the handel festival

1
1757 say that we examined a case of an infant born at the eighth say that we examined a case of an infant born at the eighth month, the mother at the time suffering from anthrax. We found numerous bacilli in the maternal portion of the placenta, but not in the foetal portion. The infant sur- vived its birth a few hours, but there were no indications that it was afflicted with the disease. With regard to typhoid fever the question has been more difficult of solution, since the symptoms are less well marked. Yet cases of apparent typhoid fever in the newly-born have been reported by Charceley, and Hastelius found lesions strongly suggesting the disease in a stillborn child of a mother dying from typhoid fever. Dr. Griffith records his case in which the Widal test was used. A family epidemic of typhoid fever occurred in the practice of Dr. J. O’Malley, of Philadelphia, and the father, mother, and three children, the oldest being five years of age, were brought to the St. Agnes Hospital. On Nov. 18th, 1896, the mother, still ill from fever in the hospital, gave birth at term to a well-developed child. It was concluded that the mother was probably in the third week of the disease when labour took place. The infant seemed to be healthy in every respect except for a slight transitory jaundice. When the child was about seven weeks old a specimen of blood was obtained and submitted to the Widal test. In four minutes the bacilli became much less active and began to collect in groups, and some little time later they became agglutinated. The conclusion drawn from the case is either that the child had had typhoid fever in 1dero and recovered after a short attack, or that the agglutinating principle had passed through the placenta from the mother to the fcetus without the latter having contracted the disease at all. There remains also the hypothesis that the child had im- bibed the virus with the mother’s milk. Analogy to other infectious diseases, and the fact that fatal typhoid fever does occur, render the first supposition most probable- namely, that the child when born had already had an attack of the fever. ___ THE HANDEL FESTIVAL. AMONGST the remarkable developments of the Victorian era must be counted the growing taste of the public for good music. This may be attributed, we think, partly to the earnest efforts of our musical leaders some years ago to cultivate the public taste and to provide or lay the ground for the performance of works of real worth, and partly to the demand which is created by the ever-increasing pace of modern life for a source of true recreation for the mind as well as for the body. The great event held every three years at the Crystal Palace, when, with few exceptions, the choicest of Handel’s inspirations are performed, is an important factor towards complying with this healthy and natural demand on the part of the public for this wholesome form of mental recreation. There could have been little disappointment in the mind of the great crowd which assembled on three occasions last week to hear the rendering of Handel’s choruses by a choir of 4000 voices. Nor could any dissatisfaction have been expressed in regard to the execution of Handel’s delightful melodies by the soloists. The programme of the great Handel week was very much in a line with that followed on previous occasions. For ourselves we confess that some little departure might with advantage have been made. The great composer has supplied a superabundance of material both for vocal and orchestral execution from which to make a selection. But we admit that there must be a considerable difficulty in including every choice excerpt. Handel wrote twelve organ concertos, and, as far as we recollect, the lst in G major and the 2nd in B flat are played over and over again. Surely the authorities might occasionally give us the llth in G minor, with its delightful second movement on a ground bass, or the 9th in F major, with the two charming minuets. Perhaps we may hear one of these at the next festival. As medical journalists there is little which calls for remark from us from our own peculiar point of view. We trust, however, that the interest in these festivals will never languish, and we are glad there is no reason for thinking that it ever will, in view of the splendid attendances which were recorded last week. From a point of view of a musical performance we believe, and those competent to judge have said, that the recent eleventh triennial event was an unqualified success. The first performance on Monday must have appealed to those who know and can appreciate the wonderful shades of feeling expressed in the Messiah; on Wednesday the light and shade were in still greater contrast, when some of the most popular solo writings, as, for example, the air from Serse, more familiarly known as the melody of the Largo in G, was most expressively sung by Miss Clara Butt as was the simple but most appealing air, "Lascia ch’ io Pianga," from the opera Rinaldo; while those who find delight in the massive and stately choruses of Israel in Egypt must have been deeply moved by the excellent rendering of the immense choir on Friday. The festival is not only a joy at the time of performance, but for a long time the impressive numbers remain in the memory and afford the mind a delightful retrospect. ------ RETENTION OF MENSTRUAL FLUID IN ONE HALF OF A DOUBLE UTERUS. WHEN this rare condition exists a mistaken diagnosis is very liable to be made. Menstruation occurs regularly from one half of the uterus, therefore the possibility of any reten- tion does not occur to the practitioner. The following case, recently published by Dr. J. Lamond Lackie,l was at first mistaken for an early fibroid condition of the uterus with endometritis. An unmarried woman, aged twenty-four years, had suffered for six years from pain in the right side, which was relieved only by a hssmorrhagic vaginal discharge every four months. After a few weeks the pain set in again and became gradually worse until once more relieved Also, for a day or two every month between her normal periods there was an acute exacerbation of pain, and she felt as if she were going to be unwell, but there was no discharge until the four months had elapsed. The patient distinguished this discharge both from blood and that of ordinary menstrua- tion. It was "more like brown paint." It always came on some days after an ordinary menstruation and continued for about three weeks. Examination showed well-marked bulging in the right fornix and fulness in the hypogastric and right inguinal regions. The patient then stated that she always observed a swelling in the right side before the hæmorrhage came on, which disappeared as it set in. She was kept under observation for seven weeks, during which increase in size and tenseness of the pelvi-abdominal swelling were noticed. The diagnosis was then thought to lie between a sessile ovarian tumour and a dilated tube. Vaginal aspiration was performed. The fluid obtained was of a dark chocolate colour, just like altered menstrual fluid. It consisted chiefly of altered blood corpuscles and pus. The patient recognised the fluid as of the same nature as that which escaped every four months. She remained free from pain or swelling for nearly two months, then there was recur- rence. The tumour was incised from the vagina. On passing a finger into the cavity and a sound into the left half of the uterus the septum at the cervical level was found to be moderately thin ; through this the sound was forced. The opening was enlarged by a pair of curved dressing forceps and a drainage-tube inserted 1 Edinburgh Medical Journal, March, 1897.

