1
326 all the experiments the process of healing of the joint surfaces was the same ; even at the end of two months there was very little formation of new bone from the denuded area. The new bone formation seen was always under the joint cartilage which had not been removed. The denuded joint surfaces were covered at the end of five days with granulation tissue which grew from the marrow spaces, and this granulation tissue developed into fibrous tissue, and when two denuded joint surfaces were in close apposition this new tissue led to a fibrous ankylosis. When a piece of fascia lata was interposed between the two bones the direct union of the denuded joint surfaces was prevented only in case the fascia underwent absorption, for where the transplanted fascia persisted in parts the surviving islands acted as adhesions between the joint surfaces. When fascia is used it appears that it is better to use a free flap, for the pedunculated flap forms an interarticular band which checks joint-movement. When chromicised pig’s bladder was used there was much more fibrous tissue formed, and in every instance the joint surfaces were more or less completely united. In all cases it appears to be essential that the transplant should be absorbed, otherwise no cavity is formed and ankylosis results. ’British JOlWnal of Inebriety.-The first place in the January number of this journal is very fittingly occupied by Sir Thomas Clouston’s address on Some Psychological and Clinical Aspects of Alcohol, delivered as the fifth Norman Kerr memorial lecture at Edinburgh on Nov. 3rd, 1913. Reviewing the question in the light of his ripe clinical experience, Sir Thomas Clouston emphasises the importance of recognising the wide range of individual variation in the mode of reacting to alcohol and in susceptibility to its injurious influences. While this fact is a warning of the risk of fallacy in any general conclusions, it may never- theless be confidently asserted that the pleasant personal and social effects of alcohol can only be safely obtained in fully developed healthy men with a reasonably good nervous heredity, and even to such favoured subjects it is harmless only when taken in strict moderation. For women, for adolescents, and for persons of neurotic constitution alcohol is always dangerous. In view of the greater tendency to tissue changes when the more concentrated alcoholic liquors are taken, the lecturer would advocate the statutory pro- hibition of the stronger drinks except for medicinal pur- poses. The address closes on an optimistic note, with a reference to the marked diminution of alcoholic excess during the last century amongst the more intelligent and self-respecting classes of the community. A continuance of this tendency may be looked for with the spread of educa- tion, the improvement of social conditions, the growth of eugenic ideals, and, especially, with a more general know- ledge of the dangers of alcohol to the individual and the race. In a very interesting paper on Institutional and National Intemperance Mr. C. J. Bond quotes statistical evidence showing the decrease in the consump- tion of alcohol in hospitals and infirmaries in this country during recent years. A table showing the total and per- centage expenditure on dressings, provisions, milk, and alcohol for the year 1912 in 46 British hospitals provides some remarkable contrasts of practice, the explanation of which presents a good many difficulties. Dr. G. Basil Price contributes a summary of reasons for pressing on the promised amendment of the Inebriates Acts on the lines of the recommendations of the Departmental Committee of 1908. The Journal also contains a very brief account by Mr. T Neild of the International Temperance Congress held at Milan last September. The British Dental Journal.-The issue for Jan. 15th contains the abstract of an interesting paper by Dr. T. von Beust, of Dresden, on the Etiology of Dental Caries. The author considers that the chemico-parasitic theory of caries is untenable. He thinks that caries is a disease which has its origin within the tooth, and believes that a process of metabolism is possible in the enamel, and that this tissue may possess a high degree of reactive power. An article on the Use of X Rays in the Practice of Dental Surgery, by Mr. C. A. Clark, draws attention to the great value of films for determining the condition of the alveolar bone in periodontal disease. Mr. C. N. Peacock writes on the Formation of a Public Dental Service for Bedford, and Mr. Graham Cotterell gives an account of the Coventry Dental Ciinic. New Inventions. TESKE’S "STANDARD" AUSCULTATION SET. WE have received an ingenious form of stethoscope with several new features from Messrs. C. A. Teske, Limited, of 33, Percy-street, Tottenham Court-road, London, W. Both the chest piece and the binaural attachment are capable of various modifications designed to render the instrument more delicate and more comfortable. The chest piece consists of a stem, provided with a thumb rest, and two finger rests in each of which there is an aperture communicating with the air space of the stem. The stem expands into a small bell, which can be used as an ordinary stethoscope. The bell is hinged on to the stem in such a manner that it can be moved through an angle of 900, and thus used to examine the posterior axillary regions or bases of a patient lying in bed and too ill to sit up. In addition there is an "automatic drum" which can be fitted into the bell of the stethoscope, enabling it to be used as a stethonoscope or a phonendoscope, according to the manner in which it is applied to the chest. This drum is a modification of the stethonoscope made by the same firm, and contains a small elastic rubber diaphragm. If the chest piece of the stethoscope with the drum attached be placed lightly in contact with the chest wall the sounds reach the ear much intensified, and the instrument is said to act as a stethonoscope. If the pressure be increased the sounds are further augmented and the effect of a phonendoscope is obtained. In this case the intensity and distinctness of the sounds can be varied by moving the fingers from the apertures in the lateral finger rests. The instrument is made of gun-metal, nickel-plated, or oxidised and coated with a hard, transparent lacquer. We have tested the stethonoscope sent to us. It is well made and well finished. Used as an ordinary stethoscope it con- ducts the sounds well, and when the’ drum attachment is fixed the sounds are intensified in the manner described by the makers. It should be a useful instrument in cases where the breath sounds are weak or the cardiac sounds indistinct or distant. A new form of binaural attachment can also be supplied for use with the instrument, although it can be used with any ordinary form if the con- ducting tubes are of sufficient calibre. The form supplied by Messrs. Teske has two special features : the first is an adjustable spring, which is controlled by two small screws, one to adjust, the other to fix it, so that the pressure at the ears may be altered to suit the comfort of the wearer. The other feature is that the ear-pieces are attached to the tubes by short lengths of flexible metal, or by a universal joint so that they can be bent to the angle most convenient for the wearer. This is a commendable feature of the instrument. CONGRESS OF THE GERMAN SURGICAL SOCIETY.- The forty-third Congress of the German Surgical Society will be held in Berlin from April 15th to 18th. The meeting place will, on this occasion, be the large hall of the Royal Academy of Music (Konigl. Hochschule fur Musik), Fasanenstrasse 1, corner of Hardenberg Strasse, no. far from the railway station for the Zoological Gardens. The office of Herr Melzer, however, for the receipt of subscrip- tions and the issue of membership cards, will be situated, up to April 14th inclusive, in Langenbeck House (Ziegel- strasse, 10/11, Berlin, N. 24), and during the Congress in the vestibule of the Congress Hall, but owing to the press of work tickets should be obtained before April 5th. The president for the year will be Dr. W. Muller (Kaiser Wilhelmstrasse, 16, Rostock). The following principal papers are already announced : Cause and Treatment of Post-operative Abdominal Hernia (Herr Sprengel, Bruns- wick) ; Permanent Results of Thyroid Gland Transplanta- tion in Human Beings (Herr Kocher, Berne); and Vesical Tumours (Herr Hildebrand, Berlin, and Herr Joseph, Berlin). A few weeks before the Congress further particulars will be issued.

