1771

ansemia, and from the action of poisons were dwelt uponby different speakers.Temporary Loss of Vision in one or both eyes was the

subject of a paper by Mr. R. MARCUS GUNN, several examplesof which had come under his care. The conclusion at

which he arrived was that in most cases there is a temporaryor complete loss of the power of conduction of an unknownnature between the lower or middle visual centres and the

highest conscient centres. It does not, however, seem

improbable that it is attributable to a vaso-motor reflexaction leading to temporary occlusion of the retinal vessels.Various vaso-motor disturbances of the eyes impairingvision have been carefully observed and described by Dr.SAMUEL LODGE.The subject of Ptosis has been treated with great fulness

by Dr. WILBRAND and Dr. SAENGER who have shown theintimate relations that this physical sign has with manyforms of disease of the system at large and of the nervoussystem in particular.The French Ophthalmological Society was much exercised

in one of its sittings (Oct. 14th) with the subject of springconjunctivitis with papillas or vegetations. M. TERSON, who

brought the subject forward, considered it to be a disease

induced by a special microbe which, however, has not as yetbeen isolated. With this view several members agreed, butM. GALEZOWSKI attributed the affection in many instancesto alterations in the lacrymal passages. Excision of the

granules, scarification, electrolysis, actual cautery, ointmentscontaining salicylic acid and other topical remedies, andthe internal administration of iodine, cod-liver oil, arsenic,and adrenalin, with residence in mountain air, have beenadvocated by other speakers and serve to show that the

disease is both frequent and rebellious to treatment. Hithertothe secretory nerve of the lacrymal gland has been held tobe the fifth, but Mr. PARSONS has adduced cogent evidenceto show that the seventh is really the active nerve.

Colour Blindness.The necessity for the use of colour names in a test for

colour blindness has been strongly insisted on by Dr. F. W.EDRIDGE-GREEN in a paper read before the OphthalmologicalSociety, his argument being that there are two classes ofcolour-blind, in one of which the subjects are not able tosee certain rays of the spectrum because their spectrum is

shortened at one or both ends, so that on being shown a redlight the patients may declare that there is no light visible ;whilst the other class includes those who make mistakes

because they are not able to recognise the difference betweenthe colours which is evident to normal-sighted persons. The

former are easily recognisable and on trial at once demon-strate their incapacity ; the latter only require attention.

With regard to the second class it is to be observed that thenormal-sighted perceive six colours or are hexachromic, thosewith defective vision may see only five colours or are penta-chromic, others see only four and are tetrachromic, but the ’,mistakes of these are unimportant. The trichromic and di-chromic members of the second class alone require to berejected in applying for responsible posts where good colourvision for red or green is required since they are apt to

confuse these colours.

Instrwnents for the IJeteotion and Extraction of -Tran- 2’aMM in the EfJ e.

A new instrument has been brought into notice byDr. J. E. WIDMARK, devised by Dr. MARTIN JANSSONand named by him the siderophone, which promisesto be of value in determining the position of iron frag-ments in the globe of the eye. It is so constructed, on

the principle of Hughes’s induction scales, that two electriccurrents running in different directions are formed which

meet in a telephone. If these are of equal strength nosound is heard, but if one end of the instrument is approxi-mated to the smallest fragment of iron the current is

increased in the corresponding half and a sound is heard inthe instrument. According to Dr. JANSSON’S estimate, asplinter of iron weighing O. 001 of a gramme can be .dis-covered at a distance of 2-3 millimetres and one weighing0’01 of a gramme at a distance of 15 18 millimetres. Mr. A.FERGUSON MACCALLAN has collected a considerable numberof cases showing the value of Haab’s magnet in theextraction of particles of iron from the eye that haveoccurred in the London Hospital and has pointed out themuch greater difficulty and danger of extracting such

particles when they have penetrated the vitreous than whenthey are only located in the anterior chamber or imbeddedin the iris. Dr. S. BARKAN of San Francisco reportssimilar successful cases in which Professor HiRSCHBERG’S

new and powerful magnet was employed. This form of

magnet, which weighs only four pounds and four ounces, cansupport a weight at one pole, which is conical, of more than30 pounds.

