743

the blood taken at night showed no filarial embryos. (None of the prisoners in this jail [300 in number] suffered from l

elephantiasis.)Professor S. A. POWELL (Bombay) said that in many i

Indian birds-owls, kites, &c.-filariæ were common in the I

lymphatics and subcutaneous tissues like filaria Bancrofti inman, but they did not find any elephantiasis so far as he wasaware. He might add a few figures bearing on the relativeincidence of filariasis and elephantiasis. In Cachar, whereelephantiasis was rare except when imported, of 256

indigenous persons whose blood he had examined only oneshowed filariæ. In Bombay, where elephantiasis was notuncommon, of 363 night bloods examined 18, about 5 percent., showed filariæ. On the other hand, the families ofseven cases of elephantiasis, 43 persons, showed no case offilariasis. That filariæ produced inflammation was un-

doubted. The phenomena of inflammation had been often studied in the cornea of the rabbit. In the swampy districtsof India nature often gave them a beautiful demonstration ,in the case of filaria in the eye of the horse. He had oftenwatched the course of the disease. A white worm aboutone and a half inches long was suddenly seen in the anteriorchamber of the horse’s eye, darting about like a miniatureeel in an aquarium; usually the aqueous humor and cornearemained quite clear for about 48 hours, then both becamesteamy, iritis set in, and in four days’ time the cornea wasdead white and opaque unless the worm had been removed.Professor A. CASTELLANI (Ceylon) described a palliative

treatment of elephantiasis by means of thiosinamin or fibro-lysin injections and methodical bandaging, followed byremoval of portions of the redundant skin when most of thefibrous tissue had been absorbed.The PRESIDENT of the section disputed Manson’s theory

of elephantiasis. The anatomical arrangement of the

lymphatics-as to distribution and valvular mechanism-prevented the ova from passing from one side of the body tothe other and the theory demanded the presence of an

aborting female in many and various parts to account for theclinical fact that the disease in the scrotum was usuallysymmetrical. After complete removal of a scrotal tumourthere was no return of the trouble, although the so-called"obstruction" remained. But a recurrence would surelyfollow if the least amount of unhealthy tissue remained inpenis or perineum. This showed that the disease was in the

parts removed and not in those that were left. He spoke atlength of treatment.

Dr. NATTAN-LARRIER described some interesting cases ofsleeping sickness with nervous and mental symptoms.

Dr. DANIELS then replied. With regard to the symmetrical,condition of the scrotal affection he said that that was commonto all conditions where the loose cellular subcutaneous tissuesof the scrotum were involved. The non-infection of othermembers of families he had observed in British Guiana with

’regard to filariasis. Frequently one member only of a familywas infected. A person with elephantiasis having no

,embryos in his peripheral blood was not so likely to infectother members of the family as a person with niariae and’without lymphatic obstruction.

Mrs. BoNTE SHELDON ELGOOD (Cairo) read a paper onBilharziosis among Women and Girls in Egypt.

It showed that the disease was common in young girls,,even in those who did not bathe and who used filtered water

only. Town children were frequently affected. Bilharziosiswas rare in adult women who might, however, have sufferedfrom it in youth. European women and girls were notknown to suffer from it, though in the towns they drank andwashed in water from the same source as natives used.Water, however, was not stored in European households.Infection was probably not due mainly to bathing, as

had been suggested. It was possibly due to faulty storage ofdrinking water or to the eating of raw vegetables and fruitwashed in dirty canals or rivers.

Dr. M. ARMAND RUFFER (Ramleh, Egypt) said that hewas of opinion that women in early life were as much infectedas were men. Infection might be due to ablutions and waspossibly rectal.

-

Dr. SANDWITH said that Dr. Ruffer’s suggestion wouldhardly explain the prevalence of bilharziosis in the Englishsoldiers in South Africa.

Sir PATRICK MANSON said that Mrs. Elgood had made amost important contribution towards the solution of the

problem of the etiotogy of bilharziosis which for many years

had been languishing for want of new facts. He disputedDr. Ruffer’s suggestion of infection per anum.

Dr. SAMBON then moved a vote of thanks to the Presidentfor the admirable manner in which he had conducted thebusiness of the section.

Looking Back.FROM

THE LANCET, SATURDAY, Sept. 4th, 1830.REMARKABLE CASE OF LONGEVITY.

