LATIN-AMERICAN MEDICAL CONGRESS AT BUENOS AYRES. (FROM OUR SPECIAL CORRESPONDENT.)
2
1382 so many forms of appendicitis showing distinct symptoms. His classification of appendicitis was into acute and sub- acute or chronic with or without perforation. When the cases were operated on early there was no perforation. Dr. KAREWSKI (Berlin) expressed the opinion that in acute cases an operation should be performed at once when medical treatment did not completely relieve the symptoms. Operation in the interval should also not be too long postponed. Professor SONNENBURG (Berlin) insisted on the fact that opinions as to the necessity of an operation have naturally changed because the clinical material itself has changed on account of patients now presenting themselves at an earlier stage of the disease than formerly. The very acute forms of appendicitis with septic symptoms and the early stages of subacute peritonitis were now better known and surgical aid was thus sought at once. Professor Sonnenburg, how- ever, did not advise early operation when the suppuration had no tendency to spread and when the symptoms nearly disappeared after some days. Dr. FEDERMANN (Berlin) reported six cases of ileus following operation for appendicitis. The patients’ tem- perature was normal; the pulse also was normal at first and only became frequent in an advanced stage. The number of leucocytes was normal or even subnormal and only increased when an abscess developed. Herrnia. Professor MADELUNG read a paper on very large herniae which frequently occurred after operations for strangu- lation or after unsuccessful radical operations. These cases were seldom improved by a simple operation ; resection of the prolapsed portion of the intestine and suture were necessary. Professor HELFERICH (Kiel) called attention to the fact that shock might ensue on the reposition of enormous hernise. Dr. KAUSCH (Breslau) expressed the opinion that these hernise ought always to be operated on while the patient’s general state was still satisfactory. Previously to the operation the patient must be confined to bed for several days with his pelvis raised so that the protruding intestines might tend to fall back. Professsor BRAUN (Gottingen) said that these hernise might be considerably reduced in size by elastic compression. Dr. BRODNITZ (Frankfort) said that he had resumed the old method of Schwalbe-namely, the treatment of hernise by injections of alcohol into the sac ; he had treated 73 patients in that way of whom 45 had since been observed for more than six months. He found that of these 45 cases 19 were serious and four had relapses ; ten milder cases and 16 hernias in children were completely cured. Operations on the Bladder. Professor REHN (Frankfort) reported recent observations on growths of the bladder in workmen employed in aniline factories. A report of such cases had been already given by him at the congress last year. He proposed a collective investigation of the matter, the number of his own obser- vations now being 23; five were papillomata, of which two afterwards degenerated into malignant growths; the others were originally sarcoma or cancer. The prognosis was very bad. Dr. SCHWERIN (Hoechst) surgeon to the Hoechster Farb- werke, said that his attempts to produce such growths in animals by adding aniline to their food had failed ; in the human subject the development of these tumours was very slow. Dr. STRAUSS (Frankfort) said that he had once operated on a large benign fibroma of the bladder with a small peduncle ; besides that fibroma there was a small indurated growth which was ascertained to be a cancer. Professor KRASKE (Freiburg) mentioned some rare cases I, of vesical growths-namely, a myoma which was cured by I partial excision, and an ulcerated gumma cured by anti- syphilitic treatment. Dr. PAGENSTECHER (Wiesbaden) spoke on malformations of the bladder such as the bladder of hour-glass shape; the double bladder, each loculus containing one ureter and associated as a rule with other deformities ; and diverticula of the bladder, cases of which last abnormality he had had under his own care. Intraspinal Injcetions of Cocaine. Dr. KLAPP read a paper on experiments made on . animals for the purpose of preventing the ripid absorp- - tion of the fluid in intraspinal injections of cocaine. He 3 found the action of adrenalin to be very unsatisfactory, whilst mucilaginous, oleaginous, and gelatinous solutions or i emulsions were better. i At the general meeting of the German Surgical Associa- . tion Professor KR6NLIllN of Zurich was elected president of the next congress. LATIN-AMERICAN MEDICAL CONGRESS AT BUENOS AYRES. (FROM OUR SPECIAL CORRESPONDENT.) [OUR Special Correspondent sent us photographs of the exhibition building at Buenos Ayres, of the building of the Faculty of Medicine, and of the San Roque and Isolation Hospitals, which were published with a preliminary note in our issue of April 23rd, p. 1155. ] IMPORTANT DEBATE ON YELLOW FEVER. The Second International (Latin-American) Medical Congress was opened at Buenos Ayres with great éclat by President Roca in person. The maugural ceremony took place in the Opera House, a handsome building, which was packed on the occasion, some 2000 people being present, On the stage, which was carpeted and