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433 the effluvia thenco arising un(ler exceptionally sultr,y days renders a walk or drive along her picturesque highways and byways a very chastened joy indeed. Not only so, but the common horse-iiy in these circumstances becomes a formidably aggressive poisouer. Not so long ago at Thun a lady was Stung under the lower oyelid by one of these winged tormentors, and in less than an hour such swelling and pain set in that nothing short of the best surgical interference, telegraphed for from Home, succeeded in saving her life. Prcfessor Maragliano. The interest aroused in Professor Maragliano’s treatment of phthisis, as submitted to the British Medical Association, has extended to France. At the Congress of the Société de Medecine, which, under the presidency of Dr. Bouchard, opened its proceedings last week at Bordeaux, Professor Maragliano has been vouchsafed an entire sitting for the exposition and discussion of his views. Before leaving London he was, I may mention, "interviewed " by the repre- sentative of that widely diffused journal 77 Secolo, to whom he expressed his high admiration of the sanitary institutions, the hospitals, and the whole hygienic organisations of the British capital. He was surprised at the solidarity pre- vailing among the British medical men, at their well- disciplined meetings, at the practical sense which guides them, not only in the field of science, but in that of pro- fessional interests. The admirable organisation of ,, the meeting itself elicited his special commendation, ’, its hospitality being superiore alle speranze anche degli esigenti" (beyoncl the hopes even of the exacting). The scientific discussions he found impressed with the gravity proper to the practical genius of the race, and while he missed the enthusiastic outburst of his southern compatriots he remarked the molta attenzione nel seguire le discussion! e le communicazioni scientifiche (great attention in follow- ing the scientific discussions and communications). Aug. 10th. VIENNA. (FROM OUR OWN CORRESPONDENT.) Ménière’s Disease. " PROFESSOR MAX GRUBER, at a recent meeting of the i Vienna Otological Society, read a paper on Meniere’s Disease. Ever since the attention of pathologists was directed to this ( disease and quinine was recommended by Charcot as a valu- able remedy against it the recognition of it has been easy if vertigo, tinnitus aurium. and deafness are present. It has been proved that the vertigo results from disease c of the semicircular canals. Meniere’s disease may, 1 however, according to Professor Gruber, be caused by secretory and exudative processes as well as by a h2;mor- ] rhage. Pigment originating from an extravasation may be found in the sacculus, cochlea, and semi-circular canals in the ears of persons who during life never suffered from vertigo. On the other hand, the aquæductus cochleae, and especially the recessus Cotunnii, into which the aqumductus vestibuli discharges itself, must not be overlooked. This recessus varies greatly in size ; sometimes it is hardly to be found, sometimes it is as large as a bean. The membranes of the recessus may be united by connective tissue, and then a lymph engorgement takes place, which produces an abnormal pressure and extravasation of blood, and conse- quently Meniere’s symptoms. A too free use of alcohol may also give rise to these symptoms, because the secretion of B lymph is increased in consequence of the determination of blood to the head. Professor Gruber proposed to restrict t the name Ménière’s disease to phenomena originating in the labyrinth and to separate it from feverish conditions such as labyrinthitis. Asepsis and Antisepsis in Ophthalmology. Ever since Gayet showed by his experiments that out of J 178 inoculations of eyes cultures resulted in 139 cases and failed only in 39 cases, it has been recognised that an abso- lutely antiseptic condition of the conjunctiva is not to be obtained; the infective action, however, is limited to those micro-organisms which adhere to the surface of the epithe- lium. As corrosive sublimate produces opacity of the cornea, and some other remedies become decomposed or have a disagreeable odour, Dr. Grossmann in the Therapeutische Wochenschrift recommends cyanide of rncrcury. It has been employed by Chibret, and possesses the same bacteri- cidal quality as corrosive sublimate, without irritating the tissues or coagulating albnmcn in such a marked degree as the latter. A solution of 1 in 5000 is sutticiently strong, but it must not be used when the capsule of the eyeball is to be opened, for if it penetrates into the anterior chamber of the eye it may injure the endothelium. Eye washes, as a rule, contain germs of micro-organisms even when pre- pared with distilled water. Dr. Grossmann therefore adopts Franke’s proposal to make use of a solution of corrosive- sublimate (1 part in 10,000) for the purpose of dissolving the salts of atropine, cocaine, and eserine ; he also recom mended frequent sterilisation by boiling. The Effect of Conrprcsscrl Air on the Health of Workmen. In the issue of THE LANCET of July 6th I mentioned some cases of the so-called caisson disease produced by compressed air. The Council of Hygiene requested Professor Max Gruber to prepare a report on this subject, and he has. now made the following recommendations: (1) the ventila- tion is to be improved with a view to diminish the carbonic acid contained in the air of the caissons; (2) a time of from seven to ten minutes is to be allowed for the entrance of the- workmen ; and (3) a permanent medical service is to be established, the medical officer of which shall satisfy himself as to the gradual condensation of the air. Dr. Silberstein has published an interesting article on Caisson Disease in the Medicinische Wochenschrift, mentioning the loss of control over the lower extremities, the urinary bladder, and the- rectum as being by far the most important symptoms. He suggested the presence of nitrogen in the spinal cord, which, when the pressure becomes lowered to that of the external air, forms gaseous vesicles in the blood, and by obstructing the vessels produces the above-enumerated paralyses. Not uncommonly patients suffer also from vertigo, increased knee- jerks, and crackling in the knee-joint due to the pressure of gas liberated in the cellular tissue. Death of Dr. Bettel7ieint. By the death of Dr. Bettelheim, who passed away on July 26th, the medical profession in Vienna has lost one of its most able representatives. Born in Pressburg (Hungary) in 1844, he studied at the Vienna School of Medicine under Hyrtl, Rokitansky, Skoda, and Bruke, and after having- obtained his diploma in 1866 he acted as assistant to the late Professor Oppolzer. In 1873 he was recognised as privat- docent in Pathology, and during the succeeding eight years. edited the Medicinisch-Chirurgusche Rundschau. Among his numerous published works I need mention only those on Pneumonia Biliaris," "The Diagnosis of Cancer of the- Stomach," and " The Use of Muriatic Acid in the Treatment of Gastric Diseases." Dr. Bettelheim felt himself slighted because he did not succed in obtaining an ordinary professor- ship ; during the last five years he was Primarius of the Rudolfinerhaus. Aug. 10th. ______________ CONSTANTINOPLE. (FROM OUR OWN CORRESPONDENT.) Granular Ophthalmia. AT the last meeting of the Imperial Society of Medicine Dr. Malgat of Paris delivered a very interesting lecture on Granular Ophthalmia. A good many members attended, not- withstanding the very hot and oppressive weather which pre- vails here just now. Dr. Malgat first of all referred to the- treatment of granular ophthalmia amongst the ancient Greeks and the Egyptians, and then enumerated the various methods that have been adopted up to the present time, showing that they were all inefficacious and dangerous. He then fully de- scribed the treatment by electrolysis. After demonstrating that the proposed cures by conjunctival cicatrices formerly recommended were not without danger for the patients, he declared that among fifty cases treated by the electrolytic method lie had seen fifty complete- cures without any cicatrix whatever, just as if the con- junctivæ had never been diseased. The practical application of electrolysis is neither painful nor complicatocl ; on the contrary, it is wonderfully simple and does not involve the slightest danger to the eye. The apparatus used for the purpose is in the hands of all practitioners, being simply a
Transcript
Page 1: CONSTANTINOPLE