FORENSIC MEDICINE.

Radcliffe v. Price.Since our last summary several actions have been tried

in which medical men have appeared in one capacity oranother. RADCLIFFE V. RRICE was a case heard in the HighCourt in which the defendant, the family physician of the lateMrs. DOWLING, was sued by the trustees of her estate to re-fund certain sums of money which he had received as giftsand not as remuneration for professional services. It wasnot alleged that Dr. A. F. PRICE had obtained the money(f:800) by illegal means, but the gifts were disputedon the ground that they were not valid in law in con-

sequence of the privacy with which they were receivedduring the later part of the lifetime of the deceased lady.We commented at the time on the propriety of a third personbeing present or consulted whenever a patient proposes tohand over substantial sums as a donation to his or her medicalattendant. Apart from the binding obligations of the lawit is desirable that a medical man should not lay himselfopen to suspicion of ’’ undue influence." Whilst Dr. PRICEwas fully absolved by the court on legal, moral, and pro-fessional grounds he was ordered to refund to the estate ofthe deceased the amount of the claim.

The Action against Dr. W. T. Law.Dr. W. T. LAW, who had professionally attended Miss

FORSYTHE, a nurse, has sustained the anxiety of a trial.The action was one for damages in which the defendant wasaccused of using sedative drugs in inordinate doses over aprotracted period, of procuring drugs for Miss FORSYTHE,and negligently placing them within her reach. Dr. LAW

lavished both time and service in ministering to the

plaintiff and for no other reward than the conscious-ness of doing what was evidently in her best interests.

Although the verdict was in his favour the mental distressconsequent on having to fight for his professional honourmust have been a heavy strain. The expression of sympathyextended to him by his medical brethren was a splendidtribute of the esteem in which he is held.

The Cathcart Case.What for a long time had been known as the CATHCART

case reached what we may hope was the final stage of astrange forensic history. Some years ago a jury impanelledto inquire into the mental condition of Mrs. CATHCART gavea verdict attesting her sanity, and that, too, in face of the

i strongest medical evidence to the contrary. Free fromrestraint upon her estate and person she entered upon themost senseless, prolonged, and costly litigation, and finallyfound herself in Holloway prison for contempt of court,

L which she persistently refused to purge. A second investi-, gation was held before a judge and jury with the result that

in future the poor victim of recurrent delusional insanity will; be protected against herself.

1772

1’ees of Medical Witnesses.An interesting case bearing on the question of the fees of

medical witnesses was decided at the New Mills countycourt. Dr. G. LORIMER of Buxton sued for payment of hisaccount in which he charged five guineas for preparing his

‘

case and five guineas per diem for attendance at the High 1

Court. We were glad to find that he was awarded the full (

amount of the claim with costs. (

Keeping Certifiable Lunatics mUhout a Licence. 1

At the North London Police-court SARAH ROACH was fined <

<E25 for having kept at the Alexandra Nursing Home with- 1

out a licence two certifiable lunatics. There were nine other 1

patients under her care. We subscribed to the decision of S

the magistrate which brought into strong light the neces- g

sity of protecting the public against the possibility of the v

freedom and well-being of individuals but little able, from a

senility or other causes, to take care of themselves being g

jeopardised.The Penruddoeke Case.

Quite recently Mrs. PENRUDDOCKE, a lady of high social ‘

position, was prosecuted at the Old Bailey by the National b "Society for the Prevention of Cruelty to Children. The 11

indictment, which included several counts, charged her with r,

having caused unnecessary suffering to her little girl, aged b

six years. The child, it appeared, was troubled with nenuresis. Numerous acts of cruelty were deposed to which ncould not by any stretch of the imagination be considered

fi

as proper corrective treatment for the affliction. The prisonerwas found guilty on a minor count and was fined 50.