artistically decorated with flowers and evergreens, were the President of the Republic, the Ministers of Public Instruction and Foreign Affairs, the members of the organising committee, the press, and the foreign delegates, numbering over 40, from the different South American republics and also from Mexico and Cuba. After the usual formalities had been gone through the foreign delegates in turn spoke for their respective Govern. ments and each vied with the other in eulogy of the country, the great and beautiful city, and the energy displayed by the organising committee-a display of oratory well worth listening to. As is usual in Latin countries all were in full evening dress and white tie although the meeting was at 3 o’clock in the afternoon. In the evening at 9 o’clock of the same day the Exhibition of Hygiene, which is being held in connexion with the Congress, was officially inaugurated and promises to be not the least interesting part of the Congress. The installations of the exhibition not being all completed it is not yet possible to give an exact and full description, but I may say that the display made by the Army Service Corps (8anidad Militar) is most complete and very interesting and I doubt if in any European capital this department would be better represented. Many of the things are made by Lef6vre of Paris, notably a cart filter with a capacity of 600 litres. At the back of the cart is the filtering apparatus (asbestos and charcoal) and a long inch hose conveys the water from any well or lake or puddle by means of a pneumatic pump to the filter from which the water issues perfectly clear and is conveyed by another smaller hose to the tank which occupies the rest of the cart which is drawn by two horses. I was much struck by the ease and rapidity with which the water was obtained and filtered. A fine portable camp oven for baking bread made in sections like a collapsable boat also drew my attention. Novelties in the shape of saddles for cargo mules, stretchers, and portable sterilisers for surgical instruments also call for notice. Some very creditable work was also apparent in aseptic furniture for hospital operating theatres and consulting rooms and there were some very fair specimens of surgical instruments all manufactured in Buenos Ayres. With one or two excep- tions British manufacturers are conspicuous by their absence with regard to sanitary fittings, furniture, surgical instru- ments, and the like, but Messrs. Allen and Hanbarys have a good show of infant foods and pharmaceutical prepara- tions ; Messrs. Brand and Co. and the Sanitas Co. are also represented but not fully. The place simply teems with French and German pharmaceutical specialities, especially French, while the show of mineral waters is a good one, "Taunus," "Kristalz," and "Birresbora" being all well represented. Turning to the Medical Congress itself the most important paper read as yet (the Congress is still proceeding) is one on the International Prophylaxis of Yellow Fever, by Dr. J. B. Lacerda and Dr. Azevedo Sodr6 of Rio Janeiro, Brazil, and the following are their conclusions: 1. Yellow
Transcript of LATIN-AMERICAN MEDICAL CONGRESS AT BUENOS AYRES. (FROM OUR SPECIAL CORRESPONDENT.)
1382
so many forms of appendicitis showing distinct symptoms.His classification of appendicitis was into acute and sub-acute or chronic with or without perforation. When thecases were operated on early there was no perforation.
Dr. KAREWSKI (Berlin) expressed the opinion that inacute cases an operation should be performed at once whenmedical treatment did not completely relieve the symptoms.Operation in the interval should also not be too longpostponed.
Professor SONNENBURG (Berlin) insisted on the fact thatopinions as to the necessity of an operation have naturallychanged because the clinical material itself has changed onaccount of patients now presenting themselves at an earlierstage of the disease than formerly. The very acute formsof appendicitis with septic symptoms and the early stagesof subacute peritonitis were now better known and surgicalaid was thus sought at once. Professor Sonnenburg, how-ever, did not advise early operation when the suppurationhad no tendency to spread and when the symptoms nearlydisappeared after some days.
Dr. FEDERMANN (Berlin) reported six cases of ileusfollowing operation for appendicitis. The patients’ tem-perature was normal; the pulse also was normal at first andonly became frequent in an advanced stage. The number ofleucocytes was normal or even subnormal and only increasedwhen an abscess developed.
Herrnia.Professor MADELUNG read a paper on very large herniae
which frequently occurred after operations for strangu-lation or after unsuccessful radical operations. Thesecases were seldom improved by a simple operation ; resectionof the prolapsed portion of the intestine and suture werenecessary.
Professor HELFERICH (Kiel) called attention to the factthat shock might ensue on the reposition of enormous
hernise.Dr. KAUSCH (Breslau) expressed the opinion that these
hernise ought always to be operated on while the patient’sgeneral state was still satisfactory. Previously to theoperation the patient must be confined to bed for severaldays with his pelvis raised so that the protruding intestinesmight tend to fall back.