433

the effluvia thenco arising un(ler exceptionally sultr,ydays renders a walk or drive along her picturesquehighways and byways a very chastened joy indeed. Not

only so, but the common horse-iiy in these circumstancesbecomes a formidably aggressive poisouer. Not so long agoat Thun a lady was Stung under the lower oyelid by oneof these winged tormentors, and in less than an hour suchswelling and pain set in that nothing short of the best

surgical interference, telegraphed for from Home, succeededin saving her life.

Prcfessor Maragliano.The interest aroused in Professor Maragliano’s treatment

of phthisis, as submitted to the British Medical Association,has extended to France. At the Congress of the Société deMedecine, which, under the presidency of Dr. Bouchard,opened its proceedings last week at Bordeaux, ProfessorMaragliano has been vouchsafed an entire sitting for the

exposition and discussion of his views. Before leavingLondon he was, I may mention, "interviewed " by the repre-sentative of that widely diffused journal 77 Secolo, to whomhe expressed his high admiration of the sanitary institutions,the hospitals, and the whole hygienic organisations of theBritish capital. He was surprised at the solidarity pre-vailing among the British medical men, at their well-

disciplined meetings, at the practical sense which guidesthem, not only in the field of science, but in that of pro-fessional interests. The admirable organisation of

,,the meeting itself elicited his special commendation, ’,its hospitality being superiore alle speranze anche degliesigenti" (beyoncl the hopes even of the exacting). Thescientific discussions he found impressed with the gravityproper to the practical genius of the race, and while hemissed the enthusiastic outburst of his southern compatriotshe remarked the molta attenzione nel seguire le discussion!e le communicazioni scientifiche (great attention in follow-ing the scientific discussions and communications).Aug. 10th.

