of 1 /1
556 tedious. The book gives particulars of these technical applications, and records as well the processes hy which the rare earths are separated and the analytical methods for their estimation. JOURNALS. Tubercle. A Monthly Journal Devoted to All Aspects of Tuberculosis. Vol. I., No. 5. February, 1920.-In the February number Dr. Morriston Davies leads off with a Consideration of the Treatment of Pulmonary Tubercu- losis by Surgical Intervention, devoted mainly to those procedures which are applicable when artificial pneumo- thorax has failed owing to adhesions. Resection of ribs and rib cartilages may be employed when general collapse of the lung is aimed at, while two procedures- (1) replacement by a foreign body when collapse of the upper lobe is desired, and (2) section of the phrenic nerve in order to collapse the lower lobe-are also discussed. The latter operation is especially of use when severe cough is due to diaphragmatic adhesions. Another operation-viz., limited artificial pneumothorax by injection of oxygen-is recommended for relief of obstinate pain in cases of dry pleurisy.-Dr. H. A. Ellis follows with an article on dispensary treat- ment, in which he maintains " that this method of controlling pulmonary tubercle is on the right lines must be admitted when the diminished death-rate from adult male tubercle in Middlesbrough is realised." These deaths numbered 95, 88, 81, 81, and 69 in the years 1914-18 in spite of a large increase of population. Taken alone the figures are impressive, but we find from the report that the total deaths from pulmonary tubercle varied little, owing to a rise in the female deaths, consequent on war conditions. An encouraging report is quoted from Dr. Tennberg, giving the results of ten years’ experimental trial of dispensary methods in a certain parish in Finland, and the report is the more valuable because the wholesale examinations of the population at the beginning and end (1909 and 1919) were carried out by the author. There was special concentration on child welfare, and, while the incidence of pulmonary tuberculosis among the general population was reduced more than 50 per cent., the best results were obtained in early life. Among the abstracts is a series on chemotherapy reporting good results from the use of cyanocuprol, and in pneumococcie complications of optochin. Copper sulphate (1 in 1,000,000) has been used effectively for some years in clearing ponds of offensive algae without harm to fish (so far as reports go), and the results of the therapeutic use of copper will be watched with great interest. A critical review deals further with this agent and the history of its employment. The number closes with valuable reports of lectures and meetings. Bulletins et Mémoires de la Société illeclicale des Hôpitaux de Bucarest. Nos. 1--8.-Whatever may be the physical difficulties of life in the Near East, it is clear that the science of medicine is not neglected. The first number of this bulletin appeared within four months of the signing of the armistice, and since its first appearance one number has been published monthly, excepting during the vacations. Each number contains two or more communications made at the previous session of the society. Papers dealing with typhus and pellagra make interesting reading to those who are not in daily association with these diseases. The last number to reach us contains an article on the Ætiology of Dementia Prsecox, in which the author, Dr. A. Popea, is "strongly inclined" to credit syphilis with being the cause of this disease. His argument depends largely on the results of Wasser- mann tests which are not sufficiently numerous to be convincing. The argument suffers, too, from the absence of any control experiments on the normal population. Also we are a little surprised to hear dementia praecox described as " bien isolee en clinique." The bulletin is printed throughout in French and several of the advertisers have addresses in Paris, which suggests that the journal is intended for consumption in France as well as in Roumania. Subscriptions, 40 lei, are received by Dr. Alexandresco-Dersca, Bd. de la Catargi 2, ,, Bucarest. New Inventions. A NEW SPLINT FOR COLLES’S FRACTURE. IN the treatment of Collcs’s fracture, good results are often obtained by flexing the wrist sharply-e.g., over an anterior rectangular splint. This method is specially valuable in cases in which the lower radial fragment shows a tendency to rotate backward. Given perfect reduction, and sliilled after-treatment, the full normal range of flexion and extension will always be recovered; and pronation will be unimpaired also, because the hand was put up fully pronated. Supina- tion is not a common movement, and therefore it .tends to become limited, unless especial care is taken to cultivate it. The splint here illustrated is expressly devised to prevent any loss of supination, whilst retaining all the advantages of the older methods. It consists essentially of an anterior flexed-wrist splint, combined with an arm-piece which keeps the forearm fully supinated. It is made of light sheet-metal, and is adjustable for any length of forearm; the wrist is bent to a suitable angle, and a comfortable rolled lower edge is provided for the fingers to grip. It will be found that one or other of the two hand-pieces provided will fit any patient who has a Colles’s fracture. It is of the utmost importance that the fracture should be fully reduced before the splint is applied ; the latter should be padded with a single layer of Gamgee tissue or thin felt, and fastened on by webbing bands round the arm and forearm and a piece of strapping or bandage round the metacarpal region. The position is not in the least irksome, which is not the case with other supination splints. Generally speaking, the splint should be removed for good in a week’s time, and massage should be employed from the very first. With perseverance all movements should be completely restored. The splint has been made for me by Messrs. Down I Bros. Portl&nd-pla,ce, W. ALAN H. TODD, M.S., B.Sc. Lond., F.R.C.S. Eng. TONSIL BAYONET FOR OPENING PERITONSILLAR ABSCESSES. IN opening peritonsillar abscesses it is usual ’to employ one of the following instruments: (1) a small scalpel guarded with strapping ; (2) unguarded forceps. When employing the scalpel it is difficult to sterilise the strapping; in the case of the unguarded forceps it is easy to go too far in searching for deep pus. With the idea of overcoming these two disadvantages I have had made for me the instrument here figured and claim for it the following advantages: (1) Ease of sterilisation ; (2) the presence of a collar, which prohibits the operator stabbing too deeply ; (3) the double-edged bayonet, which facilitates the conversion of the stab into an incision in either an upward or downward direction. The operation can then be completed with blunt forceps quite safely. Messrs. Allen and Hanburys are the makers of the instrument. Connaught-square, W. A. SCOTT GILLETT, F.R.C.S.Edin.

