1
1763 THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.&mdash;LOOKING BACK. The first paper in the appendix is Major R. H. Firth’s Report on the Progress of Hygiene for the year 1901-02, and to this we would call particular attention, because it strikes .us as a really useful and interesting _pr6cis of all that has been known and done up to date, accompanied by a running .commentary from the pen of the Professor of Military Hygiene at Netley which adds considerably to its value. It would simply be tedious to enumerate all the subjects passed in review by Major Firth. The paper should be read in of3aetenso. Those portions of it dealing with scarlet fever, the influence of hospital isolation, and the bacteriology of that disease, the remarks regarding the recent recrudescence of small-pox and the bacteriology and efficacy of vaccine, and more especially those portions of the report dealing with the enteric fever problem and the recent advances made in our knowledge regarding the transmission and prevention of yellow fever, will well repay perusal. The report on the work done in the surgical division of the Royal Victoria Hospital, Netley, in the year 1901-02, by the professor and assistant professor of military surgery will be referred ’, to with interest. Considerably more than 400 opera- tions have been performed during the year, which is a great increase over the numbers of any previous year. The increase is due almost entirely to cases of gunshot wounds from South Africa (the report is illustrated by some excellent stereoscopic skiagraphs) and to operations for the radical cure of hernia. With regard to South Africa, we may, however, very well await the anticipated appearance of an official report of the Medical and Surgical History of the War. We notice that 13 cases of abscess of the liver were operated on during the year ; of these only four recovered and nine died. One of these patients was moribund on arrival at Netley ; he was operated on and died on the day of arrival. Of the cases, five gave a definite history of dysentery, in four no cause could be ascribed, in two the abscess followed enteric fever, in one debility, and in one Mediterranean fever. In five of the fatal cases the relatives would not allow a post-mortem examination ; details are given of the remaining four. The report on the Medical History of the Campaign, ’ ’China Field Force, 1900-01, which concludes the papers in the appendix, is mainly of interest to military medical officers. THE ROYAL COLLEGE OF SURGEONS OF ENGLAND. AN ordinary meeting of the Council was held on June 11th, the President, Sir HENRY G. HowsE, being in the chair. Diplomas of Fellowship were issued to 30 successful candidates. A recommendation from the Board of Examiners in Dental Surgery was adopted. It was to the effect that candidates for the Licence in Dental Surgery should be required, when I presenting themselves for examination in mechanical ,dentistry, to provide themselves with the following instru- ments, hitherto provided by the College : wax spatula (double-ended), sculptors, gouge and handle, vulcanite files, gold files, pin-roughing and bending pliers, snipe-nose pliers, cutting nippers, broaches and handles, fret saw, one Melotte’s moldine outfit, one Bunsen burner (laboratory), fine saws, special chasers, blowpipe for mouth (12 in.), solder tweezers, crown holder, curved shears, N. P. collar pliers, plain pin nippers, riveting hammer, and dividers (4 in.). The following will be supplied by the hospital at which the candidates are examined-viz. : hammers for striking up plates, horn mallets, and ordinary casting materials and apparatus. The following examiners were appointed :&mdash; Elementary Biology.-H. B. Lyle, W. G. Ridewood, T. G. Stevens, and H. W. Marett Tims. Anatomy (Conjoint> Examining Board).-C. Addison, Aithur Keith, A. Thomson, and H. J. Waring. Physiology (Conjoint examining Board).-T. G. Brodie, G. A. Buckmaster, and W. H. Thompson. Anatomy (Fello1vship).-C. Addison, L. A. Dunn, A. Keith, and A. H. Young. Physiology (’ellmvs7tip).-De Burgh Birch, L. E. Hill, E. W. Reid, and E. H. Starling. Midra ’ery (Conjoint Examining Board).-G. F. Blacker, W. Duncan, A. H. N. Lewers, and J. H. Targett. Public .B<MA.&mdash;Part L, A. G. R. Foulerton; Part II., S. A. M. Oopema.n. Mr. W. F. Haslam of Birmingham was elected a member of the Court of Examiners. The President reported that a doctor’s signboard, dated 1623, formerly the property of Mr. Manley Sims, had been purchased by the College. The President also reported that he had purchased, on behalf of the College, a portrait by George Richmcnd, R.A., of the late Mr. Henry Hancock, President of the College in 1872. A letter was read from Mr. D. B. Balding, F.R.C.S., of Royston, presenting to the College : (1) a small Prentice bleeding bowl bearing the date 1671, and (2) a hydrocele trocar (figured in vol. i., p. 420, third edition, of Benjamin Bell’s Surgery, Edinburgh, 1787). The best thanks of the Council were given to Mr. Balding for his interesting gifts. A letter was read from Mr. Thomas Bryant reporting the proceedings of the General Medical Council at its late session. The best thanks of the Council were given to Mr. Bryant for his services as the representative of the College on the General Medical Council. The consideration of Mr. A. W. MAYO RoBSON’S motion- That a committee be appointed to consider the anomalies of the coroner’s court in its relation to the medical profession, was postponed. A vote of thanks was unanimously given to Mr. Alfred Willett and Sir Frederick Treves, Bart., K.C.V.O., for their services to the College while members of the Council. Lookding Back. FROM THE LANCET, SATURDAY, JUNE 18, 1825. LECTURES ON THE PRINCIPLES AND PRACTICE OF PHYSIC, BY DR. ARMSTRONG. Theatre of Anatomy, Webb Street. LECTURE 29.1 If you were called to a patient affected with the simple form of scarlet fever, what would you do ? The best thing at first, when the skin has become uniformly hot, is to wash the patient all over with tepid water ; procure a large shallow tub, a common washing tub, and let the patient sit on a three-legged stool in the middle of it, the feet being covered by warm water ; sponge the skin with warm water, then wipe it perfectly dry, and put him to bed between clean sheets. Give about two grains of calomel with a little rhubarb, and a dose of cold drawn castor oil a few hours afterwards. Let the diet be then arrowroot, and the drink cold water ; pursue this plan in a cool airy apartment for three or four days, and the patient will generally be con- valescent. Be careful not to expose him to cold then, as he might become dropsical. Our systematic writers have made dropsy almost a necessary consequence of scarlatina, but this is not the fact. I have seen, within the last six years, at least four hundred cases of scarlet fever, and I have only seen a single case in which dropsy occurred, which was owing to my directions being disregarded. The patient crammed himself with new bread, and cold or cramming are its usual causes. Dropsy, so far as I have observed subsequent to scarlet fever, arises often from inattention on the part of the patient, and occasionally from ignorance on the part of the practitioner. The treatment of the inflammatory scarlet fever must be regulated according to its form. If you are called to a patient in whom the fever is ardently developed, and the throat much inflamed, apply eight or ten leeches to the part ; sponge the surface of the body in the way I have mentioned, or pour about two gallons of tepid water at once over the whole surface. In the next place, give a brisk aperient, as a combination of calomel and rhubarb or jalap, followed up by an infusion of senna with sulphate of magnesia. Use a gargle also composed of diluted sulphuric acid with a little syrup ; keep the patient at rest in the recumbent posture, and keep him very cool, and on a very spare diet. This is the plan that I usually adopt. 1 Only a part has been transcribed.

