1
667 others. Professor Macalister proposed 11 The Services,’’ remarking on the preference of Irish students for the army to the navy. The toast of 11 Our Guests" was proposed by Sir Thos. Crawford. The speech of the evening was that of Lieutenant Stairs, though it scarcely occupied five minutes. We have given the pith of it in another column. The toast of the evening, that of the Association itself, was proposed by Dr. Murray Lindsay, in which he announced what he regards as a triumph over monopolies in medical qualifica- tions at Derby. It is clear, from the pleasure with which his announcement was received, that such monopolies do not find any favour in the Irish Graduates’ Association. Dr. Macnaughton Jones replied. Dr. Mapother concluded the toast list by proposing the health of the Chairman. A SUGGESTION FOR THE FOREIGN OFFICE. MANY of the British Consuls abroad furnish in their annual trade reports a few statements of births and deaths of the countries wherein they reside. Similar information might prove of great service if collected regularly and forwarded at stated intervals to the Foreign Office. The Government representatives abroad might advantageously report, say, at the beginning and end of the " season " upon such matters as the most common forms of disease, the general sanitary conditions, variations in climate, character of the water-supply, and other points of interest to English medical men. At present some few members of our consular service do this, but frequently the information reaches this country too late to be of practical value, either to invalids going abroad or to physicians advising their patients to other climes. We trust the Foreign Office will, in the event of such recommendations being adopted, urge upon their representatives the importance of transmitting the returns as early as possible. It seems quite reasonable to venture a request for some news regarding continental health resorts, in order that medical advisers at home may have trustworthy data upon which to work in recommending certain towns and seaports for their patients. POST-HEMIPLEGIC CHOREA. DR. RUBINO describes in La Riforma Medica an interest- ing case seen by him in the St. Thomas Poliambulance, Naples. The patient was a little girl then aged nine, who, apparently having been infected with syphilis, developed at the age of eleven months a sore on the tongue. A few days later, after some feverishness, hemiplegia, with clonic spasms and loss of consciousness, set in. Under anti- syphilitic treatment, continued for two years, partial recovery took place; but the left arm and leg had but little power of voluntary motion, though both the limbs were subject to clonic irregular spasmodic movements. The intelligence appeared to have returned, but the power of speech was very rudimentary. After this some further improvement was obtained by the use of the galvanic current, but when she came under Dr. Rubino’s observation at the age of nine there was still great want of power, combined with choreic movements of the left arm and leg. There was no reaction of degeneration. The intelligence appeared to be keen, but she was slow in responding to questions, as if there were a difficulty in translating thoughts into words, and her speech was laboured and confused. Dr. Rubino believes that a focus of cortical encephalitis, probably combined with meningitis, was set up in the left hemisphere, and that the cause of this was syphilis. Although no rash was observed at the time, it does not follow that there was none. If this were really a case of syphilis, it is a rare one, though Simon mentions four instances in which encephalitis had been caused by syphilis. The rapidity with which the disease attacked the brain may perhaps be accounted for by the slight capacity of resistance in a child under a year old, and the great tendency there is at this time of life for tuber- culosis and other infectious diseases to attack the brain. The persistence of the symptoms is to be ascribed to sclerosis. following the acute inflammation, and to atrophy of the- cortical area in which it occurred. THE HOWARD ASSOCIATION. ON the occasion of the centenary of this Association a. pamphlet has been issued summarising its services. Members and officials connected with the Legislatures both at home and abroad have repeatedly acknowledged the valuable aid they have received from this Association for- the discussion and enactment of important measures. In addition to numerous communications to public journals the Society has circulated many books and pamphlets through- out the world dealing with the objects for which it was. originally promoted. The committee has recently distri-- buted gratuitously to administrators and official persons. throughout the world a new work by their secretary,, entitled " Penological and Preventive Principles, with. special reference to Europe and America," which has elicited marked commendation from many practical authorities, both at home and abroad. From these and many other facts which might be adduced it may readily be inferred that this Association deserves well of the public in con- sideration of the good work it has done for suffering; humanity. - THE OBSTETRIC "BINDER." AN interesting discussion took place on this subject at. the Obstetrical Society, the abstract of which will be found in THE LANCET for March 15th. The alleged uses of the- binder cited by the reader of the paper (Dr. Herman) were- (1) comfort, (2) maintenance of the intra-abdominal pressure, and (3) preservation of the "figure." The maintenance of the intra-abdominal pressure has been thought to prevent, Hoodii3g. As to this, the author did not believe that this, effect could be relied on, and some speakers agreed with him. The bulk of the paper concerned measurements of the base of the chest, which was shown to be practically unaffected by the binder. The conclusion arrived at was. that, except as regarded the comfort of the patient, the use of a binder was a matter of indifference. As one of the speakers pointed out, the meaning of "waist" and "figure" varied with the fashion; but the Society seemed’ to think that the support of the abdomen during the post- partum involution of its walls was not a matter of in- difference, and that the binder was, after all, a valuable- safeguard against " pendulous belly " when properly used. MULTIPLE ROUND-CELLED SARCOMA OF THE SKIN. DR. H. V. TRUSHENNIKOFF describes in the Russ7:ayae 3leditsina a rare case of multiple sarcoma of the skin, which has recently been in Professor Polotebnoff’s der- matological clinic. A man thirty-seven years of age after an attack of pleuro-pneumonia noticed two small tumours- on his left breast. These continued to increase in size, and were before long followed by other similar tumours on the right breast, and then on the scalp, neck, and trunk. Some six weeks after the first were noticed he was admitted into the dermatological clinic, and by that time there were fully two hundred tumours scattered about all over the surface" of the body, varying in size from that of a pea to that of half an egg. The man was ansemic and very weak. In spite of good food and treatment he died a few days later and at the post-mortem examination it was found that the

