DEATH OF MR. CHARLES CLAY
1
758 on the first Monday in October. At the Sheffield School of Medicine Sir James Crichton Browne will inaugurate the opening by an address on the subject of Biology and Ethics, Professor Jebb will address the students at Mason College, Birmingham, and Professor T. Clifford Allbutt will distribute the prizes and deliver the opening lecture at Yorkshire College, Leeds. The University of Durham College of Medicine will commence its winter session on Oct. 3rd. The Scotch medical schools and universities will not open until nearly a fortnight later. University College, Dundee, will commence its session on Oct. l0th, and will be followed by the opening of Aberdeen University on Oct. 16th. St. Mungo’s College will open on Oct. 18th with an introductory address by Professor Kent; and on the following day Glasgow Univer- sity, Anderson’s College and the Western Medical School, Glasgow, wi!l commence the winter session. Professor Charteris will address the students at Glasgow University and Professor Thomas King will give the introductory address at Anderson’s College, Glasgow. Amongst the Irish schools, Queen’s College, Cork, will begin its winter term on Oct. 17th, whilst Queen’s College, Belfast, will not commence until Oct. 31st. DEATH OF MR. CHARLES CLAY. WE regret to have to record the death of Mr. Charles Clay, L.R.C.S. Edin., L.R.C.P. Lond., who was widely known as "Clay of Manchester." He died on Tuesday last, at Poulton-le-Fylde, near Blackpool. Mr. Clay had reached the advanced age of ninety-one years and he was in the possession of good health for one of his age until the last, when he died suddenly. His name will always be associated with the revival of ovariotomy in this country. He operated for the first time in 1842 and successfully removed a large ovarian tumour. He regarded himself as being the originator of operation by the "large incision," and his claim to be considered the "Father of Ovariotomy" in England seems to be well founded. Like many men of original force of character Mr. Clay’s activities overlapped the requirements of his own profession. He took an active interest in geology and was a well-known numismatist ; he had also written much and ably on professional topics and was a frequent con- tributor to the columns of THE LANCET. We hope to give a more detailed account of his life in an early issue. TRIONAL AND TETRONAL. DRS. RARMINDI AND MARIOFFINI have been making some investigations upon trional and tetronal as hypnotics. 1 Trional is chemically dietbylsulphomethylethylmethane. It is a crystalline powder, fusing at 76° C., is soluble in cold water, but is more soluble in hot water and alcohol; it has a slightly bitter taste. Tetronal is diethylsulphodimethyl- methane ; it crystallises in white flakes and is fusible at 86° C. It is soluble in water at the ordinary temperature, but it is more soluble in hot water and alcohol ; it has a very bitter taste and an odour somewhat like camphor. As regards the clinical action of these bodies the investigators came to the following conclusions. 1. Trional and tetronal are hypnotics with an action similar to that of sulphonal ; they act on the cortex of the brain. 2. One-half or two-thirds of a dose of trional or tetronal respectively produce the same hypnotic effect as a full dose of sulphonal. Both of the drugs were found to be successful after sulphonal had failed, but trional acted better than tetronal. 3 The general action of the ethyl group in producing hypnosis could be easily recognised, but at the same time an increase was noticed in the toxic action of these bodies in the following order: firstly, sulphonal ; secondly, trional ; thirdly, tetronal-in the proportions of 1, 1 and 3 respectively. 4. In small doses neither trional nor 1 La France Médicale, July 21st, 1893. tetronal produced any diaphoresis, nor did they have any effect on the temperature of the patient ; sleep and respira- tion appeared to be normal. 5. As with morphia, a certain tolerance of the drug was soon established, and it was found to be necessary to gradually increase the dose of the drug in order to maintain its hypnotic effects. 6. There was a slight accumulative action, and toxic phenomena occasionally occurred. 7. The secondary symptoms of intoxication were the same as those of sulphonal-namely, prolonged som- nolence, headache, a sensation of tension in the head, and in the early stages incoördination of movement and ataxic debility. These phenomena were especially noticed after the prolonged use of tetronal in rather large doses. They ceased soon after the drug had been discontinued. 8. The ordinary therapeutic dose is from ten to thirty grains. When the use of the hypnotic requires to be prolonged-as, for instance, in the case of the insane-it is better not to employ tetronal, but trional or sulphonal. 