Infrequently Cases Reached the Base Hospitals with A
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852 difficulty of finding a livelihood since the armistice the mucous membrane of the oesophagus, stomach, was signed is already making disabled men keener and small intestine. Histologically, Negri bodies to qualify for remunerative work. The Village were found in great abundance in the cornu Centre at Enham, which offers treatment and Ammonis on both sides, but were less numerous training under attractive conditions, opens its in the cerebral cortex and basal ganglia in the doors next week and will be a test case of the medulla and completely absent in the cord. Bergh desire of disabled men to rebuild their lives under attributed the severe and rapid course of the medical guidance. - disease to the facial lesion, in consequence of which the process was confined to the brain and no CHEMISTRY AT CAMBRIDGE. paralysis developed. The extensive haemorrhages THE noble gift to the University of Cambridge in the mucous membranes were to be explained of 200,000 guineas for the endowment of a chemical either by an extraordinarily weak resistance of the school is pleasing and practical evidence that the individual to the rabies virus or to the frequent and representatives of British industry are beginning severe spasms of the muscles of deglutition and to realise the importance of chemical science in respiration. - education and in national affairs. There obviously BLOOD VOLUME AND RELATED BLOOD CHANGES must be many industries whose returns have been largely expanded by the demands of the Great War, AFTER HÆMORRHAGE. and in no better direction could the surplus incomes OUR knowledge on the changes produced in the gained be used to promote scientific training, par- blood and circulatory mechanism by heamorrhage ticularly in its application to industrial develop- and the subsequent restoration of the circulation is ments, than by the endowment we announce. in a state of rapid development. The war has At the meeting of the Senate of the Uni- afforded abundant opportunity for study of these versity held on Tuesday last the Vice-Chancellor matters, to which our columns have frequently stated that Sir William Pope, professor of borne witness. An important piece of work upon chemistry, had received a letter from Mr. R. this subject by 0. H. Robertson and Arlie V. Bock, Waley-Cohen, in which he declared with pleasure of the United States Army, is published in the that the British oil companies had agreed February number of the Journal of Experimental to join together in a scheme for endowing a Medicine. Blood-volume determinations following chemical school at Cambridge, the total sum hæmorrhage, made by the vital red method, show a for this purpose representing 200,000 guineas. surprising reduction in the total blood bulk. Not Of this the Burmah Oil Company, the Anglo- infrequently cases reached the base hospitals with Persian Oil Company, and the Anglo-Saxon a diminution of volume to 60 or even 54 per Petroleum Company agreed to contribute £50,000 cent. of the normal. What is significant is each. A further sum of £50,000 has been promised that, even so, the heamoglobin percentage by Lord Cowdray and the Hon. Clive Pearson may show no reduction, indicating that observa- between them, and Mr. Deterding has offered to tions which fail to take account of the blood give a personal contribution of his own of £10,000, volume changes may give a wholly false impression raising the sum of .-B200,000 to the sum of of the degree of blood loss. Blood-pressure changes 200,000 guineas. This is a splendid gift, and one give some assistance in estimating loss of blood which we hope foretells the attitude of our great volume. Though the pressure may sometimes be industries in general towards scientific training. maintained even with a considerable loss of blood, low blood pressure has been found to be so con- stantly associated with lessened blood volume that ATYPICAL RABIES. a relationship between the two may be inferred. The in that when the AT a meeting of the Society for German Phy- writers, fact, suggest pressure is below 95 mm. the blood volume is under sicians in Prague on Jan. 10th Bergh stated that probably 70 cent., and if 80 mm. or less the volume is during an outbreak of rabies in the Ukraine more per than 22 soldiers who had been bitten by mad probably 60 per cent. or less. By means of the dogs blood volume and cent. the actual were admitted to the garrison hospital at Lemberg heamoglobin per extent of blood loss could be determined, and it after preventive inoculation. This was commenced was found that severe cases of anaemia showed a on the second to the fourth day, and only one man, loss of as much as five-sixths of their total hæmo- who had been bitten on the nose and right cheek, these seen in severe