- Email: [email protected]
TRANSLUCENCY OF THE CORNEA.
765 which must depend in the final issue upon the needs of each case and its relative urgency. Assuming this principle to be fully upheld in the Liverpool scheme, the contributions might then be regarded as in the nature of voluntary subscriptions to a charity, the essential character of the Liverpool hcspitals remaining unchanged. But it appears that distinction is to be made between contributors and non-contributors ; in other words, the contributor is to receive a quid pro quo and his contribution becomes It will be for the medical an insurance premium. staffs of the Liverpool hospitals to adopt an attitude, at once humane and logical, to the continuously growing demand on their highly skilled service.
hospital,
TRANSLUCENCY OF THE CORNEA. OPACITY of the cornea is a common cause of impaired vision in every degree from the slightest defect of .sight to complete blindness. It is, therefore, important to understand what causes corneal opacities and how far they are curable. The anatomical structure of the cornea consists of parallel fibrous lamellae bounded on the outside by an epithelium and on the inner side by an endothelium, which normally protects it from infiltration by the aqueous humour. Slight .opacities may be caused by injuries to the epithelium but this is soon regenerated and complete transparency may be restored. Infiltration of fluid into the substantia propria may be due to pressure as in glaucoma In this or to disease such as interstitial keratitis. case the infiltrating fluid contains cells and the opacity may be extreme. Nevertheless the infiltrat’on may .eventually be completely or almost completely absorbed and the transparency of the cornea restored. A third typeof corneal opacity occurs from actual injury of the fibres of the substantia propria such as results from a deep ulcer or a wound. Here the opacity may be partly due to infiltration and, in so far as this is the case, treatment by such things as ,stimulating ointments may be partially effective, but there remain the cases in which there is actual replacement of the normal fibres of the cornea by .scar tissue. In the worst cases such as follow a .severe ophthalmia neonatorum the whole cornea may be converted into scar tissue, and in these no treatment which has hitherto been devised can possibly restore the transparency. A suggestion has been made by Dr. S. G. Moore, who has seen the wonderful specimens prepared by Prof. Spalteholz, of Leipzig, in which the tissues are rendered so translucent that, for example, injected arteries are readily seen in relief in transmitted light-that this to living tissues, might restore some of useful vision in cases of blindness due to opacity of the cornea. Dr. Moore believes this process to be secret, but reference to Bulletin No. V. (p. 41) of the International Association of Medical Museums shows that it consists in impregnating the tissues with a fluid of suitable refractive index, composed of oil of wintergreen and benzyl benzoate. Although the application of methods of this kind to living tissues was foreshadowed by Mr. H. G. Wells in his " Invisible lIan," it can hardly be expected that living protoplasm should survive so gross an insult to its normal refractivee index. process,
applied
measure
____
OTAGO
MEDICAL SCHOOL.
AN experiment in clinical instruction is about to be made in Otago. The plan of university education in New Zealand is adapted to its topographical needs and differs from that elsewhere. The University of New Zealand is an examining and degree-granting body, with headquarters at Wellington ; it prescribes courses amd appoints examiners, but it undertakes no teaching. All instruction is carried on in the four constituent
colleges—Auckland University College ; Victoria College, Wellington ; Canterbury College, Christchurch ; and the University of Otago, Dunedin. The ea,rly settle! s of Otago, in good Scots fashion, established their
University
before that of New Zealand
was
founded, and Otago has consequently retained the title of University, though it does not now grant degrees. Arts and science, and some other subjects, can be studied at any of the centres, but the professional faculties are concentrated at single colleges ; engineering, for-instance, at Canterbury College, and medicine at Otago University. Some years ago the Dean of the Otago Medical School put forward a proposal that the medical curriculum should be extended from five years to six, which had already been done, either avowedly or in practice, in The various overseas schools. proposal aroused considerable discussion, and the Senate of the University of New Zealand decided to refer the question to the New Zealand Branch of the British Medical Association for an opinion. A good many members were averse from the extension, and there was a general feeling that if a year were added to the course it should be a clinical " year and also that facilities should be afforded for spending it in the public hospitals of other centres of the Dominionnamely, Auckland, Wellington, and Chiistchurch, and not wholly in Dunedin. This proposal, writes our New Zealand correspondent, could not be complied with in its entirety. There was never any intention of leaving the curriculum as it was, and merely