a case of severe dermatitis following two exposures to the x rays

1
1759 elevation of the mercury in various ways, such as inversion, friction, the application of poultices or hot-water bottles. Dr. Stephen Mackenzie exposed a case of this kind where a temperature of 120° was registered, by placing two ther- mometers in the same axilla, and finding a difference of several degrees between them.1 The subjects of extraordinary pyrexia have almost invariably been females, and often neurotic or hysterical. However, it would be going too far to assert that all were necessarily cases of deception. Many years ago the late Mr. John Teale published a case of « Excessive and Long-continued High Temperature after Spinal Injuries, with Recovery," in which the temperatures ranged up to 122 F. In this case special thermometers were used, and every source of fallacy was apparently guarded against. In commenting on the case at the time, we had to admit that he had answered all objections. The subject is -certainly one requiring further investigation. A CASE OF SEVERE DERMATITIS FOLLOWING TWO EXPOSURES TO THE X RAYS. ON June 14th M. d’Arsonval presented to the Academy of Sciences at Paris a case, which had occurred in the practice of Dr. Apostoli, of dermatitis following two exposures to the x rays. The exposures were made upon May 22nd and 28th, 1896, the duration of the first sitting being forty minutes, with the Crookes’s tube at a distance of fifteen centimetres from the skin, and the second lasted ninety minutes, the tube being at a distance of nine centimetres. After the first sitting ,nothing was noticed except great nausea on the part of the patient. After the second, however, an erythema appeared over the area which had been exposed-namely, the abdominal wall-and this erythema was followed by vesication and an abundant serous discharge. These gradually healed, and by July the patient was nearly well; but in August the whole of the afEected surface sloughed and a severe burning pain was felt. No application to promote healing had the slightest effect and skin grafting was equally useless. At the end of October, 1896, the application of a current of oxygen was tried and promoted healing in a slight degree. In February, 1897, electric treatment was commenced. Statical elec- tricity was used at first alone and then in combination with high frequency currents. In April, 1897, electric baths were commenced and employed twice a week, the current employed being the undulatory form. These applica- tions had a very good effect, and by June, 1897, the whole affected surface, which measured 17’7 by 13’6 centimetres, was soundly healed. Dr. Apostoli considers that this form of dermatitis may be produced by the tube being too near, ’the sittings being too long, or even when short if following - one another too rapidly or being too many in number. The dermatitis is very slow in healing, and apparently the best method of treatment is the employment of electric currents, both locally by using statical and undulating currents and generally by the exposure of the patient to a high frequency current. - IT is with great regret that we have learned of the deaths recently of two prominent members of the medical pro- fession in New York. Dr. J. Lewis Smith, the well-known authority on diseases of children, died on the 9th inst., an Dr. William Lusk, the Professor of Midwifery at Bellevue ’ College, on the following Sunday. THE Abernethian Society of St. Bartholomew’s Hospital will hold its mid-sessional meeting in the medical theatre of the school at 8 P.M. on July lst, when Dr. Norman Moore will give an address on the Deaths of the Kings of England. .All old members are cordially invited to attend the meeting. Medical Times and Gazette, Nov. 5th, 1881. 2 Vide THE LANCET, March 6th, 1875. THE annual general meeting of the Brussels Medical Graduates’ Association will take place at the Cafe Royal, Regent-street, W., on Thursday, July 15h, at 6.30 P m. At 7.15 for 7.30 P.M. the members and their friends will dine together, and Sir John Williams, Bart., Mr. Rentoul, Q.C., M.P., and Dr. A. E. Sansom will be the guests of the Association. Any Brussels medical graduate wishing to be present at the dinner is requested to communicate with the honorary secretary, Dr. Major Greenwood, at 12, New-court, Lincoln’s-inn, W.C., or at 243, Hackney-road, N.E. MISS JANE HARRISON, LL.D., the well-known authority on Greek antiquities, will give a lecture upon "Hospital Life in Ancient Greece," on July 8th, at 3.30 P.M., at the South- West London Polytechnic, Manresa-road, Fulham. Tickets may be obtained from the honorary secretary, University Extension, at the above address, and the proceeds will be devoted to the Extension evening classes. THE authorities of the London Post-graduate Course have arranged that daily classes in bacteriology and hygiene will commence on July 5th and end on July 10th. This will enable busy practitioners to compress the needful work into the shortest possible time. Particulars can be obtained from Dr. Fletcher Little, secretary, 32, Harley- street, W. - WE understand that Lord Lister has replied to the com- munication addressed to him by Mr. George Jackson, F.R.C S. Eng., and three co-signatories, which appeared in our columns last week, and that he courteously declined to be placed in nomination for the approaching election !to the Council of the Royal College of Surgeons of England. T.R.H. THE PRINCE AND PRINCESS OF WALES have con- sented to open the Park Hospital, Hither-green, the new hospital of the Metropolitan Asylums Board, on Monday, July 12th, at 4.15 P M. LITERARY INTELLIGENCE.-We have received a copy of a new illustrated fortnightly Italian journal. It is published in Florence and called Scena Illus rata. The illustrations are well printed. Among the list of contributors to the letterpress are the names of Professor Baccelli and Professor Lombroso among scientific men, and among the purely literary names those of Daudet, Coppee, and Zola, so that the literary part of the paper as well as the art department will evidently be of a high order. PRESENTATIONS TO MEDICAL MEN.-Mr. Charles W. Izod, medical attendant to H.R.H. the Duclaess of Albany, who, as recorded in THE LANCET of June 12th, has been celebrating his jubilee of practice and residence in the village of Esher, was on June 16th, presented with a massive silver salver and three handsome silver bowls by the residents of Esher. The presentation was made by Mr. P. M. Martineau at a public meeting of the inhabitants. Each of the pieces of plate bore the recipient’s crest and the inscription : " Presented by his many friends to Cbarles William Izod, on the completion of fifty years’ medical practice in Esher. June 16th, 1897." Mr. Izod, who has also received a silver cup from H.R.H. the Duchess of Albany, was presented with an illuminated album containing the names of the 500 subscribers.-Mr. Edward W. Parsey, M.B., B.C. Camb., has been the recipient, from the King’s Norton Ambulance Corps, of an electro-plated biscuit tray, as a thank-offering for his lectures on first aid. - Mr. J. S. Montgomery, L R.C.P., L.R.C,S. Edin., L.F.P.S. Glasg., of Sandyford, Glasgow, who has acted as resident surgeon at the works of the Steel Company of Scotland, at Newton, during the past eighteen months, was entertained to supper and presented with a handsome timepiece, suitably inscribed, and a travelling bag, on his leaving the district.-Mr.-J. H. Marsh, M.R.C.S. Eng., L.R.C.P. Lond., has been presented with a handsome quarter chiming oak clock by the members of the Trinity Wesleyan Sunday School Male Ambulance Class, Macclesfield, as a token of appreciation of his services.

