BERLIN
2
1664 , for visiting the patient up to the time of his discharge from the hospital. The father offered 800 francs, saying that as he had not asked his ordinary medical adviser either to be present at the operation or to visit the patient afterwards, he did not, in fact, owe anything under these two heads. The tribunal gave judgment in favour of the father, with the remark that attending at an operation and paying visits without the request of the family did not render the family liable to pay fees for such attendance and visits. Monument tr> Dr. Cuinccrd. Last summer I referred in this column to the murderous attack on Dr. Guinard, one of the surgeons of the H<’)tel Dieu -an attack which unfortunately caused his death. Imme- diately afterwards a subscription list was opened for the purpose of erecting a monument to him in the court of the H6tel Dieu, probably on the very spot where he fell. The subscriptions already amount to 13,000 francs, and it is hoped that 20,000 francs may be collected, for there are several medical societies which have not yet signified their intention of contributing ; it is also expected that the General Council of the Seine and the municipal council will make liberal grants. Workmen’s Assooiations and Tubere?tlosis. In the belief that he was acting for the best M. Delcasse, the Minister of Marine, on Oct. 20th issued a circular to the ports having for its object the retirement of workmen suffer- ing from tuberculosis. Compensation was to be granted to men discharged under these circumstances at the rate of 27 centimes per day for patients in the first stage of the disease, 54 centimes for those in the second stage, and 81 centimes for those in the third stage. The scale of com- pensation was not objected to, but the workmen’s association at the port of Brest held a meeting and decided to agitate against the discharge of men suffering from tuberculosis and against the dispersal of men on half pay. Other similar associations followed this example. The workmen at Roche- fort issued an appeal in which they said that if any of them were tuberculous they had become so in the service of the State as employer, and that their disease was due to over- work and to the unwholesome state of the buildings in which their duties were carried on. They furthermore argued that the State in the capacity of an employer ought not to set so bad an example to private employers. Presentation to Professor Hayem. Many professors of the Faculty of Medicine, the director of the Assistance Publique, hospital physicians, and the majority of the pupils of the eminent clinical teacher, Professor Hayem, assembled on Nov. 19t.h at the Hupital Saint Antoine for the purpose of presenting him with a medal struck on the occasion of his retirement from the position of professor and hospital physician. The medal is the work of the sculptor, Roger Bloche. On one side it represents a bust of the professor and on the other side it shows him lecturing in the amphitheatre with the most celebrated of his pupils in the background. Dr. Milard, who presided, gave an out.line of Professor Hayem’s distinguished scientific career, and in particular the discovery of the physiological serum which bears his name. Professor Landouzy recalled the fact that Professor Hayem’s grandfather had been a celebrated physi- cian. Other addresses were then delivered by M. Mesureur, M. Dastre, Professor Barrie, Professor Gilbert, and Dr. Letulle. Professor Hayem, speaking with much emotion, expressed his thanks to his friends, colleagues, and pupils, with special reference to the organisers of the presentation, Dr. Gaston Lion and Dr. Bensaude. Disorderly Soenes at tile Lect1treS oj M. V’iaolas. The disturbances created by the medical students at the lectures of M. Nicolas have begun again worse than ever. The students say that their professor, although distinguished as an embryologist, is not an anatomist, and they find fault with the time-table arrangement of the classes. For instance, instruction in osteology, which was carried on for two months at the amphitheatre of Clamant, now lasts only 16 days since the introduction of the system followed by M. Nicolas. They also complain that the dissecting-room subjects are so imperfectly injected as to be in a sorry condi- tion when brought out. As the disturbances were becoming worse, the lectures of M. Nicolas have been provisionally suspended until Dec. 8th. Dc. 4th. BERLIN. (FROM OUR OWN CORRESPONDENT.) ; Physiological Effeots ot Balloon A sacnfs. j Dr. Flemming, of the Emperor William Academy in r Berlin, has published an account of physiological and pathological observations made by him during balloon excursions, the ascents having been undertaken for the j purpose of ascertaining the influence of high altitudes on l the human body. He said that although balloon ascents . are of frequent occurrence, experiments of this particular , kind have nevertheless been rather uncommon in conse- : quence of the fact that at great elevations some : of the psychical faculties are weakened