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ROYAL GLASGOW MEDIGO-CHIRURGICAL SOCIETY

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853 Over the gastro-intestinal tract there was widespread ! disintegration of the mucosa associated with pronounced formation of mucus. The disintegration concerned the duodenum, jejunum, and upper part of ileum in particular, and the increased formation of mucus concerned the colon and rectum and, to some degree, also the stomach. Our knowledge of the effects of X rays upon the generative system would lead to the supposition that testicle and ovary would be profoundly affected by the large degree of irradiation in question. In point of fact this was not the case. There was an arrest of spermato- genesis and some impaired staining of spermatozoal heads in the male and, in the female, the primordial ovules and Graafian follicles appeared to be the seat of a change resembling coagulation necrosis. But these effects were not associated with pronounced histological features. Probably the explanation lay in the relatively short survival of animals that had undergone a prolonged exposure to the 5 g. of radium bromide. The address was illustrated by macroscopic and microscopic specimens and by lantern slides. HUNTERIAN SOCIETY. The Ministry of Health and Preventive Medicine : The Hunterian Lectures by Sir George Newman. AT the inaugural meeting of the session of this society on Oct. 13th, at Sion College, under the presi- dency of Dr. A. C. JORDAN, Sir GEORGE NEWMAN delivered the first Hunterian lecture, taking as his subject " The Ministry of Health as an Instrument in Preventive Medicine." The lecturer said Hunter left three legacies to the profession, which formed a kind of basis for the new conception of preventive medicine. For Hunter was a student of the evolution of function ; he insisted on the importance of comparative pathology, and he taught that the foundation of healing rested with the recupera- tive and defensive powers of the body. The functions with which the Ministry was charged in promoting the health of the people were the following: (1) the pre- vention- and cure of disease; (2) the avoidance of fraudulent remedies; (3) treatment of physical and mental defects; (4) the treatment and care of the blind ; (5) the initiation and direction of medical research; (6) the collection and publication of infor- mation and statistics in regard to public medicine; (7) the training of persons for the public health service. Having referred to the responsibilities in regard to education which have now been assumed by the University Grants Committee, the lecturer went on to explain that the medical work of the Ministry was divided into the following six main sections: general health and epidemiology, with a laboratory for research; maternity and child welfare, staffed by medical women, nurses, and midwives; tubercle and venereal diseases; the control of food-supply ; general medical practice ; sanitary administration. In addition it embraced the school medical service, the Registrar- General’s Department, and the Board of Control for Lunacy. Also, for the first time medical referees had been appointed who would be located in different parts of the kingdom. Information on medical and health matters was regularly sought and collected, being after- wards studied and charted, and not alone from the United Kingdom, but from all the various parts of the world. It should be clearly understood that the Ministry was not established to solve the problems of local self- government, but those .which arose in the medical work of the central departments of State. The Ministry could work only through the local authorities, and for the plans to be a success the will and impulse of the people were essential. Efforts were being made to render the sanitary cordon round these islands com- plete, special attention being given to food and aliens; to establish, an International Health Office attached to the League of Nations; to revise the preventive methods in relation to tuberculosis and maternity ; to deal with incipient mental disease ; and to improve the conditions of insurance medical practice.