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TREATMENT OF DIPHTHERITIC PARALYSIS WITH ANTITOXIN.
322
DETERMINATION OF’ THE’ SEX BY ELECTRICAL INFLUENCES.
if only 1 per cent. of recitrrent-cancer cases obtained relief the above sweeping statements could not be justifiably uttered: X ray treatment at first suffered from three things —inexperience of its use in cancer, inefficient apparatus, and the treatment, by laymen. All three have gradually The treatment is now suffering mostly from the disappeared. " conservatism" of our profession. Let us hope that in the future the medical man will permit to his patient every .assistance that science can offer and the knowledge of others 4Woai.d lead them to recommend conscientiously.
had a single failure." Those familiar with late diphtheritic paralysis will learn with surprise that M. Comby had been so unfortunate previously to the adoption of his present treatment. Many years before the introduction of antitoxin it was recognised that late diphtheritic paralysis was, as a rule, benign. Thus Greenhow, writing in 1860, says :" The majority of cases which are protracted until the development of nervous sequels recover." Henoch’s words are still more emphatic : " As gradual recovery very often takes place in the course of a few weeks without the aid of art we must not over-estimate the value of the I am, Sirs, yours faithfully, different methods of treatment which are recommended."1 Bedford-square, W.C. JJuly 28th, 1906. CHISHOLM WILLIAMS. Since 1894, when with the introduction of antitoxin more patients survived to suffer late paralysis, the benignity of DETERMINATION OF THE SEX BY ELEC- the affection has been still more marked. Complete recovery has been the rule, death the exception. Chronic diphtheTRICAL INFLUENCES. ritic paralysis, of which Dr. Wilfred Harris has collected To the Editors of THE LANCET. only seven cases,2 is a very rare occurrence. Among 1000 consecutive cases that have been under my care in the course SIRS,- Do electrical conditions influence the determination of the last four years there were 196 of late diphtheritic of the sex-? For some months past I have been making the term "late" being applied to such cases as paralysis, .observations upon mice kept under certain electrical (?) after the first fortnight of the disease. Of the 196, developed the with of the if conditions object ascertaining possible, 48 were cases of generalised palsy ; in the remainder the eyes ’any, and what influence magneto-therapy or metallo therapy or palate, either separately or in combination, were alone the at the of fecundation. .may exert upon body period All recovered except two, in whom death was due affected. I had constructed two metal cages, one of zinc and the other of copper. These cages were made and seamed to paralysis of the diaphragm. This low mortality is to be attributed not so much to the treatment nor to an together without the use of any solder, which would have extraordinary good fortune, though muchadopted is to be assigned if used this of of of class consisted, work, equal parts upon lead and tin and fluxed at the time of soldering with chloride to the zealous cooperation of the nurses, as to the essential " of zinc, which is made by killing " hydrochloric acid with benignity of the late affection. I have elsewherereported cases illustrative of the zinc—i.e., placing cuttings of zinc in the acid until chemical The cages, therefore, consisted of- nothing tendency that late diphtheritic paralysis has to recover with- . .action ceases. but the respective metals mentioned. These cages were kept out special treatment owing to the abortive character and insulated upon pieces of glass and two mice-a male and a short duration of the majority of its forms. Even in severe The food was similar. In due cases, in which the muscles of deglutition and respiration have female-housed in each. been involved, improvement both in the physical and mental - course the young family arrived and as soon as possible is often relatively rapid when once the rower to condition were minutely examined and the effects noted with conhas been regained. Any treatment employed at siderable interest. In the zinc-electro-negative or cathodic swallow such a time, whether massage, electricity, c’rugs, or other
July 24th, 1906.
THE CHICAGO MEAT SOANDAI.
