PARIS.
2
1132 He referred to the great loss sustained by the medical school as well as by the city of Belfast in the death of Professor Cuming, who took such a deep interest in everything that had to do with the advancement and well-being of the students. Dr. Kirk then gave a most interesting address on Aseptic Surgery, showing the enormous strides made in recent years in the healing of wounds, and advised the students to pay the greatest attention to acquiring a practical knowledge of their profession in the wards and out-patient - rooms of the hospital. A Midwife Claarged n;ith Manslaughter. On Oct. 13th an inquest was held into the circumstances attending the death of Mrs. Margaret Mahony, aged 36 years, the wife of a farmer who had died at her residence near Cork on Oct. llth. The coroner at the outset said that he thought it well to inform the jury why the inquest was being held, and he read a report which had been made to him by the sergeant of the Royal Irish Constabulary having charge of the case. This report included the following letter to the sergeant from Dr. Jeremiah Ryan of Cloghroe :- DHAR SIB.—I am attending a., woman named Mrs. Jerry Mahony, near Berrings Chapel. I saw her last evening (Oct. 10th), and she is likely to die, or might be dead- now. She is dying from neglect or want of proper attendance after her confinement. The facts are as follows. She was confined on last Thursday night week and attended to by a quack nurse on that night. I was called in the following Wednesday-a week less a day. She was not seen by this woman since the night she was confined. When I saw her on the Wednesday she was actually rotten in the bed, and everything in the bed was rotten for the want of being looked after. I need not say it is the duty of every nurse to attend a woman after her confinement once that she is called to attend at the confinement. The woman got puerperal fever, as far as I can learn or make out, from neglect, as the confinement was natural. I think you ought go and inquire into the case and report the matter to Coroner Horgan and have an inquest, if possible. I am sure he will hold an inquest if the facts are put rightly to him. If an inquest could be held an end would be put to this damned quackery and neglect. If I find she is dead it’s possible I will report to the coroner also, and also to your officer. This nurse, in my opinion, is responsible for her death. (Signed) JEREMIAH RYAN, M.D. On receipt of this letter the sergeant inquired into the case and found that the woman was confined, as stated by Dr. Ryan, and was attended by a woman named Mary Corkery, an untrained nurse. The nurse attended her on the night of Sept. 28th, 1899, when the woman was delivered safely. She remained with her till 6 A.M. on the morning of the 29th, when she left, " the woman being all right," and did not come back again till sent for by order of the medical man on Oct. 4th. The constable’s report added details concerning the diet and movements of the woman during the last ten days of her life. Dr. Ryan in his evidence at the inquest stated that the patient’s death was due to the neglect of the nurse, but qualified that statement by saying that puerperal fever some- times occurs in cases where every attention is paid. He described the nurse as being unskilled and untrained. The coroner in his address to the jury said that a shocking state of things had been disclosed in the case and in the interest of the community a stop should be put to the practice of women like Mrs. Corkery taking money for discharging duties they knew nothing whatever about. It was a very serious busi- ness for an inefficient person to undertake a duty which often gave a skilled person enough to do. It was essential in the interest of the community of which they were all members that human life should be looked after in an emergency of the present kind. From the facts he did not see how their verdict could be other than that the deceased died from puerperal fever owing to the culpable neglect of Mrs. Mary Corkery in not attending to her. The jury brought in a verdict accordingly and the nurse was arrested and will be brought before the magistrates on a charge of manslaughter. Oct. 17th. PARIS. (FROM OUR OWN CORRESPONDENT.) Anti-rabic Inoculations at the Pasteur Institute. DURING the year 1898 there were 1465 persons who under- went the anti-rabic treatment at the Pasteur Institute. Of these four died from rabies and in one case death occurred 10 days after the conclusion of the treatment. (It is reason- able to suppose from experiments made upon dogs that the nervous system of persons who die from rabies within 15 days after the conclusion of the treatment has been invaded by the virus of rabies before the treatment could take full effect.) Two patients developed rabies during the treatment and are. not counted in the series of those treated. The figures are therefore as follows : patients treated 1465, deaths three ; percentage mortality 0-20. For preceding years the figures are as follows: 1886, patients 2671, deaths 25, percentage 0-94 ; 1887, patients 1770, deaths 14, percentage 0 79 ; 1888, patients 1622, deaths nine, percentage 0 55 ; 1889, patients 1830, deaths seven, percentage 0 38; 1890, patients 1540, deaths five, percentage 0 32 ; 1891, patients 1559, deaths four, percentage 0-25 ; 1892, patients 1790, deaths four, per- centage 0’22; 1893, patients 1648, deaths six, percentage 0’36 ; 1894, patients 1387, deaths seven, percentage 0-50 ;. 