2
832 REVIEWS.-NEW INVENTIONS. 2. The Comparative Variability of Bones and Muscles, with Remarks on Unity of Type in Variations of the Origin and Insertion of Certain Muscles in Species unconnected by Unity of Descent, by G. E. Dobson, F.R.S. 3. Congenital Malformation of the Trachea of a Horse, by F. Smith. 4. Nature of Ligaments, by J. B. Sntton, and Plate 3. 5. Osteology of Numenius Longirostris, with Notes upon the Skeleton of other American Limicolso, by R. W. Schofeldt, and Plates 4 and 5. 6. The Anatomy of Ac. quired Flat-foot, by J. Symington, and Plate 6. 7. New Method of cutting Sections for Microscopical Examination, by James W. Barrett, M,B. 8. New Method of demon- strating Scheiner’s Experiment, by James Barrett. 9. Ab- normal Disposition of the Colon, by R. Bruce Young. 10. Delineation of Skulls by Composite Photography, by Arthur Thomson, and Plate 7. 11. Repair of Wounds and Fractures in Aged Persons, by Professor Humphry. 12. Case of Abnormal Development of the Coronary Arteries of the Heart, by F. Charlewood Turner, M.D. 13. Abnormal Ureters, by W. Stephenson Richmond. Essay on the Experienses and Opinions of John Howard on the Preservation and Improvement of the Health of the Inmates of Schools, Prisons, Workhouses, Hospitals, and other Public Institutions, as far as Health is affected by Structural Arrangements relating to Supplies of Air, Water, Drainage, &c. ByR. D. R. SWEETING. Pp. 96. London : Baillière and Co. 1884.-This essay, which gained the Howard Medal of the Statistical Society and a prize of i20, contains, in a condensed form, the reports made by Howard on the sanitary condition of the various public institutions which he visited, at home and abroad, with his recommenda- tions respecting their construction and management. It shows clearly how far ahead he was of the times in which he lived, and to what an extent he anticipated, in his recom- mendations, the measures which are now held by the best authorities to be essential to the preservation of public health. It brings him before us as a philosopher, a philan- thropist, a social reformer, a statistician of no mean order, and an able, clear-headed sanitary pioneer. New Inventions. APPARATUS FOR REMOVING FALSE MEMBRANE FROM THE TRACHEA. THE sad death and self-sacrifice of Dr. Rabbeth was clearly owing to the absence, at hand, of some emcient mechanical appliance for extracting the diphtheritic mem- brane from the trachea. It is now nearly nine years since I first made use of the aspirator for removing from the trachea inflammatory products threatening to cause suffocation, but finding the utility of the aspirator greatly interfered with, owing to the air being drawn into the trachea by the side of the suction tube, and thus destroying the vacuum, I devised the apparatus figured in the accompanying woodcut. It consists of a hollow piece of vulcanite, about an inch long, passed through the centre of a piece of wash-leather, or what is better, a thin piece of Dr. Scott Alison’s impermeable lambskin, about six inches square, which is then tied to a groove (a) about a quarter of an inch wide, situated at one end of the piece of vulcanite. The hole through the piece of vulcanite is made a little smaller than the suction tube of the pneumatic aspirator which it surrounds, so that, although the vulcanite can be easily moved along the tubing when the latter is diminished in circumference by stretching, it nevertheless grasps the tubing, when not extended, suffici- ently to prevent slipping. Without the piece of vulcanite the wash-leather could not be tied sufficiently tightly to the suction tube to prevent air passing between them and yet allow the position of the wash-leather, as regards its distance from the end of the suction tube, to be readily changed. To apply the apparatus, wet the wash-leather, and as soon as the suction tube has been inserted into the tracheotomy tube or trachea, as the case may be, spread out the wash. leather over the neck of the patient, to prevent all entrance of air except through the mouth, and then turn the tap of the aspirator. By preventing air from entering the tracheo- tomy tube from without, the full power of the aspirator is available for extracting whatever substance may be in the trachea ; but the suction power must of course be regulated as circumstances require. Although the diphtheritic mem. brane is rarely carried into the exhausted bottle, it is drawn sufficiently far into the suction tube to allow of its being pulled out of the trachea when the suction tube is with- drawn. I keep in my tracheotomy case a piece of india. rubber tubing already passed through the vulcanite with wash-leather attached, so that the wetting of the leather and slipping one end of the tubing over the suction nozzle of the aspirator, which is all that has to be done to make it ready for use, is the work of only a few moments. In the absence of an aspirator, a large syringe might be used to create the suction power. As all rubber goods when not in constant use are liable to perish quickly, the tubing should be seen to several times a year. Dr. Scott Alison’s impermeable lambskin consists of wash-leather covered on one side with a thin layer of indiarubber. It is sold by Messrs Ewen 109 Jermyn-street, W, -, Mansfield street , W. T. MARK HOVELL. ACADEMY OF MEDICINE IN IRELAND. THE second annual meeting took place at the Royal College of Surgeons in Ireland last week, presided over by the President of the College. The office-bearers for the ensuing year were elected, but few changes taking place in the various sections. The Council had recommended a pre- sentation of £100 to Mr. Thomson for his services as general secretary, but that gentleman very properly refused to accept it. The proposal last year caused a considerable amount of opposition, and it would have been in better taste if the Council had not sent a recommendation of the kind for the sanction of the Fellows. A resolution of Mr. Swanzv’s was adopted, to the effect that it be referred to the General Council, with recommendation that the Academy should endeavour to encourage original research by grants or other- wise, and to report on the subject. The proposal that in future the election of Fellows should he made at general meetings of the Academy, and that all Fellows should the right of voting, was lost by four voter. TIlE POLLUTION OF THE LEA.-At a well-attended public meeting held at Hackney on the 28th ult., a resolu- tion declaring that nothing was feasible to secure the pudty of the Lea short of an intercepting sewer to carry the sewage of Tottenham, Walthamstow, Leyton, and West Ham, after treatment, to the Thames at Barking, and that the Home Secretary be memorialised on the subject, was carried.