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1757

say that we examined a case of an infant born at the eighthsay that we examined a case of an infant born at the eighthmonth, the mother at the time suffering from anthrax. Wefound numerous bacilli in the maternal portion of the

placenta, but not in the foetal portion. The infant sur-vived its birth a few hours, but there were no indicationsthat it was afflicted with the disease. With regard to typhoidfever the question has been more difficult of solution,since the symptoms are less well marked. Yet cases of

apparent typhoid fever in the newly-born have been

reported by Charceley, and Hastelius found lesions

strongly suggesting the disease in a stillborn child of amother dying from typhoid fever. Dr. Griffith records

his case in which the Widal test was used. A familyepidemic of typhoid fever occurred in the practice of Dr.J. O’Malley, of Philadelphia, and the father, mother, andthree children, the oldest being five years of age, were

brought to the St. Agnes Hospital. On Nov. 18th, 1896,the mother, still ill from fever in the hospital, gave birth atterm to a well-developed child. It was concluded that themother was probably in the third week of the disease whenlabour took place. The infant seemed to be healthy in everyrespect except for a slight transitory jaundice. When thechild was about seven weeks old a specimen of blood wasobtained and submitted to the Widal test. In four minutesthe bacilli became much less active and began to

collect in groups, and some little time later they becameagglutinated. The conclusion drawn from the case is eitherthat the child had had typhoid fever in 1dero and recoveredafter a short attack, or that the agglutinating principle hadpassed through the placenta from the mother to the fcetuswithout the latter having contracted the disease at all.There remains also the hypothesis that the child had im-bibed the virus with the mother’s milk. Analogy to otherinfectious diseases, and the fact that fatal typhoid feverdoes occur, render the first supposition most probable-namely, that the child when born had already had an attackof the fever.

___

THE HANDEL FESTIVAL.

