operation for microcephalus

208 THE DRESDEN CONVENTION.

to the medical historian but also to the student of popularsuperstitions. Such treasure-trove has another value-that of

indicating the quarter in which manuscripts of more purelyprofessional interest may be found, and of encouragingspecial investigation ad Aoe. We may thus obtain, in time,the materials for a more systematic and coherent digest ofthe healing art in Central Asia than its pharmacopoeia—por-tentous in character as in bulk-has hitherto enabled us toform.

____

THE DRESDEN CONVENTION.

WE are informed that the British Government have now

formally given in their adhesion to the Convention which wascome to at the International Sanitary Conference at Dresden,subject to a definite reserve to the effect that the system ofobservation " to which healthy people arriving on board in-fected vessels are to be put will in England be limited to themedical supervision à domicile which has long been in

operation in this country. Having been invested with thenecessary plenary powers the document was signed in Londonlast week by Dr. Thorne Thorne, C.B., and Mr. Farnall,C. M. G., and later at Berlin by Mr. G. Strachey, Her Majesty’sMinister Resident at the Court of Saxony. We draw detailedattention to the Convention on page 214.

THE INSPECTION OF TEETH IN SWISS SCHOOLS.

"A TOOTH is worth more than a diamond," said DonQuixote on a memorable occasion; but the profound physio-logical truth of the saying has but small practical force evenin the nineteenth century. Switzerland holds a bad pre-eminence in the abuse of this precious auxiliary to digestion ;indeed, dentists, British or American, who practise in herchief towns are unanimous in declaring that nowhere is

neglect of the teeth, with all its disastrous and (on theside of personal comeliness) hideous consequences, so con-spicuous. Not a day too soon the Societe Odontologique ofGeneva, in concert with the Minister of Public Instruction,has made a series of visits to the primary schools with theview of examining the teeth of the pupils. Their report,just issued, is fraught with striking revelations, not withoutrelevance, we are afraid, to the same class of schools in

other countries. Teeth all the world over, they assert, aredegenerating-a result (amongst other causes) of the perfec-tion of the culinary art and the diminished use of mastication.We can, however, minimise this inevitable process and

by timely precautions guard against tooth-enfeeblement andcaries. Every six months the mouths of children seven yearsold should be examined by the dentist, for at that agethe eventual points of caries " can be treated in time.

Later, at the age of ten or twelve, the mischief is alreadyadvanced, but not so far as to be quite beyond pro-fessional relief. The Société Odontologique of Genevaphilanthropically makes these inspections gratuitously inthe case of primary schools containing that portion of theyoung generation which is less favourably circumstancedfor calling in the dentist. The modus operandi of the

Society is this : On visiting a school its representativeaddresses his young audience in popular language on thegenesis, the growth, the uses and the ailments of thetooth and winds up with a practical demonstration of howmuch may be done to keep it strong and healthy. The first

place in this conservative duty he assigns to "attending tothe mouth "-keeping it clean by washing it and washingthe teeth after every meal. The widespread neglect in prac-tising this precaution the Societe proves by statistics :

Out of 413 boys inspected, 370 (that is, 90 per cent.) neverbrushed their teeth at all; out of 459 girls, 320 (or 70 percent.) were equally neglectful; whilst in nearly all of themcaries was already declared or far advanced-more than 75- per cent. of these young persons requiring the urgent inter

ference of the dentist. After his visit the Société’s delegatedraws up a "schema

" or dental plan indicating in each case

the state of the child’s mouth, the teeth to be specialprotected and the general treatment to be adopted. This"schema" is sent to the child’s parents, who are thu;,instructed as to what has to be done. In these instructions theSociete insists on careful brushing of the teeth from the ageof seven and upwards as the best means of averting caries,which is so injurious to the general health. "Recent

observations," adds the Société’s report, " demonstrate in

neglected mouths the presence of the majority of the germs.or microbes which generate infective maladies. Cleansingthe mouth, therefore, is a duty imposed on the communityfrom every point of view." All honour to the Societe forits philanthropic work, which, as already hinted, might withadvantage be imitated elsewhere.

OPERATION FOR MICROCEPHALUS.

IN the Glasgo7v Medical Jowrnal for June Dr. Barlow out

Glasgow records the case of a child who, at the time she firstcame under notice, was two years and two months of age.Advice was sought on account of the inability of the child towalk or talk. The anterior fontanelle had never been noticedand was certainly non-existent when the child came underobservation. During the first year of life she was drowsy anashe had never shown the slightest interest in anything or reco.gnised anybody. In her habits she was very dirty. The headwas small and the face appeared to be relatively large. The

operation of linear craniectomy was carried out successfully,and four months after the operation there was slight but evi-dent improvement, the patient being able to walk, althoughwith some uncertainty. Talking was still impossible, but

she could indicate by sound that she wanted food. Shecould also recognise certain people. The second operationwas carried out on May 6th, and we hope at some futuretime to be able to publish a further report of the case.

A DEATH UNDER CHLOROFORM.

A BARGEMAN aged thirty-seven was admitted to the

West Ham Hospital on Wednesday, July 5th, with two fair-sized sebaceous cysts on the point of the chin. On Friday,the 7th, at about 5.45 P.M., he was taken to the operatingtheatre to have them removed. The patient was a muscular,well-made man, who said he had "never had a day’s illnessin his life." He was himself very anxious to have the

operation performed. When on the table his heart was 1examined and no lesion was found, although the heart’saction did not appear to be as strong as might have beensupposed. The anaesthetic chosen was pure chloroform,This choice was made because the mouthpiece of and

inhaler for any.- other anaesthetic would interfere mt’3the operation on account of its situation. The chloroformwas given from a drop-bottle on lint, with free admixtureof air. The early stages of anesthesia appeared to bequite normal, the patient breathing well and comfortably andthe pulse being well maintained. There was some straggle.but not more than usual. The time taken to reach the stageof complete anaesthesia was thought (afterwards) to be abou,ten minutes. The amount given was from three drachms t4-half an ounce. On complete corneal insensibility and muscularflaccidity being obtained the first incision was made. AImf

immediately afterwards the patient ceased to breathe au’became greatly cyanosed. The mouth was well opened andrn’tongue drawn forwards with forceps. Twenty minims «brandy were twice injected hypodermically over the cardia:region, the legs were raised; artificial respiration was ccs’menced and on account of the extreme congestion three minii3l3of nitrite of amyl were held to the nose and mouth. àfterabout thirty seconds the patient recommenced to breathand his feet were accordingly lowered again. The artiEe