1267

deformed, and even perhaps hideous. Can surgeryoffer a greater comfort to any man than to be ableto tell such an one that it can ease his pain, restorehis face, remodel his jaw ? Yet cold comfort

would it be to him if he knew of others to whomthese words had also been whispered, but the

promise had not been kept. And that soldier may,in these days of national service, be our own kithand kin." These words put the situation terselyand eloquently.That very much may be done to cure, or at any

rate alleviate, the terrible injuries resulting fromgunshot wounds of the jaws is proved from a

perusal of the many papers that have recentlyappeared on the subject, and it is also certain thatthe happiest results are those obtained by a closecooperation between surgeon and dental surgeon.Is all being done in this country that should bedone for such injuries ? We do not think it is.In Germany we know that as early as August, 1914,a hospital of 225 beds was opened at Dusseldorf,and that by April of last year similar institutionshad been opened in other parts of the German

Empire. The French early realised the import-ance of bringing these injuries under the care

of those capable of treating them, and they rapidlyorganised special hospitals. In England no attemptwas made to concentrate such cases until July oflast year, when the Eastern Command opened aspecial hospital at Croydon, and now nearly twoyears after the outbreak of the war fresh centresare being formed in connexion with a few of themilitary hospitals. If these special hospitals are togive the soldiers the best treatment their surgical

’

staff should be chosen from those with a specialaptitude for plastic operations, and the dentalsurgeons from those who have had experience of injured jaws in our great civilian hospitals. Gunshot 2

injuries of the jaws require the most skilful treat- I

ment, and the treatment of these cases cannot be handed over to any accessible dental surgeon without a chance of disastrous results. This is now, ofcourse, widely recognised, but we have only lately come to look at the facts in their right proportion. I

c

Lack of appreciation of the importance of these Iinjuries has meant that in the first place there are tnumbers of our wounded soldiers who will pass the o

remainder of their days with permanent facial a

deformities which might have been remedied if the P

best special treatment had been available. As a n

letter of fact such detailed forethought would havecompletely impossible, but no doubt many Isoldiers have had to be invalided out of the army it

for wounds of this character who could have been vrestored, we now know, as

" efficients." Again,

neglect of treatment has of necessity added consider- rE

ably to the period of stay in hospital and placed a sl

greater incubus on the Pension Fund. To those d:

unacquainted with the work that can be done to fegunshot injuries of the jaw we would recom- wmend a valuable paper by Mr. DOLAMORE’in the tcJune lst issue of the British Dental Journal; in

Bi

which he describes and illustrates the methods pIused in the hospitals of Germany, and to a paper to

y Mr. J. F. COLYER in the April issue of the

Royal Army Medical Corps Journal. th

Annotations."Ne quid nimis."

AUXILIARY ROYAL ARMY MEDICAL CORPSFUNDS.

THE movement inaugurated on June lst at theRoyal Army Medical College to consider the de-sirability of establishing a benevolent fund forthe Services auxiliary to the Royal Army MedicalCorps is now taking definite shape. A meetingwill be held at 2.45 P.M. at the Royal Army MedicalCollege on Monday next, June 26th, when a schemeformulated by the provisional committee will bediscussed. The three auxiliary branches of theRoyal Army Medical Corps-namely, the SpecialReserve, the Territorials, and those holding Tem-porary appointments in the R.A.M.C.-will beincluded in the administration of the funds, undertwo headings : (a) an officers’ benevolent branch,and (b) a relief branch ; the establishment of a loanfund to help medical officers of the auxiliary forceswho find themselves in temporary difficulty onreturning to civil practice is also under considera-tion. In another column the proposals under thescheme are more fully set out.

RECOVERY FROM BLINDNESS DUE TO CEREBRO-SPINAL MENINGITIS.

o AT a meeting of the Societe Medicale dess Hopitaug of Paris, M. Arnold Netter showed thepossibility of recovery from blindness due to

cerebro-spinal meningitis, even when accompanied1by ocular lesions. He related the case of a child,

aged 21 months, who was admitted into hospitalunder his care on Dec. 20th. She had been ill1 since Nov. 24th, and various diagnoses had been made. On admission she was thin and cachectic.t Neither rigidity of the neck nor Kernig’s sign was. present. The abdomen was retracted and the tache; cerebrale was obtained. Lumbar puncture yielded

a purulent fluid containing many meningococci,: and 30 c.c. of antimeningococcic serum were

. injected. The puncture and injection were repeatedon the two following days. The liquid yieldedby the third puncture was clear and sterile.Recovery appeared to take place, but on Jan. 9ththe child was found to be blind. Examinationof the eyes, including the fundi, showed nothingabnormal, but the amaurosis was absolute, and thepupils did not react to light. Though there wereno symptoms of accumulation of fluid in theventricles lumbar puncture was performed on

Jan. 15th. The cerebro-spinal fluid rushed outin a jet, indicating high tension, but it was limpid,its chemical composition was normal, and onlyvery few cells (mononuclears and lymphocytes)were present. Puncture was not followed by anyreturn of vision. On Jan. 22nd 15 c.c. of cerebro-

spinal fluid were withdrawn, and on the followingday the lumbar region was swollen, which was mani-festly due to infiltration of the connective tissuewith cerebro-spinal fluid. On the 23rd vision beganto return and by the 28th objects could be recognised.But vision again deteriorated. On Feb. 3rd puncturewas again performed. On the next day vision im-proved again and on the following days it continuedto do so and was definitely regained. M. Rochon-

Duvigneaud, the ophthalmologist who examined