THE COUNTY SANITARY DISTRICT OF ESSEX.
1
823 nation which he served that they had no honours where- with to reward him. England will not always treat her best ,, sons so, and she will not always so easily forgive statesmen I and other men of influence who are responsible for such I neglect. Even now some repentance should be shown and some effort made to offer reparation to his family and his profession, and to perpetuate the memory of an Irishman who displayed the very highest human and medical qualities. Meantime we recall with delight the tributes which have been psid to him by his medical brethren, and we record with fresh emphasis and pride the eulogy of his leader, ’’ the chronometer was not so faithful to Greenwich time as our doctor to his duties. " ____ ’, THE COUNTY SANITARY DISTRICT OF ESSEX. THE return of cases of infectious disease which were notified during August in the several urban and rural sanitary districts of this county is a very complete one, and Dr. Thresh is to be congratulated on having procured such a large number of returns. We notice, however, one im- portant omission-i. e., that of Southend urban sanitary district. The omission is probably due to some oversight, but it is to be regretted, inasmuch as during last year this district apparently suffered from an extensive pre- valence of scarlet fever, diphtheria and typhoid fever. We notice in the table of notifications that a consider- able number of cases had been imported from other dis- tricts-for instance, of ten cases of diphtheria notified in Chelmsford urban sanitary district three were apparently imported. Again, three cases of scarlet fever were notified at Clacton, but all were imported cases. It does not seem to be quite clear from the return whether the diseases were actually manifesting themselves at the time the patients arrived in the district, or whether the period which inter- vened between their arrival and the appearance of the sym- ptoms was too short to render it probable that the diseases were contracted in the district in which they were notified. A footnote given to indicate the meaning of the word imported might be of use. We notice a heavy incidence of diphtheria in Barking urban sanitary district and of typhoid fever in Rochford rural sanitary district. DIPHTHERITIC HEMIPLEGIA. Ix a recent number of the Neurologisches Centralblatt Dr. Donath of Budapest has published a case of diphtheritic hemiplegia. The patient was a boy eight years old, a peasant’s son with healthy parents, who suffered from an attack of diphtheria which lasted fourteen days. On the third day of his convalescence, when he was beginning to get about, he was seized in the night-time with an attack of hemiplegia affecting the whole of the right side of the body, including the face, and also giving rise to loss of speech. During fourteen days this loss was complete ; he could not, according to his mother’s account, utter a word but made himself understood by gestures. He was able to understand all that was said to him. The paralysis so far as it affected the face began to pass off in three weeks and the aphasia to improve in four weeks. When he began to speak he could only do so in a whisper, but there was no difficulty in swallowing. Two months later, when Dr. Donath first saw him, there was no further improvement evident in speech, face or limbs. There was a well-marked weakness of the right side of the body affect- ing the face, arm and leg; the speech was strong, but rather stammering and indistinct. There was some contracture in the right arm and the corresponding leg was dragged in walking. There was slight general wasting of the affected limbs, but the electrical reactions were normal and there was no impairment of sensibility. The myotatic irritability in the affected limbs was much increased. Under observation there was slight improvement. In his comments on the case Dr. Donath directs attention to the rarity of hemiplegic diph- theritic paralysis, and in support of this quotes Dr. Gowers to the effect that "the weakness of the extremities in this disease is gradual in its onset, seldom or never absolute, and as a rule symmetrical, whilst distinct hemiplegic weakness is never observed." We venture to think that the case here re- corded is no exception to this rule. Of course, it all depends on what constitutes diphtheritic paralysis, strictly so called. There is no doubt that Dr. Gowers has not stated that hemiplegia following diphtheria never occurs, and what he evidently means in the statement quoted is that diphtheritic paralysis, the paralysis produced by the action of the diph- theritic poison, or some product of it, on the nervous system, never affects one half of the body. The occurrence of a hemiplegia which is evidently the result of a cerebral lesion, whether thrombotic, embolic or hoemorrhagic, after diph- theria is evidently quite compatible with this statement, as it is a condition essentially different, and we think it is mis- leading that any such case should be described or regarded as an instance of