-Sir George Newman was cordially thanked for his address. ROYAL GLASGOW MEDIGO-CHIRURGICAL SOCIETY. THE first meeting of this session was held in the Faculty Hall on Oct. 15th, when Professor W. K. HUNTER delivered the Presidential address, the subject being The Basal Ganglia : Tyceir Functions and Diseccses. Professor Hunter first discussed the anatomical relations of the ganglia and quoted the most recent observations, following out in detail the tracts and fibres passing to and from the ganglia, illustrating the points by diagrams and photographs. Their micro- scopical appearance and the grouping of the cells com- posing them were also referred to. In dealing with the functions of the basal ganglia it was pointed out that these structures were phylogenetically as well as embryologically much older than the cerebral cortex, and reference was made to the evolution of the ganglia and tracts. In the lower vertebrates the basal ganglia appear to represent the higher centres of the brain, where the optic thalamus constitutes the receptive centre for afferent and the corpus striatum the centre for the direction and regulation of efferent impulses. Ascending the animal scale the basal ganglia become subordinated to higher centres, although the optic thalamus still receives sensory impulses, and the corpus striatum would seem to regulate to a certain extent automatic and associated move- ments. In considering the relationship of these lower and higher centres the case of the optic thalamus and the cerebral cortex was first taken up. Is the destination of our various sensory impulses the thalamus or the cortex? The study of cases of what is called Dejerine’s syndrome gives an ; answer. Here there is a lesion in the thalamus which , interrupts the sensory fibres passing from the thalamus to the sensory area in the region of the post-central B gyrus, and also the efferent fibres coming from the , cortical area back to the thalamus. According to Head E and Gordon Holmes, who had studied a number of L these cases, the thalamus is the centre for painful and tactile impulses, for the appreciation of heat and cold 1and of heat apart from cold, also for the vibration sense. - Appreciation of touch and temperature seem to be ; cortical, for they are lost in Dejerine’s syndrome. . Questions of comparison are determined by the cortex, ) as are appreciation of posture and passive movement, 3 which are lost in this syndrome. Further, the cortex 1 focuses attention on sensation and may inhibit sensory impulses which reach the thalamus. The lessening of : this inhibition will permit of impulses reaching con- r sciousness which would not do so under normal circum- ,1 stances. This is offered as an explanation of the 1 subjective pain and discomfort on one side of the body, which is a feature of the Dejerine syndrome. The t symptoms of disease of the thalamus will, of course, ’- vary with the exact seat and magnitude of the lesion. Diseases of the corpus striatum were next reviewed d by Professor Hunter, and evidence was offered showing that paralysis agitans is probably due to disease of this h body. The symptoms of this disease are recognised in r- three forms: (a) the pre-senile and senile, (b) the e symptomatic, and (c) the juvenile. In the first two, e vascular changes are found in the corpus striatum after y death, while in the juvenile form the large ganglion f- cells of the globus pallidus and their neurons are the k seat of primary and progressive atrophy. So also with y the progressive lenticular degeneration of Kinnier )r Wilson, where the symptoms have a certain resemblance ie to the juvenile cases of paralysis agitans, but where the duration of the disease is short and always terminates n- fatally. Post-mortem examination has shown a sym- i metrical and bilateral degeneration in the corpus to striatum. Again, in Huntington’s chorea the patho- Is logical anatomy as described by Hunt shows that this is a disease of the same type as the juvenile form of as paralysis agitans, the difference being that in the former it is the smaller cells, whilst in paralysis agitans it is the larger cells of the corpus striatum which have undergone
Transcript
Page 1: ROYAL GLASGOW MEDIGO-CHIRURGICAL SOCIETY