AT the meeting of the Medico-physical Society of Florence,on the 13th of December, Dr. Buzzi related the case of aEemale of his acquaintance, who at that time was 94 yearsf age, and in the history of whose life there were somerather curious circumstances. Her family had been remark-able for longevity; her father died in his 106th year, hergrandfather, by her father’s side, in his 109th year, and hermother’s father in his 89th year ; the latter had, even at hisold age, been remarkable for his bodily strength. Thewoman herself had been rather a delicate child, she wasmarried in her fifteenth year; in the third month ofher marriage she menstruated for the first time, andin the fourth she became pregnant; in five years shehad borne three children. At this period her husband died,and she became soon afterwards subject to hysterics,which it is stated were most effectually obviated by violentexertion ; she was passionately fond of dancing, hunting,and riding on horseback, and frequently, when heated, threwherself into a river or a cold bath. This mode of life broughton violent headache, which with slight intermissions con-tinued to her 40th year, when it yielded to the abrasion ofthe hair; it always returned, however, as soon as the hairhad grown to about two inches in length. In other respects,she was in perfect health, in very good spirits, and of mostextraordinary appetite, in which she also fully indulged;three chickens, or from five to six pounds of roast meat, andtwenty oranges or peaches, were just sufficient for her break-fast. In her 45th year, her eldest son (who at the time of thereport was 77 years old, and in the full enjoyment of health)received, in battle, a wound in the left breast, and the frightwhich this accident caused, produced, strangely enough, ahæmorrhage from her left breast; the discharge was notcopious, but continued for two years. Her menses had

always been rather scanty, and she had frequently beensubject to various haemorrhages. In her 53rd year menstrua-tion ceased, but reappeared eight months afterwards, andcontinued regularly to her 94th year, which is the age shehad attained at the time of the report. She is rather ofsmall stature, but of very robust frame, and possessesthe full use of all her senses; she sleeps only five

hours, gets up at day-break, and takes a walk ofseveral hours; her manner of life is extremely simple, andthough her appetite is rather strong, her meals are frugal,especially if compared with what she formerly had been usedto. She sleeps an hour after dinner,. the rest of the day sheis continually engaged, being employed either in domesticaffairs or reading ; she walks very much, and so quick, thatsometimes young people are scarcely able to follow her. Sixyears ago she met with an accident and broke both arms, butwas perfectly cured within four weeks. At present she is inperfect health ; at night only she has sometimes slightattacks of dyspnoea and agitation ; when they occur, shegets up and opens. the window; the fit then generallysubsides, if not, she goes out into the open air, and afterabout half an hour’s walk, feels perfectly well again.-Ann.di Med. Fase. di Maggio e Giugno, 1830, page 595.

THE BRITISH ASSOCIATION.—Since the pro-visional programme of the Chemistry Section of the BritishAssociation was announced the following additional papershave been promised: (1) the Liquefaction of Helium, byProfessor Dr. Kamerlingh Onnes; (2) Anticipations and

Experiments on the Liquefaction of Helium, by Sir JamesDewar ; and (3) Note on a Volatile Compound of Cobaltwith Carbon Monoxide, by Dr. Ludwig Mond and others.These communications are awaited with great interest.

744 PSYCHO-THERAPEUTICS.

THE LANCET.

LONDON: SATURDAY, SEPT. 5, 1908.

Psycho-Therapeutics.SUPERSTITION extinguished in one of its manifestations

ever tends to recrudesce in some other form. There is a

large and seemingly necessary place for it in the life of man,and in what we may call a scientific disguise it occupies the public attention at the present time in a constantly increasing degree. With the growth of a knowledge of hygiene, chieflyderived from the lengthy advertisements of different varietiesof nostrums which, with diagrams of the nervous or other

systems, ornament our lay press, we are perpetually beingconfronted by our patients with problems which to us at

present insoluble are easy of explanation by those who pre-tend to a knowledge they do not in fact possess. So it has

come about that now, probably to a greater degree than everbefore in the history of the world, organised charlatanism

reaps its enormous profits. In an interesting Epitome of the

Progress of Psychiatry in America which was published inthe Journal of Mental Science for April, 1908, Dr. WILLIAM

