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UNFOUNDED REFLECTIONS UPON A MEDICAL MAN.
948 shock passed off ir half an hour. The case looked like one of severe colic but the shock and previous pain made Dr. Paterson doubtful. He gave instructions that he was to be sent for if the boy became worse. He The patient saw the boy again next morning at 9 A.M. had vomited at 9 P.M. on the previous evening and again in the night and there had been frequent retching. The abdominal pain became easier during the night. There were signs of peritonitis-distended abdomen, raised temperature, and loss of liver dulness. 18 hours after rupture laparotomy was performed by Mr. F. M. Caird. General peritonitis with a mass of lymph over the liver and stomach was found. When the lymph was separated a punched-out ulcer of about the size of a split pea was found in the anterior wall of the stomach about two inches from the middle of the lesser curvature. A smear of peritoneal fluid was taken and showed a culture of staphylococci. The peritoneum was washed out and the lymph was swabbed off the surface of the liver and from the recto-vesical pouch. Nutrient enemata were given for three days and then mouth-feeding was begun. Convalescence was interrupted by a severe attack of double pneumonia which almost proved fatal. A case of perforation of a gastric ulcer in a boy, aged 13 years, has been recorded in our columns by Mr. W. Watson Cheyne and Dr. H. Wilbe.1 The pain and rigidity were most marked on the upper part of the right side. Fulminating appendicitis was diagnosed but on operation a perforated gastric ulcer was found which was successfully sutured. THE PUBLIC HEALTH
OF BELFAST.
IN another column we publish an account from one of our Irish correspondents of the election of the superintendent medical officer of Belfast. The officer elected is Mr. H. W. Bailie. His qualifications, as stated in the Medical Directory, are L.R.C.P. & S. Edin. and L.F.P.S. Glasg., and we learn from the reports of the meeting of the Belfast council held on Oct. 1st that he has recently obtained a Diploma in Public Health, but from what body is not The health of Belfast is by no means in a stated. satisfactory condition. For instance, the death-rate per 1000 for the year 1905 was 20 ’1, being second highest on a list of 19 towns in the United Kingdom. When we come to the disease in the Registrar- General’s annual " fever," of which the definition is summary entitled " continued fever, mainly enteric," we find that 135 deaths under this beading occurred in Belfast, 131 of these being due to enteric fever and the other four to pyrexia. The figures per 1000 inhabitants in 19 towns of the United Kingdom for 1905 show that the Belfast death-rate was 0’38, the next highest on the list being Salford, with a death-rate of 0 19. The Belfast fever death rate is thus exactly twice the death-rate of the next town on the list. To grapple with conditions like these we might have thought that the Belfast city authorities would have chosen a medical officer with more practical experience of public health work than Mr. Bailie apparently possesses. The appointment is subject to the approval of the Local Government Board and we hope to deal with the matter more at length in a future issue. ____
THE WARRANTING OF MILK. AT the South-Western police court a point has been raised with regard to the sale of milk adulterated with added water which apparently will require a decision of the Divisional Court before it is finally decided. The defendant who sold the milk retail relied for her defence upon a warranty from the wholesale dealer, but the legal representative of the 1
THE LANCET, June 11th,
1904, p. 1641.
Battersea borough council objected to the alleged warranty on the ground that it was too indefinite in its terms. The magistrate read the document, in which the words relied on were "all milk supplied is to be pure," and expressed the opinion that it was full of ambiguity, concluding the case by fining the defendant, who had been convicted four times before, E5, with costs. It was stated that the question of the sufficiency of the warranty would be referred to the High Court and it is certainly one of some importance to milk-sellers and to the public.
UNFOUNDED
REFLECTIONS MAN.