1895, patients 1520. deaths five, percentage 0-32 ; 1896, patients 1388, deaths four, percentage 0 30; and 1897, patients 1521, deaths six, percentage 0-39. " Doctor in Pharmacy." The High School of Pharmacy in Paris has recently given. for the first time the new diploma of Doctor in Pharmacy, a diploma created some two years ago, and which, at that time, was the cause of lively protestations from the medical : profession, one of the chief protesters being Professor Renaut , of Lyons. Nominally the diploma was created to mark out- pharmaceutists who had done advanced work as of a higher- r class than the pharmaceutist who kept a shop, but really it is of no use and pharmaceutical chemists themselves know ’ this perfectly well. The mere sending in of a thesis is suffi- : cient to obtain a diploma; such thesis must only deal- with chemistry or natural science and the degree of doctor G in these two sciences was already obtainable. Besides, any ; pharmaceutical work which could not be included under one- . or other of these two heads is rarely to be met with, more t especially when the actual state of galenical pharmacy in. ) France is considered. There is therefore no obvious need for the new diploma and it is evident that the end which the- , pharmaceutists had in view was quite another one. In France the title of "doctor without any other indication. a means Doctor of Medicine-e.g., Dr. X- is for every- 7body Doctor of Medicine X-. As soon as pharmaceutical ’f chemists at the price of a thesis-easily manufactured or r bought-have the right to call themselves Doctor it is quite- 11 certain that they will write, say, Dr. Z- and not write it . out at length as Doctor in Pharmacy Z-. Thus, owing to e the state of the law "counter prescribing," already very 11 common amongst us, will be regularly guaranteed in the- .. public eye. Of course the genuine medical man could d prosecute the defaulting druggist but such remedy is purely !. illusory. The courts are far from encouraging such prosecu- etions, and the fine for illegal practice of medicine is 16] Lt francs, while that for the illegal practice of pharmacy is 500 ;- francs and damages payable to the syndicate of pharma- e ceutists of the locality. Despite the protestations, of the e medical profession the Council of the University has reco- )f gnised the new degree and the pharmaceutists are overjoyed )f and declare that pharmacy is recovering from its long period )f of weakliness (marasme). The first Doctor in Pharmacy is. s Eymar Lacour, principal pharmaceutist of the second class. i- in the army of the military hospital at Versailles, who sent. n in a thesis on an analysis of the Versailles water. The Bacillus of Dysentery. M. Roger, agrégé professor at the Faculty of Medicine and physician to the hospitals, read a paper on Oct. 7th before the Society of Biology on a bacillus which he had discovered and which he believed to be the pathogenic agent of non- tropical dysentery (dysenterie nostras). He obtained it easily enough in seven cases of dysentery by sowing a little intestinal mucus in bouillon and on the following day injecting 10 drops of the impure culture thus obtained into the veins of a rabbit. In less than 24 hours the animal died and on examination there was found in the blood and in the tissues’ an enormous quantity of bacilli. They closely resembled the bacillus anthracis but were shorter, had rounded ends, and occasionally showed a waist (étranglement) in the middle of their bodies. They were motile, they could be stained by Gram’s method, and they grew easily in any culture medium,. though they were then of smaller size than when grown in an animal. In vegetable media they grew of an oval form and looked like large micrococci. They liquefied gelatin rapidly and coagulated milk. In bouillon they grew quickly with the production of flakes of mucin and the culture gave- off a very fœtid odour ; in the case of bouillon mixed with glycose this odour was absent. Grown on agar they formed a thick, creamy, foetid crust, while on gelose-or gelatin they
Transcript of PARIS.