POST-HEMIPLEGIC CHOREA

  • Upload
    vudan

  • View
    214

  • Download
    1

Embed Size (px)

Citation preview

Page 1: POST-HEMIPLEGIC CHOREA

667

others. Professor Macalister proposed 11 The Services,’’remarking on the preference of Irish students for the armyto the navy. The toast of 11 Our Guests" was proposed bySir Thos. Crawford. The speech of the evening was that ofLieutenant Stairs, though it scarcely occupied five minutes.We have given the pith of it in another column. The toastof the evening, that of the Association itself, was proposedby Dr. Murray Lindsay, in which he announced what heregards as a triumph over monopolies in medical qualifica-tions at Derby. It is clear, from the pleasure with whichhis announcement was received, that such monopolies donot find any favour in the Irish Graduates’ Association.Dr. Macnaughton Jones replied. Dr. Mapother concludedthe toast list by proposing the health of the Chairman.

A SUGGESTION FOR THE FOREIGN OFFICE.

MANY of the British Consuls abroad furnish in theirannual trade reports a few statements of births and deathsof the countries wherein they reside. Similar information

might prove of great service if collected regularly andforwarded at stated intervals to the Foreign Office. TheGovernment representatives abroad might advantageouslyreport, say, at the beginning and end of the " season " uponsuch matters as the most common forms of disease, thegeneral sanitary conditions, variations in climate, characterof the water-supply, and other points of interest to Englishmedical men. At present some few members of our consularservice do this, but frequently the information reaches thiscountry too late to be of practical value, either to invalidsgoing abroad or to physicians advising their patients toother climes. We trust the Foreign Office will, in theevent of such recommendations being adopted, urge upontheir representatives the importance of transmitting thereturns as early as possible. It seems quite reasonable toventure a request for some news regarding continental healthresorts, in order that medical advisers at home may havetrustworthy data upon which to work in recommendingcertain towns and seaports for their patients.

POST-HEMIPLEGIC CHOREA.

