THE POINTS OF CONTACT IN ELECTRIC SHOCK.

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170 MEDICAL DIARY.—APPOINTMENTS.—BIRTHS. MARRIAGES, AND DEATHR. THE POINTS OF CONTACT IN ELECTRIC SHOCK. IN a paper published in 1927,1 R. W. I. Urquhart adduced evidence that when an electric current passed through the brain a block was produced in the respiratory centre ; if the heart were not severely ’damaged, artificial respiration should save the patient by giving the respiratory centre time to ’recover. Survival has been recorded even after eight hours’ artificial respiration. 2 In a later com- munication3 Urquhart, with E. C. Noble, showed that -a similar block might be produced in the lower part of the spinal cord of a decerebrate cat, and even in peripheral nerves, by an alternating current. Last year 0. R. Langworthy and W. B. Kouwenhoven demonstrated that severe electrical currents, when passed through the brain, might cause permanent injury to the cells of the respiratory centres. They now describe experiments on the respiratory damage ’caused by currents which do not flow directly through ’the brain. They used rats, in which the heart is especially resistant to damage by electricity. The results indicate that a current passing through the cervical part of the spinal cord, or through the chest, may cause a suspension of respiration through a tem- porary block in the vagus nerves ; a current passing through the hinder part of the body is much less likely to produce this effect. The authors propose to undertake a histological examination’of the central nervous system of all the rats in this series in order to see whether cell change has taken place where the current has not passed through the brain. Of course with the shocks used—1000 volts for two seconds- much damage may be caused by heat alone. The continuous current caused more severe burning, and seemed to cause more cell damage. When passed between the two forelegs both kinds of current killed ;all the rats and caused much burning and destruction; when the current was passed from a foreleg to a hind leg 41 per cent. survived the alternating current, .but all needed artificial respiration; when from a foreleg to the tail only 67 per cent. needed artificial respiration with the alternating and 54 per cent. with the continuous current, and when between - the two hind legs none of the rats shocked with alternating current stopped breathing, though 29 per cent. of those shocked with the continuous current required artificial respiration. It must be remembered, as Langworthy and "Kouwenhoven point out, that respiratory block is - not the only cause of death-perhaps not even the chief cause-from electric shock in man. In many - cases, particularly of shock from low voltages, the cause is believed to be ventricular fibrillation. They quote the experiments of D. R. Hooker,6 who suc- ceeded in arresting ventricular fibrillation with injections of potassium chloride solution. 1 Jour. Indust. Hyg., 1927, ix., 140. 2 Ibid., 1930, xii., 291. 3 Ibid., 1929, xi., 154. 4 Ibid., 1930, xii., 31 ; see THE LANCET, 1930, i., 1218. 5 Jour. Indust. Hyg., 1931, xiii., 145. 6 Amer. Jour. Physiol., 1929-30, xci., 305. TRELOAR CRIPPLES’ HOSPITAL, ALTON.—The - National Sunday League has presented to this hospital a ward in the new Connaught block in memory of the late Mr. Henry Mills. A ward has also been presented by the Chine Helpers of Southampton. A NEW CLINIC FOR RHEUMATISM.—The London ’General Omnibus Company’s Employees’ Friendly Society ihas set up a clinic for the treatment of rheumatism, (together with dental surgeries, at 61, South Side, ,Clapham Common, S.W. The house has been adopted and equipped at a cost of over 7000, and the clinic,which ’was opened by the Minister of Health on July 3rd, is being administered in close association with Manor House Hospital, Golders Green, under the direction of Sir Ambrose Woodall, the senior surgeon. Medical Diary Injormafdon to be included in this column should reach us tn proper form on Tuesday, and cannot appear if it reaches us later than the first post on Wednesday morning. LECTURES, ADDRESSES, DEMONSTRATIONS, &:C. FELLOWSHIP OF MEDICINE AND POST-GRADUATE MEDICAL ASSOCIATION, 1, Wimpole-street, W. MONDAY, July 20th, to SATURDAY, July 25th.