1298

offered by Dr. Levi as a contribution to diseases caused

by the emotions. They form an addition to the list,already a long one, of the vaso-motor phenomena asso-ciated with hysteria. These symptoms cannot be con-

sidered to form a definite disease in themselves, but are a partof a series of phenomena which may take the place of oneanother, and in the form now described are caused by thesame neurosis-hysteria. Dr. Levi accepts the theory of acentral origin of hysterical affections, and points out thatfor their treatment a careful inquiry should be made into thepsychological history of the patients, so as to enable the

physician to detect any neurotic tendency, and so excludethe possibility of organic disease. He considers that hyp-notism is of great value both as regards the diagnosis andthe treatment of such cases.

THE Pall Mall Ga::;ette of Nov. 22nd -published a verysensible article on "Dentists and the Public," in which,after giving a brief account of the Dentists Act, which waspassed in the interests of and for the protection of the public,it is pointed out that the men who advertise are generally un-qualified, and use the term, "American dentistry " j ast asbakers do "Vienna bread." We might add that those whoare led away by specious advertisements are worse off thanthose who are gulled by moneylenders, for they not only losetheir money, but often an irremediable amount of harm isdone to the teeth.

__

THE British Institute of Public Health have made arrange-ments for a lecture to be given in the Examination Hall ofthe Royal Colleges of Physicians and Surgeons, Victoria

Embankment, on Friday, Dec. 7th, at 5 P.M., by Dr. G. SimsWoodhead, the Director of the Research Laboratories of theRoyal Colleges, entitled " The Diagnosis and AntitoxicSerum Treatment of Diphtheria." It is hoped in this lectureto give an authoritative statement of all the facts bearing on I,this important subject, and we understand that the Council z,of the Institute will be very glad to see any of our readers

I

present. -

THE Sanitary Institute has arranged for a discussion tobe held at the sessional meeting on Dec. 12th, at 8 P.M., onthe Sanitary Aspects of the London Building Act, which hasrecently been passed, and which will come into operation onJan. 1st next. Dr. G. B. Longstaff, chairman of the BuildingAct Committse of the London County Council, will open thediscussion, which should be interesting to the profession aswell as to members of local boards and vestries, as the newAct contains a number of provisions of great sanitaryimportance. -

THE Harveian lectures will be delivered before the Har-veian Society of London at the Stafford Rooms, Tichborne-street, Edgware-road, on Thursdays, Dec. 6th, 13th, and

20th, at 8.30 P.M., by Mr. Herbert W. Page, F.R.C.S., thesubject being Some Disorders of Nervous Function due toInjury and Shock. All medical men are welcome to attend

upon presentation of visiting card.

DR. RUSSELL REYNOLDS, F.R.S., President of the RoyalCollege of Physicians, Dr. Hermann Weber, Dr. DonglasPowell, and Dr. Cheadle have been elected ConsultingPhysicians of the Royal National Hospital for Con-

sumption. -

WE understand that a new "Society of Members of theRoyal College of Surgeons of England " has just beeninaugurated in London, and that a full programme willbe published shortly.

Pharmacology and Therapeutics.GOSSYPIUM HERBACEUM AS A HAEMOSTATIC.

THE root of the cotton plant gossypium herbaceum, whichhas been used in America and occasionally in Europe as asubstitute for ergot in labour and to check metrorrhagia, hasrecently been very strongly recommended by two Russianpractitioners as a powerful hxmostatic. Dr. Poteyenko 2prescribes twenty or thirty drops of the liquid extract threeor four times daily in haemorrhage of various kinds, and hasfrequently found it succeed where all other remedies havefailed. In three years he has treated fifty-nine cases in thisway, with entire success in fifty-two of them, only beingobliged to resort to other remedies in five instances. In thirtyof his cases the hmmorrhage was from the female genitals,in twenty-one from the lungs, in six from the nose, in onefrom the rectum, and in one from the stomach. He thinksthe drug entirely harmless, even when the patient happens tobe pregnant, and considers that it merely affects the blood-supply of the mucous membrane, and has no influence overthe uterine contractions. Dr. Narkewicz3 uses an infusionwhich he believes is more active than the liquid extract. A

tablespoonful is prescribed every hour or even every half-hour. He has used it only in uterine cases. In one instance,where the patient was vomiting, two enemata of about threeounces of the infusion were given with success after hot-water douches had failed.

NAPHTHOL CAMPHOR IN HIP AND SPINAL DISEASE.

