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THE MINERAL SPRINGS OF AUSTRIA

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910 governing such occasions. The inconsistency of the law as stated above with the criminal law prohibiting promiscuous intercourse with young girls is obvious. A girl of ] 3, but not yet 13, is nubile. She can be submitted deliberately to sexual intercourse, if married, at an age when " unlawful " carnal knowledge of her would be felony. " Unlawful " carnal knowledge of a girl between the ages of 13 and 16 is a misdemeanour, and neither in that case nor with regard to the felony can consent on the part of the child he put forward as a defence by the person charged. In other words, Parliament has held that a girl below a certain age is not competent to consent to unlawful intercourse, but has left her capable of engaging in a contract which will presumably entail her submitting to the same act, and indeed will make it her duty as a wife to do so. It may be that in practice no registrar or minister of religion would marry a boy or girl of the ages indicated without demur, and without full assurance that parents or guardians aware of their duties as such had assented, and that marriages of young persons less than 16 years of age rarely take place. It is as well, however, to realise that there is nothing at law to prevent them, or to prevent older persons from conniving at them or bringing them about. Whatever customs may obtain in oriental countries, such marriages are undoubtedly repugnant from an ethical point of view to decent-minded people in Western Europe. X RAYS IN OBSTETRIC PRACTICE. IN THE LANCET of April 29th Mr. E. W. H. Shenton called attention to the possible value of X rays in obstetric work as an aid in solving some of the prob- lems which may confront the clinician when the patient is at or near term. The possibility that this method may in the future prove useful in the diagnosis of the stage of pregnancy suggests itself, but while we hesitate to express an opinion on the scope of a diagnostic agent which is constantly improving in technique and results, it does not seem likely that the earlier stages of foetal growth will ever afford plates to the radio- grapher that will repay his trouble. Mr. Shenton, indeed, does not claim otherwise. When it is remem- bered that the first ossifications are mere pin-points in an embryo less than three-quarters of an inch in length, and that even at the beginning of the third month, when the main centres are well established, the foetus is only about an inch and a half long and that the ossific deposits are not very dense it is apparent that an embryo would in all probability be missed more often than found. Experience would no doubt increase the percentage of positive results, but it could harcllv be expected that this method could replace the usual means of diagnosis. After the third month positive results ought to be possible with proper technique, but the bunched-up position of the foetus, and its varying situation, would no doubt make the meaning of the record difficult to interpret, and probably interfere decidedly with any effort to get at its age with an approach to accuracy. Moreover, there are variations in ossification, and the extra centres are very small. However, there can be no doubt that in certain cases the radiologist may be of great help, and obstetricians may at least be enabled to diagnose twins in advance. EQUITATION AS A TREATMENT OF PULMONARY TUBERCULOSIS. THE history of horse-riding as a method of treat- ment of pulmonary tuberculosis is the subject of an article by Dr. R. J. Cyriax in the April issue of the British Journal of Tuberculosis. Dr. Cyriax makes it clear that Thomas Sydenham was responsible for the introduction of the method ; riding was mentioned, as an auxiliary measure of exercise prescribed in pulmonary tuberculosis, by Celsus, but Antyllos, in the second century A.D., stated that this form of exercise was very injurious to the chest. The " Phthisiologia " of R. Morton; published in 1694 (five years after Sydenham’s death) contains no allusion to riding ; not until the beginning of the eighteenth century, when Sydenham’s posthumous fame arose, did riding become a popular treatment for phthisis in England, although considerable use had by then already been made of it upon the Continent. Several of Sydenharn’s contemporaries strongly recommended the method ; among them was F. Fuller, who extended its prescription to many other chronic diseases. John Wesley was reputed to have been cured by the new remedy, but it was soon found to possess serious disadvantages ; before 1830 the reaction had set in, both in England and abroad, and the limitation of the uses of the method to mild forms of consumption suggests that disastrous effects of its indiscriminate application had been observed. The improvements noted in cases during the period when the treatment was popular were ascribed by Sydenham and his followers not to the fresh air, but to the exercise obtained on horseback, and various rocking machines and swings were from time to time elaborated for home treatment of phthisical patients. Dr. Cyriax points out that even allowing for. the great probability that many of Sydenham’s own cases were not in reality tuberculous, it is hard to understand how the indiscriminate use of equitation proved sufficiently successful to warrant emphatic support for the method. But no doubt in certain cases the patients were exposed to fresh a,ir which they would not other- wise have obtained. Laennec regarded the method as useless, and at the beginning of the nineteenth century it had entirely lost its position as one of the principal forms of treatment in pulmonary tuberculosis. THE MINERAL SPRINGS OF AUSTRIA. ON another page of this issue our Hungarian corre- spondent describes the Czecho-Slovakian watering- place Postyen, formerly the Hungarian Pistyan; it will be of interest to make some reference to the Austrian watering-places to the west of the Danube. Our Vienna correspondent writes as follows : The Austrian Ministry of Public Health has caused a State register to be compiled containing information concerning all the mineral springs of Austria, including those in the district, formerly called Burgenland, which has been handed over by Hungary to Austria under the terms of the Treaty of St. Germain. The Austrian Republic contains 90 places where thermal springs are found ; -, the springs number 160, and there are in addition 30 other localities with 50 cold-water springs having no special chemical or physical quality, but used for bathing on account of their mild radio-active proper- ties. The majority of the Austrian springs give sparkling alkaline waters, containing carbonic acid; a number of them contain sulphuretted hydrogen, potassium chloride, sodium chloride, magnesium, and iron ; their mean temperature varies between 24° C. and 39° C. One resort, Hall, contains the strongest iodine and bromide water in Europe, and several others have strong hot sulphur baths. A few months ago a powerful spring was accidentally discovered at Schallenbach in Upper Austria, by men boring for oil at a depth of 1600 feet; a jet of warm water appeared, which proved to have a large content of sulphur practically unmixed with other minerals. This spring produces 65 litres per second-more than any other in Europe. Other well-known waters are those of the typical radio-active springs of Gastein, and the salt lake at Neusiedl, which sometimes dries up to one- tenth of its size at high-water mark, and of which the large sodium content is similar to that of the lakes of Western Asia and Syria. Most of the Austrian springs can be used for drinking purposes-either thera- peutically, or as simple table-waters-in addition to their uses for bathing. Not less than 30 per cent. of the total number of waters still require exact investi- gation with regard to their chemical and physical properties. A special department of the Ministry of Health will deal with this matter in collaboration with the chemical department of the University of Vienna. Two geological fissures, one running north and south
Transcript