—MILLER GENERAL HOSPITAL, Greenwich-road, S.E. Intensive Course in general medicine and surgery. Two weeks, daily 10.30 A.M., to 5.30 P.M., demonstrations, lectures, operations. For either week.—Further particulars from the Fellowship of Medicine. WEST LONDON HOSPITAL POST-GRADUATE COLLEGE, Hammersmith, W. MONDAY, July 20th.-10 A.M., Gynrecological Ward Visit. Genito-Urinary Operations, Skin Department. 11 A.M., Surgical Ward Visit. 2 P.M., Surgical Ward Visit, Medical, Surgical, Eye, Gynaecological Out-patients. TUESDAY.—9.30 A.M., Operations. 10 A.M., Medical Ward Visit, Dental Department. 11 A.M., Throat Operations. 11.30 A.M., Surgical Clinical Demonstrations. 2 P.M., Medical. Surgical, Throat, Out-patients, Operations, Medical Ward Visit. WEDNESDAY.—10 A.M., Medical Ward Visit. Children’s Medical Out-patients. 2 P.M., Medical, Surgical, and Eye Out-patients. Gynaecological Operations, 4.45 P.M., Venereal Diseases. THURSDAY.—10 A.M., Neurological Department. 11:30 A.M., Treatment of Fractures. 2 P.M., Medical, Surgical, and Eye Out-patients. Genito-Urinary Department. Operations. FRIDAY.-10 A.M., Medical Ward Visit, Skin and Dental Departments. 12 noon, Medical Lecture. 2 P.M., Medical, Surgical, and Throat Out-patients. Opera. tions. SATURDAY.-9 A.M., Throat Operations. 10 A.M., Medical Ward Visit, Surgical and Children’s Medical Out, patients. CHARING CROSS HOSPITAL MEDICAL SCHOOL POST- GRADUATE COURSE. SUNDAY, July 19th.—10.45 A.M., Mr. H. E. Batten: Various Forms of Club Foot. 11.45 A,;’I1., Mr. J. Bright Bannister : Some Common Disorders of the Menopause. ST. MARK’S HOSPITAL, City-road, E.C. THURSDAY, July 23rd.-4.30 P.M., Mr. E. T. C. Milligan: The Injection Treatment of Piles. UNIVERSITY OF BIRMINGHAM. TUESDAY, July 21st.—3.30 P.M. (at the General Hospital), Dr. H. Featherstone : Basal Anesthesia. FRIDAY (at the Children’s Hospital).-3.30 P.M., Dr. B. C. Tate : Eczema in Infants and Children. Appointments BAIRD, D. I., M.B., Ch.B. Edin., D.P.H., has been appointed Asst. Medical Officer of Health, Blackburn. BLISS, T. P., M.B., Ch.B. Edin., Certifying Surgeon under the Factory and Workshop Acts for Mauchline, Ayr. LEARMONTH, A. G., M.B., Ch.B. Edin., Asst. Medical Officer, Stirling. Births, Marriages, and Deaths BIRTHS. ATKIN.—On July 7th, the wife of Dr. C. S. Atkin, The Glen, Sheffield, of a daughter. GIBBERD.—On July 7th, at Welbeok-street, W., the wife of G. F. Gibberd, M.S., F.R.C.S., of a son. SMITH.—On July 6th, at Cullingworth, Broadstairs, the wife of R. Wylie Smith, M.B., B.Chir., of a daughter. WORSELDINE.—On July 10th, at Stonefleld, Blackheath, the wife of Stanley C. H. Worseldine. Captain I.M.S., of a son. MARRIAGES. FAULKNER—WARDE.—On July 9th, at Plymouth, Odin T. Faulkner, C.M.G., Director of Agriculture, Nigeria, to Mildred Warde, M.S., F.R.C.S. WALKER—DIPLOCK.—On July llth, at the Parish Church, Croydon, Geoffrey Seeker Walker, M.A., M.B., B.Ch. Oxf., Reading-road, Farnborough, Hants, to Joan, only daughter of Mrs. Diplock, of Barclay-road, Croydon, and of the late Mr. Hubert Diplock. DEATHS. ANDERSON.—On July 2nd, at a Manchester nursing home, George Reinhardt Anderson, M.B.E., J.P., F.R.C.S., of 45, Westbourne-road, Birkdale, Southport, aged 67. CROSS.—On July 12th, at Worcester House, Clifton, Bristol, Francis Richardson Cross, F.R.C.S., J.P., LL.D., following an attack of influenza, aged 83. N.B.—A fee of 7s. 6d. is charged for the insertion of Notices of Births. Marriages and Deaths.

