- Email: [email protected]
THE TUBE RAILWAYS.
1269
heartburnings Medical Corps, times,
no
of individual members of the
Royal Army
among whom it was, at any rate until recent and in most cases a uncommon complaint,
very justifiable complaint, that neither their position nor their services received recognition from the combatant We do not enter here into any branches of the army. detailed comparison between the conditions of the service under the new Warrant and those that held previously. The subject has been fully dealt with in our columns,
and
we
content ourselves with
recording
conditions of the new certain of gratitude and
withTtheimproved
view that, Warrant before
"
DENTAL
the future should have it in his own hands to make hiss’ position not only one m the highest utility but also one off Until the present time the great dignity and influence. main
reproach cast upon the Army Medical Service by’ critics without its ranks was one which was not deservedI in many instances, while it was very easily earned by eveni most capable members of the service. It was maintained that, however brilliant his attainments, however eager his devotion to medicine on entering the service, a man necessarily deteriorated afterwards by reason of the limitedL The amount of routine! medical field presented to him. clerical work expected of him, and the scant opportunity afforded him of keeping abreast with the various branches of medical science as they progressed in civil practice, blunted his scientific enthusiasm. Now all such objections are to’ The changes introduced into a large extent removed. the medical service of the army by the recent Warrant, especially the provision for study leave, by which officers returning from distant stations are enabled to keep themselves abreast of modern medicine, must have a wonderfully stimulating effect upon the scientific zeal of the military medical man. Not only can he use his own experiences to advantage, but he can benefit by the experiences of his colleagues, both medical and lay-a true interchange of knowledge resulting. Some of the work already done in India and South Africa, particularly in connexion with typhoid fever and malaria, shows clearly enough that among the members of the Army Medical Service there will be no lack of men from whom under favourable opportunities researches may be expected of the highest practical value. From the nature of their surroundings the army medical officers must be above all things practical. If the conditions imposed upon an officer of the service develop also that ability for scientific research which is present in many members of the corps, the importance of the benefits that should accrue both to the condition of troops on active service and to medical science in general ought to be very distinct. Any advance that is made will almost certainly be made along definite lines. The occupation of a medical officer in the army of Great Britain offers an unparalleled ,
’
’
.
.
’
field for scientific work. In every quarter of the globe he is likely at some time or other to have medical of
and
interesting
I
Ne
DISEASE
quid nimis." AND
GENERAL
HEALTH.
THE distribution of prizes to the students of the National Dental Hospital and College, Great Portland-street, London, was held on Oct. 29th, when an address was given by Sir He urged the students to study all the Thomas Barlow. anatomical, physiological, pathological, and bacteriological subjects which made up the natural history of disease in the particular tissues with which they were concerned. It was the intimate pathology of dental disease that he urged them to study. He hoped that they would keep up their bacteriology and remember that in every single case of disease there was something to be learned about the mode of onset, the order of evolution of symptoms, and the concomitant conditions, some of which in time might be found to be the actual factors in producing the morbid state. Dentists as well as medical men were continually being called upon to consider the vicious circle of local and general disease and both dentists and medical men had realised of late in a way they neither of them realised before the vast importance of oral sepsis in causing various forms of chronic intoxication. They were aware that strong arguments had been urged in favour of the view that pernicious ansemia was induced by some form of oral sepsis arising in connexion with dental caries. There could be no doubt that marked improvement often ensued on making the oral cavity perfectly wholesome. Many cases of what was called Riggs’s disease had been accompanied by chronic septicaemia which had been absolutely cured after efficient treatment of the oral cavity. It should never be forgotten that so long as a man’s general health was good he might be enabled to neutralise and to dispose of the toxic products which he was constantly swallowing from a small discharging sinus connected with an old carious root. But if that man became lowered in his general tone from some acute illness, from severe h2emorrhage, or from some grave blood change, as in Bright’s disease, then that little sinus assumed great importance and the slight septic absorption might grow into a serious risk. When people got well on into middle life and degenerative changes began to be apparent, that was the time when dentists might often score their most brilliant successes by aiding digestive processes with the mechanical resources at their disposal and removing the causes of toxic absorption. In that way they would deserve gratitude and gain credit. Sir Thomas Barlow concluded by laying particular stress on the importance of the proper care of the teeth in children because there were special risks of absorption of morbid products in connexion with ulceration of the gums and it seemed fairly clearly shown that such a lesion was one of the modes by which tubercle obtained access to the lymphatic glands.