adding another year during which students should kick their heels until they had put in the necessary terms to allow them to sit the final examination. One of the additional terms was required for the " intermediate " subjects, chemistry, physics, and biology, and one for the " first professional subjects, anatomy and physiology, leaving only one term for additional clinical study. However three complete years, or nine terms, are now available for clinical work, and by the new scheme a student may elect to spend one, two, or three terms of the final year in the hospital of another centre, provided an adequate syllabus has been submitted by the medical staff of the hospital concerned to the Faculty of Medicine in Dunedin ; all the hospitals have now submitted schemes, and one, at least, is providing quarters for the students. This publicspirited action on the part of the hospital staffs concerned will mean a considerable addition to their work. By this arrangement the students’ clinical experience will be undoubtedly much increased, since the whole facilities of a considerable hospital will be available for a small group who have already had two years’ ward-training. The result will be watched with interest by other schools. "
"
DÜSSELDORF CONFERENCE. eighty-ninth conference of Naturforscher
THE THE
Arzte at Dusseldorf from Sept. 19th to 26th
and was over
divided into 34 sections and attended by well 8000 scientists and medical men from Germanv and German-speaking countries, so that its mere size gave rise to difficulties in organisation, while the large proportion of natural scientists resulted in the treatment of medical subjects on lines suitable for the advanced medical student. But these difficulties were largely surmounted by Dr. Arthur Schlossman and Frl. Dr. Marta Fraenkel, who were responsible for the arrangements. The outstanding feature of the conference was a series of communications by Prof. P. Miihlens (Hamburg), Prof. F. Sioli (Dusseldorf), Drs. Horlein and Rohl (Elberfeld) on a new synthetic remedy for malaria, to wl-iieh the name plasmochin had been given. Tested first by Rohl on canaries infected with bird malaria, it was then administered by Sioli to paralytics under treatment by malaria, in whom repeated doses of 0-2 g. proved uniformly effective. Muhlens and his colleagues began to use the drug at the Hamburg Tropical Diseases Institute in August, 1925, and 134 cases from all parts of the world have now been treated with careful dailv The preparation is almost control of the blood. tasteless and for this reason especially useful for children. Four to six weeks’ treatment are required. Fever and parasites disappeared in a few days and relapses were less numerous than when quinine was
hospital,
TRANSLUCENCY OF THE CORNEA. OPACITY of the cornea is a common cause of impaired vision in every degree from the slightest defect of .sight to complete blindness. It is, therefore, important to understand what causes corneal opacities and how far they are curable. The anatomical structure of the cornea consists of parallel fibrous lamellae bounded on the outside by an epithelium and on the inner side by an endothelium, which normally protects it from infiltration by the aqueous humour. Slight .opacities may be caused by injuries to the epithelium but this is soon regenerated and complete transparency may be restored. Infiltration of fluid into the substantia propria may be due to pressure as in glaucoma In this or to disease such as interstitial keratitis. case the infiltrating fluid contains cells and the opacity may be extreme. Nevertheless the infiltrat’on may .eventually be completely or almost completely absorbed and the transparency of the cornea restored. A third typeof corneal opacity occurs from actual injury of the fibres of the substantia propria such as results from a deep ulcer or a wound. Here the opacity may be partly due to infiltration and, in so far as this is the case, treatment by such things as ,stimulating ointments may be partially effective, but there remain the cases in which there is actual replacement of the normal fibres of the cornea by .scar tissue. In the worst cases such as follow a .severe ophthalmia neonatorum the whole cornea may be converted into scar tissue, and in these no treatment which has hitherto been devised can possibly restore the transparency. A suggestion has been made by Dr. S. G. Moore, who has seen the wonderful specimens prepared by Prof. Spalteholz, of Leipzig, in which the tissues are rendered so translucent that, for example, injected arteries are readily seen in relief in transmitted light-that this to living tissues, might restore some of useful vision in cases of blindness due to opacity of the cornea. Dr. Moore believes this process to be secret, but reference to Bulletin No. V. (p. 41) of the International Association of Medical Museums shows that it consists in impregnating the tissues with a fluid of suitable refractive index, composed of oil of wintergreen and benzyl benzoate. Although the application of methods of this kind to living tissues was foreshadowed by Mr. H. G. Wells in his " Invisible lIan," it can hardly be expected that living protoplasm should survive so gross an insult to its normal refractivee index. process,
applied
measure
____
OTAGO
MEDICAL SCHOOL.