Transcript of THE POINTS OF CONTACT IN ELECTRIC SHOCK.

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170 MEDICAL DIARY.—APPOINTMENTS.—BIRTHS. MARRIAGES, AND DEATHR.

THE POINTS OF CONTACT IN ELECTRICSHOCK.

IN a paper published in 1927,1 R. W. I. Urquhartadduced evidence that when an electric currentpassed through the brain a block was produced in therespiratory centre ; if the heart were not severely’damaged, artificial respiration should save thepatient by giving the respiratory centre time to’recover. Survival has been recorded even aftereight hours’ artificial respiration. 2 In a later com-munication3 Urquhart, with E. C. Noble, showed that-a similar block might be produced in the lower partof the spinal cord of a decerebrate cat, and even inperipheral nerves, by an alternating current. Lastyear 0. R. Langworthy and W. B. Kouwenhovendemonstrated that severe electrical currents, whenpassed through the brain, might cause permanentinjury to the cells of the respiratory centres. Theynow describe experiments on the respiratory damage’caused by currents which do not flow directly through’the brain.

They used rats, in which the heart is especiallyresistant to damage by electricity. The resultsindicate that a current passing through the cervicalpart of the spinal cord, or through the chest, maycause a suspension of respiration through a tem-porary block in the vagus nerves ; a current passingthrough the hinder part of the body is much lesslikely to produce this effect. The authors proposeto undertake a histological examination’of the centralnervous system of all the rats in this series in order tosee whether cell change has taken place where thecurrent has not passed through the brain. Of coursewith the shocks used—1000 volts for two seconds-much damage may be caused by heat alone. Thecontinuous current caused more severe burning, andseemed to cause more cell damage. When passedbetween the two forelegs both kinds of current killed;all the rats and caused much burning and destruction;when the current was passed from a foreleg to a hindleg 41 per cent. survived the alternating current,.but all needed artificial respiration; when froma foreleg to the tail only 67 per cent. needed artificialrespiration with the alternating and 54 per cent.with the continuous current, and when between- the two hind legs none of the rats shocked withalternating current stopped breathing, though 29 percent. of those shocked with the continuous currentrequired artificial respiration.

It must be remembered, as Langworthy and"Kouwenhoven point out, that respiratory block is- not the only cause of death-perhaps not even thechief cause-from electric shock in man. In many- cases, particularly of shock from low voltages, thecause is believed to be ventricular fibrillation. Theyquote the experiments of D. R. Hooker,6 who suc-ceeded in arresting ventricular fibrillation withinjections of potassium chloride solution.

1 Jour. Indust. Hyg., 1927, ix., 140.2 Ibid., 1930, xii., 291.3 Ibid., 1929, xi., 154.

4 Ibid., 1930, xii., 31 ; see THE LANCET, 1930, i., 1218.5 Jour. Indust. Hyg., 1931, xiii., 145.

6 Amer. Jour. Physiol., 1929-30, xci., 305.

TRELOAR CRIPPLES’ HOSPITAL, ALTON.—The- National Sunday League has presented to this hospitala ward in the new Connaught block in memory of thelate Mr. Henry Mills. A ward has also been presentedby the Chine Helpers of Southampton.A NEW CLINIC FOR RHEUMATISM.—The London

’General Omnibus Company’s Employees’ Friendly Societyihas set up a clinic for the treatment of rheumatism,(together with dental surgeries, at 61, South Side,,Clapham Common, S.W. The house has been adoptedand equipped at a cost of over 7000, and the clinic,which’was opened by the Minister of Health on July 3rd, is beingadministered in close association with Manor House Hospital,Golders Green, under the direction of Sir Ambrose Woodall,the senior surgeon.

Medical DiaryInjormafdon to be included in this column should reach us

tn proper form on Tuesday, and cannot appear if it reachesus later than the first post on Wednesday morning.

LECTURES, ADDRESSES, DEMONSTRATIONS, &:C.FELLOWSHIP OF MEDICINE AND POST-GRADUATEMEDICAL ASSOCIATION, 1, Wimpole-street, W. ’

MONDAY, July 20th, to SATURDAY, July 25th.—MILLERGENERAL HOSPITAL, Greenwich-road, S.E. IntensiveCourse in general medicine and surgery. Two weeks,daily 10.30 A.M., to 5.30 P.M., demonstrations, lectures,operations. For either week.—Further particularsfrom the Fellowship of Medicine.

