-brushing operation in such a manner that dust,
hair-cuttings. another
-
EPIDEMIC
CEREBRO-SPINAL
FEVER.
DURING the last six or seven days epidemic cerebro-spinal fever has made its appearance in several fresh localities. In London on March 7th an inquest was held on a girl, aged five months, who had died at Kensal Rise. The medical evidence was to the effect that death was due to cerebro" spinal meningitis and the jury returned a verdict accordingly. The medical officer of health of Poplar reported on March 7th that a fatal case had occurred on the Isle of Dogs, Cases are also said to have occurred at Wealdstone, near
Harrow, Middlesex, at Langley Green, near Oldbury, Worcestershire, at the village of Elson in Shropshire, and at Warrington. An alleged case in St. Helens, near
Liverpool, was at the necropsy found to be tuberculous meningitis. Two fatal cases are reported from Liverpool. In Glasgow the daily announcement of the notified and the deaths has been discontinued since March 4th and in future only a weekly official report will be issued on Fridays. The report for March 8th stated that only 101 cases were under observation. There had then been notified in Glasgow a total of 340 cases with 174 deaths. Since the beginning of March there have been eight or nine deaths from the disease in Leith. In Greenock three patients have recovered and three remain in the hospital. In Paisley there have been 13 cases with nine deaths, and in Govan a total of 26 cases with 14 deaths. In Dundee there havebeen several cases, some of which are described on p. 739 of our present issue, and there has been a case in Dunfermline. In Belfast nine fresh cases and one death There had then been in that were announced on March 12th. city a total of 177 cases and 96 deaths. In Dublin there has been a total of nine deaths but no fresh case has been notified since March 5th.
cases
____
THE THERAPEUTIC VALUE
OF CACTUS
GRANDIFLORUS. THE therapeutic value of Cactus grandiflorus, the nightblooming cereus, in functional disorders of the heart has been considered by some physicians to be such as to warrant the inclusion of the drug in the current edition of the United States Pharmacopoeia. The subcommittee on and its results have the question pharmacognosy investigated been published by Professor L. E. Sayre in a recent number of the Therapeutia Gazette (1906, No.12, pp. 812-16). It was found difficult to obtain a supply of trustworthy material, as the greenhouse varieties were not considered to be of value and the plants growing wild in tropical countries occur in many species and varieties.
Alcoholic tinctures were made from the fresh stems of authentic material and examined physiologically, with the result that the action of the drug on the heart was found to be slight and uncertain, if not practically nil, as shown by tracings taken from the right ventricle and carotid artery of dogs anaesthetised by chloretone and morphine. The subcommittee came to the conclusion that the drug should not be made official, as it is difficult toobtain and to identify ; moreover, it rapidly deteriorates, owing to the presence of an enormous quantity of water, 95 per cent., in the fresh stem, together with mucilage and other easily decomposed bodies. No alkaloid or other definite principle has yet been discovered in the drug ; indeed, if one be present there is reason to suppose that its percentage yield would be remarkably low, amounting to no more than 0’00076 in the tincture. For the present, therefore,.
754 the therapeutic value of Cactus grandiflorus is open to considerable doubt, in spite of many favourable opinions expressed by clinicians.
THE RÔLE OF THE BLOOD PLASMA IN
DISEASE.
---
THE
of Public Health of Queensland in a bulletin dated Jan. 26th states that 6 more cases of plague had occurred and been notified. Of these (the numbering follows the cases reported in the bulletin of Jan. 19th) Case 10, a boy, aged 14 years, was removed to hospital on Jan. 20th and died on the 25th. Case 11, a woman, aged 75 years, was the grandmother of Case 10 and had been nursing him. She was attacked on Jan. 19th and died on the 21st, being too ill to be moved to hospital. Case 12, a boy, aged eight years, was attacked on Jan. 19th, and the case was only reported after death. Cases 13 and 14 a respectively, boy aged eight years and a girl aged nine years, came, as did all the other cases, from the New Farm infected area and had been in constant association with the other cases reported. The boy was attacked on Jan. 19th and the girl on Jan. 23rd. Case 15, a male, aged 40 years, was the father of Cases 6 and 7. He was attacked on Jan. 22nd. A plan is attached to the bulletin showed that the outbreak is a typical example of local infection. All the cases are associated with the general and produce stores known as Garnett’s, in James-street, New Farm. Dead rats were found in and near these stores previously to the outbreak and all the boys had been playing recently in the stores. With regard to Cases 8 and 9 (the suspect cases) they are convalescent. Bacteriological investigation was negative in both. With regard to Port Douglas, 31 cases have been reported and 1 has proved fatal. They all come from a sugar mill eight miles outside the town.
Department
BY HARRY CAMPBELL,
M.D., B.S.LOND., F.R.C.P.LOND.,
PHYSICIAN TO THE NORTH-WEST LONDON HOSPITAL AND TO HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM, WELBECK-STREET.