UPON A MEDICAL
AN inquest was held on Sept. 24th on the body of a Mrs. Oliver, a widow, aged 63 years, who died on Dec. lst, 1905. Some two months ago the body was exhumed for an inquest which was then held and adjourned. The body had been apparently exhumed on the request of the brother of the deceased and Mr. C. E. Adams, the medical attendant, offered no objection. The affidavit of the brother of the deceased stated that Mr. Adams had been in a great hurry to get the body buried. As a matter of fact, it had been buried six days after the death. The affidavit also stated that the deponent believed the death of his sister to be due either to the administration of improper drugs or to incorrect treatment. Evidence was given by the deceased’s sister-in-law and by her maid that the deceased had for a long time been suffering from her heart. Mr. Adams, who gave evidence, said that he had first treated Mrs. Oliver in 1898 for dyspepsia. Some three years afterwards symptoms of cardiac degeneration set in. Dr. J. Rose Bradford had seen her with him in 1904 and had agreed entirely with his treatment. As to the funeral he had had nothing to do with it. Evidence was also given by Dr. W. H. Willcox, analyst to the Home Office, and by Dr. F. J. Smith, professor of forensic medicine at the London Hospital. The evidence of this gentleman showed that there was no indication whatever of any irritant or corrosive poison, or indeed of any other poison. The jury returned a verdict saying that the certificate of death given by Mr. Adams was perfectly correct and that there was no ground for attributing any unprofessional conduct to him. We must congratulate Mr. Adams upon the result of this case, but the conduct of the relatives responsible for the exhumation and the inquest was so singularly foolish that it almost seems unnecessary to say anything about it. The case is only one more example of the way in which medical men can be worried and harassed for doing no more than their duty, and we are glad to see that all the lay papers give publicity to the case and especially to the verdict of the jury.
ON Sept. 28th Mr. Alderman Thomas Boor Crosby, M.D. St. And., F.R.C.S. Eng., was admitted a Sheriff of the City of London for the ensuing year. On Sept. 26th Dr. Crosby was presented with his shrieval chain and badge on behalf of the inhabitants of his ward, the Langbourn, by Lord Avebury. The chain contained six medallions bearing the arms of the Turners’ Company, the Royal College of Surgeons of England, the University of St. Andrews, the Society of Apothecaries of London, St. Thomas’s Hospital, and the City of London. -
THE Mabel Webb research scholarship, tenable by past or present students of the London (Royal Free Hospital) School of Medicine for Women, will be awarded in October. The
scholarship a
second
is worth Z30 third year.
or a
year and is renewable for The candidate must undertake
a
949 research work in pathology,
physiology,
or
chemistry.
Applications should be sent to the secretary of the school by Oct. 20th stating the nature of the research work which it is proposed to undertake. -
opening address of the session 1906-07 of the North Clinical Society will be given on Thursday, London East at the Tottenham Hospital at 4 P.M. by Sir Oct. 11th, The subject of the address will be the Croom. Halliday Obstetrical and Gynaecological Relations of Exophthalmic Goitre. All medical practitioners are cordially invited. The annual dinner will be held at the Great Eastern Hotel, Liverpool-street, at 7.30 P.M. on the same day. THE
I but theof them ;
for books, when worn out, may ba restored ; opportunity of acquiring knowledge, which is afforded to a generation, if once lost, can never be redeemed ,1 a use
i
I’
THE LONDON MEDICAL EXHIBITION.
THROUGH the munificence of Mrs. Stephen Ralli the endowment of the Bacteriological and Pathological Laboratory which she established at the Sussex County Hospital in memory of her husband has been increased to 20,000 and in consequence of this addition to the fund it is proposed to appoint an assistant pathologist. The post will be advertised shortly and the office will be entered upon at about the commencement of the new year.
regret to announce the death, at the age of 60 years, Brigade-Surgeon Lieutenant Colonel Alexander Crombie, C.B., M.D. Edin., l.M.S. retired, which took place in London on Sept. 29th. We hope to give an account of his life and work in an early issue. WE
of
-
IT is officially announced in the London Gazette that Dr. Diarmid Noel Paton has been appointed to the ctair of physiology in the University of Glasgow ftce Professor John Gray McKendrick, LL.D., F.R S., who has resigned.
Looking Back. FROM
THE LANCET, SATURDAY, Oct. 4th,
1828.
There is scarcely a library in these countries, which the fashionable spirit of monopoly has not fenced round with It some impossible or inconvenient conditions of admission. is this " dog in the manger " spirit which has given rise to a pleasant story, told of the College of Physicians of London. "A book, which ought not to be unknown by any wellread man, was once inquired for in their library, by a person of more than ordinary curiosity; the volume was in a press which was locked, and after a very diligent search, the key was found in a place where it was clearly it must have remained ascertained, from circumstances, undisturbed for eighty years 1 " We can match this story by one in which we were ourselves the principals in the library of the Dublin College of Surgeons: "We were there once on a visit; the conversation happened to turn on the discoveries of Laennec ; an appeal was made to his volume, which was taken down from one of the shelves for reference; but, mirabile dictu, though the work, we learned, had been nearly two years in the library, not a single sheet of it had yet been cut." On learning the regulations of the establishment, and that Mr. Colles, one of the principal surgeons of Dublin, was then ridiculing the invaluable discovery of Laennec, by representing his stethoscope as useful only for carrying adhesive plaster, our surprise, of course, ceased. But to preserve books this year in this way, thati they may be preserved the next, and so on for ever, is idle ; it would almost be better to use them, like the Caliph Omar, in heating baths and ovens, than not to use them at all. A reasonable wear and tear of books must be borne with ; they ought to be used as much as is consistent with their preservation, and preserved as much as is consistent with a free and ample use. The safer side to err upon, especially with such works as may be replaced, is to sin by too great
1 Excerpt from a leading article on the library of Dublin College which "has lately enacted a law, by which, together with the payment of three guineas, the candidate for the honour of reading in the library, is to be ballotted for, and one-third, at least, of the whole votes required to secure his election." .