1132
He referred to the great loss sustained by the medical school as well as by the city of Belfast in the death of Professor Cuming, who took such a deep interest in everything thathad to do with the advancement and well-being of thestudents. Dr. Kirk then gave a most interesting address onAseptic Surgery, showing the enormous strides made inrecent years in the healing of wounds, and advised thestudents to pay the greatest attention to acquiring a practicalknowledge of their profession in the wards and out-patient
- rooms of the hospital.A Midwife Claarged n;ith Manslaughter.
On Oct. 13th an inquest was held into the circumstancesattending the death of Mrs. Margaret Mahony, aged 36 years,the wife of a farmer who had died at her residence nearCork on Oct. llth. The coroner at the outset said that he
thought it well to inform the jury why the inquest was beingheld, and he read a report which had been made to him bythe sergeant of the Royal Irish Constabulary having chargeof the case. This report included the following letter to thesergeant from Dr. Jeremiah Ryan of Cloghroe :-DHAR SIB.—I am attending a., woman named Mrs. Jerry Mahony,
near Berrings Chapel. I saw her last evening (Oct. 10th), and she islikely to die, or might be dead- now. She is dying from neglect orwant of proper attendance after her confinement. The facts are asfollows. She was confined on last Thursday night week and attendedto by a quack nurse on that night. I was called in the followingWednesday-a week less a day. She was not seen by this woman sincethe night she was confined. When I saw her on the Wednesday shewas actually rotten in the bed, and everything in the bed wasrotten for the want of being looked after. I need not say it isthe duty of every nurse to attend a woman after her confinement oncethat she is called to attend at the confinement. The woman gotpuerperal fever, as far as I can learn or make out, from neglect, as theconfinement was natural. I think you ought go and inquire intothe case and report the matter to Coroner Horgan and have an inquest,if possible. I am sure he will hold an inquest if the facts are putrightly to him. If an inquest could be held an end would be put tothis damned quackery and neglect. If I find she is dead it’s possibleI will report to the coroner also, and also to your officer. This nurse,in my opinion, is responsible for her death.
(Signed) JEREMIAH RYAN, M.D.
On receipt of this letter the sergeant inquired into the caseand found that the woman was confined, as stated byDr. Ryan, and was attended by a woman named MaryCorkery, an untrained nurse. The nurse attended heron the night of Sept. 28th, 1899, when the womanwas delivered safely. She remained with her till 6 A.M.on the morning of the 29th, when she left, " thewoman being all right," and did not come back againtill sent for by order of the medical man on Oct. 4th.The constable’s report added details concerning the diet andmovements of the woman during the last ten days of her life.Dr. Ryan in his evidence at the inquest stated that the
patient’s death was due to the neglect of the nurse, but
qualified that statement by saying that puerperal fever some-times occurs in cases where every attention is paid. Hedescribed the nurse as being unskilled and untrained. Thecoroner in his address to the jury said that a shocking state ofthings had been disclosed in the case and in the interest ofthe community a stop should be put to the practice ofwomen like Mrs. Corkery taking money for discharging dutiesthey knew nothing whatever about. It was a very serious busi-ness for an inefficient person to undertake a duty which oftengave a skilled person enough to do. It was essential in theinterest of the community of which they were all membersthat human life should be looked after in an emergency ofthe present kind. From the facts he did not see how theirverdict could be other than that the deceased died frompuerperal fever owing to the culpable neglect of Mrs. MaryCorkery in not attending to her. The jury brought in averdict accordingly and the nurse was arrested and will bebrought before the magistrates on a charge of manslaughter.
Oct. 17th.
PARIS.(FROM OUR OWN CORRESPONDENT.)