DR. RUBINO describes in La Riforma Medica an interest-ing case seen by him in the St. Thomas Poliambulance,Naples. The patient was a little girl then aged nine, who,apparently having been infected with syphilis, developed atthe age of eleven months a sore on the tongue. A fewdays later, after some feverishness, hemiplegia, with clonicspasms and loss of consciousness, set in. Under anti-

syphilitic treatment, continued for two years, partialrecovery took place; but the left arm and leg had but littlepower of voluntary motion, though both the limbs weresubject to clonic irregular spasmodic movements. The

intelligence appeared to have returned, but the power ofspeech was very rudimentary. After this some further

improvement was obtained by the use of the galvaniccurrent, but when she came under Dr. Rubino’s observationat the age of nine there was still great want of power,combined with choreic movements of the left arm

and leg. There was no reaction of degeneration. The

intelligence appeared to be keen, but she was slow in

responding to questions, as if there were a difficultyin translating thoughts into words, and her speech waslaboured and confused. Dr. Rubino believes that a focusof cortical encephalitis, probably combined with meningitis,was set up in the left hemisphere, and that the cause ofthis was syphilis. Although no rash was observed at thetime, it does not follow that there was none. If this were

really a case of syphilis, it is a rare one, though Simonmentions four instances in which encephalitis had beencaused by syphilis. The rapidity with which the disease

attacked the brain may perhaps be accounted for by theslight capacity of resistance in a child under a year old,and the great tendency there is at this time of life for tuber-culosis and other infectious diseases to attack the brain.The persistence of the symptoms is to be ascribed to sclerosis.following the acute inflammation, and to atrophy of the-

cortical area in which it occurred.

THE HOWARD ASSOCIATION.

ON the occasion of the centenary of this Association a.

pamphlet has been issued summarising its services.Members and officials connected with the Legislatures bothat home and abroad have repeatedly acknowledged thevaluable aid they have received from this Association for-the discussion and enactment of important measures. Inaddition to numerous communications to public journals theSociety has circulated many books and pamphlets through-out the world dealing with the objects for which it was.

originally promoted. The committee has recently distri--buted gratuitously to administrators and official persons.throughout the world a new work by their secretary,,entitled " Penological and Preventive Principles, with.

special reference to Europe and America," which has elicitedmarked commendation from many practical authorities,both at home and abroad. From these and many otherfacts which might be adduced it may readily be inferredthat this Association deserves well of the public in con-sideration of the good work it has done for suffering;humanity.

-

THE OBSTETRIC "BINDER."

AN interesting discussion took place on this subject at.the Obstetrical Society, the abstract of which will be foundin THE LANCET for March 15th. The alleged uses of the-binder cited by the reader of the paper (Dr. Herman) were-(1) comfort, (2) maintenance of the intra-abdominal pressure,and (3) preservation of the "figure." The maintenance ofthe intra-abdominal pressure has been thought to prevent,Hoodii3g. As to this, the author did not believe that this,effect could be relied on, and some speakers agreed withhim. The bulk of the paper concerned measurements ofthe base of the chest, which was shown to be practicallyunaffected by the binder. The conclusion arrived at was.

that, except as regarded the comfort of the patient, theuse of a binder was a matter of indifference. As one ofthe speakers pointed out, the meaning of "waist" and

"figure" varied with the fashion; but the Society seemed’to think that the support of the abdomen during the post-partum involution of its walls was not a matter of in-

difference, and that the binder was, after all, a valuable-safeguard against " pendulous belly " when properly used.

MULTIPLE ROUND-CELLED SARCOMA OF THESKIN.

DR. H. V. TRUSHENNIKOFF describes in the Russ7:ayae3leditsina a rare case of multiple sarcoma of the skin,which has recently been in Professor Polotebnoff’s der-

matological clinic. A man thirty-seven years of age afteran attack of pleuro-pneumonia noticed two small tumours-on his left breast. These continued to increase in size, andwere before long followed by other similar tumours on theright breast, and then on the scalp, neck, and trunk. Somesix weeks after the first were noticed he was admitted into

the dermatological clinic, and by that time there were fullytwo hundred tumours scattered about all over the surface"of the body, varying in size from that of a pea to that ofhalf an egg. The man was ansemic and very weak. In

spite of good food and treatment he died a few days laterand at the post-mortem examination it was found that the