IRRIGATION OF EMPYEMA CAVITIES.

IRRIGATION OF EMPYEMA CAVITIES.

888 who are and who are not already infected. When this information is obtained matters would be ripe for vaccination with BCG on a large scale, a pro...

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888 who are and who are not already infected. When this information is obtained matters would be ripe for vaccination with BCG on a large scale, a proceeding which Dr. Heimbeck thinks would usher in a new era in the campaign against tuberculosis.

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excuse for the even if the ill-health

non-performance of a contract to marry, be such that the performance of conjugal duties would endanger life. The legal view, it will be noticed, is not eugenic. Some day, perhaps, a reform of the divorce law will allow the marriage contract to be dissolved where one party

suffers from permanent and incurable mental or IRRIGATION OF EMPYEMA CAVITIES. physical disease. That reform, however, if and when of a DURING the last few years a good deal of progress it comes, will have no bearing upon the position man who, having knowingly married a consumptive has been made in the treatment of empyema so that the mortality has dropped considerably, especially wife, afterwards refuses to live with her. It is equally in the acute cases which follow the streptococcal or irrelevant to refer here to the old French tradition influenzal type of disease. The two chief principles that callous English husbands habitually sell their of modern treatment are: (1) to avoid an open wives at Smithfield market, but students of legal social curiosities may care to be directed to a pneumothorax-i.e., to avoid operation until the and brief but interesting article on this subject from the localised has become and by adhesions ; empyema pen of Prof. Courtney Kenny in the recent (2) to wash out the empyema cavity. In a paper learned issue of the Law Quarterly Review. Dr. J. S. of this issue Passeron on 870 published p. describes a new method by which this second object may be achieved. After a preliminary incision MOORFIELDS EYE HOSPITAL. through the skin the patient is put into a bath in which the empyema is opened so that the water of ALL old Moorfields students will not only enjoy the bath mingles with the pus ; the wound is held but will desire to possess, the story of the reading, open with forceps in such a way that water has free The book1 access to the empyema cavity, and the pus and hospital as told by Mr. Treacher Collins. fibrinous exudate are expelled into the bath. Some- takes us back to 1805, when the " London Dispentimes two baths a day are given in severe cases. sary for Curing Diseases of the Eye and Ear " was When there is communication between the bronchi opened in Charterhouse-square. This was practically and the empyema cavity, air can be expelled through the beginning of ophthalmology as a surgical specialty, the lung and is seen bubbling through the water. In Astley Cooper being, as it were, the godfather of the the case of children this expulsion of air will be new institution, and John Cunningham Saunders its. noticed when the child cries and affords a method of first surgeon. On the advice of the latter, the aural ascertaining whether or not there is a bronchialI part of the work was soon dropped, and the name London Infirmary for fistula. Most of the cases hitherto treated by this of the institution changed to method have been children, and while a bath of this Curing Diseases of the Eye." In 1811 the practice .sort may well have proved a convenient means of of the infirmary was opened to medical students, and dealing with them, the difficulty of moving patients thus was started the School of Ophthalmology, which into the bath would sometimes arise in the case of has since become of world-wide renown. The original adults. Modern methods of irrigation give pretty building was soon found to be too small for its requireand in 1822 a new building was erected in satisfactory results, but those recorded in Dr. ments, Passeron’s paper are certainly promising, and, as he what was then called Lower Moorfields, on the outskirts of the city, the site now occupied by Broadpoints out, facts should have more weight than street Station being then an open space. Here practitheories. cally all the older generation of ophthalmic surgeons. in England received their training. The Princess DESERTING A CONSUMPTIVE WIFE. Victoria became patron of the institution a year before A HUSBAND, summoned at Marylebone police- her accession to the throne, and its name was again court last week for the desertion of his wife, made altered on this account to the Royal London OphHe pleaded that he was acting thalmic Hospital. The work quickly grew ; the staff an unusual defence. under medical advice in living apart from her, as was gradually increased and the building extended, she was consumptive. Unimpressed by this plea, until it eventually became far too cramped for the the magistrate ordered him to pay 18s. weekly towards work undertaken. In 1899 it was removed to its the maintenance of his wife. The wife in her evidence present quarters in the City-road, the old name had admitted her ill-health, but said she had told Moorfields," with the traditions attaching to it, her husband all about it before the marriage. Legally, still being in popular use. All this and much more it appears, it would have made no difference if she Mr. Treacher Collins relates ; he gives us thumbhad not told him. Marriage is not one of those nail sketches of many of the surgeons whose work contracts classified by lawyers as uberrimce fidei- has made the world reputation of the hospital. There that is to say, contracts of the utmost good faith in are not many still living who can recall the personaliwhich (as in the case of a contract of life insurance) ties of the elder Critchett and Sir William Bowman. one party must disclose to the other every single Jonathan Hutchinson, the elder, joined the staff at circumstance which might affect the other party’s a somewhat later date, but resigned in 1878, the mind. A woman once became engaged to marry refraction work of the hospital having grown so a man without telling him that she had previously arduous that he felt he could no longer carry out his been shut up in a lunatic asylum. It was held that duties. At that time, and for long afterwards, there this non-disclosure gave the man no right to break were no paid refraction assistants at the hospital. his promise to marry her, provided that she was Since it was impossible for the surgeons to devote sane at the time of their engagement. " It would their whole time to the work of testing for spectacles, be most mischievous," said Lord Kenyon in 1797 they were largely dependent on the work of volun(Atkinson v. Baker), " to compel parties to marry tary assistants, who were not all equally efficient. who can never live happily together." Nevertheless Many will recall the great days when Nettleship, it has been held that a man cannot escape from his Marcus Gunn, Tweedy, the elder Lang, J. B. Lawford, promise to marry by pleading his own bad health. and Stanford Morton were on the staff. The book will In Hall v. Wright (1858) a defendant alleged that, do something to keep green the memories of these since his promise to marry, he had become afflicted and of many others. There is much in it besides with a dangerous illness, occasioning frequent and sketches of the personnel of the staff. The three great But the judges events of the Victorian epoch which affected all severe haemorrhage of the lungs. held that this was no defence to an action for breach of promise ; the lady might like to be his widow. 1 History and Traditions of the Moorfields Eye Hospital: Ill-health is a valid excuse for the non-performance One Hundred Years of Ophthalmic Discovery and Development. By E. Treacher Collins, consulting surgeon to the hospital. of certain contracts for personal service-e.g., by a With 27 plates. London : H. K. Lewis and Co., Ltd. 1929. a to be valid not allowed it is 226. 12s. 6d. Pp. professional singer ; "

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