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Ménière’s Disease. "

PROFESSOR MAX GRUBER, at a recent meeting of the iVienna Otological Society, read a paper on Meniere’s Disease. Ever since the attention of pathologists was directed to this (disease and quinine was recommended by Charcot as a valu- able remedy against it the recognition of it has been easy if vertigo, tinnitus aurium. and deafness are present. It has been proved that the vertigo results from disease cof the semicircular canals. Meniere’s disease may, 1however, according to Professor Gruber, be caused by secretory and exudative processes as well as by a h2;mor- ]rhage. Pigment originating from an extravasation maybe found in the sacculus, cochlea, and semi-circular canalsin the ears of persons who during life never suffered fromvertigo. On the other hand, the aquæductus cochleae, andespecially the recessus Cotunnii, into which the aqumductusvestibuli discharges itself, must not be overlooked. Thisrecessus varies greatly in size ; sometimes it is hardly to befound, sometimes it is as large as a bean. The membranesof the recessus may be united by connective tissue, andthen a lymph engorgement takes place, which produces anabnormal pressure and extravasation of blood, and conse- quently Meniere’s symptoms. A too free use of alcohol may also give rise to these symptoms, because the secretion of Blymph is increased in consequence of the determination ofblood to the head. Professor Gruber proposed to restrict tthe name Ménière’s disease to phenomena originating in the labyrinth and to separate it from feverish conditions such as labyrinthitis.

Asepsis and Antisepsis in Ophthalmology. Ever since Gayet showed by his experiments that out of J

178 inoculations of eyes cultures resulted in 139 cases and failed only in 39 cases, it has been recognised that an abso-lutely antiseptic condition of the conjunctiva is not to be obtained; the infective action, however, is limited to thosemicro-organisms which adhere to the surface of the epithe-lium. As corrosive sublimate produces opacity of the cornea,and some other remedies become decomposed or have a

disagreeable odour, Dr. Grossmann in the Therapeutische

Wochenschrift recommends cyanide of rncrcury. It hasbeen employed by Chibret, and possesses the same bacteri-cidal quality as corrosive sublimate, without irritating thetissues or coagulating albnmcn in such a marked degree asthe latter. A solution of 1 in 5000 is sutticiently strong,but it must not be used when the capsule of the eyeballis to be opened, for if it penetrates into the anterior chamberof the eye it may injure the endothelium. Eye washes, as arule, contain germs of micro-organisms even when pre-pared with distilled water. Dr. Grossmann therefore adoptsFranke’s proposal to make use of a solution of corrosive-sublimate (1 part in 10,000) for the purpose of dissolvingthe salts of atropine, cocaine, and eserine ; he also recommended frequent sterilisation by boiling.

The Effect of Conrprcsscrl Air on the Health of Workmen.In the issue of THE LANCET of July 6th I mentioned

some cases of the so-called caisson disease produced bycompressed air. The Council of Hygiene requested ProfessorMax Gruber to prepare a report on this subject, and he has.now made the following recommendations: (1) the ventila-tion is to be improved with a view to diminish the carbonicacid contained in the air of the caissons; (2) a time of fromseven to ten minutes is to be allowed for the entrance of the-workmen ; and (3) a permanent medical service is to be

established, the medical officer of which shall satisfy himself asto the gradual condensation of the air. Dr. Silberstein has

published an interesting article on Caisson Disease in theMedicinische Wochenschrift, mentioning the loss of controlover the lower extremities, the urinary bladder, and the-rectum as being by far the most important symptoms. He

suggested the presence of nitrogen in the spinal cord, which,when the pressure becomes lowered to that of the externalair, forms gaseous vesicles in the blood, and by obstructingthe vessels produces the above-enumerated paralyses. Notuncommonly patients suffer also from vertigo, increased knee-jerks, and crackling in the knee-joint due to the pressure ofgas liberated in the cellular tissue.

