the phrenic nerve

156

the disease, whether, for instance, it is due to malarial or

atmospheric conditions, or to faosal accumulations, andconsequently no treatment which is known is able to

adequately cope with it. Mr. Edwin Lawrence, ina communication we have received, points out thatit is known that at New Orleans so soon as the firstfrost appears yellow fever disappears, and sea captainsknow that if they can steam for colder regions the

patients on board recover and no fresh cases arise ; andhe has suggested a mode of treatment by placing thepatients, even in tropical countries, in an artificial ice

atmosphere on board ships, to place ice in the patients’mouths, and to ice all foods and drinks. The idea seems atleast worthy of a trial, especially as it is not difficult in

any climate to keep a chamber at freezing-poinb, or at anytemperature below it, and the expense is comparativelysmall. It is unfortunately the case that the etiology of thisfatal disease is as little known now as it was at the time of

Columbus, and its effects have been scarcely, if at all,alleviated. IV forms one of those unexplored regions of thedark continent of medical science concerning which muchinvestigation is still required by the scientific minds in theprofession. -

THE FOLKESTONE HEALTH OFFICER.

THE attitude adopted by the majority of the FolkestoneTown Council in regard to the appointment of a medicalofficer of health is not one which is calculated to inspire con-fidence in the minds of the many visitors who have beenin the habit of frequenting that town in quest of health andrecreation. The discussion has related to the question ofsalary, and the dispute has had to do with either a remunera-tion just sufficient to compensate for a perfunctory per-formance of the ordinary duties of the office-that is to say,as one member put it, to secure one hour’s services for sixdays in the week,-or, on the other hand, to indicate by asomewhat higher salary that Folkestone desires to attract tothe cffice some skilled practitioner who will really make thehealth requirements of the place a constant care and study.The majority prefer the former class of appointment, anddecline to pay more than

11 6s. or 7s. an hour " for one hour’sservices every week-day. More than once the Local Govern-ment Board have had to intervene in connexion with pre-ventable disease in and around Folkestone; and it wouldcertainly conduce to the sanitary interests of the place ifit were understood that the Town Council desire for thefuture to place their town above suspicion as regards itssanitary administration. -

THE PHRENIC NERVE.

IN the recent number of Brain Dr. John Ferguson ofToronto has a note on the function of this nerve. He hadunder observation some time ago a patient suffering fromprogressive muscular atrophy, in whom there was an affectionof the diaphragm. The phrenic nerve was examined after thepatient’s death, and while some fibres were found to be com-pletely degenerated, others were undergoing degeneration,and a third set werequitehealtby. He drew the inference thatthe phrenic nerve was not wholly motor, but in part sensory.To support his hypothesis, he examined the condition in acat after division of the right phrenic nerve, and threeweeks later, on opening the abdomen, the sensibility ofthe diaphragm was found much impaired. The nerve

was completely degenerated. In another experi-ment the posterior roots of the third, fourth, fifth,and sixth cervical nerves were divided, and sub-

sequent examination of the nerve showed that therewas well-marked degeneration of about a third of itsfibres. Before the animal was killed it was found to beanaesthetic on the side of its diaphragm corresponding to

which the posterior roots had been divided. Dr. Fergusonconcludes from these facts that the phrenic is to be regardedas a mixed nerve, and that in inflammations involving thediaphragm or the serous membranes attached to it we maylook for sensory disturbances, often of wide distribution.The phrenic being sensory, from irritation of that nerve, paia,in the cervical region where it arises is to be looked for, andin this way he accounts for severe pain at the back of,the neck and in the shoulder in a patient whom he hadunder his care suffering from an abscess of the liverwhich subsequently proved fatal.

HOSPITAL SUNDAY IN LIVERPOOL.

I THE second Sunday in the new year has since the year 187)been observed as Hospital Sunday in Liverpool. Its recurrencethis year was therefore invested with unusual importance,Hospital Sunday having thus completed its majority in Liver.pool. The day, though cold, was fine and bright, but thestate of the streets, frozen and slippery in the extreme, hada marked effect in reducing the number of church and)

chapel-goers. Still it is gratifying to note that thecollections show their usual munificence. At the headof the list is the Sefton Park Presbyterian Church, theminister of which is the Rev. John Watson, one of theHonorary Secretaries of the Hospital Sunday Committee.Here the collection amounted to the excellent total of

jE666, an increase of jS25 over the amount realised last year.Next comes the Renshaw street Unitarian Chapel, whichcontributed :E639. Up to Monday evening the treasurerhad been advised of collections amounting to upwards ofJE2000, and so far as can be ascertained the total amountpromises to be a fair average of those of recent years.

THE PHYSIOLOGICAL EFFECTS OF PARA-CENTESIS.

THE physiological effects of tapping the abdomen in casesof ascites from atrophic cirrhosis of the liver have beenstudied by Dr. Gravirovski, who gives the details of hisobservations in a recent thesis for the degree of M.D. in theMedico-Chirurgical Academy in St. Petersburg. He foundthat the assimilation of nitrogen was increased by the,operation, but that of the fatty elements of food waS’

diminished ; the metabolism of the nitrogenous principleewas also increased, and the loss of albumen in the blooawas soon compensated by the greater assimilative power forthis nutritive principle. He comes to the conclusion, too,that more is gained by early than by late paracentesis.

EXPERIMENTS AT THE PHARMACOLOGICALINSTITUTE AT DORPAT.

A RECENT volume of the Transactions of the Pharmaco-logical Institute at Dorpat, edited by Professor R. Kobert,contains two experiments by Nicolai Kruskal, one on somecombinations with saponin, and the other on the corn

cockle (Agrostemma githago). The former partially con-cludes a series of experiments by the editor himself, andcontains a number of new and important observations inchemistry, toxicology, and hygiene. Dr. Kobert had foundthat saponin, as described by various authors, especially thesaponin extracted from quillaja bark, is not an elementarybody, but a mixture of two substances, which are botb

poisonous, and which he calls respectively quillaja acid and tsapotoxin. The researches of Kruskal are a valuable addi-tion to our knowledge, as they have shown that the so-calledsaponins are a whole series of bodies, corresponding ?several different general formulse. Every series containsseveral members which, though they are identical as far ?elementary analysis goes, and give the same chemicalreactions, yet on pharmacological examination show &