charcot's joint disease in general paralysis

1
477 Medical Officers of Health (Dr. Alfred Hill, President), Municipal and County Engineers (Mr. Francis J. C. May, President), Sanitary Inspectors (Dr. George Reid, President), and Domestic Hygiene (the Mayoress of Newcastle, Pre- sident). The Section of Sanitary Science and Preventive Medicine (Professor W. H. Corfield, President) will meet on Sept. 4th, the Section of Engineering and Architectnre (Sir Andrew Noble, President) on Sept. 7th, and the Section of Chemistry, Meteorology, and Geology on Sept. 8bh. The sections will sit from 10.30 A.M. to 2 r.m. each day, and the closing meeting will be held on Sept. 8th at 5 P.M. Saturday, Sept. 5th, and Wednesday, Sept. 9th, will be devoted to excursions. The exhibition will remain open till Sept. 26th. - AN UNSATISFACTORY INQUEST. ONE of the coroners for Cheshire, if correctly reported in a newspaper cutting wh’.ch has reached us, seems to have curious ideas as to the use of an inquest. He recently held an inquest at Audlem, near Nantwich, upon the body of a young unmarried woman who died after a continement. She was attended by a midwife, but a medical man was called in after the birth of the child owing to some com- plications arising. He continued to attend the patient until her death and declined to give a certificate. Hence the inquest. The jury, as was to be expected, expressed a wish . for the medical man to be called. The medical man described the complications which arose, and then (we quote from the newspaper report which we have received) the following scene occurred :- " Upon the coroner suggesting that the jury should return a verdict of natural causes the foreman, Mr. George Beeston, a local tradesman, proceeded to ask a cross-examination, when the coroner, interrupting, said, the case is at an end.’-The Foreman: No, it is not, sir. It is contrary to the feeling of the jury, and an outrage upon society, that a confinement should be undertaken without medical attendance.- The Coroner: That’s another matter altogether. In all country places there are midwives. To the jury : You are all excepting your foreman agreed as to the verdict?—Several jurymen, rising : No, sir, we are not.-A juryman said Dr. Twyford ought to be allowed to say whether he understood the mother to say that complications had arisen.-Dr. Twyford: Can I reply to that question ?-The Coroner: No; I don’t think it is necessary.—A. Juror: It seems that we are to shut up.-The Foreman: Is the doctor here to give evidence or not ?-The Coroner: He has given evidence.-The Foreman: He has not answaed the question, and we insist upon having an answer. (Applause from the .jury.)-The Coroner: What do you want ?-The Foreman : He has been asked a question, and we insis- upon his being allowed to answer it. (The jury again applauded.)—The Coroner (to tne jury,: I hope you will not interfere in the conduct of these proceedings.-Tne Foreman: They are only confirming my attitude. I request this statement.-Dr. Twyford asked the coroner if he could reply ? The Foreman: We are entitled to your statement.- Tne Coroner (to the doctor) : You can answer if you like -Dr. Twyford then made a statement, in which he said that the mother knocked him up at seven o’clock in the morning. He spoke to her through his bedroom window, and she said that her daughter had been confined, that it was all over, and asked him if he would call. Witness said he would call during the morning, and he did so. He found the girl in a collapsed condition, and in a very poor state indeed. He examined the girl, and it was his opinion that the slightest manipu- lation by a certificated midwife would have been sufficient. (Applause from the jury.) The midwife at that time had gone home, and he remarked to the mother, ’Why on earth has she left the girl in this state?’-The coroner read to the jury a verdict which lie had pre- pared-viz., that the deceased died from natural causes, to wit, inflam- mation, but there was no evidence to show how the inflammation was produced.-The jury then signed the verdict." We consider this most unsatisfactory. A coroner should not curtail a witness’s evidence in this way, especially when the witness, as in this case, is the one whose evidence wholly, or nearly wholly, ought to direct the opinion of the jury. Neither do we see how inflammation, of which the cause is quite unknown, can be a " natural cause " of death. STREET NOISES. THE resources of civilisation occasionally seem to be afflicted with deadly ineptitude. We have a known and recognised nuisance of the worst kind in the perpetual yelling of newspaper boys. Residents in the Scrand and other parts of London complain, pages have been written to the daily press, we have added our part to the unanimous chorus, and the Society for the Suppression of Street Noises has applied to the Home Secretary who refers them to his letter to the County Council. The Home Office says it can do nothing, the County Council says the same, and the police join in. Anyway the County Council which has done excellent work in improving sanitation, looking after lamps, &c., might pass a bye-law such as exists in Liverpool, i e., No person shall, for the purpose of hawking, selling, or distributing any newspaper or other article, shout, use any ball, gong, or noisy instrument in such a manner as to cause nuisance or annoyance to the residents or passengers." This would be an earnest of its desire to do something in the matter, for at present the Council adheres to the attitude of Giant Pope, who sat "in his eave’s mouth grinning at pilgrims a-! they go by, and biting his nails because he cannot come at them." All newspaper hawkers should be made to pay for a licence. We are glad to see that the Middlesex County Council ha3 taken a step in the right direction by passing a by-law of which the following is an abstract :-‘ No person shall sound or play any musical or noisy instrument or sing in any street within fifty yards of any dwelling house after being required by any constable or by any inmate of such house personally or by his servant to depart from the neighbourhood of such house. No person shall shout, or sing, or play any instrument within fifty yards of certain specified public buildings." These are good rules, but they do not deal with the news- paper nuisance. Not very long ago we counted between twenty-five and thirty newspaper hawkers around South Kensington Station who all yelled, and we consider this an intolerable nuisance. CHARCOT’S JOINT DISEASE IN GENERAL PARALYSIS. , IN the Charité-Annalen for 1895 Dr. Westphal record. the ; case of a woman aged thirty-eight years whose husband had suffered from tabes dorsalis and who herself had had ; symptoms of commencing general paralysis for a year. t Examination revealed the usual signs and symptoms, but in ; addition there was arthropathy of the right foot and ; apparently also atrophy of the jaw and dropping out of the ; teeth. The left knee-jerk was active, but the right could not be obtained. The further progress of the case was marked by diminution of the left knee-jerk and by the evidences of an affection of the left foot similar to that occurring in the right, as well as by the development in the left big toe of a deep perforating ulcer. The case illustrates the close similarity between the physical conditions in some l cases of general paralysis and of tabes dorsalis. CONSCRIPTION GRIEVANCES. ACCORDING to a well-known author and journalist the conscription would be a remedy for most of the bodily ills to which the youths of Great Britain and Ireland are heirs, or which they manufacture for themselves by objectless, indolent lives, and perhaps if the system were to be intro- duced into the United Kingdom it would be found to be not altogether an unmixed evil. The contingency, however, does not at the present moment appear to be at all probable, but if ever compulsory enrolment for military service does chance to become law the regulations in force on the Con- tinent must not be adopted en blo, as there are many matters of detail that might with advantage be altered. It is almost universally the practice, for instance, to post up in public places long lists of conscripts in the order in which their names were drawn from the uras, and in the cases of those who are exempted from service for bodily infirmities the nature of the infirmity is plainly stated. Among the causes of rejection the following affections would seem to be the most common: varic3ce’,e, hernia, stuttering, deafness, ocular affections, nervous complaints, such as epilepsy and idiotcy, malformation of one or more members, and various