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Page 1: ACADEMY OF MEDICINE IN IRELAND

832 REVIEWS.-NEW INVENTIONS.

2. The Comparative Variability of Bones and Muscles, withRemarks on Unity of Type in Variations of the Origin andInsertion of Certain Muscles in Species unconnected byUnity of Descent, by G. E. Dobson, F.R.S. 3. CongenitalMalformation of the Trachea of a Horse, by F. Smith.4. Nature of Ligaments, by J. B. Sntton, and Plate 3.5. Osteology of Numenius Longirostris, with Notes uponthe Skeleton of other American Limicolso, by R. W.Schofeldt, and Plates 4 and 5. 6. The Anatomy of Ac.quired Flat-foot, by J. Symington, and Plate 6. 7. NewMethod of cutting Sections for Microscopical Examination,by James W. Barrett, M,B. 8. New Method of demon-

strating Scheiner’s Experiment, by James Barrett. 9. Ab-normal Disposition of the Colon, by R. Bruce Young.10. Delineation of Skulls by Composite Photography, byArthur Thomson, and Plate 7. 11. Repair of Wounds andFractures in Aged Persons, by Professor Humphry. 12. Caseof Abnormal Development of the Coronary Arteries of theHeart, by F. Charlewood Turner, M.D. 13. Abnormal

Ureters, by W. Stephenson Richmond.Essay on the Experienses and Opinions of John Howard

on the Preservation and Improvement of the Health of theInmates of Schools, Prisons, Workhouses, Hospitals, andother Public Institutions, as far as Health is affected byStructural Arrangements relating to Supplies of Air, Water,Drainage, &c. ByR. D. R. SWEETING. Pp. 96. London :Baillière and Co. 1884.-This essay, which gained theHoward Medal of the Statistical Society and a prize of i20,contains, in a condensed form, the reports made by Howardon the sanitary condition of the various public institutionswhich he visited, at home and abroad, with his recommenda-tions respecting their construction and management.It shows clearly how far ahead he was of the times in whichhe lived, and to what an extent he anticipated, in his recom-mendations, the measures which are now held by the bestauthorities to be essential to the preservation of publichealth. It brings him before us as a philosopher, a philan-thropist, a social reformer, a statistician of no mean order,and an able, clear-headed sanitary pioneer.

New Inventions.APPARATUS FOR REMOVING FALSE MEMBRANE

FROM THE TRACHEA.

