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321 PHARMACOLOGY AND THERAPEUTICS. midst, but it may be that ere we succeed in bringing about its total extinction an increased phase of activity of the virus will show us some weak spots in cities other than Liverpool and Dublin. ___ DR. H. R. SILVESTER: AN UNREQUITED BENEFACTOR. IT unfortunately happens only too often that benefactors of their fellow men fail to obtain any personal reward or distinction for the important services which they have rendered. A conspicuous example of this kind has lately been suggested to us by a correspondent in the course of a letter on the "Silvester method" of restoring persons after apparent death from drowning and other causes of asphyxia. There can be no doubt that’the community has benefited immensely by Dr. Silvester’s discovery, the Royal Humane Society alone having recorded hundreds of instances in which it was the means of saving the lives of persons who were to all appearance drowned. Not only the Royal Humane Society, but the Admiralty, the Board of Trade, the Emigration Board, the Coast Guard Service, the National Lifeboat Institution, and various life- saving societies, both in this country and abroad, have approved of the method and directed it to be used by their officials, and in various publications have carefully described the details of the process for the information of seafaring men and the world at large. Dr. Silvester, however, has received only one recognition of his services to the public, ,the Fothergill medallion, awarded by the Royal Humane Society, a high honour it is true, but the circumstances are exceptional, for the lesson which Dr. Silvester has taught is one to be learned, not only by the medical profession, but by the thousands whose business or pleasure leads them into positions where life may be lost by drowning. The "Silvester method" is, in fact, one of the most useful of life-saving devices, its discoverer happily is still with us, and vthe present time, when he is retiring from the practice of ,his profession, would seem to be a fitting occasion for some public appreciation of his valuable work. MR. RALPH STOCKMAN, M.D., F.R.C.P. Edin., F.R.S. Edin., who has been appointed to the chair of Materia Medica and Therapeutics in the University of Glasgow by the Crown, in room of the late Professor Charteris, holds the position ,of Lecturer on Materia Medica and Therapeutics in the Edinburgh Extra-mural School, and is Examiner in Materia Medica in the University of Oxford, He has also held the post of Examiner in the same subjects at Victoria and Glasgow Universities. - THE date of delivery of the Bradshaw Lecture by Dr. Markham Skerritt has been fixed for Nov. 4th, 1897. On Nov. llth Dr. Pavy will deliver a lecture supplementary to his previous Croonian Lectures. The Gulstonian Lectures for 1898 will be delivered by Dr. J. Rose Bradford, the Lumleian Lectures by Sir R. Douglas Powell, and the Croonian Lectures for 1899 by Dr. J. B. Bradbury. AMONG their appointments to Science Research Scholar- ships Her Majesty’s Commissioners for the Exhibition of 1851 have placed the name of William Alexander Osborne, M.B., of Queen’s College, Belfast. These scholarships are of the annual value of &pound;150 and are tenable for two years, and, under special circumstances, for three years. THE Treasury have appointed a small committee to consider and report upon the desirability of establishing a ’National Physical Laboratory for the testing and verification <of instruments for physical investigation and for other similar purposes. Lord Rayleigh will be chairman, and with him are associated several leading physicists. AT the Viceregal Lodge, Dublin, on Aug. 2nd, his Excellency the Lord-Lieutenant conferred the honour of knighthood on Mr. George F. Duffey, M.D. Dub., President of the Royal College of Physicians of Ireland ; and on Mr. William Thomson, M.D. Q.U.I., President of the Royal College of Surgeons in Ireland. ENGLISH visitors to the Moscow Congress who may avail themselves of the opportunity of passing through Hamburg are assured of a welcome by the profession there. In another column we publish a letter by Dr. Kummell, of the Allgemeines Krankenhaus in Hamburg, on this subject. WE have received from the Foreign Office a Programme of the Conference which is to be held on the subject of Leprosy at Berlin from Oct. llth until Oct. 16th next. Intending members should communicate with Dr. E. Ehlers, 6, Lanegarde, Copenhagen. AT a meeting of the Council of the Metropolitan Hospital Sunday Fund held on Thursday, Aug. 5th, at the Mansion House, the sum of nearly &pound;40,000 was recommended to be paid to 132 hospitals and 56 dispensaries. SIR CHRISTOPHER NIXON, M.D. R.U.I., has been appointed Representative of the Royal University of Ireland on the General Medical Council, in lieu of Sir John Banks, resigned. THIRTY-FIVE duly qualified medical practitioners have applied for the post of superintendent of the Aberdeen Royal Infirmary. - THE London University Commission Bill has shared the fate of other opposed measures and has been withdrawn. Pharmacology and Therapeutics. TREATMENT OF HYDROCELE BY CARBOLIC WATER. WHAT appears to be both a simple and effective method of dealing with hydroceles has been practised for the last couple of years by Dr. Pilate and Dr. Vissemans in the Orleans Military Hospital. It consists in the washing out of the cavity of the tunica vaginalis-after evacuation, of course- with a weak solution of carbolic acid. The surface is first cleaned with soap and brush and then washed with a solu- tion of perchloride of mercury. The trocar is then inserted, and after the serous fluid has been drawn off warm carbolic water of the strength of 3 per cent., which has been previously boiled, is injected. This is allowed to come out, and is seen to be turbid, containing fibrinous flocculi. The washing out is repeated four or five times until the liquid emerges from the cannula quite clear. The instrument is then withdrawn and the puncture closed in the usual way, a suspensory bandage being put on. Owing to the anoes- thetic effect of the carbolic acid the patient feels no pain. Some further effusion into the sac usually occurs in four or five days, but this soon subsides and the patient can resume his ordinary work. He is advised, however, to continue to wear the suspensory bandage for a time. This treatment has proved quite satisfactory, but is only recommended in simple cases occurring in young subjects. NUTRITIVE EFFECT OF SUBCUTANEOUS INJECTIONS OF OIL. Dr. Fornaca and Dr. Micheli, of Professor Bozzolo’s clinic in Turin, have made a series of trials of the effects to be obtained by injecting oil under the skin. They find that a dose of from 30 to 200 grammes introduced in this way is rapidly absorbed, and that it produces a marked decrease in the quantity of nitrogen eliminated, thus of course allowing more to remain in the tissues without undergoing metabolic change, the body weight increasing and the general condi- tion being improved. It would appear that oil introduced subcutaneously has much the same nutritive value as when it is ingested, and produces better effects that when it is injected per rectum. Indeed, it seems to these investigators that the hypodermic might be substituted for the rectal method in most
Transcript
Page 1: Pharmacology and Therapeutics

