1
165 ance of blood, and to intra-ocular hemorrhage following on the operation of extraction of cataract, during which there has been a large escape of fluid vitreous. 2. In acertain number of cases, on a man’s first "entrance on catheter life," there occurred chemical alterations in the - condition of the urine within the bladder, leading to its de- composition ; and when this took place the patient frequently sank and died with symptoms resembling those of septic poison- ing. The second of the two cases narrated by Sir Andrew <!lark he could not help thinking was rather of that character than possessing anything in common with urethral fever properly so called. This decomposition of the urine occurred mostly in old men and persons who from any cause had paralysis of the muscles of micturition. He had seen it occur in a case in which the urethra was not interfered with at all, but where for three weeks a cannula had been fixed in the bladder above the pubes; and he believed it was really due to absorption of septic material from the bladder. 3. A man might die from shock within a few minutes of the instrument passing through the urethra, just as he might die from shock after an incision in the soft parts, the ex- traction of a tooth, or the reduction of a dislocation without anesthetics. A case of sudden death after urethral instru- mentation was related by Mr. Mitchell Banks.2 2 Persons vith a weak flabby heart were, of course, most liable to this disastrous sequel of catheterism. 4. In addition to all these classes ot cases there was another (to which he would " " "’ ’ the term urinary fever or urethral fever), in which irritation of the urethra, sometimes by instruments, sometimes in other ways, led, by reflex influence through the sympathetic nervous system, to attacks of a very sudden and sometimes alarming fever. This was a disease of male adult life, when the liability of the organs of generation to nervous shock were greatest. It varied in degree from a slight feverishness lasting for an hour or two to a grave fever which occasionally terminated in death. Its symptoms were vomiting, rigors, frontal headache, injected conjunctivse, and partial or total suppression of urine. Catheter fever was not a happy term, as it had no special connexion with retention of urine and the use of the catheter. It occurred frequently after the passage of bougies through a strictured urethra for the first time, or the passage of a larger instrument than usual, and also in sounding for stone; he had seen it follow the passage of a calculus, and in one case of a quantity of uric acid gravel through the urethra. It was met with, sometimes in a very severe form, after lithotomy when the urine first flowed again through the urethra. In days when strictures were treated by the application of caustics the sequel was well known.- Dr. MACLEOD said that he was convinced the use of chloro- form in instrumentation would to a large extent prevent these consequences. In treating the fever he relied on ’quinine, morphia suppositories, aconite, and heat.-Dr. A. rAliK.-iUN 8ai<l H1HL ill llU a lew U1 B>lle:se UdSVI3 une I.18K. Ot. instrumentation arose from their being complicated with diseased kidneys and other morbid conditions.-Dr. MoRTON said that the fever was often met with in cases of simple stricture ; and as it might perhaps be regarded as a con- ’comitant or consequence of that state of body which pre- disposed to stricture, it might be called " stricture fever."- Dr. COATS, in reference to the pathology of the disease, was not satisfied with the usual explanation of nervous irritation extending from the urethra to the kidney setting up inflam- mation in the kidney. Inflammation of the kidney would not produce absolute stoppage of urine. It occurred to him that as the rigors might be due to spasm of the arteries of the skin, in the same way a violent irritation of the urethra might, by stimulating the vaso-motor centres, produce such a contraction of the arteries of the kidney as to give rise to a stoppage of the circulation of that organ.-Several other members spoke. WOOLWICH MILITARY MEDICAL SOCIETY. THIS Society held a meeting at the Army Medical Depart- ment Mess on Wednesday, January 16th, at 8.30 P.M., the President, Sir James Hanbury, K.C.B., in the chair. Surgeon-Major GODWIN read a paper on Antiseptic Surgery and its Application to Military Hospitals and Field Service," in which, after a short description of the theory and object of antiseptic surgery and of the dressings used in 1 THE LANCET, Dec. 22nd, 1883. 2 Edinburgh Medical Journal, 1871. the Liaterian method (specimens of which were handed round), he advocated the application of a simple antiseptic covering to wounds on the field, without probing or further interference than was necessary to stop hromorrhage and prevent further mischief ; the patient to be then removed as soon as possible to the field hospital, where the wound could be examined with antiseptic precautions. To show the value of the Listerian method Surgeon-Major Godwin then referred to a number of cases which had been successfully treated according to that method by Surgeon-Major Stevenson and himself in the hospital at the Arsenal. In conclusion, he called upon Dr. Rice of the Plumstead Infirmary to give a short account of a case of recent fracture of the patella on which he had lately operated successfully by the method of Sir Joseph Lister.-Dr. RICE described the case, and after a short discussion the meeting terminated. Reviews and Notices of Books. Life History Album. Prepared by direction of the Collective Investigation Committee of the British Medical Associa- tion. Edited by FRA.Ncis GALTON, F.R.S. London: Macmillan and Co. 1884. Record of Family Faculties. Consisting of Tabular Forms and Directions for entering Data. With an Explanatory Preface. Bv FRANCIS GALTON, F.R.S. London: Mac- millan and Co. 1884. THESE two works are intended to afford information in regard to past generations which may prove serviceable to future ones. The history of a man’s life, if carefully coR- sidered, will, however, do more than this; it will enable him to recognise the mode in which his health has been affected by his residence, occupation, and habits of life, and it will frequently afford information that may prove of great importance in the treatment of disease. It is intended that each child should be provided with one of these albums at its birth, though it may be begun at any period. The Album is divided into several sections. The first of these is the genealogical record, in which a skeleton form is drawn up where entries can be made of the family medical history, including the date of death of all near relatives, and their liability to gout, rheumatism, cancer, asthma, epilepsy, insanity, diabetes, and other serious diseases, and to such minor ailments as boils, quinsy, bilious attacks, constipation, skin eruptions, and the like, with any imperfections of the special senses. The second section is spaced for observations on the child at birth, including its height and weight, its girth, colour of eyes and hair, and condition of general health, with any information that may lead to the explana- tion of mothers’ marks-no observation on the latter point, however, being considered valid unless reduced to writing before the birth of the child. The medical and life histories are expected to be taken every five years, with anthropo- metric observations, which include the colour of the eyes and hair, the chest girth round nipples, the strength of pull, acuteness of vision for distant and near objects, colour, vision, hearing and other special senses, and state of the teeth. Information is further sought in regard to endurance, both mental and physical; any special bodily or mental charac- teristic, any marked artistic capacity, and any characters referable to heredity. Lastly, there are spaces for photo- graphs. We fear that, however useful this Album would be if completed, Mr. Galton will induce but few persons to fill the spaces and answer the queries he proposes. In the first place, it could only be done by a quiet, well-to-do, settled family. In few houses with which we are acquainted would such a book be forthcoming at the end of every five years; in the next place, somewhat expensive apparatus is required, as a weighing and measuring machine, costing four or five guineas, a dynamometer, nearly another pound, and a series of photographs which, when there are several children, would

