205

Coleraine Cottage Hospital.At the annual meeting of the supporters of this excellent

charity, held on Jan. 13th, it appears, from the report pre-sented, that 71 cases (36 medical and 35 surgical) had beenadmitted, and that 12 operations (all successful) had beenperformed. There had been only three deaths. Thetreasurers statement showed that the expenditure had.exceeded the income by f.37.

Enteric Fever in Dublin Barracks.Considerable uneasiness exists in Dublin on account of the

persistent rumours as to the prevalence of enteric fever inthe military barracks of the city and the neighbourhood.The policy of reticence adopted by the military authoritiesand their refusal to permit independent sanitary investiga-tion have produced an unfavourable impression in the publicmind. Island-bridge and Richmond Barracks are said to havesuffered most.

Jem. Mth. ____________

PARIS.(FROM OUR OWN CORRESPONDENT.)

What is Chlorosis?IN a suggestive article appearing in the Gazette Hebdonuc-

alaire (Jan. 2nd) M. Charrin gives as the cause of thatpeculiar condition, chlorosis, menstrual auto-intoxication.It is known that on the eve of the menstrual flow the

serum-toxicity is increased. Wet-nurses who continue tomenstruate are the cause of these menstrual periods ofdiarrhœa, and divers eruptions in their sucklings, whilst

hey themselves are, at these times, particularly proneto suffer from fever, herpes, headache, and muscularpains. Directly the flow is established these disorders- cease. Experimental researches conducted by M. Carnot(a, son of the late regretted President Carnot) and M. Charrintend to show that the auto-intoxication theory is the correctone. The purifying influence of the menstrual flow is anold idea, but its connexion with chlorosis had, so far asI know, not been hitherto suggested. Imperfect celldevelopment, due to hereditary scrofula, &c., makes itselffelt in the genital system, and the increased metabolism- coincident with puberty throws a greater strain on this

system, the eliminatory insufficiency of which is then demon-strated bv the condition which we denominate chlorosis.Abnormal narrowness of arteries, such as the mesenteric andpulmonary conduce still further to the retention of noxiousmaterials in the blood. But, after all, only direct experi-mentation with menstrual blood can settle the question, andsat is, therefore, to be hoped that MM. Charrin and Carnotwill pursue their researches in this direction and publish theresults.

Theobromine as a Diuretic in Cardiae and Renal Diseases.

For the last two years M. Huchard has made extensiveuse of theobromine as a diuretic in the above-named diseases,and he has come to the conclusion that it is, as a diuretic,superior to digitalis and caffeine. Its prolonged adminis-tration involves no inconvenience, provided that the dailydose does not exceed 5 grammes, and more especially if thisquantity be given in fractional doses of 50 centigrammes.Exceptionally it may, however, even in smaller doses, causesevere headache. Nausea and vomiting are rare, as isalso cerebral excitement. Once only did the exhibition ofthe drug cause albuminuria, and in three instances onlywas previously existing albuminuria increased by it. Inthese latter cases the increased albuminuria coincided withrapid disappearance of the cedema. M. Huchard prescribesthe theobromine after the following plan : lst day, 3 grammesin fractional doses of 50 centigrammes (in cachets) ; 2nd day,4 grammes in eight cachets ; and 3rd day, 5 grammes in tencachets. This latter dose is continued for three or four’days. In certain cardiac diseases he prolongs the diureticaction by the administration (consecutively) of half or

one milligramme of digitalin given in one day. Theo-bromine is a direct diuretic, its action being to inducea heightened activity of the renal epithelium. Its employ-ment is particularly indicated in arterial cardiopathies, inthose complicated with renal lesions, in hyposystole (heartfailure), and in interstitial nephritis. The simultaneousexhibition of digitalis, caffeine, or lactose does not increase

1 Société Thérapeutique, Jan. 8th.

its diuretic action. Theobromine diuresis is not prolongedafter three or four days after the last dose given. The drugis not cumulative or toxic; it succeeds often when digitalinor caffeine have failed ; and it has apparently been of use intyphoid fever and pneumonia, where a free secretion of urineis of importance.

The Country Practitioner in France., The President of the French Chamber of Deputies, whenannouncing the loss that assembly had sustained by thedeath of Dr. Ernest Leroy, deputy for the Somme, tookadvantage of the occasion to pay a graceful and well-meritedcompliment to the members of the medical fraternity whoexercise their profession in the provinces. The followingtranslation of M. Brisson’s eulogy will doubtless be ofinterest to all British practitioners, whether urban or pro-vincial, albeit they themselves are not overburdened withsimilar laudation: "Our excellent colleague belonged tothat portion of the medical corps whose duty lies in ourrural districts, and whose devotion and disinterestednessare everywhere far above all praise. Obliged to minister

promptly to the requirements of the most complicated cases,constrained to be at all times everything to everybody, thesemodest doctors amass treasures of experience, and unfoldstores of goodness, which suffice to stamp the country prac-titioner as a type of all that is most elevated and interestingin human nature. They one and all are in constant contactwith extremes of misery and suffering whereof we know littleor nothing."Jan. 14th.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Photography through Opaque Screens.COMMUNICATIONS made last week to the Verein ftir Innere

