667

first musculo-cardiac and the latter ptÛmo-cardiac. Dr.Lee’s

theory of loss of wind is as follows :-He holds that theeffect of muscular contraction is to render the muscle

ansemic, and that, both veins and arteries being squeezed bythe contracting fibres, the blood which should enter themuscle has to go elsewhere.

" The fatigue which arises from disturbance in respira-tion depends on a change in the quantity of blood in thelungs, heart, and large bloodvessels. This takes placewhen many muscles are engaged in the exercise, and con-sequently a large quantity of arterial blood is preventedfrom passing into the muscular tissue, while another similarquantity of venous blood is expelled from it into the largeveins connected more or less directly with the heart. Inthis way muscular contraction is related to the organs ofcirculation. Now, beyond a certain point the heart andbloodvessels are unable to support distension, and as thelungs are the organs which are most closely connected withthe heart, it follows that such a disturbance as we havedescribed soon affects their vessels likewise, and producesan arrest in the flow of blood through the tissue of thelungs. From these causes arises that distress commonlyknown as loss of wind."

We dare say that this theory is right enough, as far as itgoes, but why does Dr. Lee limit himself so entirely to themechanical side of the question, and neglect what to usseems of infinitely more importance, the chemical ? We donot find a word in Dr. Lee’s book touching increased tissue-change, and the consequent increased demand for oxygenin the lungs. If Dr. Lee’s theory were correct, it seems tous that the bigger a man7s muscles became and the morethoroughly they contracted, the greater would be the pulmo-cardiac distress induced, whereas it is a matter of observa-tion that the improvement of his muscular system keepspace with the increase of vital energy, and that shortnessof wind disappears (in a healthy subject) as training is pro-longed. The effect of exercise is to increase the force and

rapidity of the heart’s action, and one has only to place afinger on the radial pulse to discover that the dammingback of arterial blood in the left ventricle is not so greatas Dr. Lee would have us believe. We are entirely of Dr.Lee’s opinion, that training of the body is quite as im-portant as training of the mind. The element which is

prone to do harm in both is .. 4;ompetition," and just as manya valuable intellect has been spoiled by being overtaxedand over-crammed, so, we believe, has the health of many ayoung man been injured by entering into athletic compe-titions for which his physical powers did not fit him.There is one side to athletics which is an unmitigated

evil. Public attention has of late been too much attracted

by them, and we have no hesitation in saying that themoral effect on a student of being made the general topic ofconversation, of having his physiognomy made the subjectof commercial speculation, and of being dragged from thequiet seclusion of his university to be cheered and bettedon by all Belgravia and Whitechapel, and feasted by theCity, not because he has excelled in learning, but becauseprobably he has neglected it, must be bad; and this is theaspect of "exercised and training" to which the universityauthorities will do well to attend. Dr. Lee’s little bookcontains some valuable hygienic rules to be observed whiletraining.

Outlines of Physiological Chemistry, including the Qualitativeand Quantitative Analysis of the Tissues, Fluids, and Excre-tory Products. By CHARLES HENRY RALFE, M.A., M.B.,late Scholar of Gonville and Caius College. Member ofthe Royal College of Physicians. pp. 236. London:H. K. Lewis. 1873.

Tiais little book will supply a want which is acutely feltby teachers of practical physiology. It is a short and

simple laboratory guide, containing no more theory than is

necessary for the comprehension of the facts, and no morefacts than are really wanted by students and practitionersof medicine.The introduction is mainly occupied with an account of

the system of classification and notation which the authorhas adopted. The notation differs little from the well-known type formulae of Gerhardt. Probably most readersof the book will be thankful that they are not compelled tomaster the complex constitutional formulae which are thelatest fashion among chemists. Short tables of radicals,alcohols, and acids are included in this part of the volume.The bulk of the book is divided into four parts, which are.

devoted respectively to Proximate Principles, Products ofDecomposition, Inorganic Constituents, and Tissues andFluids. Under each compound a short account is given ofits occurrence and changes in the animal body, the mode ofpreparing it, its properties, and in many cases the appro-.priate methods of testing for and estimating it. Now andthen we find that a better method of preparation than theone described might have been selected, but for the mostpart sound judgment has been shown, and in nearly everycase the directions given are clear and simple. Part IV. is

perhaps the best part of the book. The sections on blood,,bile, and urine, in particular, may be quoted as lucid andpractical.

Altogether we think Dr. Ralfe’s little compilation is likelyto be very useful, not only to students, but also to practi-

I tioners, many of whom will be glad to have so simple andI intelligible a guide to physiological analysis. Very few.

processes are described in the book which could not easily,. be carried out by a medical man.

