1
45 SUMMER FRUIT AS A CAUSE OF DISEASE. destinations by convenient arrangements and hygienic carriages, it is to the interest of the latter to regard this ex- perience, as every other in life, with that patience and philo- sophy which are native to some, and must be acquired by all who would study their own well-being. That the continuous vibration of a railway carriage may cause consider- able discomfort is a common experience; that it may in some persons and in some conditions of health produce alarming objective symptoms is shown by a case which Sir B. W. Richardson relates in his article in which there was temporary loss of power in the limbs. The more sensi- tive is the central nervous system the more will it naturally resent such continuous stimulation. On the other hand, there appear to be cases of blunted sensibility in which French physicians have found such vibration beneficial. As, however, a railway system cannot be constructed on the principle of studying the convenience of such exceptional persons, it is to be hoped that everything calculated to further irritate an overjaded generation will be avoided by our railway companies. Travellers, again, must remember that while express speed in a railway carriage is pleasurable rather than otherwise, in the ordinary incidents of private and public life it is the pace that kills. " - INCREASE OF LEUCOCYTES AFTER COLD BATHS. IN the B1Ûletin of the John Hopkins Hospital Dr. Thayer gives a short preliminary account of some observa- tions made at the hospital with reference to the occur- rence of this phenomenon. Dr. Winternitz has found that in normal individuals, as well as in cases of fever, an appreciable leucocytosis is found as early as half an hour after the exposure to cold, and he suggests that this increase in the leucocytes is an important factor in producing the good result so often obtained in typhoid fever by means of cold baths. Dr. Billings, jun., and Dr. Thayer studied the conditions in several cases of typhoid fever and in one of pneumonia as well as in two healthy individuals, and their observations fully confirm those of Dr. Winter- nitz. As regards the different kinds of leucocytes, no marked difference could be discovered in the proportion before andafter a bath. In the cases of typhoid fever the only con- stant change was a slight diminution in the multinuclear neutrophiles and a slight increase in the mononuclear forms. In the healthy individual no difference in the relative pro- portions of the different varieties could be made out after the bath. Several important points are left in the mean- time unanswered, such as the place and r6le of the reaction after the bath, the influence of coldness and blueness of the parts from which the blood is taken upon the result, and the question whether the superficial blood and the deep venous blood have the same peculiarities. The effect of local appli- cations of cold on the state of the blood has also not been determined, but no doubt light will be thrown on these points by future observations. As regards the red corpuscles, no constant change in their numbers or appearance seems to be caused by the cold bath. - FEVER HOSPITALS IN RELATION TO VACCINATION. A PERUSAL of Dr. Joseph Priestley’s annual report will convey some idea of the condition of things which is likely to obtain should the attitude adopted by Leicester in reference to vaccination be widely followed. When we read of patients , who were admitted into hospital with scarlet fever contracting small-pox, and conversely of a " quarantined " person or two falling ill of scarlet fever, we can only express surprise that the sanitary authority have not made provision for giving their much-vaunted but now sadly discredited "system "a better chance. But beyond this we see a new danger threatening the isolation hospitals of the country should the exposure of this so-called Leicester method " not teach the lesson which it ought to inculcate. Unfortunately there are even yet some drawbacks to hospitals for infectious diseases, and these can- only be slowly, if ever, remedied. The impossibility, or at least the often grave difficulty, in the present state of our knowledge- of diagnosing the infectious fevers during their incubative- stages and initial manifestations is by no means the least, of these drawbacks ; and whilst this difficulty exists there must always remain the risk of introducing into a warcl, set apart for one disease a, patient who, in addition to the disease for which he was admitted, is incubating another. Up to the present time, or at any rate since fever hospitals have been widely patronised, the chief danger has been that of introducing scarlet fever or measles into a ward intended for neither, as in a well-administered and freely ventilated wardi there is little danger from the temporary sojourn of a case, say, of enteric fever amongst patients suffering from, fon instance, scarlet fever, assuming, of course, that the patient. attacked with enteric fever is also suffering from scarlet fever. In dealing, however, with the sudden development of small-pox in a ward devoted to the treatment of some other infectious, disease, the danger of its spreading to the other patients is a. very serious one, at least when all those other patients are- as by hypothesis they would be-unprotected by vaccination. If to the present unavoidable drawbacks of a fever hospital) were to be added the dangers of small-pox, it is to be feared that the public would soon withhold the confidence they are- now, in such a rapidly increasing degree, reposing in them. Let us hope, however, that Leicester has played the scale- goat to some purpose. - COCK-CROWING AND SLEEPLESSNESS. COMPLAINT was lately made by the secretary of the- : Victoria Hospital for Sick Children of a cock-crowing nuisance,’ : in the neighbourhood of that institution. Every form of polite remonstrance was exhausted in vain, and the matter’ was finally brought before the local bench, which granted ax : summons against the keepers of the fowls. It appears, how- ever, that some doubt may arise as to the jurisdiction of the; court in the matter. We confess that we cannot recognise.- the justice of controlling its preventive power, especially in a. case of such urgency as that in question. The need of inter- ference is obvious. It is admitted that serious conse-- quences have resulted from the crowing, and most of us have experienced at some time or other the pecu- liarly persistent disturbance of sleep which is thus occa- sioned. In the present instance the subjects of the.- annoyance are invalids, to some of whom a night’s rest may easily turn the scale between illness or even death and; recovery. In cases of infinitely less gravity the roadsider organist or singer, whose notes are, after all, his means of livelihood, must be silent if called upon ; the road-engine one steam-car must not endanger the ordinary course of traffic ;. the insanitary stye or stable is liable to be condemned. If it be not possible, on the same grounds of public utility and in circumstances of much greater urgency, to remove the- hubbub of a clamorous fowl-yard, the sooner the needful) power is acquired the better for the public health. SUMMER FRUIT AS A CAUSE OF DISEASE. NOTHING is more essential to method in learning than frequent reiteration, and it is therefore needless to pleads excuses in seeking thus to impress even the elementary facts of sanitary science. It might be supposed that by this tima: every one understood the importance of observing particular- care in the selection of a summer dietary, especially as re- gards fruit. Hardly any question of domestic management i& either more vital or more elementary. Yet error continually arises in this connexion in the simplest way. A few days. ago a child died soon after eating strawberries. Why 71 Because the fruit had been purchased two days previously,. and, as was only to be expected, when eaten was in a state of decay. It is impossible to resist the impres-

