BERLIN
2
1673 PARIS. (FROM OUR OWN CORRESPONDENT.) The Consumption of Tobacco in France. A NON-SMOKER like myself is a 1’ara a1;is in this tobacco- loving community ; no wonder, then, if the State exercises a monopoly of the sale of the fragrant and remunerative weed. The net profits accruing to the Government from the sale of tobacco during the last year attained the colossal dimensions of 366,539,875 fr. 46 c. The Nord is a long way ahead of all other departments in the smoking, chewing, and snuff-taking propensities of the inhabitants, each of whom consumes annually 2 kilogrammes 391 grammes. At the opposite end of the scale is the department of La Lozere, where the average annual consumption per head-or rather per mouth and nostrils-does not exceed 310 grammes. The consump- tion of tobacco for smoking and chewing purposes has increased 35 per cent. during the last twenty years, whereas the habit of snuff-taking has diminished 20 per cent. By the way, it is by no means uncommon to see students smoking an the hospital wards, and anyone who knew the late Pro- fessor Trelat, the distinguished surgeon of the Charite, will recollect how liberal he was with his cigarette case directly the morning visit was over, whilst he was having a final chat before leaving the wards. The Cause of the Colouration and Coagqtlation of Milk when Heated. It is a matter of common observation that milk heated in contact with air for a certain time becomes coagulated and assumes a yellow tint. Heated in a water bath this phenomenon occurs in from ten to fifteen hours. When boiled, coagulation occurs, and the milk assumes a caramel tint. The coagulation takes place as soon as the yellow colouration has attained a certain intensity. Observers have ascribed these curious colour changes to alteration either of the lactose or of the casein (Daclaux), and no satis- factory explanation of the clotting has ever been advanced. MM. Cazeneuve and Haddon have, in consequence of researches on the subject, arrived at the following conclu- sions : (1) the yellowing by heat is due to the oxidation of the lactose in presence of the alkaline salts of the milk ; (2) such oxidation generates acids, amongst others, formic acid, the presence of which determines, as would that of any other acid, the coagulation of the milk ; and (3) the coagu- lated casein is not changed, but simply coloured yellow by the brown bodies developed at the expense of the milk-sugar. Sudden Death after Fracture of the Patella. Dr. Cern6 reports in the Normandie Mcdicale of May l5th a case in which about twenty-four hours after a seance of massage for simple fracture of the knee-cap the patient died quite suddenly. The necropsy revealed as the cause of death an obliteration of the pulmonary artery by large clots detached from the deep femoral vein. Although the long interval between the occurrence of the catastrophe and the final massage would appear to exonerate this form of treat- ment, it is more than probable that it paved the way for the migration of the clots by breaking them up. It would follow that, whereas massage is indicated very early or very late after the receipt of the fracture, it is contraindicated where, after consolidation, the limb remains oedematous and boggy. ’’ Here it is probable that the large veins contain clots which any such manœuvres are liable to displace, to the great danger of the patient. A Delicate Test for Albumen in Urine. A 1 in 3 solution of resorcin is strongly recommended by M. Carrès2 as an infinitely more delicate test of the presence of albumen in urine than nitric acid. The modus operandi is so simple that the practitioner can easily apply it at the bedside, the material necessary being only a test-tube, a little pipette of 2 cubic centimetres capacity, and a packet- containing 1 gramme of resorcin. The gramme of resorcin is introduced into the test-tube and dissolved, with shaking, in 2 cubic centimetres of ordinary water. The urine (whatever may be its reaction) is then, by means of the pipstte, allowed to gently flow on the surface of the solution, when, should albumen be present, a white ring is developed at the line of demarcation, no other coloura- tion ever being observed. Alkaloids (unless, as is never the 1 Académie des Sciences, June 10th. 2 Journal des Sciences Médicales de Lille, March 23rd. case in urine, they be present in very large quantities), urates, and urea do not yield the white ring with resorcin. Peptones, however, when. as is rare, they are present in urine, give the ring, but the albumen ring remains while the peptone ring disappears when the tube is plunged into hot water. It is claimed that resorcin will give a cloudiness of albumen when nitric acid gives no result at all. June 25tb. _______________ BERLIN. . (FROM OUR OWN CORRESPONDENT.) The University of Jena. ’ THE publication of a rumour that the authorities intend-to abolish the University of Jena has caused a stir in the scientific world, the university being one of the oldest in , Germany and having often occupied a leading position. , Financial reasons are said to have induced the authorities to arrive at this decision. The constitution of the University of , Jena is somewhat peculiar. It is not under the jurisdiction of a single State, but belongs jointly to four States of Thuringia-viz., Saxe-Weimar, Meiningen, Coburg, and Altenburg. The Governments of those small States entirely control the affairs of the university. If, for instance, a new professor is to be appointed they must all consent to his