853

Over the gastro-intestinal tract there was widespread ! disintegration of the mucosa associated with pronounced formation of mucus. The disintegration concerned theduodenum, jejunum, and upper part of ileum in particular,and the increased formation of mucus concerned thecolon and rectum and, to some degree, also the stomach.Our knowledge of the effects of X rays upon the

generative system would lead to the supposition thattesticle and ovary would be profoundly affected by thelarge degree of irradiation in question. In point of factthis was not the case. There was an arrest of spermato-genesis and some impaired staining of spermatozoalheads in the male and, in the female, the primordialovules and Graafian follicles appeared to be the seat of achange resembling coagulation necrosis. But theseeffects were not associated with pronounced histologicalfeatures. Probably the explanation lay in the relativelyshort survival of animals that had undergone a prolongedexposure to the 5 g. of radium bromide.The address was illustrated by macroscopic and

microscopic specimens and by lantern slides.

HUNTERIAN SOCIETY.

The Ministry of Health and Preventive Medicine : The Hunterian Lectures by Sir George Newman.

AT the inaugural meeting of the session of this society on Oct. 13th, at Sion College, under the presi-dency of Dr. A. C. JORDAN, Sir GEORGE NEWMAN delivered the first Hunterian lecture, taking as his subject " The Ministry of Health as an Instrument inPreventive Medicine."The lecturer said Hunter left three legacies to the

profession, which formed a kind of basis for the newconception of preventive medicine. For Hunter was astudent of the evolution of function ; he insisted on theimportance of comparative pathology, and he taughtthat the foundation of healing rested with the recupera-tive and defensive powers of the body. The functionswith which the Ministry was charged in promoting thehealth of the people were the following: (1) the pre-vention- and cure of disease; (2) the avoidance offraudulent remedies; (3) treatment of physical andmental defects; (4) the treatment and care of theblind ; (5) the initiation and direction of medicalresearch; (6) the collection and publication of infor-mation and statistics in regard to public medicine;(7) the training of persons for the public health service.Having referred to the responsibilities in regard to

education which have now been assumed by theUniversity Grants Committee, the lecturer went onto explain that the medical work of the Ministrywas divided into the following six main sections:

general health and epidemiology, with a laboratory forresearch; maternity and child welfare, staffed by medicalwomen, nurses, and midwives; tubercle and venerealdiseases; the control of food-supply ; general medicalpractice ; sanitary administration. In addition itembraced the school medical service, the Registrar-General’s Department, and the Board of Control for

Lunacy. Also, for the first time medical referees hadbeen appointed who would be located in different partsof the kingdom. Information on medical and healthmatters was regularly sought and collected, being after-wards studied and charted, and not alone from theUnited Kingdom, but from all the various parts of theworld. It should be clearly understood that the Ministrywas not established to solve the problems of local self-government, but those .which arose in the medical workof the central departments of State. The Ministrycould work only through the local authorities, and forthe plans to be a success the will and impulse of thepeople were essential. Efforts were being made torender the sanitary cordon round these islands com-plete, special attention being given to food and aliens;to establish, an International Health Office attached tothe League of Nations; to revise the preventive methodsin relation to tuberculosis and maternity ; to deal withincipient mental disease ; and to improve the conditionsof insurance medical practice.-Sir George Newman wascordially thanked for his address.

ROYAL GLASGOW MEDIGO-CHIRURGICALSOCIETY.

THE first meeting of this session was held in theFaculty Hall on Oct. 15th, when Professor W. K.HUNTER delivered the Presidential address, the subjectbeing

The Basal Ganglia: Tyceir Functions and Diseccses.Professor Hunter first discussed the anatomical

relations of the ganglia and quoted the most recentobservations, following out in detail the tracts andfibres passing to and from the ganglia, illustrating thepoints by diagrams and photographs. Their micro-scopical appearance and the grouping of the cells com-posing them were also referred to. In dealing with thefunctions of the basal ganglia it was pointed out thatthese structures were phylogenetically as well as

embryologically much older than the cerebral cortex,and reference was made to the evolution of the gangliaand tracts. In the lower vertebrates the basal gangliaappear to represent the higher centres of the brain,where the optic thalamus constitutes the receptivecentre for afferent and the corpus striatum the centrefor the direction and regulation of efferent impulses.Ascending the animal scale the basal ganglia becomesubordinated to higher centres, although the opticthalamus still receives sensory impulses, and the

corpus striatum would seem to regulate to a

certain extent automatic and associated move-

ments. In considering the relationship of theselower and higher centres the case of the optic

thalamus and the cerebral cortex was first taken

up. Is the destination of our various sensoryimpulses the thalamus or the cortex? The study of

cases of what is called Dejerine’s syndrome gives an; answer. Here there is a lesion in the thalamus which, interrupts the sensory fibres passing from the thalamusto the sensory area in the region of the post-centralB gyrus, and also the efferent fibres coming from the, cortical area back to the thalamus. According to HeadE and Gordon Holmes, who had studied a number ofL these cases, the thalamus is the centre for painful andtactile impulses, for the appreciation of heat and cold1and of heat apart from cold, also for the vibration sense.- Appreciation of touch and temperature seem to be; cortical, for they are lost in Dejerine’s syndrome.. Questions of comparison are determined by the cortex,) as are appreciation of posture and passive movement,3 which are lost in this syndrome. Further, the cortex1 focuses attention on sensation and may inhibit sensoryimpulses which reach the thalamus. The lessening of: this inhibition will permit of impulses reaching con-r sciousness which would not do so under normal circum-,1 stances. This is offered as an explanation of the1 subjective pain and discomfort on one side of the body,

which is a feature of the Dejerine syndrome. Thet symptoms of disease of the thalamus will, of course,’- vary with the exact seat and magnitude of the lesion.

