HOSPITAL PROVISION FOR MEDICAL CASES IN CHESTERFIELD
1897
The Lancet
only see fingers at a distance of three feet. In the left eye also there was a large central scotoma which could not be mapped out. In the centre of this eye white objects could only be seen with difficulty, and red and green were ,quite invisible. Six years later vision in the right eye with correction was with the left, fingers could be counted'at three feet, and there was a well-marked scotoma for red. The left disc was found distinctly pale in colour, but the vessels did not seem to be
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... ished in size. The vessels and disc in the right eye appeared normal. The chief points of interest in this case are, Mr. Treacher Collins points out, the great defect in vision which resulted and the prolonged exposure to the sun which brought about this great impairment of vision. He also points out that so far as he is aware no instance has been recorded in which atrophy of the optic nerve has followed blinding by exposure to sunlight. Reference is made to the recently recorded experiments of Usher and Dean, in which it was shown that retinal wounds were followed by partial atrophy of the optic nerve. These observers found that degeneration always corresponded to the part of the retina that had been wounded, and that in a monkey's eye, when the lesion was made between the optic disc and yellow spot, the degenerated area lay in the outer part of the nerve anteriorly. Mr. Treacher Collins suggests that in his patient the exposure may have caused destruction of some of the retinal elements in the macular region and consequently atrophy of nerve fibres supplying it. Although there was general pallor of the disc the outer part was decidedly the whiter. brief religious service Mr. Bayard declared the;[stone to be 'fairly and squarely laid," and spoke eloquently on the philanthropic and altruistic spirit which had been such a distinctive characteristic of the Victorian reign. Sir James Crichton Browne, in proposing a vote of thanks to Mr. and Mrs. Bayard, said that it was fitting that Mr. Bayard should take part in this ceremony at an epileptic colony, as he was a distinguished specialist whose province was, by skilful sedative treatment, to avert disastrous convulsions in the body politic. He spoke of the frequency of nervous disorders at the present time, when the " so-called march of civilisation had often a tendency to degenerate into a wild stampede from poverty and hunger." Mr. Passmore Edwards, who was very cordially greeted, spoke of the friendly feeling between this country and the United States, which would render a war between the two countries an impossibility in future. Mrs. Bayard subsequently opened the new Home for Women, the foundation-stone of which was laid by Lord Addington last year. This home will accommodate twenty women, who will be employed in the laundry (which is now being constructed) and in the dairy. Up to the present there has been no resident medical officer, there being no accommodation for one. With the admission of women to the colony, however, the need for adequate supervision of the colony becomes doubled, and it is very satisfactory to learn that Colonel Montefiore has induced an anonymous donor to give E5000 for the erection of a suitable house for a resident physician. It is intended, we believe, that there shall be accommodation in this house for eight or ten patients of a superior class, whose payments on a higher scale will cover the cost of the services of the medical officer to the whole colony. The colony so far has been an unqualified success. Although from the fact that only very severe cases have been taken there have been few "cures," yet in nearly all instances there has been remarkable improvement in the general condition. A glance at the carefully kept market garden and at the large amount of work turned out from the carpenter's shop gave an idea of the useful work which is being done, though there appears room for more variety of occupation, particularly in-door industries, during continued bad weather. Provision of these is, no doubt, only postponed owing to the lack of the necessary funds. PARALYSIS OF THE FOREARM FROM BICYCLING. DR. DESTOT has published in the Gazette des Hôpitauax an account of his own experiences. An abstract of the paper appears in a recently published number of the Neurologisches Centralblatt. After a long ride he experienced paræsthesiæ in the fourth and fifth fingers, with impaired sensibility and paresis in the interossei, lumbricales, and the adductor pollicis. This paresis was followed by distinct atrophy in the affected muscles. He considers the affection to be the result of pressure upon the branches of the ulnar nerve, aggravated, doubtless, by the vibration occasioned by bad roads. He also considers that predisposing factors existed in the softness of the skin of the hand and in the exhaustion of the muscles and the consequent loss of protection to the nerves lying in or under them.
doi:10.1016/s0140-6736(01)96119-7
fatcat:qlfi43kezrfjhf5bv5fqziawyq