AN experiment in clinical instruction is about to be made in Otago. The plan of university education in New Zealand is adapted to its topographical needs and differs from that elsewhere. The University of New Zealand is an examining and degree-granting body, with headquarters at Wellington ; it prescribes courses amd appoints examiners, but it undertakes no teaching. All instruction is carried on in the four constituent
colleges—Auckland University College ; Victoria College, Wellington ; Canterbury College, Christchurch ; and the University of Otago, Dunedin. The ea,rly settle! s of Otago, in good Scots fashion, established their
University
before that of New Zealand
was
founded, and Otago has consequently retained the title of University, though it does not now grant degrees. Arts and science, and some other subjects, can be studied at any of the centres, but the professional faculties are concentrated at single colleges ; engineering, for-instance, at Canterbury College, and medicine at Otago University. Some years ago the Dean of the Otago Medical School put forward a proposal that the medical curriculum should be extended from five years to six, which had already been done, either avowedly or in practice, in The various overseas schools. proposal aroused considerable discussion, and the Senate of the University of New Zealand decided to refer the question to the New Zealand Branch of the British Medical Association for an opinion. A good many members were averse from the extension, and there was a general feeling that if a year were added to the course it should be a clinical " year and also that facilities should be afforded for spending it in the public hospitals of other centres of the Dominionnamely, Auckland, Wellington, and Chiistchurch, and not wholly in Dunedin. This proposal, writes our New Zealand correspondent, could not be complied with in its entirety. There was never any intention of leaving the curriculum as it was, and merely adding another year during which students should kick their heels until they had put in the necessary terms to allow them to sit the final examination. One of the additional terms was required for the " intermediate " subjects, chemistry, physics, and biology, and one for the " first professional subjects, anatomy and physiology, leaving only one term for additional clinical study. However three complete years, or nine terms, are now available for clinical work, and by the new scheme a student may elect to spend one, two, or three terms of the final year in the hospital of another centre, provided an adequate syllabus has been submitted by the medical staff of the hospital concerned to the Faculty of Medicine in Dunedin ; all the hospitals have now submitted schemes, and one, at least, is providing quarters for the students. This publicspirited action on the part of the hospital staffs concerned will mean a considerable addition to their work. By this arrangement the students’ clinical experience will be undoubtedly much increased, since the whole facilities of a considerable hospital will be available for a small group who have already had two years’ ward-training. The result will be watched with interest by other schools. "
"
DÜSSELDORF CONFERENCE. eighty-ninth conference of Naturforscher
THE THE
Arzte at Dusseldorf from Sept. 19th to 26th
and was over
divided into 34 sections and attended by well 8000 scientists and medical men from Germanv and German-speaking countries, so that its mere size gave rise to difficulties in organisation, while the large proportion of natural scientists resulted in the treatment of medical subjects on lines suitable for the advanced medical student. But these difficulties were largely surmounted by Dr. Arthur Schlossman and Frl. Dr. Marta Fraenkel, who were responsible for the arrangements. The outstanding feature of the conference was a series of communications by Prof. P. Miihlens (Hamburg), Prof. F. Sioli (Dusseldorf), Drs. Horlein and Rohl (Elberfeld) on a new synthetic remedy for malaria, to wl-iieh the name plasmochin had been given. Tested first by Rohl on canaries infected with bird malaria, it was then administered by Sioli to paralytics under treatment by malaria, in whom repeated doses of 0-2 g. proved uniformly effective. Muhlens and his colleagues began to use the drug at the Hamburg Tropical Diseases Institute in August, 1925, and 134 cases from all parts of the world have now been treated with careful dailv The preparation is almost control of the blood. tasteless and for this reason especially useful for children. Four to six weeks’ treatment are required. Fever and parasites disappeared in a few days and relapses were less numerous than when quinine was