1
141 Tous white corpuscles, in some cases separated from each other, in others grouped together, and this not only where the tube was closely connected with the tumour, but where it was quite free from any neoplastic growth. Here it appeared that the stretching of the tube might be the cause of the inflammatory appearance?. A careful microscopical examina- tion was made to study the process of karyomitosis, from which it was concluded that this process was not a rapid one, the figures characteristic of indirect division being rare, and the advanced stages of division-wreaths, equatorial elates, and daughter asters-rarer still. A larger number of cells were met with in which the chromatin was increased, especially in the muscular layer. Side by side with the progressive changes signs of retrograde metamorphosis were iound. Thus, in preparations with Flemming’s solution some cells, both of the epithelial and of the muscular layers, were found filled with fat; while in others fat was seen around the poles of the nucleus, and in the connective tissue layer large globules of fat could be here and there distinguished. THE INTERNATIONAL MEDICAL CONGRESS. THE Italian physicians have responded with great ’cordiality to the invitation of their German brethren to assist at the International Congress which opens its sittings at Berlin on the 4th prox., and the committee of the Decinio Congresso Italiano di Medicina is now taking every step to aid its members in reaching that rendezvous. In a manifesto with which we have been favoured the Italian committee, amply acknowledging the debt which they and others of the profession in Italy owe to their German ’brethren, and inspired by the true "fratellanza" " which knits together men of science in general and physicians in particular, call upon their medical compatriots to make their representation at Berlin as effective as pos- sible, so as to bring back from the Congress the full ’benefit of the new light its transactions are expected to throw on the healing art in theory and practice for the furtherance of professional efficiency throughout the peninsula. This is the true spirit in which such inter- national congresses should be regarded, and the genial expression given to it in the manifesto before us is additional proof, if such were needed, of the noble estimate of their science and calling which characterises now, as of old, the votaries of medical study and practice in Italy. HOW TO REACH AND ENJOY OLD AGE. IT is no simple matter to state in terms at all precise ’what forces are directly connected with the production of hale and happy old age. More certainly is involved in the process than mere strength of constitution. Healthy sur- roundings, contentment, and active, temperate, and regular .habits are most valuable aids. Hard work, so long at least -as it is not carried beyond the limit necessary to permit of the timely repair of worn tissues, is not only a harmless, but a conducive circumstance. It is, in fact, by living as far as possible a life in accordance with natural law that we may expect to reap the appropriate result in its prolonga- tion. Civilisation is at once helpful and injurious. Under its protecting influence normal development at all ages is allowed and fostered, while the facilities it affords for self- indulgence are constantly acting in an opposite direction. The case of Hugh Macleod, aged almost 107, which has lately been published, illustrates in a remarkable manner the truth of these observations. This man, a Ross-shire High- lander, in what must be the sombre twilight of a blameless and fairly active life spent in his native count , still shows, it is said, a notable degree of vigour. He takes a lively interest in the affairs of life, has good appetite, is generally healthy, cuts and carries his peat for household use, and goes about among his neighbours as of old. His food is of the plainest though nutritious-porridge, fish, a little meat; and his habit in this and other matters is not unworthy the attention of many who are daily hastening by opposite courses the end of a merrier, shorter, but perhaps not happier life. SCARLET FEVER IN THE METROPOLIS. THE fortnightly returns of the’ metropolitan asylums show a steady increase in the number of fever cases. The admissions have risen from 256 in the fortnight ending May 29th to 358 in that ending July 10th, and the increase has been almost entirely in scarlet fever. The number under treatment for this disease on the first of these dates was 1049, and on the second it was 1263. The increase, though shared by all the hospitals, has been much the greatest in the Eastern Hospital. The subject was brought under the notice of the Board of Managers of the Metropolitan Asylums at their meeting on Saturday last, when certain measures were authorised with a view to meet the con- tingency of a further spread of the disease. The Committee of the South-Western Hospitals were instructed to open, as soon as possible, the lower of the two hospitals at Stockwell, which has been for some time closed ; the transfer of con- valescents from enteric fever to the Northern Hospital was ordered to be discontinued for the present; and the Small-pox Hospital Committee were instructed to fit up and furnish the brick hospital at Darenth for the reception of con- valescing fever patients, should the increase of cases in the other hospitals render such a step necessary or desirable. It is satisfactory to find the Asylums Board alive to the importance of being prepared beforehand for the not improbable event of an extension of the epidemic in the autumn. ___ TREATMENT OF TUBERCULAR JOINT DISEASE. THE latest methods for the treatment of tubercle have mostly taken the form of injections of antiseptic fluids. This has especially been the case with regard to tubercular disease of joints. Two papers on this subject appear in the Central- blattfiir Chirurgie, No. 25, by Bruns and Krause. These two observers speak in the highest terms of the success of this treatment. Bruns has treated fifty cases, in all of which there was more or less improvement. Krause gives the results of sixty cases, the disease being far advanced in them all ; of this number, thirteen were perfectly cured, in so far that no fresh outbreak occurred after the lapse of a year. In the remaining cases improvement was manifested in nearly all; two died, one from advanced phthisis, and another from acute miliary tuberculosis. The best results were obtained when the knee was the joint attacked; good effects were also produced in aged patients in whom the wrist was diseased, and in which amputation through the forearm would have generally been performed. In cases of tubercular hip-joint disease ankylosis nearly always occurred ; in two cases of severe coxitis, with numerous abscesses, erosion of cartilage, and displacement of the articular surfaces, most satisfactory results were obtained. This treatment is easy to carry out. The injections are best made with a strong exploring needle. The solution recommended by Bruns is me part of iodoform to ten or twenty of glycerine; that by Krause is a 10 per cent. emulsion of iodoform or glycerine, or a 10 per cent. mixture of water and iodoform. The injections should be made at intervals of two to four weeks, accord- ing to the severity of the case, and four injections will generally be found sufficient. After the withdrawal of the needle the aperture must be at once closed, and slight pas- sive movement of the joint performed, so that the iodoform may be equally distributed throughout the cavity. Should