Medicin and the Physical Society have caused an extra-ordinary sensation, not only throughout the medical pro-fession, but also in every department of the scientific world.Professor Roentgen of Wiirzburg, in Bavaria, has discoveredthat the beams of light produced by passing an electriccurrent through a vacuum tube are able to penetrate mediawhich are opaque to ordinary light, and he has in this waysucceeded in photographing objects which were coveredby various opaque solids, such as a wooden board, or aclosed book containing a thousand pages. Metal andsome other substances proved to be less transparent tothese rays than wood and paper are, but no screen

was found to be totally impermeable to the light of a

vacuum tube, so that it is now possible, for instance, to

photograph the bones of a living person’s hand through thesurrounding soft tissues, and photographs of this kind wereshown at the meetings of the above societies. ProfessorRoentgen has in this way obtained photographs even whenthe box containing the photographic glass plate was closed.It is the general opinion that the new discovery will producequite a revolution in the present methods of examining theinterior of the human body.

The Medical -Directory.Borner’s Medical Directory for 1896, edited by Dr.

Schwalbe, shows that there are now 23,099 medical men inGermany, the numbers having been 22,287 in 1894, 19,630in 1891, and 16,864 in 1887. Since last year the numericalincrease has therefore been 812, or 3’6 per cent., and duringthe last eight years the increase has been 6235, or 37 percent., whereas the increment of the general population hasbeen only 12 per cent. in the same space of time. There are13,778 medical men in Prussia, 2559 in Bavaria, 784 in

Wurtemberg, 1711 in Saxony, 862 in Baden, and 661 inAlsace-Lorraine, the remainder being in the smaller States ofthe Confederation. The directory states that there are 1978medical men at present in Berlin, but this number does notinclude the practitioners in the suburbs of the city.The increase of the medical profession in Berlin exceeds itsaverage increase throughout the empire, for the number hasrisen by not less than 580 practitioners (= 41 per cent.)since 1889, whereas the addition to the population of the-city is only 9 per cent. Munich has 435 medical men,Breslau 355, Leipzig 337, Hamburg 460, Frankfort 233, andStrassburg 220. There is now an average of 4’55 medicalmen for every 10,000 inhabitants, but in Berlin the propor-tion is as high as 12-59. There are 1071 registered dentistsand 5144 pharmacies. The Medical Practitioners’ Association

206

has 249 branches, with 14,270 members ; there are 96scientific societies, 15 societies for the discussion of ques-tions relating to public health, and 13 societies of armymedical officers. The 20 medical faculties have 263 teachersand 8361 students. The largest numbers of medicalstudents are in Berlin, Munich, Leipzig, and Wiirzburg. Theovercrowding of the profession and the extension of the clubsystem have had the effect of making medical practice muchless lucrative than formerly.

Laparotomy in Tuberculous Peritonitis.Professor Israel has contributed to the Deutsche Nedicinische

Wochenschrift a paper on Some Cases of Tuberculous Perito-nitis cured by Simple Laparotomy, and expresses the opinionthat as our knowledge of the conditions of healing under thesecircumstances is very limited it is desirable that every newobservation should be published. Laparotomy for this diseasehas seldom to be performed in childhood, but of ProfessorIsrael’s cases three were those of children who were operated onat a somewhat early stage. The local affection was very exten-sive, and all the patients were feverish, but the ascites was veryslight. The laparotomy was performed in the usual way; afterthe opening of the abdominal cavity a quantity of iodoformoil was thrown into it. The time elapsed since recovery hasbeen, for the three cases, fourteen, sixteen, and seven

months respectively. The first patient was a boy four yearsof age, in whom the tuberculous peritonitis had taken originfrom a tuberculous ulcer in the colon ; the intestines werepartially matted together, and the omentum was rolled uplike a curtain. A fistula which appeared a fortnight afterthe operation healed under the application of tincture ofiodine. In the second case the disease progressed rapidly,with high fever and severe abdominal pain, and on openingthe abdomen the mesentery and the peritoneum were foundto be covered with tumours of the size of a cherry-stone.After the operation the temperature became nearly normal,but the boy did not improve, and there was a recurrenceof diarrhoea together with enlargement of the abdomen, sothat thirty-six days after the first operation a secondlaparotomy was performed and Professor Israel was greatlysurprised to see that all the tumours had disappeared. Theboy thereupon quickly recovered and increased in weightconsiderably. In the third case, also, the child recoveredquickly, although he suffered from pleurisy and tuberculousinfiltration of the right apex. Professor Israel concludes(1) that the disappearance of tuberculous peritonitis cannotbe explained by the removal of the ascites, as in thesethree successful cases there was hardly any ascites ;(2) that laparotomy may be followed by recoveryeven when the peritonitis is combined with intestinalulceration; (3) that tuberculous tumours of the size ofa cherry-stone may disappear within thirty-six days; and(4) that hectic fever does not contraindicate the operation,as some French surgeons suppose. The fourth case was thatof a young woman aged twenty years, who had suffered fromabdominal pains since her thirteenth year. Symptoms ofileus had appeared, and a tumour could be felt in the rightside of the abdomen. A surgeon performed laparotomy andfound at the cascum a tumour of the size of an apple withswelling of the mesenteric glands and matting of the intes-tines. Believing the disease to be carcinoma, he closedthe abdominal wound without removing the tumour, and theileus disappeared, but the patient remained very weak. A