Lookding Back. FROM THE LANCET, SATURDAY, JUNE 18, 1825

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1763THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.&mdash;LOOKING BACK.

The first paper in the appendix is Major R. H. Firth’sReport on the Progress of Hygiene for the year 1901-02, andto this we would call particular attention, because it strikes.us as a really useful and interesting _pr6cis of all that hasbeen known and done up to date, accompanied by a running.commentary from the pen of the Professor of MilitaryHygiene at Netley which adds considerably to its value. Itwould simply be tedious to enumerate all the subjects passedin review by Major Firth. The paper should be read inof3aetenso. Those portions of it dealing with scarlet fever, theinfluence of hospital isolation, and the bacteriology ofthat disease, the remarks regarding the recent recrudescenceof small-pox and the bacteriology and efficacy of vaccine, andmore especially those portions of the report dealing withthe enteric fever problem and the recent advances made inour knowledge regarding the transmission and prevention ofyellow fever, will well repay perusal. The report on thework done in the surgical division of the Royal VictoriaHospital, Netley, in the year 1901-02, by the professor andassistant professor of military surgery will be referred ’,to with interest. Considerably more than 400 opera-tions have been performed during the year, which is a

great increase over the numbers of any previous year.The increase is due almost entirely to cases of gunshotwounds from South Africa (the report is illustrated by someexcellent stereoscopic skiagraphs) and to operations for theradical cure of hernia. With regard to South Africa, wemay, however, very well await the anticipated appearance ofan official report of the Medical and Surgical History of theWar. We notice that 13 cases of abscess of the liver wereoperated on during the year ; of these only four recoveredand nine died. One of these patients was moribund onarrival at Netley ; he was operated on and died on the dayof arrival. Of the cases, five gave a definite history ofdysentery, in four no cause could be ascribed, in two theabscess followed enteric fever, in one debility, and in oneMediterranean fever. In five of the fatal cases the relativeswould not allow a post-mortem examination ; details are

given of the remaining four.The report on the Medical History of the Campaign,

’ ’China Field Force, 1900-01, which concludes the papersin the appendix, is mainly of interest to military medicalofficers.

THE ROYAL COLLEGE OF SURGEONS OFENGLAND.

AN ordinary meeting of the Council was held on June 11th,the President, Sir HENRY G. HowsE, being in the chair.