323
often distressing, especially in the case of adults. Though intimating that he was giving up general practice to take up fatal results have been recorded the occurrence of such a specialty and askirg for their support. If he has any accidents invites us to adopt a safer and pleasanter method claim to special knowledge this ]st method would, no doubt, I am, ;:;ir8, yours faithfully, of treatment. M. Comby states that it is only excep- be successful. J. W. tionally that serum phenomena of any importance have to London, July 28th, 1906. be deplored, but it must be remembered that the cases recorded are relatively few and there is always the possibility of the occurrence of such sequelsc. On reference to THE CHICAGO MEAT SCANDAL. Mourniac’s thesis it will be found that in five out of the 18 cases these serum phenomena were noted. HOW THE POPULAR PRESS MAY PREVENT REFORM I am. Sirs. vours faithfully, J. D. ROLLESTON. Grove Hospital, S.W., July 28th, 1906. (BY OUR SPECIAL SANITARY COMMISSIONER.) no
THERE
no doubt that the public is thoroughly general question of food-supply and on the special grievance in rfgard to the Chicago stockyards. On I To the Editors vf THE LANCET. all sides, among all classes of the community, conversations ‘constantly turn to these questions. This widespread interest Dawson Turner’s remarks on the F. D. electrical SIRS,—Dr. I if properly directed, produce very beneficent results,. resistance of the blood and urine in THE LANCET of July 28tb,may, 1 there is great danger that the present indignation will p. 223, are of great interest, and the hope which he expresses but that this method of research may come into extended use inwear itself out without achieving anything of a very the future deserves emphasis. There seems little doubt that ‘ durable and efficacious character. For many years efforts electro conductivity measurements of body fluids may throw 1 been made to obtain better laws and more Effective considerable light on their nature. I also think that inhave ‘ over cattle and meat markets, slaughter-houses, and practice cryoscopy may also be supplanted by electro-conduc-control tivity measurement, even though the two methods depend onifood-preserving establishments. The denunciations whkbdifferent things. As regards the determination of the func-i inspectors have made annually of the insanitary condition of tional efficiency of the kidney by this method I believe that and other factories where animal or vegetable subthe use of the " salt" and "water"tests introduced byjam stances are preserved for food have past unnoticed by the is almost certain. The tests in this-that a consist Strauss single large dose of salt or water is given after a night’s fast; igeneral public. This year, however, these reports of thethe urine collected hourly and examined. In this case I findGovernment and municipal inspectors have been carefully that the conductivity follows the same curve that the scanned and the most sensational passages have been freezing-point depression has. The former may therefore widely reproduced by the press at large. All this isdo in place of a cryosopic determination. excellent: it educates the public as to existing evils and It seems to me, however, that one or two points must not prepares the way for future legislation. So long as the4 be lost sight of. One is that the electrical method does not lay press contents itself with reproducing the reports of give a reliable figure for the concentration of the electro- qualified official inspectors and of technicians nothing but lytes, whereas cryoscopy gives a definite figure for the total good will result. Unfortunately the very popularity which the concentration. It is true that by combining with the con- subject now enjoys has led a number of persons to rush into ductiv.ity-determination an estimation of the chlorides print though they know absolutely nothing about the (Volhardt’s method) one can deduce the concentration of the technicalities at issue. As the general public is equally achloride electrolytes (in terms of NaCl) which does vary ignorant, it is not capable of distinguishing between those under different conditions. But it is not as satisfactory a who write with technical knowledge and those who are deduction as can be desired. The second point is that the unacquainted with what constitutes a properly constructed presence of colloids greatly influences the conductivity. abattoir or effective meat inspection.
THE ELECTRO-CONDUCTIVITY OF BODY FLUIDS.
