universal hypertrichosis and premature menstruation in a child

1
736 THE CLOSURE OF WELLS LIABLE TO POLLUTION. the Wycombe councillors have but recently taken ad- vantage of the facilities offered by the Infectious I, Diseases ’Notification Act; but certainly suspicion attaches ’, itself to all authorities who are unwilling to make them- selves cognisant of the dangers in their midst, and perhaps enteric fever may be found to be more or less endemic in High Wycombe. The town council is said to be at last bestirring itself in the matter of stopping the leaks in the sewers ; but the amount voted for the purpose is not regarded by all as adequate, and it has yet to be proved that the sewage can be so treated as to afford any guarantee that pathogenic organisms arriving on the farm may not retain their virulence until they reach the sub- soil water of Wycombe Marsh. The town councillors are naturally angry at their affairs being discussed in public, but it is their obvious duty at once to set their house in order ; and it appears from the reports which we have read that a pure water-supply for the whole of High Wycombe and for Wycombe Marsh is not the least pressing question for the urban and rural district councillors to grapple with. UNIVERSAL HYPERTRICHOSIS AND PREMATURE MENSTRUATION IN A CHILD. THE following case, published by Lesser, appears in the July number of the -Revite des S‘ciences Midicales. A girl, aged six years, who was not abnormal at birth, showed for the past two years a remarkable development of hair. The body, especially in the lower limbs, was covered with hairs more abundantly than in a very hairy man. The pubic hairs were more developed -than in many adult females. There were whiskers on the face. The hair of the ’head was normal. Menstruation began at the age of three ; it lasted six or seven days, and was profuse. In the following eighteen months it reappeared eight or nine times at almost regular intervals, and then ceased. The intel’ ’ligence was advanced in a corresponding degree. The child’s parents and elder brothers and sisters had normal develop- ment of hair, but two brothers, aged sixteen and twelve years, and next in age, had precocious beards. We may Direct attention to one point. The case shows something more than precocious sexual development in the case of the hair. There is also production of male characteristics. Now, curiously, in the adult female this event is also asso- ciated with abnormal conditions of the genital organs. THE SPAS OF SPAIN. , SpAlx possesses many mineral springs, but very few of them are at all well known in other countries. Amongst the few exceptions may be reckoned some aperient waters, the sulphurous springs of Panticosa in the Pyrenees near the French frontier, and also the alkaline waters of Vidago, termed the Spanish Vichy." From the official statistics published by the Spanish Government it appears that the , total number of establishments is 169, and that they are scattered over forty-three different provinces. The total . number of springs is 443, and those of Alhama (Zaragoz a), Alhama Nuevo (Granada), and Fitero Nuevo (Navarra) yield the most copious supply of water. Amongst the , hottest springs are those of Caldas de Montbuy in Barce- lona (122° to 158° F.) and Archena in Murcia (131° F.). The spa of Panticosa in Huesca has the loftiest position, being about 5600 English feet above sea-level and nearly rivalling St. Moritz in altitude. Amongst strong sulphated waters the Spanish sources of Rubinat, Carabana, and Villacabras are tolerably well-known in other parts of Europe, . especially in France; the aperient water of La Margarita, Loeches (Province of Madrid) is widely known in Spain, and is sold in bottles everywhere. The annual number of visitors 1 La Gaceta de Madrid, May 8th, 1897. is nearly 2500 at Caldas-de-Oviedo and at Montemayor (Caceres) ; some other spas, as Archena, attract considerably more. The greater proportion of the springs can be classed in either the common salt, simple thermal, or sulphurous groups. ------ THE SPECIAL CANADIAN SUPPLEMENT TO THE LANCET. SOME copies of the Special Canadian Supplement to THE LANCET produced, printed, and published in Montreal on Sept. 3rd on the occasion of the meeting of the British Medical Association in Canada have reached us by the last mail. Such a publication is, we venture to think, a new departure in medical journalism. The supplement appears as a journal of forty eight pages and contains the addresses of Dr. Roddick, Dr. Osler, and Mr. Mitchell Banks, a leading article, and editorial notes and comments upon the pro- ceedings of the meeting, together with a (necessarily brief) report of the proceedings in the different sections. THE CLOSURE OF WELLS LIABLE TO POLLUTION. THE interpretation which the law usually places upon the provisions of Section 70 of the Pablic Health Act is far from satisfactory to the medical officers of health, who, in spite of a well being in a most dangerous environment, may be unable to effect its closure unless the water from it can be demonstrated by analysis to be polluted. That liability to pollution is a far more important point than the result of chemical or bacteriological examination is admitted by every epidemiologist, but, as a matter of practice, a given case must, as a rule, stand or fall according to the finding of the chemist at any given time. The decisions of the law have, however, a way of being modified in a remark- able manner, and when a legal position is obviously opposed to what may be called the common sense view the law tends to place an interpretation upon words and sentences in keeping with the spirit of the moment. This point was illustrated in an interesting fashion by a decision arrived at recently at the St. Albans divisional sessions, when the St. Albans rural district council sought closure orders against twenty-three owners of wells in the Bowling-alley, Harpenden. The contention of the council was that the whole of the area in which the wells in question were situated was pervaded by the enteric fever bacillus owing to the fact that the subsoil was permeated with infected excreta ; furthermore, it was shown by chemical analysis that the water from the wells pre- sented different degrees of organic pollution, although the wells were all supplied from the same source. It was urged, too, that the variations in the analyses during dry and wet weather showed the wells to be liable to intermittent pollution. For the defence it was argued that no chemical analyses had been produced, and that it must be proved before the Court that a well was actually polluted, and not that it was liable to pollution. The Bench, however, after much deliberation, decided to issue orders for closure, as they considered that the wells might prove dangerous in the event of a fresh outbreak of enteric fever taking place. Whatever may be the merits of this decision from a strictly legal stand- point, no epidemiologist is likely to quarrel with it. A locality where the excrement is placed in one pervious hole, and the drinking water taken from another but a short distance away, cannot be other than a dangerous one, and if the law does not enable wells which are thus situated to be closed the sooner an alteration is effected the better. Dr. Frank Dobbin, the deputy medical officer of health of St. Albans, is to be congratulated upon the manner in which he supplied the evidence in this case, and