OF BELFAST.
IN another column we publish an account from one of our Irish correspondents of the election of the superintendent medical officer of Belfast. The officer elected is Mr. H. W. Bailie. His qualifications, as stated in the Medical Directory, are L.R.C.P. & S. Edin. and L.F.P.S. Glasg., and we learn from the reports of the meeting of the Belfast council held on Oct. 1st that he has recently obtained a Diploma in Public Health, but from what body is not The health of Belfast is by no means in a stated. satisfactory condition. For instance, the death-rate per 1000 for the year 1905 was 20 ’1, being second highest on a list of 19 towns in the United Kingdom. When we come to the disease in the Registrar- General’s annual " fever," of which the definition is summary entitled " continued fever, mainly enteric," we find that 135 deaths under this beading occurred in Belfast, 131 of these being due to enteric fever and the other four to pyrexia. The figures per 1000 inhabitants in 19 towns of the United Kingdom for 1905 show that the Belfast death-rate was 0’38, the next highest on the list being Salford, with a death-rate of 0 19. The Belfast fever death rate is thus exactly twice the death-rate of the next town on the list. To grapple with conditions like these we might have thought that the Belfast city authorities would have chosen a medical officer with more practical experience of public health work than Mr. Bailie apparently possesses. The appointment is subject to the approval of the Local Government Board and we hope to deal with the matter more at length in a future issue. ____
THE WARRANTING OF MILK. AT the South-Western police court a point has been raised with regard to the sale of milk adulterated with added water which apparently will require a decision of the Divisional Court before it is finally decided. The defendant who sold the milk retail relied for her defence upon a warranty from the wholesale dealer, but the legal representative of the 1
THE LANCET, June 11th,
1904, p. 1641.
Battersea borough council objected to the alleged warranty on the ground that it was too indefinite in its terms. The magistrate read the document, in which the words relied on were "all milk supplied is to be pure," and expressed the opinion that it was full of ambiguity, concluding the case by fining the defendant, who had been convicted four times before, E5, with costs. It was stated that the question of the sufficiency of the warranty would be referred to the High Court and it is certainly one of some importance to milk-sellers and to the public.
UNFOUNDED
REFLECTIONS MAN.
UPON A MEDICAL
AN inquest was held on Sept. 24th on the body of a Mrs. Oliver, a widow, aged 63 years, who died on Dec. lst, 1905. Some two months ago the body was exhumed for an inquest which was then held and adjourned. The body had been apparently exhumed on the request of the brother of the deceased and Mr. C. E. Adams, the medical attendant, offered no objection. The affidavit of the brother of the deceased stated that Mr. Adams had been in a great hurry to get the body buried. As a matter of fact, it had been buried six days after the death. The affidavit also stated that the deponent believed the death of his sister to be due either to the administration of improper drugs or to incorrect treatment. Evidence was given by the deceased’s sister-in-law and by her maid that the deceased had for a long time been suffering from her heart. Mr. Adams, who gave evidence, said that he had first treated Mrs. Oliver in 1898 for dyspepsia. Some three years afterwards symptoms of cardiac degeneration set in. Dr. J. Rose Bradford had seen her with him in 1904 and had agreed entirely with his treatment. As to the funeral he had had nothing to do with it. Evidence was also given by Dr. W. H. Willcox, analyst to the Home Office, and by Dr. F. J. Smith, professor of forensic medicine at the London Hospital. The evidence of this gentleman showed that there was no indication whatever of any irritant or corrosive poison, or indeed of any other poison. The jury returned a verdict saying that the certificate of death given by Mr. Adams was perfectly correct and that there was no ground for attributing any unprofessional conduct to him. We must congratulate Mr. Adams upon the result of this case, but the conduct of the relatives responsible for the exhumation and the inquest was so singularly foolish that it almost seems unnecessary to say anything about it. The case is only one more example of the way in which medical men can be worried and harassed for doing no more than their duty, and we are glad to see that all the lay papers give publicity to the case and especially to the verdict of the jury.