HOW TO REACH AND ENJOY OLD AGE

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Tous white corpuscles, in some cases separated from eachother, in others grouped together, and this not only where thetube was closely connected with the tumour, but where itwas quite free from any neoplastic growth. Here it appearedthat the stretching of the tube might be the cause of theinflammatory appearance?. A careful microscopical examina-tion was made to study the process of karyomitosis, fromwhich it was concluded that this process was not a rapidone, the figures characteristic of indirect division being rare,and the advanced stages of division-wreaths, equatorialelates, and daughter asters-rarer still. A larger numberof cells were met with in which the chromatin was increased,especially in the muscular layer. Side by side with theprogressive changes signs of retrograde metamorphosis wereiound. Thus, in preparations with Flemming’s solutionsome cells, both of the epithelial and of the muscular layers,were found filled with fat; while in others fat was seen aroundthe poles of the nucleus, and in the connective tissue layerlarge globules of fat could be here and there distinguished.

THE INTERNATIONAL MEDICAL CONGRESS.

THE Italian physicians have responded with great’cordiality to the invitation of their German brethren toassist at the International Congress which opens its sittingsat Berlin on the 4th prox., and the committee of theDecinio Congresso Italiano di Medicina is now taking everystep to aid its members in reaching that rendezvous. Ina manifesto with which we have been favoured the Italian

committee, amply acknowledging the debt which they andothers of the profession in Italy owe to their German’brethren, and inspired by the true "fratellanza" " whichknits together men of science in general and physiciansin particular, call upon their medical compatriots tomake their representation at Berlin as effective as pos-sible, so as to bring back from the Congress the full’benefit of the new light its transactions are expectedto throw on the healing art in theory and practice forthe furtherance of professional efficiency throughout thepeninsula. This is the true spirit in which such inter-national congresses should be regarded, and the genialexpression given to it in the manifesto before us is

additional proof, if such were needed, of the noble estimateof their science and calling which characterises now, as ofold, the votaries of medical study and practice in Italy.

HOW TO REACH AND ENJOY OLD AGE.