TESKE'S "STANDARD" AUSCULTATION SET

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326

all the experiments the process of healing of the jointsurfaces was the same ; even at the end of two monthsthere was very little formation of new bone from the denudedarea. The new bone formation seen was always under thejoint cartilage which had not been removed. The denudedjoint surfaces were covered at the end of five days withgranulation tissue which grew from the marrow spaces, andthis granulation tissue developed into fibrous tissue, andwhen two denuded joint surfaces were in close appositionthis new tissue led to a fibrous ankylosis. When a pieceof fascia lata was interposed between the two bones thedirect union of the denuded joint surfaces was preventedonly in case the fascia underwent absorption, for where thetransplanted fascia persisted in parts the surviving islandsacted as adhesions between the joint surfaces. When fasciais used it appears that it is better to use a free flap, for thepedunculated flap forms an interarticular band which checksjoint-movement. When chromicised pig’s bladder was usedthere was much more fibrous tissue formed, and in everyinstance the joint surfaces were more or less completelyunited. In all cases it appears to be essential that the

transplant should be absorbed, otherwise no cavity is formedand ankylosis results.

’British JOlWnal of Inebriety.-The first place in the Januarynumber of this journal is very fittingly occupied by Sir ThomasClouston’s address on Some Psychological and Clinical

Aspects of Alcohol, delivered as the fifth Norman Kerrmemorial lecture at Edinburgh on Nov. 3rd, 1913.

Reviewing the question in the light of his ripe clinical

experience, Sir Thomas Clouston emphasises the importanceof recognising the wide range of individual variation in themode of reacting to alcohol and in susceptibility to its

injurious influences. While this fact is a warning of therisk of fallacy in any general conclusions, it may never-theless be confidently asserted that the pleasant personaland social effects of alcohol can only be safely obtained infully developed healthy men with a reasonably good nervousheredity, and even to such favoured subjects it is harmlessonly when taken in strict moderation. For women, foradolescents, and for persons of neurotic constitution alcoholis always dangerous. In view of the greater tendency totissue changes when the more concentrated alcoholic liquorsare taken, the lecturer would advocate the statutory pro-hibition of the stronger drinks except for medicinal pur-poses. The address closes on an optimistic note, with areference to the marked diminution of alcoholic excess

during the last century amongst the more intelligent andself-respecting classes of the community. A continuance ofthis tendency may be looked for with the spread of educa-tion, the improvement of social conditions, the growth ofeugenic ideals, and, especially, with a more general know-ledge of the dangers of alcohol to the individual and therace. In a very interesting paper on Institutionaland National Intemperance Mr. C. J. Bond quotesstatistical evidence showing the decrease in the consump-tion of alcohol in hospitals and infirmaries in this countryduring recent years. A table showing the total and per-centage expenditure on dressings, provisions, milk, andalcohol for the year 1912 in 46 British hospitals providessome remarkable contrasts of practice, the explanation ofwhich presents a good many difficulties. Dr. G. Basil Pricecontributes a summary of reasons for pressing on the

promised amendment of the Inebriates Acts on the linesof the recommendations of the Departmental Committee of1908. The Journal also contains a very brief account byMr. T Neild of the International Temperance Congress heldat Milan last September.