Professsor BRAUN (Gottingen) said that these hernise mightbe considerably reduced in size by elastic compression.
Dr. BRODNITZ (Frankfort) said that he had resumed theold method of Schwalbe-namely, the treatment of herniseby injections of alcohol into the sac ; he had treated 73
patients in that way of whom 45 had since been observedfor more than six months. He found that of these 45 cases19 were serious and four had relapses ; ten milder cases and16 hernias in children were completely cured.
Operations on the Bladder.Professor REHN (Frankfort) reported recent observations
on growths of the bladder in workmen employed in anilinefactories. A report of such cases had been already givenby him at the congress last year. He proposed a collectiveinvestigation of the matter, the number of his own obser-vations now being 23; five were papillomata, of whichtwo afterwards degenerated into malignant growths; theothers were originally sarcoma or cancer. The prognosiswas very bad.
Dr. SCHWERIN (Hoechst) surgeon to the Hoechster Farb-werke, said that his attempts to produce such growthsin animals by adding aniline to their food had failed ; inthe human subject the development of these tumours wasvery slow.
Dr. STRAUSS (Frankfort) said that he had once operatedon a large benign fibroma of the bladder with a smallpeduncle ; besides that fibroma there was a small induratedgrowth which was ascertained to be a cancer.
Professor KRASKE (Freiburg) mentioned some rare cases I,of vesical growths-namely, a myoma which was cured by Ipartial excision, and an ulcerated gumma cured by anti-syphilitic treatment.
Dr. PAGENSTECHER (Wiesbaden) spoke on malformationsof the bladder such as the bladder of hour-glass shape; thedouble bladder, each loculus containing one ureter andassociated as a rule with other deformities ; and diverticulaof the bladder, cases of which last abnormality he had hadunder his own care.
Intraspinal Injcetions of Cocaine.Dr. KLAPP read a paper on experiments made on
. animals for the purpose of preventing the ripid absorp-- tion of the fluid in intraspinal injections of cocaine. He3 found the action of adrenalin to be very unsatisfactory,
whilst mucilaginous, oleaginous, and gelatinous solutions ori emulsions were better.i At the general meeting of the German Surgical Associa-. tion Professor KR6NLIllN of Zurich was elected president of the next congress.
LATIN-AMERICAN MEDICAL CONGRESSAT BUENOS AYRES.
(FROM OUR SPECIAL CORRESPONDENT.)
[OUR Special Correspondent sent us photographs of theexhibition building at Buenos Ayres, of the building of theFaculty of Medicine, and of the San Roque and IsolationHospitals, which were published with a preliminary note inour issue of April 23rd, p. 1155. ]
IMPORTANT DEBATE ON YELLOW FEVER.
The Second International (Latin-American) MedicalCongress was opened at Buenos Ayres with great éclat byPresident Roca in person. The maugural ceremony tookplace in the Opera House, a handsome building, which waspacked on the occasion, some 2000 people being present,On the stage, which was carpeted and artistically decoratedwith flowers and evergreens, were the President of theRepublic, the Ministers of Public Instruction and ForeignAffairs, the members of the organising committee, the press,and the foreign delegates, numbering over 40, from thedifferent South American republics and also from Mexico andCuba. After the usual formalities had been gone through theforeign delegates in turn spoke for their respective Govern.ments and each vied with the other in eulogy of thecountry, the great and beautiful city, and the energydisplayed by the organising committee-a display of oratorywell worth listening to. As is usual in Latin countries allwere in full evening dress and white tie although themeeting was at 3 o’clock in the afternoon.