IT is no simple matter to state in terms at all precise’what forces are directly connected with the production ofhale and happy old age. More certainly is involved in theprocess than mere strength of constitution. Healthy sur-roundings, contentment, and active, temperate, and regular.habits are most valuable aids. Hard work, so long at least-as it is not carried beyond the limit necessary to permit ofthe timely repair of worn tissues, is not only a harmless,but a conducive circumstance. It is, in fact, by living asfar as possible a life in accordance with natural law that wemay expect to reap the appropriate result in its prolonga-tion. Civilisation is at once helpful and injurious. Underits protecting influence normal development at all ages isallowed and fostered, while the facilities it affords for self-indulgence are constantly acting in an opposite direction.The case of Hugh Macleod, aged almost 107, which has latelybeen published, illustrates in a remarkable manner thetruth of these observations. This man, a Ross-shire High-lander, in what must be the sombre twilight of a blamelessand fairly active life spent in his native count , still shows,it is said, a notable degree of vigour. He takes a livelyinterest in the affairs of life, has good appetite, is generallyhealthy, cuts and carries his peat for household use, and

goes about among his neighbours as of old. His food is ofthe plainest though nutritious-porridge, fish, a little meat;and his habit in this and other matters is not unworthy theattention of many who are daily hastening by oppositecourses the end of a merrier, shorter, but perhaps nothappier life.

SCARLET FEVER IN THE METROPOLIS.

THE fortnightly returns of the’ metropolitan asylumsshow a steady increase in the number of fever cases. Theadmissions have risen from 256 in the fortnight endingMay 29th to 358 in that ending July 10th, and the increasehas been almost entirely in scarlet fever. The number undertreatment for this disease on the first of these dates was 1049,and on the second it was 1263. The increase, though sharedby all the hospitals, has been much the greatest in theEastern Hospital. The subject was brought under thenotice of the Board of Managers of the MetropolitanAsylums at their meeting on Saturday last, when certainmeasures were authorised with a view to meet the con-

tingency of a further spread of the disease. The Committeeof the South-Western Hospitals were instructed to open, assoon as possible, the lower of the two hospitals at Stockwell,which has been for some time closed ; the transfer of con-valescents from enteric fever to the Northern Hospital wasordered to be discontinued for the present; and the Small-poxHospital Committee were instructed to fit up and furnishthe brick hospital at Darenth for the reception of con-valescing fever patients, should the increase of cases in theother hospitals render such a step necessary or desirable.It is satisfactory to find the Asylums Board alive to theimportance of being prepared beforehand for the not

improbable event of an extension of the epidemic in theautumn.

___

TREATMENT OF TUBERCULAR JOINT DISEASE.

THE latest methods for the treatment of tubercle have

mostly taken the form of injections of antiseptic fluids. Thishas especially been the case with regard to tubercular diseaseof joints. Two papers on this subject appear in the Central-blattfiir Chirurgie, No. 25, by Bruns and Krause. Thesetwo observers speak in the highest terms of the success ofthis treatment. Bruns has treated fifty cases, in all ofwhich there was more or less improvement. Krause givesthe results of sixty cases, the disease being far advanced inthem all ; of this number, thirteen were perfectly cured, inso far that no fresh outbreak occurred after the lapse of ayear. In the remaining cases improvement was manifestedin nearly all; two died, one from advanced phthisis, andanother from acute miliary tuberculosis. The best resultswere obtained when the knee was the joint attacked; goodeffects were also produced in aged patients in whomthe wrist was diseased, and in which amputationthrough the forearm would have generally been performed.In cases of tubercular hip-joint disease ankylosis nearlyalways occurred ; in two cases of severe coxitis, withnumerous abscesses, erosion of cartilage, and displacementof the articular surfaces, most satisfactory results wereobtained. This treatment is easy to carry out. The

injections are best made with a strong exploring needle.The solution recommended by Bruns is me part of iodoformto ten or twenty of glycerine; that by Krause is a10 per cent. emulsion of iodoform or glycerine, or a

10 per cent. mixture of water and iodoform. The injectionsshould be made at intervals of two to four weeks, accord-ing to the severity of the case, and four injections willgenerally be found sufficient. After the withdrawal of theneedle the aperture must be at once closed, and slight pas-sive movement of the joint performed, so that the iodoformmay be equally distributed throughout the cavity. Should