Together with many of our contemporaries we had to expressthe opinion that the jury leaned to the side of mercy in a]their verdict. Mr. Justice BIGHAM, who tried the case, mregretted that they had been "constrained" to return a

h,

finding adverse to the accused. The lenient punishment fc

which he inflicted was strongly animadverted upon by a large lo

section of the public Criminal Abortion. bl e36W?MMM Abortion

There have been comparatively few charges during the JB1year of procuring criminal abortion. The most remarkable Pc

was the case of WILLIAM HOLLIS, a quack and herbalist Tl

who had a striking career of crime. 30 years ago he was fo

awarded 10 years’ penal servitude. Subsequently he was t)

condemned to death for a repetition of the offence but the w]sentence was commuted to life-long imprisonment. Givenhis liberty 20 years later he once more resorted to his

nefarious practices and for this Mr. Justice WRiGHT gave in

him another life sentence. in

Baby-farndng.Baby-farming seems to have been more rife than ever.

We have thought it incumbent upon us to advocate both KI

registration and inspection of all children put out to nurse ac

for gain, and further that all the contracting parties, in- gr.

cluding the parents of the children, should be included in de

the registration. sliCrime in General Paralysis of the Insane. da

As regards crime in general paralysis of the insane an had

instructive communication was made in the Journal of oc,

Mental Science by Dr. W. C. SULLIVAN who found by investi-gation of a large number of cases that as compared with :

alcoholic crimes where homicide, suicide, and sexual ofoffences predominated, the crimes of the general paralytic clil

were mostly those of acquisitiveness prompted by optimistic ani

ideas. 90Asphyxia from Pressure on the Cltest. &deg;

pigTwo interesting cases of asphyxia from pressure on the in

chest have been recorded, one in THE LANCET of Jan. 25th fro

(p. 245) and the other by Dr. BEACH and Dr. FARRERCOBB in the Boston Medical and Surgical Journal. In the former there was a peculiar mottled dusky-bluish hue of the car

skin which did not disappear on pressure. The cause of this the

was shown to be stasis of hypervenous blood in the dilatedf capillaries.

Poisoning by Illuminating Gas., Chronic poisoning by illuminating gas has been carefully. studied by Dr. J. 0. BAYLEY of New York. He found that

the prominent symptoms were anaemia, albuminuria, and

1 occasionally enlargement of the spleen causing a simulationof malaria. The patients improved or quite recovered onbeing removed to a pure atmosphere. The poisoning was

caused by gas having leaked slowly from mains and servicepipes, sometimes in such small quantity as to give no warn-

. ing by the smell. Dr. J. T. YARROW, jun., has described, similar cases. In two cases he detected carbonyl haema-

globin in the blood and in one case in the urine. It is note-

worthy that coal-gas contains 7 per cent. of carbon monoxideand recently manufactured water-gas (New York illuminatinggas) from 30 to 45 per cent.

’ Poisonous Stoves." "

Several instances of death from the vapour given off bypoisonous stoves " have been chronicled, that of M. ZOLAbeing the most notable. At Bayswater one man lost hislife and another was seriously affected. They slept in aroom the chimney of which received the products of com-bustion, complete and incomplete, of a stove outside. Themost potent factors were no doubt acetylene and carbonmonoxide. At Wakefield two girls were overcome by thefumes emanating from a geyser in a bathroom.

Poisoning by Methyl Alcohol.Dr. R. HUNT in the Johns Hopkins Hospital Bulletin has

recorded some valuable observations on poisoning by methylalcohol. The coma due to ethyl alcohol is as a rule of notmore than six hours’ duration, never lasting more than 24hours, whilst in the case of methyl alcohol it may persistfor two, three, or even four days. Methyl alcohol is retainedlonger in the nerve tissues and is thus cumulative. In

experiments on animals degeneration of the optic nerve’andblindness were observed in fatal cases. Professor WURDER-MANN has published in American Medicine two cases of

poisoning by the inhalation of the fumes of methyl alcohol.The symptoms were frontal headache, dizziness, and nausea,followed by loss of sight. He found that the prognosis oftxic amblyopia the result of methyl alcohol was worse thanwhen it was due to ordinary alcohol or to tobacco.