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Page 1: UNIVERSAL HYPERTRICHOSIS AND PREMATURE MENSTRUATION IN A CHILD

736 THE CLOSURE OF WELLS LIABLE TO POLLUTION.

the Wycombe councillors have but recently taken ad- vantage of the facilities offered by the Infectious I,Diseases ’Notification Act; but certainly suspicion attaches ’,itself to all authorities who are unwilling to make them-selves cognisant of the dangers in their midst, and

perhaps enteric fever may be found to be more or lessendemic in High Wycombe. The town council is said tobe at last bestirring itself in the matter of stopping theleaks in the sewers ; but the amount voted for the purposeis not regarded by all as adequate, and it has yet to beproved that the sewage can be so treated as to afford anyguarantee that pathogenic organisms arriving on the farmmay not retain their virulence until they reach the sub-soil water of Wycombe Marsh. The town councillors are

naturally angry at their affairs being discussed in public, butit is their obvious duty at once to set their house in order ;and it appears from the reports which we have read that apure water-supply for the whole of High Wycombe and forWycombe Marsh is not the least pressing question for theurban and rural district councillors to grapple with.

UNIVERSAL HYPERTRICHOSIS AND PREMATUREMENSTRUATION IN A CHILD.

THE following case, published by Lesser, appears in theJuly number of the -Revite des S‘ciences Midicales. A girl,aged six years, who was not abnormal at birth, showed forthe past two years a remarkable development of hair. The

body, especially in the lower limbs, was covered with hairsmore abundantly than in a very hairy man. The pubichairs were more developed -than in many adult females.There were whiskers on the face. The hair of the

’head was normal. Menstruation began at the age of

three ; it lasted six or seven days, and was profuse. In the

following eighteen months it reappeared eight or nine timesat almost regular intervals, and then ceased. The intel’’ligence was advanced in a corresponding degree. The child’sparents and elder brothers and sisters had normal develop-ment of hair, but two brothers, aged sixteen and twelveyears, and next in age, had precocious beards. We mayDirect attention to one point. The case shows somethingmore than precocious sexual development in the case of

the hair. There is also production of male characteristics.Now, curiously, in the adult female this event is also asso-ciated with abnormal conditions of the genital organs.

THE SPAS OF SPAIN.