AMONGST the remarkable developments of the Victorianera must be counted the growing taste of the public for goodmusic. This may be attributed, we think, partly to theearnest efforts of our musical leaders some years ago tocultivate the public taste and to provide or lay the groundfor the performance of works of real worth, and partly to thedemand which is created by the ever-increasing pace ofmodern life for a source of true recreation for the mind aswell as for the body. The great event held every three yearsat the Crystal Palace, when, with few exceptions, thechoicest of Handel’s inspirations are performed, is an

important factor towards complying with this healthyand natural demand on the part of the public forthis wholesome form of mental recreation. There could havebeen little disappointment in the mind of the great crowdwhich assembled on three occasions last week to hear the

rendering of Handel’s choruses by a choir of 4000 voices.Nor could any dissatisfaction have been expressed in regardto the execution of Handel’s delightful melodies by thesoloists. The programme of the great Handel week was verymuch in a line with that followed on previous occasions.For ourselves we confess that some little departure mightwith advantage have been made. The great composer hassupplied a superabundance of material both for vocal andorchestral execution from which to make a selection.But we admit that there must be a considerable difficultyin including every choice excerpt. Handel wrote twelve

organ concertos, and, as far as we recollect, the lst inG major and the 2nd in B flat are played over and overagain. Surely the authorities might occasionally giveus the llth in G minor, with its delightful second

movement on a ground bass, or the 9th in F major,with the two charming minuets. Perhaps we may hearone of these at the next festival. As medical journaliststhere is little which calls for remark from us from our

own peculiar point of view. We trust, however, that theinterest in these festivals will never languish, and we areglad there is no reason for thinking that it ever will, inview of the splendid attendances which were recorded lastweek. From a point of view of a musical performance webelieve, and those competent to judge have said, that therecent eleventh triennial event was an unqualified success.The first performance on Monday must have appealed to thosewho know and can appreciate the wonderful shades of feelingexpressed in the Messiah; on Wednesday the light and shadewere in still greater contrast, when some of the most popularsolo writings, as, for example, the air from Serse, more

familiarly known as the melody of the Largo in G, wasmost expressively sung by Miss Clara Butt as was the simplebut most appealing air, "Lascia ch’ io Pianga," from theopera Rinaldo; while those who find delight in the massiveand stately choruses of Israel in Egypt must have beendeeply moved by the excellent rendering of the immensechoir on Friday. The festival is not only a joy at the timeof performance, but for a long time the impressive numbersremain in the memory and afford the mind a delightfulretrospect. ------

RETENTION OF MENSTRUAL FLUID IN ONEHALF OF A DOUBLE UTERUS.

WHEN this rare condition exists a mistaken diagnosis isvery liable to be made. Menstruation occurs regularly fromone half of the uterus, therefore the possibility of any reten-tion does not occur to the practitioner. The following case,recently published by Dr. J. Lamond Lackie,l was at firstmistaken for an early fibroid condition of the uterus withendometritis. An unmarried woman, aged twenty-fouryears, had suffered for six years from pain in the right side,which was relieved only by a hssmorrhagic vaginal dischargeevery four months. After a few weeks the pain set in

again and became gradually worse until once more relievedAlso, for a day or two every month between her normal

periods there was an acute exacerbation of pain, and she feltas if she were going to be unwell, but there was no dischargeuntil the four months had elapsed. The patient distinguishedthis discharge both from blood and that of ordinary menstrua-tion. It was "more like brown paint." It always came on somedays after an ordinary menstruation and continued for aboutthree weeks. Examination showed well-marked bulgingin the right fornix and fulness in the hypogastric and rightinguinal regions. The patient then stated that she alwaysobserved a swelling in the right side before the hæmorrhagecame on, which disappeared as it set in. She was keptunder observation for seven weeks, during which increasein size and tenseness of the pelvi-abdominal swelling werenoticed. The diagnosis was then thought to lie betweena sessile ovarian tumour and a dilated tube. Vaginalaspiration was performed. The fluid obtained was of adark chocolate colour, just like altered menstrual fluid. Itconsisted chiefly of altered blood corpuscles and pus. The

patient recognised the fluid as of the same nature as thatwhich escaped every four months. She remained free from

pain or swelling for nearly two months, then there was recur-rence. The tumour was incised from the vagina. On

passing a finger into the cavity and a sound into theleft half of the uterus the septum at the cervicallevel was found to be moderately thin ; throughthis the sound was forced. The opening was enlarged by apair of curved dressing forceps and a drainage-tube inserted

1 Edinburgh Medical Journal, March, 1897.