puerperal polyneuritis

1
827 trades, not excluding the gentle craft of the blacksmith, had claimed the right to be on the Register. Many of these, of course, possessed no qualification whatever, but time must necessarily erase their names from the roll. At the present time the total number on the Register is 4901, including 27 gentlemen who possess the dental qualifications of Harvard or Michigan Universities, U.S.A. These quali- fications are not yet recognised by the General Medical Council, and these gentlemen are designated in the Register "Foreign Dentists." Slowly, yet surely, the number of Licentiates in Dental Surgery of the various Royal Colleges of the United Kingdom is increasing, while the number of those whose names are upon the Register by virtue of their being in practice before the passing of the Act is decreasing. The proportion of the former to the total number on the Register is 27’82 as compared with a percentage of 2648 in 1894, Of the latter class who do not possess qualifications the proportion is 70’98 as compared with 72-35 last year. On deducting the 27 foreign dentists from the total number on the Register and comparing the remainder with last year’s figures it will be seen that there is an addition of 79 names. PUERPERAL POLYNEURITIS. DB. LUNZ of Warsaw has recorded in a recent number of t the Deutsche Medicinisclee ld’oclcenschri;t an interesting case t of this rare and peculiar condition, in which the symptoms 1 differed considerably from those usually recognised. In the 1 usual form there is an isolated neuritis of the upper or I lower extremities, while the case here mentioned resembles more closely post-diphtheritic paralysis, inasmuch as difficulty] in swallowing and diplopia were present, and also what is rare in diphtheritic paralysis, an affection of the face. With I regard to the etiology of the condition it does not seem to follow only a pathological puerperium. Dr. Lunz believes that cases can be divided into three groups : a pyasmio or septic group, in which the neuritis follows some local infection; a cachectic form, which succeeds grave disturb- ance of nutrition, such as may be produced by loss of blood, persistent vomiting, &c. ; and a third group, in which neither infection nor cachexia can be regarded as the cause, but in which the psychical disturbance which the confinement pro- duces is to be regarded as determining the onset, just as it probably does of the puerperal psychoses which occur with- out puerperal infection. He urges, in conclusion, that ob- stetricians and psychologists should cooperate to elucidate the obscurities of these important and little understood conditions. ___ THE RECENT GALE. THE gale of Sunday, March 24th, was remarkable in many ways. It was extremely destructive within the district where it was felt, but that district was remarkably circum- scribed. According to the livies, if we take a triangle formed by joining the points of Valentia, the mouth of the Thames, and Scarborough we shall pretty accurately map out the affected region. Within thi3 area the wind worked terrible destruction, and the accounts of the damage done to buildings and trees recall those of the great storm of 1703, when Winstanley, over-confident in the stability of his newly built Eddystone Lighthouse, hoped "that God would send the greatest storm that ever blew out of Heaven," and, as a contemporary writer remarked, " God took him at his word." Perhaps the most distressing feature of the re:ent storm was the number of hospitals that were de- molished. At Walsall two wards in the district hospital were completely wrecked, in one of which the floor, a nui se, and eight female patients collapsed into the board-room below, but all were apparently unhurt. More disastrous were the results in the other ward, where the roof fell in and buried the patients. One man had both legs fractured and otherwise badly cut. At Grimsby a chimney crashed through the roof of the childron’s ward in the hospital, burying a child aged six years, who died an hour afterwards. At Hinckley, in Leicestershire, the isolation hospital, in which were nineteen patients suffering from diphtheria, was completely destroyed. Fortunately, warning was given by the wrecking of the out- buildings, and the patients were carried out wrapped in blankets and laid under a hedge. A word of praise is due to Mr. Goode, who offered his house as a temporary shelter. Compared with tropical hurricanes, our record of disaster is perhaps light, but for all that we fear that widespread distress has been caused. ___ MENTAL DISTURBANCE FROM IODOFORM. IN the Neurologisches Central blatt there is the abstract of a curious case recorded by Dr. Oldenburg. A female patient aged fifty-one, who had suffered from epileptic attacks from the age of twenty, but in the intervals between the attacks had been quite healthy and not psychically peculiar, injured her hand in a fit and was treated with a 10 per cent. iodo- form ointment. Twelve days later she became excitable, restless, and confused, and by-and-bye had hallucinations. The urine gave a distinct iodine reaction. When admitted to hospital she talked incessantly, would not answer ques- tions, could scarcely be kept in bed, and complained of plots and persecution. The restlessness increased, and the patient became cyanotic ; the urine contained albumen, but gave a very slight iodine reaction. She then remained quiet for a few days, but became again demented, after which she had another period of quietude followed by another outbreak, which, however, subsided, so that she was then able to be discharged. Dr. Oldenburg thinks the condition cannot be regarded as a post-epileptic mental disturbance, because of the interval that elapsed between the last attack and the onset of mental symptoms. He thinks it was determined by the iodoform poisoning acting upon a nervous system pre- disposed by epilepsy to grave disturbance. THE LIOUEFACTION OF HYDROGEN ACCOMPLISHED. UNDER the combined influences of great pressure and intense cold, hydrogen has at last surrendered and been liquefied. The means by which this has been effected have, of course, been at the disposal of the physicist and chemist for many years, but Professor Olszewski of Cracow, who, it may be remembered, also liquefied argon and examined its properties, has been the first to succeed in obtaining liquid hydrogen in tolerable quantity, since he has been able, we learn, to give two constants in regard to it. Thus it is announced that its critical point-the temperature at which it passes from a liquid to the condition of vapour- is - 233° C., and its boiling point at normal pressure is - 243° C. It is well known that hydrogen has hitherto most strenuously resisted all attempts at liquefaction, and the fact of its obduracy in this respect, though in other respects it is most tractable, having now been overcome, removes the only gaseous element known to us which has not been liquefied. Until, therefore, more attenuated gases even than hydrogen are added to the list of chemical simplicities no further discoveries on this particular line of research can be hoped for. Meanwhile a detailed communication from Professor Olbzewski on his very important discovery, which has just been announced, will be awaited with keen interest. ___ IT has been decided by the Abernethian Society of St. Bartholomew’s Hospital to hold a conversazione in the Great Ilall of the Hospital and in the Medical School build- ings to celebrate the centenary of the Abernethian Society on May lat, 1895. Any past members of the society who desire