In the evening at 9 o’clock of the same day the Exhibitionof Hygiene, which is being held in connexion with the
Congress, was officially inaugurated and promises to be notthe least interesting part of the Congress. The installationsof the exhibition not being all completed it is not yetpossible to give an exact and full description, but I may saythat the display made by the Army Service Corps (8anidadMilitar) is most complete and very interesting and I doubtif in any European capital this department would be betterrepresented. Many of the things are made by Lef6vre ofParis, notably a cart filter with a capacity of 600 litres. Atthe back of the cart is the filtering apparatus (asbestos andcharcoal) and a long inch hose conveys the water from anywell or lake or puddle by means of a pneumatic pump tothe filter from which the water issues perfectly clear andis conveyed by another smaller hose to the tank whichoccupies the rest of the cart which is drawn by twohorses. I was much struck by the ease and rapidity withwhich the water was obtained and filtered. A fine portablecamp oven for baking bread made in sections like a
collapsable boat also drew my attention. Novelties in theshape of saddles for cargo mules, stretchers, and portablesterilisers for surgical instruments also call for notice. Somevery creditable work was also apparent in aseptic furniturefor hospital operating theatres and consulting rooms andthere were some very fair specimens of surgical instrumentsall manufactured in Buenos Ayres. With one or two excep-tions British manufacturers are conspicuous by their absencewith regard to sanitary fittings, furniture, surgical instru-ments, and the like, but Messrs. Allen and Hanbarys havea good show of infant foods and pharmaceutical prepara-tions ; Messrs. Brand and Co. and the Sanitas Co. are alsorepresented but not fully. The place simply teems withFrench and German pharmaceutical specialities, especiallyFrench, while the show of mineral waters is a good one,"Taunus," "Kristalz," and "Birresbora" being all wellrepresented.Turning to the Medical Congress itself the most important
paper read as yet (the Congress is still proceeding) is oneon the International Prophylaxis of Yellow Fever, by Dr.J. B. Lacerda and Dr. Azevedo Sodr6 of Rio Janeiro,Brazil, and the following are their conclusions: 1. Yellow
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fever is transmitted by means of the mosquito stegomyiafasciata which infects by the blood sucked from a yellowfever patient during the first three days of the disease. 2.The prophylaxis of yellow fever should tend to protectpatients against the bites of mosquitoes and prevent thelatter when infected from biting healthy persons. 3. All theold prophylactic measures such as quarantine, disinfections,cordons sanitaires, obligatory isolations, &c., should beabolished as illusory, inefficacious, and prejudicial.These conclusions are also supported by Dr. William Dolz y
Arango of Cuba, and Dr. Sodr6 proved that, working on theabove lines, they are in a position to state that yellow feverhad almost disappeared from Rio Janeiro. So much enthu-siasm was provoked by these assertions that the Congressthere and then resolved to send congratulatory telegramsto Dr. Octavio Cruz, chief of the sanitary service of Rio,and to Dr. Agramante and Dr. Carrol of the United Statesfor their work in connexion with yellow fever. The contraryside was taken by Dr. Penna, chief of the isolation hospitalsin Buenos Ayres, who sustained the following propositions :1. The remits of the studies of Dr. Sanarelli on the etiologyand pathogeny of yellow fever have not suffered the slightestmodification and may be considered at the present time asperfectly established. 2. These investigations have beenconfirmed in France, Italy, Brazil, and in the Argentine.3. The conclusions arrived at by the United States militarycommittee that the mosquito stegomyia fasciata, serves asintermediate host between the yellow fever patient and thehealthy individual have not been demonstrated and lacksufficient proof. 4. The counter proof of specific prophylaxismade in Cuba and San Paulo (Brazil) by destruction of thespecific mosquito is not conclusive (insufficient). 5. TheHavana committee has not proved that the disease trans-mitted experimentally by the mosquito is really yellow feverand the same applies to the French committee. 6. Theprophylaxis of yellow fever should be conducted on theold system of disinfection and isolation. 7. Internationalprophylaxis of yellow fever should suppress all measurestending to interrupt free commercial and individual traffic.8. If it be true that the transmission of yellow feveris made by a mosquito of a certain species and thatthe statistics of the results obtained by artificial trans-mission of yellow fever are also true, then the meansadopted for prophylaxis should not be 11 death to themosquito" but preservation of these providential beingsdestined to act in the necessary cases as "immunisers" "
exactly as we preserve and utilise vaccination.The last conclusion is of considerable interest and many
speeches were made for and against, but no vote was takenas the subject possibly may be discussed afresh. Some goodwork was done in other sections but I must postpone themention of these for a later date.duenna Avres.
LIVERPOOL.
(FROM OUR OWN CORRESPONDENT.)
