WHAT IS WHISKY? THE APPEAL
1
1846 general paralysis vary enormously, modern authors giving figures ranging from 20 to 90 per cent. Moreover, a point which is frequently lost sight of and the neglect of which detracts much from the value of statements made upon this subject is that syphilis is very rarely present alone but exists usually in combination with other causative agencies the possible influence of which cannot be ignored. As regards the interval between the date of infection with syphilis and the appearance of the earliest symptoms of general paralysis, the opinion expressed was that whilst this might in rare cases be even less than one year it is commonly very much longer, a perioi of about 11 years being frequent, and even the latter may be largely exceeded. In the course of the discussion Dr. Allen Starr made the statement that in about 80 per cent. of a large number of cases of general paralysis which he had analysed physical symptoms appeared before mental symptoms.. Whilst it is known that physical disorders are sometimes the earlier to appear the above pro. portion is o enormous that we are almost compelled to believe that subtle mental changes, as of character, judgment, and aptitude, must in very many instances have been overlooked. The discussion brought out the importance -of making a careful physical examination in cases of so-called neurasthenia, by means of which significant early symptoms of general paralysis, such as facial tremor, alteration of pupillary reactions and of knee-jerks, may be recognised. The difficulty of diagnosing the disease from conditions due to cere- bral syphilis and the importance of carrying out a course of anti-syphilitic treatment in doubtful cases were alluded to. A history of the abuse of alcohol had been obtained by certain observers who took part in the discussion ; of 250 cases this was ascertained in about 25 per cent., a proportion which agrees with that given in recent works-namely, from 20 to 30 per cent. But here again the observation made above re- specting the causative influence of syphilis will apply: alcohol can but rarely be dissociated from other factors in causation. It is nevertheless looked upon by many com- petent observers as a genetic factor only second in import- ance to syphilis. Syphilis and alcoholism, however, prevail to an extent compared to which general paralysis is a rare malady and observation shows that in most cases of the latter disease a combination of causes, psychical and physical, is present. Much labour is clearly necessary before we can adequately appreciate the relative value of these and ascertain whether they act directly or merely by preparing the way for the operation of toxic agencies. WHAT IS WHISKY? THE APPEAL. Mr. rordhams view that spirit produced by the patent still from a mash consisting to a large extent of maize, to which a " dash " of whisky made from barley malt had been added, cannot be considered as either Scotch or Irish whisky must so far stand, inasmuch as the proceedings for appeal concluded at the sessions house, Newington, on Monday last, with the announcement that the bench of magistrates was - equally divided and therefore there could be no judgment. It is possible that the appellants will make application to quarter sessions for a re bearing of the appeal, in which event we should not be justified in making any comment on the aspects of the case. The proceedings are costing a considerable sum of money and it is unfortunate that they should have ended in this fiasco. We cannot help thinking that the trade would be well advised if they ceased to fight the matter out in court and if they would come to an agreement all round to make a clean breast of it and adopt an honest, straight- forward description of their goods. There are firms who do not hesitate to declare accurately the nature of the goods they are selling, whether they are pot-still all-malt or patent-still spirits, or a mixture of both, and surely if such a policy succeeds in one or more cases there can be no reason why it should not succeed in others. If, as many declare it to be the fact, the public prefer light grain spirit or a blend to a pure full all-malt spirit, the fact that the spirit is correctly described on the label, as the case may be, should not disturb this preference in the least degree. The public must be the judge in the question of taste and they would welcome being frankly dealt with. The hatchet might thus be buried and an end put to costly and vexatious proceedings. - THE ROYAL SANITARY INSTITUTE. THE Twenty third Congress of the Royal Sanitary In- stitute will be held from July 9th to 14th at Bristol under the presidency of the Right Hon. Sir Edward Fry. On the first day at noon there will be a reception of members and delegates in the Council House by the Lord Mayor of Bristol, Mr. A. J. Smith, after which a public luncheon will be held in the Royal Hotel. The inaugural address will be delivered in the Victoria Rooms by the President at 8 P.M. The sectional meetings will commence on July 10th, the first, that of "Sanitary Science and Preventive Medi- cine," being presided over by Sir William Collins, M.P.; the second, .. Engineering