long-heads, square-heads, and short-heads
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some time he suffered from general muscularpain and was confined to bed for ten days. He wasthen able to get about, but pain persisted in theleft hip and sacral region. He had several attacksof loss of consciousness in which he fell, but therewere no convulsive movements. He had beentreated for neuxasthenia, and hysteria. Examinationshowed only marked limitation of all the move-ments of the spine. A skiagram revealed a fractureof the fifth lumbar vertebra. In a third case a boy,aged 11 years, was seen on Dec. 7th, 1914. OnOct. 8th he fell from a tree, a distance of 8 feet,falling on the buttocks. He was stunned forseveral minutes, but went home and continued togo to school for two days. On the second day hehad pain in the left lumbar region. Fever beganon the third day and lasted several weeks, duringwhich time he had pain.in the left side and lowerpart of the abdomen and left leg. The left hipgradually became flexed. On examination hewalked with the hip flexed and his hand on hisknee. The hip could not be extended beyond 90°.Abduction was slightly limited, but flexion androtation were free. The psoas muscle was con-tracted, and the left lower quadrant of the abdomenwas slightly tender. He could not bend the spineto the right and only slightly to the left; flexionwas nearly normal and extension limited. A
radiogram showed lateral displacement withpossible fracture of the articular processes of thefourth lumbar vertebra. The general plan of treat-ment consisted in traction on the head and lowerlimbs with gradual hyperextension of the spineuntil over-correction or the best possible positionwas attained, and application of a plaster jacket inextreme hyperextension. Under this treatment allthe cases did well. It might be supposed that con-siderable force is necessary to fracture the vertebra,but the following case shows it is not. A farmer,aged 20 years, slipped and fell backwards, strikinghis spine against some curbing. For three days hewalked about in great pain in the lower lumbarregion. He then became so weak that he could notwalk. On examination marked lumbar kyphosis wasfound with limitation of movement but no paralysis.A radiogram showed impaction and comminution ofthe body of the second lumbar vertebra.
THE THERAPY OF WHOOPING-COUGH.
As a disease that is always with us, whoop-ing cough is deserving of attention. Dr. NellyBenstz, of Amsterdam, has recently recorded1 her experience with a few of the innumerableremedies that have been recommended for its treat-ment. She divides these into four classes. InClass 1 are medicaments that had no influenceon the course of the disease-namely, adrenalin,inhalations of oxygen or of cypress oil, hot baths, and an extract of thyme known as pertussinum.The drugs in Class 2 gave better results -morphine or dionine in doses of from 1 to 4
milligrammes two or three times a day, opium,and droserin. Class 3 contains drugs that gavedecidedly favourable results-bromoform, antipyrin,extract of belladonna; a 1 per cent. solution ofsilver nitrate painted on to the pharynx daily, inthe case of older children, and the inunction of afluorine compound known as antitussin into theneck and chest as a counter irritant. Dr. Benstz
places in Class 4 the drugs that gave good resultsalmost without exception; these are phosphate
1 Nederl. Tijdsschr. v. Geneesk., Amsterdam, 1916, i., 153.
of codein in doses of from 10 to 30 milligrammesa dav, which is particularly useful in cases withmuch vomiting; sulphate of quinine, which lessensthe cough and improves the appetite; and potassiumbromide, of which infants should receive 15 grainsa day, the older children from 15 to 40 grains aday. Dr. Benstz also finds that whooping-cough inchildren is always accompanied by a leucocytosis,the white cells reaching a count of 40,000-50,000 atthe acme of the disease. The differential countshows an increase in the percentage of lympho-cytes, both large and small, with a diminution inthe proportion of polymorphonuclear and eosino-phile cells. ____
LONG-HEADS, SQUARE-HEADS, AND
SHORT-HEADS.
