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THERAPEUTIC USES OF OREXIN

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Page 1: THERAPEUTIC USES OF OREXIN

1019SANITARY WORK IN THE PORT OF LONDON.-WISE BENEVOLENCE.

gratuitous work to create an inferior order of prac-titioners and to give them a start by requiring the medicalprofession whose work they are in a measure to take awayto put an :imprimatttr upon them. We trust that the

medical profession in the United States will give earlynotice that its cooperation is not to be obtained so

cheaply. A third objection found to the Bill by the editoris its limited application. It is only to affect the city of NewYork, whereas the Medical Society of the State of New Yorkhas always strongly opposed Bills to create examining boardsfor midwives in separate cities and counties and has insisted ’,that if midwives are to be licensed the practice should includethe whole State. Our contemporary goes on to repeat that IIthe general tendency of medical opinion is against such I

Bills. " There has been but little convincing testimony thatthe Midwives Bill is called for." While admitting that theservices of a midwife who has undergone an examinationtestifying that she possesses some knowledge and experiencewould be preferable to those of one who has been put to nosuch test, the writer observes that it must be obvious thateven a licensed midwife cannot be expected to grapple withall the complications which may occur. On these groundshe argues that the public should be educated to realise theadvantage of medical attendance as distinguished from thatof ignorant midwives who would in the natural course of

things pass away. If all this be so perhaps the MedicalRecord is a little inconsistent in regretting that the Billdoes not include the State, as well as the city, of New York,for surely, if such Bills are wrong, the more limited theirscope the better.

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SANITARY WORK IN THE PORT OF LONDON.

THE recently published report of Dr. William Colling-ridge, medical officer of health of the Port of London, showsthat during the half year ended Dec. 31st, 1899, a totalnumber of 16,384 vessels were inspected by the sanitaryofficers in the docks and in the river. The majority of thesevessels were of British nationality-namely, 81’52 per cent.,Swedish and Norwegian coming next as usual with 8’6 per<lent. ; according to the table which gives these particularsonly one American vessel was inspected during the halfyear. There were 34 sick seamen referred to hospital overand above the cases of infectious disease dealt with underthe Public Health Act. In the course of the medical

inspection of arrivals at the port, 5236 vessels were visitedby the medical officers stationed at Gravesend, this involvingthe medical examination of 5412 passengers and crewsto the number of 19,916. At Sheerness 135 vesselsfrom foreign ports were visited by the medical officer.The result of such medical inspection was the discoveryand removal to hospital of two cases of plague, six of small-pox, one of scarlet fever, 15 of enteric fever, two of erysipelas,22 of measles, and two of other diseases. The two casesof plague were reported on board the s.s. Eastbozcrne fromAlexandria on July 25th; they were isolated in the portsanitary hospital, all the usual precautions being taken withregard to the vessel. The patients recovered, but no furtherdetails are given regarding them. The system of medicalinspection at Gravesend and Sheerness obviates the necessityfor any extraordinary measures being taken with respect toplague. All the passengers and crews of all vessels arrivingfrom any port either known or suspected to be infected aremustered for inspection, and the addresses to which they areabout to proceed are given. The owners of such vessels arealso asked to arrange for the capture and destruction, so faras possible, of all rats found on board. Dr. Collingridgedevotes a paragraph to the space allottel to Lascars on

board ship, and in referring to the great difference betweenthe requirements of the Indian and the British Merchant

Shipping Acts he mentions that it has already been strongly

contended by the Port of London sanitary authority that thepresent legal minimum of 72 cubic feet is insufficient. At

the infectious hospital of the authority 22 cases were

admitted during the half year and the same number weredischarged recovered, the patients being detained for an

average period of 18 days. Mention is made of a case in

which rags forming a cargo arrived from Egypt I were foundto be in a filthy condition, containing fascal matter, blocd,and swarming with animal life." These rags were dis-infected by superheated steam before being landed.

WISE BENEVOLENCE.

