housing in the irish free state

1
674 THE LATE PROF. W. H. PERKIN. lungs, and their resistance might consequently be expected to be higher. This factor may account for the relatively small incidence of suppuration which followed the experiments. Harkavy has certainly shown that it is possible to produce suppura- tion in the lungs of dogs by direct inoculation with septic material, but it is hard to see how this knowledge will reduce the incidence of pulmonary complications following tonsillectomy. As it is, every possible precaution is taken by surgeons to prevent the inhalation of septic material during these operations, because they are confident, without the reassurance of experiment, that it is a real source of danger. HOUSING IN THE IRISH FREE STATE. A CENSUS was taken in the Irish Free State in 1926, and that section of the report which deals with the relation of population to housing was published last week. Accepting as the standard of overcrowding the fact of more than two people living in one room, it appears that in the whole country 781,000 persons, or 27-2 per cent. of the population, live in over- crowded conditions. The comparative percentages for Northern Ireland, Scotland, England, and Wales are respectively 18-1, 43-3, 9-8, and 7-2. The Irish Free State is thus shown to be in a better position than Scotland in this respect, but compares unfavour- ably with Northern Ireland, England, and Wales. The overcrowding in Ireland is worse in the rural areas than in the smaller towns, and among rural areas the worst are those along the western coast, particularly the counties of Donegal, Mayo, and Kerry. It is noteworthy, however, that this overcrowding in the rural areas does not express itself in a higher death-rate. Mayo, for example, with 41-7 per cent. overcrowding has a lower death-rate than the com- bined 24 best-housed urban districts with an over- crowding of 15-2 per cent. In urban areas there are other influences deleterious to health which more than counterbalance any advantage that may arise from better housing. EMBOLECTOMY. To those who cherish the belief that medical practice is international, at any rate on the surgical side, it must come as a surprise to discover that certain operations are frequently practised in some countries while they remain almost unknown in others. The operation of embolectomy illustrates this point. Were it an exceedingly technical and dim cult opera- tion, or were there grave reasons for regarding it as undeserving the serious attention of the practitioner, it would be easy to understand why its employment is geographically so patchy. More than 20 years ago Mr. Sampson Handley attempted the removal of an embolus lodged at the bifurcation of the abdominal aorta, and restored for a time the blood current in the femoral artery. He placed the case on record 1 as " one of those pioneer failures on which ultimate success so often rests." His report led Sir Berkeley Moynihan to mention 2 a case under his care at the Leeds Infirmary four years previously, in which an embolus was removed from the popliteal artery and the artery sutured; the patient, who had mitral disease and granular kidneys, died with extensive infarcts five days later. But this work does not seem to have been followed up, and for the most part it has been Scandinavian surgeons at home or in the United States who have taken the lead in this field of surgery. The names of Haggstrom, Key, Lundberg, and Michaelsson appear in the literature of the subject, and in the public hospitals of Scan- dinavia this operation has been increasingly per- formed during the last ten years, the general practi- tioners in these countries being sufficiently cognisant of the indications for, and prospects of, embolectomy to send their patients to hospital as soon as the correct 1 Brit. Med. Jour., 1907, ii., 712. 2 Ibid., p. 826. diagnosis has been made. In Minnesota Medicine for May, 1929, the Norwegian surgeon, F. H. Wiese,. publishes a case of embolism of the right brachial artery in a woman, aged 64, suffering from heart disease. She awoke one morning with severe pain in the right arm, which was pale, cold, and paralysed. But she was not medically examined till between- 6 and 7 P.M., nor was the operation, under local anaesthesia, started until 10.40 P.M., at least 14 hours after the onset of symptoms. Yet the operation was successful, relieving her of severe pain, restoring- movement to the arm, and saving her from the- gangrene which would eventually have developed,. had the operation not been undertaken. Her death seven weeks after the operation from embolism else- where in the body, complicated by a three-day- attack of pneumonia, emphasises the fairly common observation that this operation is in a certain sense- only a palliative. But even then the operation may be justified, as it relieves pain, saves the patient from the much more serious operation of amputation for- gangrene, and restores the use of the limb. Dr. Wiese’s paper includes a useful summary of the- literature. ____ THE LATE PROF. W. H. PERKIN. To many doctors the name of Perkin--especially in association with Kipping-will recall little more- than a text-book on organic chemistry, which, in their student days, they were compelled, more or less unwillingly, to study. At that early stage of his; career the medical student has little time, inclination, or knowledge to grasp the true significance of organic chemistry, and the important bearing which its methods have upon medicine. As the result of the introduction of the term biochemistry there is a tendency to overlook the fact that, without the preparatory work of the pure organic chemist, many of the outstanding achievements of biochemistry would still be in the realm of unsolved problems. The ability to establish the constitution of a complex carbon compound. depends upon the skilful application of the methods of organic chemistry, and no sooner has the constitution of a physiologically important natural product been determined-be it hormone or alkaloid or what not- than attempts are made to synthesise it by those same methods. It is in this field of synthetic organic chemistry that the work of Prof. W. H. Perkin, who died last week, has been of such outstanding value. The son of Sir William Perkin, whose discovery of the first aniline dye from coal tar led to the foundation of the modern dye industry, Prof. Perkin was gifted with great technical skill and an amazing facility in overcoming experimental difficulties. He devoted most of his life to elucidating the constitution of some of the most complicated natural products and accomplished synthesis of many of them. At the beginning of his research career he set himself the problem of synthesising compounds con- taining three, four, or five membered carbon rings- the possible existence of which was, at that time, scouted by such great organic chemists as Adolf vonBayer-his teacher ,Victor Meyer, and Emil Fischer. In spite of this discouragement, which would have been sufficient to make other people hesitate, he persisted, and succeeded in producing such com- pounds. It would be impossible in small space to give an adequate account of Perkin’s contributions to organic chemistry, but a few of his outstanding researches may be recalled, while he originally studied the synthesis of closed carbon chains for its own sake, the methods thus initiated came to be . developed and applied to the synthesis of natural products ; amongst these, the colourless precursors. of the logwood dyes brazilin and haematoxylin claimed his attention, and resulted in his assigning to these- substances their probable constitution. It is in the group of alkaloids, however, that in recent years he