Death of Dr. Bettel7ieint.By the death of Dr. Bettelheim, who passed away on

July 26th, the medical profession in Vienna has lost one ofits most able representatives. Born in Pressburg (Hungary)in 1844, he studied at the Vienna School of Medicine underHyrtl, Rokitansky, Skoda, and Bruke, and after having-obtained his diploma in 1866 he acted as assistant to the lateProfessor Oppolzer. In 1873 he was recognised as privat-docent in Pathology, and during the succeeding eight years.edited the Medicinisch-Chirurgusche Rundschau. Among hisnumerous published works I need mention only those onPneumonia Biliaris," "The Diagnosis of Cancer of the-

Stomach," and " The Use of Muriatic Acid in the Treatmentof Gastric Diseases." Dr. Bettelheim felt himself slightedbecause he did not succed in obtaining an ordinary professor-ship ; during the last five years he was Primarius of theRudolfinerhaus.Aug. 10th.

______________

CONSTANTINOPLE.(FROM OUR OWN CORRESPONDENT.)

Granular Ophthalmia.AT the last meeting of the Imperial Society of Medicine

Dr. Malgat of Paris delivered a very interesting lecture onGranular Ophthalmia. A good many members attended, not-withstanding the very hot and oppressive weather which pre-vails here just now. Dr. Malgat first of all referred to the-treatment of granular ophthalmia amongst the ancient Greeksand the Egyptians, and then enumerated the various methodsthat have been adopted up to the present time, showing thatthey were all inefficacious and dangerous. He then fully de-scribed the treatment by electrolysis. After demonstratingthat the proposed cures by conjunctival cicatricesformerly recommended were not without danger forthe patients, he declared that among fifty cases treatedby the electrolytic method lie had seen fifty complete-cures without any cicatrix whatever, just as if the con-junctivæ had never been diseased. The practical applicationof electrolysis is neither painful nor complicatocl ; on the

contrary, it is wonderfully simple and does not involve theslightest danger to the eye. The apparatus used for thepurpose is in the hands of all practitioners, being simply a

Page 2: CONSTANTINOPLE

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small Gaiffe’s continuous current battery of seven pairs.Dr. Malgat uses negative electrolysis. n order to make

. sure of success it is necessary to follow the gramilationseverywhere, even into the cul-de-sac of the upper eyelid,and for this purpose it will often be necessary to make asmall incision into the conjunctival cul-cle-sac. Dr. Ma,lga,talways prefers this last method. At the conclusion of the

meeting he was unanimously nominated a correspondingmember of the society.

C’laolcra.The epidemic has not quitted our country, but is slowly

spreading in several provinces in the interior. The latest

telegrams announce an outbreak of the disease in the pro-vinces of Maamuret-ul-Aziz and Adana. At one of the

villages in the former province no fewer than twenty-sevencases of cholera, with six deaths, occurred between July 20th- and 22nd. Sporadic cases are reported from several villagesin these two provinces.

Quarantine.The General Board of Health decided at its meeting on

July 22nd that arrivals from the littoral between Alexandriaand Suedieh shall be subject to a quarantine of five days ;vessels without passengers need not, however, remain in’quarantine longer than twenty-four hours. The quarantinemeasures against arrivals from the Karamanian coast are

maintained.July 26th.

_________________

NEW ZEALAND.

(FROM OUR OWN CORRESPONDENT.)

A GENTLEMAN who seems to have devoted a certain

portion of his leisure while in America in the directionof medical study, made a very sturdy attempt recently’to compel the Registrar-General in Wellington to havehis name placed on the list of recognised medical

practitioners; in fact. Mr. Justice Richmond paid a highcompliment to the applicant’s counsel for the exceedingly.able manner in which he had argued his case. Now, as amatter of fact, we have quite enough legalised medical:practitioners in New Zealand at the present time withoutsemi-qualified persons attempting to have their names en-Tolled on the list ; indeed, it is only too true that the numberof medical men coming to reside in this colony has increasedvery considerably of late. I fear many are disappointedwith the general results attending their emigration here, forNew Zealand is amply provided for in the way of medicalmen even unto the humblest country village. These remarksare penned in the hope that disappointment in the futuremay be saved, for New Zealand is not now the Elysiumthat it was for the medico. When the colony was in its

’infancy persons holding almost any kind of qualification wererecognised as medical men, but times have changed sincethen, as the applicant has now discovered, for his request wasemphatically refused by Mr. Justice Richmond, whose judg-ment will, let us hope, deter others from emulating such anexample.

Obituary.STEPHEN JENNINGS GOODFELLOW, Vi.D.,

F.R.C.P. LoND.