910

governing such occasions. The inconsistency of thelaw as stated above with the criminal law prohibitingpromiscuous intercourse with young girls is obvious.A girl of ] 3, but not yet 13, is nubile. She can besubmitted deliberately to sexual intercourse, if married,at an age when " unlawful " carnal knowledge of herwould be felony.

" Unlawful " carnal knowledge of agirl between the ages of 13 and 16 is a misdemeanour,and neither in that case nor with regard to the felonycan consent on the part of the child he put forwardas a defence by the person charged. In other words,Parliament has held that a girl below a certain ageis not competent to consent to unlawful intercourse,but has left her capable of engaging in a contractwhich will presumably entail her submitting to thesame act, and indeed will make it her duty as a wifeto do so. It may be that in practice no registrar orminister of religion would marry a boy or girl of theages indicated without demur, and without fullassurance that parents or guardians aware of theirduties as such had assented, and that marriages ofyoung persons less than 16 years of age rarely takeplace. It is as well, however, to realise that there isnothing at law to prevent them, or to prevent olderpersons from conniving at them or bringing themabout. Whatever customs may obtain in orientalcountries, such marriages are undoubtedly repugnantfrom an ethical point of view to decent-mindedpeople in Western Europe.

X RAYS IN OBSTETRIC PRACTICE.