COCK-CROWING AND SLEEPLESSNESS

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45SUMMER FRUIT AS A CAUSE OF DISEASE.

destinations by convenient arrangements and hygieniccarriages, it is to the interest of the latter to regard this ex-perience, as every other in life, with that patience and philo-sophy which are native to some, and must be acquired by allwho would study their own well-being. That the continuousvibration of a railway carriage may cause consider-able discomfort is a common experience; that it may in

some persons and in some conditions of health producealarming objective symptoms is shown by a case which

Sir B. W. Richardson relates in his article in which therewas temporary loss of power in the limbs. The more sensi-

tive is the central nervous system the more will it naturallyresent such continuous stimulation. On the other hand, thereappear to be cases of blunted sensibility in which Frenchphysicians have found such vibration beneficial. As, however,a railway system cannot be constructed on the principle ofstudying the convenience of such exceptional persons, it is tobe hoped that everything calculated to further irritate anoverjaded generation will be avoided by our railway companies.Travellers, again, must remember that while express speedin a railway carriage is pleasurable rather than otherwise, inthe ordinary incidents of private and public life it is the

pace that kills. "

-

INCREASE OF LEUCOCYTES AFTER COLD BATHS.IN the B1Ûletin of the John Hopkins Hospital Dr.

Thayer gives a short preliminary account of some observa-tions made at the hospital with reference to the occur-

rence of this phenomenon. Dr. Winternitz has found thatin normal individuals, as well as in cases of fever, an

appreciable leucocytosis is found as early as half an hourafter the exposure to cold, and he suggests that this increasein the leucocytes is an important factor in producing thegood result so often obtained in typhoid fever by means ofcold baths. Dr. Billings, jun., and Dr. Thayer studiedthe conditions in several cases of typhoid fever and in oneof pneumonia as well as in two healthy individuals,and their observations fully confirm those of Dr. Winter-nitz. As regards the different kinds of leucocytes, no

marked difference could be discovered in the proportion beforeandafter a bath. In the cases of typhoid fever the only con-stant change was a slight diminution in the multinuclearneutrophiles and a slight increase in the mononuclear forms.In the healthy individual no difference in the relative pro-portions of the different varieties could be made out afterthe bath. Several important points are left in the mean-

time unanswered, such as the place and r6le of the reactionafter the bath, the influence of coldness and blueness of the

parts from which the blood is taken upon the result, and thequestion whether the superficial blood and the deep venousblood have the same peculiarities. The effect of local appli-cations of cold on the state of the blood has also not been

determined, but no doubt light will be thrown on these pointsby future observations. As regards the red corpuscles, noconstant change in their numbers or appearance seems to becaused by the cold bath.