and the bodily : energy becomes paralysed. No actual pain is felt, : but the result is a state of apathy which renders the : occupants of the car unfit for scientific work. In- halation of oxygen, however, restores the normal psychical . state The symptoms are, in fact, very like those . observed in anaemic persons and are produced by a deficient supply of oxygen to the cerebral cortex. In anaamia the carriers of the oxygen-namely, the red corpuscles of the blood-are insufficient to convey the neces- sary amount of oxygen to the cortex, whilst at high alti- tudes a similar effect is produced by the diminished supply of oxvgen in consequence of the rarefaction of the air. In Dr. Flemming’s experience one of the symptoms observed at a great elevation was well-marked cyanosis of the skin, the mucous membranes, and the hands, which began to appear at a height between 4000 and 5000 metres. The pulse became very frequent, but inhalation of oxygen from a supply carried in a gas bottle brought its rate down to that which is usual on awaking after a quiet rest in bed. When the administration of oxygen was irregular or was commenced too late, then the frequency of the pulse became diminished, but not to the low rate of 68 beats per minute, as was the case when the supply of oxygen had been regular from the beginning. The respiration became more frequent with the increasing rarefaction of the air and also more superficial and irregular. This was partly caused by the deficiency of oxygen, which made the muscles less active; the insufficient oxidation of the tissues also led to the forma- tion of certain products which had an irritant effect on the motor centres of the spinal cord. The respiration was also embarrassed by the expansion of the intestinal gases, as was shown by measuring the circumference of the abdomen. Dr. Flemming remarked that the red corpuscles of the blood were generally supposed to increase in number during resi- dence in mountain resorts, but in the course of his balloon ascents he found that they decreased from 5,800,000 per cubic millimetre on the low ground, to 3,388,000 at an altitude of 8910 metres. This was, in his opinion, due to the fact that the low temperature of - 40° C. at that altitude produced a contraction of the capillary vessels of the skin, so that they became pervious only for the plasma of the blood but not for the corpuscular elements, the tem- perature and not the altitude being thus the decisive factor. It was remarkable that this low temperature was supported without much difficulty and without a feeling of intense cold, the cause being the dryness of the air and the intensity of the sun’s rays, especially of the calorific ultra-red rays. The ultra-violet rays sometimes produced severe dermatitis ; some of the balloonists suffered from conjunctivitis, but Dr. Flemming, who had protected his eyes by green-yellow glasses, fortunately escaped it. In conclusion, he described some interesting bacteriological experiments on the influence of the sunbeams on certain pathogenic micro-organisms, especially on pure cultures of the bacilli of enteric fever and cholera, bacillus pyocyaneus, bacillus prodigiosus, and the tubercle bacillus. In the result it was found that by exposure to the sun’s rays the bacillus prodigiosus was destroyed after one hour and a quarter on the low ground and after only 20 minutes at an altitude of 5000 metres ; for the bacillus of cholera the corresponding periods were one hour and a half on the low ground and one hour at the high altitude ; while for the bacillus of enteric fever the periods were an hour and a half on the low ground and 20 minutes at the high altitude. Dr. Flemming then made an experiment on the influence of sunbeams on the development of tuberculosis. He found that the incubation period of tuberculosis was lengthened
Transcript of BERLIN
1664
, for visiting the patient up to the time of his discharge fromthe hospital. The father offered 800 francs, saying that as
he had not asked his ordinary medical adviser either to bepresent at the operation or to visit the patient afterwards, hedid not, in fact, owe anything under these two heads. Thetribunal gave judgment in favour of the father, with theremark that attending at an operation and paying visitswithout the request of the family did not render the familyliable to pay fees for such attendance and visits.
Monument tr> Dr. Cuinccrd.Last summer I referred in this column to the murderous
attack on Dr. Guinard, one of the surgeons of the H<’)tel Dieu-an attack which unfortunately caused his death. Imme-
diately afterwards a subscription list was opened for the
purpose of erecting a monument to him in the court of theH6tel Dieu, probably on the very spot where he fell. Thesubscriptions already amount to 13,000 francs, and it is
hoped that 20,000 francs may be collected, for there areseveral medical societies which have not yet signified theirintention of contributing ; it is also expected that the GeneralCouncil of the Seine and the municipal council will makeliberal grants.