year afterwards Professor Israel was consulted, and, being ofopinion that the case was not one of carcinoma, he performed asecond laparotomy and found the peritoneum to be coveredwith tubercles. The tumour grew from the posterior wall ofthe colon and partly closed its lumen. To avoid ileus hemade an anastomosis between the ileum and the colon, butabstained from extirpation. Since the operation the patienthas regained good health; but what makes the case especiallyinteresting is the fact that the tumour, which was un-doubtedly of tuberculous nature, became smaller and smaller,until at present it is only the size of a walnut.Jan. 14th.

_______________

ROME.

(FROM OUR OWN CORRESPONDENT.)

The War in Abyssinia.CONCURRENTLY with the despatch of reinforcements to the

seat of war the Army Medical Department is proportionallyrepresented. The Croce Rossa Italiana, which has now four

stations in the Colonia Eritrea (to say nothing of the infirmaries in connexion with it at the various garrison towns),forms an effective auxiliary to that department, differ-ing as it does, in a military sense, from the Red CrossSociety elsewhere. The Geneva Convention is not recognisedin the colony, so that all the personnel at the fourstations referred to-the strictly professional staff as

well as the lay assistants-are provided with firearms,the medical officers with revolvers, and their servants withWetterly rifles. Any day we may now read of the activeintervention of the Red Cross, the encounters on the 7thinst. between the Shoan skirmishers and the Italian outpostsat Makalle being but the prelude to an engagement whichmust become general. The present disposition of the serviceis as follows. On the Asmara heights Dr. G. Del Prete,medical head of the Red Cross in the " Eritrea," directs the"ospedaletto da montagna" (mountain hospital), havingunder him Dr. De Ferrari (pharmacist) and the Cavaliere G,Badini (commissary), with the relative personnel. At AdiUgri Dr. Muzzioli presides over the garrison infirmary and the" posto di medicazione

" in connexion with it. At SaganritiDr. Goffredo Spinelli conducts another hospital of the kind,replacing the army medical officer now on duty in the field.At Adigrat there is a fourth station-the ambulanza dimontagna," fully equipped and with the necessary personnelunder Dr. Giuseppe Quattrociocchi. The other two ambu-

lances (Nos. 2 and 3) will be told off to positions selectedby General Baratieri, whose experience of the Red Crossservice in Abyssinia has been so favourable as quite toexplain the active countenance it receives from the WarOffice. At Massowah it commands rich stores of matiriel,entrusted to the Marquess Oreglia di Santo Stefano, whorepresents the central committee of the Red Cross in the"Eritrea." Meanwhile contributions of money, medicines,and comforts are pouring in, not from Italy only, but fromthe Italian settlements in South America-notably BuenosAyres and Santa Fe.

Sero-therapy at Naples.The Neapolitan school was one of the first in Italy to

recognise the new weapon afforded in practice by sew.therapy, but till now had taken no steps to provide itselfwith an establishment for the supply of the serum. Thedefect is already in course of being made good, a committee,with the Senator Spinelli for president, having raised fundsto take over the Istituto Vaccinogeno and adapt it for thepurpose desiderated. A better building and site could nohave been devised.

Professor Gaetano Mazzoni.

King Humbert has, proprio motu, conferred on Dr. GaetanoMazzoni, Professor of Clinical Surgery and Lecturer on

Special Pathology in our university, the badge of Cavaliereof SS. Maurizio e Lazzaro in recognition of His Majesty’sappreciation of his recent work entitled "Neutralità deiFeriti in Gueira" (" Neutrality of the Wounded in War").Jan. llth.

_____________

EGYPT.(FROM OUR OWN CORRESPONDENT.)

C7aolera.DURING the last fortnight there have been in all Egypt 15

new cases admitted as in-patients to, and 14 deaths reportedoutside, the hospitals, besides 12 deaths in hospitals. Thereare thus still about two cases every day, and they come nowfrom three villages quite in the interior. But there have alsobeen two cases at Alexandria, the first of which was fatal,and the second is now said to be convalescing afterbeing treated with some of Behring’s anti-cholera serum.

Cholera continues to be absent from the villages where !Itbroke out in October and November, but the same sanitaryprecautions are still being taken, and Dr. Rogers Pasha ishimself inspecting the suspicious haunts in Lower Egypt.

Small-pox.The existence of variola excites no comment, but as a

matter of fact there are 73 cases now being treated, as com-pared to 20 cases of cholera. The disease is nearly con-fined to four of the six provinces of Lower Egypt, butaltogether there are cases reported from twenty-one villages."Fièvre typhique," by which is meant probably typhus or