SINCE the almost entire disappearance fromethnology of the Aryans and the merging of theCelts in the Alpine stock of Central Europe, theold race divisions have practically vanished. Itwould, indeed, seem, in view of the now accepteddoctrines as to the distribution of the long-headedand short-headed races throughout Europe, thatthe French are half Germans, the Germans halfCelts, the Anglo-Saxons mainly Scandinavians, theCeltic Fringe not Celtic at all but Iberian. Eventhe Basques would seem to have ceased to be ahomogeneous racial relic, and to be Iberiansor Alpines according as they live south or
north of the Pyrenees. Not a little of theGermanisation of the older ethnologists maybe said to have been due to the teachings ofMax Muller, whose assiduously preached Aryans,emanating from a vague plateau in Central Asia,were virtually Germans. He was followed byBergmann, among others, with his Scythian ancestryof the Slavonic and Teutonic races, and among our-selves by such brilliant historians as Stubbs andFreeman, who traced the institutions of our Anglo-Saxon ancestors to the German forests and to theirdenizens as described in the " Germania " ofTacitus. Historians such as Coote, with his theoryof Roman influences, and anthropologists have formany years been fighting counter to these doctrines.By the aid of craniometry it is now pretty wellestablished that Europe is at most divided betweentwo or three strata of races-the dolichocephalic, themesocephalic, and the brachycephalic. The dolicho-cephalic are the oldest, and are pre-Aryan. On the
high authority of Ripley, Keith, Chalmers Mitchell,and others we now know that the dolichocephals orlong-heads, coming originally from the northernshores of Africa, have encircled Europe to thenorth-west as far as Finland. The short-heads areat most only a zone or offshoot in Central Europeof some race derived from Asia, and are perhaps theAryans or Aryan Celts. They brought with themfrom beyond the Black Sea the Sanskritic language-drift, cremation, and the use of metals. Thatpeculiar and, to our taste, unpleasing type ofGerman head, which looks square and is exemplifiedby the portraits of Von Hindenburg, may be said tobe in type Alpine. It is in appearance, if not infact, brachycephalic, and its squareness may be theorigin of the word boche-a French argot wordmeaning blockhead (see Rigaud’s "Argot Moderne,"1888). This type of German probably owes his
aspect to original brachycephaly, aided by sexualselection. He is rather Bavarian than- Prussian,but the type, so common in the German army,is found throughout the empire. Primitivepeasant women marry the type of man voted
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.handsome by their fellows. A fleshy-necked, short-taaded type has probably always set Gretchen
adoring. The Basque, as Professor Ripley pointsout, has often a long head behind his peculiar butnot unpleasing brachycephalic type of face, andsometimes the Teutonic square-head may be reallylong. ’Proverbialwisdom is favourable to the long-headed man, who is held to be sagacious, whereas thebullet.-headed man is the dunderhead, the ignoblecreature, the barbarian. " He would have whippedpoor bullet-head, so they called the negro," saysDe Foe in "ColonelJack" (1722). And the seventeenthcentury Dictionary of the Canting Crew " speaksof " a dull silly fellow " as "bullet-headed." TheFrench have some 15 idiomatic sayings referring tothe head, but in only one case do we find anallusion to its shape. They say " C’est une têtecarr6e" in reference to an obstinate fellow.According to Ripley, people do not as a rule payregard to the- shape of the head, despite the abovecitations. ’The long-headed Greeks of antiquitymade their statues brachycephalic. It is a ques-tion, indeed, whether the broad heads are in anyway inferior to the long heads in intellectualachievement or the capacity for civilisation. Andthis being so, it would be wiser for the Anglo-Saxonto pride himself on the excellent use that duringthe centuries he has made of culture-drifts, whichhave given him freedomand other benefits, ratherthan on the shape of his skull.
RETINAL GLIOMA IN A BOY AGED 13.