nomination. To put a stop to the farther propagation of this rumour the official journals of the four united Govern- ments declare that the continued existence of this venerable university is assured both by public grants and by large donations recently made by old pupils and others. This communication has been received with general satisfaction, particularly in the town of Jena itself, which is entirely dependent upon the university. The Resident Medical Officers of the Friedrichshain Hospital. A conflict has arisen between the resident medical officers of this hospital and their superiors. The chief physicians and surgeons complained that the young medical men used to come home at unusually late hours, that they gave frequent festivities in the hospital, and that they were con- sequently not always fit for the next day’s work. The resident medical men rather brmquely retorted that their superiors ought to mind their own business, and declined to modify their manner of living. The matter was accordingly brought before the Municipal Hospital Board, which decreed that all the resident medical officers were to be dismissed from their appointments. Although an arrangement took place after- wards between the chief physicians and surgeons and the resident medical staff, the board nevertheless adhered to its decision, and all the resident staff will accordingly leave the hospital at the end of this month. The Result of the Mellage Trial. This sensational case, which I reported to you in my last letter, has led to several important consequences. The visiting physicians of the Mariaberg Asylum resigned their posts before the verdict was published, and the district officer of health has been dismissed from his appointment by the Government. The Mariaberg Asylum will entirely lose its ecclesiastical character. The provincial council intends to lease the premises, and will also undertake the care of the inmates, who for the most part belong to the poorer classes. Physicians have been already sent from other provincial asylums to attend the patients. Two of the brethren have been arrested for perjury, and will be brought before the next assizes. The clerical press, too, is unanimous in blaming the conduct of the brotherhood, and in accusing them of having brought great discredit on all branches of ecclesiastically conducted nursing. Public opinion being very much alarmed by the disclosures made during the trial, it is probable that the lunacy laws will be modified. The Successors of Professors Thierse7i and Ludwig. Dr. Trendelenberg, Professor of Surgery in Bonn (Rhenish Prussia), will leave that town for Leipzig, where he has been elected successor to the late Professor Thiersch. Professor Trendelenberg is connected with English medicine. He began his studies in Edinburgh, where he attended botanical and zoological lectures ; and from that town he went to Glasgow University to study anatomy and physiology. He finished his medical training in Berlin, but as a post-graduate returned to England in order to familiarise himself with the new antiseptic method of Professor Lister. Afterwards he became an
Transcript of BERLIN
1673
PARIS.(FROM OUR OWN CORRESPONDENT.)
The Consumption of Tobacco in France.A NON-SMOKER like myself is a 1’ara a1;is in this tobacco-
loving community ; no wonder, then, if the State exercises amonopoly of the sale of the fragrant and remunerative weed.The net profits accruing to the Government from the sale oftobacco during the last year attained the colossal dimensionsof 366,539,875 fr. 46 c. The Nord is a long way ahead of allother departments in the smoking, chewing, and snuff-takingpropensities of the inhabitants, each of whom consumesannually 2 kilogrammes 391 grammes. At the opposite endof the scale is the department of La Lozere, where theaverage annual consumption per head-or rather per mouthand nostrils-does not exceed 310 grammes. The consump-tion of tobacco for smoking and chewing purposes hasincreased 35 per cent. during the last twenty years, whereasthe habit of snuff-taking has diminished 20 per cent. Bythe way, it is by no means uncommon to see students smokingan the hospital wards, and anyone who knew the late Pro-fessor Trelat, the distinguished surgeon of the Charite, willrecollect how liberal he was with his cigarette case directlythe morning visit was over, whilst he was having a finalchat before leaving the wards.The Cause of the Colouration and Coagqtlation of Milk when
Heated.It is a matter of common observation that milk heated in
contact with air for a certain time becomes coagulated andassumes a yellow tint. Heated in a water bath this
phenomenon occurs in from ten to fifteen hours. Whenboiled, coagulation occurs, and the milk assumes a carameltint. The coagulation takes place as soon as the yellowcolouration has attained a certain intensity. Observers haveascribed these curious colour changes to alteration either ofthe lactose or of the casein (Daclaux), and no satis-
factory explanation of the clotting has ever been advanced.MM. Cazeneuve and Haddon have, in consequence ofresearches on the subject, arrived at the following conclu-sions : (1) the yellowing by heat is due to the oxidation ofthe lactose in presence of the alkaline salts of the milk ;(2) such oxidation generates acids, amongst others, formicacid, the presence of which determines, as would that of anyother acid, the coagulation of the milk ; and (3) the coagu-lated casein is not changed, but simply coloured yellow bythe brown bodies developed at the expense of the milk-sugar.