Anti-rabic Inoculations at the Pasteur Institute.DURING the year 1898 there were 1465 persons who under-
went the anti-rabic treatment at the Pasteur Institute. Ofthese four died from rabies and in one case death occurred10 days after the conclusion of the treatment. (It is reason-able to suppose from experiments made upon dogs that thenervous system of persons who die from rabies within 15 daysafter the conclusion of the treatment has been invaded by
the virus of rabies before the treatment could take full effect.)Two patients developed rabies during the treatment and are.not counted in the series of those treated. The figures aretherefore as follows : patients treated 1465, deaths three ;percentage mortality 0-20. For preceding years the figuresare as follows: 1886, patients 2671, deaths 25, percentage0-94 ; 1887, patients 1770, deaths 14, percentage 0 79 ; 1888,patients 1622, deaths nine, percentage 0 55 ; 1889, patients1830, deaths seven, percentage 0 38; 1890, patients 1540,deaths five, percentage 0 32 ; 1891, patients 1559, deathsfour, percentage 0-25 ; 1892, patients 1790, deaths four, per-centage 0’22; 1893, patients 1648, deaths six, percentage0’36 ; 1894, patients 1387, deaths seven, percentage 0-50 ;.1895, patients 1520. deaths five, percentage 0-32 ; 1896,patients 1388, deaths four, percentage 0 30; and 1897,patients 1521, deaths six, percentage 0-39.
" Doctor in Pharmacy."The High School of Pharmacy in Paris has recently given.
for the first time the new diploma of Doctor in Pharmacy, adiploma created some two years ago, and which, at thattime, was the cause of lively protestations from the medical
: profession, one of the chief protesters being Professor Renaut, of Lyons. Nominally the diploma was created to mark out-
pharmaceutists who had done advanced work as of a higher-r class than the pharmaceutist who kept a shop, but really itis of no use and pharmaceutical chemists themselves know’ this perfectly well. The mere sending in of a thesis is suffi-: cient to obtain a diploma; such thesis must only deal-
with chemistry or natural science and the degree of doctorG in these two sciences was already obtainable. Besides, any; pharmaceutical work which could not be included under one-.
or other of these two heads is rarely to be met with, moret especially when the actual state of galenical pharmacy in.) France is considered. There is therefore no obvious need
for the new diploma and it is evident that the end which the-,
pharmaceutists had in view was quite another one. InFrance the title of "doctor without any other indication.
a means Doctor of Medicine-e.g., Dr. X- is for every-7body Doctor of Medicine X-. As soon as pharmaceutical’f chemists at the price of a thesis-easily manufactured orr bought-have the right to call themselves Doctor it is quite-11 certain that they will write, say, Dr. Z- and not write it. out at length as Doctor in Pharmacy Z-. Thus, owing toe the state of the law "counter prescribing," already very11 common amongst us, will be regularly guaranteed in the-.. public eye. Of course the genuine medical man couldd prosecute the defaulting druggist but such remedy is purely!. illusory. The courts are far from encouraging such prosecu-etions, and the fine for illegal practice of medicine is 16]Lt francs, while that for the illegal practice of pharmacy is 500;- francs and damages payable to the syndicate of pharma-e ceutists of the locality. Despite the protestations, of thee medical profession the Council of the University has reco-)f gnised the new degree and the pharmaceutists are overjoyed)f and declare that pharmacy is recovering from its long period)f of weakliness (marasme). The first Doctor in Pharmacy is.s Eymar Lacour, principal pharmaceutist of the second class.i- in the army of the military hospital at Versailles, who sent.n in a thesis on an analysis of the Versailles water.