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165

ance of blood, and to intra-ocular hemorrhage followingon the operation of extraction of cataract, during whichthere has been a large escape of fluid vitreous. 2. Inacertain number of cases, on a man’s first "entrance oncatheter life," there occurred chemical alterations in the- condition of the urine within the bladder, leading to its de-composition ; and when this took place the patient frequentlysank and died with symptoms resembling those of septic poison-ing. The second of the two cases narrated by Sir Andrew<!lark he could not help thinking was rather of that characterthan possessing anything in common with urethral feverproperly so called. This decomposition of the urine occurredmostly in old men and persons who from any cause hadparalysis of the muscles of micturition. He had seen itoccur in a case in which the urethra was not interfered withat all, but where for three weeks a cannula had been fixedin the bladder above the pubes; and he believed it wasreally due to absorption of septic material from the bladder.3. A man might die from shock within a few minutes of theinstrument passing through the urethra, just as he mightdie from shock after an incision in the soft parts, the ex-traction of a tooth, or the reduction of a dislocation withoutanesthetics. A case of sudden death after urethral instru-mentation was related by Mr. Mitchell Banks.2 2 Personsvith a weak flabby heart were, of course, most liable to thisdisastrous sequel of catheterism. 4. In addition to all theseclasses ot cases there was another (to which he would " " "’ ’the term urinary fever or urethral fever), in which irritationof the urethra, sometimes by instruments, sometimes inother ways, led, by reflex influence through the sympatheticnervous system, to attacks of a very sudden and sometimesalarming fever. This was a disease of male adult life, whenthe liability of the organs of generation to nervous shockwere greatest. It varied in degree from a slight feverishnesslasting for an hour or two to a grave fever which occasionallyterminated in death. Its symptoms were vomiting, rigors,frontal headache, injected conjunctivse, and partial or totalsuppression of urine. Catheter fever was not a happy term,as it had no special connexion with retention of urine andthe use of the catheter. It occurred frequently after thepassage of bougies through a strictured urethra for the firsttime, or the passage of a larger instrument than usual, andalso in sounding for stone; he had seen it follow the passageof a calculus, and in one case of a quantity of uric acid gravelthrough the urethra. It was met with, sometimes in a verysevere form, after lithotomy when the urine first flowed againthrough the urethra. In days when strictures were treatedby the application of caustics the sequel was well known.-Dr. MACLEOD said that he was convinced the use of chloro-form in instrumentation would to a large extent preventthese consequences. In treating the fever he relied on’quinine, morphia suppositories, aconite, and heat.-Dr. A.rAliK.-iUN 8ai<l H1HL ill llU a lew U1 B>lle:se UdSVI3 une I.18K. Ot.