roused
on
can
be
the
1
I
Tangl.and Bugarsky found that every gramme of albumin conductivity of blood serum by 25 per cent. ; not only this, but the albumin also diminishes the degree of dissociation of the serum electrolytes. It is for this reason
In the United States of America this is not the first time that the abominations prevalent at Chicago have been denounced. A ter the Spanish-American war there was a great "embalmed meat" scare and the Senatehad to appoint a comt that I think the electrical method fails in the case of the of inquiry which issued a report of about 3000 pages. Here examination of the blood. all the abominations of the Chicago stockyards were attacked The last point is one of considerable importance. The hip and thigh. But the whole thirg died down, though it expression of results as " specific resistance" in ohms is was commonly believed, and said, that the American troops in. simple but has the great objection that the number only Cuba had suffered more from the canned meat which they holds good when the electrodes and vessels used are of received from Chicago than from the bullets fired at them by If one the Spaniards. The fact that even in such circumstances the certain dimensions (which Dr. Turner gives). determines the capacity of the vessel and expresses the agitation could possibly have died down should be considered results as eqllivalent conductivity the size of electrodes and as a very grave warning. Care must be taken that the vessel, &3., ceases to matter. The figures obtained by anypresent outcry is not stifled in a similar manner. To observer will then agree with those of any other. The: effect this end the Chicago packers and other interested minute electrodes described do not give as accurate results; parties will encourage the present tendency to introduce non-technicians into the controversy. Appeals will be madeas large ones, which could well be employed if one were to, use venesection blood. The electrical method has, in my to the daily political press to send their reporters and experience without exception up to now, shown a difference correspondents to view premises and to write reports thereon. between various kinds of body fluids such that it would be; These correspondents, though many of them very able men possib’e by this simple method alone to diagnose the source and admirable writers, have naturally no idea as to the natmeof a given fluid. of the defects which they should seek out. They will be I am, Sirs, yours faithfully. OSKAR C. GRUNER. impressed by an outward appearance of cleanliness and theClinical Laboratory, Leeds General Infirmary, tidy, perhaps coquettish, aspect of the young women employed July <:öth, l3U6. to dress some of the meat and to fill some of the cans. As a result, there will be whitewashing accounts published of the Chicago stockyards and also of some British establishments, and thus it is hoped to lull the public once more into a sens eWHAT IS A SPECIALIST? of false security. 2b the Editors of THE LANCET. As a proof and demonstration of this very imminent and SIRs,-Are there not several ways in which " A. Z." could1 serious danger nothing could be more to the point than an advertise his desire for special work without being " in-- article published in the London Daily Chrroniùle of July 27th famous." He might put a notice in his waiting-roum that in*last. First, there are three delightful cartoons by Mr. Tom a Browne and then a paragraph giving a complimentary notice future he will only see certain cases. He might send a circular letter to his regular patients. He might send aa of the princely terms offered by the Chicago Daily Tribulle tocircular note to the other general practitioners in his districtt this British artist to draw for that paper. S-o far ko good,.
diminishes the
.
,
DETERMINATION OF’ THE’ SEX BY ELECTRICAL INFLUENCES.
if only 1 per cent. of recitrrent-cancer cases obtained relief the above sweeping statements could not be justifiably uttered: X ray treatment at first suffered from three things —inexperience of its use in cancer, inefficient apparatus, and the treatment, by laymen. All three have gradually The treatment is now suffering mostly from the disappeared. " conservatism" of our profession. Let us hope that in the future the medical man will permit to his patient every .assistance that science can offer and the knowledge of others 4Woai.d lead them to recommend conscientiously.
had a single failure." Those familiar with late diphtheritic paralysis will learn with surprise that M. Comby had been so unfortunate previously to the adoption of his present treatment. Many years before the introduction of antitoxin it was recognised that late diphtheritic paralysis was, as a rule, benign. Thus Greenhow, writing in 1860, says :" The majority of cases which are protracted until the development of nervous sequels recover." Henoch’s words are still more emphatic : " As gradual recovery very often takes place in the course of a few weeks without the aid of art we must not over-estimate the value of the I am, Sirs, yours faithfully, different methods of treatment which are recommended."1 Bedford-square, W.C. JJuly 28th, 1906. CHISHOLM WILLIAMS. Since 1894, when with the introduction of antitoxin more patients survived to suffer late paralysis, the benignity of DETERMINATION OF THE SEX BY ELEC- the affection has been still more marked. Complete recovery has been the rule, death the exception. Chronic diphtheTRICAL INFLUENCES. ritic paralysis, of which Dr. Wilfred Harris has collected To the Editors of THE LANCET. only seven cases,2 is a very rare occurrence. Among 1000 consecutive cases that have been under my care in the course SIRS,- Do electrical conditions influence the determination of the last four years there were 196 of late diphtheritic of the sex-? For some months past I have been making the term "late" being applied to such cases as paralysis, .observations upon mice kept under certain electrical (?) after the first fortnight of the disease. Of the 196, developed the with of the if conditions object ascertaining possible, 48 were cases of generalised palsy ; in the remainder the eyes ’any, and what influence magneto-therapy or metallo therapy or palate, either separately