1
30 peutic side, by Drs. Peroni, Bovero, and Oliva. An inte- resting point was brought out at the instance of Dr. Fo,, who started the question as to whether euphorine acts by modifying the micro- organism or by modifying the soil in which it develops. The answer to this inquiry was that of Dr. Giacosa, supported by the experiments of Dr. Belfanti. Euphorine, it would appear, exerts its specific action directly on the micro-organism ; but in the tissues-in other words, in clinical cases-this action is notably increased by the circumstance that euphorine decomposes, and the de- composition, in part, generates phenic acid. RETENTION OF AN ALMOST FULL-TERM PLACENTA FOR TWO MONTHS IN the Indian Medical Record of last month the editor, Dr. James R. Wallace, relates a very interesting case of retention of a placenta for nearly two months without any unfavourable symptoms supervening. The facts are peculiar. He was called to attend a woman during her second delivery, which had come on at the eighth month. He found the head low down in the pelvis, and the expulsion of the child terminated naturally. While waiting for the uterine contractions to expel the placenta he received an urgent message, and left the midwife to see to the after- birth. He did not visit the patient again, but about two months afterwards he was called, to find her in great pain. There was some hoemorrhage, and on examination the uterus was as large as a child’s head. The os was somewhat dilated, allowing two fingers to pass which touched a fibrous mass, found to be the placenta. On inquiry he ascertained that the midwife, finding that the after-birth did not come away within an hour, concluded that probably "everything had come away," and forthwith applied a bandage. The discharge ceased in about ten or twelve days, and the woman got up, going about her work without any discomfort, pain, or sense of weight. On applying com- pression over the fundus uteri, the placenta, quite fresh in appearance and without fetor, was expelled. PUBLIC HEALTH AND LIBERTY. THE leading article which we published in last week’s s issue under the above heading has called forth several communications of somewhat considerable length, but that which is signed by the President of the Right and Liberty Defence League may be regarded as suffi- ciently embodying the several views set forth. Mr. J. P. Yeatman, the president of that body, objects to our article as unfair and misleading, and he begins by referring to interferences with right and liberty, which are concerned with dancing, public music, and a number of questions with which our comments had absolutely no con- cern. And, even where considerations of public health are ’’ in question, he does not, we think, sufficiently apprehend the fact that a "manifesto," issued 11 by order," and deal- ing with general principles, can hardly be limited in its application to one single borough where certain offences against right and liberty are alleged to be in operation. Approaching the subject with which we more especially dealt-namely, as Mr. Yeatman puts it, "the infamous mode of spending the rate-payer’s money.... in the establish- ment of epidemic hospitals"-he convinces us more than ever that the views we expressed are those which should be upheld if the best interests of the general public, as con- trasted with the " liberty of the individual, are really aimed at. Besides which Mr. Yeatman fails to apprehend the true bearing of his own contentions. He alleges that, because the town he refers to can no longer " get up epi- demics," an isolation hospital is not needed; but he altogether forgets that one of the most potent means by which that very absence of epidemics has been secured has been the removal to the authority’s hospital of first attacks of infectious disease which have come to knowledge; and that it was the existence of an epidemic in years past that led to the necessity of providing a hospital. It is always difficult to differentiate between the effects of a number of measures operating simultaneously ; but in the borough in question the annual death-rate from the principal zymotic diseases for some ten years before the provision of an isolation hospital was over 4’0 per 1000 living, and since that date it has been reduced to a mean of about 25. Then Mr. Yeat- man scoffs at the I I nonsense of safeguards contained in the Public Health Act as to compulsory removal to hospital, and cites the borough from which the manifesto issued as a place where these are disregarded. But the safe- guards exist all the same, - they serve as safe. guards elsewhere, and if he chooses to educate people as to their statutory rights, no one can complain. When, however, Mr. Yeatman claims the right of people to carry the infectious dead from isolation-hospitals back to the very houses from which they were removed in order to prevent the spread of infection, we must contend that the right of the community to the benefit of protection from the risk involved is one to which the desire of the individual must and ought to give way. Mr. Yeatman maintains, in conclusion, that he has no wish " to prevent the strong arm of the law from making prisoners of those affected with disease who are without means to combat it." The law as to isolation is limited by this very condition, but the whole burden of the manifesto, in so far as public health is concerned, is one of opposition to this law, and, above all, to the law as amended last year. DURHAM UNIVERSITY MEDICAL GRADUATES’ ASSOCIATION. THE annual meeting of this flourishing Association was held at the Cafe Royal, London, on June 26th, when the following officers were elected for the year 1891-2:—Pre- sident : Dr. Milson. Vice-Presidents: Drs. Mantle and Cullingworth. Council: Professor Philipson, Drs. Arnison, Benington, Carter, Drummond, Goldsmith, Macdonald, Openshaw, Powell, Slater, Walker, and Wilson. Secre- taries : Drs. Beatley and Robinson. In the evening the members dined together. In giving the toast of "The Durham University Medical Graduates’ Association," the President stated that it now had nearly 200 members, and that thirty- nine new members had that day been elected. He stated that nearly all the recommendations sent up from the Association had been adopted by the Senate of the Univer- sity of Durham, and he dwelt specially upon the fact that valuable and lasting friendships were made through the existence of the Association. A very pleasant evening was spent, the toasts being interspersed with songs. A principal feature of the evening was a speech by Professor Philipson of Newcastle, in response to the toast of 11 The University of Durham." ___ ARSENIC AS A DOMESTIC POISON. Dp,. PUTNAM of Boston, in a paper in the Chicago Journal, emphasises the frequency with which arsenic must be absorbed under what are supposed to be ordinary healthy conditions. He also draws attention to the dangers attend- ing its medicinal use, and the occasional onset of sudden and severe, even fatal, effects in the course of such adminis- tration. As to its absorption under domestic conditions, it is evident that examination of the urine will furnish important evidence, and that this is the case is confirmed by the facts adduced by Dr. Putnam. He states that in a careful analysis made by a competent chemist of 150 speci- mens of urine taken from patients, most of them presenting certain obscure symptoms, but not such as would have