THE
TUBE
RAILWAYS.
unusual
character. Under the conditions that now obtain his training and knowledge should permit him to make use of these opportunities. In older days the great JOHN HUNTER was n army surgeon, as Lord ROBERTS, speaking in HUNTER’S an
Annotations.
our
him, and feeling respect on the part of the combatant branches as represented by Lord! ROBERTS, the officer of the Royal Army Medical Corps in
opportunities
hospital, could not fail to remember. It behoves the military medical omcer of to-day to strive that what HIUNTER did in the matter of gunshot wounds shall be paralleled by what the Royal Army Medical Corps achieves in the matters of infectious and tropical disease. own
THE recent acquisition of the control of the London United Electric Tramway Company by Messrs. Speyer Bros., the financial sponsors of the competing Metropolitan District line now associated with the name of Yerkes, has caused a complete revolution in the proposed new tube railway
1270 feared not much to the ultimate morning hallucinations occurring in a state between sleep The physical and mental characters assoThe immediate result has been and waking. the withdrawal from Parliament of the proposed Bill for ciated with alcoholism permit such cases to be readily the line from Hammersmith to Piccadilly promoted by recognised and they are almost invariably observed the London United Electric Tramway Company and in adult males. The female self-accuser is rarely seen the consequent compulsory abandonment of the line in in the law court and she is usually the subject of marked continuation under the Strand to Tottenham and Palmer’sI hysteria. More often such a dement appears as an accuser Green promoted by Messrs. Morgan and Co. Thus the of others and weaves extraordinary and plausible romances Metropolitan District Railway and the Central London to bear out her statements. These generally refer to sexual Railway are relieved from the threatened competition. assaults and personal violence sustained at the hands of At all events the Metropolitan District line will gain others, but in rare instances she charges herself also time which it may be hoped the directors will devote to with such crimes as poisoning, abortion and adultery. establishing their claim to public favour and so removing Dr. Dupr6 finally points out that many unfortunate men and the chances of attracting a rival to their locality. This women who were mentally atl3icted in one or other of the scheme of the Morgan group being defeated for the present ways above mentioned and who accused themselves of all their energies can now be devoted to push forward their poisoning, murder, communion with evil spirits, and the like, new venture-viz., a tube line which they are promoting to were in the Middle Ages gravely tried by legal or ecclerun from the Lothbury station of the Great Northern and siastical tribunals and even suffered the death penalty or City line, under the Central London Tube to the Marble were burnt at the stake as witches and sorcerers, while in a Arch, an express service being contemplated between these more enlightened age they are now consigned to care in stations. At the Marble Arch the line will connect with lunatic asylums or other suitable institutions. the new line to Cricklewood on the north and with the proposed new line to Clapham Junction on the south. THE FACTORY AND WORKSHOP ACT. This will give the directors of the Central London THE Factory and Workshop Act (1901) has necessarily Railway something like a sbock. Sir Henry Oakley. thrown an enormous amount of work on the Home Office and the the chairman of company, has already been a good deal exercised in his mind by the decision of the a form has recently been prescribed by the Secretary of State for a register which is to be kept in all the places Parliamentary Committee which rejected the scheme of the whichgeneral come under the provisions of the Act. In this document Central London Railway to form its line into a complete are included the schedules which are to be used in the case of circle, in favour of the now defunct rival scheme of the certificates of the fitness of young persons and children for White-Morgan groap. He has been, as he says, " ventilating the prescribed forms for the return of accidents the question" in the Timps. It would be much more employment, and of cases of poisoning, and the register which has to be satisfactory to the public if he devoted his undoubted on premises in which lime-washing is obligatory. There abilities to promote some more effectual method of venti- kept is also a form to be filled up in the case of shop assistants lating the Central London Tube, which, notwithstanding who are employed during extra hours, whether before or the assertions of his manager to the contrary. leaves much after the period of employment fixed by notice, on the same to be desired. The recent efforts to accomplish this object day as that on which the worker has been employed in the at Bond-street station have been by no means successful. or workshop. Finally, there is a schedule for the There is some talk of a suggestion to admit compressed air factory The general form, insertion of reports on steam boilers. into the tunnel through a series of pipes, though owing to is to be found on the first page, is a very full one. which the small size of the tunnel itself there is not much room in After the ordinary information, such as the name of the which to experiment in this direction. occupier, the address, the nature of the work, and so forth, there are spaces allotted for giving the dates at which certiTHE PSYCHOLOGY OF "AUTO-ACCUSATION." ficates (if any) were granted-(l) from the local authority AUTO-ACCUSATION"is a curious phenomenon which as to means of escape in case of fire ; (2) from His Majesty’s possesses both medical and legal interest. The committal Chief Inspector of Factories as to part of the premises