IN THE LANCET of April 29th Mr. E. W. H. Shentoncalled attention to the possible value of X rays inobstetric work as an aid in solving some of the prob-lems which may confront the clinician when the patientis at or near term. The possibility that this methodmay in the future prove useful in the diagnosis of thestage of pregnancy suggests itself, but while we hesitateto express an opinion on the scope of a diagnostic agentwhich is constantly improving in technique andresults, it does not seem likely that the earlier stagesof foetal growth will ever afford plates to the radio-grapher that will repay his trouble. Mr. Shenton,indeed, does not claim otherwise. When it is remem-bered that the first ossifications are mere pin-points inan embryo less than three-quarters of an inch in length,and that even at the beginning of the third month,when the main centres are well established, the foetusis only about an inch and a half long and that the ossificdeposits are not very dense it is apparent that anembryo would in all probability be missed more oftenthan found. Experience would no doubt increase thepercentage of positive results, but it could harcllv beexpected that this method could replace the usualmeans of diagnosis. After the third month positiveresults ought to be possible with proper technique, butthe bunched-up position of the foetus, and its varyingsituation, would no doubt make the meaning of therecord difficult to interpret, and probably interferedecidedly with any effort to get at its age with anapproach to accuracy. Moreover, there are variationsin ossification, and the extra centres are very small.However, there can be no doubt that in certain casesthe radiologist may be of great help, and obstetriciansmay at least be enabled to diagnose twins in advance.

EQUITATION AS A TREATMENT OF PULMONARYTUBERCULOSIS.

THE history of horse-riding as a method of treat-ment of pulmonary tuberculosis is the subject of anarticle by Dr. R. J. Cyriax in the April issue of theBritish Journal of Tuberculosis. Dr. Cyriax makes itclear that Thomas Sydenham was responsible for theintroduction of the method ; riding was mentioned,as an auxiliary measure of exercise prescribed in

pulmonary tuberculosis, by Celsus, but Antyllos, inthe second century A.D., stated that this form ofexercise was very injurious to the chest. The" Phthisiologia " of R. Morton; published in 1694 (five

years after Sydenham’s death) contains no allusion toriding ; not until the beginning of the eighteenthcentury, when Sydenham’s posthumous fame arose, didriding become a popular treatment for phthisis inEngland, although considerable use had by thenalready been made of it upon the Continent. Severalof Sydenharn’s contemporaries strongly recommendedthe method ; among them was F. Fuller, who extendedits prescription to many other chronic diseases. JohnWesley was reputed to have been cured by the newremedy, but it was soon found to possess seriousdisadvantages ; before 1830 the reaction had set in,both in England and abroad, and the limitation ofthe uses of the method to mild forms of consumptionsuggests that disastrous effects of its indiscriminateapplication had been observed. The improvementsnoted in cases during the period when the treatmentwas popular were ascribed by Sydenham and hisfollowers not to the fresh air, but to the exerciseobtained on horseback, and various rocking machinesand swings were from time to time elaborated for hometreatment of phthisical patients. Dr. Cyriax pointsout that even allowing for. the great probability thatmany of Sydenham’s own cases were not in realitytuberculous, it is hard to understand how theindiscriminate use of equitation proved sufficientlysuccessful to warrant emphatic support for themethod. But no doubt in certain cases the patientswere exposed to fresh a,ir which they would not other-wise have obtained. Laennec regarded the method asuseless, and at the beginning of the nineteenthcentury it had entirely lost its position as one of theprincipal forms of treatment in pulmonary tuberculosis.

THE MINERAL SPRINGS OF AUSTRIA.

ON another page of this issue our Hungarian corre-spondent describes the Czecho-Slovakian watering-place Postyen, formerly the Hungarian Pistyan; it willbe of interest to make some reference to the Austrianwatering-places to the west of the Danube. OurVienna correspondent writes as follows : The AustrianMinistry of Public Health has caused a State registerto be compiled containing information concerning allthe mineral springs of Austria, including those in thedistrict, formerly called Burgenland, which has beenhanded over by Hungary to Austria under the termsof the Treaty of St. Germain. The Austrian Republiccontains 90 places where thermal springs are found ; -,the springs number 160, and there are in addition 30other localities with 50 cold-water springs having nospecial chemical or physical quality, but used for

