TRAUMATIC ADDISON'S DISEASE
1
26 enabled the whole nutritive problem of the country to be studied as never before by the best scientific brains, and this surely is the most cogent argument of all for the existence and maintenance of food control. It will enable the nation to retain the services of their scientific food advisers. How necessary this is the latest report of the Food (War) Committee of the Royal Society, to which we have already alluded, is sufficient evidence. This con- cludes with the pregnant words: " The above report shows how very inadequate is our present knowledge of the science of nutrition, and demon- strates the necessity of renewed investigations on almost every point discussed in it." Sir Auckland Geddes recently remarked that the universities, through the professors of the various faculties, had contributed more fully to victory than any other organised section of the community, and he begged men of science in future not to remain dumb at critical periods, but to come forward to help the country. It would be hard to devise a more efficient medium for the vocal help sought than such a Royal Society’s committee. Professor E. H. Starling’s recent Oliver-Sharpey Lectures on the Feeding of Nations : a Study in Applied Physiology, were a luminous exposition of the results which may be thus obtained. Even the most cursory study of these lectures should convince our legislators that the scientific method will and must pay. Let them only compare the debit and credit sides of the food balance-sheet. The continuation in being of an expert advisory committee at the Food Ministry will serve to build up a body of sound data from which the needs of the community may be accu- rately computed. Nor is this the only department outside the Ministry of Health that needs such .expert advice. The fixing of a minimum wage is ardently desired. On what basis should this be founded, the cost of living, the aesthetic conditions of labour, the amenities of life, or the actual energy expended ? Here is another problem which applied physiology should help to solve. DEPOPULATION. AN aspect of the reconstruction problem which is gravely exercising statesmen is that of the main- tenance of a sufficient population to carry out any projects of reform which may be deemed necessary. Perhaps, in course of time, the National Birth-rate Commission may have some helpful recommenda- tions to offer, and meanwhile those who wish to learn how the matter presents itself to a Frenchman may care to read a work entitled " La Natalite," written by Professor Gaston Rageot,l in which he discusses the economic and psychologic laws which have determined modern views as to the place of the child in the social scheme. It is his desire, he says, " to dissipate some of the illusions which envelope the problem of natality," the principal being the belief that it is a simple one which may be solved by particular measures such as the award of premiums or the grant of allowances. His statement of the position is philosophical, and he displays none of the special weakness to which debaters of- this subject are prone-an inability to realise that the demolition of an opponent’s argument by means of a triumphant reductio ad absurdum does not, of itself, show that one’s own case is any better. A low birth-rate is, he finds, associated historically with extremes of civilisation which are themselves incompatible with the existence of the family. It is natural, he 1 Paris; Ernest Flammarion. says, for human parents not to concern themselves about their children. " Ce n’est pas la nature qui protege 1’enfant, mais la societe." And society is for each of us only an abstraction which becomes concrete and living when it stands for" " la patrie en danger." To the French mode of devolution of property, which has been held to discourage the production of large families, he attaches little importance, if only for the reason that in England freedom of testamentary capacity has not prevented a fall in the birth-rate; its effects, too, have varied -it stimulated natality under the Revolution and depresses it to-day. Summing up the various factors which he has dealt with at length he concludes that " la fausse démocratie produit le depeuplement," but he is not without hope of better things. ____ TRAUMATIC ADDISON’S DISEASE. THE subject of traumatic Addison’s disease is discussed by Dürck,1 who reports the following case. A hitherto healthy man, aged 48, was caught between a railway carriage and a revolving plat- form and had four ribs fractured. Apparent recovery took place, and he was able to resume his work in about six weeks, but a week later he had to give up owing to weakness in the arms and legs and palpitation. Bronzing of the skin of the face’ ‘ and hands gradually set in and the muscular weak- ness increased. Treatment consisted in the adminis- tration of suprarenal preparations, and death did not take place until about eight years after the acci- dent. The autopsy showed considerable bronzing of the skin of the face, hands, forearms, and external genitals, and apparently complete absence of both suprarenals with a healed fracture of the sixth to the ninth ribs on the right side. On microscopical examination some necrotic fragments representing the remains of the medulla of the left suprarenal were found, while on the right side there was hardly any trace of the suprarenal, but remains of blood pigment indicated that a haemorrhage had formerly taken place in this situation a long time previously. Tuberculosis could be excluded, and there was no evidence of syphilis. A CHILD-BEARING STRIKE. THE insertion at the front of the most recent number of the M1mieh Medical Journal, which has reached us, of a polemic against a threatened child- bearing strike in Bavaria is something of a portent. The author, Fritz Burgdorfer, a doctor of public economy holding office in Munich, begins by calling. attention to the active propaganda at present being carried on in that city, directed towards a pre. vention of conception and an encouragement of intentional abortion, leading up to a demand for what amounts to a strike of child-bearers. This " communistic " programme, Dr. Burgdorfer tells us, assumes that the population of Germany is at present too large by 30 millions, and that since under present conditions the usual outlets in the form of exported goods or emigra- tion are impracticable, the cry should be ’’ No more children!" " since even a wise peasant does not breed more cattle than he can feed. Largely attended public gatherings in Munich have, we learn, been instructed in the systematic use of conception-preventing apparatus, the instru- ments themselves being shown and their applica- tion described. Dr. Burgdorfer’s reply to all this is 1 Aerztl. Sachverständ.-Ztg., 1919, xxv., 73-81.
