379

point is that the work need not be magnified into an im-possibility and then neglected. The fees of medical witnesses

.-should be revised. ____

THE FILTERS SUPPLIED TO THE TROOPS INSOUTH AFRICA.

’CONSIDERABLE discussion is taking place in public health- circles as to the merits of the filters supplied to the troopsin the South African campaign. It is stated that the filters.decided upon by the War Office showed a lower efficiencythan the existing standard and that they were permeableto the typhoid bacillus. If this be so it is evident, con-sidering the enteric fever from which many of our soldierssuffered, that they were given a false sense of securityin regard to this matter. These allegations, it seems to us,- should be thoroughly sifted, and yet another explanation ofthe action of the War Office is called for. The probabilityis that no portable filter can be regarded as secure in the ex-cessively trying conditions under which our troops conductedthe campaign. It was difficult enough to find water to

drink, and how under such circumstances could the filters be

periodically cleansed and sterilised ? The evidence of labora.-

tory experiments is worth very little in such a case and

some method of purification of water other than filtration,such as sterilisation by the addition of sodium bisulphate,tseems indicated. We trust, however, that the matter will beduly investigated.

-

FATAL INTESTINAL HÆMORRHAGE IN BRIGHT’SDISEASE.

AT the meeting of the Societe Medicale des H&ocirc;pitaux of’Paris on June 28th Dr. M. A. Sonques related the following<case. A man, aged 58 years, was admitted to hospital with,albuminuria which he appeared to have had for five years.Some months previously his urine was examined and con- I

tained 0’3 centigramme of albumin to the litre. He looked

- strong, but his legs were oedematous and his abdomen was- swollen and a little painful and tender. The heart was hyper-trophied, the pulse was 120 and small, and the temperaturewas 1010 F. In the chest there were sonorous and sibilant

Tales. There were diarrhoea and albuminuria. Bright’s diseasewith slight ursemia was diagnosed and milk and dry-cuppingwere prescribed. Though the patient was apparently in agood condition he died on the following morning. There

had been vomiting during the night and some diarrhoea and- slight delirium. The necropsy showed that death was dueto intestinal hemorrhage. The ileum was uniformly’’blackish for an extent of one and a half metres. In this partit was filled with black fluid and the mucous membrane was

hsemorrhagic and livid. All the intestinal coats were tingedwith blood, and even a small quantity of ascitic fluid whichwas present was reddened. The most careful examination

,of the mucous membrane of the affected part did not revealany ulceration. The stomach and the rest of the intestineswere normal. There was no venous thrombosis. The

kidneys were large and each weighed 250 grammes.The section had the appearance of large white kidney.’The capsules were adherent in places. The lungs were

’cedematous and congested. The heart had the typical aspectof cor bovin1lm ; the left ventricle was greatly hypertrophied.In this case death resulted from an intestinal haemorrhagewhich had not had time to show itself externally. Intestinal

haemorrhage in Bright’s disease is now well recognised, butwriters simply mention it without entering into details.Cases such as the present have been rarely recorded. Rayer 1has described the following one. A man, aged 48 years,succumbed to a second attack of nephritis with melsena. The

.necropsy showed signs of pleurisy and haemorrhagic perito-nitis. In the peritoneum were several litres of red

1 Trait&eacute; des Maladies des Reins, tome ii., p. 335.

serous fluid. The ileum and large intestine were black ;on the mucous membrane were fibrinous clots. Theintestinal contents were blackish and liquid. Treitz,who has specially studied the gastro-intestinal troublesof nephritis, has found intestinal lesions in 209out of 220 cases of urasmia. In 27 cases there was’’ dysentery," croupous or ulcerative ; in four there were

effusions of blood into the intestine. Auvert has describeda case of Bright’s disease with Cheyne-Stokes respirationin which repeated and abundant intestinal haemorrhagestook place for a week.2 2 Intestinal haemorrhage in Bright’sdisease is of two clinical types. In one, the most

frequent, there is intestinal ulceration ; in the other thereis simply haemorrhage, more or less abundant, which

may show itself externally or not. Haemorrhage withoutulceration can be explained by intestinal congestion andrupture of capillaries. As to the mechanism, it has been

shown that toxins, for example the diphtheritic, will causeintestinal hsemorrhage in animals. No doubt during theirelimination by the intestine they produce congestion. In

ursemia toxic substances are eliminated by the intestine,possibly with the same result.

THE CRIPPLES’ MISSION.

THERE are several societies the objects of which are to

provide the children who live in the slums and poorer neigh-bourhoods of London with an annual holiday, but poorcrippled children, of whom we believe there are about

6300 in our vast metropolis, are unable by reason of

their deformities to join in the holidays and treats

which are provided for them by people who possess bothmoney and kind hearts. The Cripples’ Mission, which isa development of the Ragged School Union and ShaftesburySociety, sends every week from 50 to 100 helpless boys andgirls to the seaside for a stay of two or more weeks. Other

parties of equal number are conveyed for the day to EppingForest or to one of the parks In connexion with this missionwe are glad to see that a new holiday home for cripples wasrecently opened at Margate, Gordon House, the old homeof the Young Men’s Christian Association, having been

renovated at a cost of .f.400. It possesses accommodationfor 30 beds. The offices of the Cripples’ Mission are at

32, John-street, London, W.C. The society looks after thechildren until they are of the age of 16 years.

THE RAPID DETECTION OF BORIC ACID INMILK.

THE usual methods employed for the detection of boricacid in milk (the turmeric test and the alcohol and glycerolflame tests) in order to be delicate require a preliminaryevaporation and incineration. Though this presents no

difficulty in the laboratory, it renders the tests somewhat

impracticable in the many cases where it may be desirableto make a test on the spot. Mr. Droop Richmond, F.I.C.,points out that there is a reaction peculiar to boric acidwhich may be employed as a test ; in aqueous solution boricacid hydrolyses almost completely into B203 and H2O, and istherefore hardly acid to phenolphthalein, which he has

proved by cryoscopic determinations of the molecular weightin aqueous solution. Re-combination is effected by the addi-tion to the solution of polyhydric alcohols. Thus, as R. T.

Thompson was the first to point out, boric acid could betitrated with phenolphthalein in a 30 per cent. glycerolsolution, showing that it is completely re-combined. No otheracid possesses this property. Milk sugar behaves as a

polyhydric alcohol and a 4 to 5 per cent. solution causescombination to the extent of about two-thirds. This

2 Th&egrave;se de Paris, 1879.