being of a notorious crime which excites popular imagination and treated as a separate workshop ; and (3) from His Majesty’s which remains undetected for a time often leads to the Inspector of Factories as to separation of departments for There is no doubt appearance in .law courts of self-accusing culprits who overtime and for period of employment. with in that the Home has a themselves the authors of the crime Office made start in its endeavour charge good being question. Dr. Ernest Dupre of Paris in a paper read before to supervise effectively the carrying out of the new Factory the Annual Congress of French Alienists and Neurologists Act, and it is to be hoped that local authorities will in like, recently held at Grenoble attempts to delineate with exacti- manner perform the duties with which they have been tude the psychological nature of "auto-accusation"and to intrusted. A special notice has been issued by the Homeshow that certain morbid elements play an important part in Office in regard to explosives which contain nitro-glycerine, it. He points out that auto-accusation"" is not often or and it is rather to be feared that the caution which it conmerely the result of weak-mindedness ; the subject of it is veys may not be brought to the notice of a number of a person who has positively developed general ideas of those who would be most likely to benefit by it. There are unworthiness, guilt, and remorse, and in a word is suffering many quarries in the country which are only intermittently from mild melancholia with vague delusions of guilt and worked. The stones obtained are used chiefly for metalling" sin. Another type of self-accuser is the proud and vain the roads and they are quarried as occasion requires. Nitro"degenerate"who with a brain warped by congenital glycerine explosives are often used for the blasting operaanomaly of development constructs romances of which he tions which form part of the work. The men employed readily persuades himself to be the hero or the martyr. are usually engaged also in other occupations and spend but There is, adds Dr. Dupr6, a marked contrast between these a small fraction of their time in quarrying. It is said to be two types. The one is abject, lowly, self-humiliating ; the custom of some of these men in cold weather to thaw the the other proud, egoistic, and vain. Among other types nitro-glycerine compounds by placing them in their pockets. of the same abnormality are found persons of alcoholic or This is not the method recommended by the Home Office, for hysterical character. The alcoholic self-accuser is one whose the notice recently issued is as follows : "All cartridges made delusion generally has its starting-point in nocturnal or of dynamite, gelignite, blasting gelatin, and other explosives
schemes,
it
is
to
be
advantage of the public.
I
’’
heartburnings Medical Corps, times,
no
of individual members of the
Royal Army
among whom it was, at any rate until recent and in most cases a uncommon complaint,
very justifiable complaint, that neither their position nor their services received recognition from the combatant We do not enter here into any branches of the army. detailed comparison between the conditions of the service under the new Warrant and those that held previously. The subject has been fully dealt with in our columns,
and
we
content ourselves with
recording
conditions of the new certain of gratitude and
withTtheimproved
view that, Warrant before
"
DENTAL
the future should have it in his own hands to make hiss’ position not only one m the highest utility but also one off Until the present time the great dignity and influence. main
reproach cast upon the Army Medical Service by’ critics without its ranks was one which was not deservedI in many instances, while it was very easily earned by eveni most capable members of the service. It was maintained that, however brilliant his attainments, however eager his devotion to medicine on entering the service, a man necessarily deteriorated afterwards by reason of the limitedL The amount of routine! medical field presented to him. clerical work expected of him, and the scant opportunity afforded him of keeping abreast with the various branches of medical science as they progressed in civil practice, blunted his scientific enthusiasm. Now all such objections are to’ The changes introduced into a large extent removed. the medical service of the army by the recent Warrant, especially the provision for study leave, by which officers returning from distant stations are enabled to keep themselves abreast of modern medicine, must have a wonderfully stimulating effect upon the scientific zeal of the military medical man. Not only can he use his own experiences to advantage, but he can benefit by the experiences of his colleagues, both medical and lay-a true interchange of knowledge resulting. Some of the work already done in India and South Africa, particularly in connexion with typhoid fever and malaria, shows clearly enough that among the members of the Army Medical Service there will be no lack of men from whom under favourable opportunities researches may be expected of the highest practical value. From the nature of their surroundings the army medical officers must be above all things practical. If the conditions imposed upon an officer of the service develop also that ability for scientific research which is present in many members of the corps, the importance of the benefits that should accrue both to the condition of troops on active service and to medical science in general ought to be very distinct. Any advance that is made will almost certainly be made along definite lines. The occupation of a medical officer in the army of Great Britain offers an unparalleled ,
’
’
.
.
’
field for scientific work. In every quarter of the globe he is likely at some time or other to have medical of
and
interesting
I
Ne
DISEASE
quid nimis." AND
GENERAL
HEALTH.
