CHELSEA CLINICAL SOCIETY

1899 The Lancet  
1096 thorax respiration recommenced after two minutes, being slow, shallow, and sighing. The same patient had taken gas previously with a similar cessation of respiration.-Mr. BELLAMY GARDNER and Dr. FLUX deprecated the death being attributed to gas and oxygen.-Dr. SiLK's experience went to show that the after effects of gas and oxygen were more varied and more frequent than those consequent upon nitrous oxide alone. He pointed out that the physiological effects of the gas and oxygen might
more » ... st in the individual even when he appeared to resume consciousness, and it was quite conceivable that chloroform might increase these effects and finish what the mixture had commenced. He cautioned against the mixture being employed indiscriminately, as no doubt its value would thereby be lessened.-Mr. CROUCH narrated a case of a patient to whom he gave gas diluted with air and found evidence of dilatation of the heart during the administration. He had had precisely similar experience in giving j , gas with oxygen, in which case he carefully noted the condii tion of the heart.-The PRESIDENT spoke a few words of warning against the elevation of the mixture into a kind of panacea among anaesthetics. He had found that many persons had formed the most extravagant conception of its possibilities and were not aware of its limitations.-Dr. MCPHAIL having narrated his experiences Mr. BELLAMY GARDNER replied. Food. It was under many circumstances necessary to preserve foods from decomposition and for this purpose drying, smoking, salting, and heating, followed by exclusion of air, with or without the addition of oil or sugar were variously applicable and harmless. Salt was distinguished from other chemical preservatives by being a normal constituent of the animal body, the ingestion of between half an ounce and one ounce daily being necessary to health. The antiseptics which he would consider were chemicals foreign to the living body and exerting physiological actions of which advantage might be taken by the physician in the treatment of disease, but the inconsiderate consumption of such substances was presumably injurious to persons in health. Perhaps those most widely used at the present time were boric acid, borax, and salicylic acid, though of late a solution of formic aldehyde, under the name of formalin, had been extensively employed. Between 1896 and 1898 Dr. Hill had examined 1016 samples of milk, of which 59 were preserved by boric acid and 29 (of 600 only examined for it) with formic aldehyde. Boric acid was found in 216 out of 574 samples of butter and in 28 out of 33 of margarine. Boric acid was present in five out of six samples of cream, one containing salipylic acid also. Four out of seven samples of sausages, four out of six of ham, all of four hams and tongues, one out of three pork pies, one of two samples of pickled meat, and one of two polonies, five out of six samples of jam, five out of 11 of ipecacuanha wine, and one out of 12 of sherry contained salicylic acid. Benzoic acid had been used in France since the prohibition of salicylic acid. Sulphurous acid was widely employed in the treatment of wines, beers, lime juice, &c., and fluoride of sodium, a powerful antiseptic, but in doses of a few grains almost a poison, had been so too. As to their effect on digestion the case of formic aldehyde admitted of no doubt ; one part per 1000 of milk rendering the casein insoluble in pepsin and hydrochloric acid, and one part of formalin (a 40 per cent. alcoholic solution of formic aldehyde) to 2000 parts by weight of fish, hardening them so as to be quite unsaleable. England was almost the only country in the civilised world where the use of antiseptics as such was wholly unrestrained and prosecutions had to be undertaken under Section 6 of the Sale of Foods and Drugs Act, on the ground that the sample is not of the nature or quality demanded, or under Section 2, that " the addition is injurious to health," and the defence always endeavoured to throw on the prosecution the onus of proving injury in the particular case, the quantity of adulterative matter found by the analyst, or the proportion requisite for the purpose in view. But while one man deemed 18 grains of boric acid to one pound of butter sufficient another put in 84 grains, and though the quantity consumed in one article of food might be productive of no ill effects it was quite possible that the aggregate dosage of several in daily use might be highly injurious, to say nothing of individual susceptibilities. So-called experts, mostly chemists ignorant of physiology, could always be had to give evidence for the defence, and it was safer that Section 6 only should be relied upon. Dr. Hill quoted the opinions of numerous authorities based on clinical observa.tions or upon experiments on themselves and on dogs as, to the effects of small and large doses of boric acid to show that it tended to interfere with nutri,tion, to increase excretion by the bowel and kidney, 7 to induce catarrhal and inflammatory conditions and! cutaneous eruptions, and to depress the heart's action to> such an extent that fatal consequences had followed its use even in surgery. The action of salicylic acid on the heart and cerebral functions as well as on nitrogenous, metabolism was well known, and its great value as a drug made its habitual use more evidently dangerous. Perhaps, however, the most serious aspect of the question at present was the effect of boric acid in milk upon infants whosesole or chief food was milk, and it was not improbable that much infantile diarrhoea might be due thereto. In Germany all antiseptics were illegal-boric acid in meat and milk especially-and their use was prohibited more or less strictly in France, Italy, Holland" and even in Spain and some States of both North and South America. In France, however, produce intended for exportation was exempt, and "Brittany butter" and the milk recently sent over from Normandy were highly charged with. boric acid. There was no real justification for the use of chemical preservatives, but if they were not prohibited unconditionally some authoritative regulation was required, as would have been exercised by the proposed Board of Reference in the Bill introduced in 1897 by Mr. Kearley and other members of the House of Commons. Refrigeration, however, was a means of preserving all perishable, articles of food which was absolutely free from objection. and applicable to all alike. Mr. TUBB THOMAS said that boric acid was employed in large amounts for preserving in an apparently fresh state thefish imported from Sweden and Norway. Dr. WILLOUGHBY believed that the use of preservatives for milk was in London practically confined to the small retail dealers, enabling them to carry over to the next day the few gallons left unsold. The great companies, at any rate that with which he was connected, strictly prohibited the use of preservatives while insisting on effectual refrigeration by special apparatus. Mr. others having spoken Dr. HILL replied. Two resolutions (1) deprecating the use of chemical antiseptics in general, and (2) demanding that if they were permitted their nature and amount should be clearly stated werepassed almost unanimously. CHELSEA CLINICAL SOCIETY. Tuberculosis. A SPECIAL meeting of this society was held at the Jenner Institute of Preventive Medicine, Chelsea-gardens, S.W., on April l8th, the President, Mr. J. FOSTER PALMER, being inthe chair. The subjects of discussion were the Recent Investigations relating to the Etiology, Prevention, and Treatment of Tuberculosis. Dr. AUSTIN E. COOPER, the honorary secretary, read the minutes of the last ordinary meeting which were then confirmed and the names of new members were read out. The PRESIDENT in the course of a few introductory remarks touched upon the several aspects of tuberculosis. He said that the additions to our knowledge of this subject were, after all, confined principally to bacteriological research. The contagious nature of the tubercle and the:
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