THE sad death and self-sacrifice of Dr. Rabbeth wasclearly owing to the absence, at hand, of some emcientmechanical appliance for extracting the diphtheritic mem-brane from the trachea. It is now nearly nine years since Ifirst made use of the aspirator for removing from the tracheainflammatory products threatening to cause suffocation, butfinding the utility of the aspirator greatly interfered with,owing to the air being drawn into the trachea by the side ofthe suction tube, and thus destroying the vacuum, I devisedthe apparatus figured in the accompanying woodcut. Itconsists of a hollow piece of vulcanite, about an inch long,passed through the centre of a piece of wash-leather, orwhat is better, a thin piece of Dr. Scott Alison’s impermeablelambskin, about six inches square, which is then tied to agroove (a) about a quarter of an inch wide, situated at oneend of the piece of vulcanite. The hole through the pieceof vulcanite is made a little smaller than the suction tubeof the pneumatic aspirator which it surrounds, so that,although the vulcanite can be easily moved along the tubingwhen the latter is diminished in circumference by stretching,it nevertheless grasps the tubing, when not extended, suffici-ently to prevent slipping. Without the piece of vulcanitethe wash-leather could not be tied sufficiently tightly to thesuction tube to prevent air passing between them and yetallow the position of the wash-leather, as regards its distancefrom the end of the suction tube, to be readily changed. Toapply the apparatus, wet the wash-leather, and as soon as

the suction tube has been inserted into the tracheotomytube or trachea, as the case may be, spread out the wash.leather over the neck of the patient, to prevent all entranceof air except through the mouth, and then turn the tap ofthe aspirator. By preventing air from entering the tracheo-tomy tube from without, the full power of the aspirator isavailable for extracting whatever substance may be in thetrachea ; but the suction power must of course be regulatedas circumstances require. Although the diphtheritic mem.brane is rarely carried into the exhausted bottle, it is drawnsufficiently far into the suction tube to allow of its beingpulled out of the trachea when the suction tube is with-drawn. I keep in my tracheotomy case a piece of india.

rubber tubing already passed through the vulcanite withwash-leather attached, so that the wetting of the leatherand slipping one end of the tubing over the suction nozzle ofthe aspirator, which is all that has to be done to make itready for use, is the work of only a few moments. In theabsence of an aspirator, a large syringe might be used tocreate the suction power. As all rubber goods when not inconstant use are liable to perish quickly, the tubing shouldbe seen to several times a year. Dr. Scott Alison’simpermeable lambskin consists of wash-leather covered onone side with a thin layer of indiarubber. It is sold byMessrs Ewen 109 Jermyn-street, W,

-, Mansfield street , W. T. MARK HOVELL.

ACADEMY OF MEDICINE IN IRELAND.

THE second annual meeting took place at the RoyalCollege of Surgeons in Ireland last week, presided over bythe President of the College. The office-bearers for the

ensuing year were elected, but few changes taking place inthe various sections. The Council had recommended a pre-sentation of £100 to Mr. Thomson for his services as generalsecretary, but that gentleman very properly refused to acceptit. The proposal last year caused a considerable amount ofopposition, and it would have been in better taste if theCouncil had not sent a recommendation of the kind for thesanction of the Fellows. A resolution of Mr. Swanzv’s wasadopted, to the effect that it be referred to the GeneralCouncil, with recommendation that the Academy shouldendeavour to encourage original research by grants or other-wise, and to report on the subject. The proposal that infuture the election of Fellows should he made at generalmeetings of the Academy, and that all Fellows shouldthe right of voting, was lost by four voter.

TIlE POLLUTION OF THE LEA.-At a well-attendedpublic meeting held at Hackney on the 28th ult., a resolu-tion declaring that nothing was feasible to secure the pudtyof the Lea short of an intercepting sewer to carry the sewageof Tottenham, Walthamstow, Leyton, and West Ham, aftertreatment, to the Thames at Barking, and that the HomeSecretary be memorialised on the subject, was carried.

Page 2: ACADEMY OF MEDICINE IN IRELAND

833THE CLOSE OF THE HEALTH EXHIBITION

THE LANCET.

LONDON: SATURDAY, NOVEMBER 8, 1884.

WITHOUT ceremony of any kind the most successful show

which has been seen in this country since 1851 came toan end on the 30th ult. The grand total of visitors hadreached 4,167,000, or an average of 27,000 per diem from

