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A Risk Of TravelSource: The British Medical Journal, Vol. 1, No. 1431 (Jun. 2, 1888), pp. 1175-1176Published by: BMJ Publishing Group

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June 2,*1888.] THE BRITISH MEDICAL JOURNAL. _ 1175

briety. The victim is generallyan automaton, and acts without

or consciousness of passing events. 2. This trance state

is distinct from epilepsy, hysteria,or any known forms of mania,

and is found associated with some unknown conditions following

alcoholic poisoning, continuouslyor at intervals. 3. The condition

is probably one of brain-exhaustion, followed bya

lowering of

consciousness, or a suspension of nerve force in certain directions.

There is profound disturbance of the brain centres, with impaired

and lessened sensibility. In some recorded cases the subject has

gone about his daily work, the abnormal state being revealed only

on anunexpected call for mental energy, producing confusion and

stupor instead of adaptability to new conditions. In other cases

the subjects had done unusual acts ; for example,a city banker

suddenly took to delivering tracts in the slums, but subsequently

remembered nothing of the incident. In other cases'some unusual

line of conduct seemed to grow out of the surroundingsor some

old buried idea came to the surface, as in the instance of a mer

chant suddenly declaring aloud to all whom he met that he would

kill an old schoolmaster who punished him in boyhood.

FIRE PREVENTION.

If there were any further proof needed of the lamentably inade

quacy of our means of affording escape to the inmates of a burn

ing building, it would be afforded by the calamitous fire which

broke out soon after G o'clock onWednesday morning last at a

draper's shop in Edgware Road, by which five persons lost their

lives. The absence, in the present case, of any fire escape was

due to an extraordinary rule which provides for their removal at

6 A.M., when the greater part of Londoners are in their beds. But

for this strange arrangement, the unfortunate persons who

lost their lives by this disaster would have been saved. Great

responsibilities rest upon the owners of large establishments

where alarge number of persons are housed ; it is clearly their

duty to provide adequate means of escape. The question ought

to be considered whether all such establishments ought not to be

placedunder restrictive regulations by by-laws framed for the

purpose by the local sanitary authority.

THE CENTENARYOF THE LINNEAN

SOCIETY.The centenary of the Linnean Societywas celebrated on

May 24th

bya

meeting at which eulogiums of Linnosus, of Robert Brown,

of Charles Darwin, and of George Bentham were pronounced. It

is interesting to note that two of the eminent biologists to whom

this honourable dutywas intrusted, Sir Joseph Hooker and Pro

fessor Flower, are both members of the medical profession, and

that, of the two recipients of the gold medal of the Societyon this

memorable occasion, one was Sir Joseph Hooker, and the other Sir

Richard Owen, who became a Member of the Royal College of Sur

geons in 182G, and a Fellow in 1843. On May 25th a conversazione was

held in the rooms of the Society, at which all the memorials of

Limueus in the possession of the Society were exhibited, together

with many other interesting objects.

A HARDWORKING WOMAN.

The death is announced of Miss Martha Petrovna Grabovskana, the

first female medical practitionerwho has settled in the important

Siberian city of Tobolsk, where she had entire charge of the

female department of the city hospital and lunatic asylum. She

lectured also at the School of Midwifery, and had a considerable

private practice ; in addition to her multifarious duties, she found

time to pursue scientific investigations. One of her researches had

reference to the hygieniceffect of treating hospital walls with

corrosive sublimate ; for this purpose she is stated to have made

fully 100 experiments in the laboratory. She was also much occu

pied in bacteriological research. Working sixteen hours aday,

as

this young lady is said to have done, tells, however, on the

strongest constitutions, and it is not much to be wondered at that

she succumbed. Before going to Siberia, she was for a time chief

of Professor Slavianski*s clinic.

PROFESSOR DONDERS.Professor Donders attained on Sunday last his seventy-first

year, an age at which the Dutch law compels him to resign his

professorship

in the

University

of Utrecht. At the festivitiesbywhich the occasion was celebrated a

large number of distinguished

men, not only from all parts of Holland and the Dutch colonies,

but from this and other countries, assembled. An address was pre

sented to Professor Donders, recognising his forty years' services to

science and humanity. The Professor announced that; he desired

the memorial fund to be appropriated toassisting young physio

logists and ophthalmologistsat the University. The King con

ferred the distinction of Commander of the Golden Lion on

Professor Donders, and the Government was represented at the

ceremony by the Home Minister. King Humbert sent him the

Order of the Crown of Italy, and Sir Joseph Lister congratulated

the Professor on behalf of the Royal Society of England. A

medal was also struck commemorative of the day's ceremony.