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827

trades, not excluding the gentle craft of the blacksmith, hadclaimed the right to be on the Register. Many of these,of course, possessed no qualification whatever, but time

must necessarily erase their names from the roll. At the

present time the total number on the Register is 4901,including 27 gentlemen who possess the dental qualificationsof Harvard or Michigan Universities, U.S.A. These quali-fications are not yet recognised by the General MedicalCouncil, and these gentlemen are designated in the Register"Foreign Dentists." Slowly, yet surely, the number of

Licentiates in Dental Surgery of the various Royal Collegesof the United Kingdom is increasing, while the number ofthose whose names are upon the Register by virtue of theirbeing in practice before the passing of the Act is decreasing.The proportion of the former to the total number on the

Register is 27’82 as compared with a percentage of 2648 in1894, Of the latter class who do not possess qualificationsthe proportion is 70’98 as compared with 72-35 last year.On deducting the 27 foreign dentists from the total numberon the Register and comparing the remainder with last year’sfigures it will be seen that there is an addition of 79 names.

PUERPERAL POLYNEURITIS.

DB. LUNZ of Warsaw has recorded in a recent number of t

the Deutsche Medicinisclee ld’oclcenschri;t an interesting case t

of this rare and peculiar condition, in which the symptoms 1differed considerably from those usually recognised. In the 1usual form there is an isolated neuritis of the upper or Ilower extremities, while the case here mentioned resemblesmore closely post-diphtheritic paralysis, inasmuch as difficulty]in swallowing and diplopia were present, and also what israre in diphtheritic paralysis, an affection of the face. With

I

regard to the etiology of the condition it does not seem tofollow only a pathological puerperium. Dr. Lunz believesthat cases can be divided into three groups : a pyasmio orseptic group, in which the neuritis follows some local

infection; a cachectic form, which succeeds grave disturb-ance of nutrition, such as may be produced by loss of blood,persistent vomiting, &c. ; and a third group, in which neither

infection nor cachexia can be regarded as the cause, but inwhich the psychical disturbance which the confinement pro-duces is to be regarded as determining the onset, just as itprobably does of the puerperal psychoses which occur with-out puerperal infection. He urges, in conclusion, that ob-stetricians and psychologists should cooperate to elucidatethe obscurities of these important and little understoodconditions.

