MEDICAL NOTES.

New Zealand Herald, Volume XXXVI, Issue 11056, 6 May 1899, Page 1 (Supplement)

MEDICAL NOTES.

TYPHOID FEVER GERMS. So much stress has been laid upon the fact that typhoid fever is in many cases a waterborne disease, and so definite has been the connection of great outbreaks—as, for example, that at Maidstone last year—with water supplies, that penple are apt- to forget how often the infection is carried in other ways. In Public Health Dr. John Brownlee records a series of cases of enteric fever which arose among patients in the city of Glasgow Fever Hospital, apparently from infection caught while within the hospital; and he traces the origin of the outbreak to dust carried to the patients' food from infected earth which had been thrown up in the repair of certain drains, which were known to have leaked into surrounding soil while containing enteric excreta. Dr. Brownleo gives another instructive instance of typhoid fever becoming endemic when implanted in a district the general sanitation of which was bad. How the fever is spread in such a district is pretty clear. The refuse from the ashpits is first- emptied out into the street, and thence removed. The street is thus fouled, and a certain amount of this refuse being left behind is converted into dust, and scattered about by the wind. We have but. to look at a basin of milk which has stood a single night to see how much dust is deposited from the atmosphere, and to understand that if such dust be specifically polluted there is no end to the vicious circle which keeps up not- only the supply of the poison but its distribution. Thus by dust distribution we get a long continuing endemic prevalence of typhoid, very different from the short and sudden outbreak which is characteristic of the water-borne disease when it is spread by means of a public water supply.—The Hospital.

SPINAL CURVATURE. The lic'inuT" spinal column has a certain proper shape, consisting of gentle, even curves from before back, but perfectly straight between right and left. Weakness, ill-health, want of lime in the bones, rickets, and actual ulcerating disease in the bones may all lead to improper, unhealthy, and deforming bends in the spine. Anterior curvature is due to caries or bone disease leading to abscess. This may occur in the neck or back, and is generally related to scrofula, or to tubercular consumptive disease in the constitution. It is the most serious form, because if the disease makes much progress t,Ue curvature may injifre the extremely delicate and important spinal cord within the spinal canal. Sudden death may occur from this reason. Permanent defosmity follows this caries even if it be arrested and recovery follows. Cripples with permanently deformed spines are often seen.

Lateral curvature is generally less serious, and rarely is fatal. This occurs in very weak and delicate persons who follow certain occupations in cramped positions or take up some habitual posture. In delicate young women of lax fibre, weak muscles, and with bones too soft from want of a due proportion of lime in them, there is often a tendency to stoop and to acquire an awkward, ill-balanced gait and position. These girls are generally said to have outgrown theii strength. We observe that one shoulder is higher than the other, and that the back is curved, and the shoulder blades stick out too much. The bending of the spine may also lead to further deformity at tlie hip from the habit of standing awkwardly to correct the spinal position. The greatest care is necessary to correct these ailments, and, above all. the food must be ample, and fresh air is of vital importance. Cod liver oil is needed, animal food and eggs. Quinine and iron tonics must be given, and lime i.; some form, such as the syrup of the m-Dopho„phites. or saccharated solution of lime. Rest : n the lying down position must lie taken daily. Sea baths often do much good, -and so do properly-conducted gymnastics. In bad cases some mechanical apparatus is needed.

HOW TO REDUCE FLESH. The proper treatment for the reduction of obesity is as simple as it is effective. In point of fact, all that is nccessary is to induce the patient resolutely to abstain from all bread, cereals, and "starchy vegetables. Almost any flesh food is admissible, although the lean will be found to be more favourable to redntcion than the fat, and beef is more effective and desirable than any other. A patient will need from one pound to two and a-Lalf pounds per day, according to the amount of obesity and the amount of exercise that must be taken. The obese patient rarely needs more than two meals a day. We usually ordeied paiiir.ts to abstain from their breakfast, to take their first meal about twelve o'clock, arid the last one at the usual dinner time- -six, seven, or eight in the evening. Many patients weighing from 100 to 250 pounds (from seven to eighteen stone) more than is natural will frequently be adequately nourished on a half-pound of lean beef taken twice a day, and from two to four pints of hot water taken before meals and before boa— Nature Cures," by Emmet Densmore, M.D.

• CARE OP THE TEETH. Most people have a general idea that it is wise to take care of the teeth, and accordingly do so, as they suppose. They rub a brush hurriedly two or three times over the front of the teeth before going to bed, or on getting up in the morning, and think they have cleaned their teeth. The importance of sound and serviceable teeth as an aid to health cannot be overestimated, for upon their good condition depends the thorough mastication of the food, which is the first, ted not the least, requisite of good digestion. Many a person doses himself with all sorts of remedies to aid digestion, when the real cause of his dyspepsia may be found in the poor state of his teeth. The proper time to brush the teeth is after each meal and at bedtime. Before this is done all particles of food should be removed from between the teeth by means of a toothpick, or, better, dental floss. Then they should be brushed thoroughly with a brush of medium stiffness dipped in tepid water. Very hot and cold water are equally harmful. The brush should be used with an up and down movement, and not sideways only, and the backs of the teeth should be brushed even more carefully than the fronts, for it is there that tartar tends to accumulate. Many think that tartar is harmless, but this is an erroneous belief; its accumulation is one of the principal causes of loosoning of the teeth, and its presence exposes one constantly to the recurrence of gum-boils. The use of some good dentifrice once a day, or two or three times a week, keeps the teeth whiter and better-looking, but is not absolutely necessary when the tooth-brush is used after each meal. Rinsing the mouth after each brushing with some pleasantly flavoured antiseptic solution helps to avert decay of the teeth. Finally, not the least important point in the care of the teeth is a regular semi-annual visit to the dentist, that he may examine the teeth and fill at once any beginning cavity. In this way the teeth may be preserved, accidents excepted, for a long lifetime, and tho natural teeth, even when filled and repaired, are many times better from every point pf view than any artificial ones.