THE
IV.l INFLUENCE OF THE PLASMIC ENVIRONMENT DEVELOPMENT OF THE ORGANISM.
ON THE
THE fact that the evolution of the individual cell is so under the control of its environment prepares us for the conclusion that the development of the organism as a whole is in great measure determined by the environmental influences operating on its constituent cells and by no means solely by a developmental impulse inherent in these cells. How far this is true of embryonic development cannot here be discussed, but that it is true of post-partum life there can be no shadow of doubt. It is safe to predict that were the individual cell environments to remain, during the entire post-partum life, the same as on the last day of intra-uterine life-were the plasmic environment to remain the same, the nervous system never to be stimulated by external agencies, nor the muscle and gland cells energised through their nerves - supposing life were possible under such conditions, it is, I say, safe to predict that little or no development would take place. Growth there would doubtless be, but it would be growth without development-a mere magnification of the infantile type ; some glimmering of mind there might evolve, but the mental personality would be built up of visceral sensations alone, rising to no higher level than that of the
greatly
proverbial oyster. The structural
..
changes
-
which
characterise the various
stages in the vital cycle-infancy, childhood, puberty, adolescence, maturity, and old age-are all in large measure determined by the plasma, as also are the changes which take place in the pregnant woman. The composition of the plasma varies with each of these vital stages. As each is AN ordinary meeting of the Royal Meteorological Society reached a particular spring is as it were touched, and the will be held at the Institution of Civil Engineers, Great plasma changed in such wise as to induce the structural changes characteristic of the stage attained ; during the George-street, Westminster, S.W., on Wednesday, March 20th, developmental period the tissues are urged by specific plasmic at 7.30 P.M., when a lecture will be delivered on the Explora- stimuli to develop along definite lines, in the absence of tion of the Air, by Major B. F. S. Baden-Powell. The which stimuli they tend to remain in statu quowhile in the lecture will be illustrated by models and lantern-slides. The final stage they suffer senile decay not so much because they annual dinner will be held at the Trocadero Restaurant, wear out as because decay is deliberately thrust upon them by specific plasmic influences, which thus check that Piccadilly-circus, W., on Tuesday, June 18th, at7 P.M. tendency to corporeal immortality which is innate in all
living things, and set a definite term to the length of life : the organism commits, in fact, slow suicide through the plasma.2 A MEETING will be held at the Mansion House on Wednes. That the various stages of post-partum development are day, March 20th, at 3 P.M., with the permission of the Lord brought about by specific plasmic stimuli is proved by the that development may cease at any one of them, if the Mayor, to promote the interests of the Second International fact needed hormonic stimulus be wanting, and by the further on to be School held in in London Congress Hygiene fact that in some cases, at all events, it may be made to August next. The following are announced as speakers : Sir proceed normally by supplying the plasma with the inLauder Brunton, Sir John Cockburn, Dr. T. J. Macnamara, gredient which it lacks. Thus in certain cases of infantilism the administration of pancreatic extract is known to have M.P., Sir Richard Martin, and Sir Edward Brabrook. Dr. L. E. Hill and Dr. H. A. Caley have been nominated candidates for the two vacancies upon the Senate of the University of London. The election will resolve itself into a contest between those who do and those who do not believe in the necessity for the erection and foundation of an Institute of Medical Sciences in connexion with the University of London.
as
-
THE death is announced, on March 10th, at Bournemouth, of Dr. A. E. Sansom, consulting physician to the
London Hospital. Dr. Sansom had written much upon diseases of the heart. We hope to give details of his career in a future issue. ____
A PAPER by Mr. Noel A. Humphreys, LS 0., entitled The Alleged Increase of Insanity," will be read before the Royal Statistical Society at 9, Adelphi Terrace, Strand, London, W.C., on Tuesday, March 19tb, at 5 P.M.
this remarkable influence, and there can be little doubt that the pancreatic hormone which produces this effect is only one among many similar hormones operating during early life. Absence of the thyroid implies, as we know, impeded development, which can to some extent be advanced by the administration of thyroid extract, and the fact that the thymus gland atrophies soon after birth strongly suggests that it also plays a necessary part in development, especially during its earlier phases. Its persistence in cases of Graves’s disease is of interest in this connexion. The influence of the plasma on development is also shown by the phenomena of puberty. It is now known that the secondary sexual characters, both mental and physical, are induced by the presence in the blood of specific hormones derived from the ovaries and testes. Possibly these or kindred hormones begin to be formed in small quantities quite early in life and are responsible for such secondary sexual characters as are observed before puberty, for the boy 1
Articles I., II., and III. were published in THE LANCET of Feb. 2nd 9th (p. 375), and 23rd (p. 535), 1907, respectively. I have elsewhere given my reasons for concluding that senility is essentially a process of slow suicide, committed through the medium of the plasma. See THE LANCET of August 5th, 1905, p. 403
(p.2 313),