MEDICAL NOTES. .

New Zealand Herald, Volume LI, Issue 15766, 14 November 1914, Page 3 (Supplement)

MEDICAL NOTES. .

RHEUMATISM AND ITS CAUSE. De, Or. L. Kerr Pringle had under his care at the Royal Bath Hospital, England, -61 cases, which he classified under the following groups:—Chronio arthritis, muscular rheumatism or fibrositis, sabacute rheumatism, neuritis, skin diseases, and miscellaneous. Eighty-three cases of the 261 suffered from some form of oral sepsis. That means their teeth had been neglected. The cases of chronic arthritis he again subdivided, and in one subdivision proliferative polyarticular or infective arthritis, 67 per cent, had oral sepsis. It is now recognised that rheumatism in all its forms is a germ disease, and when it appears the form of poisoning setting up the septic condition should be sought for. Dr. Pringle says: (< If the general practitioner would send these cases to the dentist when they first come under his notice instead of dosing them with salicylates and aspirin, we should soon see fewer of these distressing cases of severe crippling which are so common at ail our spas, but the cases must be seen early and before the damage is done."

THE WORRY FIEND. The anxieties and worries peculiar to modern life have much to answer for. They certainly have as much to do with causing and perpetuating a more or less universal state of invalidism as any other condition. Those who have given most thought and study to the subject concur in the testimony that it is not the work of brain or body that kills, but the accompanying worries and anxieties, combined with unphysiological habits of life, that undermine the sensitive nervous system and ruin the constitution. And here an aggravating fact comes in—in nine cases out of ten the disquieting thoughts and carking cares which are harboured and brooded over are entirely unnecessary and frequently imaginary. There are numberless kinds of worry, and many people seem born with a predisposition to it. When we add to this hereditary diathesis the ambitions and competitions for display, for position, the multiplication of individual wants, and the demands of an 11creasing complex home and society life, we cannot much wonder that this fiend carries forebodings and restlessness into the home circle, into places of business and pleasure, and robs the spirit of contentment, the mind of peace, and the body of health. When health is gone the portals aro opened yet wider to the entrance and the sway of real and imaginary anxiettes, cares, and ills. Under their influence the judgment often becomes warped, the will Becomes weakened, the intellect clouded, and the conscience morbid. We cannot, unfortunately, always control the circumstances of our lives, and in the experience of nearly ali of us there are conditions to oe endured and cares to be borne for which we are not responsible.

NOISES IN THE HEAD. Noises in the head are of various kinds, and come from a good many different causes; they are not always indications of ear disease. Sometimes they are owing to changes in the walls of the blood-vessels, in the composition of the blood, or- in the force of the blood pressure; or they may t>e caused by certain drugs, such as quinine ! and salicylic acid. The character of the I sound differs according to the cause that 13 lat work. It may be described by the j sufferer as creaking, crackling, buzzing, puffing, drumming, bubbling, rumbling, or bell-ringing. Sometimes the noises are so faint that they are noticed only at night or in absolute stillness; in other cases they are so loud that even the noise of a railway train fails to drown them. In chronic cases the head noises are usually worse when the sufferer is worried, overworked, or out of health, find they seem to be increased by smoking or living in stuffy rooms. The most frequent cause of tinnitus I — for that is the medical name for tho affection —is tar disease, either acute or chronic. If it is owing to an accumulation of wax in the ear the noises will ce«se promptly when the wax is removed; but if the noises come from disease of the. j middle ear, or of the internal ear, treatj ment is a much more difficult matter. If the physician can cure or ameliorate the I inflammation, the tinnitus will be relieved at the same time, and sometimes he can do much to help it, even when the ear disease itself is incurable. The vibrations made r>y a "buzzer" held close to the ear will occasionally give relief, and the noises have been known to disappear after prolonged listening at the telephone. But, on the other hand, those things have sometimes made a bad matter worse rather than better. The sufferer must not take the advice of his sympathising friends and put drops of various kinds into the car. They can seldom do any good, and may make the condition more serious. The trouble may come from so many different conditions that only a thorough examination by an experienced physician can determine the real cause and the proper treatment.

SUN AND HEAT STROKES. Thermic fever, or what is generally understood as true sunstroke, is dive to heat, and heat alone. It may occur at night or in hot fire rooms. Its. charactens. tics are fever and debility, with more or less .•una, and its treatment is the withdrawal of heat as soon as possible. The ice bath with antipyretics caused a great reduction of the death rate, but certain Frenchmen have reported greater success with hot baths which dilate the superficial arterioles and thus favour loss of heat by radiation and evaporation if a gentle current of air later plays over the body. In cases of great urgency u where every second's delay counts against the patient, the hot bath is certainly unsuitable. " Heat exhaustion" is a condition of shock. There is ample evidence that it «., a form of paralysis due to excessive light, and that neat has nothing to do with it. It ought to be called actinic shock. In insects which fly too near ihi cold ultra violet rays of certain lamps it is seen in all grades, from mere weakness up to instant death. In man it is rarely, if ever, fatal, as it is difficult to apply enough light to | do more than injure or destroy a few I superficial cells. It is rare in negroes and others whose pigment keeps out the light, but it is quite common in the blonde. Its symptoms are the exact opposite of those! due to heat. The temperature is normal or subnormal, pulse weak, 'skin wet, and there is no loss of consciousness, but a general debilitated state. The treatment is instant removal to the shade und the administration of heat and stimulants. It is difficult to get exposure to light without also receiving heat, as in sun-exposure, hence the cases are generally complicated, with more or less thermic fever. Dark skins absorb heat easily from hotter sources, so that in conditions of very high air temperature dark men suffer more from thermic fever than those of light complexion. In more moderate heat, below 9B degrees, the dark men have an advantage because they radiate better. The negro is therefore suited to his natural habitat, wnere the air temperature is rarely over bO degrees, and the light is excessive. In such conditions white men suffer unduly from both heat and light. Heat cramps is the third condition of "sunstroke." It is due to the withdrawal of water by excessive perspiration, and its symptoms are identically the same as in cholera or Any other disease in which the body fluids are drained off by the bowel. The temperature may be normal or subnormal, and all the muscles are thrown into more or less spasm. The mortality is dreadfully high because of the effect on the heart. " It is common in hot fire rooms, but naval surgeons have loarned to cure it almost miraculously by restoring the lost fluid, intravenously in desperate cases, but in any other way practicable, by mouth, rectum, or subctitaueously. Negroes are the greater sufferers because they perspire so enormously in a heat greater- than 98 degrees when their dark skins absorb so much more heat than white ones. People should drink plenty of cold water frequently when perspiring, but avoid ice water unless taken in such small amounts eg a half-glass.