PUBLIC HEALTH AND LIBERTY

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peutic side, by Drs. Peroni, Bovero, and Oliva. An inte-

resting point was brought out at the instance of Dr. Fo,,who started the question as to whether euphorine acts bymodifying the micro- organism or by modifying the soil inwhich it develops. The answer to this inquiry was that ofDr. Giacosa, supported by the experiments of Dr. Belfanti.Euphorine, it would appear, exerts its specific action

directly on the micro-organism ; but in the tissues-in otherwords, in clinical cases-this action is notably increased bythe circumstance that euphorine decomposes, and the de-composition, in part, generates phenic acid.

RETENTION OF AN ALMOST FULL-TERMPLACENTA FOR TWO MONTHS

IN the Indian Medical Record of last month the editor,Dr. James R. Wallace, relates a very interesting case ofretention of a placenta for nearly two months without anyunfavourable symptoms supervening. The facts are peculiar.He was called to attend a woman during her seconddelivery, which had come on at the eighth month. Hefound the head low down in the pelvis, and the expulsionof the child terminated naturally. While waiting for theuterine contractions to expel the placenta he received anurgent message, and left the midwife to see to the after-birth. He did not visit the patient again, but abouttwo months afterwards he was called, to find her in greatpain. There was some hoemorrhage, and on examinationthe uterus was as large as a child’s head. The os wassomewhat dilated, allowing two fingers to pass whichtouched a fibrous mass, found to be the placenta. On inquiryhe ascertained that the midwife, finding that the after-birthdid not come away within an hour, concluded that probably"everything had come away," and forthwith applied abandage. The discharge ceased in about ten or twelve days,and the woman got up, going about her work without anydiscomfort, pain, or sense of weight. On applying com-pression over the fundus uteri, the placenta, quite fresh inappearance and without fetor, was expelled.

PUBLIC HEALTH AND LIBERTY.

THE leading article which we published in last week’s sissue under the above heading has called forth severalcommunications of somewhat considerable length, butthat which is signed by the President of the Rightand Liberty Defence League may be regarded as suffi-

ciently embodying the several views set forth. Mr. J. P.