Sudden Death after Fracture of the Patella.Dr. Cern6 reports in the Normandie Mcdicale of May l5th
a case in which about twenty-four hours after a seance ofmassage for simple fracture of the knee-cap the patientdied quite suddenly. The necropsy revealed as the cause ofdeath an obliteration of the pulmonary artery by large clotsdetached from the deep femoral vein. Although the longinterval between the occurrence of the catastrophe and thefinal massage would appear to exonerate this form of treat-ment, it is more than probable that it paved the way for themigration of the clots by breaking them up. It would followthat, whereas massage is indicated very early or very lateafter the receipt of the fracture, it is contraindicated where,after consolidation, the limb remains oedematous and boggy.
’’
Here it is probable that the large veins contain clots whichany such manœuvres are liable to displace, to the great dangerof the patient.
A Delicate Test for Albumen in Urine.A 1 in 3 solution of resorcin is strongly recommended
by M. Carrès2 as an infinitely more delicate test of thepresence of albumen in urine than nitric acid. Themodus operandi is so simple that the practitioner can
easily apply it at the bedside, the material necessary beingonly a test-tube, a little pipette of 2 cubic centimetrescapacity, and a packet- containing 1 gramme of resorcin.The gramme of resorcin is introduced into the test-tube anddissolved, with shaking, in 2 cubic centimetres of ordinarywater. The urine (whatever may be its reaction) is then, bymeans of the pipstte, allowed to gently flow on the surfaceof the solution, when, should albumen be present, a whitering is developed at the line of demarcation, no other coloura-tion ever being observed. Alkaloids (unless, as is never the
1 Académie des Sciences, June 10th.2 Journal des Sciences Médicales de Lille, March 23rd.
case in urine, they be present in very large quantities),urates, and urea do not yield the white ring with resorcin.Peptones, however, when. as is rare, they are present inurine, give the ring, but the albumen ring remains while thepeptone ring disappears when the tube is plunged into hotwater. It is claimed that resorcin will give a cloudiness ofalbumen when nitric acid gives no result at all.June 25tb.
_______________
BERLIN.. (FROM OUR OWN CORRESPONDENT.)
The University of Jena.’ THE publication of a rumour that the authorities intend-to
abolish the University of Jena has caused a stir in thescientific world, the university being one of the oldest in
, Germany and having often occupied a leading position., Financial reasons are said to have induced the authorities to
arrive at this decision. The constitution of the University of,
Jena is somewhat peculiar. It is not under the jurisdictionof a single State, but belongs jointly to four States of
Thuringia-viz., Saxe-Weimar, Meiningen, Coburg, andAltenburg. The Governments of those small States entirelycontrol the affairs of the university. If, for instance, a newprofessor is to be appointed they must all consent to hisnomination. To put a stop to the farther propagation ofthis rumour the official journals of the four united Govern-ments declare that the continued existence of this venerableuniversity is assured both by public grants and by largedonations recently made by old pupils and others. Thiscommunication has been received with general satisfaction,particularly in the town of Jena itself, which is entirelydependent upon the university.The Resident Medical Officers of the Friedrichshain Hospital.A conflict has arisen between the resident medical officers
of this hospital and their superiors. The chief physiciansand surgeons complained that the young medical men usedto come home at unusually late hours, that they gavefrequent festivities in the hospital, and that they were con-sequently not always fit for the next day’s work. The residentmedical men rather brmquely retorted that their superiorsought to mind their own business, and declined to modifytheir manner of living. The matter was accordingly broughtbefore the Municipal Hospital Board, which decreed that allthe resident medical officers were to be dismissed from theirappointments. Although an arrangement took place after-wards between the chief physicians and surgeons and theresident medical staff, the board nevertheless adhered to itsdecision, and all the resident staff will accordingly leave thehospital at the end of this month.