A FREE convalescent home has lately been built at CastleHill, Bletchingley, by Mr. Partridge to the memory of hisdaughter. It is intended for the benefit of patients of bothsexes of the better class but in poor circumstances, primarilyfor those recovering from acute rheumatism; but othercases are occasionally admitted. The Home is absolutelyfree and is under the charge of a trained nurse. The house,which is on sandy soil, faces south and looks across theWeald of Sussex away to the Isle of Wight. It is an

exceedingly favourable site-high, breezy, dry, and warm-and is admirably suited for the kind of patients whom it is’intended to benefit. The appointments are hygienic and yetartistic; there are a good piano, a nice collection of books,games, and every home comfort. Patients are admitted fromhospitals, or direct from the physician in charge of the case.All applications should be made to the Matron, ConvalescentHome, Castle Hill, Bletchingley, Surrey.

THERAPEUTIC USES OF OREXIN.

DR. J. W. SMITHWICK found orexin tannate of specialbenefit in the dyspepsias of functional character or in thoseoccurring during convalescence from the acute specificfevers. In his own individual case, the trouble beingfunctional dyspepsia with a disagreeable saline taste in themouth in the morning and with a tendency to constipation,orexin proved more efficacious than bitter tonics or the

combination of pepsin with hydrochloric acid. In 18 casesit was found very effective as a curative agent, and thesecases were as follows: functional gastric atony, five cases ;

anaemia, three; tuberculosis, four; dyspepsia of con-

valescence, six. " In all cases the body-weight increased,and this was especially noticeable in phthisical patients."The length of time required was variable, being three weeksor longer for simple atonic dyspepsia, from four to six weeksfor ansemic dyspepsia, and six weeks or more for phthisicalpatients. The following illustrative clinical cases bear outvarious interesting features in the treatment. Case 1. A

man, aged 34 years, had been subject to atonic dyspepsiafor one and a half years. His epigastrium was sore and tenderto pressure and the bowels were inclined to constipation.During this period he lost 33 pounds in weight. After un-successful treatment with nux vomica and hydrochloric acidhe was put on orexin tannate in doses of six grainstaken one hour before meals. In two days there was

improvement of appetite and of digestive power. The bowelsbecame regular, the assimilative powers were much improved,and his weight began to increase. He progressed satis-

factorily and was cured, his weight having increased by18 pounds. Case 2 was that of a young woman, aged17 years, who was ansemic and was subject to malaria.

Appetite and digestion were exceedingly poor and she hadlost during the three months of her present illness about30 pounds in weight. She was pale, weak, and had a sallowcomplexion. Orexin tannate was given in six-grain dosesone hour before meals and two drops of Fowler’s solution weregiven half an hour after meals. Within a week she began

1 Merck’s Archives, March, 1900.

Page 2: THERAPEUTIC USES OF OREXIN

1020 THE CONTRACTOR AND THE VOLUNTEERS.

visibly to improve and at the end of the fourth week she hadconsiderably regained her lost weight and was feeling quitewell. The other cases recorded also show the beneficialeffects of the drug in a tuberculous patient and in one con-valescing from typhoid fever, and the results obtained in thetotal of cases are highly encouraging.

THE PREVENTION OF CRUELTY TO CHILDREN.

ON April 1st the National Society for the Preventionof Cruelty to Children entered the twelfth year of its exist-ence. Since the date of its birth the area covered by itsuseful activity has greatly increased. The number of cases

investigated annually has risen in proportion from 737 to28,165. Its inspectors, originally 10, are now 150 in number,a total far from excessive in relation to the work which

they have to do. 25 " centres" occupied in its first year havebeen augmented by 750. Its annual income of .f.3000has become .650,000. These facts in themselves are

instructive of the necessity which called the societyinto being ; enforced as they are by well-authenti-cated reports from all parts of the country of cases in

which the law has been called upon to secure the mostelemental rights of humanity for unhappy children theycannot fail to convince the judgment of every candid person.We are aware that there are those in every district who holdthat a parent is the natural and supreme authority in hisown household. We admit that this is the right arrange-ment under natural and wholesome conditions. We denyit entirely in the too frequent cases where sloth, vice, orself-indulgence has transformed the parents into despots andthe children into helpless victims. The society, we under-stand, is desirous of considerably extending its operationsduring the coming year. For this purpose it is estimatedthat a special fund of L5000 will be required, and this in theface of a deficit during the past year of not less than .66000.The costly emergencies created by the South African warand the Indian famine have already imposed a heavy taxupon public generosity and will entail yet further expendi-ture. Notwithstanding those more distant but freely re-cognised obligations we are not without hope that charitywill be equal to the claims which are made upon her at home.Heavy though our national expense has been we cannot

overlook the fact so clearly proved by the Exchequer returnsthat the past financial year has been one of unexampled com-mercial prosperity. -

THE CONTRACTOR AND THE VOLUNTEERS.