9. The quantity of trional for a single dose varies from ten to forty-five grains, according to the age, sex &c. of the patient. If a prompt effect is desired it is advisable to administer the dose suspended in mucilage or milk and to have the mixture warmed. Both trional and tetronal should be given at bedtime, and not some hours before, as is necessary with sulphonal. THE ETIOLOGY OF THE CHOLERA INCIDENCE AT HAMBURG. THE recrudescence of cholera at Hamburg, related as it is to the new water-supply, is a fact of considerable etiological interest. The new filter-beds have been constructed on the island of Kaltehofe and the intake is much higher up the river than formerly. But the old pumping-station is still in use, and the filtered water is conveyed to the station by means of a large main which passes under a branch of the Elbe, at a point where the river is subject to pollution, to the engines, which are situated on the main land. In connexion with the new works some subsidence took place; unfiltered water direct from the river entered the main and was pumped to the Hamburgers, amongst whom isolated cases of cholera, have occurred in all parts of the city. And, further, it has for some time past been known that the Elbe water has con- tained comma bacilli which were indistinguishable from those met with last year. It seems impossible to take water without risk for domestic purposes from a river known to be polluted by sewage, even when all modern contrivances, in- cluding filtration, are put in operation to remove noxious and specific organisms. - THE USE OF PHOTOGRAPHY IN MEDICAL TEACHING. IT is a truism that after actual demonstration there is nothing so essential to reality in description as accurate pictorial illustration. Means may vary, but the fact remains the same. It is one which has been attested by the history of every art and science and in a conspicuous degree by that of medicine and surgery. For many years the skill of the draughtsman was alone employed in the work, and we cannot even now by any other process attain to quite the same exactitude of expression. We have more recently, however, added to this another power in photography, of which we may say that if it lacks the clear precision and the facility in using colour associated with the older method it offers instead other and important advantages. A fair idea of what these are and how best to avail ourselves of them may be gathered from the published reports of a photographic congress recently held at Chicago. 1 Some of the papers read on this occasion were specially devoted to the consideration of photography as an aid to medical teaching and one paper 1 Vide Photography Sept. 7th, 1893.
Transcript of DEATH OF MR. CHARLES CLAY
758
on the first Monday in October. At the Sheffield School of
Medicine Sir James Crichton Browne will inaugurate theopening by an address on the subject of Biology and Ethics,Professor Jebb will address the students at Mason College,Birmingham, and Professor T. Clifford Allbutt will distributethe prizes and deliver the opening lecture at Yorkshire College,Leeds. The University of Durham College of Medicine willcommence its winter session on Oct. 3rd. The Scotchmedical schools and universities will not open until nearlya fortnight later. University College, Dundee, will commenceits session on Oct. l0th, and will be followed by the openingof Aberdeen University on Oct. 16th. St. Mungo’s Collegewill open on Oct. 18th with an introductory address byProfessor Kent; and on the following day Glasgow Univer-sity, Anderson’s College and the Western Medical School,Glasgow, wi!l commence the winter session. ProfessorCharteris will address the students at Glasgow Universityand Professor Thomas King will give the introductoryaddress at Anderson’s College, Glasgow. Amongst theIrish schools, Queen’s College, Cork, will begin its winterterm on Oct. 17th, whilst Queen’s College, Belfast, will notcommence until Oct. 31st.
DEATH OF MR. CHARLES CLAY.
WE regret to have to record the death of Mr. Charles Clay,L.R.C.S. Edin., L.R.C.P. Lond., who was widely knownas "Clay of Manchester." He died on Tuesday last, at
Poulton-le-Fylde, near Blackpool. Mr. Clay had reachedthe advanced age of ninety-one years and he was in thepossession of good health for one of his age until the last,when he died suddenly. His name will always be associatedwith the revival of ovariotomy in this country. He operatedfor the first time in 1842 and successfully removed a largeovarian tumour. He regarded himself as being the originatorof operation by the "large incision," and his claim to beconsidered the "Father of Ovariotomy" in England seemsto be well founded. Like many men of original force of
character Mr. Clay’s activities overlapped the requirements ofhis own profession. He took an active interest in geologyand was a well-known numismatist ; he had also written
much and ably on professional topics and was a frequent con-tributor to the columns of THE LANCET. We hope to give amore detailed account of his life in an early issue.
TRIONAL AND TETRONAL.