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Page 1: HOUSING IN THE IRISH FREE STATE

674 THE LATE PROF. W. H. PERKIN.

lungs, and their resistance might consequently beexpected to be higher. This factor may accountfor the relatively small incidence of suppurationwhich followed the experiments. Harkavy hascertainly shown that it is possible to produce suppura-tion in the lungs of dogs by direct inoculation withseptic material, but it is hard to see how this knowledgewill reduce the incidence of pulmonary complicationsfollowing tonsillectomy. As it is, every possibleprecaution is taken by surgeons to prevent theinhalation of septic material during these operations,because they are confident, without the reassuranceof experiment, that it is a real source of danger.

HOUSING IN THE IRISH FREE STATE.

A CENSUS was taken in the Irish Free State in 1926,and that section of the report which deals with therelation of population to housing was published lastweek. Accepting as the standard of overcrowdingthe fact of more than two people living in one room,it appears that in the whole country 781,000 persons,or 27-2 per cent. of the population, live in over-crowded conditions. The comparative percentagesfor Northern Ireland, Scotland, England, and Walesare respectively 18-1, 43-3, 9-8, and 7-2. The IrishFree State is thus shown to be in a better positionthan Scotland in this respect, but compares unfavour-ably with Northern Ireland, England, and Wales.The overcrowding in Ireland is worse in the ruralareas than in the smaller towns, and among ruralareas the worst are those along the western coast,particularly the counties of Donegal, Mayo, and Kerry.It is noteworthy, however, that this overcrowding inthe rural areas does not express itself in a higherdeath-rate. Mayo, for example, with 41-7 per cent.overcrowding has a lower death-rate than the com-bined 24 best-housed urban districts with an over-crowding of 15-2 per cent. In urban areas there areother influences deleterious to health which morethan counterbalance any advantage that may arisefrom better housing.

____

EMBOLECTOMY.