WEST LONDON HOSPITAL POST-GRADUATE COLLEGE,Hammersmith, W.MONDAY, July 20th.-10 A.M., Gynrecological Ward Visit.

Genito-Urinary Operations, Skin Department. 11 A.M.,Surgical Ward Visit. 2 P.M., Surgical Ward Visit,Medical, Surgical, Eye, Gynaecological Out-patients.

TUESDAY.—9.30 A.M., Operations. 10 A.M., Medical WardVisit, Dental Department. 11 A.M., Throat Operations.11.30 A.M., Surgical Clinical Demonstrations. 2 P.M.,Medical. Surgical, Throat, Out-patients, Operations,Medical Ward Visit.

WEDNESDAY.—10 A.M., Medical Ward Visit. Children’sMedical Out-patients. 2 P.M., Medical, Surgical,and Eye Out-patients. Gynaecological Operations,4.45 P.M., Venereal Diseases.

THURSDAY.—10 A.M., Neurological Department. 11:30 A.M.,Treatment of Fractures. 2 P.M., Medical, Surgical,and Eye Out-patients. Genito-Urinary Department.Operations.

FRIDAY.-10 A.M., Medical Ward Visit, Skin and DentalDepartments. 12 noon, Medical Lecture. 2 P.M.,Medical, Surgical, and Throat Out-patients. Opera.tions.

SATURDAY.-9 A.M., Throat Operations. 10 A.M., MedicalWard Visit, Surgical and Children’s Medical Out,patients.

CHARING CROSS HOSPITAL MEDICAL SCHOOL POST-GRADUATE COURSE.SUNDAY, July 19th.—10.45 A.M., Mr. H. E. Batten:

Various Forms of Club Foot. 11.45 A,;’I1., Mr. J. BrightBannister : Some Common Disorders of the Menopause.

ST. MARK’S HOSPITAL, City-road, E.C.THURSDAY, July 23rd.-4.30 P.M., Mr. E. T. C. Milligan:

The Injection Treatment of Piles.UNIVERSITY OF BIRMINGHAM.

TUESDAY, July 21st.—3.30 P.M. (at the General Hospital),Dr. H. Featherstone : Basal Anesthesia.

FRIDAY (at the Children’s Hospital).-3.30 P.M., Dr. B. C.Tate : Eczema in Infants and Children.

AppointmentsBAIRD, D. I., M.B., Ch.B. Edin., D.P.H., has been appointed

Asst. Medical Officer of Health, Blackburn.BLISS, T. P., M.B., Ch.B. Edin., Certifying Surgeon under the

Factory and Workshop Acts for Mauchline, Ayr.LEARMONTH, A. G., M.B., Ch.B. Edin., Asst. Medical Officer,

Stirling.

Births, Marriages, and DeathsBIRTHS.

ATKIN.—On July 7th, the wife of Dr. C. S. Atkin, The Glen,Sheffield, of a daughter.

GIBBERD.—On July 7th, at Welbeok-street, W., the wife of G. F.Gibberd, M.S., F.R.C.S., of a son.

SMITH.—On July 6th, at Cullingworth, Broadstairs, the wife ofR. Wylie Smith, M.B., B.Chir., of a daughter.

WORSELDINE.—On July 10th, at Stonefleld, Blackheath, the wifeof Stanley C. H. Worseldine. Captain I.M.S., of a son.

MARRIAGES.FAULKNER—WARDE.—On July 9th, at Plymouth, Odin T.

Faulkner, C.M.G., Director of Agriculture, Nigeria, toMildred Warde, M.S., F.R.C.S.

WALKER—DIPLOCK.—On July llth, at the Parish Church,Croydon, Geoffrey Seeker Walker, M.A., M.B., B.Ch. Oxf.,Reading-road, Farnborough, Hants, to Joan, only daughterof Mrs. Diplock, of Barclay-road, Croydon, and of the lateMr. Hubert Diplock.

DEATHS.ANDERSON.—On July 2nd, at a Manchester nursing home,

George Reinhardt Anderson, M.B.E., J.P., F.R.C.S., of45, Westbourne-road, Birkdale, Southport, aged 67.

CROSS.—On July 12th, at Worcester House, Clifton, Bristol,Francis Richardson Cross, F.R.C.S., J.P., LL.D., followingan attack of influenza, aged 83.

N.B.—A fee of 7s. 6d. is charged for the insertion of Notices ofBirths. Marriages and Deaths.