DRS. RARMINDI AND MARIOFFINI have been makingsome investigations upon trional and tetronal as hypnotics. 1Trional is chemically dietbylsulphomethylethylmethane. Itis a crystalline powder, fusing at 76° C., is soluble in cold
water, but is more soluble in hot water and alcohol; it hasa slightly bitter taste. Tetronal is diethylsulphodimethyl-methane ; it crystallises in white flakes and is fusible at 86° C.It is soluble in water at the ordinary temperature, but it ismore soluble in hot water and alcohol ; it has a very bittertaste and an odour somewhat like camphor. As regards theclinical action of these bodies the investigators came to thefollowing conclusions. 1. Trional and tetronal are hypnoticswith an action similar to that of sulphonal ; they act on thecortex of the brain. 2. One-half or two-thirds of a dose oftrional or tetronal respectively produce the same hypnoticeffect as a full dose of sulphonal. Both of the drugs werefound to be successful after sulphonal had failed, but trionalacted better than tetronal. 3 The general action of theethyl group in producing hypnosis could be easily recognised,but at the same time an increase was noticed in the toxic
action of these bodies in the following order: firstly, sulphonal ;secondly, trional ; thirdly, tetronal-in the proportions of 1,1 and 3 respectively. 4. In small doses neither trional nor
1 La France Médicale, July 21st, 1893.
tetronal produced any diaphoresis, nor did they have anyeffect on the temperature of the patient ; sleep and respira-tion appeared to be normal. 5. As with morphia, a certaintolerance of the drug was soon established, and it was foundto be necessary to gradually increase the dose of the drug inorder to maintain its hypnotic effects. 6. There was a slightaccumulative action, and toxic phenomena occasionallyoccurred. 7. The secondary symptoms of intoxication werethe same as those of sulphonal-namely, prolonged som-nolence, headache, a sensation of tension in the head, andin the early stages incoördination of movement and ataxic
debility. These phenomena were especially noticed after theprolonged use of tetronal in rather large doses. They ceasedsoon after the drug had been discontinued. 8. The ordinarytherapeutic dose is from ten to thirty grains. When the useof the hypnotic requires to be prolonged-as, for instance, inthe case of the insane-it is better not to employ tetronal, buttrional or sulphonal. 9. The quantity of trional for a singledose varies from ten to forty-five grains, according to theage, sex &c. of the patient. If a prompt effect is desired itis advisable to administer the dose suspended in mucilage ormilk and to have the mixture warmed. Both trional andtetronal should be given at bedtime, and not some hours
before, as is necessary with sulphonal.
THE ETIOLOGY OF THE CHOLERA INCIDENCEAT HAMBURG.
THE recrudescence of cholera at Hamburg, related as it
is to the new water-supply, is a fact of considerable etiologicalinterest. The new filter-beds have been constructed on theisland of Kaltehofe and the intake is much higher up theriver than formerly. But the old pumping-station is still in
use, and the filtered water is conveyed to the station by meansof a large main which passes under a branch of the Elbe, at apoint where the river is subject to pollution, to the engines,which are situated on the main land. In connexion with the
new works some subsidence took place; unfiltered water
direct from the river entered the main and was pumped tothe Hamburgers, amongst whom isolated cases of cholera,have occurred in all parts of the city. And, further, it has
for some time past been known that the Elbe water has con-tained comma bacilli which were indistinguishable from
those met with last year. It seems impossible to take waterwithout risk for domestic purposes from a river known to be
polluted by sewage, even when all modern contrivances, in-cluding filtration, are put in operation to remove noxious andspecific organisms.
-
THE USE OF PHOTOGRAPHY IN MEDICALTEACHING.
IT is a truism that after actual demonstration there is
nothing so essential to reality in description as accurate
pictorial illustration. Means may vary, but the fact remainsthe same. It is one which has been attested by the historyof every art and science and in a conspicuous degree by thatof medicine and surgery. For many years the skill of the
draughtsman was alone employed in the work, and we cannoteven now by any other process attain to quite the sameexactitude of expression. We have more recently, however,added to this another power in photography, of which wemay say that if it lacks the clear precision and the facilityin using colour associated with the older method it offersinstead other and important advantages. A fair idea ofwhat these are and how best to avail ourselves of them
may be gathered from the published reports of a photographiccongress recently held at Chicago. 1 Some of the papers readon this occasion were specially devoted to the considerationof photography as an aid to medical teaching and one paper
1 Vide Photography Sept. 7th, 1893.