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Page 1: CHARCOT'S JOINT DISEASE IN GENERAL PARALYSIS

477

Medical Officers of Health (Dr. Alfred Hill, President),Municipal and County Engineers (Mr. Francis J. C. May,President), Sanitary Inspectors (Dr. George Reid, President),and Domestic Hygiene (the Mayoress of Newcastle, Pre-sident). The Section of Sanitary Science and PreventiveMedicine (Professor W. H. Corfield, President) will meet onSept. 4th, the Section of Engineering and Architectnre (SirAndrew Noble, President) on Sept. 7th, and the Section ofChemistry, Meteorology, and Geology on Sept. 8bh. Thesections will sit from 10.30 A.M. to 2 r.m. each day, and theclosing meeting will be held on Sept. 8th at 5 P.M.

Saturday, Sept. 5th, and Wednesday, Sept. 9th, will bedevoted to excursions. The exhibition will remain opentill Sept. 26th.

-

AN UNSATISFACTORY INQUEST.

ONE of the coroners for Cheshire, if correctly reported in anewspaper cutting wh’.ch has reached us, seems to have

curious ideas as to the use of an inquest. He recently heldan inquest at Audlem, near Nantwich, upon the body of ayoung unmarried woman who died after a continement. Shewas attended by a midwife, but a medical man was

called in after the birth of the child owing to some com-plications arising. He continued to attend the patientuntil her death and declined to give a certificate. Hence the

inquest. The jury, as was to be expected, expressed a wish. for the medical man to be called. The medical man

described the complications which arose, and then (wequote from the newspaper report which we have received)the following scene occurred :-" Upon the coroner suggesting that the jury should return a verdict

of natural causes the foreman, Mr. George Beeston, a local tradesman,proceeded to ask a cross-examination, when the coroner, interrupting,said, the case is at an end.’-The Foreman: No, it is not, sir. It iscontrary to the feeling of the jury, and an outrage upon society, thata confinement should be undertaken without medical attendance.-The Coroner: That’s another matter altogether. In all country placesthere are midwives. To the jury : You are all excepting your foremanagreed as to the verdict?—Several jurymen, rising : No, sir, we are

not.-A juryman said Dr. Twyford ought to be allowed to say whetherhe understood the mother to say that complications had arisen.-Dr.Twyford: Can I reply to that question ?-The Coroner: No; I don’tthink it is necessary.—A. Juror: It seems that we are to shut up.-TheForeman: Is the doctor here to give evidence or not ?-The Coroner:He has given evidence.-The Foreman: He has not answaed thequestion, and we insist upon having an answer. (Applause from the.jury.)-The Coroner: What do you want ?-The Foreman : He hasbeen asked a question, and we insis- upon his being allowed to answer it.(The jury again applauded.)—The Coroner (to tne jury,: I hope youwill not interfere in the conduct of these proceedings.-TneForeman: They are only confirming my attitude. I requestthis statement.-Dr. Twyford asked the coroner if he could