PULMONARY DISEASES IN THE STAFFORD-SHIRE POTTERIES.

IN the appendix to his report on the sanitary condition ofthe Staffordshire Potteries, to which attention has alreadybeen directed in THE LANCET, Dr. Ballard discusses the

Pottery industry in its relation to the death-rate from pul-monary affections-namely, from phthisis and other diseasesof the lungs. Dr. Greenhow had shown, in 1862, that thedeath-rate from these affections in the Potteries was con-nected with the unwholesome character of the manufactureand the mode in which it was carried on. Dr. Ballard, inthe present report, has instituted a comparison between thepulmonary death-rate in the Potteries during the decennia1851-60 and 1861-70, and also between the same death-ratesin the Potteries during 1861-70 and similar death-rates inEngland and Wales during 1851-60. The general result ofhis observations and comparisons is as follows :-" 1. That, during the years 1861-70, the pulmonary death-

rate among persons (males and females together) betweenthe ages of 15 and 25 in the pottery districts, has been lessthan the standard rate from pulmonary disease of Englandgenerally. [The standard rate is based on the deaths of adifferent ten years, but it may safely be assumed to haveundergone no important change.]

"2. That during the same ten years, the pulmonarydeath-rate among persons above the age of 25 in the potterydistricts has been higher than the standard in Englandgenerally; and that this excess, comparatively small inpersons aged 25 to 45, is very considerable in persons(especially in males) between the ages of 45 and 55, andstill more considerable (in males reaching to the double ofthe standard rate) in persons between 55 and 65.

"3. That this excessive mortality from pulmonarydiseases in persons over 25 years of age in the pottery dis-tricts as compared with England at large is, generallyspeaking, on the increase. Between the ten years ending1860 and the ten years ending 1870 it has increased inmales aged 25 to 45, in males aged 45 to 55, in males aged

668

55 to 65 ; and also in females aged 55 to 65 ; but it has de-creased in females below 55 years old."These facts, Dr. Ballard observes, are in accordance with

the known influence of the pottery trade in causing lungdisease. " The diseases of the lungs set up by dusty occu-pations, among which the pottery manufacture stands pro-minent, are of slow progress, and exhibit themselves upondeath-registers only after they have rendered existencemiserable during a number of years." Dr. Ballard furtherremarks, as to the increase of the pulmonary death-rate ofrecent years, as compared with earlier times, among malesof all ages after 25, that an explanation will probably befound "in the circumstance of the male population of thedistrict being employed in larger proportion now than for-merly in the pottery trade ; while the decrease of suchdeath-rate in females under 55 appears to be connectedwith the smaller proportion now than formerly of femalesemployed. The reason," he adds, H why females above 55years of age are dying of lung disease in recent years morethan before is probably that, in this class, many people areincluded who had been brought in increasing numbers intothe trade before the recent movement against the employ-ment of women, and that the women of this class are onlynow dying of the chronic pulmonary diseases from whichthey have long suffered during the years of their potterywork."Such improvements as have been made in the conditions

under which the manufacture of earthenware, china, andpottery generally is carried on, have been almost entirelyconfined, it would seem, to new establishments. These havebeen erected with various modern provisions for diminish-ing the unwholesomeness of the manufacture; but theolder establishments remain much as they were. The im-provements referred to are the use of steam-power in placeof hand labour in certain processes; the abandonment ofthe H presser’s stoves" for a mechanical contrivance by

’’

which the newly-made articles are brought by the mereturning of a sort of screen or partition at once into a hotdrying chamber; the construction of buildings in such away that consecutive processes are carried on in adjoining.parts of the premises, thus doing away in part with thenecessity of carrying heavy weights long distances; thesubstitution of the 11 pugmill " for the laborious operationof "wedging" the clay; and, lastly, the substitution of

pressure-frames for the slip-kiln in getting rid of super-fluous moisture from the mixture of clays. Dr. Ballardstates that if it were rendered compulsory to introducethese improvements into the older establishments the build-ings would have to be partially pulled down and recon-.structed.