321PHARMACOLOGY AND THERAPEUTICS.

midst, but it may be that ere we succeed in bringing aboutits total extinction an increased phase of activity of the viruswill show us some weak spots in cities other than Liverpooland Dublin.

___

DR. H. R. SILVESTER: AN UNREQUITEDBENEFACTOR.

IT unfortunately happens only too often that benefactorsof their fellow men fail to obtain any personal reward ordistinction for the important services which they haverendered. A conspicuous example of this kind has latelybeen suggested to us by a correspondent in the course of aletter on the "Silvester method" of restoring persons afterapparent death from drowning and other causes of asphyxia.There can be no doubt that’the community has benefitedimmensely by Dr. Silvester’s discovery, the Royal HumaneSociety alone having recorded hundreds of instances in

which it was the means of saving the lives of persons whowere to all appearance drowned. Not only the RoyalHumane Society, but the Admiralty, the Board of

Trade, the Emigration Board, the Coast Guard Service,the National Lifeboat Institution, and various life-

saving societies, both in this country and abroad, have

approved of the method and directed it to be used by theirofficials, and in various publications have carefully describedthe details of the process for the information of seafaringmen and the world at large. Dr. Silvester, however, hasreceived only one recognition of his services to the public,,the Fothergill medallion, awarded by the Royal HumaneSociety, a high honour it is true, but the circumstances areexceptional, for the lesson which Dr. Silvester has taughtis one to be learned, not only by the medical profession,but by the thousands whose business or pleasure leads theminto positions where life may be lost by drowning. The

"Silvester method" is, in fact, one of the most useful oflife-saving devices, its discoverer happily is still with us, andvthe present time, when he is retiring from the practice of,his profession, would seem to be a fitting occasion for somepublic appreciation of his valuable work.