-

FEVER HOSPITALS IN RELATION TOVACCINATION.

A PERUSAL of Dr. Joseph Priestley’s annual report willconvey some idea of the condition of things which is likelyto obtain should the attitude adopted by Leicester in referenceto vaccination be widely followed. When we read of patients

,

who were admitted into hospital with scarlet fever contractingsmall-pox, and conversely of a " quarantined " person or twofalling ill of scarlet fever, we can only express surprise that thesanitary authority have not made provision for giving theirmuch-vaunted but now sadly discredited "system "a betterchance. But beyond this we see a new danger threateningthe isolation hospitals of the country should the exposure ofthis so-called Leicester method " not teach the lesson whichit ought to inculcate. Unfortunately there are even yet some

drawbacks to hospitals for infectious diseases, and these can-only be slowly, if ever, remedied. The impossibility, or at leastthe often grave difficulty, in the present state of our knowledge-of diagnosing the infectious fevers during their incubative-stages and initial manifestations is by no means the least,of these drawbacks ; and whilst this difficulty exists theremust always remain the risk of introducing into a warcl,set apart for one disease a, patient who, in addition to thedisease for which he was admitted, is incubating another. Upto the present time, or at any rate since fever hospitals havebeen widely patronised, the chief danger has been that ofintroducing scarlet fever or measles into a ward intended forneither, as in a well-administered and freely ventilated wardithere is little danger from the temporary sojourn of a case,say, of enteric fever amongst patients suffering from, foninstance, scarlet fever, assuming, of course, that the patient.attacked with enteric fever is also suffering from scarlet fever.In dealing, however, with the sudden development of small-poxin a ward devoted to the treatment of some other infectious,

disease, the danger of its spreading to the other patients is a.very serious one, at least when all those other patients are-as by hypothesis they would be-unprotected by vaccination.If to the present unavoidable drawbacks of a fever hospital)were to be added the dangers of small-pox, it is to be fearedthat the public would soon withhold the confidence they are-now, in such a rapidly increasing degree, reposing in them.Let us hope, however, that Leicester has played the scale-goat to some purpose. -

COCK-CROWING AND SLEEPLESSNESS.’

COMPLAINT was lately made by the secretary of the-: Victoria Hospital for Sick Children of a cock-crowing nuisance,’: in the neighbourhood of that institution. Every form of

polite remonstrance was exhausted in vain, and the matter’was finally brought before the local bench, which granted ax

: summons against the keepers of the fowls. It appears, how-

ever, that some doubt may arise as to the jurisdiction of the;court in the matter. We confess that we cannot recognise.-the justice of controlling its preventive power, especially in a.

case of such urgency as that in question. The need of inter-

ference is obvious. It is admitted that serious conse--

quences have resulted from the crowing, and most ofus have experienced at some time or other the pecu-liarly persistent disturbance of sleep which is thus occa-sioned. In the present instance the subjects of the.-

annoyance are invalids, to some of whom a night’s rest mayeasily turn the scale between illness or even death and;

recovery. In cases of infinitely less gravity the roadsiderorganist or singer, whose notes are, after all, his means oflivelihood, must be silent if called upon ; the road-engine onesteam-car must not endanger the ordinary course of traffic ;.the insanitary stye or stable is liable to be condemned. Ifit be not possible, on the same grounds of public utility andin circumstances of much greater urgency, to remove the-hubbub of a clamorous fowl-yard, the sooner the needful)

power is acquired the better for the public health.

SUMMER FRUIT AS A CAUSE OF DISEASE.

NOTHING is more essential to method in learning thanfrequent reiteration, and it is therefore needless to pleadsexcuses in seeking thus to impress even the elementary factsof sanitary science. It might be supposed that by this tima:every one understood the importance of observing particular-care in the selection of a summer dietary, especially as re-gards fruit. Hardly any question of domestic management i&either more vital or more elementary. Yet error continuallyarises in this connexion in the simplest way. A few days.ago a child died soon after eating strawberries. Why 71Because the fruit had been purchased two days previously,.and, as was only to be expected, when eaten was ina state of decay. It is impossible to resist the impres-