, SpAlx possesses many mineral springs, but very few of

them are at all well known in other countries. Amongstthe few exceptions may be reckoned some aperient waters,the sulphurous springs of Panticosa in the Pyrenees near theFrench frontier, and also the alkaline waters of Vidago,termed the Spanish Vichy." From the official statistics

published by the Spanish Government it appears that the, total number of establishments is 169, and that they arescattered over forty-three different provinces. The total

. number of springs is 443, and those of Alhama (Zaragoz a),Alhama Nuevo (Granada), and Fitero Nuevo (Navarra)yield the most copious supply of water. Amongst the, hottest springs are those of Caldas de Montbuy in Barce-lona (122° to 158° F.) and Archena in Murcia (131° F.).The spa of Panticosa in Huesca has the loftiest position,being about 5600 English feet above sea-level and nearly

rivalling St. Moritz in altitude. Amongst strong sulphatedwaters the Spanish sources of Rubinat, Carabana, andVillacabras are tolerably well-known in other parts of Europe,

. especially in France; the aperient water of La Margarita,Loeches (Province of Madrid) is widely known in Spain, andis sold in bottles everywhere. The annual number of visitors

1 La Gaceta de Madrid, May 8th, 1897.

is nearly 2500 at Caldas-de-Oviedo and at Montemayor(Caceres) ; some other spas, as Archena, attract considerablymore. The greater proportion of the springs can be classedin either the common salt, simple thermal, or sulphurousgroups.

------

THE SPECIAL CANADIAN SUPPLEMENT TOTHE LANCET.

SOME copies of the Special Canadian Supplement to THELANCET produced, printed, and published in Montreal on

Sept. 3rd on the occasion of the meeting of the British

Medical Association in Canada have reached us by the lastmail. Such a publication is, we venture to think, a new

departure in medical journalism. The supplement appears asa journal of forty eight pages and contains the addresses ofDr. Roddick, Dr. Osler, and Mr. Mitchell Banks, a leadingarticle, and editorial notes and comments upon the pro-ceedings of the meeting, together with a (necessarilybrief) report of the proceedings in the different sections.

THE CLOSURE OF WELLS LIABLE TOPOLLUTION.

THE interpretation which the law usually places upon theprovisions of Section 70 of the Pablic Health Act is far fromsatisfactory to the medical officers of health, who, in spiteof a well being in a most dangerous environment, may beunable to effect its closure unless the water from it can bedemonstrated by analysis to be polluted. That liability topollution is a far more important point than the result ofchemical or bacteriological examination is admitted byevery epidemiologist, but, as a matter of practice, a givencase must, as a rule, stand or fall according to the finding ofthe chemist at any given time. The decisions of the law

have, however, a way of being modified in a remark-able manner, and when a legal position is obviouslyopposed to what may be called the common sense

view the law tends to place an interpretation uponwords and sentences in keeping with the spirit of the

moment. This point was illustrated in an interesting fashionby a decision arrived at recently at the St. Albans divisional

sessions, when the St. Albans rural district council soughtclosure orders against twenty-three owners of wells in theBowling-alley, Harpenden. The contention of the councilwas that the whole of the area in which the wells in

question were situated was pervaded by the enteric feverbacillus owing to the fact that the subsoil was permeatedwith infected excreta ; furthermore, it was shown bychemical analysis that the water from the wells pre-sented different degrees of organic pollution, althoughthe wells were all supplied from the same source. Itwas urged, too, that the variations in the analysesduring dry and wet weather showed the wells to beliable to intermittent pollution. For the defence it was

argued that no chemical analyses had been produced, andthat it must be proved before the Court that a well wasactually polluted, and not that it was liable to pollution.The Bench, however, after much deliberation, decided toissue orders for closure, as they considered that the wellsmight prove dangerous in the event of a fresh outbreakof enteric fever taking place. Whatever may be themerits of this decision from a strictly legal stand-

point, no epidemiologist is likely to quarrel with it.A locality where the excrement is placed in one

pervious hole, and the drinking water taken from anotherbut a short distance away, cannot be other than a dangerousone, and if the law does not enable wells which are thussituated to be closed the sooner an alteration is effected thebetter. Dr. Frank Dobbin, the deputy medical officer ofhealth of St. Albans, is to be congratulated upon the

manner in which he supplied the evidence in this case, and