reply ? The Foreman: We are entitled to your statement.-Tne Coroner (to the doctor) : You can answer if you like -Dr.Twyford then made a statement, in which he said that the motherknocked him up at seven o’clock in the morning. He spoke to herthrough his bedroom window, and she said that her daughter hadbeen confined, that it was all over, and asked him if he would call.Witness said he would call during the morning, and he did so. Hefound the girl in a collapsed condition, and in a very poor state indeed.He examined the girl, and it was his opinion that the slightest manipu-lation by a certificated midwife would have been sufficient. (Applausefrom the jury.) The midwife at that time had gone home, and heremarked to the mother, ’Why on earth has she left the girl in thisstate?’-The coroner read to the jury a verdict which lie had pre-pared-viz., that the deceased died from natural causes, to wit, inflam-mation, but there was no evidence to show how the inflammation wasproduced.-The jury then signed the verdict."We consider this most unsatisfactory. A coroner shouldnot curtail a witness’s evidence in this way, especiallywhen the witness, as in this case, is the one whose evidencewholly, or nearly wholly, ought to direct the opinion ofthe jury. Neither do we see how inflammation, of which thecause is quite unknown, can be a " natural cause " of death.

STREET NOISES.

THE resources of civilisation occasionally seem to beafflicted with deadly ineptitude. We have a known and

recognised nuisance of the worst kind in the perpetualyelling of newspaper boys. Residents in the Scrand andother parts of London complain, pages have been writtento the daily press, we have added our part to the

unanimous chorus, and the Society for the Suppression

of Street Noises has applied to the Home Secretary whorefers them to his letter to the County Council. The HomeOffice says it can do nothing, the County Council says thesame, and the police join in. Anyway the County Councilwhich has done excellent work in improving sanitation,looking after lamps, &c., might pass a bye-law such as existsin Liverpool, i e., No person shall, for the purpose ofhawking, selling, or distributing any newspaper or other

article, shout, use any ball, gong, or noisy instrument insuch a manner as to cause nuisance or annoyance to theresidents or passengers." This would be an earnest of its

desire to do something in the matter, for at present theCouncil adheres to the attitude of Giant Pope, who sat"in his eave’s mouth grinning at pilgrims a-! they go by,and biting his nails because he cannot come at them." All

newspaper hawkers should be made to pay for a licence. Weare glad to see that the Middlesex County Council ha3 takena step in the right direction by passing a by-law of which thefollowing is an abstract :-‘ No person shall sound or playany musical or noisy instrument or sing in any street withinfifty yards of any dwelling house after being required by anyconstable or by any inmate of such house personally or byhis servant to depart from the neighbourhood of such house.No person shall shout, or sing, or play any instrumentwithin fifty yards of certain specified public buildings."These are good rules, but they do not deal with the news-paper nuisance. Not very long ago we counted betweentwenty-five and thirty newspaper hawkers around South

Kensington Station who all yelled, and we consider this anintolerable nuisance.

____

CHARCOT’S JOINT DISEASE IN GENERALPARALYSIS.

, IN the Charité-Annalen for 1895 Dr. Westphal record. the; case of a woman aged thirty-eight years whose husband had

suffered from tabes dorsalis and who herself had had; symptoms of commencing general paralysis for a year.

t Examination revealed the usual signs and symptoms, but in; addition there was arthropathy of the right foot and

; apparently also atrophy of the jaw and dropping out of the; teeth. The left knee-jerk was active, but the right could

not be obtained. The further progress of the case was

marked by diminution of the left knee-jerk and by theevidences of an affection of the left foot similar to that

occurring in the right, as well as by the development in theleft big toe of a deep perforating ulcer. The case illustratesthe close similarity between the physical conditions in some

l cases of general paralysis and of tabes dorsalis.

CONSCRIPTION GRIEVANCES.

ACCORDING to a well-known author and journalist theconscription would be a remedy for most of the bodily illsto which the youths of Great Britain and Ireland are heirs,or which they manufacture for themselves by objectless,indolent lives, and perhaps if the system were to be intro-duced into the United Kingdom it would be found to be notaltogether an unmixed evil. The contingency, however,does not at the present moment appear to be at all probable,but if ever compulsory enrolment for military service doeschance to become law the regulations in force on the Con-tinent must not be adopted en blo, as there are many mattersof detail that might with advantage be altered. It is almost

universally the practice, for instance, to post up in publicplaces long lists of conscripts in the order in which theirnames were drawn from the uras, and in the cases of thosewho are exempted from service for bodily infirmities thenature of the infirmity is plainly stated. Among the causesof rejection the following affections would seem to be themost common: varic3ce’,e, hernia, stuttering, deafness,ocular affections, nervous complaints, such as epilepsy andidiotcy, malformation of one or more members, and various