LiverpooZ Cancer Research.Dr. A. S. F. Gfflnbaum, the director of the Liverpool
cancer research, has issued his report of the first year’swork of investigation for the discovery, if possible, of thecauses and cure of cancer. The plan of work adopted was(a) therapeutical and (b) experimental. The cytolytic milkof a cow and subsequently, when it yielded no more
milk, its serum were tried. It was expected that it wouldhave effect only on cancer of the breast but it was triedalso on two cases of cancer of the stomach and one
of the rectum. In one case of cancer of the stomachthe milk was taken constantly until death ; the other twopatients did not continue to send for it so that their sub-sequent history is not known. Of two cases of cancerof the breast in one the disease is apparently arrested ;the other, in which the disease was too far advanced, died.Three cases of uterine cancer are being treated with the serumfrom a horse ; they all show objective signs of improvement.It is, of course, obvious that while surgical interference isconsidered the most hopeful treatment any new methodtried only on cases beyond surgical skill will be severelyhandicapped. Of the value of the x rays as a curativeagent in certain cases there can be no doubt but at thepresent moment the clinical and pathological characteristics
L of such cases are not defined and require minute investiga-tion. Experimental work has been directed towards thecauses of cancer. Until these are known very little can bedone towards its cure and practically nothing towards itsprevention. If once a strain of human cancer can beexperimentally secured and continued the goal will beappreciably nearer. In carrying on the work the develop-mental and the parasitic hypotheses have consequentlybeen kept in view. The recent additional evidenceobtained by the London observers towards the germinaltheory raises the hope that a comparatively simple physio-logical cure may be possible when it is remembered by whatsimple means experimental embryologists are able to alterthe development of germinal cells. The occurrence ofmalignant disease in animals also carne under investigation.A number of tumours from the human body were received inresponse to appeals made by Dr. Gtunbaum to his pro-fessional brethren for specimens : about 57 per cent. camefrom the Liverpool Royal Infirmary, 16 per cent. from theLondon Hospital, 1 per cent. from the Royal SouthernHospital, and 26 per cent. from outside sources. Severaltumours, mostly malignant, from animals have been receivedand examined; they include specimens from the horse, thecow, the sheep, the dog, the pig, the cat, the mouse, and thetrout. The report practically includes only nine month’swork to Feb. lst, 1904, as the rooms in the laboratory ofexperimental medicine at the University of Liverpool werenot ready until April, 1903.
The Roentgen Rays Department at the Royal SouthernHospital.
Through the liberality of Mr. John W. Hughes the x-rayroom at the Royal Southern Hospital has been enlarged andfully equipped with the most up-to-date scientific apparatus.A few days since the new room was formally opened byMrs. Hughes, the wife of the donor, in the presence of thehonorary medical staff and several members of the generalcommittee. Immediately afterwards Mr. C. Thurstan Holland,the honorary medical officer of the x-ray department, gave ademonstration on radium to an appreciative audience.
Health of Liverpool.The death-rate for the past week was 22 - 3 per 1000. Three
cases of small-pox were reported during the past week. Thereare 320 cases of scarlet fever in the corporation hospitals.
Death (If Aldcrman John Lawrenoe, J.P. ,
By the death of Alderman John Lawrence the medical pro-fession of Liverpool has lost a warm friend. He was a man ofgreat abilities for business and public a:f!a.irs and was especiallyinterested in hospital administration. He was a prominent
, member of the committee of the Royal Infirmary since the
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year 1881; he was also a member of the council of theUniversity of Liverpool as a civic representative. During therebuilding of the Royal Infirmary his advice on legal matters,especially in reference to the purchase and the acquisition ofneighbouring property, was invaluable. He also took agreat interest in the subject of the renewal of the leaseof the Medical Institution buildings, which has nearlyrun out and which is now a soarce of much anxiety tothe trustees of the institution. At a general meeting ofthe society two months ago, at which he was specially invited
. to be present, he strongly expressed the opinion that as thel objects of the institution were for the cultivation of medicine,surgery, and the collateral branches of science, thus tending
’ to benefit society in general, a nominal fine ought to meet
’ the circumstances of the case. His help was looked forward. to when the matter would again come before the estate com-’ mittee of the city council but it was decreed otherwise. He’
was a man of wide culture and possessed a charm of manner. which made him a general favourite. His death occurred’ in pathetic circumstances, the intelligence of which came
as a great shock to his numerous medical friends and others.’ He left Liverpool on March 31st, not specially ailing but in
. the hope that a trip to the Mediterranean would be of benefit
.
after having somewhat overworked. He visited Constanti-, nople, Smyrna, and Athens but, unfortunately, when nearing
Gibraltar developed pneumonia, to which he succumbed intwo days. He passed away on Sunday, A[ril 24th, and wasburied at sea on the following day. Mr. Lawrence, who was
’
a solicitor, was brother-in. law of Mr. T. Pickering Pick,consulting surgeon to St. George’s Hospital, London, andinspector of anatomy for England and Wales.
: Liverpool Baths and Waslahouses : opening of a New Bath.! The new public bath in Lister Drive was formally orened