The Bacillus of Dysentery.M. Roger, agrégé professor at the Faculty of Medicine
and physician to the hospitals, read a paper on Oct. 7th beforethe Society of Biology on a bacillus which he had discoveredand which he believed to be the pathogenic agent of non-tropical dysentery (dysenterie nostras). He obtained it easilyenough in seven cases of dysentery by sowing a little intestinalmucus in bouillon and on the following day injecting 10drops of the impure culture thus obtained into the veins of arabbit. In less than 24 hours the animal died and on
examination there was found in the blood and in the tissues’an enormous quantity of bacilli. They closely resembledthe bacillus anthracis but were shorter, had rounded ends,and occasionally showed a waist (étranglement) in the middleof their bodies. They were motile, they could be stained byGram’s method, and they grew easily in any culture medium,.though they were then of smaller size than when grown inan animal. In vegetable media they grew of an oval formand looked like large micrococci. They liquefied gelatinrapidly and coagulated milk. In bouillon they grew quicklywith the production of flakes of mucin and the culture gave-off a very fœtid odour ; in the case of bouillon mixed withglycose this odour was absent. Grown on agar they formeda thick, creamy, foetid crust, while on gelose-or gelatin they
1133
produced numerous bubbles of gas. Pure’ cultures of thisbacillus injected into the veins of a rabbit produceddeath after an interval varying according to the virulenceof the dose. In acute cases the rabbit died in 24 hours withhasmorrhagic diarrhoea while numerous haemorrhages werefound in the large intestine. If the animal survived for a
longer period the characteristic lesions of dysentery werefound in the intestines and in one case the descending colonwas covered with deep ulcers showing sharp-cut edges. Thewall of the bowel around was thickened and there were
deposits of lymph on the peritoneum. The bacillus had anobvious tendency to localise itself in the large intestine evenwhen injected into the veins. It was only found in thesecases of non-tropical dysentery and never in cases of choleraicdiarrhoea (diarrhée choleriforme). M. Roger intends to con-tinue his researches into the relations between the form of
dysentery found in France and the genuine dysentery oftropical climates with a view to observing whether the bacilliof the two forms are identical.
Congresses.During the present week two important annual congresses
are sitting in Paris. The Thirteenth French Congress of
Surgery meets under the presidency of Professor Poncet ofLyons. There are two subjects for discussion: "TotalAbdominal Hysterectomy," to be opened by Dr. Ricard,and Tumours of Bone," to be opened by Dr. Pollosson andDr. Berard (of Lyons). The other congress is the FrenchAssociation of Urology, of which Professor Guyon is thepresident. The subject for discussion is " So-called EssentialH2ematuria." The discussion will be opened by M. Malherbe (and M. Legueu. ;
Oct. 17th. _______________
]
BERLIN.
(FROM OUR OWN CORRESPONDENT.)
Spondylitis a Seq2ceZ of Enteric Fever.DR. K6NITZER has described in the Miinehener Medicinische
Wochenschrift a case of spondylitis following enteric feverobserved in the Bethanien Hospital at Stettin. The patientwas a smith, 25 years of age, who fell ill in November, 1898,with :fever and diarrhoea. He was attended at home by amedical man who declared the illness to be enteric fever. In
February, 1899, he was able to do easy work, but pains inthe back and the lower extremities prevented him from work-ing as well as he did before his illness. On March llth hesuddenly complained of severe pains in the lumbar region sothat he was unable to stand, and he was therefore admitted-into the hospital. The symptoms included slight fever,pain in the lumbar portion of the vertebral column,and flexion of the femur; sensibility and the functionof the bladder were normal. The patellar reflexes wereincreased, but they soon became less strong, and on
March 30th they had entirely disappeared. The patientwas unable to raise his legs and complained of severe painsradiating from the lumbar region to the femur. In a fewweeks his state became better, so that on April 7th he couldonce more move his legs and the patellar reflexes returned.On April 12th he was able to leave his bed and to walk a fewsteps and the reflexes were normal. When he was dischargedat the end of April he was able to walk, although hisvertebral column was still somewhat rigid and painful whenhe tried to stoop. Cases of this kind have been alreadydescribed by Professor Quinke.