___

THE RECENT GALE.

THE gale of Sunday, March 24th, was remarkable in manyways. It was extremely destructive within the district

where it was felt, but that district was remarkably circum-scribed. According to the livies, if we take a triangleformed by joining the points of Valentia, the mouth of theThames, and Scarborough we shall pretty accurately mapout the affected region. Within thi3 area the windworked terrible destruction, and the accounts of thedamage done to buildings and trees recall those of thegreat storm of 1703, when Winstanley, over-confident in

the stability of his newly built Eddystone Lighthouse, hoped"that God would send the greatest storm that ever blew outof Heaven," and, as a contemporary writer remarked, " Godtook him at his word." Perhaps the most distressing featureof the re:ent storm was the number of hospitals that were de-molished. At Walsall two wards in the district hospital werecompletely wrecked, in one of which the floor, a nui se, andeight female patients collapsed into the board-room below,but all were apparently unhurt. More disastrous were theresults in the other ward, where the roof fell in and buriedthe patients. One man had both legs fractured and otherwise

badly cut. At Grimsby a chimney crashed through the roofof the childron’s ward in the hospital, burying a child agedsix years, who died an hour afterwards. At Hinckley,in Leicestershire, the isolation hospital, in which were nineteenpatients suffering from diphtheria, was completely destroyed.Fortunately, warning was given by the wrecking of the out-buildings, and the patients were carried out wrapped inblankets and laid under a hedge. A word of praise is due toMr. Goode, who offered his house as a temporary shelter.

Compared with tropical hurricanes, our record of disaster isperhaps light, but for all that we fear that widespread distresshas been caused.

___

MENTAL DISTURBANCE FROM IODOFORM.

IN the Neurologisches Central blatt there is the abstract of acurious case recorded by Dr. Oldenburg. A female patientaged fifty-one, who had suffered from epileptic attacks fromthe age of twenty, but in the intervals between the attackshad been quite healthy and not psychically peculiar, injuredher hand in a fit and was treated with a 10 per cent. iodo-form ointment. Twelve days later she became excitable,restless, and confused, and by-and-bye had hallucinations.The urine gave a distinct iodine reaction. When admittedto hospital she talked incessantly, would not answer ques-tions, could scarcely be kept in bed, and complained ofplots and persecution. The restlessness increased, and the

patient became cyanotic ; the urine contained albumen, butgave a very slight iodine reaction. She then remained quietfor a few days, but became again demented, after which shehad another period of quietude followed by another outbreak,which, however, subsided, so that she was then able to be

discharged. Dr. Oldenburg thinks the condition cannot beregarded as a post-epileptic mental disturbance, because ofthe interval that elapsed between the last attack and theonset of mental symptoms. He thinks it was determined bythe iodoform poisoning acting upon a nervous system pre-disposed by epilepsy to grave disturbance.

THE LIOUEFACTION OF HYDROGENACCOMPLISHED.

UNDER the combined influences of great pressure andintense cold, hydrogen has at last surrendered and been

liquefied. The means by which this has been effected have,of course, been at the disposal of the physicist and chemistfor many years, but Professor Olszewski of Cracow, who, itmay be remembered, also liquefied argon and examined itsproperties, has been the first to succeed in obtaining liquidhydrogen in tolerable quantity, since he has been able, welearn, to give two constants in regard to it. Thus it isannounced that its critical point-the temperature atwhich it passes from a liquid to the condition of vapour-is - 233° C., and its boiling point at normal pressure is

- 243° C. It is well known that hydrogen has hitherto

most strenuously resisted all attempts at liquefaction, andthe fact of its obduracy in this respect, though in other

respects it is most tractable, having now been overcome,removes the only gaseous element known to us which has notbeen liquefied. Until, therefore, more attenuated gases eventhan hydrogen are added to the list of chemical simplicitiesno further discoveries on this particular line of research canbe hoped for. Meanwhile a detailed communication fromProfessor Olbzewski on his very important discovery, whichhas just been announced, will be awaited with keeninterest.

___

IT has been decided by the Abernethian Society ofSt. Bartholomew’s Hospital to hold a conversazione in theGreat Ilall of the Hospital and in the Medical School build-ings to celebrate the centenary of the Abernethian Society on

May lat, 1895. Any past members of the society who desire