With regard to the different conditions described by Dr.Greenhow as particularly affecting the health of the labour-ing population engaged in the pottery manufacture, Dr.Ballard reports as follows :-In respect to the inhalationof dust, probably some of the workpeople in the newerestablishments are less exposed to this source of dangerthan they were formerly, but in the older establishmentsthere is no change for the better in this respect. In

respect to lead-poisoning, nothing has been devised to avoidthe necessity of the dippers immersing their hands in theglaze. " Ground layers," who dust a preparation of leadupon some coloured wares, are still unprotected. In oneestablishment only did Dr. Ballard see an arrangement fordrawing off the dust from the bench at which this workwas carried on. In respect to the heat of the workshops,this is moderated in the instances in which the flat pressers’stoves are done away with, and there is less exposure tovicissitudes of temperature where pressure-frames havebeen substituted for slip-kilns. In respect to overcrowdingand insufficient ventilation of workshops, where the printingpaper design is carried on, and where printing, painting,gilding, and burnishing the wares are performed, somethingbaq been done to lessen the evils. 11 generally, however,"Dr. Ballard states, "the ventilation of the workshops, ex-cept in the newest buildings, is still bad. The workpeopleobject to fresh air; and even where special means ofventilation have been provided, they do their best to rendeithem nugatory." Dr. Ballard sums up his thoughtful andinstructive report in the following words :-" A-Ithouchsome improvements have been effected, and are in sloviprogress in the pottery establishments, they have not beerlong enough in operation or become so general as to pro

duce any marked reduction in the mortality from lung dis-eases among potters. Some time yet must elapse beforethis can fairly be looked for. The workpeople engaged inthe new establishments have all their lives previouslyworked under the unfavourable conditions of the older work-shops. Even now, boys and girls, on commencing theirtrade, mostly enter at first these older establishments, onlya comparatively small number of them being employed atthe new works. The only advantages they possess now arethose furnished by the wholesome provisions of the FactoryActs."

Foreign Cleanings.PATHOGENIC INFLUENCE ON THE SKIN OF BROMIDE OF

POTASSIUM EMPLOYED INTERNALLY.

IN the Wiener Med. Wochenschrift (No.6, 1873), Dr. J.Neumann has investigated the above subject. The authorrecalls the observations of Voisin of Paris, and Mitchellof Philadelphia, according to whom the employment ofbromide of potassium in weak doses brings on eruptionssimilar to acne, with itching and the consecutive forma-tion of indurated tubercles; whilst the prolonged use ofthe substance gives rise to the production of red tumours,which often become sore, of carbuncles, anthrax, eczema,and nettle-rash. Dr. Neumann states that, for his ownpart, he has observed eruptions very much like molluscoidacne coming on in successive outbreaks, and, in anothercase, a carbuncular eruption consisting of infiltratedtumours, with considerable loss of substance in the centre.The author inclines to think that the bromine passes intothe blood, and thence into the various glands of, the skin,and he accounts thus for the production of the eruption.It is known that the presence of bromide of potassium hasbeen observed in urine, saliva, and the secretions of theakin.

CRITICISMS ON PHONOMETRY.

In the Berlin Klin. Woch. (No. 7, 1873) Dr. Guttmann haspublished some valuable critical remarks on the newmethod of investigation which Dr. Baas had described bythe name of phonometry in the Deutsches Archiv f. Klin.Med., 1872, Bd. xi. This method consisted in placing avibrating diapason on various parts of the chest and abdo-men, and in determining, by means of the varying degreesof intensity of sound, the presence or absence of air in theunderlying organs. The application of the diapason, saysDr. Guttmann, is immediate or mediate; when immediate,it cannot be employed usefully to the soft parts, on accountof their slight degree of resistance; when mediate it is

practised by means of the ordinary pleximeter, and, any-how, it is quite inferior to percussion. When applied tosituations which are entirely soundless, there always existsa certain degree of resonance, so that it is impossible toexactly define the boundaries of such organs as the liver, theheart, and spleen. The information it affords in patho-logical conditions of the thoracic and abdominal organs,is equally valueless ; for instance, it is difficult to mark outpleuritic exudata., and impossible to diagnosticate pulmo-nary caverns. So that phonometry can furnish informationonly in the presence or absence of air in the organs, and itsapplication demands thrice as much time as percussion.ALTERATIONS OF THE NERVOUS SYSTEM OF THE GREAT ’

SYMPATHETIC IN CASES OF CONSTITUTIONAL SYPHILIS.

Dr. Petrow (Virchow’s Archiv, Band 5;, Heft 1, 1873),on examining portions of the plexus of the great sympa-thetic which he had taken (ten to twenty-four hours afterdeath) from the bodies of individuals affected with acquiredconstitutional syphilis, has stated two sorts of pathologicalchanges:-1. Modifications of the protoplasma of nervouscells which become loaded with brilliant pigmentary cor-puscles, increasing with the age of the disease, and oftenaccompanied by colloid transformation of the cells; thecells of the endothelium surrounding the nervous cells

frequently undergo the same gelatiniform transformation,and cannot then be distinguished from the nervous cells.These changes can exist without the interstitial connective