or in combination, were alone the at the of fecundation. .may exert upon body period All recovered except two, in whom death was due affected. I had constructed two metal cages, one of zinc and the other of copper. These cages were made and seamed to paralysis of the diaphragm. This low mortality is to be attributed not so much to the treatment nor to an together without the use of any solder, which would have extraordinary good fortune, though muchadopted is to be assigned if used this of of of class consisted, work, equal parts upon lead and tin and fluxed at the time of soldering with chloride to the zealous cooperation of the nurses, as to the essential " of zinc, which is made by killing " hydrochloric acid with benignity of the late affection. I have elsewherereported cases illustrative of the zinc—i.e., placing cuttings of zinc in the acid until chemical The cages, therefore, consisted of- nothing tendency that late diphtheritic paralysis has to recover with- . .action ceases. but the respective metals mentioned. These cages were kept out special treatment owing to the abortive character and insulated upon pieces of glass and two mice-a male and a short duration of the majority of its forms. Even in severe The food was similar. In due cases, in which the muscles of deglutition and respiration have female-housed in each. been involved, improvement both in the physical and mental - course the young family arrived and as soon as possible is often relatively rapid when once the rower to condition were minutely examined and the effects noted with conhas been regained. Any treatment employed at siderable interest. In the zinc-electro-negative or cathodic swallow such a time, whether massage, electricity, c’rugs, or other
July 24th, 1906.
THE CHICAGO MEAT SOANDAI.
323
often distressing, especially in the case of adults. Though intimating that he was giving up general practice to take up fatal results have been recorded the occurrence of such a specialty and askirg for their support. If he has any accidents invites us to adopt a safer and pleasanter method claim to special knowledge this ]st method would, no doubt, I am, ;:;ir8, yours faithfully, of treatment. M. Comby states that it is only excep- be successful. J. W. tionally that serum phenomena of any importance have to London, July 28th, 1906. be deplored, but it must be remembered that the cases recorded are relatively few and there is always the possibility of the occurrence of such sequelsc. On reference to THE CHICAGO MEAT SCANDAL. Mourniac’s thesis it will be found that in five out of the 18 cases these serum phenomena were noted. HOW THE POPULAR PRESS MAY PREVENT REFORM I am. Sirs. vours faithfully, J. D. ROLLESTON. Grove Hospital, S.W., July 28th, 1906. (BY OUR SPECIAL SANITARY COMMISSIONER.) no
THERE
no doubt that the public is thoroughly general question of food-supply and on the special grievance in rfgard to the Chicago stockyards. On I To the Editors vf THE LANCET. all sides, among all classes of the community, conversations ‘constantly turn to these questions. This widespread interest Dawson Turner’s remarks on the F. D. electrical SIRS,—Dr. I if properly directed, produce very beneficent results,. resistance of the blood and urine in THE LANCET of July 28tb,may, 1 there is great danger that the present indignation will p. 223, are of great interest, and the hope which he expresses but that this method of research may come into extended use inwear itself out without achieving anything of a very the future deserves emphasis. There seems little doubt that ‘ durable and efficacious character. For many years efforts electro conductivity measurements of body fluids may throw 1 been made to obtain better laws and more Effective considerable light on their nature. I also think that inhave ‘ over cattle and meat markets, slaughter-houses, and practice cryoscopy may also be supplanted by electro-conduc-control tivity measurement, even though the two methods depend onifood-preserving establishments. The denunciations whkbdifferent things. As regards the determination of the func-i inspectors have made annually of the insanitary condition of tional efficiency of the kidney by this method I believe that and other factories where animal or vegetable subthe use of the " salt" and "water"tests introduced byjam stances are preserved for food have past unnoticed by the is almost certain. The tests in this-that a consist Strauss single large dose of salt or water is given after a night’s fast; igeneral public. This year, however, these reports of thethe urine collected hourly and examined. In this case I findGovernment and municipal inspectors have been carefully that the conductivity follows the same curve that the scanned and the most sensational passages have been freezing-point depression has. The former may therefore widely reproduced by the press at large. All this isdo in place of a cryosopic determination. excellent: it educates the public as to existing evils and It seems to me, however, that one or two points must not prepares the way for future legislation. So long as the4 be lost sight of. One is that the electrical method does not lay press contents itself with reproducing the reports of give a reliable figure for the concentration of the electro- qualified official inspectors and of technicians nothing but lytes, whereas cryoscopy gives a definite figure for the total good will result. Unfortunately the very popularity which the concentration. It is true that by combining with the con- subject now enjoys has led a number of persons to rush into ductiv.ity-determination an estimation of the chlorides print though they know absolutely nothing about the (Volhardt’s method) one can deduce the concentration of the technicalities at issue. As the general public is equally achloride electrolytes (in terms of NaCl) which does vary ignorant, it is not capable of distinguishing between those under different conditions. But it is not as satisfactory a who write with technical knowledge and those who are deduction as can be desired. The second point is that the unacquainted with what constitutes a properly constructed presence of colloids greatly influences the conductivity. abattoir or effective meat inspection.