STEPHEN JENNINGS GOODFELLOW was born in Falmouth

- on Oct. 21st, 1809, his mother having come over from Portugalfor her confinement, and returning to that country withhim in the early part of 1810, his father, a member ofan ancient Northamptonshire family, being then a merchantresident at Lisbon. They returned to England before thePeace of 1815, as Dr. Goodfellow remembered the illumina-tions at Falmouth on that occasion. His family were

-not greatly in sympathy with intellectual pursuits, buteven as a very young man lie showed marked ability,reading such works as ..Locke on the Understanding,"&c., for the pleasure of the intellectual exercise. Hewas very anxious to go either to Oxford or Cambridge,but, his father not being alive to the advantages of a uni-versity education for him, he was unable to go and therefore.most gladly availed himself of the opportunities given by theestablishment of the University of London. There he passed

his examination as rapidly as possible. He has oftendescribed the diniculty of the vivâ voce in those early days,students passing from one table to another to be examined insix dttierent subjects befoTe quitting the examinationroom. He was an enthusiast in his profession, devotingmany hours to its study, and when attached to theLondon Fever Hospital he often pursued his studies far intothe night, once or twice being overtaken with sleep inthe post-mortem room. He was particularly neat andskilful in his preparations of microscopic objects, and manyof his preparations still exist in the museums of the RoyalCollege of Surgeons of England and the Middlesex Hospital.He married in 1846 Elizabeth, the daughter of William NansonEyre of Carlisle. She took great interest in his scientificwork, assisting in the translation of foreign works andhelping in drawing diagrams and sketches to illustratehis lectures. He had a. particularly happy method of

teaching, as many of the old students who studied underhim must remember. Everything was presented to the mindwith great clearness and in an interesting manner. Even inhis practice he made his patients understand the reason ofmuch of his treatment, and was particularly successful withnervous and hysterical patients. He had at one time a largeconnexion in America, and many and urgent invitations weresent to him to visit Boston and other parts ; and, though henever went over, many persons came from America on purposeto consult him. When he settled in London after hismarriage he was one of the founders of an observationsociety, to which some of the subsequently leading membersof the profession belonged. The members of this societymet at each other’s houses at stated intervals for the dis-cussion of interesting cases and scientific facts.

Dr. Goodfellow was educated at grammar schools in Corn-wall, the last one being the endowed school at Bodmin ;his early professional education was under the super-intendence of a gentleman in large general practice atSt. Austell ; in October, 1830. he entered at St. Bar-tholomew’s Hospital, and in 1832 became a Memberof the Royal College of Surgeons and a Licentiate of theApothecaries’ Company. He did not enter into practiceuntil 1834, but from a dislike to general practice becamea candidate for, and was elected to, the posts of residentmedical officer and superintendent of the London Fever

Hospital. On the establishment of the University of Londonhe obtained at the first examinations under the Charter the

degree of ill.B., and the following year that of M.D. In

1841, at the request of Mr. Skey, he consented to join himin the lectures on general Anatomy and Physiology at theAldersgate School of Medicine, especially that part relatingto the minute anatomy of muscle, skin, and mucous mem-branes, to which he had for some time given special attention.Shortly before the commencement of the winter sessionMr. Skey was appointed lecturer on Anatomy and Physiologyat St. Bartholomew’s Hospital, and Dr. Goodfellow in

consequence was urgently requested by the other lecturersto take the whole course, to which he reluctantly consented.About this time he translated for the lllicroscopical JournalGruby’s thesis on the ’’ Morphology of Pathological Fluids,"and on the death of the editor of that journal was appointedto fill his place. As a result of a consultation with thepublisher, Mr. Van Voorst, and several persons who tooka warm interest in the use of the microscope as an

important instrument in anatomical investigation, it wasdeemed desirable to enlarge the objects of the journaland to give it a more special designation. In furtheranceof this view it was published under the name of the London ;

Physiological Journal, Dr. Goodfellow and Mr. EdwinGuckett, the lecturer on botany at the London Hospital,being the editors. Several important papers were pub-lished in successive numbers by Dr. Carpenter, theeditors, and others. Among other papers was included oneby Dr. Goodfellow on the minute structure of voluntarymuscle. with careful drawings, confirming for the most

part the views of Dr. Todd and Mr. Bowman. In 1840 hediscovered, by TU I object glass, moving bodies (animalcule) inthe blood of a patient suffering from typhoid fever, and senta description of them with accurate measurements by themicrometer eyepiece to the Medical linies and Gazette.These bodies closely resembled, if they were not identicalwith, those now known as bacilli. In 1844 he was electedto the post of honorary physician to the CumberlandInfirmary, and, resigning his ottice at the Fever Hospital,took up residence at Carlisle. But in 1846, findingthat the practice was never likely to come up to his ex-pectations, and with a large and influential connexion in


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