Carbon Bisulphide.Dr. D. GILBERr of the Belgian Inspection du Travail has

investigated the effects of the vapour of carbon bisulphidein connexion with the industry of vulcanising indiarubber.

Poisoning by Acetanilide.In the American Journal of the Medical Sciences Dr. P.

KING BROWN has recorded a death from poisoning byacetanilide (antifebrin). Six powders each containing 10

grains were taken in a few hours. The symptoms weredelirium, headache, pyrexia, rapid action of the heart,slight jaundice, nausea and vomiting, bloody motions, urinedark red and later nearly black from the presence of

h&aelig;matoporphyrin, and finally suppression of urine. Deathoccurred after several days.

The Cutaneous Absorption of Aniline.In the Archives Generales de M&eacute;decine Dr. G. BROUARDEL

of Paris has drawn attention to cases of poisoning from thecutaneous absorption of aniline. No deaths occurred. The

aniline was contained in a boot blacking in the proportion of90 per cent. Control experiments on rabbits and guinea-pigs furnished corroborative evidence of the facts observedin the human subject, in which the symptoms appeared infrom one to four hours.

lee-creams.The London County Council General Powers Act, which *

came in force on Nov. lst, 1902, is calculated to diminishthe number of cases of poisoning by ice-creams. Long

1773

ago THE LANCET issued a special Commission to inquireinto the insanitary condition of the Italian quarter, the headcentre of ice-cream manufacture.

Ptomaine Poisoning.Ptomaine poisoning has claimed several victims. The

most noteworthy instances were those which resulted fromeating pork pies purchased from a Derby firm. In all 130

eople were more or less affected. Professor DEL&Eacute;PINE, whoconducted the bacteriological investigations, found a colonbacillus in the pies. A culture of this injected into someanimals killed them. There was neither bad taste nor smellin the pies. The bacillus seems to have been derived fromthe large intestines of pigs which were prepared for sale inclose proximity to the place where the pies were made. Our

comment on this case was the necessity for the compulsoryinstitution of public abattoirs."

DENTAL SURGERY.

.Papers.Under the title of " Is the Symmetrical Extraction of the

First Permanent Molars Justifiable ? " Mr. ELOF FORBERG of

Stockholm has reviewed the many objections to the removalof these teeth for the relief of crowding. Since the time whensymmetrical removal of the first molars was advocated and

carried out somewhat extensively the methods of saving teethhave undergone a marked improvement, with the result thatviews on the subject have been modified. The results which

followed from symmetrical extraction were often undoubtedlygood and even now the treatment is an excellent one to

pursue in certain conditions.

Several communications have been published on PyorrhoeaAlveolaris, one of the most interesting being by Mr.KENNETH W. GOAD BY. He states that he has often found

yeasts in the small masses of tissue adhering to the apicesof teeth extracted in cases of suppurative gingival peri-odontitis (pyorrhoea alveolaris), but as yet they have not beeninoculated into animals. Culturally they appear to corre-spond to the yeasts found in the so-called chronic abscesses.In the later stages of the disease he ’states that it is rare tofind many cocci ; bacilli of various kinds and a good numberof threads are usually present, many of the later showinga tendency to stain irregularly and in patches. He described Ione organism which he thought may possibly have some Icausal relation to pyorrhoea alveolaris. It is a coccus

not hitherto described. The coccus is found in the pulp pchambers of teeth which are the seat of septic apical peri-odontitis and are also present in cases of acute oral

suppuration. The subject of Oral Sepsis and its Relationto General Disease was discussed by Mr. J. F. COLYER in apaper read at the annual general meeting of the BritishDental Association. He referred to several interesting casesof gastric ulcer in which marked improvement followed treat-ment of the teeth and he pointed out the constant relation-ship which existed between oral sepsis and conditions fami-liarly known as general debility. He urged the importance ofmore accurate accounts being recorded of the condition of theteeth in cases in which septic absorption was suspected, andhe pointed out that much more work, clinical, chemical, andbacteriological, was required before a correct idea of the