Workmen’s Assooiations and Tubere?tlosis.In the belief that he was acting for the best M. Delcasse,
the Minister of Marine, on Oct. 20th issued a circular to theports having for its object the retirement of workmen suffer-ing from tuberculosis. Compensation was to be granted tomen discharged under these circumstances at the rate of27 centimes per day for patients in the first stage of thedisease, 54 centimes for those in the second stage, and81 centimes for those in the third stage. The scale of com-
pensation was not objected to, but the workmen’s associationat the port of Brest held a meeting and decided to agitateagainst the discharge of men suffering from tuberculosis andagainst the dispersal of men on half pay. Other similarassociations followed this example. The workmen at Roche-fort issued an appeal in which they said that if any of themwere tuberculous they had become so in the service of theState as employer, and that their disease was due to over-work and to the unwholesome state of the buildings in whichtheir duties were carried on. They furthermore argued thatthe State in the capacity of an employer ought not to set sobad an example to private employers.
Presentation to Professor Hayem.Many professors of the Faculty of Medicine, the director
of the Assistance Publique, hospital physicians, and the
majority of the pupils of the eminent clinical teacher,Professor Hayem, assembled on Nov. 19t.h at the HupitalSaint Antoine for the purpose of presenting him with a medalstruck on the occasion of his retirement from the position ofprofessor and hospital physician. The medal is the work ofthe sculptor, Roger Bloche. On one side it represents a bustof the professor and on the other side it shows him lecturingin the amphitheatre with the most celebrated of his pupils inthe background. Dr. Milard, who presided, gave an out.lineof Professor Hayem’s distinguished scientific career, and in
particular the discovery of the physiological serum whichbears his name. Professor Landouzy recalled the fact thatProfessor Hayem’s grandfather had been a celebrated physi-cian. Other addresses were then delivered by M. Mesureur,M. Dastre, Professor Barrie, Professor Gilbert, and Dr. Letulle.Professor Hayem, speaking with much emotion, expressedhis thanks to his friends, colleagues, and pupils, with
special reference to the organisers of the presentation, Dr.Gaston Lion and Dr. Bensaude.
Disorderly Soenes at tile Lect1treS oj M. V’iaolas.The disturbances created by the medical students at the
lectures of M. Nicolas have begun again worse than ever.The students say that their professor, although distinguishedas an embryologist, is not an anatomist, and they find faultwith the time-table arrangement of the classes. Forinstance, instruction in osteology, which was carried on fortwo months at the amphitheatre of Clamant, now lasts only16 days since the introduction of the system followed byM. Nicolas. They also complain that the dissecting-roomsubjects are so imperfectly injected as to be in a sorry condi-tion when brought out. As the disturbances were becomingworse, the lectures of M. Nicolas have been provisionallysuspended until Dec. 8th.Dc. 4th.
BERLIN. (FROM OUR OWN CORRESPONDENT.)
; Physiological Effeots ot Balloon A sacnfs.j Dr. Flemming, of the Emperor William Academy inr Berlin, has published an account of physiological and
pathological observations made by him during balloonexcursions, the ascents having been undertaken for the
j purpose of ascertaining the influence of high altitudes onl
the human body. He said that although balloon ascents.
are of frequent occurrence, experiments of this particular, kind have nevertheless been rather uncommon in conse-
: quence of the fact that at great elevations some
: of the psychical faculties are weakened and the bodily: energy becomes paralysed. No actual pain is felt,: but the result is a state of apathy which renders the: occupants of the car unfit for scientific work. In-
halation of oxygen, however, restores the normal psychical. state The symptoms are, in fact, very like those.
observed in anaemic persons and are produced by a
deficient supply of oxygen to the cerebral cortex. Inanaamia the carriers of the oxygen-namely, the red
corpuscles of the blood-are insufficient to convey the neces-sary amount of oxygen to the cortex, whilst at high alti-tudes a similar effect is produced by the diminished supplyof oxvgen in consequence of the rarefaction of the air. InDr. Flemming’s experience one of the symptoms observedat a great elevation was well-marked cyanosis of the skin,the mucous membranes, and the hands, which began to appearat a height between 4000 and 5000 metres. The pulsebecame very frequent, but inhalation of oxygen from asupply carried in a gas bottle brought its rate down tothat which is usual on awaking after a quiet rest in bed.When the administration of oxygen was irregular or was
commenced too late, then the frequency of the pulse becamediminished, but not to the low rate of 68 beats per minute,as was the case when the supply of oxygen had been regularfrom the beginning. The respiration became more frequentwith the increasing rarefaction of the air and also moresuperficial and irregular. This was partly caused by thedeficiency of oxygen, which made the muscles less active;the insufficient oxidation of the tissues also led to the forma-tion of certain products which had an irritant effect on themotor centres of the spinal cord. The respiration was alsoembarrassed by the expansion of the intestinal gases, as wasshown by measuring the circumference of the abdomen. Dr.