JOURNALS

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556

tedious. The book gives particulars of these technicalapplications, and records as well the processes hywhich the rare earths are separated and the analyticalmethods for their estimation.

JOURNALS.Tubercle. A Monthly Journal Devoted to All Aspects

of Tuberculosis. Vol. I., No. 5. February, 1920.-In theFebruary number Dr. Morriston Davies leads off with aConsideration of the Treatment of Pulmonary Tubercu-losis by Surgical Intervention, devoted mainly to thoseprocedures which are applicable when artificial pneumo-thorax has failed owing to adhesions. Resection of ribsand rib cartilages may be employed when generalcollapse of the lung is aimed at, while two procedures-(1) replacement by a foreign body when collapse of theupper lobe is desired, and (2) section of the phrenicnerve in order to collapse the lower lobe-arealso discussed. The latter operation is especiallyof use when severe cough is due to diaphragmaticadhesions. Another operation-viz., limited artificial

pneumothorax by injection of oxygen-is recommendedfor relief of obstinate pain in cases of dry pleurisy.-Dr.H. A. Ellis follows with an article on dispensary treat-ment, in which he maintains " that this method of

controlling pulmonary tubercle is on the right linesmust be admitted when the diminished death-rate fromadult male tubercle in Middlesbrough is realised."These deaths numbered 95, 88, 81, 81, and 69 in theyears 1914-18 in spite of a large increase of population.Taken alone the figures are impressive, but wefind from the report that the total deaths frompulmonary tubercle varied little, owing to a rise inthe female deaths, consequent on war conditions.An encouraging report is quoted from Dr. Tennberg,giving the results of ten years’ experimental trial of

dispensary methods in a certain parish in Finland, andthe report is the more valuable because the wholesaleexaminations of the population at the beginning andend (1909 and 1919) were carried out by the author.There was special concentration on child welfare, and,while the incidence of pulmonary tuberculosis amongthe general population was reduced more than 50 percent., the best results were obtained in early life.Among the abstracts is a series on chemotherapyreporting good results from the use of cyanocuprol, andin pneumococcie complications of optochin. Coppersulphate (1 in 1,000,000) has been used effectively forsome years in clearing ponds of offensive algae withoutharm to fish (so far as reports go), and the results of thetherapeutic use of copper will be watched with greatinterest. A critical review deals further with this

agent and the history of its employment. The numbercloses with valuable reports of lectures and meetings.