and Architecture," by Mr. Edwin T. Hall ; and the third, "Physics, Chemistry, and Biology," by Mr. W. N. Shaw, F.R.S. The special conferences include "Municipal Representatives," "Medical Officers of Health," " Sanitary Inspectors," and "Veterinary Inspectors." There will also be conferences of women on " Hygiene " and on "The Hygiene of School Life." The lecture to the Con- gress will be delivered by Professor C. Lloyd Morgan who will take for his subject " Relation of Heredity to Physical Degeneration." Nearly 200 authorities, including several county councils and county boroughs, have already appointed delegates to the Congress. With the object of giving a practical illustration of the application and carry- ing out of the principles and methods discussed at the meeting a health exhibition of apparatus and appliances relating to health and domestic use is beicg organised. OPERATIONS FOR NON-EXISTENT APPENDICITIS. AT a meeting of the Académic de Medecineon May 29th M. Dieulafoy made the statement that many persons suffer- ing from typhlo colitis are operated on for appendicitis which does not exist.’ The importance attaching to any announcement by the eminent French surgeon is increased in this instance by the fact that he is one of the most extreme advocates of the operative treatment of appendicitis, holding that it is the sole efficacious and rational method. "Remove the toxi-infectious appendicular focus before it can become fatal " is his rule. He related 12 cases of which the following are some examples. A man was admitted into the Hôtel Dieu who had undergone operation for " appendi- citis." The surgeon sent with him the appendix which was sound. The patient was suffering from an attack of muco- membranous typhlo-colitis which followed the same course as other attacks which occurred before the operation. In a second case M. Dieulafoy saw in consultation a young man who had suffered for a long time from muco-membranous typhlo- colitis. Finding a scar in the right iliac fossa he said, "You have been operated on for appendicitis." "Yes," replied the patient, " for appendicitis which I had not." In a third case a woman suffering from the same disease gave the same history. She continued to suffer just as before , operation. On examination there was pain in the right iliac Eossa like that of appendicitis. In a fourth case M. Dieulafoy saw in consultation a young woman who had suffered for 1 THE LANCET, June 23rd, 1906, p. 1793
Transcript of WHAT IS WHISKY? THE APPEAL
1846
general paralysis vary enormously, modern authors givingfigures ranging from 20 to 90 per cent. Moreover, a pointwhich is frequently lost sight of and the neglect of whichdetracts much from the value of statements made upon this
subject is that syphilis is very rarely present alone but existsusually in combination with other causative agencies thepossible influence of which cannot be ignored. As regardsthe interval between the date of infection with syphilis andthe appearance of the earliest symptoms of general paralysis,the opinion expressed was that whilst this might in rare
cases be even less than one year it is commonly very muchlonger, a perioi of about 11 years being frequent, and eventhe latter may be largely exceeded. In the course of the
discussion Dr. Allen Starr made the statement that in about
80 per cent. of a large number of cases of general paralysiswhich he had analysed physical symptoms appeared beforemental symptoms.. Whilst it is known that physicaldisorders are sometimes the earlier to appear the above pro.
portion is o enormous that we are almost compelled to
believe that subtle mental changes, as of character,judgment, and aptitude, must in very many instances havebeen overlooked. The discussion brought out the importance-of making a careful physical examination in cases of so-calledneurasthenia, by means of which significant early symptomsof general paralysis, such as facial tremor, alteration of
pupillary reactions and of knee-jerks, may be recognised. Thedifficulty of diagnosing the disease from conditions due to cere-bral syphilis and the importance of carrying out a course ofanti-syphilitic treatment in doubtful cases were alluded to. Ahistory of the abuse of alcohol had been obtained by certainobservers who took part in the discussion ; of 250 cases thiswas ascertained in about 25 per cent., a proportion whichagrees with that given in recent works-namely, from 20 to 30per cent. But here again the observation made above re-specting the causative influence of syphilis will apply:alcohol can but rarely be dissociated from other factors incausation. It is nevertheless looked upon by many com-petent observers as a genetic factor only second in import-ance to syphilis. Syphilis and alcoholism, however, prevailto an extent compared to which general paralysis is a raremalady and observation shows that in most cases of the
latter disease a combination of causes, psychical and
physical, is present. Much labour is clearly necessarybefore we can adequately appreciate the relative value ofthese and ascertain whether they act directly or merely bypreparing the way for the operation of toxic agencies.
WHAT IS WHISKY? THE APPEAL.