MR. RALPH STOCKMAN, M.D., F.R.C.P. Edin., F.R.S. Edin.,who has been appointed to the chair of Materia Medica andTherapeutics in the University of Glasgow by the Crown,in room of the late Professor Charteris, holds the position,of Lecturer on Materia Medica and Therapeutics in the

Edinburgh Extra-mural School, and is Examiner in MateriaMedica in the University of Oxford, He has also held the

post of Examiner in the same subjects at Victoria and

Glasgow Universities. -

THE date of delivery of the Bradshaw Lecture by Dr.Markham Skerritt has been fixed for Nov. 4th, 1897. On

Nov. llth Dr. Pavy will deliver a lecture supplementary tohis previous Croonian Lectures. The Gulstonian Lectures for

1898 will be delivered by Dr. J. Rose Bradford, the LumleianLectures by Sir R. Douglas Powell, and the CroonianLectures for 1899 by Dr. J. B. Bradbury.

AMONG their appointments to Science Research Scholar-ships Her Majesty’s Commissioners for the Exhibition of1851 have placed the name of William Alexander Osborne,M.B., of Queen’s College, Belfast. These scholarships areof the annual value of &pound;150 and are tenable for two years,and, under special circumstances, for three years.

THE Treasury have appointed a small committee toconsider and report upon the desirability of establishing a’National Physical Laboratory for the testing and verification<of instruments for physical investigation and for othersimilar purposes. Lord Rayleigh will be chairman, andwith him are associated several leading physicists.

AT the Viceregal Lodge, Dublin, on Aug. 2nd, his

Excellency the Lord-Lieutenant conferred the honour of

knighthood on Mr. George F. Duffey, M.D. Dub., Presidentof the Royal College of Physicians of Ireland ; and onMr. William Thomson, M.D. Q.U.I., President of the RoyalCollege of Surgeons in Ireland.

ENGLISH visitors to the Moscow Congress who may availthemselves of the opportunity of passing through Hamburgare assured of a welcome by the profession there. Inanother column we publish a letter by Dr. Kummell, ofthe Allgemeines Krankenhaus in Hamburg, on this subject.

WE have received from the Foreign Office a Programme ofthe Conference which is to be held on the subject of Leprosyat Berlin from Oct. llth until Oct. 16th next. Intendingmembers should communicate with Dr. E. Ehlers, 6,Lanegarde, Copenhagen.

-

AT a meeting of the Council of the Metropolitan HospitalSunday Fund held on Thursday, Aug. 5th, at the MansionHouse, the sum of nearly &pound;40,000 was recommended to bepaid to 132 hospitals and 56 dispensaries.

SIR CHRISTOPHER NIXON, M.D. R.U.I., has been appointedRepresentative of the Royal University of Ireland on theGeneral Medical Council, in lieu of Sir John Banks, resigned.

THIRTY-FIVE duly qualified medical practitioners haveapplied for the post of superintendent of the Aberdeen

Royal Infirmary. -

’ THE London University Commission Bill has shared thefate of other opposed measures and has been withdrawn.

Pharmacology and Therapeutics.TREATMENT OF HYDROCELE BY CARBOLIC WATER.

WHAT appears to be both a simple and effective method ofdealing with hydroceles has been practised for the lastcouple of years by Dr. Pilate and Dr. Vissemans in the OrleansMilitary Hospital. It consists in the washing out of thecavity of the tunica vaginalis-after evacuation, of course-with a weak solution of carbolic acid. The surface is firstcleaned with soap and brush and then washed with a solu-tion of perchloride of mercury. The trocar is then inserted,and after the serous fluid has been drawn off warm carbolicwater of the strength of 3 per cent., which has been

previously boiled, is injected. This is allowed to come out,and is seen to be turbid, containing fibrinous flocculi.The washing out is repeated four or five times until theliquid emerges from the cannula quite clear. The instrumentis then withdrawn and the puncture closed in the usual way,a suspensory bandage being put on. Owing to the anoes-thetic effect of the carbolic acid the patient feels no pain.Some further effusion into the sac usually occurs in four or fivedays, but this soon subsides and the patient can resume hisordinary work. He is advised, however, to continue to wearthe suspensory bandage for a time. This treatment has

proved quite satisfactory, but is only recommended in simplecases occurring in young subjects.NUTRITIVE EFFECT OF SUBCUTANEOUS INJECTIONS OF OIL.