Flemming remarked that the red corpuscles of the bloodwere generally supposed to increase in number during resi-dence in mountain resorts, but in the course of his balloonascents he found that they decreased from 5,800,000 per cubicmillimetre on the low ground, to 3,388,000 at an altitude of8910 metres. This was, in his opinion, due to the factthat the low temperature of - 40° C. at that altitude
produced a contraction of the capillary vessels of theskin, so that they became pervious only for the plasmaof the blood but not for the corpuscular elements, the tem-perature and not the altitude being thus the decisive factor.It was remarkable that this low temperature was supportedwithout much difficulty and without a feeling of intense cold,the cause being the dryness of the air and the intensity ofthe sun’s rays, especially of the calorific ultra-red rays. Theultra-violet rays sometimes produced severe dermatitis ; someof the balloonists suffered from conjunctivitis, but Dr.
Flemming, who had protected his eyes by green-yellowglasses, fortunately escaped it. In conclusion, he describedsome interesting bacteriological experiments on the influenceof the sunbeams on certain pathogenic micro-organisms,especially on pure cultures of the bacilli of enteric fever andcholera, bacillus pyocyaneus, bacillus prodigiosus, and thetubercle bacillus. In the result it was found that by exposure tothe sun’s rays the bacillus prodigiosus was destroyed after onehour and a quarter on the low ground and after only 20 minutesat an altitude of 5000 metres ; for the bacillus of cholera thecorresponding periods were one hour and a half on the lowground and one hour at the high altitude ; while for thebacillus of enteric fever the periods were an hour and a halfon the low ground and 20 minutes at the high altitude. Dr.
Flemming then made an experiment on the influence ofsunbeams on the development of tuberculosis. He foundthat the incubation period of tuberculosis was lengthened
1665
by three and a halt weeks when an emulsion ot tuberclebacilli was exposed on the low ground for 15 minutes, andthat tuberculosis did not develop at all after an exposure cfthe emulsion for 60 minutes. In contrast with this he foundthat an exposure for five minutes at an altitude of 5000metres was sufficient to prevent the development of tuber-culosis altogether. The bactericidal action of the sun’s
rays at the high altitude was therefore far greater than onthe low ground. Dr. Flemming moreover remarked that athigh altitudes wounds usually healed rapidly ; furuncles andthe pustules of acne also disappeared owing to the destructionof pathogenic germs.
Deatn of Professor Fraenkel.Dr. Bernhard Fraenkel, formerly professor of laryngology
and director of the laryngological clinic of the University ofBerlin, died in that city on Nov. llth, as mentioned inthe last issue of THE LANCET. Professor Fraenkel wasthe son of a medical practitioner and was born in 1841at Elberfeld in Rhenish Prussia. He obtained his pro-fessional qualifications in Berlin and settled there, first as ageneral practitioner, in which capacity he soon rose to a
prominent position, but eventually specialised in laryngology.He served in the wars of 1864, 1866, and 1870-71, after thelast of which he was appointed a privat-docent and becamephysician to the Augusta Hospital. In 1884 he was pro-moted to be professor ; in 1887 he became director of thepoliclinic, and in 1893 director of the clinic for laryngology,then newly instituted in connexion with the University. Forreasons of age and of health he resigned his appointmentsome six months ago. Among the various subjects to whichProfessor Fraenkel gave his attention mention may be made ofhis work on the anatomy of the nose, on the connexionbetween asthma and diseases of the nose, on cancer
of the larynx, on the histology of the vocal cords, andon tuberculosis of the pharynx. In 1894 he founded theArchivfür Laryngologieand the Berlin Laryngological Society,of which he was the president until his death. He, more-over, did valuable work in connexion with tuberculosis,especially by advocating sanatorium treatment. He was thefounder of the Berlin Sanatoriums Society, a member of theInternational Association for the Prevention of Tuberculosis,and co-editor of the two journals Tuberczclosis and Zeitsckriftfiir Taberoulose. Formerly he took an active part in move-ments for improving the position of the medical profession,being one of the founders and a member of the committee ofthe Deutscher Aertzevereinsbund. For 25 years he was thefirst secretary of the Berlin Medical Society. His death is
generally regretted.Attempted murder of a Medical Man.
That club practice in Germany is far from being remunera-tive is generally admitted, and a recent incident has shownthat the holder of such a position may even go in peril of hislife. The event in question occurred at Essen, in RhenishPrussia. A medical man on going home from the rail-way station was followed by a man unknown to him, andat the door of his house a shot was fired at him, the bulletlodging in his chest. His assailant then took to flight, butwas arrested, and found to be a member of a sick club. Thevictim of this outrage is a medical officer of this club andhad incurred the resentment of the club member by decliningto certify him as being ill, with the result that the clubrefused to make him an allowance of sick pay.