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Transcript of TRAUMATIC ADDISON'S DISEASE
26
enabled the whole nutritive problem of the countryto be studied as never before by the best scientificbrains, and this surely is the most cogent argumentof all for the existence and maintenance of foodcontrol. It will enable the nation to retain theservices of their scientific food advisers. How
necessary this is the latest report of the Food (War)Committee of the Royal Society, to which we havealready alluded, is sufficient evidence. This con-cludes with the pregnant words: " The abovereport shows how very inadequate is our presentknowledge of the science of nutrition, and demon-strates the necessity of renewed investigations onalmost every point discussed in it." Sir AucklandGeddes recently remarked that the universities,through the professors of the various faculties, hadcontributed more fully to victory than any otherorganised section of the community, and he beggedmen of science in future not to remain dumb atcritical periods, but to come forward to help thecountry. It would be hard to devise a more
efficient medium for the vocal help sought thansuch a Royal Society’s committee. Professor E. H.Starling’s recent Oliver-Sharpey Lectures on theFeeding of Nations : a Study in Applied Physiology,were a luminous exposition of the results whichmay be thus obtained. Even the most cursory studyof these lectures should convince our legislatorsthat the scientific method will and must pay. Letthem only compare the debit and credit sides of thefood balance-sheet. The continuation in being ofan expert advisory committee at the Food Ministrywill serve to build up a body of sound data fromwhich the needs of the community may be accu-rately computed. Nor is this the only departmentoutside the Ministry of Health that needs such.expert advice. The fixing of a minimum wage is
ardently desired. On what basis should this befounded, the cost of living, the aesthetic conditionsof labour, the amenities of life, or the actual energyexpended ? Here is another problem which appliedphysiology should help to solve.
DEPOPULATION.
AN aspect of the reconstruction problem whichis gravely exercising statesmen is that of the main-tenance of a sufficient population to carry out anyprojects of reform which may be deemed necessary.Perhaps, in course of time, the National Birth-rateCommission may have some helpful recommenda-tions to offer, and meanwhile those who wish tolearn how the matter presents itself to a Frenchmanmay care to read a work entitled " La Natalite,"written by Professor Gaston Rageot,l in which hediscusses the economic and psychologic laws whichhave determined modern views as to the place ofthe child in the social scheme. It is his desire, hesays, " to dissipate some of the illusions whichenvelope the problem of natality," the principalbeing the belief that it is a simple one which maybe solved by particular measures such as the awardof premiums or the grant of allowances. Hisstatement of the position is philosophical, and hedisplays none of the special weakness to whichdebaters of- this subject are prone-an inabilityto realise that the demolition of an opponent’sargument by means of a triumphant reductioad absurdum does not, of itself, show thatone’s own case is any better. A low birth-rateis, he finds, associated historically with extremes ofcivilisation which are themselves incompatiblewith the existence of the family. It is natural, he
1 Paris; Ernest Flammarion.
says, for human parents not to concern themselvesabout their children. " Ce n’est pas la nature quiprotege 1’enfant, mais la societe." And society isfor each of us only an abstraction which becomesconcrete and living when it stands for" " la patrieen danger." To the French mode of devolution ofproperty, which has been held to discourage theproduction of large families, he attaches littleimportance, if only for the reason that in Englandfreedom of testamentary capacity has not preventeda fall in the birth-rate; its effects, too, have varied-it stimulated natality under the Revolution anddepresses it to-day. Summing up the variousfactors which he has dealt with at length heconcludes that " la fausse démocratie produit ledepeuplement," but he is not without hope ofbetter things.
____
TRAUMATIC ADDISON’S DISEASE.
THE subject of traumatic Addison’s disease isdiscussed by Dürck,1 who reports the followingcase. A hitherto healthy man, aged 48, was caughtbetween a railway carriage and a revolving plat-form and had four ribs fractured. Apparentrecovery took place, and he was able to resumehis work in about six weeks, but a week later hehad to give up owing to weakness in the arms andlegs and palpitation. Bronzing of the skin of the face’ ‘and hands gradually set in and the muscular weak-ness increased. Treatment consisted in the adminis-tration of suprarenal preparations, and death didnot take place until about eight years after the acci-dent. The autopsy showed considerable bronzingof the skin of the face, hands, forearms, and externalgenitals, and apparently complete absence of bothsuprarenals with a healed fracture of the sixth tothe ninth ribs on the right side. On microscopicalexamination some necrotic fragments representingthe remains of the medulla of the left suprarenalwere found, while on the right side there was hardlyany trace of the suprarenal, but remains ofblood pigment indicated that a haemorrhage hadformerly taken place in this situation a long timepreviously. Tuberculosis could be excluded, andthere was no evidence of syphilis.
A CHILD-BEARING STRIKE.
THE insertion at the front of the most recentnumber of the M1mieh Medical Journal, which hasreached us, of a polemic against a threatened child-bearing strike in Bavaria is something of a portent.The author, Fritz Burgdorfer, a doctor of publiceconomy holding office in Munich, begins by calling.attention to the active propaganda at present beingcarried on in that city, directed towards a pre.vention of conception and an encouragement ofintentional abortion, leading up to a demandfor what amounts to a strike of child-bearers.This
" communistic " programme, Dr. Burgdorfer
tells us, assumes that the population of Germanyis at present too large by 30 millions, andthat since under present conditions the usualoutlets in the form of exported goods or emigra-tion are impracticable, the cry should be ’’ Nomore children!" " since even a wise peasantdoes not breed more cattle than he can feed.Largely attended public gatherings in Munichhave, we learn, been instructed in the systematicuse of conception-preventing apparatus, the instru-ments themselves being shown and their applica-tion described. Dr. Burgdorfer’s reply to all this is
1 Aerztl. Sachverständ.-Ztg., 1919, xxv., 73-81.