bathing on account of their mild radio-active proper-ties. The majority of the Austrian springs givesparkling alkaline waters, containing carbonic acid;a number of them contain sulphuretted hydrogen,potassium chloride, sodium chloride, magnesium, andiron ; their mean temperature varies between 24° C.and 39° C. One resort, Hall, contains the strongestiodine and bromide water in Europe, and several othershave strong hot sulphur baths. A few months agoa powerful spring was accidentally discovered atSchallenbach in Upper Austria, by men boring for oilat a depth of 1600 feet; a jet of warm water appeared,which proved to have a large content of sulphurpractically unmixed with other minerals. This springproduces 65 litres per second-more than any otherin Europe. Other well-known waters are those of thetypical radio-active springs of Gastein, and the saltlake at Neusiedl, which sometimes dries up to one-tenth of its size at high-water mark, and of which thelarge sodium content is similar to that of the lakes ofWestern Asia and Syria. Most of the Austrian springscan be used for drinking purposes-either thera-peutically, or as simple table-waters-in addition totheir uses for bathing. Not less than 30 per cent. ofthe total number of waters still require exact investi-gation with regard to their chemical and physicalproperties. A special department of the Ministry ofHealth will deal with this matter in collaboration withthe chemical department of the University of Vienna.Two geological fissures, one running north and south

911

on the eastward side of the Alps, and the other running z’

east and west in the Styrian group, are apparentlyresponsible for the numerous springs in this part ofCentral Europe. Along these lines of fissure theAustrian Government proposes to continue its searchfor further useful mineral waters.

THE "NEW YORK MEDICAL RECORD."

THE final issue of the Med,ical Record, the well-known New York weekly medical publication,appeared on April 22nd, when it was announced thatthe journal had been sold to, and combined with,the New York Medical Journal, which appearsfortnightly. Throughout the 56 years of its serviceto the medical profession, the ltTedical Record has hadthe same publishers, Messrs. William Wood and Co.,and but two editors. Dr. George F. Shrady guided itscourse for the first 38 years and was succeeded by hisassistant, Dr. Thomas L. Stedman, who has long beenthe widely esteemed dean of American medical editors.The firm of William Wood and Co. will now devoteits energies entirely to the publication of medicalbooks, in which service it has been engaged for118 years.Many of the most important discoveries and

developments in the progress of medicine were firstannounced to the American profession by the ]yl edicalRecord. These include Lister’s doctrines of antisepsis,Koch’s discovery of the tubercle bacillus, the employ-ment of cocaine in eye surgery, the Rontgen rays,the discovery of the antitoxins of tetanus and diph-theria, and the discovery of radium.

THE Annual Oration of the Medical Society ofLondon will be given by Mr. H. J. Waring onMay 8th at 9 P.M., the subject being " Hospitals :Some Suggestions as Regards their Future."

THE next session of the General Council of MedicalEducation and Registration will commence at 2 P.M.,on Tuesday, May 23rd, when the President, Sir DonaldMacAlister will take the chair and give an address.

A COMMITTEE, consisting of Sir R. Henry Rew(chairman) and Messrs. A. K. Davies, Rayner Goddard,A. E. Holmes, and J. F. Mason, has been appointedby the Board of Trade to inquire whether optical andother scientific instruments manufactured in Germanyare being sold or offered for sale in the United Kingdomat prices below those at which such instruments canbe profitably manufactured in the United Kingdom.The committee has been appointed under the powersconferred upon the Board of Trade by Part II. of theSafeguarding of Industries Act, 1921, as a result ofrepresentations made by the British Optical Instru-ment Manufacturers, Ltd., the British PhotographicManufacturers’ Association, the Spectacle Manu-facturers’ Association, and the Drawing InstrumentManufacturers’ Association.

CHILDREN’S HOSPITAL AT NoRTHWiCH.—A bazaarpromoted with the object of building a children’s wing atthe Northwich Victoria Hospital resulted in the raising of3350.