Diseases of the corpus striatum were next reviewedd by Professor Hunter, and evidence was offered showing

that paralysis agitans is probably due to disease of thish body. The symptoms of this disease are recognised inr- three forms: (a) the pre-senile and senile, (b) thee symptomatic, and (c) the juvenile. In the first two,e vascular changes are found in the corpus striatum aftery death, while in the juvenile form the large ganglionf- cells of the globus pallidus and their neurons are thek seat of primary and progressive atrophy. So also with

y the progressive lenticular degeneration of Kinnier)r Wilson, where the symptoms have a certain resemblanceie to the juvenile cases of paralysis agitans, but where the

duration of the disease is short and always terminatesn- fatally. Post-mortem examination has shown a sym-i metrical and bilateral degeneration in the corpusto striatum. Again, in Huntington’s chorea the patho-Is logical anatomy as described by Hunt shows that this

is a disease of the same type as the juvenile form ofas paralysis agitans, the difference being that in the former

it is the smaller cells, whilst in paralysis agitans it is thelarger cells of the corpus striatum which have undergone

Page 2: ROYAL GLASGOW MEDIGO-CHIRURGICAL SOCIETY

854

degeneration. A fourth disease with its lesion in thecorpus striatum is primary, idiopathic, or doubleathetosis, sometimes called the Vogt syndrome. Herethe larger as well as the smaller cells of the caudatenucleus and putamen are destroyed. The lesion

produces athetotic movements of practically all the

voluntary muscles and is increased by voluntarymovement. Surveying these four diseases, the con-clusion might be formed that the essential symptomato-logy in lesions of the corpus striatum are rigidity,tremor of the paralysis agitans type, choreic move-ments, athetosis, and mobile spasm. The corpusstriatum, therefore, is a centre with certain coordinatingand inhibiting. functions, controlling associated andautomatic movements. Professor Hunter concludedwith some speculations as to the presence in the centralganglia of centres for the emotions as well as for thevarious viscera, and pointed out that lesions of the opticthalamus might cause loss of emotional movements asexpressed by the facial muscles, while this does notoccur with lesions of the corpus striatum.At the close of the meeting a vote of thanks was

awarded Professor Hunter for his interesting address.

Reviews and Notices of Books.THE LIFE AND WORK OF SIR JAGADIS C. BOSE.

An Indian Pioneer of Science. By PATRICK GEDDES.London : Longmans, Green, and Co. 1920. Pp. 259.

- 16s.IT may be possible to write a good biography of a

man who is still alive ; it is certainly very difficult.Professor Geddes has not succeeded. There is inevitablya feeling that it would be indecent were the authorto be cold-blooded and honest enough to strip hissubject really naked and hold him up for the world tolook at. In the present case there is no exhibition ofthis sort; we feel that we are not being shown morethan is proper for us to see, and we get no clearimpression of what sort of man Bose is. ProfessorGeddes’s admiration of him is plain enough, and soexaggerated is his expression of it that the whole isentirely unconvincing. It is not very much to ask thatone who, as he tells us, has lived for 40 years in thediscipline of the pursuit of natural knowledge shouldavoid patent hyperbole in giving an account of thescientific work of a brother pilgrim. But it is simplynonsense to say (p. 204) of Bose’s discovery that directstimulation induces contraction and indirect stimula-tion expansion, that it is a generalisation which willrank as high as the universal theory of gravitation." Direct" and " indirect stimulation are in no senseultimate terms, nor are " contraction " and " relaxa-tion " fundamental biological realities. From the

English world of science Bose, no doubt, did not alwaysreceive the recognition which many would have likedfor him and which he deserved; but ill-natured criticismand opposition is not worth the emphasis it receives,and only a partisan could say that Burdon-Sanderson’smind was " one of authority and influence, accustomedto be unquestioned" (p. 100). Is it possible that therewere faults on both sides ?The pity of it is that the story of Bose’s life would

probably be of almost unique interest if it were dealtwith in a sober manner and not by way of propaganda.Bose is the first Indian in modern times to achieve con-siderable success as an independent seeker after newknowledge in natural science. It has been commonlysupposed that his countrymen are temperamentallyunfitted for this sort of progress. As a whole it maybe that their attainments in imaginative literature areless unexpected, though it is open to suspect whetherthe mentality of Bose and his friend Tagore are reallyof such diverse kinds. His originality and independenceof mind are clearly brought out in the interestingnarrative of his discoveries, and no one can fail toadmire the pluck and spirit with which he pursued the

, path he had mapped out and achieved success; perhapssome day we shall have a better account of how hedid it.