Sanatoria for Children at the S’easide.A report of the results obtained in the German seaside
sanatoria has been published in the Berliner KlinischeWochenschrift by Professor Ewald, secretary to the SanatoriaAssociation. He says that in anaemia, in chlorosis, in chronicaffections of the respiratory organs, and especially in scrofula,residence in a seaside sanatorium is much more efficaciousthan any other treatment. The good effect is due to thepurity of the air, to the presence of salt in it, to its humidityand movement, and to the regularity of the temperature.The average winter temperature at a seaside place likeNorderney is from 1° to 2° higher than in Berlin andWiesbaden. The report gives detailed statistics of theNorderney sanatorium where 7561 children were receivedfrom 1889 to 1898. Of these cases 949 were tubercu-lous, 24 of the children suffering from pulmonary tuberculosisin an advanced stage; 8’3 per cent. were improved but 91.3 3
per cent. were not improved. 107 were affiicted with thefibroid form of pulmonary tuberculosis and were in a relativelygood general state ; of these cases 56 per cent. were cured,72 per cent. were improved, and in 22-4 per cent. the
symptoms remained unaltered. 112 had pleuritic adhesions ;of these cases 43 7 per cent. were cured, 51’7 per cent. wereimproved, and 46 per cent. were unaltered. 265 patientshad chronic bronchitis, the majority of them showing ahereditary disposition to tuberculosis ; of these 45’3 percent. were cured, 50’9 per cent, improved, and 3’7 per cent.showed no change. Of 441 patients with tuberculous affec-tions of the bones, joints, skin, and glands, 14 per cent.were cured, 762 per cent. were improved, and 98 percent. showed no change. Of 2384 anæmic children47’4 per cent. were cured, 51’9 per cent. were improved, and0 7 per cent. showed no change. Of 2341 children sufferingfrom scrofula 26 per cent. were cured, 70’7 per cent. wereimproved, and 3 3 per cent. showed no change. It wasobserved that haemoptysis was much less frequent than usualand that after surgical operations for tuberculous affections-of the bones, joints, &c., recovery was much better at- theseaside than elsewhere. Professor Ewald is of opinion thatthe results would be still better if the children were allowedto stay longer in the sanatorium, as is the rule in France,where there are from 70 to 80 per cent. of recoveries.
The Medical Temperance Association.The Medical Temperance Association held its annual.
meeting in connexion with the congress of the Association ofNaturalists and Medical Men in Munich. Professor Krapelin-of Heidelberg, who was in the chair, read the first paper, thesubject being the Influence of Alcohol on the PsychicalFunctions. He has found by experiment that alcohol has aprejudicial influence on perception ; errors in calculation, forinstance, were more frequent after alcoholic liquors had beentaken. With regard to muscular work he pointed out that.alcohol temporarily increased the muscular force, but whentaken for some time it diminished it. Dr. Kolla thendelivered an address on alcohol as a medicament.
The Friedrichshain HospitaZ.The twenty- fifth anniversary of the Friedrichshain Hospital
in Berlin was celebrated on Oct. 7th and 8th. The present-and former chief and assistant physicians and surgeons andtheir ladies dined together in the ’’ Norddeutsche Hot" onthe evening of Oct. 7th and it was gratifying to see thatmany old Friedrichshain men had come from abroad for the
purpose of taking part in the proceedings. Toasts were
proposed by Professor Trendelenburg of Leipsic, who.was chief surgeon to the hospital at the time of its
foundation, by Professor Hahn, the present chief surgeon,by Professor Furbringer, and others. On the followingmorning the old Friedrichshain men visited the hospital andwere there entertained by the present medical officers at aJ/’riiltschoppen. The Deutsche Medicinische Wochenschriftissued a special number consisting entirely of essays byformer and present medical officers to the hospital. It maybe said that although some of the newer hospitals of Berlinand also outside Germany are provided with some modernarrangements (electric light, for instance) there are never-theless none of them which equal the FriedrichshainHospital in its hygienic conditions, its beautiful gardens, its.splendid and spacious wards, its heating and ventilation.Dr. F. J. Mouat was quite right in saying in his book on"Hospital Construction and Management" that "all thegeneral hospitals of the future should be constructed strictlyon the lines of the Friedrichshain."
Trachoma contracted at a Public Bath.The majority of the patients suffering from trachoma in
Berlin come from the eastern districts, especially near theRussian frontier where the disease is endemic. Recent.trachoma being comparatively rare in Berlin, Dr. Settegast,an ophthalmic surgeon in the city, was naturally somewhatsurprised at having lately to attend 18 cases in a month.rhe patients were all young men from 14 to 20 years of ageand it was found that they had been in the habit of visiting aswimming bath which was so much resorted to that therewere sometimes from 40 to 50 men there. It was further-ascertained that some of the people connected with the placeiad complained of their eyes, so that very likely germs ofirachoma had got into the water and had spread the disease.Che medical authorities were informed and the bath was.lisinfected by direction of the medical officer of health.Oct. 16th.