May to November. The secret of the success was doubt-

less due to the breadth of the Exhibition, if we mayuse such a term, and to the fact that the articles dis-

played and the amusements provided were calculated

to suit all tastes and to interest everybody, from the

philosopher to the village housewife. If we are to have a

continuance of such exhibitions (and this desirable projectis entertained), it is of course essential that they should payfinancially. Any lasting good which may be derived froman exhibition such as that which is just closed is (in thiscountry, where voluntary effort takes the place of State

endowment) contingent on financial success. When the

guarantors are called upon to make good a deficit, we shallhave seen the last Exhibition. The managers of the HealthExhibition did wisely to spare no effort to make the Exhibi-tion attractive. Illuminated garden?, bands of music,concerts and restaurants, were the attractions which broughtthe crowd and paid the bill, and if a certain percentage ofthe visitors never succeeded in dragging themselves awayfrom the sensuous pleasures of the gardens, no possibleharm has been done. Some of the writers for the dailypress seem to have been of the sensuous order, and becausethe pleasures of an open-air concert and a cigar have keptthem from more serious studies, they seem inclined to

pooh-pooh the whole affair, and to ridicule the idea of anypermanent good resulting from the Exhibition. We do not

share this view, but, on the contrary, believe that very fewcan have visited the Exhibition without deriving somebenefit or instruction therefrom. If the Exhibition had

its glittering side, it certainly had its serious side as well :and if no good results or lasting impressions remain, the faultlies with the public and not with the promoters. The fact

is that while the many have been amused, the few have beeninstructed. There will be, we are told, twenty stout

volumes as the literary outcome of the Exhibition, and thisrepresents a large amount of serious work, produced at great Icost.

The library, containing some 7000 volumes on Health andEducation, has been very largely used during the summer,

I

the number of readers showing a steady increase. The I

readers of THE LANCET do not require to be reminded of theBiological Laboratory, which we have been at great pains toreproduce as graphically as may be in our columns. The

scientific lessons taught in this laboratory have been of un-doubted value, and have succeeded in drawing public atten-tion to the study of bacteriology, which hitherto has been toomuch neglected in this country. Of Lectures, Conferences,the Sanitary and Insanitary Houses, and of the various

exhibits of scientific interest we say nothing, except that

they were all at hand for those who had eyes and ears,and taught not a little when these were accompanied byintelligence. -

The questions now arise, What is the surplus, and what is tobe done with it? The second question is necessarily dependenton the first, and the destination of the surplus must clearlydepend on its amount. That there will be a surplus seemscertain, and we hope that it may be substantial, but it mustnot be forgotten that the expenses of the Exhibition havebeen enormous, and until the accounts are all rendered it isuseless to speculate. The Executive Council is well quali.fied to advise the Prince of WALES as to the bestowal of the

surplus funds. There is a rumour that efforts will be made tofound a Central Institution for the Instruction of Sanitarians s

of all grades-an institution which will gather under its wingthe various voluntary efforts made by different societies.Oar readers will remember, however, that we recently urgedwith much earnestness that no use of the profits of this greatExhibition could be more satisfactory than to apply them tothe creation and endowment of a biological or a bacterio.logical laboratory, wherein the nature and properties of

germs might be investigated. This country has been lament-ably behind other countries in this branch of investigation-notably behind France, Germany, and Italy. The admir.

able remarks of the Duke of BUCKINGHAM, or rather of theExecutive Committee of which he is the spokesman, happilyshow that this discreditable defect in our State provisions isbeing realised by public men. After referring to the hygieniclaboratories, biological and physical, as a leading feature ofthe Exhibition, his Grace said :-" The maintenance of thelaboratories would ensure a means of sanitary research andteaching for the future which England has not had in thepast. In these laboratories studies could be carried on and

teaching could be given of a kind similar to that which isafforded by various foreign institutions which have beenestablished in the interest of public health. These studies

have a direct bearing on the relation of health problems whichnot only affect the well-being of communities, but exercisean important influence on agricultural and commercial in-terest?." " We cannot douot that his Royal Highness willheartily adopt the views thus foreshadowed for his approval,which we trust to see enforced in the further reportpromised by the Committee. The Exhibition has been a

success as a show and as a financial undertaking. But it

will live much more honourably in history if it is associatedwith a new and permanent impulse to sanitary science. It

may seem monstrous that the happiness and prosperity ofgrea.t nations should ba at the mercy of bacteria, beingswhich, judged by their weight and size, are quite con-

temptible ; but we have to do with facts, and it looks

I certainly like a fact that such is the case. At any rate,

the truth has to be found out. And if this kingdom, whichhas done so much in the way of leading sanitary science, is

not to sink into a third-rate position amongst enlightenedi nations, it is high time to be showing some sign. We have

competent men. We hold the country in which cholera hasits seat and home. We practically hold the gate throughwhich it passes thence to Europe to work such vast de-

struction and disaster as we have seen this year in France

and Italy. On every ground we ought to be foremost in the