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Page 1: A CASE OF SEVERE DERMATITIS FOLLOWING TWO EXPOSURES TO THE X RAYS

1759

elevation of the mercury in various ways, such as inversion,friction, the application of poultices or hot-water bottles.

Dr. Stephen Mackenzie exposed a case of this kind where atemperature of 120° was registered, by placing two ther-mometers in the same axilla, and finding a difference of

several degrees between them.1 The subjects of extraordinarypyrexia have almost invariably been females, and often

neurotic or hysterical. However, it would be going too farto assert that all were necessarily cases of deception. Manyyears ago the late Mr. John Teale published a case of

« Excessive and Long-continued High Temperature after

Spinal Injuries, with Recovery," in which the temperaturesranged up to 122 F. In this case special thermometers wereused, and every source of fallacy was apparently guardedagainst. In commenting on the case at the time, we had toadmit that he had answered all objections. The subject is-certainly one requiring further investigation.

A CASE OF SEVERE DERMATITIS FOLLOWINGTWO EXPOSURES TO THE X RAYS.

ON June 14th M. d’Arsonval presented to the Academy ofSciences at Paris a case, which had occurred in the practiceof Dr. Apostoli, of dermatitis following two exposures to thex rays. The exposures were made upon May 22nd and 28th,1896, the duration of the first sitting being forty minutes, withthe Crookes’s tube at a distance of fifteen centimetres fromthe skin, and the second lasted ninety minutes, the tubebeing at a distance of nine centimetres. After the first sitting,nothing was noticed except great nausea on the part of thepatient. After the second, however, an erythema appearedover the area which had been exposed-namely, the abdominalwall-and this erythema was followed by vesication and anabundant serous discharge. These gradually healed, and byJuly the patient was nearly well; but in August the wholeof the afEected surface sloughed and a severe burning painwas felt. No application to promote healing had the slightesteffect and skin grafting was equally useless. At the end of

October, 1896, the application of a current of oxygen wastried and promoted healing in a slight degree. In February,1897, electric treatment was commenced. Statical elec-

tricity was used at first alone and then in combinationwith high frequency currents. In April, 1897, electricbaths were commenced and employed twice a week, thecurrent employed being the undulatory form. These applica-tions had a very good effect, and by June, 1897, the wholeaffected surface, which measured 17’7 by 13’6 centimetres,was soundly healed. Dr. Apostoli considers that this formof dermatitis may be produced by the tube being too near,’the sittings being too long, or even when short if following- one another too rapidly or being too many in number. Thedermatitis is very slow in healing, and apparently the bestmethod of treatment is the employment of electric currents,both locally by using statical and undulating currents

and generally by the exposure of the patient to a highfrequency current.