The Result of the Mellage Trial.This sensational case, which I reported to you in my last
letter, has led to several important consequences. The visitingphysicians of the Mariaberg Asylum resigned their posts beforethe verdict was published, and the district officer of health hasbeen dismissed from his appointment by the Government.The Mariaberg Asylum will entirely lose its ecclesiasticalcharacter. The provincial council intends to lease thepremises, and will also undertake the care of the inmates,who for the most part belong to the poorer classes.Physicians have been already sent from other provincialasylums to attend the patients. Two of the brethren havebeen arrested for perjury, and will be brought before thenext assizes. The clerical press, too, is unanimous inblaming the conduct of the brotherhood, and in accusingthem of having brought great discredit on all branches ofecclesiastically conducted nursing. Public opinion beingvery much alarmed by the disclosures made during the trial,it is probable that the lunacy laws will be modified.
The Successors of Professors Thierse7i and Ludwig.Dr. Trendelenberg, Professor of Surgery in Bonn (Rhenish
Prussia), will leave that town for Leipzig, where he has beenelected successor to the late Professor Thiersch. ProfessorTrendelenberg is connected with English medicine. He beganhis studies in Edinburgh, where he attended botanical andzoological lectures ; and from that town he went to GlasgowUniversity to study anatomy and physiology. He finished hismedical training in Berlin, but as a post-graduate returned toEngland in order to familiarise himself with the new antisepticmethod of Professor Lister. Afterwards he became an
1674
assistant to the late Professor von Langenbeck and chiefsurgeon of the new Friedrichshain Hospital in Berlin. Hisfirst professorial appointment was at the University ofRastook, which town he left for Bonn. His chair at thelatter university will be taken by Professor Mikulicz ofBreslau, formerly assistant to Professor Billroth in Vienna.The medical faculty has recently elected Professor Heringof Prague as successor to the great physiologist ProfessorLudwig.
Colonial Laboratories.The Imperial Government will bring a Bill before the
Reichstag in order to establish medical laboratories in theGerman colonies. There is already one in Cameroon, WestCoast of Africa, under the direction of Dr. Plehn, who hasmade several valuable researches, especially on the etiologyof blackwater fever, as I mentioned in one of my recentletters. This laboratory is his private property, but hereceives a subsidy from the colonial Government. Labora-tories of this kind are now to be established in all thecolonies, their principal purpose being the investigation oftropical diseases and tropical hygiene. The conditions ofEuropean acclimatisation in the different colonies will also becarefully examined. In addition a central institute forcolonial medicine will be established in Berlin, which willreceive communications from the laboratories, and willcollect and publish the results of their investigations. IJune 24th.
ROME.(FROM OUR OWN CORRSPONDENT.)
Italian Hospitals.THE LANCET has from time to time deplored the back-
ward condition of the Italian hospitals, which (as ProfessorLuciani of our university has lately testified of the biologicallaboratories) are quite inadequate to modern requirements,whether from a humanitarian point of view or from thatof medicine, scientific as well as clinical. All throughthe peninsula, and still more in the islands, the mono-
tonous cry is heard from every medical school : "We arenot abreast of the times. We are, even in our best-
equipped hospitals, almost mediseval in our appoint-ments," The justly distingaished school of Genoa, which,in spite of many and grave disadvantages, has sent forthsurgeons and physicians of European reputation, has latelybeen the subject of a " Commissione d’ Inchiesta," speciallynominated to report on its hospitals. On that commission ofinquiry are found the aathoriative names of Dr. GiovanniGaribaldi (Professor of Surgical and Topographical Anatomy ’,in the University), Dr. Canalis (Professor of Hygiene), and
’’
such eminent practitioners as Drs. Muzio, Carbone, andRavano -men whose competence is not greater thantheir independence and impartiality. Their report, now
made public, is a thorough-going and severe indictmentof nearly all the departments of the city hospitals,in well-nigh every one of which they lament ’’ lamancanza delle piu elementari prescrizioni igieniche "(the want of the most rudimentary prescriptions ofhygiene), and the slovenly manner in which the "serviztoamministrativo " is carried out. The Italian public, which,as lately shown, can respond so nobly to the appeal of theCentral Committee of the Red Cross, has only to becomeaware (through such reports as the present) of the discredit-able state of the city hospitals to bring adequate pressureto bear on the Government and on the local municipalitiesfor the worthy rehabilitation of tho:e all-essential institu-tions. Relatively to the times the hospitals of Italy are farinferior to those in which her great mediaeval surgeons andphysicians practised and taught. Is she content to courtmuch longer the humiliating comparison ? Her penitentiaryprisons are actually better appointed and better administeredthan her hospitals, as a recent visit to the great I I peniten-ziario " of San Leopoldo (Leghorn) put clearly en evidence.The Commendatore dall’ Oglio, the local prefect, concludeda rigorous inspection of the latter, in its sanitary and medicaldepartments, with hearty words of praise for what he hadexamined and witnessed. Could he have said as much forthe hospitals of the greatest city on that seaboard which isalso the seat of a historical medical school ?