THE distribution of prizes to the students of the National Dental Hospital and College, Great Portland-street, London, was held on Oct. 29th, when an address was given by Sir He urged the students to study all the Thomas Barlow. anatomical, physiological, pathological, and bacteriological subjects which made up the natural history of disease in the particular tissues with which they were concerned. It was the intimate pathology of dental disease that he urged them to study. He hoped that they would keep up their bacteriology and remember that in every single case of disease there was something to be learned about the mode of onset, the order of evolution of symptoms, and the concomitant conditions, some of which in time might be found to be the actual factors in producing the morbid state. Dentists as well as medical men were continually being called upon to consider the vicious circle of local and general disease and both dentists and medical men had realised of late in a way they neither of them realised before the vast importance of oral sepsis in causing various forms of chronic intoxication. They were aware that strong arguments had been urged in favour of the view that pernicious ansemia was induced by some form of oral sepsis arising in connexion with dental caries. There could be no doubt that marked improvement often ensued on making the oral cavity perfectly wholesome. Many cases of what was called Riggs’s disease had been accompanied by chronic septicaemia which had been absolutely cured after efficient treatment of the oral cavity. It should never be forgotten that so long as a man’s general health was good he might be enabled to neutralise and to dispose of the toxic products which he was constantly swallowing from a small discharging sinus connected with an old carious root. But if that man became lowered in his general tone from some acute illness, from severe h2emorrhage, or from some grave blood change, as in Bright’s disease, then that little sinus assumed great importance and the slight septic absorption might grow into a serious risk. When people got well on into middle life and degenerative changes began to be apparent, that was the time when dentists might often score their most brilliant successes by aiding digestive processes with the mechanical resources at their disposal and removing the causes of toxic absorption. In that way they would deserve gratitude and gain credit. Sir Thomas Barlow concluded by laying particular stress on the importance of the proper care of the teeth in children because there were special risks of absorption of morbid products in connexion with ulceration of the gums and it seemed fairly clearly shown that such a lesion was one of the modes by which tubercle obtained access to the lymphatic glands.
THE
TUBE
RAILWAYS.
unusual
character. Under the conditions that now obtain his training and knowledge should permit him to make use of these opportunities. In older days the great JOHN HUNTER was n army surgeon, as Lord ROBERTS, speaking in HUNTER’S an
Annotations.
our
him, and feeling respect on the part of the combatant branches as represented by Lord! ROBERTS, the officer of the Royal Army Medical Corps in
opportunities
hospital, could not fail to remember. It behoves the military medical omcer of to-day to strive that what HIUNTER did in the matter of gunshot wounds shall be paralleled by what the Royal Army Medical Corps achieves in the matters of infectious and tropical disease. own
THE recent acquisition of the control of the London United Electric Tramway Company by Messrs. Speyer Bros., the financial sponsors of the competing Metropolitan District line now associated with the name of Yerkes, has caused a complete revolution in the proposed new tube railway
1270 feared not much to the ultimate morning hallucinations occurring in a state between sleep The physical and mental characters assoThe immediate result has been and waking. the withdrawal from Parliament of the proposed Bill for ciated with alcoholism permit such cases to be readily the line from Hammersmith to Piccadilly promoted by recognised and they are almost invariably observed the London United Electric Tramway Company and in adult males. The female self-accuser is rarely seen the consequent compulsory abandonment of the line in in the law court and she is usually the subject of marked continuation under the Strand to Tottenham and Palmer’sI hysteria. More often such a dement appears as an accuser Green promoted by Messrs. Morgan and Co. Thus the of others and weaves extraordinary and plausible romances Metropolitan District Railway and the Central London to bear out her statements. These generally refer to sexual Railway are relieved from the threatened competition. assaults and personal violence sustained at the hands of At all events the Metropolitan District line will gain others, but in rare instances she charges herself also time which it may be hoped the directors will devote to with such crimes as poisoning, abortion and adultery. establishing their claim to public favour and so removing Dr. Dupr6 finally points out that many unfortunate men and the chances of attracting a rival to their locality. This women who were mentally atl3icted in one or other of the scheme of the Morgan group being defeated for the present ways above mentioned and who accused themselves of all their energies can now be devoted to push forward their poisoning, murder, communion with evil spirits, and the like, new venture-viz., a tube line which they are promoting to were in the Middle Ages gravely tried by legal or ecclerun from the Lothbury station of the Great Northern and siastical tribunals and even suffered the death penalty or City line, under the Central London Tube to the Marble were