-

IT is with great regret that we have learned of the deathsrecently of two prominent members of the medical pro-fession in New York. Dr. J. Lewis Smith, the well-knownauthority on diseases of children, died on the 9th inst., anDr. William Lusk, the Professor of Midwifery at Bellevue’ College, on the following Sunday.

THE Abernethian Society of St. Bartholomew’s Hospitalwill hold its mid-sessional meeting in the medical theatre ofthe school at 8 P.M. on July lst, when Dr. Norman Moorewill give an address on the Deaths of the Kings of England..All old members are cordially invited to attend the meeting.

Medical Times and Gazette, Nov. 5th, 1881.2 Vide THE LANCET, March 6th, 1875.

THE annual general meeting of the Brussels MedicalGraduates’ Association will take place at the Cafe Royal,Regent-street, W., on Thursday, July 15h, at 6.30 P m. At

7.15 for 7.30 P.M. the members and their friends will dine

together, and Sir John Williams, Bart., Mr. Rentoul,Q.C., M.P., and Dr. A. E. Sansom will be the guests of theAssociation. Any Brussels medical graduate wishing to bepresent at the dinner is requested to communicate with thehonorary secretary, Dr. Major Greenwood, at 12, New-court,Lincoln’s-inn, W.C., or at 243, Hackney-road, N.E.

MISS JANE HARRISON, LL.D., the well-known authorityon Greek antiquities, will give a lecture upon "Hospital Lifein Ancient Greece," on July 8th, at 3.30 P.M., at the South-West London Polytechnic, Manresa-road, Fulham. Tickets

may be obtained from the honorary secretary, UniversityExtension, at the above address, and the proceeds will bedevoted to the Extension evening classes.

THE authorities of the London Post-graduate Course havearranged that daily classes in bacteriology and hygiene willcommence on July 5th and end on July 10th. Thiswill enable busy practitioners to compress the needfulwork into the shortest possible time. Particulars can beobtained from Dr. Fletcher Little, secretary, 32, Harley-street, W. -

WE understand that Lord Lister has replied to the com-munication addressed to him by Mr. George Jackson,F.R.C S. Eng., and three co-signatories, which appeared inour columns last week, and that he courteously declined to beplaced in nomination for the approaching election !to theCouncil of the Royal College of Surgeons of England.

T.R.H. THE PRINCE AND PRINCESS OF WALES have con-sented to open the Park Hospital, Hither-green, the newhospital of the Metropolitan Asylums Board, on Monday,July 12th, at 4.15 P M.

LITERARY INTELLIGENCE.-We have received acopy of a new illustrated fortnightly Italian journal. Itis published in Florence and called Scena Illus rata. Theillustrations are well printed. Among the list ofcontributors to the letterpress are the names of ProfessorBaccelli and Professor Lombroso among scientific men, andamong the purely literary names those of Daudet, Coppee,and Zola, so that the literary part of the paper as well as theart department will evidently be of a high order.

PRESENTATIONS TO MEDICAL MEN.-Mr. CharlesW. Izod, medical attendant to H.R.H. the Duclaess ofAlbany, who, as recorded in THE LANCET of June 12th,has been celebrating his jubilee of practice and residencein the village of Esher, was on June 16th, presentedwith a massive silver salver and three handsome silverbowls by the residents of Esher. The presentation wasmade by Mr. P. M. Martineau at a public meeting ofthe inhabitants. Each of the pieces of plate bore therecipient’s crest and the inscription : " Presented by hismany friends to Cbarles William Izod, on the completion offifty years’ medical practice in Esher. June 16th, 1897."Mr. Izod, who has also received a silver cup from H.R.H. theDuchess of Albany, was presented with an illuminatedalbum containing the names of the 500 subscribers.-Mr.Edward W. Parsey, M.B., B.C. Camb., has been the

recipient, from the King’s Norton Ambulance Corps, ofan electro-plated biscuit tray, as a thank-offering for hislectures on first aid. - Mr. J. S. Montgomery, L R.C.P.,L.R.C,S. Edin., L.F.P.S. Glasg., of Sandyford, Glasgow,who has acted as resident surgeon at the works of the SteelCompany of Scotland, at Newton, during the past eighteenmonths, was entertained to supper and presented with ahandsome timepiece, suitably inscribed, and a travelling bag,on his leaving the district.-Mr.-J. H. Marsh, M.R.C.S. Eng.,L.R.C.P. Lond., has been presented with a handsome quarterchiming oak clock by the members of the Trinity WesleyanSunday School Male Ambulance Class, Macclesfield, as atoken of appreciation of his services.