Professor Donders declared that, although he was leaving the

University, he had not finished his task. A banquet was given to

him in t.bn PVAnincr.

I THE RISKS OF A GENERAL HOSPITAL.

ITub question whether a general hospital can be regarded as a

nuisance to a residential neighbourhood has recently been raised

jin the law courts, and will probably be still further investigated.

Whatever the final decision may be, it is clearly the duty of every

hospital to take special precautionsto prevent infectious persons

found in the out-patient room, either from exposing to the risk of

infection other patientsin the institution, or the public who may

chance to meet these persons on their return home. The actual

requirements for such a hospital in London are (1) telephonic

communication with the central offices of the Metropolitan Asy

lums Board ; (2) rooms set apart for the isolation of infectious

|cases occurring either in the out-patient department or in the

wards ;(3)

an ambulance for the removal of those persons who

Iare unwillingor unable to obtain admission into hospitals for in

fectious diseases. Many institutions have already adopted these

precautions, and it is well that the attention of others should be

directed by the case to which we refer to the need for following

their example. _

A RISK OF TRAVEL.

The reported indispositionof the Duke of Edinburgh from

drinking impure water at a foreign station gives prominenceto

what is perhapsthe most usual and frequent source of danger in

foreign and Continental travel. Many of the sanitary authorities

who have looked into the question have from time to time

uttered warnings to Continental travellers as to the dangers of the

ordinary drinking water to be found abroad. The pollution of

table water at

foreign

hotels and houses is due to agreat variety

of causes. The water-supplyof foreign cities is as a rule, to

which there are only few exceptions, taken from sources lament

ably liable to sewage pollution, either in open streams or un

covered reservoirs, or from defective sanitation in the house

supply. A large part of the domestic supply of drinking water

is, moreover, from surface wells, which are constantly liable to

sewage filtration. An examination made only a few years

since, of syphonsof sparkling

"seltzer

"in a great Continental

city disclosed the fact that theywere horribly polluted with sew

age, and that the effervescing fixed air with which theywere

charged only served to conceal unutterable contaminations of a

most dangerous kind. Sir Henry Thompson and Dr. Herman

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1176_THEBBITISH

MEDICAL JOURNAL_[June

2;: 18881

Weber, who have both given attention to the subject,are very

emphatic in their counsel to travellers to avoid ordinary drinking

water abroad. The easiest and most agreeablemeans of avoiding

the danger is the habitual use of a pure natural mineral water in

lieu of the doubtful drinking water of the hotel or the private

house. When the Prince of Wales went to India he took with

him a large supply of the kind, and successfully avoided this risk.

Another method in which safety is sought is by invariably

boiling the water before drinking it. This, however, in

volves more trouble than many people are willing to take,

and makes the table-water flat and insipid. This insipidity may

be relieved by squeezing fresh lemons into the water. But for I

those who cannot always be bothered with the boiling-pot or

troubled with performing this little domestic operation before

taking a draught ofdrinking-water,

it would be,wise when

travelling abroad to select as a table-water a natural mineral

water of undoubted purity rather than run the risks of blood

poisoning, typhoid, and diarrhoea to which so considerable a

number of travellers at present fall victims, finding death and

disease where they are seeking health and pleasure. The in

stances of typhoid, blood-poisoning, diarrhoea, and dysentery, of

wjiich we hear this year from Italy and Egypt, are very lament

able, and for the most part avoidable.

MYX DEMA.The usual scanty attendance of members at a

"last night

"meet

ing, when a massacre of the innocents is to be expected, did not

obtain at the closing meeting of the session of the Clinical

Society onFriday last, when a full house, which included Dr.

Fordyce Barker, of New York, assembled to hear the conclusions

arrived at by the Committee of the Society, which for years has

been considering the whole question of myx dema. These con

clusions, which were read by Dr. ?rd, the Chairman of the Com

mittee, will be found in full at page 1162. It is nearly four yearssince this Committee was

appointed, during thepresidency of Sir

Andrew Clark, and the labour has been enormous. The whole

question has beeninvestigated in every way that could tend to

throw light on this complex subject, and the result has been the

volume shortly to be published, which will be found a mine of

informationconcerning myx dema and its immediate congeners.