MATERIA MEDICA AND THERAPEUTICS.1. Mteria Medica, Pharimacy, Pharmacology, and

Therapeactics. Seventeenth edition. By WILLIAMHALE-WHITE, K.B.E., M.D. Lond., M.D. Dub. (Hon.),Colonel, R.A.M.C. (T.). London : J. and A. Churchill.1920. Pp. 712. 10s. 60!.

2. ATreatise on Materia Medica and Therapeutics,including Pharmacy, Dispensing, Pharmacology, andthe Administration of Drugs. By the late RAKHALDASGHOSH. Eighth edition. By B. H. DEARE, Lieutenant-Colonel, Indian Medical Service, and BIRENDRANATH GHOSH, F.R.F.P.S. Glasg. Calcutta : Hiltonand Co. 1920. Pp. 698. 9s. net.

3. Thø Qneen’ s Hospital for Children PharmacopiaSixth edition. Prepared by a Committee of theMedical Staff.. London: H. K. Lewis and Co., Ltd.1920. Pp. 76. - ,

1. We welcome anew edition of Sir William Hale-White’s "Materia Medica, Pharmacy, Pharmacology,and Therapeutics." The present issue is the seven-

teenth, the first having appeared in 1892. The workis so well known-probably few medical works of anykind occur so commonly on the shelves of students andpractitioners alike-that no detailed description of itscontents is called for. The war regulations have beenomitted from this edition, and the whole book has beenrevised. The results of much recent pharmacologicalresearch will be found in these pages, but practitionerswould have liked to see some reference to the benzylderivatives, particularly benzyl benzoate, which, as aresult of the work of Macht and others, are beingused with apparent success in the treatment ofvarious conditions associated with spasm of un-

striped muscle, notably dysmenorrhoea and bronchialasthma. It must be admitted that in a manualdealing with pharmacy, pharmacology, and thera-

peutics, as well as materia medica proper, verymuch space cannot be devoted to the last-named

subject, which is commonly regarded as the least

interesting in the medical curriculum. It is, neverthe-less, to be regretted that students are not, as a rule,given any encouragement to acquire more than thebarest and dullest outlines of the subject. A piece ofrhubarb, for example, acquires fresh interest when onelearns that by pass and river it has been brought to theChinese coast from the Tibetan and neighbouringmountains, and that in the same regions the root wascollected as many as 1000 and possibly 2000 yearsago, to be carried westward by caravan throughPersia to the Levantine ports. Again, the discoveryof cinchona by the Spaniards in Peru and the deri-vation of its name from that of the wife of a viceroy,Ana Countess of Cinchon, who by its use was curedof fever, is not without a suggestion of romance; it

may be added, also, that the present-day cultivationof cinchona in India is a matter of great imperialinterest in view of the necessity that we should beindependent of foreign countries as far as the supply ofquinine is concerned. It is not suggested that muchinformation of this nature should be incorporated in thebook under review, and we would not willingly add toThe ever-increasing number of facts which requireassimilation, but we do think that in the teaching ofmateria medica to medical students in general someslightly greater effort might be made to clothe the dryJones of the subject. Of this manual, regarded moreparticularly as a handy work of reference for the

general praétitioner, it may be said that no book

lealing with similar subjects can be more confidentlyecommended.

2. The fact that Dr. Ghosh’s treatise on MateriaMedica has reached its eighth edition is evidence thatt serves a useful purpose and that it is widely used by;hose requiring information on the subject both in itsgeneral aspects and in those relating to Indian productsand methods of practice. The work is divided into;ections headed as follows : Materia Medica proper;:’harmacy and Dispensing; Pharmacology, MateriaMedica and Therapeutics; Vaccine and Serum Thera-teutics ; Organotherapy. In the section on PharmacyGnd Dispensing more precise information is givenIII such subjects as the choice of pill excipients


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