QUESTIONS and answers in the House of Commons have

recently shown the country that the army contractor of thetype associated with so many hideous scandals in the pastis dying hard and that if his race is to some extent dis-

appearing it is at all events not yet extinct. Some ofthese questions have referred to boots supplied to the lstVolunteer Battalion of the Worcestershire Regiment. The

inspection of feet and of foot-gear is not practised in ourarmy in times of peace with the method and with the samesense of its importance as is the case in continental armiessuch as that of Germany, but in times of war it is at

least recognised by everyone that it is useless to expectmen to march on stony ground in any boots that

are not of good quality, and that if the contract specifiesboots of good quality and allows a fair price for them suchboots should be supplied. In the case of the WorcestershireVolunteers the boots seem to have been ordered by thoseconnected with the corps itself and not by the contractdepartment of the War Office, which was not even con-

sulted, and in the result the boots, or a large number ofthem, had to be condemned as unfit for their purpose. Astatement to this effect having been made by Mr. Powell

Williams in the House of Commons the firm of con-

tractors named, Messrs. Samuel Brothers, of Ludgate-hill,have addressed to the Tirnes a letter of, as it seems

to us, inefficient excuses. They state that not beingmanufacturers of army boots they had to purchase what theyrequired and that they stipulated for good boots. Theyalso suggest that their shortcomings were due to want oftechnical knowledge, and state that the War Office, with allits technical knowledge and resources, appears to have falleninto similar difficulties. This obviously does not absolve thefirm in question from their responsibility or from any part ofit. If a man undertakes to supply sound food or clothing tohis fellow-man for an adequate price, or even for an in-

adequate one, he is bound by his contract to do so andcannot shelter himself behind the plea that he had to buythe goods from a third party and was not sufficiently skilfulto be able to judge of their quality. His purchaser might havebelieved himself to be dealing with the manufacturer, or hemight have employed a middleman for the express purposeof availing himself of his skill and experience. In any casea volunteer colonel dealing with large contractors may beexcused if he trusts to their judgment, where their reputa-tion and trade are at stake, although it may be thoughtthat but for the haste with which many volunteer com--

panies have been equipped for active service a system morelikely to ensure good results might have been employed.

THE MEDICAL FOLK LORE OF SHAMROCK.

THE order of the Queen that her Irish regiments shallwear the green on St. Patrick’s Day in recognition of theirbravery in the South African war has made the botany ofthe shamrock a topical question. There is some difference of

opinion as to what really was the plant by the aid of whichSt. Patrick demonstrated the doctrine of the Trinity, and aningenious correspondent suggests to us that medical folk loremight come to the aid of accurate science, as a plant withsuch a sacred history would certainly be endowed by.theCelts with high therapeutic virtues. Medical folk lore, alas,has nothing conclusive to say. Two botanical tribes claimthe honour of possessing the true shamrock-viz., theoxalidese and the trefoils-and to both are ascribed bypopular superstition medicinal properties. The Oxaliff

acetosella, which is said by one school of observersto be the actual plant with which St. Patrick’s name is sointimately associated, was at one time used in the makingof a cooling drink for use in fevers, and had a reputationas a cardiac sedative. On the other hand, clover, whichmost English people believe to be the sub-order of legumi-nosse including shamrock, is credited with the power of

curing" scrofulous sores and whooping-cough. The name"shamrock" is said to be derived from seamrog, thediminutive of seamar, which meians a trefoil, and Gerardein his "Herbal" says that the Irish call the common

meadow trefoil "shamrocks." But George Bentham, althoughadmitting that Trifolium repens and shamrock in the popularmind are identical, says that shamrock was originally

believed to be the Oxalis acetosella.PATHOLOGY AT THE SCOTTISH ASYLUMS.

THE third annual report of the pathologist for the

Scottish asylums covers the year 1899 and has been justissued. It points out that the Pathological Laboratory inEdinburgh has been utilised for giving a course of instruc-tion to nine gentlemen (six being medical officers of

asylums and three being medical men unconnected withthe asylum service) on the methods of pathological tech-nique. All the more important home and foreign neuro-logical journals are accessible at the library of this insti-tution, which also concerns itself with the preparation andsale (or loan) of "demonstration sets of microscopic