M. M6nard, of Berck-sur-Mer, stated in a paper read beforethe French Surgical Congress that he has almost been ableto dispense with operative measures in hip disease and Pott’sdisease in children by employing naphthol camphor.During the last two years he has treated forty cases ofdiseased hip and forty-two cases of Pott’s disease inthis way. Of these, thirty-seven of the hip cases recoveredfrom the abscess without any fistulous period. In twoof them, however, suppuration returned, and resectionwas required. Four recovered after Bstulas, which lasted forfrom four to twelve months. Only one case was dischargedwith a fistulous opening. Of the forty-two cases ofspinal disease thirty-seven also were cured without fis-tula3, one was discharged with an open sinus, and two diedfrom tuberculosis. In one case the liquid produced toxic sym-ptoms. The method of procedure is as follows. A large trocaris inserted into the cavity of the abscess and fixed there whilea thorough washing out is performed with boiled water.Naphthol camphor is then introduced, the quantity dependingon the size of the cavity. If after a time the abscess showssigns of returning a fresh puncture is made. The liquid whichflows out is found to be quite clear and smells strongly ofcamphor. If the case is approaching a cure the pus is veryfluid. More naphthol camphor is introduced, and this pro-ceeding is repeated as often as may be necessary. Usuallyeight or ten punctures are required and the case lasts fromfour to twelve months. M. Menard has noticed that abscesseswhich appear late are more amenable to treatment thanthose that appear at a very early period. His method is notsuited for cases where sinuses already exist or where ordinarysuppuration microbes are present along with tubercle bacilli.

ADONIS VERNALIS WITH BROMIDES IN EPILEPSY.

Referring to the observations of Dr. Todorsk 5-whichshowed that epileptic attacks must be due to vasculo-motorchanges in the brain in the form of active cerebral hypemmia,and remarking that the action of bromine compounds onepilepsy consists principally, as far as we can j udge, of adiminution of the irritability of the cerebral centres, andmore especially of those in the cortex-Professor Bekhtereffstates in the l4eurolniclaeski Vestniks that for many years hehas successfully prescribed a combination of adonis vernaliswith bromides in epilepsy, which, raising the blood pressure,diminishes to some extent the lumen of the vessels themselves.The mixture he gives is made by adding to the ordinary solu-tion of from two to three drachms of bromide in eight ounces of

1 See THE LANCET, Sept. 27th, 1884.2 Meditzinsköe Obozrenie, No. 23, 1893, quoted in Allgemeine Medi-

cinische Central-Zeitung, Oct. 13th, 1894.3 Zemski Vrach, April 7th, 1894, quoted in Allgemeine Medicinische

Central-Zeitung, Oct. 13th, 1894.4 Report in Le Bulletin Medical, Oct. 17th, 1894.

5 Meditzinsköe Obozrênie, No. 10, 1894. Quoted in the Vrach, No. 25,1894.

6 Vol. ii., Fasc. 3. Quoted in the Vrach, No. 43, 1894.

1299

water one drachm of tincture of adonis, and as a sedative threegrains of codeine. Of this a tablespoonful is taken from fourto six or even eight times per diem. This is continued formany months and never occasions any unpleasant effects.In the course of several years Professor Bekhtereff hasnever seen a case in which this treatment systematicallycarried out has failed to produce at least some improvement,the attacks being either altogether put a stop to or diminishedin frequency and severity. Digitalis, if substituted foradonis, produces a similar effect, but is not so suitable onaccount of its cumulative action, which renders it impossibleto continue it for any long period of time.

OIL INJECTIONS IN DRY PLEURISY.

Dr. Cérenville7 of Lausanne, in obstinate cases of drypleurisy, injects about thirty drops of olive oil, previouslybterilised, with the object of imitating nature in providing alubricating fluid. This very small quantity of oil appears tobe sufficient for the purpose, as it is very diffi1sible and

rapidly spreads over a very large part of the surface of thelung. With care and practice it is not difficult, he says, tofind the right depth to insert the needle so as to penetrateinto the pleural cavity without wounding the substance ofthe lung. He has up to the present time employed this littleoperation in ten cases which had resisted the ordinary methodsof treatment by external stimulating applications &0. In twoof them only was no beneficial result observed, in six amarked improvement in the pain took place within a fewhours, while in the remaining two cases a complete and last-ing cure was obtained. It is obvious that this plan mayconceivably be useful in pericarditic troubles ; indeed, Dr.Cerenville has employed it already in one case of the kind.Of course, he does not recommend that in every case of drypleurisy olive oil should be injected, but he brings his planbefore the profession as one that may fairly be tried inobstinate and painful cases when other and more ordinarymeans have failed. The site which should be chosen for theinsertion of the needle is the spot where the friction soundsare the most distinctly heard.

SENNA IN THE INCONTINENCE OF URINE OF LOCO-,NIOTORATAXY.

Dr. Angel Bilbao,8 having prescribed a senna purgative forseveral consecutive days in a case of commencing locomotorataxy, was surprised to find that the incontinence of urinewhich had existed was arrested. That this was due to thesenna was evident, because when the medicine was discon-tinued the incontinence returned, to disappear again on theresumption of the treatment. Subsequently this remedy wastried in eleven cases of the early stage of ataxy where therewas incontinence. In five of them the urinary trouble dis-appeared in from ten to twelve days’ treatment with infusionof senna. In the rest the incontinence was diminished.

THE CHELSEA HOSPITAL FOR WOMEN.