post-diphtheritic paralysis. SOCIAL RESIDENCE IN EDINBURGH UNIVERSITY. MAN is naturally a social being, or, in the words of exact if not very deferential philosophy, a gregarious animal. Civilised man, under the influence of wealth, rank, common sympathies and numerous other factors, has tended to leave the general . herd and aggregate in coteries by a process of natural selec- tion. The extreme development of this separative faculty is the conclusion to which the Edinburgh student appears to have come-namely, that it is best for man to live alone. Those, however, who have his welfare at heart do not seem to share that opinion, of which an isolated existence is the outcome, but seem to think that the mode of residence is answerable for the opinion, not the opinion for the mode of residence. There has accordingly been a movement on foot for some years to establish the system of common residence, and we are informed that during the present year about forty students have taken advantage of the opportunities thus offered for living together in the different houses of ’’ University-hall.’’ The laudable objects of the promoters are said to be the fostering of the solidarity, sociability and esprit de corps of the Edinburgh students. We earnestly desire that they may have every success in their undertaking. Students thus resident appear to be a self-governing body and have no "lock and key" restrictions. The conditions of Scottish university life are not those which obtain at the wealthier universities in England, where the residential system has been so long established, but resemble rather those of Continental uni- versity life. The esprit de corps and sociability of the German student are too well known to be dwelt upon at greater length. These qualities are embodied in the various "corps" " of the Fatherland, and admission to the latter is regulated by various social, personal and territorial con- siderations. The students are not in common residence. We e cannot help thinking that useful lessons for the Scottish student are to be learned from a study of the methods of their German confrères. There are now altogether five houses in Edinburgh University- hall," and in one of these the students are under wardenship. APPLIED BACTERIOLOGY. WE have from time to time drawn the attention of our readers to the importance of an early bacteriological exami- nation of tuberculous sputa, diphtheritic membrane and choleraic and other dejecta in order that any evidence of specific infective disease may be obtained and preventive measures may be taken as soon as possible. This is fully appreciated abroad, where arrangements are made, especially in the larger cities, for placing at the disposal of the medical officers of health and others interested the services
Transcript of THE COUNTY SANITARY DISTRICT OF ESSEX.
823
nation which he served that they had no honours where-with to reward him. England will not always treat her best ,,
sons so, and she will not always so easily forgive statesmen Iand other men of influence who are responsible for such Ineglect. Even now some repentance should be shown andsome effort made to offer reparation to his family and hisprofession, and to perpetuate the memory of an Irishmanwho displayed the very highest human and medical qualities.Meantime we recall with delight the tributes which have beenpsid to him by his medical brethren, and we record withfresh emphasis and pride the eulogy of his leader, ’’ thechronometer was not so faithful to Greenwich time as ourdoctor to his duties. "
____ ’,
THE COUNTY SANITARY DISTRICT OF ESSEX.
THE return of cases of infectious disease which were
notified during August in the several urban and rural sanitarydistricts of this county is a very complete one, and Dr.
Thresh is to be congratulated on having procured such alarge number of returns. We notice, however, one im-
portant omission-i. e., that of Southend urban sanitarydistrict. The omission is probably due to some oversight,but it is to be regretted, inasmuch as during last yearthis district apparently suffered from an extensive pre-valence of scarlet fever, diphtheria and typhoid fever.We notice in the table of notifications that a consider-able number of cases had been imported from other dis-tricts-for instance, of ten cases of diphtheria notified inChelmsford urban sanitary district three were apparentlyimported. Again, three cases of scarlet fever were notifiedat Clacton, but all were imported cases. It does not seemto be quite clear from the return whether the diseases wereactually manifesting themselves at the time the patientsarrived in the district, or whether the period which inter-vened between their arrival and the appearance of the sym-ptoms was too short to render it probable that the diseaseswere contracted in the district in which they were notified.A footnote given to indicate the meaning of the word
imported might be of use. We notice a heavy incidenceof diphtheria in Barking urban sanitary district and of
typhoid fever in Rochford rural sanitary district.
DIPHTHERITIC HEMIPLEGIA.