The name of the Chairman of the Committee, Dr. Ord, will hence

forth be indissolubly associated with the literature of myx dema,in conjunction with that of Sir William Gull, who, some fifteen

years ago, first accurately described the clinical features of the

disease, though the name which he applied to it has since been

altered. Altogether, the [Society, and British medicine generally,are to be congratulated on the completion of this most important

work. By it the relationship subsisting between myx dema and

disease, or absence of the thyroid gland, seems to be placed

beyond all doubt, though the ultimate cause of the loss of func

tion of the thyroid gland has not yet been determined.

THE MEDICAL DEFENCE UNION.This useful union of medical men has been reconstituted, and is

nowentirely controlled and administered

bymedical men, whilst

it seems calculated to be able to fulfil the defensive requirementsof members of the profession. Mr. Lawson Tait is the President,

and the Vice-Presidents and other members of the Council are

well-known men, practising in various parts of the United Kingdom. One of the new articles of association states that :?" The

Council may, after due investigation, undertake the conduct or

defence of, or assist in conductingor

defending any proceedings,whether of a

strictly legal nature or otherwise, concerning or

affecting any member of the union who may desire their assist

ance, providing that the cause of action, or of the proceeding, or

the action or the proceeding, have not arisen or been commenced

prior to the date of the commencement of his membership of the

union." Only those actions, therefore, which originateafter the

date of membership can be undertaken by the union. That some

society of the kind has been needed seems to be generally admitted,

though there is probablysome diversity of opinion as to what

sort of association it should be. There are now 449 members of

the Medical Defence Union, to which large additions should be

made, that the society may be the better able to pursue success

.'fully its career. Besides conducting the defence of its members

jagainst any legal proceedings, the union will endeavour to sup

press unauthorised practitioners by their prosecution. The

subscription is fixed at ten shillingsa year, and a call on the

members to contribute funds for the purpose of the union, in pro

portion to the guarantee of each, is liable to be made. The name

of the secretary is Dr. Leslie Phillips, 393, Moseley Road, Bir

Imingham._

THE THYROID GLAND IN GRAVES'S DISEASE.

Recent investigations have given probability to the hypothesis

that some, if not all, of the symptoms of Graves's disease are to

be traced to derangement of the functions of the thyroid gland.

The enlargement of this gland is an early symptom, though not

generally the earliest, being preceded by some acceleration of carr

diacaction,

and itis,

on the whole, doubtless more

probable

that

both are dependent on some one cause than that either is the con

sequence of the other ; the possibility that the anaemia and other

symptoms of cachexia may be due to the thyroid lesion ought not

to be overlooked. Cases have been recorded within the last eightor nine years in which the symptoms of Graves's disease have

been observed to disappear after an operation on the gland ; to

this limited series Dr. Gauthier, of Charolles, has contributed a

sixth {Lyon M?dical, lviii, 22). In this case a cyst developed after

four years and was. tapped ; the operation was followed by in

\ ense inflammation and suppuration, but the patient recovered

freed from all the symptoms of exophthalmic goitre, except some

cardiac palpitation. Though the cure was not permanent, the

patient beingas bad as ever seven years after the operation, the

case is extremely interesting in the connection above referred to.

THE GERMAN EMPEROR.Whilst the whole civilised world must rejoice at the relatively

favourable turn which the malady of the German Emperor has

recently taken* it is important from every point of view that the

true significance of the facts should be clearly understood, and

:that hopes should not be excited which are doomed to dis

appointment. The illustrious patient has, no doubt, recovered

to a considerable extent from the severe local inflammation which

not long ago caused him so much suffering, and even placed his

life in jeopardy; and this result is, of course, in itself highly

satisfactory. It may be well, however, to remind the public that

this distressing complication was after all only an accident of the

disease, the essential nature of which remains unaffected by its

disappearance. The negative result of Professor Virchow's last

microscopic examination is of no clinical importance, as the

eminentpathologist

would no doubt behimself the first to

admit ; and we are sorry to have to say that hardly any greater

weight can be attached to his reported failure to detect any glandular enlargement in the Emperor's neck. Apart altogether from

the fact that in this, as in other cases, there may be secondary

deposits in glands top deeply situated to be felt, it is not by anymeans the rule for malignant disease beginning within the larynxto affect the related lymphatic, glands. The statement attributed

to Professor Virchow by a lay contemporary that he could now say

positively that the disease is not cancerous is simply incredible.

IMedical men, who are accustomed to have their clearest utter-*

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