Dr. Fornaca and Dr. Micheli, of Professor Bozzolo’s clinicin Turin, have made a series of trials of the effects to beobtained by injecting oil under the skin. They find that adose of from 30 to 200 grammes introduced in this way israpidly absorbed, and that it produces a marked decrease inthe quantity of nitrogen eliminated, thus of course allowingmore to remain in the tissues without undergoing metabolicchange, the body weight increasing and the general condi-tion being improved. It would appear that oil introducedsubcutaneously has much the same nutritive value as when itis ingested, and produces better effects that when it is injectedper rectum. Indeed, it seems to these investigators that thehypodermic might be substituted for the rectal method in most

Page 2: Pharmacology and Therapeutics

322 THE LANCET SPE CIAL COMMISSION ON SICILY AS A HEALTH RESORT.

of the cases in which the latter is usually employed. Two ofthe subjects on whom observations were made were sufferingfrom diabetes. In one of these cases 1780 cubic centimetreswere injected in the course of thirteen days, and produceda remarkable diminution in the quantity of nitrogen elimi-nated and in the amount of sugar excreted, together with aslight increase in the body weight. No alteration was foundin the quantity of urine passed. In the other case it wasnot possible to inject more than 310 grammes in four days,but even this small amount produced some decrease in theamount of nitrogen eliminated.

RECTAL FEEDING IN ’lYPHOID FEVER.

For some time past Dr. Queirolo, Professor of ClinicalMedicine in the University of Pisa, has been in the habit offeeding his cases of typhoid fever entirely by the rectum inorder to afford the dis eased bowel complete rest. The nutrientenemata are given four times daily, and consist of trituratedmeat and pancreas with a few drops of laudanum, eachinjection being preceded by irrigation of the bowel withboracic acid-the plan, in fact, advocated by Leube. The

patients are allowed to drink hydrochloric acid lemonade.In this way the digestive tract is preserved from putresciblesubstances, and this Dr. Qlleirolo considers obviates one ofthe most fruitful sources of auto-toxic action. All the casestreated on this system, many of them of a very severe type,are stated to have recovered.

The Lancet Special CommissionON

SICILYAS A HEALTH RESORT.

V.1V.1 ‘

Consideration of the Suitability of Sicily as a Health Resortfor cases of (1) Bronchitis and Bronchial Asthma;(2) Laryngeal Affections,. (3) Impaired Contaloseence ;(4) Serolitla " and 4i)t , _phatisnie"; ,. (5) 6’enileAffections,. (6) An&oelig;mia and Chlorosis; (7 ) Nervous-Diseases; and (8) Phthisis.-Sicily as a SummerS’tation. - Gibilmanna. - Accommodation in Sicily.-Deficiency qf Artificial Attractions.-Question of Brigand-age -Season for Visiting Sicily -Richness of Sicily inMatters of Historic and Antiquarian Interest.-Renanand Goethe.-Concluding Remarks.

IN the previous articles the data-meteorological andbotanical-for forming a correct estimate of the climate ofSicily have been sufficiently set forth. It was found that the

climate was intermediate between that of Earape and Africa,and that its leading characteristics were warmth, mildneEs,brightness, breeziness, equability, and moderate humidity,and that the proportion of fine weather, free from extremes,was remarkably high. It was further pointed out that thephysiological action of the climate upon the human organismmight be described as (1) moderately tonic and (2) sedative.It remains to inquire in detail what are the morbid con-ditions likely to be benefited by a temporary residence inSicily-or, in other words, what is the special utility of theisland as a health resort. The following statements embodythe experience and opinions of the leading Sicilian physicianswho have been kind enough to farnish THE LANCET SpecialCommissioner with their views.

