343

EXHAUSTION PARESIS SIMULATING EARLYGENERAL PARALYSIS.

IN the Jourraat of the American Medical Associa-tion Dr. J. Ramsay Hunt has called attention to acondition brought to light in the training of

America’s armies which was new even to a neuro-

logist of his experience-the complete simulationof early general paralysis by paresis due to exhaus-tion. He was given the duty of making a neuro-logical examination of about 1500 men in an

officers’ training camp. Among these he encounteredfour cases, of which the following is typical.A man, aged 36, had been in the camp for a month engaged

in the arduous work of digging trenches. For some yearshe had practised law and led a sedentary life. He deniedhaving had syphilis. He complained of vertiginous seizures,headache, and depression. The face was flushed, theexpression dull, and the speech tremulous. The pupilswere dilated and unequal, the right being slightly the larger.The reaction to light was sluggish and scarcely appreciable.The reaction on accommodation was preserved. There wasno optic neuritis. There were marked facial and somelingual tremors. When the effort was made to close the eyesand expose the teeth simultaneously the muscles of the facebroke into a coarse tremor identical with that of earlygeneral paralysis. Speech was also tremulous and suggestive.On repetition of test phrases there was distinct dysarthria,with some syllable stuttering and associated movements ofthe upper facial muscles. There was a coarse tremor of thehands and fingers and the writing was irregular andtremulous. The tendon reflexes were all active. Mentallythe man was dull and slow and performed problems inmental arithmetic with difficulty and occasional errors.

Thus the clinical picture coincided with that of earlygeneral paralysis. Wassermann tests were therefore appliedto the blood and cerebro-spinal fluid, but both werenegative. After a week’s rest there was marked improve-ment. The pupils were equal and responded actively tolight, and the tremors and mental dullness had disappeared.The final diagnosis was acute exhaustion of the cerebro-spinal centres.It is well known that mental dullness and tremorsmay be produced by fatigue. In neurasthenicstates tremor is an almost constant symptom. Itis not, however, generally known that in simpleexhaustion the pupils may be dilated and reactsluggishly to light. Dr. Hunt suggests that thetoxins of fatigue may influence the sympatheticinnervation of the pupil, producing dilatation andretardation of the reaction to light. In all the casesthe patients were business men, unaccustomed toexercise, and suddenly put to the arduous work ofthe training camp. No such " experiment" wouldbe possible in civil life-a fact which explains thenovelty of the condition.

THE PROGRESS OF INDUSTRIAL CHEMISTRY.

THE issue is forthcoming of a series of mono-

graphs on industrial chemistry, comprising theremarkable developments that have taken place inthis direction in recent years. The announcementis welcome ; it is made by Messrs. Longmans, Green,and Co., and the work of editing the monographshas been entrusted to Sir Edward Thorpe, whohas secured the services of a strong staff. Thereis scarcely an industry that has not benefiteddirectly or indirectly from the increasing applica-tion of chemical science, while the recondite know- !ledge of one generation becomes a part of thetechnology of the next. Phenomena at one timeregarded as of mere academic interest have giventhe lead to immense improvements in productiveprocesses ; and the doctrines of chemical structureand constitution tentatively taught at one periodhave formed the basis of large-scale synthetical pro-cesses at another ; for example, at the present timewe are witnessing the widespread application of

catalysis in manufacturing operations of the mostdiverse character. This obscure phenomenon has, in

fact, given a remarkable stimulus to the economicoutput of many valuable products. The followingare among the promised monographs, and some ideaof the wide and important ground covered may begathered from the titles they bear, which are as

follows : " The Scientinc Use of Coal " ; " Cata-lysis in Industrial Chemistry" ;

"

Synthetic Colour-ing Matters : Sulphur Dyes"; "Organic Compoundsof Arsenic and Antimony ";

..

Synthetic ColouringMatters : Vat Colours ";

"

Naphthalene "; "

SyntheticColouring Matters: Azo Dyes"; "Utilisation of

Atmospheric Nitrogen : Synthetical Production ofAmmonia and Nitric Acid"; "Cement"; "EdibleOils and Fats"; "The Principles and Practice ofGas-purincation "; "Refractories"; "The Applica-tions of Electrolysis in Chemical Industry";"Ozone and Hydrogen Peroxide"; "The NaturalOrganic Colouring Matters"; "Industrial Appli.cations of the Rarer Metals"; "Liquid Fuelfor Internal Combustion Engines "; " CelluloseSilk "; " The Zinc Industry "; " The ElectricArc in Chemical Industry"; "By-product CokingPractice"; "Organic Synthetic Reactions : Their

Application to Chemical Industry"; "Colour inRelation to Chemical Constitution"; "SyntheticColouring Matters " (4 volumes) ;

"

Synthetic Drugs:Local Anaesthetics." Those who are responsible fororganising this valuable series may well be con- _

gratulated on this wealth of material illustratingthe applications of recent scientific knowledge tomodern manufacture.

____

THE VALUE OF THE MUSEUM.

Mr. Tate Regan, in a lecture at King’s College Hos-ital, which we commented upon last week I-one)f the series being delivered at the College on theelations of animal life to human progress, dealtin an interesting manner with the right use ofnational collections as centres of research. But itLs a fact that while an occasional dramatic discoveryby some particular member of a museum staffarrests public attention from time to time, little orno credit is given to the year-in and year-out workon which the usefulness of a museum primarilydepends. It is the routine of museum labourwhich is well set out in the current issue ofthe Museums Journal in relation to the workof the Natural History Museum at South Kensing-ton. It is here shown how the identification ofa fossil may determine the expenditure of vastsums of money in mining or industrial operations,while the working out of an insect’s life-history maysave as much in actual money and human lives intothe bargain. The average citizen takes some pridein the picturesque and curious exhibits set out inhis national collections, and estimated to representmillions of public money, but there is little realisa-tion of the constant labour carried on in the museumlaboratories and work-rooms, with its return tothe community at large in the form of health andwealth. Yet this labour forms the greatest justifica-tion for the money spent on museums. More, itwould justify such expenditure in this countrybeing many times over greater than it is. Thearticle in the Museums Journal is advisedlynot a complete account of the part played inmilitary matters by museum research, but itis sufficiently enlightening. One investigationhas led to the destruction of a fungus attackingArmy tents in Malta, another to a great economyin the supply of sphagnum moss for surgicaldressings; others have been directed towards the

1 THE LANCET, Feb. 23rd, p. 321.