Notes and Queries. URTICARIA OF MUCOUS MEMBRANES.-The eruption of urticaria does not affect the skin only, but may extend to the mucous membranes. On some patients it can be observed; on others its existence is to be inferred from the symptoms. Affection of the stomach usually shows itself by vomiting, but in a few rare instances hematemesis has occurred. In the British Journal of Dermatology, May, 1898, Dr. T. H. Chittenden has published the following case: An unmarried woman, aged thirty-eight years, became subject to attacks of urticaria. They increased in severity; the tongue and lips became very swollen, there was sore throat with dysphagia and dyspnea lasting three or four hours, and the mucous membrane of the nose was much swollen and congested. These attacks usually lasted about a week. Later they were accompanied by nausea and by vomiting of large quantities of blood, which was followed by relief and the disappearance of the rash. There appeared to be some relation between the catamenia and the hematemesis; the latter came on about the first day of the former. Menstruation for the most part was regular but very profuse. No cause for the disease could be traced; there was no family history of gout, asthma, or hemophilia, and the strictest rules of diet had no effect. In the Transactions of the Clinical Society of London, 1885, Dr. Pringle recorded an exactly similar case in a man; he concluded that the hematemesis was the result of capillary hemorrhage from an urticarial gastric mucous membrane. In urticaria of the skin analogous hemorrhage may take place into the wheals (urticaria hemorrhagica). The mucous membrane of the bronchi may be affected, and a typical attack of asthma may accompany the skin disease. Of this a marked example was published in the Lancet of May 22, 1886, by Mr. T. Davies Pryce. Indeed, apart from such cases of concurrence, urticaria and asthma show many analogies. Idiosyncrasy plays the same prominent part in their causation. These facts lend support to the theory of the late Sir Andrew Clark that asthma is a neurovascular affection of the bronchial mucous membrane.-Lancet. TRI-STATE MEDICAL SOCIETY.-The tenth annual meeting of the TriState Medical Society of Alabama, Georgia, and Tennessee will be held at Birmingham, Ala., Tuesday, Wednesday, and Thursday, October 25th, 26th, and 27th, 1898. The following are some of the papers promised: President's Address, J. A. Goggans, Alexander City, Ala.; Early Diagnosis of Cancer of the Uterus, Thos. E. Cullen, Baltimore, Md.; Acute Anterior Poliomyelitis, E. D. Bondurant, Mobile, Ala.; A Case of Com plete Obstruction of the Common Bile Duct by Floating Gall-Stone, W. H. BEWARE OF THE MANCHINEAL TREE.-The following circular, prepared by Dr. J. T. Rothrock, Commissioner of Forestry, Department of Agriculture of the Commonwealth of Pennsylvania, has been published and distributed by direction of Hon. Daniel H. Hastings, Governor of the Commonwealth : SOLDIERS! BEWARE OF THE MANCHINEAL TREE!! It grows along the seashore in Cuba and the West India Islands generally. It is from forty to fifty feet high, has oval, pointed, toothed, shining leaves, which are from three to four inches long. When the fresh leaves are pulled off a drop of milky juice comes from the leaf stem. The fruit is a yellowish green, fragant, and somewhat resembles an apple in shape. If bitten into it makes the mouth very sore for a time and may produce serious results. After handling any part of the tree-root, leaves or fruit-rubbing the eyes may cause them to become seriously inflamed. Mucous membranes (such as the red margin of the lips or eyes or anus are particularly subject to its poisonous effect. It is said by many of the natives to cause poisonous effects even if the tree is not touched, but by simply being in its neighborhood. Many persons are alleged to have been injured from being under the tree during a shower, when the drops of water fell upon them from the tree. Some persons are more sensitive to the effect of this poison than others. In fact, there are a few who are not affected by it at all, just as is the case with our poison-oak or poison-ivy, the chief difference being that the manchineal affects the mucous membranes, above alluded to, more than the skin proper, whereas the poison-ivy affects the skin much more frequently than it does the mucous membranes. Many persons of experience in the tropics assert that it is unwise to camp near this tree. If poisoned by the manchineal, and beyond reach of your surgeon's help, the best thing to do is to wash the part affected freely with salt-water. It is sometimes called by the natives manzanilla (pronounced man-zane-ya.)-Journal Amer. Med. Association. THE ROENTGEN RAY IN WAR SURGERY.-The English papers of May 21st give considerable space to a lecture delivered on the previous day before the Royal United Service Institution by Surgeon-Major Beevor, of the army medical staff. The object of the lecturer was to give his experience in the working of the X-ray in military surgery, and to show by the results obtained in the recent frontier expedition in India that the apparatus can be carried on a campaign and be of the greatest possible benefit to the wounded. He maintained, in view of his success, that it was the duty of every civilized nation to supply its wounded in war with an X-ray apparatus, among other surgical aids, not only at base hospitals but close at hand wherever there might be fighting. There is no doubt of the desirability of having this aid in field hospitals nor of the possibility of furnishing it for the field hospital of a particular expeditionary force, but we doubt the ability of any army medical department, with our present experience of the X-ray, to have it available in the field hospitals of a large army during the hours of activity that follow the incoming of the wounded from a great battle. Surgeon-General Sternberg has provided the apparatus for the Philippine expedition, for the hospital ship Relief, and for the general hospitals to which the wounded from the field hospitals will be sent for treatment; and the experience thus gained in its applicability to war surgery may lead hereafter to a further extension of its use on behalf of the wounded in war.