Ix a recent number of the Neurologisches CentralblattDr. Donath of Budapest has published a case of diphtheritichemiplegia. The patient was a boy eight years old, a peasant’sson with healthy parents, who suffered from an attack ofdiphtheria which lasted fourteen days. On the third day ofhis convalescence, when he was beginning to get about, hewas seized in the night-time with an attack of hemiplegiaaffecting the whole of the right side of the body, includingthe face, and also giving rise to loss of speech. Duringfourteen days this loss was complete ; he could not, accordingto his mother’s account, utter a word but made himselfunderstood by gestures. He was able to understand all thatwas said to him. The paralysis so far as it affected the facebegan to pass off in three weeks and the aphasia to improvein four weeks. When he began to speak he could only do soin a whisper, but there was no difficulty in swallowing. Twomonths later, when Dr. Donath first saw him, there was nofurther improvement evident in speech, face or limbs. There
was a well-marked weakness of the right side of the body affect-ing the face, arm and leg; the speech was strong, but ratherstammering and indistinct. There was some contracture in
the right arm and the corresponding leg was dragged inwalking. There was slight general wasting of the affectedlimbs, but the electrical reactions were normal and there wasno impairment of sensibility. The myotatic irritability in theaffected limbs was much increased. Under observation therewas slight improvement. In his comments on the case
Dr. Donath directs attention to the rarity of hemiplegic diph-theritic paralysis, and in support of this quotes Dr. Gowers tothe effect that "the weakness of the extremities in thisdisease is gradual in its onset, seldom or never absolute, andas a rule symmetrical, whilst distinct hemiplegic weakness isnever observed." We venture to think that the case here re-corded is no exception to this rule. Of course, it all depends onwhat constitutes diphtheritic paralysis, strictly so called.
There is no doubt that Dr. Gowers has not stated that
hemiplegia following diphtheria never occurs, and what heevidently means in the statement quoted is that diphtheriticparalysis, the paralysis produced by the action of the diph-theritic poison, or some product of it, on the nervous system,never affects one half of the body. The occurrence of a
hemiplegia which is evidently the result of a cerebral lesion,whether thrombotic, embolic or hoemorrhagic, after diph-theria is evidently quite compatible with this statement, as itis a condition essentially different, and we think it is mis-
leading that any such case should be described or regardedas an instance of post-diphtheritic paralysis.
SOCIAL RESIDENCE IN EDINBURGH UNIVERSITY.
MAN is naturally a social being, or, in the words of exact ifnot very deferential philosophy, a gregarious animal. Civilised
man, under the influence of wealth, rank, common sympathiesand numerous other factors, has tended to leave the general .
herd and aggregate in coteries by a process of natural selec-tion. The extreme development of this separative faculty isthe conclusion to which the Edinburgh student appears tohave come-namely, that it is best for man to live alone.
Those, however, who have his welfare at heart do not seemto share that opinion, of which an isolated existence is theoutcome, but seem to think that the mode of residence is
answerable for the opinion, not the opinion for the mode ofresidence. There has accordingly been a movement on footfor some years to establish the system of common residence,and we are informed that during the present year about fortystudents have taken advantage of the opportunities thus offeredfor living together in the different houses of ’’ University-hall.’’The laudable objects of the promoters are said to be thefostering of the solidarity, sociability and esprit de corps ofthe Edinburgh students. We earnestly desire that they mayhave every success in their undertaking. Students thus residentappear to be a self-governing body and have no "lock andkey" restrictions. The conditions of Scottish university lifeare not those which obtain at the wealthier universities in
England, where the residential system has been so longestablished, but resemble rather those of Continental uni-versity life. The esprit de corps and sociability of theGerman student are too well known to be dwelt upon at
greater length. These qualities are embodied in the various"corps" " of the Fatherland, and admission to the latter isregulated by various social, personal and territorial con-
siderations. The students are not in common residence. We ecannot help thinking that useful lessons for the Scottishstudent are to be learned from a study of the methods oftheir German confrères. There are now altogether five
houses in Edinburgh University- hall," and in one of thesethe students are under wardenship.
APPLIED BACTERIOLOGY.
WE have from time to time drawn the attention of our
readers to the importance of an early bacteriological exami-nation of tuberculous sputa, diphtheritic membrane and
choleraic and other dejecta in order that any evidence ofspecific infective disease may be obtained and preventivemeasures may be taken as soon as possible. This is fullyappreciated abroad, where arrangements are made, especiallyin the larger cities, for placing at the disposal of themedical officers of health and others interested the services