McDoNALD, jun., gave a graphic description of the multi-tude of "prosperous-appearing establishments flauntingin highly polished brazen letters " such trades as those of

spiritualism, clairvoyance, astrology, osteopathy, and

palmistry, in Boston, U.S.A., a city which is always claimed

by its inhabitants as an abode of the intellectuals. Here,

too, is the church built to "Mother EDDY, CHRIST, andJOHN the BAPTIST " for a million dollars. But beyond theterritories of that which the majority of us would un-

doubtedly call superstition there lies a sphere of influenceover which science can claim some sort of control and which

has been developed in Boston in a remarkable way. At

the Protestant Episcopal Church of Emmanuel an effort

has been made "to weld into friendly alliance the

most progressive neurological knowledge of the schools

and a primitive New Testament Christianity as schòlar-

ship has disclosed it, with a view to the relief of human

suffering and the transformation of human character."

A group of medical men connected with the church, whohave enjoyed a training in neurology and psychiatry thatmust be of rather an exceptional character, have formedthemselves into a clinique, with the result that worshippersat the church have unusual opportunities for obtaining in-

telligent advice administered out of a rare combination ofreligious spirit with scientific knowledge and skill. Dr.

McDONALD speaks warmly of the enthusiasm which has been

aroused, but the reasons for this are quite easy to see." The thing that hath been, it is that which shall be ; and

that which is done is that which shall be done : and there is

no new thing under the sun." Without here endeavouringaccurately to define suggestion and persuasion, words

about which considerable controversy is even now going

on, we may explain psycho-therapy as the art wherebywe endeavour to treat a patient by altering in some way hismental state, whether we produce that alteration by givinghim a so-called placebo or by encouraging him when he isdown-hearted or by the more elaborate methods of

argumentation. That this is no new thing is well knownto anyone who has ever practised medicine, while the

practice at Emmanuel Church finds its prototype in hoaryantiquity. In Egypt, long since, the sick were laid in the ,

temples of Isis to await the voice of the oracle which shouldreveal to them the means of cure, while the priests treatedthem according to the rules laid down in the sacred books.Below the Acropolis at Athens facing out towards the

- tEgean Sea stood the Temple of Esculapius and, accordingto the testimony of votive offerings, marvellous cures werethere effected chiefly by psycho-therapeutic measures. The

imagination was ’strongly stimulated and processions to the

accompaniment of music, prayers to the god, the sanctity ofthe surroundings, and, perhaps above all, the personal .

influence of the priests, contributed to the happy results.To other extraordinary and perhaps less elevating agencies,

’

such as have been used from the earliest times to the

present, we can only attribute psycho-therapeutic effects.

HIPPOCRATES advocated in magisterial terms the skin of theviper for the cure of rashes. Among the Arabian physiciansprecious stones administered internally had a great reputa-tion ; in the Roman Imperial court treacle was vaunted as a

panacea against fevers, infectious disorders, and intoxica-

tions, while later in history mica panis has had apparentlyas much efficacy as many of the synthetic preparations. To

what can we attribute the good effects of the complicatedand nauseous prescriptions of not so very long ago?Are we to deny that any effects at all were produced ? ?Or are we to conclude that effects were then produced onthe human body which can no longer be produced, or

do we nowadays neglect many valuable preparationswhich have signally succeeded in times gone by ? ? The

effects produced were what may be called legitimatelypsycho-therapeutical. The success of charlatanism through-out the ages is surely evidence enough, even with-

out a consideration of the obsolete practices of our

profession, to convince the sceptical that psycho-thera-peutic measures at least have their place in any systemof medicine. How often is the medical man confronted

with the well-authenticated story of some cure wrought bya "rheumatic ring," by an "electric belt," or by some pre-scription picked out from the lumber of the past and pro-claimed as a specific for the most startlingly dissimilar

disorders. How difficult it is to reason with those having faithin such agencies. The point of view of the medical man is

diametrically opposite to that of such a patient, for the

! medical man has learned the limitations as well as the

possibilities of the therapeutic art. To set forth those limi-

L tations is often to be found guilty of professional jealousy,and one of the most difficult of our labours is to get into the

minds of our patients what we can and what we cannot do.) That certain mental states are accompanied by certain

bodily states is a matter of common knowledge. Terror and

fear may produce profuse sweating, dryness of the mouth, and an alteration in the amount of the renal and intestinal