relationship of oral sepsis to general disease could be deter-mined. A paper by Dr. A. LoGAN TURNER on Some Points inthe Anatomy of the Antrum of Highmore is worthy of notice.Attent:on is directed to the frequent occurrence of an

accessory opening. It is situated posterior to, and on alower level than, the normal opening and its situation

explains those cases in which pus from antral suppurationdrains mainly backwards into the naso-pharynx and, indeed,may never appear at the anterior nares. The dangers of tooenergetic syringing were referred to and cases were recorded

in which an infection of the frontal sinus had resulted fromthis cause.A paper on the Influence of Mastication on the Jaws and

their Appendages has been read before the OdontologicalSociety of Great Britain by Dr. HARRY CAMPBELL. The im-

portant part played by muscular contraction in the formationof the nasal fossa was clearly shown. It was pointed out thatthe effect of rhythmic contraction of the masticatory muscleswas to accelerate the flow of blood and lymph in the jaws andall the accessory and neighbouring parts. Dr. CAMPBELLreferred fully to the type of palate at times found in thosesuffering from nasal obstruction and described what in his

opinion were the chief factors operating to produce the

deformity. His conclusions are open to criticism and he doesnot appear to have taken into account the important partplayed by the order of the eruption of the teeth in producingmany of the deformed arches. Mr. W. ARBUTHNOT LAKE in

a contribution to the British Medical Journal on the Valueof Respiratory Exercises on the Naso-pharyngeal Lesions ofChildren, has also referred to the question of deformeda:ches. The views of Mr. LANE, like those of Dr. CAMPBELL,are open to criticism, but this does not detract from the valueof the papers which should be the means of stimulatingothers to investigate these interesting subjects. Mr. MAYOCOLLIER has also published a paper in THE LANCET 1 onNasal Obstruction and Deformities of the Upper Jaw, Teeth,and Palate. Illustrations are given of three types ofdeformed arches which he considers are commonly associatedwith obstructed nasal respiration : the first deformity isknown as "open bite," the second as "inferior protrusion," and the third as "superior protrusion." These types of

deformed arches are constantly met with in dental practiceand in many instances there is not the slightest reason

to believe that they have been produced by nasal ob-struction.

Cases of Composite Odontomes have been recorded by Mr.C. W. GLAssnwToN and Mr. W. H. DOLAMORE. Thatrecorded by the latter occurred in the mandible on the rightside and is one of the largest yet described in this situation.The measurements were : length 4’2 centimetres, depth 2’8centimetres, and width 1-6 centimetres. The weight was 24’ 5grammes. The capsule came away with the solid pertionof the tumour and so allowed a microscopical section to bemade showing the mode of growth of the odontome. Under

the title of "An Anomalous Tumour from the Antrum"Mr. J. BLAND-SUTTON has described a curious tumour

which occupied the right antrum and caused considerablebulging of the facial portion of the maxilla in a girl,aged 11 years. The tumour was composed of soft

muscular tissue containing a large quantity of pieces ofbone to the number of 500, The tumour probably belongsto that rare category of growths known as "compoundfollicular odontomes." In a paper on the Clinical andChemical Study of a Case of Dental Erosion, in Items ofInterest, July, 1902, Dr. E. C. KIRK refers to the importance

. of studying the condition of the saliva in cases of dental

disease. M. MICHAELS of Paris is working in this direc-tion and the extended study of the saliva will no doubt domuch to assist in the elucidation of many of the pathologicalconditions of the teeth. Papers of interest have also appearedon the Pathology of Certain Growths about the Lower Jaw,by Mr. J. H. TARGETT ; a resume of the Histology of theDental Pulp, by Mr. F. A. LATHAM ; and a series of paperson the Etiology of Irregularities of the Teeth, by Dr. J. SIMWALLACE. The Dental Review has also during the yearpublished biographical sketches of dental practitioners living

in the beginning of the last century.) B Operative Dentistry.

Advance in operative dentistry has been made in the

1 THE LANCET, Oct. 18th, 1902, p. 1038.