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Notes of Post-Nwrlem Examination Made by Me, White. Larynx Trachea

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Notes of Post-Nwrlem Examination Made by Me, White. Larynx Trachea CORRESPONDENCE. 359 Saturday, June 4th, x898. On the evening of that inflamed, contained a little undigested milk ; it was day they were said to have eaten some ice cream deeply bile stained, especially at the pyloric end. bought trom an Italian's barrow in the street near Jefunum and Duodenum, inflamed and bile stained, by their home, the younger boy having three times empty. Cvecum and Colon, empty. ATesenteric as much as his brother. Glands, very hard. Liver, smooth surface, natural Their mother stated that the younger boy did appearance on section, weighed i lb. 13 ozs., lower not seem quite himself on Sunday, June 5th, 1898 , lobes extremely bile stained, almost black. Gold and was only "pretty well" on Monday, but that Bladder, full of bile. S~leen, 2 ozs. in weight, on Monday night both boys were taken ill with section normal, but I thought darker perhaps than pain in the stomach and vomiting ; that in the usual. Kidneys, healthy, 3 ozs. each; Ureters, interval between Saturday night and Monday night normal: Urine (before death), black and full of they had had nothing more than their ordinary plain albumen. Bladder, empty and normal. Sujbrarena[ and wholesome food. bodies and generative organs, normal. I saw them for the first time on Tuesday, the Brain--membranes healthy and non-adherent ; 7th, and found them in bed, pale, breathing blood vessels, fall; brain substance, healthy; rapidly, especially the younger one, and vomitting superficial congestion. at intervals a yellow fluid containing mucus. They 2Voles on Post-morlem Examination.--There were were both cyanosed to their finger tips. The face no "naked eye" changes which could account for of the younger boy appeared puffy and swollen, death in such a healthy boy, and for this reason, and both patients were slightly jaundiced. They as well as judging from the clinical symptoms (and did not complain much df thirst--there was in signs, e.g., urine) in the two brothers, I am forced each case some, but not much abdominal to infer that the nervous centres were rendered tenderness. incapable of duly performing their functions by The urine they passed, scanty in quantity, some poison which had been taken into the system, appeared black by reflected, and of dark porter and, by a process of exclusion, to conclude that colour by transmitted, light ; when boiled or mixed this poison, whether animal, vegetable, or mineral, with nitric acid it almost solidified--reaction was was swallowed with the ice cream. acid, S.G.Io23. The smaller boy was passing Kentish Town, N.W. hardly any, about 6 ozs. in the 24 hours, and by the time he died it was completely suppressed. In the case of the elder it slowly cleared as he ADMISSION OF PATIENTS TO FEVER recovered. HOSPITALS. The younger gradually became comatose, with increased difficulty of breathing, and died about To tke Editor of PUBLIC HEALTH. 7 p.m. on Wednesday, June 8th, 1898. SIR,--I beg to hand you a copy of the local newspaper for the purpose of eliciting your opinion on the views of this I refused to give a certificate of death, reported District Council re the isolation of cases of infectious disease the case to the Coroner, and requested a post- as enunciated in the report of their last meeting. The action mortem examination. therein proposed is probably unique, and is opposed to tne Notes of Post-nwrlem Examination made by me, practical working of Sanitary Authorities ; it is directly inimical to the public health, and the object of the Notifica- June 9th, 1898 , at five p.m.--The body was that of tion Act. All sufferers from infectious diseases possess a very well nourished boy, three feet seven inches in infectivity, all ratepayers, and presumably all inhabitants, height and about fifty pounds in weight. There have equal rights to protection at the hands of the Sanitary were no superficial peculiarities ; Rigor ~ertt's had Authority. If so, the proposed action of the Council would established an administration of "discriminating injustice '" gone off except from lower extremities; there was to the public, it would hamper the duty and action of the a greenish hue on the skin of the iliac regions, and Medical Officer of He~dth, and ultimately prove even a false some hypostasis at the back of the chest. Tempera- economy to the pockets of the ratepayers, which seems to be lure of external air about 55 ~ F.