HOSPITALS APPEAL.-At the annual Easter banquet,held at the Mansion House on April 26th, the Lord Mayor,giving the toast of the Royal hospitals, stated that so far115,000 had been contributed towards the cost of thenurses’ new quarters at St. Bartholomew’s Hospital, thefoundation-stone of which was laid by the Queen last year.Of that sum, Sir Edward Stern had given 225,000 andAlderman Sir John Bell 210,000-these gifts having beenmade anonymously some time ago--and 17 generous citizenshad each given ;8]000, whilst 130 more had each given 100.The 116,000 enabled the governors to build one block toaccommodate 165 nurses. Two other blocks had beenctesigned giving accommodation for 550 nurses in all, butthese would not be proceeded with until sufficient fundswere collected. For this work and for the hospitals generallythe Lord Mayor made a strong appeal.

Public Health Services.GENERAL PRACTITIONERS AND ’VELFARE CLINICS.CONTRARY to the recommendation of its public

health committee, St. Pancras borough council hasdecided that the post of assistant medical officer ofhealth for maternity and child welfare, renderedvacant through the dismissal of Dr. Gladys Miall-Smith on her marriage, shall be open to either sex,not to men only. The committee is said to have madethe recommendation in order that those women whoprefer to consult a male doctor shall have more chanceof doing so. At present the council maintains 33 consultations per week, of which 28 are held by14 part-time medical men and women. Of these, ] 9ïconsultations are at present held by women and81 by men.1 It is considered desirable, for reasons ofadministration, that the rest of the consultationsshould be held by the full-time assistant medicalofficer. In advertising the part-time posts it is usualin this borough to include a phrase to the effect thatapplications from local practitioners will be given dueconsideration, but so far the bulk of the local prac-titioners have given very little indication of anydesire to take part in the work. This has hithertobeen found in other boroughs also, to the mutualdisadvantage of the clinic and the practitioner. Theremuneration offered might not compensate him (orher) in actual cash for the time taken up, but theexperience of closely watching the development ofhealthy children would be as valuable in his practiceas his intimate knowledge of the end-results of faultyfeeding and unhygienic conditions would be to themother. Moreover, such cooperation alone can

correlate the work being done on the preventive andcurative side of medicine and create and maintainhappy relations between the two branches of theprofession. ____

SCHOOL MEDICAL SERVICE.ANNUAL REPORTS FOR 1921.

Bristol.Of a school population of over 57,000, 18,000 children

underwent the routine and 15,000 a special medicalexamination ; altogether over 18,000 showed somedefect requiring treatment or observation. Of 5000found at routine inspections requiring treatment, 3000had received it by the end of the year. Bristol hasnow four clinics the general treatment of each of whichis in charge of the school doctor of the area. Theattendances for the year amounted to 115,650. A newdeparture was the establishment in May of an X raydepartment for the treatment of ringworm. About 300new cases of this disease appeared last year and 47 ofthem received X ray treatment. The remainder werefor the most part treated by local application at thedistrict clinics. Dental examination of 3177 childrenaged 5 to 6 revealed 2652 requiring treatment, abouthalf of these were attended to. Of 1389 cases for whomspectacles were prescribed only 7 failed to obtain them.The aural clinics accounted for 22,607 attendances.Mr. J. P. 1. Harty, honorary surgeon to the ear, throat,and nose department of Bristol Royal Infirmary,reports that " the treatment afforded at the schoolclinics is of necessity far more efficacious than can beobtained at any of the voluntary institutions. Dailyattendance of the child and skilled administration ofthe prescribed treatment is feasible, while in institu-tions, except in a few special instances, drugs are dis-pensed and the best is hoped for from the parents. Theresults obtained, especially in the case of suppurativemiddle-ear disease, are immeasurably superior." Heurges, too, that operative treatment in the case ofadenoids is too long delayed. " The period at whichoperation should be performed is not determined by .any particular age, but rather by the time whensymptoms of chronic infection of lymphoid tissueappear. Once mouth-breathing is well established

1 The fractions being due to the fact that some clinics are heldmonthly and some fortnightly.


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