Dec. 4th. __________________
SWITZERLAND.(i*HOM OUR OWN UORRESPONDHNT.)
Olinioal Teao7Ûn.q in zVeuro.1t)gy.THE Swiss Federal (State) examinations for the licence
to practise medicine in Switzerland (I praktischer Arzt "are at present under revision, and Swiss neurologists aremaking efforts to secure a proper representation of the
specialty of neurology. Dr. Veraguth. lecturer on neurology(privat-doeent) at the University of Zurich, has worked outpropositions which, having been accepted by the Swiss
Neurological Society, have been laid before the Societyof Swiss Medical Men. He pleads for a better educa-tion of the medical student in neurology, includingobligatory attendance at a neurological clinique-still
a desideratum,-a half-year course at a neurologicalout-patient department, and lectures on neurology andmedical psychology. These propositions have not been
accepted by the Federal Examination Commission, whichconsiders the medical student already overburdened with aseries of new subjects, such as dermatology and legalmedicine, and they have also encountered sharp oppositionboth on the part of clinical teachers as well as from the
professors of mental medicine. The former, with ProfessorSahli as representative, hold that neurology should continueto be taught by the professor of clinical medicine, withthe assistance of an experienced neurologist. ProfessorSahli, at the annual meeting of the Neurological Society heldat Bern on Nov. llth and 12th, emphasised the detrimentcaused by further specialisation, calling Dr. Veraguth’s .
proposition an attack on the teachers of clinical medicine.The latter, with Professor Forel as spokesman, at a meetingof the Swiss Psychiatric Society held at Zurich on Nov. 25thand 26th, declared that neurology should remain dependenton the professorship of mental medicine, but should be dulyenlarged in scope by the establishment of neurological clinicsand policlinics under capable sub-professors and medicalassistants. Professor Forel objected to having the subject ofnervous diseases further split up, lest one morbid condition-for example, hysteria-should be demonstrated to the studentat three clinics from three different points of view both asregards definition and treatment. It is probable that severalyears will still elapse before the conflicting views on thisimportant subject can be harmonised.Dec. 4th.
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UNITED STATES OF AMERICA.(FROM OUR OWN CORRESPONDENTS.)
A Strike of Scavengers.THE work of the familiar White Wings," so named from
their white drill uniform, who do the street cleaning of thecity of New York, having caused gpeat annoyance to
pedestrians and others from the flying dust, the hours of thebrigade were changed to eight hours between sunset andsunrise. Although these men are extremely well paid forunskilled work-viz.,$18, or $3 12s., a week-the change intheir hours moved them to strike. In less than 48 hoursthe accumulation of filth, especially in the east side of thecity, was appalling, and the people were threatened with allthe troubles of filth-borne diseases. To the surprise of thestrikers, it was pointed out to them that they were civilservice employees and were consequently somewhat in theposition of soldiers or sailors, a strike among whom meansmutiny. " Strike breakers " were promptly imported by thethousand, under whose efforts, extending over a week, thepiles of garbage were removed. The misled strikers now findthemselves forced out of good employment by the automaticsuccession of the men following them upon the civil servicelist. It is likely that New York will be spared a similarlydangerous strike for many years to come.
Transplantation of a Human Xidney.Although Dr. L. J. Hammond, of the Methodist Episcopal
Hospital of Philadelphia, has not yet given an officialaccount of his work, it is well known that on Nov. 13th hetransplanted a kidney from the body of a man recently killedin an automobile accident to that of a patient afflicted withrenal tuberculosis, with the immediate result of anastomosisof vessels and other satisfactory consequences. Dr. Hammondhad a large audience of American and Canadian surgeonswho were attending the Clinical Congress at Philadelphia,during which an immense number of major operations wereperformed.
A Christian Science Home.A statement made in a former of these letters to the effect
that a home for Christian Scientists had been founded in theState of New York has elicited expressions of doubt. TheNew York evening papers of Oct. 6th published as news aparagraph, of which the following are extracts : " In SpecialTerm of the Supreme Court, Justice Pendleton to-daysigned an order approving the certificate of incorporationof the First Christian Science Home Association of the Stateof New York. The avowed purpose of the association,which is said to be the first of its kind in this State,
