534 



NA TURE 



[September 19, 1907 



results admittedly supported the contention put forward 

 by Sir Victor Horsley, F.R.S., and Miss Sturge, that the 

 ergograph gave results which were as yet too uncertain 

 to yield a verdict which could be considered as final. 



On one point there was unanimity, namely, that alcohol 

 even in the smallest quantities was deleterious to the 



I. — Diagram showing the gradual d: 

 the administration of alcohol and thi 

 same period. The figures : 

 London hospitals. 



during the past forty years in 

 ' ilk during the 



.ed from the statistics of 



ac 2,000 



quality of mental work. This was insisted upon, not only 

 by Sir Victor Horsley, but by Prof. Di.xon, who took a 

 much more optimistic view of the value of alcohol. Prof. 

 Dixon especially considered it valuable in cases of cardiac 

 collapse, on account of the readiness with which it appears 

 to be absorbed and assimilated. 



From the point of view of the use of alcohol in the 

 treatment of disease, Sir Victor Horsley 

 showed curves (Figs, i and 2) illustrating the 

 departure from alcohol which has taken place 

 in the last decade, not only in hospitals gener- 

 ally, but in hospitals for the treatment of 

 fevers — a class of complaints in which alcohol 

 was previously supposed to be especially 

 beneficial. 



Still dealing with the relation of alcohol 

 to disease. Dr. Reid Hunt gave an account 

 of the interesting experiments that he has 

 been conducting which point conclusively to 

 the fact that alcohol lowers the power of 

 resistance of the body to a certain specific 

 toxic body, acetonitryl. 



Two points remain, the dose of alcohol 

 which may be regarded as harmless, and the 

 much-debated question of whether alcohol is 

 a food. These points are closely connected. 

 The impression left on the mind at the end 

 of the discussion was that whether alcohol 

 is or is not a food is largely a matter of 

 definition. It seems certain, on the one 

 hand, that it is oxidised in the body, yield- 

 ing a corresponding amount of energy — in 

 this sense it is a food. Such a definition 

 includes many substances — morphia, for in- 

 stance — which are clearly injurious. If 

 alcohol is not only a " food " but " a useful 

 food," it must be shown that it can be taken 

 without injury to the organism in sufficient 

 quantities to supply an appreciable proportion 

 of the energy of the body. This has not yet 

 been done. 



Tue.<;day, August 6, was devoted to a 

 discussion upon a much more technical 

 subject, the value of perfusions. This 

 was introduced by Prof. Schafer, F.R.S., who gave 

 an exact account of the best methods for perfusing the 

 heart and the kidney. Others who took part in the dis- 

 cussion were Prof. Cushny, Dr. Alcock, Prof. Zuntz, 

 and Mr._ Barrroft. Perfusion has become so important a 

 method in physiological and pharmacological research that 

 NO. 1977, VOL. 76] 



some authoritative statement of its limitations would be 

 useful. At present this may be approached in two ways : 

 (i) by a discussion of the best fluids for the purpose, and 

 here we may mention the work recently done at Oxford 

 by Dr. Vernon, who advocated the addition of albuinin 

 to Ringer's solution ; and (2) by an inquiry into the 

 organs which seem to react most readily, 

 when perfused, to the stimuli which normally 

 produce functional activity. Along this line 

 Mr. Barcroft tentatively put forward the 

 thesis that those organs the coefficient of 

 oxidation of which is lowest stand perfusion 

 much better than others. Thus the heart 

 and muscle react well when perfused, whilst 

 the glandular structures appear incapable of 

 full functional activity when irrigated with 

 an artificial blood supply. Such a tissue as 

 unstriated muscle, which probably has a 

 lower coefficient of oxidation than any of the 

 organs mentioned, will retain a considerable 

 degree of functional activity if it be merely 

 suspended in warm saline solution. 



A very interesting discussion followed upon 

 the presidential address. We need not further 

 allude to the address itself, as it has already 

 appeared in the columns of N.^ture, than to 

 say that the president's main thesis was 

 that every practitioner should be trained in 

 the quantitative administration of chloroform 

 in surgical cases with an apparatus which 

 delivered air containing a known percentage 

 of the anjEsthetic to the patient. 

 This vievi' was very warmly supported by Sir \'ictor 

 Horsley and Dr. Vernon Harcourt. Dr. Frederick Hewitt 

 pointed out the difficulties which attended the adminis- 

 tration of chloroform in this way, which consisted partly 

 in the impracticability of having apparatus at hand in a 

 great number of cases, and the difficulty in using them 

 in cases where there was great personal idiosyncrasy in 





Fig. 



politan Asylum's Board Statistics. Diagram 

 of alcohol to fever patients during the 

 dotted line shows the number of patients beginning in i 

 continuous black line shows the amount of money e.vpended ( 

 1894 with 1388/., and falling to 515/. in 1905, although the nu 

 hospitals that year was 27,162. 



the patients. Prof. Waller made it clear, however, in a 

 few words at the end that a person who had been in- 

 structed in quantitative ideas as to the administration of 

 chloroform was in a better, not a worse, position to 

 adininister it without apparatus if need be, than the man 

 who had only a rule-of-thumb knowledge^ This view 