THE ELECTRO-CONDUCTIVITY OF BODY FLUIDS.
roused
on
can
be
the
1
I
Tangl.and Bugarsky found that every gramme of albumin conductivity of blood serum by 25 per cent. ; not only this, but the albumin also diminishes the degree of dissociation of the serum electrolytes. It is for this reason
In the United States of America this is not the first time that the abominations prevalent at Chicago have been denounced. A ter the Spanish-American war there was a great "embalmed meat" scare and the Senatehad to appoint a comt that I think the electrical method fails in the case of the of inquiry which issued a report of about 3000 pages. Here examination of the blood. all the abominations of the Chicago stockyards were attacked The last point is one of considerable importance. The hip and thigh. But the whole thirg died down, though it expression of results as " specific resistance" in ohms is was commonly believed, and said, that the American troops in. simple but has the great objection that the number only Cuba had suffered more from the canned meat which they holds good when the electrodes and vessels used are of received from Chicago than from the bullets fired at them by If one the Spaniards. The fact that even in such circumstances the certain dimensions (which Dr. Turner gives). determines the capacity of the vessel and expresses the agitation could possibly have died down should be considered results as eqllivalent conductivity the size of electrodes and as a very grave warning. Care must be taken that the vessel, &3., ceases to matter. The figures obtained by anypresent outcry is not stifled in a similar manner. To observer will then agree with those of any other. The: effect this end the Chicago packers and other interested minute electrodes described do not give as accurate results; parties will encourage the present tendency to introduce non-technicians into the controversy. Appeals will be madeas large ones, which could well be employed if one were to, use venesection blood. The electrical method has, in my to the daily political press to send their reporters and experience without exception up to now, shown a difference correspondents to view premises and to write reports thereon. between various kinds of body fluids such that it would be; These correspondents, though many of them very able men possib’e by this simple method alone to diagnose the source and admirable writers, have naturally no idea as to the natmeof a given fluid. of the defects which they should seek out. They will be I am, Sirs, yours faithfully. OSKAR C. GRUNER. impressed by an outward appearance of cleanliness and theClinical Laboratory, Leeds General Infirmary, tidy, perhaps coquettish, aspect of the young women employed July <:öth, l3U6. to dress some of the meat and to fill some of the cans. As a result, there will be whitewashing accounts published of the Chicago stockyards and also of some British establishments, and thus it is hoped to lull the public once more into a sens eWHAT IS A SPECIALIST? of false security. 2b the Editors of THE LANCET. As a proof and demonstration of this very imminent and SIRs,-Are there not several ways in which " A. Z." could1 serious danger nothing could be more to the point than an advertise his desire for special work without being " in-- article published in the London Daily Chrroniùle of July 27th famous." He might put a notice in his waiting-roum that in*last. First, there are three delightful cartoons by Mr. Tom a Browne and then a paragraph giving a complimentary notice future he will only see certain cases. He might send a circular letter to his regular patients. He might send aa of the princely terms offered by the Chicago Daily Tribulle tocircular note to the other general practitioners in his districtt this British artist to draw for that paper. S-o far ko good,.
diminishes the
.
,