Mr. rordhams view that spirit produced by the patentstill from a mash consisting to a large extent of maize, towhich a " dash " of whisky made from barley malt had beenadded, cannot be considered as either Scotch or Irish whiskymust so far stand, inasmuch as the proceedings for appealconcluded at the sessions house, Newington, on Monday last,with the announcement that the bench of magistrates was- equally divided and therefore there could be no judgment.It is possible that the appellants will make applicationto quarter sessions for a re bearing of the appeal, inwhich event we should not be justified in making anycomment on the aspects of the case. The proceedings arecosting a considerable sum of money and it is unfortunatethat they should have ended in this fiasco. We cannot
help thinking that the trade would be well advisedif they ceased to fight the matter out in court and
if they would come to an agreement all round to makea clean breast of it and adopt an honest, straight-forward description of their goods. There are firmswho do not hesitate to declare accurately the nature of thegoods they are selling, whether they are pot-still all-malt orpatent-still spirits, or a mixture of both, and surely if such
a policy succeeds in one or more cases there can be noreason why it should not succeed in others. If, as manydeclare it to be the fact, the public prefer light grain spiritor a blend to a pure full all-malt spirit, the fact that thespirit is correctly described on the label, as the case may be,should not disturb this preference in the least degree. The
public must be the judge in the question of taste and theywould welcome being frankly dealt with. The hatchet
might thus be buried and an end put to costly and vexatiousproceedings. -
THE ROYAL SANITARY INSTITUTE.
THE Twenty third Congress of the Royal Sanitary In-stitute will be held from July 9th to 14th at Bristol underthe presidency of the Right Hon. Sir Edward Fry. On thefirst day at noon there will be a reception of members anddelegates in the Council House by the Lord Mayor of
Bristol, Mr. A. J. Smith, after which a public luncheon willbe held in the Royal Hotel. The inaugural address willbe delivered in the Victoria Rooms by the President at
8 P.M. The sectional meetings will commence on July 10th,the first, that of "Sanitary Science and Preventive Medi-
cine," being presided over by Sir William Collins, M.P.; thesecond, .. Engineering and Architecture," by Mr. Edwin T.Hall ; and the third, "Physics, Chemistry, and Biology," byMr. W. N. Shaw, F.R.S. The special conferences include"Municipal Representatives," "Medical Officers of Health,"" Sanitary Inspectors," and "Veterinary Inspectors." There
will also be conferences of women on " Hygiene " and on"The Hygiene of School Life." The lecture to the Con-
gress will be delivered by Professor C. Lloyd Morgan whowill take for his subject " Relation of Heredity to
Physical Degeneration." Nearly 200 authorities, includingseveral county councils and county boroughs, have alreadyappointed delegates to the Congress. With the object ofgiving a practical illustration of the application and carry-ing out of the principles and methods discussed at the
meeting a health exhibition of apparatus and appliancesrelating to health and domestic use is beicg organised.
OPERATIONS FOR NON-EXISTENTAPPENDICITIS.
AT a meeting of the Académic de Medecineon May 29thM. Dieulafoy made the statement that many persons suffer-ing from typhlo colitis are operated on for appendicitiswhich does not exist.’ The importance attaching to anyannouncement by the eminent French surgeon is increasedin this instance by the fact that he is one of the mostextreme advocates of the operative treatment of appendicitis,holding that it is the sole efficacious and rational method."Remove the toxi-infectious appendicular focus before itcan become fatal " is his rule. He related 12 cases of whichthe following are some examples. A man was admitted intothe Hôtel Dieu who had undergone operation for " appendi-citis." The surgeon sent with him the appendix which wassound. The patient was suffering from an attack of muco-membranous typhlo-colitis which followed the same courseas other attacks which occurred before the operation. In asecond case M. Dieulafoy saw in consultation a young man whohad suffered for a long time from muco-membranous typhlo-colitis. Finding a scar in the right iliac fossa he said,"You have been operated on for appendicitis." "Yes,"replied the patient, " for appendicitis which I had not." Ina third case a woman suffering from the same disease gavethe same history. She continued to suffer just as before ,
operation. On examination there was pain in the right iliacEossa like that of appendicitis. In a fourth case M. Dieulafoysaw in consultation a young woman who had suffered for
1 THE LANCET, June 23rd, 1906, p. 1793
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