~; temperature inside the sole consideration underlying ithe proposed action. Equhy would require the other contributory authorities to abdomen 62 ° F. the Joint Hospital to accept and act upon the same principle. The Dia~bhragm was normally arched upwards. Possibly the County Council and the Local Government The Pericardium contained a little clear fluid. The Board may have something to say bearing on that matter. ~eart weighed four ounces and was of average Lastly, there is the question of its legality ; if perchance it be not illegal, the sooner it is m~de so the better it will be size, its muscular substance was healthy, so were for the public health. its lining naembrane, valves, and the aorta; the Yours faithfully, right chambers contained two large clots, the left H. PAGE, M.D., D.P.H. chambers two small. Redditch, May 23rd, I898. Alouth and CEso~hagus healthy, tongue furred, The following is that part of the report of the Council's white. Larynx Trachea, Bronchi and.Bronchial proceedings relerred to bF our Correspondent :~ Glands, healthy. Pleura, smooth, hardly any fluid in them. Lungs, congested and o~dematous, THE TI~MPORARY" INFRCTIOUS HOSPITAL. but otherwise healthy. Mr. Hobson (joint clerk) in the absence of Mr. Woodfield Peritoneum smooth and healthy. Stomach, announced that at a meeting of the Joint Isolation Hospital 360 PARLIAMENTARY PUBLICATIONS.--APPOINTMENTS. Committee, it was decided to open a temporary hospital at APPOINTMENTS. IZock Hill, Bromsgrove, on Wednesday next. Patients would be received after due notification by the Medical Officer o[ Heahh that they must be moved to the hospital. The Council ought to decide what procedure they would ARMSTRONG, W. G., M.B. Syd., appointed M.O.H. take ; whether the Medical Officer would have the sole right Combined Metropolitan District, Sydney. to decide matters or say that that question should be sub- BOOTH, J., L.R.C.P. Edin., appointed M.O.H. for the ject to the Chairman of the Council dealing with such Shire of Dunmunkle, East Riding, Victoria, Australia. matters. DICI¢, R., M.B., appointed M.O.tt. to the Combined The Chairman said ho had intended asking whether the Hunter River District, Newcastle, N.S.W. Chairman of the Sanitary Committee had been applied to, in respect of a case which had been sent to King's EI~WARDS, 3". W., M.B. Ediu., appointed M.O.H. to the l~orton. Tees Port Sanitary Authority. Mr. Johnson replied that the feeling was flhat it would be ELLIS, H. D. A, L.R.C.P., appointed M.O.H. to the well that the case should be decided by the Chairman of tho Amblecote Urban District Council. Committee. FAWCETT, I-][., M.D., re-appointed M.O.H. to the Mr. Townsend considered that they should possess some Middlesboro' Rural District Council. discretio,~ary power over the Medical Officer. He wished to FRASER, P., M.D. Edin., re-appointed M.O.H. to the say nothing detrimental of Dr. Wade, but that gentleman Llanrwst Urban District Council. should not have sole power to send patients to the hospital. Mr. Wade would otherwise very quickly fill the GIBB, R. S., M.B. Aberd., appointed M.O.H. for hospital. Berwiekshire. The Cha:rman was of opinion that the Sanitary Com- GODFREY, H. P., M.B. Melb., appointed M.O.H. mittee should be consulted and should certify what cases Bardock, Western Australia. should be sent to the hospital. HAI~VEY, R.R., M.B. Melb., ~ppointed M.O.H. for Mr. Gibbs proposed that the Chairman of the Sanitary Norseman, Western Australia. Committee, together with any two members of that Com- HAY, ]'. B., M.B. Edin., appointed M.O.H. for the Shire mittee, should form a Hospital Committee. of Heytesbury, Victoria. Mr. Malinsenquired whether it was necessary to take such action at the present moment. The Sanitary Com- JZNKINS, Dr. E. M., appointed M.O.]~. to the Calverley mittee bad discussed the subject and a resolution was Urban District Couneit. recorded on the minutes of the Committee. LAWSON, G. L. S., M.R.C.P., Edin., appointed M.O.H. Mr. Dolphin : Will the patients' own medical men have Mullewa, Western Australia. any voice in the matter ? McKRE, J. C., LR.C.P. Edin., appointed M.O.H. to the The Clerk : No. Borough of Eaglehawk, Victoria, Australia. Mr. Malins : They report to the Medical Officer. MACKENZIE, D. J., M.D. Aberd., appointed M.O.H. to The Chairman mentioned that when Dr. Morton held the the Glossop M.B. appointment of medical officer he took no aclion in a case of small-pox without consulting the Chairman of the Sanitary MARTIN, J., L.R.C.P. Glasg., appointed H.O. Black Committee. Flag, Western Australia. Mr. Hiscock asked whether, in cases of scarlatina, it was MILN~R, E. A., M.B. Edin.,re-appointed M.O.H. to the necessary for a patient to be removed if he could be Lolated Lostwithiel Urban District Council. in his own house. MONTgG~rEXY, ]'. P., M.B., Melb., appointed M.O.H. The Chairman : That's for the Committee to investigate. to the Shire of Rosedale, Victoria, Australia.
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