A SPECIAL MEETING of Governors of the Chelsea Hospitalfor Women was held at the hospital on Wednesday, Nov. 28tb,1894, to elect a new Board of Management and to receivesuggestions from the medical staff. Sir Algernon Borthwick,Bart., M.P., presided. -

In opening the proceedings the CHAIRMAN briefly alluded tothe sequence of events which had led to the present meeting.The Committee of Investigation in their report spoke severelyof some of the classes of work of the hospital, and there wasa general tone of a certain amount of blame. The question ofmixed committees had been considered, and in the future theCommittee of Management would consist of laymen only.There would. therefore, be a committee of laymen and a housecommittee of medical men. These committees would inter-change their opinions from time to time. The Committee ofManagement would have attached to it one of the medicalstaff, who would always be ready to give advice to the com-mittee, but he would not be a member of that committee, and

7 Communication to the French Congress of Internal Medicine. SeeLe Bulletin Medical, Nov. 18th, 1894.8 Revista de Méd. y Cir. Práct., September, 1894, quoted in La In-

dependencia Médica, Nov. 8th, 1894.

would not have a vote upon it. All the recommendationsof the Committee of Investigation had been carried out.The present Board of Management now placed their resigna-tion in the hands of the meeting. He explained that thiswas necessary owing to another misunderstanding. Theyhad asked some eminent members of the medical professionto help them in the choice of physicians for the hospital,and it was felt that it would be better not to have generalpractitioners on the hospital. This was in consequence of asuggestion by Dr. Barnes and Sir Spencer Wells that thegeneral practitioner might possibly convey the germs ofdisease into the hospital. By an oversight this exclusion ofgeneral practitioners was left out of the advertisements, andthe general practitioners were justly angry when, aftersubmitting themselves for election, they found they werenot eligible. Some of the medical journals had takenumbrage at the matter, and complaints had been madein very general terms ; but he did not think those complaintswere altogether well founded. As a whole he consideredthat the hospital had been conducted in a manner that woulddo credit to any other hospital. He was sorry that Lord

Cadogan and Mr. Webb-Peploe had tendered their resigna-tions ; their retirement would be a great loss to the institu-tion. In submitting the list of names for the suggested newBoard of Management to the meeting, the Chairman remarkedthat he did not see how the work of the board could becarried on if it did not contain two or three members of theold board to give to new members advice.

Sir ALGERNON BORTHWICK then submitted the names of thefollowing gentlemen to constitute the new Board of Manage-ment :-Sir Algernon Borthwick, Bart., M.P., Mr. W. L. A.Burdett-Coutts, M.P., Mr. Thomas W. Brookes, Mr. A. J.Wright-Biddulpb, J.P., D,L, Mr. James Bailey, Mr. RobertJ. Beadon, the Hon. Colonel William Colville, Mr. T. DyerEdwards, J.P., Mr. Charles Fish, Mr. George Hilditch, Mr.J. L. LaDgman, Mr. Samuel Lithgow, Sir 05wald Moseley,Mr. J. Camming Macdona, M.P., Mr. Ernest Oppenheim,Major Probyn, L.C.C., Mr. Holmes Stone, Colonel Shipway,Mr. J. G. Woodroffe, and Mr. J. S. Wood.Mr. H. D. F. FERGUSSON moved that these gentlemen be

elected.Dr. TBAVBRS said the new board was an admirable one,

but there were three names upon the lbt upon whoseshoulders the whole work of the hospital lay, and uponwhom the blame of the Commission absolutely fell.

Mr. KING seconded Mr. Fergusson’s motion.Dr. TRAVERS moved that the names be voted for seria,tim,

but the meeting decided that they should be taken en bloe,and the new board was appointed by 71 to 9 votes.

Dr. SCHACHT wished for a definition of the term "generalpractitioner." If this suggestion that general practitionersshould be excluded were to become a rule the board shoulddefine the term or ask such an authority as the Royal Collegeof Physicians or the Royal College of Surgeons to do so.

".Dr. DUNCAN handed in the resignations of himself and hiscolleagues on the medical staff, upon whose behalf heventured to make the following suggestions. First, that thenew Board of Management should not ask the Governors atthe next annual meeting to confirm the nominations. Theynow tendered their resignations to the new Board of Manage-ment, and gave the latter perfect freedom in the selectionof a new staff. Secondly, the staff suggested that in adver-tising for gentlemen to come forward to form the new staffthe advertisements should not only state the essential quali-fications, but also that the new advertisements should con-tain the notification of any conditions that would disqualifya candidate for election. Thirdly, they suggested that,as the new Board of Management could not have the adviceeither of the consulting staff or of the acting medicalstaff, they having resigned, the cooperation should be soughtof several of the leading London surgeons and obstetric phy-sicians. From his experience of other hospitals he was surethe hospital would stand secottAno other special hospitalin the kingdom. The medical staff proposed to seek re-elec-tion, but, meanwhile, would carry on the work of the insti-tution.The Rev. A. J. MYERS and the Chairman pressed Lord

Cadogan to reconsider his resignation.Lord CADOGAN made a long statement, going mainly over

the ground covered by the letters which have already appearedin THE LANCET. He thanked them for their request, butwished to be allowed not to make any reply on this occasion.

’, The meeting then closed with the customary vote ofthanks to the chairman.