The British Dental Journal.-The issue for Jan. 15thcontains the abstract of an interesting paper by Dr. T.von Beust, of Dresden, on the Etiology of Dental Caries.The author considers that the chemico-parasitic theory ofcaries is untenable. He thinks that caries is a diseasewhich has its origin within the tooth, and believes that aprocess of metabolism is possible in the enamel, and thatthis tissue may possess a high degree of reactive power.An article on the Use of X Rays in the Practice of DentalSurgery, by Mr. C. A. Clark, draws attention to the great valueof films for determining the condition of the alveolarbone in periodontal disease. Mr. C. N. Peacock writes onthe Formation of a Public Dental Service for Bedford, andMr. Graham Cotterell gives an account of the CoventryDental Ciinic.

New Inventions.TESKE’S "STANDARD" AUSCULTATION SET.

WE have received an ingenious form of stethoscope withseveral new features from Messrs. C. A. Teske, Limited, of33, Percy-street, Tottenham Court-road, London, W. Both

the chest piece and the binaural attachment are capable ofvarious modifications designed to render the instrument moredelicate and more comfortable.The chest piece consists of a stem, provided with a thumb

rest, and two finger rests in each of which there is an

aperture communicating with the air space of the stem.

The stem expands into a small bell, which can be used as anordinary stethoscope. The bell is hinged on to the stem insuch a manner that it can be moved through an angle of 900,and thus used to examine the posterior axillary regions orbases of a patient lying in bed and too ill to sit up. In

addition there is an "automatic drum" which can befitted into the bell of the stethoscope, enabling it to

be used as a stethonoscope or a phonendoscope, accordingto the manner in which it is applied to the chest.This drum is a modification of the stethonoscope madeby the same firm, and contains a small elastic rubberdiaphragm. If the chest piece of the stethoscope withthe drum attached be placed lightly in contact with thechest wall the sounds reach the ear much intensified, and theinstrument is said to act as a stethonoscope. If the pressurebe increased the sounds are further augmented and theeffect of a phonendoscope is obtained. In this case theintensity and distinctness of the sounds can be varied bymoving the fingers from the apertures in the lateral fingerrests. The instrument is made of gun-metal, nickel-plated,or oxidised and coated with a hard, transparent lacquer.We have tested the stethonoscope sent to us. It is well madeand well finished. Used as an ordinary stethoscope it con-ducts the sounds well, and when the’ drum attachment isfixed the sounds are intensified in the manner described bythe makers. It should be a useful instrument in cases wherethe breath sounds are weak or the cardiac sounds indistinctor distant. A new form of binaural attachment can alsobe supplied for use with the instrument, althoughit can be used with any ordinary form if the con-

ducting tubes are of sufficient calibre. The form suppliedby Messrs. Teske has two special features : the first is an

adjustable spring, which is controlled by two small screws,one to adjust, the other to fix it, so that the pressure at theears may be altered to suit the comfort of the wearer. Theother feature is that the ear-pieces are attached to the tubesby short lengths of flexible metal, or by a universal joint sothat they can be bent to the angle most convenientfor the wearer. This is a commendable feature of theinstrument.

CONGRESS OF THE GERMAN SURGICAL SOCIETY.-The forty-third Congress of the German Surgical Societywill be held in Berlin from April 15th to 18th. The

meeting place will, on this occasion, be the large hall of theRoyal Academy of Music (Konigl. Hochschule fur Musik),Fasanenstrasse 1, corner of Hardenberg Strasse, no. farfrom the railway station for the Zoological Gardens. Theoffice of Herr Melzer, however, for the receipt of subscrip-tions and the issue of membership cards, will be situated,up to April 14th inclusive, in Langenbeck House (Ziegel-strasse, 10/11, Berlin, N. 24), and during the Congress in thevestibule of the Congress Hall, but owing to the press ofwork tickets should be obtained before April 5th. Thepresident for the year will be Dr. W. Muller (KaiserWilhelmstrasse, 16, Rostock). The following principalpapers are already announced : Cause and Treatment ofPost-operative Abdominal Hernia (Herr Sprengel, Bruns-wick) ; Permanent Results of Thyroid Gland Transplanta-tion in Human Beings (Herr Kocher, Berne); andVesical Tumours (Herr Hildebrand, Berlin, and HerrJoseph, Berlin). A few weeks before the Congress furtherparticulars will be issued.