(1) Bronchial affections, especially the dry and irritablevarieties, and including bronchial asthma,-All authoritiesare unanimous that these affections do exceptionally well inSicily. That is a conclusion which theoretical considerationswould strongly suggest, and which practical experience isfound to corroborate. A climate which is warm withoutextreme heat, neither excessively dry nor excessively humid,almost exempt from frost, snow, and cold winds, and whichpresents a remarkable degree of diurnal, mensual, andannual equability would naturally suggest itself as highlyfavourable for bronchial affections Further, the unquestion-ably sedative influence of the climate upon the nervous

1 Nos. I., II., III., and IV., were published in THE LANCET of June 5thand 12th, and July 3rd and 24th, 1897, respectively.

system add the additional element which is desirable inbronchial affections of an irritable or spasmodic type. 011the other hand, cases of bronchitis attended by profuse,secretion, whether or not amounting to actual bronchorrhcea,do not progress favourably in Sicily, inasmuch as theyrequire a drier atmosphere. Bronchial asthma is well knownto be a most erratic affection, for which it, is difficult.to select a suitable climate, but all the Sicilian observers.are unanimous that, on the whole, it does well in Sicily.

(2) Laryngeal affections.- The remarks just made withregard to bronchial affections may be substantiallyrepeated with regard to laryngeal affections. The dry andirritable varieties do extremely well in Sicily-the moistvarieties do not do well. Tuberculous laryngitis will be con.sidered in connexion with phthisis.

(3) Impaired convalescence after wasting diseases, after.effects of the specific fevers, mzLccria, bone and joint diseases;,pneumonia, pleurisy, yc.-Thia large class of patients on thewhole do well in Sicily. The mildly tonic influence of theclimate seems to promote the recuperative processes withoutstimulating the dregs of these diseases to renewed activity.The large proportion of mild, sunny weather permittingregular exercise almost daily is much in favour of thesecases. Convalescents sufficiently advanced towards recoveryto require a distinctly bracing climate should not be sent;to Sicily.

(4) "Scrofula" " and lymphatisme."-These cases do wellin Sicily for reasons analogous to those which render the,climate favourable for convalescents. As regards Britishpatients of this class, only the more delicate cases are

suitable for Sicily. The more robust patients will generallybe found to do better at Margate, Broadstairs, Folkestone, orperhaps Biarritz.

(5) Senile affeations.-These cases do well in Sicily,the warmth and equability of the climate and its mildlysedative influence being highly favourable to them. Elderlypatients, who are free from grave organic disease, but whofeel the weight of years and are depressed by the gloom andcold of the British winter, would in most cases benefitdecidedly by wintering in Sicily. The bronchitis anddyspepsia from which they so often suffer would be relieved,and tne generally mildly tonic influence of the climate suitstheir case. These patients are often sent to the Riviera, andfrequently with benefit, but the R viera climate is too

exciting for many of them-insomnia resulting-and themistral tries them severely.

(6) An&oelig;mia, and chlorosis. -These cases do well in Sicily,the large amount of sunshine and ample facilities for out.door exercise promoting digestion and sanguification.

(7) Irritable nerve aff, ctions, including hysteria andneurasthenia,-These cases are likely to benefit by the mildlysedative influence of the Sicilian climate. The great scenicattraction of the island and its historic and antiquarianinterest may prove valuable in certain cases of nerve disorder.Insomnia will probably be favourably affected.

(8) Phthisis. -This disease requires somewhat fullerconsideration for various reasons. It is the chief diseasefor which climttic change is usually sought, its climatictreatment is admittedly a very difficult matter, andthe Sicilian physicians are not unanimous regarding theresults obtained at the Sicilian sanatoria. It has been shownthat phthisis is common in Sicily, but that its prevalenceis below the general European average, and ProfessorUgetti’s remarkable figures tending to show the com-

parative exemption of Catania have been given, altboaghthey cannot be regarded as in any sense final andconclusive. The Sicilian practitioners in general are

guarded in their statements respecting the result3of treatment obtained among foreign phthisical patientswintering in Sicily. Many cases would appear to do well,some very well, and even the least promising cases-e.g.,laryngitis tuberculosa-are sometimes relieved, but thegeneral results are doubtful in nature, and the suitability ofthe climate for phthisical patients is still a moot point.Where practical experience speaks with doubtful voice it isfair to inquire what light can be thrown on this importantsubject by the general principles known to apply to theclimatic treatment of phthisis. Are there cases ofthe disease likely to benefit by wintering in a climatecharacterised by warmth, mildness, equability, moderatehumidity, &c., or not ? Are there cases, on the other hand,upm which the effect of such a climate will be either neutralor injurious ? These questions admit of a more or lessdefinite answer. The ground may be somewhat cleared by


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