instrumentation arose from their being complicated withdiseased kidneys and other morbid conditions.-Dr. MoRTONsaid that the fever was often met with in cases of simplestricture ; and as it might perhaps be regarded as a con-’comitant or consequence of that state of body which pre-disposed to stricture, it might be called " stricture fever."-Dr. COATS, in reference to the pathology of the disease, wasnot satisfied with the usual explanation of nervous irritationextending from the urethra to the kidney setting up inflam-mation in the kidney. Inflammation of the kidney wouldnot produce absolute stoppage of urine. It occurred to himthat as the rigors might be due to spasm of the arteries ofthe skin, in the same way a violent irritation of the urethramight, by stimulating the vaso-motor centres, produce sucha contraction of the arteries of the kidney as to give rise toa stoppage of the circulation of that organ.-Several othermembers spoke.

___________

WOOLWICH MILITARY MEDICAL SOCIETY.

THIS Society held a meeting at the Army Medical Depart-ment Mess on Wednesday, January 16th, at 8.30 P.M., thePresident, Sir James Hanbury, K.C.B., in the chair.

Surgeon-Major GODWIN read a paper on AntisepticSurgery and its Application to Military Hospitals and FieldService," in which, after a short description of the theoryand object of antiseptic surgery and of the dressings used in

1 THE LANCET, Dec. 22nd, 1883.2 Edinburgh Medical Journal, 1871.

the Liaterian method (specimens of which were handedround), he advocated the application of a simple antisepticcovering to wounds on the field, without probing or furtherinterference than was necessary to stop hromorrhage andprevent further mischief ; the patient to be then removed assoon as possible to the field hospital, where the wound couldbe examined with antiseptic precautions. To show thevalue of the Listerian method Surgeon-Major Godwin thenreferred to a number of cases which had been successfullytreated according to that method by Surgeon-MajorStevenson and himself in the hospital at the Arsenal. Inconclusion, he called upon Dr. Rice of the PlumsteadInfirmary to give a short account of a case of recentfracture of the patella on which he had lately operatedsuccessfully by the method of Sir Joseph Lister.-Dr. RICEdescribed the case, and after a short discussion the meetingterminated.

Reviews and Notices of Books.Life History Album. Prepared by direction of the Collective

Investigation Committee of the British Medical Associa-tion. Edited by FRA.Ncis GALTON, F.R.S. London:Macmillan and Co. 1884.

Record of Family Faculties. Consisting of Tabular Formsand Directions for entering Data. With an ExplanatoryPreface. Bv FRANCIS GALTON, F.R.S. London: Mac-millan and Co. 1884.

THESE two works are intended to afford information in

regard to past generations which may prove serviceable tofuture ones. The history of a man’s life, if carefully coR-sidered, will, however, do more than this; it will enablehim to recognise the mode in which his health has beenaffected by his residence, occupation, and habits of life, and

it will frequently afford information that may prove of greatimportance in the treatment of disease. It is intended thateach child should be provided with one of these albums atits birth, though it may be begun at any period.The Album is divided into several sections. The first of

these is the genealogical record, in which a skeleton form isdrawn up where entries can be made of the family medicalhistory, including the date of death of all near relatives, andtheir liability to gout, rheumatism, cancer, asthma, epilepsy,insanity, diabetes, and other serious diseases, and to suchminor ailments as boils, quinsy, bilious attacks, constipation,skin eruptions, and the like, with any imperfections of thespecial senses. The second section is spaced for observationson the child at birth, including its height and weight, itsgirth, colour of eyes and hair, and condition of generalhealth, with any information that may lead to the explana-tion of mothers’ marks-no observation on the latter point,however, being considered valid unless reduced to writingbefore the birth of the child. The medical and life historiesare expected to be taken every five years, with anthropo-metric observations, which include the colour of the eyesand hair, the chest girth round nipples, the strength of pull,acuteness of vision for distant and near objects, colour, vision,hearing and other special senses, and state of the teeth.Information is further sought in regard to endurance, bothmental and physical; any special bodily or mental charac-teristic, any marked artistic capacity, and any charactersreferable to heredity. Lastly, there are spaces for photo-graphs.

’ We fear that, however useful this Album would be if

completed, Mr. Galton will induce but few persons to fillthe spaces and answer the queries he proposes. In the firstplace, it could only be done by a quiet, well-to-do, settledfamily. In few houses with which we are acquainted wouldsuch a book be forthcoming at the end of every five years;in the next place, somewhat expensive apparatus is required,as a weighing and measuring machine, costing four or fiveguineas, a dynamometer, nearly another pound, and a seriesof photographs which, when there are several children, would