1897 The Lancet  
Chronic Nephritis. ACCORDING to Dr. Chvostek chronic arthritis does not -depend on the presence of micro-organisms in either the joints or the blood. The finding of bacteria in the joints, -either after death or when death is impending, proves nothing, and the hypothesis that a specific micro-organism is the cause of arthritis is untenable. The symptoms of the disease are not constant, the only characteristic feature 'being a swelling of short duration affecting a joint-,a condition which may
more » ... induced by toxins altogether apart from living bacteria. On the other hand, Dr. Singer, who has examined the blood, the urine, and the articular exudations in ninety-two cases, states that both staphylococci and streptococci are to be found. In three instances post-mortem examination showed the same bacteria as in the living subjact; in one case the synovial membrane contained bacteria, but the exudation was free from them ; in a third case there were haemorrhages with numerous -streptococci in the peri-articular tissue. These facts explain why in a great many cases the articular exudations are free -from bacteria. The inflammation of the synovial membrane is symptomatic, the infiltrations which contain the bacteria being frequently in the peri-articular tissue. Dr. Singer considers that the erythema multiforme which frequently aceompanies arthritis is a typical pyasmic affection of the -akin ; he is opposed to the view that salicylic preparations have a specific action, and he has seen very favourable results produced by intravenous injections of a mercurial salt. The Murphy Button. In an article published in the Medicinische Wochensehmift Dr. Marwedel has given an account of the results obtained with the Murphy button in fifty-five operations. In thirtyfive cases an anastomosis was made between the stomach and the intestine and in three cases between the gall-bladder and the intestine ; in twenty-nine cases there was carcinomatous stenosis. Twenty-three of the thirty-five cases of gastroenterostomy showed an improvement ; two of the cases of 'cholecystenterostomy showed an improvement, and the remaining one died. The button was usually passed after the lapse of two weeks. According to statistics published by Dr. Brentano cicatricial stenosis resulted in only three among 328 button operations. Compulsory Insurance and Medical Aid Societies. At the last meeting of the Medical Chambers Dr. Janovsky, <of Prague, called attention to the compulsory insurance of workmen-a subject of which I have already given an account in THE LANCET.1 On the ground of the disastrous effects which this system of insurance produces on the incomes of medical practitioners Dr. Janovsky proposed a resolution the substance of which was that all the Medical Chambers should be invited to declare that the holding of a permanent appointment in connexion with this work constitutes an ethical misdemeanour, and that such practitioners will consequently be brought before the council of honour. The resolution was unanimously adopted, and the meeting also made arrangements for presenting a petition to Parliament praying for the repeal of the compulsory laws. The following gentlemen were then elected on the committee :
doi:10.1016/s0140-6736(01)90691-9 fatcat:f4srx5k5fbdfrof3bol6xl6dru