Bulletins et Mémoires de la Société illeclicale des

Hôpitaux de Bucarest. Nos. 1--8.-Whatever may bethe physical difficulties of life in the Near East, it isclear that the science of medicine is not neglected. Thefirst number of this bulletin appeared within fourmonths of the signing of the armistice, and since itsfirst appearance one number has been publishedmonthly, excepting during the vacations. Eachnumber contains two or more communications madeat the previous session of the society. Papers dealingwith typhus and pellagra make interesting reading tothose who are not in daily association with thesediseases. The last number to reach us contains anarticle on the Ætiology of Dementia Prsecox, in whichthe author, Dr. A. Popea, is "strongly inclined" tocredit syphilis with being the cause of this disease.His argument depends largely on the results of Wasser-mann tests which are not sufficiently numerous to beconvincing. The argument suffers, too, from the absenceof any control experiments on the normal population.Also we are a little surprised to hear dementia praecoxdescribed as " bien isolee en clinique." The bulletin isprinted throughout in French and several of theadvertisers have addresses in Paris, which suggests thatthe journal is intended for consumption in France aswell as in Roumania. Subscriptions, 40 lei, are receivedby Dr. Alexandresco-Dersca, Bd. de la Catargi 2,

,,

Bucarest.

New Inventions.A NEW SPLINT FOR COLLES’S FRACTURE.

IN the treatment of Collcs’s fracture, good resultsare often obtained by flexing the wrist sharply-e.g.,over an anterior rectangular splint. This method is

specially valuable in cases in which the lower radialfragment shows a tendency to rotate backward. Givenperfect reduction, and sliilled after-treatment, the fullnormal range of flexion and extension will always berecovered; and pronation will be unimpaired also,because the hand was put up fully pronated. Supina-tion is not a common movement, and therefore it.tends to become limited, unless especial care is takento cultivate it. The splint here illustrated is expressly

devised to prevent any loss of supination, whilstretaining all the advantages of the older methods. Itconsists essentially of an anterior flexed-wrist splint,combined with an arm-piece which keeps the forearmfully supinated. It is made of light sheet-metal,and is adjustable for any length of forearm; thewrist is bent to a suitable angle, and a comfortablerolled lower edge is provided for the fingers togrip. It will be found that one or other of thetwo hand-pieces provided will fit any patient whohas a Colles’s fracture. It is of the utmost importancethat the fracture should be fully reduced before thesplint is applied ; the latter should be padded with asingle layer of Gamgee tissue or thin felt, and fastenedon by webbing bands round the arm and forearm and apiece of strapping or bandage round the metacarpalregion. The position is not in the least irksome, whichis not the case with other supination splints. Generallyspeaking, the splint should be removed for good in aweek’s time, and massage should be employed from thevery first. With perseverance all movements should becompletely restored.The splint has been made for me by Messrs. Down

I Bros. -

Portl&nd-pla,ce, W.

ALAN H. TODD, M.S., B.Sc. Lond.,F.R.C.S. Eng.

TONSIL BAYONET

FOR OPENING PERITONSILLAR ABSCESSES.

IN opening peritonsillar abscesses it is usual ’toemploy one of the following instruments: (1) a smallscalpel guarded with strapping ; (2) unguarded forceps.When employing the scalpel it is difficult to sterilise thestrapping; in the case of the unguarded forceps it iseasy to go too far in searching for deep pus. With theidea of overcoming these two disadvantages I have had

made for me the instrument here figured and claim forit the following advantages: (1) Ease of sterilisation ;(2) the presence of a collar, which prohibits theoperator stabbing too deeply ; (3) the double-edgedbayonet, which facilitates the conversion of the stabinto an incision in either an upward or downwarddirection. The operation can then be completed withblunt forceps quite safely.

Messrs. Allen and Hanburys are the makers of theinstrument.

Connaught-square, W.A. SCOTT GILLETT, F.R.C.S.Edin.