" Death in the Pot."We have been having a more than usually depressing turn
of sirocco weather, well defined as " heat without sun, wind
without air, and rain without freshness "--conditions underwhich all kinds of food, particularly meat and fish, are apt todecompose. Rome, like most populous Italian cities, abounds.in" rivenditori ambulanti" (itinerant retail dealers) in sucharticles, frequenting the poorer quarters and often eludingthe vigilance of the sanitary officers in the sale of unsound
. comestibles. In consequence, we have from time to, time cases of ptomaine poisoning after the consumption
of those viands, an exceptionally tragic case of whichoccurred early this year in Florence, where three out,
i of a family of four died after eating fish in a putrescer.t.state. The other day a well-to-do Roman farmer, with his
; wife and four children, nearly encountered a similar fateI from precisely the same cause. At midday they had par-r taken of some fish from the Tiber, and by the evening they; were all ill-all except the youngest child, who had dined on; other viands. Severe intestinal pain was followed in each. case by violent retching, and by eight o’clock they hadI to be removed for treatment to the Ospedale di Sant’
Antonio. Fortunately, there was still time to evacuatee the primæ viæ of their poisonous contents, and the patients,; though in a deplorably reduced condition, are now doingr well. But the lay press, not unjustifiably, is calling out for
a more rigid censorship of these itinerant food-hawkers, whobuy up the unsaleable stock of the butchers and fishmongersand vend it in obscure quarters on the sly. Naturally enough,it asks if it is only when the forestieri are in Rome that thesanitary inspectors are on the alert ; and if the lives of thelieges must be endangered the moment the "foreign import"(alias well-to. do visitor) turns his back?June 21st.
Obituary.PATRICK KAVANAGH, M.D. ST. AND.
I THE news of the death of Dr. Kavanagh, which took placequite suddenly at his residence in Brighton on the 25th inst.,will be received with regret by a large circle of friends.Dr. Kavanagh retired from practice some years ago, havingbeen formerly in practice at L9wisham for thirty years,and much confidence was feJG in the neighbourhood inhis professional skill and sound judgment. It wouldbe impossible to speak of his benevo!encs and charitywithout apparent exaggeration, for his name will be ren-dered a household word with those among whom he laboured.
Many officers now in the Army and Navy who were studyingat the Royal Naval School, New-cross, of which he wasmedical dficer, will remember his kindness. He was aciassical and scientific scholar, as those who met him cantestify. Prior to his death he was preparing an address to hissupporters in Ireland, having accepted an invitation to standas an Irish member. By his sudden decease many will havelost not only a wise adviser, but a true friend.
DEATHS OF EMINENT FOREIGN MEDICAL MEN.-Thedeaths of the following eminent foreign medical men areannounced :-Dr. Wölfler, Imperial Councillor, and for manyyears director of the Vienna Jewish Hospital.-Dr. F. vonRied, formerly Professor of Surgery in the University ofJena.-Dr. A. Takacs, _privat-docent in Medicine in theUniversity of Budapest.-Dr. J. S. Alleyne, formerly Pro-fessor of Materia Medica and Therapeutics in the St. LouisMedical College.
THE OBSTETRICAL CONGRESS IN VIENNA.
The Development of Obstetrics.THE Congress met on Jane 5th, and was attended by a.
great many leading medical men. Professor Chrobak ofVienna presided, and in his opening address gave a shortsketch of the Development of Obstetrics, in the course ofwhich he remarked that some questions of the physiology
, and pathology of pregnancy and labour were as yet imper-fectly understood, such as the foetal metabolic processes,the placental nourishment and respiration, the theory of theinferior segment of the uterus, the mechanism of delivery,
l oateomalacia, and eclampsia. Baichard, Chamberland, and