-Ibid. BELGIAN PHYSICIANS AND THE Abuse of MEDICAL CHARITY.-Belgian medical men are said by the German medical journals to be at odds over the question that is attracting the attention of the medical profession almost universally, the abuse of medical charities. Owing to a protest on the part of the Belgian Medical Society that the public polyclinics were treating a number of patients free who could well afford to pay for treatment, or at least could pay a small fee, and so were depriving physicians of their rights, the Belgian Minister for Medical Affairs drafted a law for the regulation of dispensaries, and of the relations of physicians to each other. This was followed by a series of resignations of prominent medical men from their positions in public dispensaries on the pretext that the government was attempting to meddle in a purely private professional matter. The Ministry has continued its effort, however, to introduce legal regulations of these matters, and there the question rests.-The Philadelphia Medical Journal. THE HISTORY OF THE MASSAGE TREATMENT.-It is often impossible to determine the origin of our methods of treatment, particularly as most of them date back to the dark ages, when accuracy in detail was not a characteristic feature in medical records. Sweden is usually credited with being the place of origin of the scientific system of massage and physical exercises. This is no doubt correct as far as modern Europe is concerned, but the real originators of massage and physical exercises appear to have been the Chinese. An interesting article appeared recently in the Deutsche medicinische Wochenschrift in which reference was made to a book lately published by P'an Wei, Governor of Hupeh. The author, a great authority on massage, was consulted by the late Empress of China. The Chinese legends contain many references to various systems of physical exercises, and these are associated in a curious manner with metaphysical thought. Life, according to the Chinese traditions, is entirely dependent on "air currents," which are designated as the primary aura of the organism. So long as the body is permeated by the "air current " it is proof against disThe object of physical exercises is to circulate the "air current." The Chinese system is divided into three periods, each period occupying 100 days. The first period should commence at the time of the new moon. The patient must rise at 4 A. M. and walk outside his house, and take seven deep inspirations; immediately after this two youths, who have been specially trained, commence a gentle friction all over the body, starting over the cardiac area. At the time of full moon a further set of inspiratory exercises must be taken. Later on in the second period the various parts of the body are rubbed with wooden planks until the muscles are hardened. It is not until the hardening of the muscles takes place that the real physical exercises commence. Between the fifth and sixth month is the period of greatest activity; the European dumb-bell is replaced by large sacks filled with stones. In the third period the back muscles are chiefly exercised. Great benefit is said to have resulted from this system.-British Medical Journal. ease. THE HEROISM OF A MEDICAL OFFICER.-Sir Walter Foster has submitted the following interesting statement for the consideration of the Secretary of State for India, in reference to the campaign on the Indian Frontier: "Lieutenant Ford, of the Malakand Field Force, was dangerously wounded in the shoulder, and was bleeding to death from the bullet having cut the main artery, when Surgeon-Lieutenant Hugo came to his aid. The fire was too hot to permit lights to be used to examine the wound, and there was no cover; nevertheless, the surgeon struck a match and examined the wound. The match went out amid a splutter of bullets which kicked up the dust all round, but by its uncertain light he saw the nature of the injury, and seized the bleeding artery, and as no ligature was available, he remained for three hours under fire holding the vessel between his finger and thumb. When, at length, it seemed that the enemy had broken into camp, he picked up the officer, who was unconscious from loss of blood, and bore him into a place of safety without relaxing his hold of the artery." Sir Walter Foster has pressed on the authorities the expediency of rewarding in a suitable manner this splendid act of devotion.— Ibid. A POCKET-KNIFE blade embedded in the skull and projecting for 1⁄4 inch into the cranial cavity was an unlooked-for discovery at an autopsy in the Pathological Institute of the Charite (Virchow's laboratory) in Berlin not long ago. The blade had wounded the outer, cellular or periosteal layer of the dura, but had pushed the fibrous layer before it. There had been no inflammatory reaction, and no symptoms seem to have occurred. There was no history to account for the presence of the knife-blade. The friends of the patient could recall nothing that might furnish an explanation for what might easily have proved a fatal wound.-The Phila. Med. Jour. FORCED ARTIFICIAL RESPIRATION WITH THE USE of O'DwyER'S INTUBATION TUBE.-Lowy, of Budapest (Deutsche medicinische Wochenschrift, 1898, No. 19; Wiener klinische Rundschau, June 26th), reports six cases in which he has successfully employed the O'Dwyer method of artificial respiration. The larynx is intubated, and air is forced through the tube by means of a bag connected with it.-New York Medical Journal. AGAINST DISCRIMINATION.-The Senate, on July 2d, passed a resolution preventing discrimination against graduates of legally chartered medical colleges in appointments to the Medical Corps of the Army, Navy, and Marine-Hospital Service. AWARD OF THE Jenner MEDAL.-The first award of the Jenner medal of the Epidemiological Society of London has been made to Mr. William Henry Power, F. R. S., senior assistant medical officer of the Local Government Board. PROF. H. OPPENHEIM, of Berlin, has been made corresponding member of the Society for Mental and Nervous Diseases of Moscow, Russia. DR. B. SACHS, of New York, has been elected a foreign member of the Society of Psychiatry and Nervous Diseases of Moscow. |