CORRESPONDENCE, Length, and Never Graduated, I Have Used This Expedient So- That I May Know Exactly Where the Point Is ;And I Never, Except-In Certain URINARY FEVER
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Dee. 29, 1888.] THB BRITJS.S ?DACJJRNAL 1319 It is respecting the first or "transient" form, that I am reported as saying, "it occurs in persons wh6 have not the most healthy ASSOCIATION. INTELLIGENCE urinary organs." The word " not." isthe error;' the exact reverse is that' which- I desired to express. - This' transient attack may; aud COUNCIL. commonly does, happen in persons who have hio sign whatever of NOTICE OF QUARTERLY MEETINGS FOR 1884: renal disease, or of inadequate excreting power. It is thus unlike ELECTION OF MEMBERS. to the second or - recurring" formh, which is associated, in many MEETINGS of the Council will be held on Wednesday, January 16th, cases, with some affection of the kidney, but one which is--not April 9th, July 9th, and October 15th, 1884. Gentlemen desirous of 'necessarily severe. On' the other hand -the recurring attacks may becoming members of the Association must send in their forms of prove to be the signs of a septicemic infection, or a«prelude -to .uremic application for election to the General Secretary not later than poisoning. It is unlike also to the third or " o6ntinuous " form, in twenty-onedaysbeforeeach meeting, viz., March 20th, June 20th, and which the renal organs are mostly considerably diseased. September 25th, 1884, in accordance with the regulation for the The "transient" form arises at any age after puberty, -often, election of members passed at the meeting of theCommittee of probably, as the result of absorption of a minute quantity of urine Council of October 12th, 1881. after a very slight injury to the urethra. Possibly the attack may FRANCIS FOWXE, Geerwal Secreta. be due sometimes to a temporary disturbanceof the nervous system, without local lesion ; but inasmuch as there is reason to believe that the minutest recent lesion suffices to give occasion to absorption, C 0 U NC IL. when 'an act of micturition subsequently takes plate, it is difficult NOTICE OF MEETING. to determine the 6anse of the phenomena in all cases. The foregoing classification does not, of course, include the slight A MEETING of the Council will be held in the Council Room of "shock" or fainting, which occurs to some individuals when. a Exeter Hall, Strand, London, on Wednesday, the 16th day of catheter is passed; nor the fatal " shock," which, in excessively rare January next, at 2 o'clock in the afternoon.. Instances, succeeds to simple catheterism, death occurring in twenty- four hours or so, with suppression of urine, the renal function ap.- FRANCIS FOWKE, General &cretary. pearing to be suddenly arrested. Such occurrences cannot be ranked 161A, Strand, December 22nd, 1883. as examples of "febrile" action. I may be permitted to 'add that I have adopted the tetm COLLECTIVE INVESTIGATION OF DISEASE. "urinary""ever and not "urethral," becalse, although the urethra CARDS for recording individual cases of the following diseases have is generally the point of departure, the whole of the urinary organs been prepared by the Committee; they may be had on application atare implicated in the pathological manifestation which results; to the Honorary Secretaries of the Local Committees in each moreover, 'the term corresponds with the fivra uineuse of French Branch, or on application to the Secretary of the Collective Investi- authors.--I am, sir, yours obediently,. HENRY THoMPsoN. gation Committee. Wimpole Street, December 22nd, 1883. I. Acute Pneumonia. v. Syphilis, acquired. II. Chorea. Va. ,, inherited. CATHETER-FEVER. III. Acute Rheumatism. VI. Acute Gout. SIR,-No doubt there are such things as urethral fever, as well as IV. Diphtheria, clinical. fever due to vitiated urine, but I have a conviction that most of. the URGENT.-The Committee propose to publilh a final report on cases towhichSirA. Clark refersarecaused bythepoint-of the catheter Acute Pneumonia as soon as possible. Cases are therefore urgently pressing against the apex of the bladder in a man .of. one of those needed. Cards will be received untilfurther notice. typesof constitution, whetherdue to age, intemperance, renaldisease, NOTICE.-The Iife-History Album prepared by the Collective In- or any ether cause, in which a weak form of inflammation is easily vestigation Committee is now ready, and can be ordered of all set up. Imagine. a patient of this sort going to a surgeon who passes, booksellers, price 3s. 6d. ofuen with impetus, a catheter up to its hilt, or as far as it will go, se.,- until it is pressed strongly against a lowly vitalised, if not Applications should be addressed to diseased, mucous membrane; then, the urine being drawn off, the The Secretary of the Collective Investigation Committee, mucous membrane is still further compressed against the point of September, 1883. 