To those who cherish the belief that medicalpractice is international, at any rate on the surgicalside, it must come as a surprise to discover that certainoperations are frequently practised in some countrieswhile they remain almost unknown in others. Theoperation of embolectomy illustrates this point.Were it an exceedingly technical and dim cult opera-tion, or were there grave reasons for regarding it asundeserving the serious attention of the practitioner,it would be easy to understand why its employmentis geographically so patchy. More than 20 years agoMr. Sampson Handley attempted the removal of anembolus lodged at the bifurcation of the abdominalaorta, and restored for a time the blood current inthe femoral artery. He placed the case on record 1as

" one of those pioneer failures on which ultimate

success so often rests." His report led Sir BerkeleyMoynihan to mention 2 a case under his care at theLeeds Infirmary four years previously, in which anembolus was removed from the popliteal artery andthe artery sutured; the patient, who had mitraldisease and granular kidneys, died with extensiveinfarcts five days later. But this work does notseem to have been followed up, and for the mostpart it has been Scandinavian surgeons at home orin the United States who have taken the lead in thisfield of surgery. The names of Haggstrom, Key,Lundberg, and Michaelsson appear in the literatureof the subject, and in the public hospitals of Scan-dinavia this operation has been increasingly per-formed during the last ten years, the general practi-tioners in these countries being sufficiently cognisant ofthe indications for, and prospects of, embolectomyto send their patients to hospital as soon as the correct

1 Brit. Med. Jour., 1907, ii., 712.2 Ibid., p. 826.

diagnosis has been made. In Minnesota Medicinefor May, 1929, the Norwegian surgeon, F. H. Wiese,.publishes a case of embolism of the right brachialartery in a woman, aged 64, suffering from heartdisease. She awoke one morning with severe painin the right arm, which was pale, cold, and paralysed.But she was not medically examined till between-6 and 7 P.M., nor was the operation, under localanaesthesia, started until 10.40 P.M., at least 14 hoursafter the onset of symptoms. Yet the operation wassuccessful, relieving her of severe pain, restoring-movement to the arm, and saving her from the-gangrene which would eventually have developed,.had the operation not been undertaken. Her deathseven weeks after the operation from embolism else-where in the body, complicated by a three-day-attack of pneumonia, emphasises the fairly commonobservation that this operation is in a certain sense-only a palliative. But even then the operation maybe justified, as it relieves pain, saves the patient fromthe much more serious operation of amputation for-gangrene, and restores the use of the limb. Dr.Wiese’s paper includes a useful summary of the-literature.

____

THE LATE PROF. W. H. PERKIN.

To many doctors the name of Perkin--especiallyin association with Kipping-will recall little more-than a text-book on organic chemistry, which, in theirstudent days, they were compelled, more or lessunwillingly, to study. At that early stage of his;

career the medical student has little time, inclination,or knowledge to grasp the true significance of organicchemistry, and the important bearing which its methodshave upon medicine. As the result of the introductionof the term biochemistry there is a tendency tooverlook the fact that, without the preparatory workof the pure organic chemist, many of the outstandingachievements of biochemistry would still be in therealm of unsolved problems. The ability to establishthe constitution of a complex carbon compound.depends upon the skilful application of the methods oforganic chemistry, and no sooner has the constitutionof a physiologically important natural product beendetermined-be it hormone or alkaloid or what not-than attempts are made to synthesise it by those samemethods. It is in this field of synthetic organicchemistry that the work of Prof. W. H. Perkin, whodied last week, has been of such outstanding value.The son of Sir William Perkin, whose discovery of thefirst aniline dye from coal tar led to the foundation ofthe modern dye industry, Prof. Perkin was giftedwith great technical skill and an amazing facilityin overcoming experimental difficulties. He devotedmost of his life to elucidating the constitutionof some of the most complicated natural productsand accomplished synthesis of many of them.At the beginning of his research career he sethimself the problem of synthesising compounds con-taining three, four, or five membered carbon rings-

the possible existence of which was, at that time,scouted by such great organic chemists as AdolfvonBayer-his teacher ,Victor Meyer, and Emil Fischer.In spite of this discouragement, which wouldhave been sufficient to make other people hesitate,he persisted, and succeeded in producing such com-pounds. It would be impossible in small space togive an adequate account of Perkin’s contributionsto organic chemistry, but a few of his outstandingresearches may be recalled, while he originallystudied the synthesis of closed carbon chains for itsown sake, the methods thus initiated came to be

. developed and applied to the synthesis of naturalproducts ; amongst these, the colourless precursors.

.

of the logwood dyes brazilin and haematoxylin claimed’ his attention, and resulted in his assigning to these-

substances their probable constitution. It is in thegroup of alkaloids, however, that in recent years he