Yeatman, the president of that body, objects to our

article as unfair and misleading, and he begins byreferring to interferences with right and liberty, whichare concerned with dancing, public music, and a number ofquestions with which our comments had absolutely no con-cern. And, even where considerations of public health are ’’in question, he does not, we think, sufficiently apprehendthe fact that a "manifesto," issued 11 by order," and deal-ing with general principles, can hardly be limited in itsapplication to one single borough where certain offencesagainst right and liberty are alleged to be in operation.Approaching the subject with which we more especiallydealt-namely, as Mr. Yeatman puts it, "the infamousmode of spending the rate-payer’s money.... in the establish-ment of epidemic hospitals"-he convinces us more thanever that the views we expressed are those which shouldbe upheld if the best interests of the general public, as con-trasted with the " liberty of the individual, are reallyaimed at. Besides which Mr. Yeatman fails to apprehendthe true bearing of his own contentions. He alleges that,because the town he refers to can no longer " get up epi-demics," an isolation hospital is not needed; but he

altogether forgets that one of the most potent means bywhich that very absence of epidemics has been secured has

been the removal to the authority’s hospital of first attacksof infectious disease which have come to knowledge; andthat it was the existence of an epidemic in years past thatled to the necessity of providing a hospital. It is alwaysdifficult to differentiate between the effects of a number ofmeasures operating simultaneously ; but in the borough inquestion the annual death-rate from the principal zymoticdiseases for some ten years before the provision of an isolationhospital was over 4’0 per 1000 living, and since that date ithas been reduced to a mean of about 25. Then Mr. Yeat-man scoffs at the I I nonsense of safeguards contained inthe Public Health Act as to compulsory removal to hospital,and cites the borough from which the manifesto issuedas a place where these are disregarded. But the safe-

guards exist all the same, - they serve as safe.

guards elsewhere, and if he chooses to educate peopleas to their statutory rights, no one can complain.When, however, Mr. Yeatman claims the right of people tocarry the infectious dead from isolation-hospitals back tothe very houses from which they were removed in order toprevent the spread of infection, we must contend that theright of the community to the benefit of protection fromthe risk involved is one to which the desire of the individualmust and ought to give way. Mr. Yeatman maintains, inconclusion, that he has no wish " to prevent the strong armof the law from making prisoners of those affected withdisease who are without means to combat it." The lawas to isolation is limited by this very condition, but thewhole burden of the manifesto, in so far as public health isconcerned, is one of opposition to this law, and, above all,to the law as amended last year.

DURHAM UNIVERSITY MEDICAL GRADUATES’ASSOCIATION.

THE annual meeting of this flourishing Association washeld at the Cafe Royal, London, on June 26th, when thefollowing officers were elected for the year 1891-2:—Pre-sident : Dr. Milson. Vice-Presidents: Drs. Mantle and

Cullingworth. Council: Professor Philipson, Drs. Arnison,Benington, Carter, Drummond, Goldsmith, Macdonald,Openshaw, Powell, Slater, Walker, and Wilson. Secre-taries : Drs. Beatley and Robinson. In the evening themembers dined together. In giving the toast of "The DurhamUniversity Medical Graduates’ Association," the Presidentstated that it now had nearly 200 members, and that thirty-nine new members had that day been elected. He statedthat nearly all the recommendations sent up from theAssociation had been adopted by the Senate of the Univer-sity of Durham, and he dwelt specially upon the fact thatvaluable and lasting friendships were made through theexistence of the Association. A very pleasant evening wasspent, the toasts being interspersed with songs. A principalfeature of the evening was a speech by Professor Philipsonof Newcastle, in response to the toast of 11 The Universityof Durham."

___

ARSENIC AS A DOMESTIC POISON.

Dp,. PUTNAM of Boston, in a paper in the Chicago Journal,emphasises the frequency with which arsenic must beabsorbed under what are supposed to be ordinary healthyconditions. He also draws attention to the dangers attend-ing its medicinal use, and the occasional onset of suddenand severe, even fatal, effects in the course of such adminis-tration. As to its absorption under domestic conditions,it is evident that examination of the urine will furnish

important evidence, and that this is the case is confirmed

by the facts adduced by Dr. Putnam. He states that ina careful analysis made by a competent chemist of 150 speci-mens of urine taken from patients, most of them presentingcertain obscure symptoms, but not such as would have