Diplomas of Fellowship were issued to 30 successfulcandidates.A recommendation from the Board of Examiners in Dental

Surgery was adopted. It was to the effect that candidatesfor the Licence in Dental Surgery should be required, when Ipresenting themselves for examination in mechanical,dentistry, to provide themselves with the following instru-ments, hitherto provided by the College : wax spatula(double-ended), sculptors, gouge and handle, vulcanite files,gold files, pin-roughing and bending pliers, snipe-nose pliers,cutting nippers, broaches and handles, fret saw, one

Melotte’s moldine outfit, one Bunsen burner (laboratory), finesaws, special chasers, blowpipe for mouth (12 in.), soldertweezers, crown holder, curved shears, N. P. collar pliers,plain pin nippers, riveting hammer, and dividers (4 in.).The following will be supplied by the hospital at which thecandidates are examined-viz. : hammers for striking upplates, horn mallets, and ordinary casting materials andapparatus.The following examiners were appointed :&mdash;

Elementary Biology.-H. B. Lyle, W. G. Ridewood, T. G.Stevens, and H. W. Marett Tims.Anatomy (Conjoint> Examining Board).-C. Addison,

Aithur Keith, A. Thomson, and H. J. Waring.Physiology (Conjoint examining Board).-T. G. Brodie,

G. A. Buckmaster, and W. H. Thompson.Anatomy (Fello1vship).-C. Addison, L. A. Dunn, A.

Keith, and A. H. Young.Physiology (’ellmvs7tip).-De Burgh Birch, L. E. Hill,

E. W. Reid, and E. H. Starling.Midra ’ery (Conjoint Examining Board).-G. F. Blacker,

W. Duncan, A. H. N. Lewers, and J. H. Targett.Public .B<MA.&mdash;Part L, A. G. R. Foulerton; Part II.,

S. A. M. Oopema.n.

Mr. W. F. Haslam of Birmingham was elected a memberof the Court of Examiners.The President reported that a doctor’s signboard, dated

1623, formerly the property of Mr. Manley Sims, had beenpurchased by the College.The President also reported that he had purchased, on

behalf of the College, a portrait by George Richmcnd, R.A.,of the late Mr. Henry Hancock, President of the College in1872.A letter was read from Mr. D. B. Balding, F.R.C.S., of

Royston, presenting to the College : (1) a small Prenticebleeding bowl bearing the date 1671, and (2) a hydroceletrocar (figured in vol. i., p. 420, third edition, of BenjaminBell’s Surgery, Edinburgh, 1787). The best thanks of theCouncil were given to Mr. Balding for his interesting gifts.A letter was read from Mr. Thomas Bryant reporting the

proceedings of the General Medical Council at its latesession. The best thanks of the Council were given to Mr.Bryant for his services as the representative of the Collegeon the General Medical Council.The consideration of Mr. A. W. MAYO RoBSON’S motion-That a committee be appointed to consider the anomalies of the

coroner’s court in its relation to the medical profession,was postponed.A vote of thanks was unanimously given to Mr. Alfred

Willett and Sir Frederick Treves, Bart., K.C.V.O., for theirservices to the College while members of the Council.

Lookding Back.FROM

THE LANCET, SATURDAY, JUNE 18, 1825.

LECTURES ON THE PRINCIPLES AND PRACTICEOF PHYSIC,

BY DR. ARMSTRONG.

Theatre of Anatomy, Webb Street.

LECTURE 29.1If you were called to a patient affected with the simple

form of scarlet fever, what would you do ? The best thing atfirst, when the skin has become uniformly hot, is to wash thepatient all over with tepid water ; procure a large shallowtub, a common washing tub, and let the patient sit on a

three-legged stool in the middle of it, the feet being coveredby warm water ; sponge the skin with warm water, thenwipe it perfectly dry, and put him to bed between cleansheets. Give about two grains of calomel with a littlerhubarb, and a dose of cold drawn castor oil a few hoursafterwards. Let the diet be then arrowroot, and the drinkcold water ; pursue this plan in a cool airy apartment forthree or four days, and the patient will generally be con-valescent. Be careful not to expose him to cold then, as hemight become dropsical. Our systematic writers have madedropsy almost a necessary consequence of scarlatina, butthis is not the fact. I have seen, within the last six years,at least four hundred cases of scarlet fever, and I have onlyseen a single case in which dropsy occurred, which wasowing to my directions being disregarded. The patientcrammed himself with new bread, and cold or crammingare its usual causes. Dropsy, so far as I have observed

subsequent to scarlet fever, arises often from inattentionon the part of the patient, and occasionally from ignoranceon the part of the practitioner.The treatment of the inflammatory scarlet fever must be

regulated according to its form. If you are called to a

patient in whom the fever is ardently developed, and thethroat much inflamed, apply eight or ten leeches to thepart ; sponge the surface of the body in the way I havementioned, or pour about two gallons of tepid water at onceover the whole surface. In the next place, give a briskaperient, as a combination of calomel and rhubarb or jalap,followed up by an infusion of senna with sulphate ofmagnesia. Use a gargle also composed of diluted sulphuricacid with a little syrup ; keep the patient at rest in therecumbent posture, and keep him very cool, and on a veryspare diet. This is the plan that I usually adopt.

1 Only a part has been transcribed.