GLIOMA of the retina almost always occurs ininfants or young children, and is most often,indeed, congenital. Dr. E. Paparcone has recently Idescribed a case occurring in a boy aged 13 withina month of a slight injury to the eye. Whileplaying the boy ran his right eye against a lowbranch of a tree; the blow was painful but seemedto cause no further trouble. A few days later thesight of the eye began to fail. A month later the
’boy was seen by Dr. Paparcone, who found the left ’eye quite normal; the vision of the right eye wasreduced to 5/30, the cornea, iris, and intra-oculartension were normal, but examination of the fundusshowed a large oval white area in the internal andlower segment about the equator of the eye. Thewhite surface was not shiny, was fairly sharplydelimited, and was traversed by two minute blood-vessels ; there was no retinal oedema or elevation.Leucosarcoma of the choroid was diagnosed, to theexclusion of tuberculoma, detachment of the retina,cysticercus, and some congenital defect. The
patient disappeared for four months and returnedwith a manifest intra-ocular tumour. The eye wasremoved under local anaesthesia; the boy was inperfect health more than a year later. Examina-tion of the eye showed a tumour free in thevitreous and another .adherent to the choroid.The tumour was found under the microscope toconsist of small round cells consisting mainly ofnucleus and grouped closely round blood-vessels;structures resembling the so-called Wintersteiner’srosettes were seen; the blood-vessels were
numerous and thin-walled. Cyst-formation andhaemorrhages were not observed. A few canalsbetween the gliomatous cells were detected;ganglion cells and neuroglial cells were not seen.’The general structure of the tumour was that ofa tubular angiosarcoma; Dr. Paparcone concludesthat it was an endophytic glioma of the retina,
1 Lo Sperim., Florence, 1915, vol. lxix., p. 855.
with a metastasis into the vitreous. Alternativelyhe calls it a neuro-epithelial glioma, or a glio-sarcoma, or a glioma sarcomatodes. He has founda single case [like his own in the literature of thesubject, to which he makes numerous referenoes.But how trauma of the eye can give rise to thedevelopment of such a tumour as is described abovehe is not able to say.
CEREBRO-SPINAL FEVER IN RELATION TOCERTAIN COSMIC PHENOMENA.
IN the Journal of the Royal Army Medical Corpsfor November, 1915, Lieutenant Arthur Comptongives the results of a series of interesting observa-tions concerned with the temperature and the rela-tive humidity of the air in relation to the cases ofcerebro.spinal fever occurring at Weymouth duringMarch-June, 1915. Referring to humidity, Lieu-tenant Compton shows that whenever the curvepassed through a maximum value the occurrence ofa case of the disease was an almost invariableaccompaniment. In other words, the degree ofsaturation of the atmosphere by water-vapour maybe an etiological factor in determining an outbreakof the disease. Referring to temperature, LieutenantCompton’s observations reveal the fact that casesof the disease most often made their appearance inconnexion with minimum readings on the curve orwhen the maximum and minimum temperatureswere not widely separated. That is to say, that thecases are most liable to occur when the tempera-ture conditions are equable. No doubt equabletemperature conditions, as Lieutenant Comptonpoints out, are favourable to the survival of themeningococcus in the air, and possibly also to itsmultiplication there. The number of cases of
cerebro-spinal fever dealt with in this investiga-tion was only 15, and it remains to be seen ifsimilar careful observations in other localities andwith larger numbers of cases yield similar results.From the material available Lieutenant Comptonseems to have demonstrated that two factors maydetermine the incidence of cases of cerebro-spinalfever—namely, s-udden saturation of the atmo-
sphere by water-vapour, combined with equableconditions of temperature.
INVERSION OF THE PELVIC BONES AS A CAUSEOF DEFORMITY.
A NOVEL cause of female pelvic deformity, dueto developmental inversion of the pelvic bones,whereby the ilio-sacral or ischio-pubic segmentstake on a male instead of a female type, is describedby Dr. D. Berry Hart in the -current number of theEdinburgh Medical Review. In addition to thecharacters ordinarily assigned to the female humanpelvis-greater width and roominess with lightergeneral structure-Dr. Hart calls attention to thedifferent shape of the sacro-sciatic notch as seen inthe two sexes. In the male the arch forming theupper border of the notch is comparatively sharpand is formed by the ilium alone, whereas in thefemale the arch is flattened and the posterior curveis formed principally by the sacrum. Again, in themale the sacral auricular surface is usually madeup of two and a half or even three sacral vertebrae,while in the female only two vertebrae take part inthis structure, apart from special conditions such askyphosis or the existence of six sacral segments.If inversion or change of sexual type of thepelvic bones occur, the sacro-sciatic notch in