ON Sept. 28th Mr. Alderman Thomas Boor Crosby, M.D. St. And., F.R.C.S. Eng., was admitted a Sheriff of the City of London for the ensuing year. On Sept. 26th Dr. Crosby was presented with his shrieval chain and badge on behalf of the inhabitants of his ward, the Langbourn, by Lord Avebury. The chain contained six medallions bearing the arms of the Turners’ Company, the Royal College of Surgeons of England, the University of St. Andrews, the Society of Apothecaries of London, St. Thomas’s Hospital, and the City of London. -
THE Mabel Webb research scholarship, tenable by past or present students of the London (Royal Free Hospital) School of Medicine for Women, will be awarded in October. The
scholarship a
second
is worth Z30 third year.
or a
year and is renewable for The candidate must undertake
a
949 research work in pathology,
physiology,
or
chemistry.
Applications should be sent to the secretary of the school by Oct. 20th stating the nature of the research work which it is proposed to undertake. -
opening address of the session 1906-07 of the North Clinical Society will be given on Thursday, London East at the Tottenham Hospital at 4 P.M. by Sir Oct. 11th, The subject of the address will be the Croom. Halliday Obstetrical and Gynaecological Relations of Exophthalmic Goitre. All medical practitioners are cordially invited. The annual dinner will be held at the Great Eastern Hotel, Liverpool-street, at 7.30 P.M. on the same day. THE
I but theof them ;
for books, when worn out, may ba restored ; opportunity of acquiring knowledge, which is afforded to a generation, if once lost, can never be redeemed ,1 a use
i
I’
THE LONDON MEDICAL EXHIBITION.
THROUGH the munificence of Mrs. Stephen Ralli the endowment of the Bacteriological and Pathological Laboratory which she established at the Sussex County Hospital in memory of her husband has been increased to 20,000 and in consequence of this addition to the fund it is proposed to appoint an assistant pathologist. The post will be advertised shortly and the office will be entered upon at about the commencement of the new year.
regret to announce the death, at the age of 60 years, Brigade-Surgeon Lieutenant Colonel Alexander Crombie, C.B., M.D. Edin., l.M.S. retired, which took place in London on Sept. 29th. We hope to give an account of his life and work in an early issue. WE
of
-
IT is officially announced in the London Gazette that Dr. Diarmid Noel Paton has been appointed to the ctair of physiology in the University of Glasgow ftce Professor John Gray McKendrick, LL.D., F.R S., who has resigned.
Looking Back. FROM
THE LANCET, SATURDAY, Oct. 4th,
1828.
There is scarcely a library in these countries, which the fashionable spirit of monopoly has not fenced round with It some impossible or inconvenient conditions of admission. is this " dog in the manger " spirit which has given rise to a pleasant story, told of the College of Physicians of London. "A book, which ought not to be unknown by any wellread man, was once inquired for in their library, by a person of more than ordinary curiosity; the volume was in a press which was locked, and after a very diligent search, the key was found in a place where it was clearly it must have remained ascertained, from circumstances, undisturbed for eighty years 1 " We can match this story by one in which we were ourselves the principals in the library of the Dublin College of Surgeons: "We were there once on a visit; the conversation happened to turn on the discoveries of Laennec ; an appeal was made to his volume, which was taken down from one of the shelves for reference; but, mirabile dictu, though the work, we learned, had been nearly two years in the library, not a single sheet of it had yet been cut." On learning the regulations of the establishment, and that Mr. Colles, one of the principal surgeons of Dublin, was then ridiculing the invaluable discovery of Laennec, by representing his stethoscope as useful only for carrying adhesive plaster, our surprise, of course, ceased. But to preserve books this year in this way, thati they may be preserved the next, and so on for ever, is idle ; it would almost be better to use them, like the Caliph Omar, in heating baths and ovens, than not to use them at all. A reasonable wear and tear of books must be borne with ; they ought to be used as much as is consistent with their preservation, and preserved as much as is consistent with a free and ample use. The safer side to err upon, especially with such works as may be replaced, is to sin by too great
1 Excerpt from a leading article on the library of Dublin College which "has lately enacted a law, by which, together with the payment of three guineas, the candidate for the honour of reading in the library, is to be ballotted for, and one-third, at least, of the whole votes required to secure his election." .