subsequently developed rabies. The first sym- globin. Accompanying changes ptoms, which consisted of fever, headache, and anaemia there occurs a well-marked difference in cent. between and venous anxiety, appeared on the day of the eighteenth heamoglobin per capillary injection, and six hours later the disease became blood, indicating capillary blood concentration, a fully developed. Psychical symptoms condition often observed also in shock, and due predominated to failure. The to in the form of an anxiety psychosis, at times circulatory body attempts counteract the loss of blood in two increas- amounting to maniacal attacks, and were accom- ways-by the blood volume means of fluid panied by frequent and severe spasms of the ing by withdrawing muscles of deglutition and respiration, anarthria, from the tissues, and by new red cell formation. insomnia in of doses of The one process, however, seems to depend upon complete spite large If chloral, and later disorientation. All the other the other. the added fluid from the tissues dilute the a certain critical of rabies were saliva- haemoglobin beyond symptoms present except addition is tion, generalised convulsions, and paralysis. point such automatically arrested, and recurs when further red cells are into Death took within 48 hours after a severe only passed place circulation; and increased blood attack of haamorrhagic vomiting. The necropsy conversely, pro- in the very anaemic cases, seems showed moderate hyperaemia of the brain, a few duction, except to largely upon the restoration of the blood small haemorrhages in the brain substance, and a depend large number of small haemorrhages throughout volume. Treatment in the light of these observations is 1 Wien. klin. Wchnschr., 1919, xxxii., 244. indicated upon the following lines. It is suggested 853 that in circumstances of battle the soldier has wise healthy region in which the population was often had little water to drink. He has perspired remarkable for its longevity and in which, in spite freely, too, so that his- fluid reserves in the body are of an extremely impure water-supply, enteric fever already at a low ebb when he is wounded. The and other intestinal diseases were conspicuous by shock still further increases fluid loss. So that their absence. It is not, however, easy to see whence it is important to supply abundant water at as Knapp derived his convictions. early a stage as possible after the haemorrhages. Later, the blood restoration can be aided artificially THE TREATMENT OF PAROXYSMAL TACHYCARDIA in three ways. By transfusion of blood: this is indicated when the haemoglobin is reduced to BY RESPIRATORY EFFORT. 25 per cent., for besides supplying new oxygen- AT a recent meeting of the Académie de Medecine carrying cells it actually stimulates increase in of Paris M. Ch. Fiessinger called attention to a very blood volume. By injection into the blood stream simple treatment of paroxysmal tachycardia. This of a solution of gum acacia on the lines suggested condition may accompany a cardiac affection or be by Professor W. M. Bayliss: this acts similarly to independent of one, being in both cases due to a transfusion, but both only partially restore the trouble of innervation. It differs from all other blood volume. Lastly, and this method the authors tachycardias in the precipitate acceleration of the strongly recommend, by putting the patients upon heart. While in the tachycardias due to cardiac a large fluid intake by mouth and per rectum. This lesions or to emotion the number of beats does not procedure has been found promptly and greatly to exceed 130 to 160 per minute, in paroxysmal tachy- increase the blood volume with beneficial effect. cardia it reaches 180, 200, or even more. The The result of this treatment is to cause a pro- malady suddenly appears during the decline of an gressive rise of blood pressure, an increased blood acute disease, or it may occur without obvious volume, and a more even distribution of red cells, reason in apparent health. It lasts for several and these changes were often well marked after hours, sometimes for days or weeks, with short only two or three hours of the treatment. remissions, producing rapid fatigue of the myo- cardium and marked asystole of the right cavities. A CANCER DISTRICT IN FRANCE. For the treatment the authorities mention slow and but do not WHILE attached to the German headquarters at deep inspirations, they emphasise the point of respiratory effort, which M. Fiessinger Solesmes. received a large number of Knappl appli- as of cations from the French for milk for considered the greatest importance. He population described the case of a 40 cancer and on from local woman, aged years, patients, inquiry practi- attacked with whom tioners found that cancer was one of the most paroxysmal tachycardia, he saw in consultation.