1199

THE PREVENTION OF LIFE-WASTE.

ON Dec. 29th last there was incorporated in theCity of New York a " Life Extension Institute,"having for its aim the lengthening of humanlife and the safeguarding and increase of indi-

vidual human efficiency. This end it proposesto achieve by the appointment throughout theland of expert medical. examiners, with fullyequipped clinical laboratories in all the largertowns, who will periodically examine the phy-sical condition of its own policy-holders, of allthe policy-holders of such life insurance companiesas contract with it to do so, and for a small fee of

any person not embraced in either of these classes,who may desire it. Schools, industrial establish-ments, and other associations will also be contractedwith, and its aid will be further afforded in coopera-tion with the anti-tuberculosis, social hygiene,eugenics, and similar movements, and with the healthauthorities. It is thought that by this means impair-ments " in the human machinery will be systemati-callydetected while they are still remediable, and the.damaged individual directed before it is too late toseek the aid of his medical attendant, who will befurnished with the collaborated findings of theinstitute’s experts. The " Hygiene ReferenceBoard of the institute, which is to consist of 100leading experts on various subjects pertaining tohealth, contains many names well known to themedical profession at large, among whom may bementioned Surgeon-General Gorgas, the sanitarianof Havana and the Panama Canal Zone, Dr. William J.Mayo, Professor William H. Welch of Johns HopkinsUniversity, Dr. Harvey Wiley, whose name is associ-ated with the pure food laws in the United States,-Professor Chittenden, of Yale, and others. Theindividual will benefit by having his attention calledto beginning defects while there is yet time torepair the damage. The medical practitioner willfind many of his patients directed to seek his carelong before they would otherwise have done so, withthe advantage of receiving a carefully collaboratedphysical report by various experts in their respectivelines to work on. The insurance companies willhave their losses from life-waste reduced as thefire insurance companies have long reduced theirlosses from fire-waste. It is further hoped that thevast material accumulated by the HygieneReference Board may in course of time enable it tofurnish data whereby many disputed points in

personal hygiene may ultimately be cleared up,The experiment will be watched in this countrywith interest: the prophecies of its future work.which we have set out. show its scope to be indeedcomprehensive. ____

TRAUMATIC RUPTURE OF THE HEART.

IN the Journal of the American Medical Associa-tion of Feb. 28th Dr. B. J. O’Neill has reported acase of a very rare accident-traumatic rupture ofthe heart. A schoolboy, aged 9 years, while playingwas set on by some older boys, who knocked himdown and jumped on him. He walked home com-plaining of pain in the left groin, remained in bedtwo days, and then got up and about for four days,still complaining of pain in the left groin and hip.On the seventh day he was taken a distance of30 miles by train to Dr. O’Neill, still complaining ofthe same symptoms. At no time did he complainof pain in any other part. He walked from thestation to the office. Examination showed a well-developed boy walking with a decided limp andevidently in considerable pain. Slight redness and

swelling over the left saphenous opening was dis-covered. There was considerable limitation of themovements of abduction and rotation of the left

thigh. No examination of the chest was made.The boy was sent to hospital, where a skiagram ofthe hip and pelvis was taken and showed nothingabnormal. Hot fomentations were applied to thehaematoma in the groin. The temperature was98’6° F., the pulse was 102 and regular, andthe respirations were 25. He rested comfortablyuntil about 12 hours after admission. Then he

suddenly collapsed, the pulse and respiration becamevery rapid, and he died in an hour. At the necropsythe pericardium was found bulging forwards, verytense and full. It contained about 500 c.c. of freshblood and about 200 grammes of dark clotted blood.At the auriculo-ventricular junction on the left sidewas a perforating slit about 3 millimetres longabove the middle of the anterior leaf of the mitralvalve. The myocardium and valves were normal.Evidently the heart was ruptured at the time theboy was jumped on, and some haemorrhage took

place into the pericardium, which was followed bysealing of the perforation with clot. Some move-ment probably dislodged this clot, and deathresulted from haemorrhage into the pericardium.It is remarkable that the boy was up and about forfour days with only the clot sealing the opening.The case illustrates the lesson which will never

cease to require enforcing-the necessity for com-plete examination of a patient. Dr. O’Neill thinksthat had this been done at least an approximatediagnosis might have been made.

THE ORGANISM OF EPIDEMIC POLIOMYELITIS.

THE discovery that the human disease epidemicpoliomyelitis could be transmitted to monkeysopened the way to accurate experimental researchon this infection, and many valuable papers havesince been written on this subject. The work doneat the Rockefeller Institute in New York by Pro-fessor Flexner, with the assistance of Dr. Noguchi,Dr. Paul Clark, Dr. Harold Amoss, and Dr. F. R.Fraser, has been largely recorded in the Journal of Experimental Medicine, and it may be useful tosummarise the results which they have obtained.The micro-organism which is the infective agenthas now been cultivated on artificial media, themethod used being that devised by Noguchi forthe cultivation of spirochætæ, human ascitic fluidbeing the basis of the medium, with the addi-tion of small pieces of solid sterile tissue, theculture being kept anaerobic by covering it with alayer of paraffin oil. Thus grown the organismsappear as minute globular bodies arranged in pairs,chains, and clusters, and they can also be demon-strated in the infected tissues by means of

appropriate dyes. Reinoculation of susceptibleanimals with the cultures has been effected in oneor two instances, thus fulfilling Koch’s second

canon, but failures often occur owing to rapid lossof virulence in the organisms when introduced toartificial conditions. Their exact biological positionhas not yet been determined-whether they shouldbe classed with the bacteria or with the mysteriousgroup of chlamydozoa. Their minute size enablesthem to pass through the pores of a Berkefeld filter.Within the body the organisms are visible not onlyin the spinal cord, but also in the brain, vertebraland Gasserian ganglia, and abdominal sympathetic.Poliomyelitis is thus not a special disease ofthe anterior cornual cells as was previouslysupposed, but a general infection of the central