Looking Back

1908 The Lancet  
the most typical form of pseudo-hypertrophic paralysis as a convenient instance of the heredity of the abiotrophies. A second class might include the hereditary maladies which begin later in life, after the period of growth was over. They presented persistent disturbance of function and were commonly hereditary, but from either side. In the so-called heredo-ataxy of Marie the symptoms begin about 30, and were usually fatal in about 20 years. A third class of .diseases in which heredity was
more » ... h heredity was operative consisted of the so-called functional affections. Some of them varied extremely in degree and baffled attempts to group them so as to discover their relation to heredity. Such were hysteria and the defective nerve strength which might manifest themselves in varied ways, and which they were all drawn, sometimes against their better judgment. to designate neurasthenia." .other functional disorders, such as chorea and neuralgia, had relations too complex for the clear discernment of heredity ; while migraine, defined as it was, was connected with quite different constitutional states from disease of the nervous system. Two forms of functional diseases had been much studied in relation to heredity, epilepsy and insanity. He found that in the cases which he had seen in private there was a family history of one or both, in 47 per cent. in antecedents, and present or past collaterals. Taking into consideration certain difficulties, the assumption was justified that at least 50 per cent., and probably more, really presented a family tendency. Among hospital patients the number was not more than 35 per cent. In the figures presented the percentage was taken from 2400 cases, of which 600 were seen in private. Heredity was ascertained in 39 per cent. of 1193 males and 43 per cent. of 1207 females. Of the total cases in which inheritance was paternal the father himself suffered in 40 per cent., when maternal the mother suffered in only 36 per cent. When epilepsy itself occurred in a parent it was the father who was epileptic in 49 per cent. of the cases, the mother in 51. The cases with insanity in a parent were only one-third the number with parental epilepsy. Of the cases with parental insanity the father was insane in 37 per cent., the mother in 63. One effect of heredity was to increase the female cases. Where it was absent the excess of males amounted to 4 per cent., but in -cases with heredity the same excess was presented by females. That was partly due to the fact that inheritance was more frequently from the mother's side by 13 per cent. 's Hospital has recently benefited by a gift of .great utility from the widow of the late Mr. Frederick Henriques. In memory of her husband she has presented a complete equipment of fittings and instruments for the new operating theatre in the Clarence Wing, which our representative has been given an opportunity of inspecting. The theatre is on the second floor of the building and can be ,entered through the anaesthetic room or directly from the 'corridor. The walls are covered with white glazed tiles from the terrazo floor to the ceiling, which is coated with a washable white paint. The source of light is a large northwest window of corrugated glass occupying the greater part of one wall ; this can be swung open in panels to .admit of the airing of the room but is constructed in a dust-proof manner. Beneath the windows are two teak benches with white tiled fronts, protected by enamelled iron rails, for onlookers. The room is heated by radiators and has bottom and top grating ventilators, the latter being connected with an outside shaft at the top of which is a powerful electric exhaust fan. Above the head of the table is an electric pendant containing transformers of high and low resistance for cauteries and "-oscopy" " lamps and plugs for heador hand-lamps. Another pendant electrolier supplies light for the table and is fitted with emergency gasburners. The basins have hot and cold foot-taps and the water is delivered through large roses. The table, by Messrs. Down Bros., is of simple and effective construction and allows of the various positions being readily obtained during an operation. It is heated by tanks under the patient. The table is served by two white metal ward trollies. The aseptic glass tables and metal stools are of an equally good design. A dozen Schimmelbusch's drums for dressings are included in the equipment. The sterilising-room, which leads from one corner of the theatre and is shut off from it by a door, contains steam sterilisers for dishes and instruments and a device for the hot storage of lotions which is, we believe, new. It consists of a metal cupboard heated by steam pipes at the back and bottom and closed by a door sliding on rollers. This cupboard contains shelves on which are stored all requisite lotions in large glass jars, which are sterilised in another department and then stored in the cupboard where they can be kept at any required temperature up to about 800C. until they are wanted. At the opposite corner of the theatre is the instrument room, equipped with a large and very handsome glass cabinet by Messrs. Weiss and Son, containing a complete instrumental armamentarium for general and special surgery, noteworthy features of which are a beautiful set of lithotrites and solid silver catheters and tracheotomy tubes, which in the long run prove the most economical. Another cupboard contains urethroscopes, cystoscopes, sigmoidoseope, bronchoscope, cauteries, head-lamps, and other accessory apparatus. A tablet on the wall of the theatre commemorates this munificent gift of its original equipment In Memory of Frederick Gutteres Henriques." Looking Back. FROM THE LANCET, SATURDAY, Nov. 13th, 1830. We cannot omit to notice some facts connected with the use of the stethoscope, which are of the utmost practical importance, and which the authors explain in a masterly manner. m a n n e r . ' The first is, the occasional disappearance of hepatization without the occurrence of the " crepitus " of resolution. The second respects the sonorous rale, and is of the deepest practical importance. In several cases of the worst catarrhal fever, while the patient was in a semicomatose condition, nothing is often observable by the stethoscope during ordinary respiration, though a loud sonorous sound is heard upon a deep respiration. Where the fever, however, is on the wane, when convalescence is setting in, and the patient in every respect improved, then a loud sonorous rale is heard even in ordinary respiration, owing to a diminution of inflammatory action, and not to its increase, as an inexperienced stethoscopist might readily imagine. The great modifications which laryngeal affections create in the stethoscopic evidence of pulmonary disease, is made the subject of lengthened observations. A singular phenomenon is also noticed of the formation of temporary tumours on the percussed parts of the chest in tubercular phthisis. Some cases of phthisis are alluded to, in which the pulse was full and slow, contrary to that state of quickness which, by many authorities, is even considered as diagnostic of the disease. A case is also cited, in which, notwithstanding the destruction of the greater part of the lungs, the calorific functions were increased in activity. Finally, a most extraordinary instance of malformation is described, in which the stomach lay within the thorax, above the diaphragm, and completely beyond the reach of its contractions. Vomiting occurred continually during the patient's illness, "a fact," as they observe, "worth a thousand experiments, and which completely decides the question that vonaatng mccy be prod1wed by the action of the stomach itself, unassisted by any external compressing force, notwithstanding what Le Gallois and late physiologists have said to the contrary. 112 2
doi:10.1016/s0140-6736(01)47427-7 fatcat:slwvlpyk7nffzhj4khz75vlogy