burnt at the stake as witches and sorcerers, while in a Arch, an express service being contemplated between these more enlightened age they are now consigned to care in stations. At the Marble Arch the line will connect with lunatic asylums or other suitable institutions. the new line to Cricklewood on the north and with the proposed new line to Clapham Junction on the south. THE FACTORY AND WORKSHOP ACT. This will give the directors of the Central London THE Factory and Workshop Act (1901) has necessarily Railway something like a sbock. Sir Henry Oakley. thrown an enormous amount of work on the Home Office and the the chairman of company, has already been a good deal exercised in his mind by the decision of the a form has recently been prescribed by the Secretary of State for a register which is to be kept in all the places Parliamentary Committee which rejected the scheme of the whichgeneral come under the provisions of the Act. In this document Central London Railway to form its line into a complete are included the schedules which are to be used in the case of circle, in favour of the now defunct rival scheme of the certificates of the fitness of young persons and children for White-Morgan groap. He has been, as he says, " ventilating the prescribed forms for the return of accidents the question" in the Timps. It would be much more employment, and of cases of poisoning, and the register which has to be satisfactory to the public if he devoted his undoubted on premises in which lime-washing is obligatory. There abilities to promote some more effectual method of venti- kept is also a form to be filled up in the case of shop assistants lating the Central London Tube, which, notwithstanding who are employed during extra hours, whether before or the assertions of his manager to the contrary. leaves much after the period of employment fixed by notice, on the same to be desired. The recent efforts to accomplish this object day as that on which the worker has been employed in the at Bond-street station have been by no means successful. or workshop. Finally, there is a schedule for the There is some talk of a suggestion to admit compressed air factory The general form, insertion of reports on steam boilers. into the tunnel through a series of pipes, though owing to is to be found on the first page, is a very full one. which the small size of the tunnel itself there is not much room in After the ordinary information, such as the name of the which to experiment in this direction. occupier, the address, the nature of the work, and so forth, there are spaces allotted for giving the dates at which certiTHE PSYCHOLOGY OF "AUTO-ACCUSATION." ficates (if any) were granted-(l) from the local authority AUTO-ACCUSATION"is a curious phenomenon which as to means of escape in case of fire ; (2) from His Majesty’s possesses both medical and legal interest. The committal Chief Inspector of Factories as to part of the premises being of a notorious crime which excites popular imagination and treated as a separate workshop ; and (3) from His Majesty’s which remains undetected for a time often leads to the Inspector of Factories as to separation of departments for There is no doubt appearance in .law courts of self-accusing culprits who overtime and for period of employment. with in that the Home has a themselves the authors of the crime Office made start in its endeavour charge good being question. Dr. Ernest Dupre of Paris in a paper read before to supervise effectively the carrying out of the new Factory the Annual Congress of French Alienists and Neurologists Act, and it is to be hoped that local authorities will in like, recently held at Grenoble attempts to delineate with exacti- manner perform the duties with which they have been tude the psychological nature of "auto-accusation"and to intrusted. A special notice has been issued by the Homeshow that certain morbid elements play an important part in Office in regard to explosives which contain nitro-glycerine, it. He points out that auto-accusation"" is not often or and it is rather to be feared that the caution which it conmerely the result of weak-mindedness ; the subject of it is veys may not be brought to the notice of a number of a person who has positively developed general ideas of those who would be most likely to benefit by it. There are unworthiness, guilt, and remorse, and in a word is suffering many quarries in the country which are only intermittently from mild melancholia with vague delusions of guilt and worked. The stones obtained are used chiefly for metalling" sin. Another type of self-accuser is the proud and vain the roads and they are quarried as occasion requires. Nitro"degenerate"who with a brain warped by congenital glycerine explosives are often used for the blasting operaanomaly of development constructs romances of which he tions which form part of the work. The men employed readily persuades himself to be the hero or the martyr. are usually engaged also in other occupations and spend but There is, adds Dr. Dupr6, a marked contrast between these a small fraction of their time in quarrying. It is said to be two types. The one is abject, lowly, self-humiliating ; the custom of some of these men in cold weather to thaw the the other proud, egoistic, and vain. Among other types nitro-glycerine compounds by placing them in their pockets. of the same abnormality are found persons of alcoholic or This is not the method recommended by the Home Office, for hysterical character. The alcoholic self-accuser is one whose the notice recently issued is as follows : "All cartridges made delusion generally has its starting-point in nocturnal or of dynamite, gelignite, blasting gelatin, and other explosives
schemes,
it
is
to
be
advantage of the public.
I
’’