161A, Strand, W.C. the instrument by all those forces (increased by the erect posture), which empty the organ-can one be at all surprised at evil con- BRANCH MEETINGS TO BE HELD. sequences occasionally occurring, and if ending fatally to find, as in Sir A. Clark's second case, " the mucous lining congested, and in parts NORTH OF IRELAND BRANCH.-A meeting of this Branch will be held in the eroded, and everywhere covered with a greyish-white stinking Bar Room of the County Court-house, Omagh, on Thursday, January 24th, at mucus," in fact, sloughing ? It is evident, too, that different degrees 1 P.x.-ALExAxDzR DExMPsEY, M.D., Honorary Secretary, 26, Clifton Street, of injury, and different amounts of constitutional tendency to Belfast. asthenic inflammation, might result in producing the varieties MIDLAND BRArCH.-A meeting of this Branch will be held in the Board Room of the Infirmary, Derby, on January 10th, to amend the rules of the Branch in described by Yelpeau, ranging from irritabilityi of-the bladder and accordance with the recent alteration of the laws of the Association.-L. W. early recovery, to Low suppurative nephritis or py2mia. For a long MARsHALL, MD., Honorary Secretary and Treasurer, Nottingham, December time past, and on. this very account, I have been in the habit of 24th, 1883. putting two rings of paint around all my urethral instruments, one at six inches from the point, to mark 'the entrance through the -triangular ligament, and the other at nine inches, to show when the bladder is reached. As- these instruments are made of variable CORRESPONDENCE, length, and never graduated, I have used this expedient so- that I may know exactly where the point is ;and I never, except-in certain URINARY FEVER. cases, as in usink staff or sound, etc., push the catheter in morethan SIR,-In the detailed report, which you were good enough to half an inch or so beyond the; second ring of paint, i.e., just -within give, of my remarks on Urinary. Fever, at the. Medical Society of the'bladder, and nothing more. I have recently had under my care London, there is a slight verbal error, which is, however, of so a gentleman, scarcely middle-aged, but of somewhat broken consti- much importance, that I cannot let it pass without requesting you tution, in whom unpleasant bladder-symptoms arsee when he pushes to correct it. on the bougie M far as it win readily go. I would 9trongly urge on Let me premise that I stated that the various .febrile phenoriena the profession the advantage of using graduate4 urethral instru- which occur in connection with disturbance of the urinary organs ments, of only passing the point of a catheter or bougie just within might be conveniently designated, for clinical purposes, as belng- the bladder,- and, when giving a patient an instirment to use on him- ing to three distinct classes: self, -to put a ring of paint around it at the distance of nine Inches 1. The transient attack of urinary fever; from the point, and urge on him the importance of not pushing it 2. The acute recurring form of urinary fever;. onward. after the ring has disappeared within -the meatu.-Yours 3. The continuous form. of urinary. fever, which may be either slnperely,. - WILLIAM HiuvS,., London. chronic or subacute. Teignmouth, Devon, December 22nd, 1883. 1320 THE BRITISH MEDICAL JOURNAL. [Dec. 29,1883. BRITISH MEDICAL BENEVOLENT FUND. tition with their unsubsidised brethren. If the prestige and experience which few which have since the are obtained by service in those large institutions for the insane which are SIa,-In the days passed publication of maintained at the public expense, are to be used as passports to practice, then my letter in the BRITISH MEDICAL JOURNAL, I have received the it is clear that their medical organisation must be altered and assimilated to following donations and subscriptions, which I desire to acknow- hospital. ledge with warm and sincere thanks:-from John Colebrook, Esq., that of a general William Street, Lowndes Square, £10 lOs. (making, with previous donations, a total of 50 guineas); Gerald Crecy Parnell, Esq., Forest Hill, lOs.; Frank Smith, Esq., Plumstead, £1 ls.; Dr. Turner, Finsbury Square, £5 5s.; Dr. Dakes, Sunnyside, Rugby, £1 ls.; Dr. Henry MEDICAL NEWS, Castle, Newport, £1 ls.; W. Eddowes, Esq., Shrewsbury, £1 ls.; Mrs. Evans, Matron, City of London Lying-in Hospital (sub.), £l ls.; MEDICAL VACANCIES. don., £1; Dr. Sheldon, Wells, 5s. The following vacancies are announced: Three shillings, for the purchase of the coveted fowl, have been BIRMINGHAM GENERAL DISPENSARY.-Resident Surgeon. Salary, £150 sent by Mrs. Doubleday, and forwarded to the writer of the letter per annum. Applications by January 15th. copied in my last communication, who has also been supplied with BIRSAY, HARRAY, AND SANDWICH MEDICAL AID ASSOCIATION.-Me- a ton of the best coal by Mrs. Coulson. dical Officer. Salary, £70 per annum. Applications to Mr. Moar, Quoyloo I should like to add that, besides the £2,200 given during the by Stromness.