Part 5

We may glance at another and very similar instance of referred sensations occurring also in surgical practice. Amongst the rarer operations of what is termed plastic, and, by Sir James Paget, ‘decorative’ surgery is that by which a new nose is formed by calling in the aid of the tissue of other parts of the body. This has been done by bringing a flap of skin cut from the forehead down over the nasal bones. The flap retains its connection with the deeper tissues at a point between the eyes by means of a small pedicle, and thus its blood-vessels and nerves are not all severed. This flap is not simply pulled down from the forehead—it is twisted at the pedicle, so that the raw surface lies on the bones of the nose. Now, for some time after this operation has been performed, any irritation in the nose is referred by the mind to that part of the forehead from which the flap of skin was taken; and therefore, if a fly crawls over the patient’s nose, it appears to him to be creeping across his forehead. Before the operation, whenever the nerve-ends in the flap were irritated, it was caused by something touching the forehead, and it is some time before the mind ceases to refer such irritation to that part of the face.

Leaving, now, the domain of surgery, we may notice two simple experiments mentioned by physiologists, which all can perform for themselves. They both prove that conclusions formed upon the evidence of the sense of touch alone may be quite incorrect. By crossing the second finger over the first, and then placing a marble between the tips of the fingers, we get a sensation that leads us to suppose that there must be two marbles instead of one only. This is because two points in the fingers are touched simultaneously, which in the ordinary position could only be touched at the same moment by two marbles. Judging, then, from the sense of touch alone, the mind infers that there are two round hard substances beneath the finger-tips; but the evidence of eyesight and the knowledge that we have placed but one marble in position, corrects the misapprehension. Again, if we take a pair of compasses the points of which are not sufficiently sharp to prick the skin, and separating the extremities rather more than an inch from one another, draw them across the cheek transversely from a little in front of one ear to the lips, we shall be tempted to think, from the evidence of touch alone, that the points are becoming more widely separated. By measuring the distance between the two points afterwards, we can assure ourselves that this has not been so; but whilst the compasses were being drawn along the cheek, and still more when they had reached the lips, the impression that the distance between the points increased was very strong. This delusion is said to depend upon the fact, that some parts of the cutaneous covering of the body are much more plentifully supplied with nerves than others. It is stated that the mind probably forms its idea of the distance between two points on the skin which are irritated in any way—as, for instance, by the points of a pair of compasses touching the surface—by the number of nerve-endings lying between these two points which remain unirritated. Thus, if there be fewer unirritated nerve-endings lying between the two points of the compasses when placed on the cheek, than there are when they are placed at the lips, the mind will infer that the distance between these points is smaller in the former position than in the latter.

THE STATE’S NEGLECT OF DENTISTRY.

The machinery of the State is so vast that it may well be imperfect here and there. It frequently falls to the lot of individuals to point out how the tide of progress has left details in a condition of inefficiency. We note a recent instance of this. In August last, at the annual meeting of the British Dental Association, Mr George Cunningham, one of its members, drew attention to the backwardness of the practice of dentistry in the various departments of the State. The substance of his case amounted to this: In the army and navy, unskilled practitioners wielded uncouth and inefficient instruments in following antiquated and unscientific methods; while the police force and the employees of the India and Post offices by no means derived the full advantages of this department of medical science. Mr Cunningham was bold enough to include the inmates of prisons among those whose interests were neglected; and of course the principle of the humane treatment of criminals is already conceded in the appointment of jail chaplains and surgeons. We need not enter here into the voluminous details with which Mr Cunningham substantiated his case. The broad conclusions he would seem to draw are these: that the medical practitioner employed by the State should possess a more thorough knowledge of dentistry; that, where necessary, the services of the completely trained and qualified dentist should be secured; and that full resort should be had to the remedial resources of dental science. Seeing the suffering caused by diseases of the teeth, and the subtle and intimate connection existing between dental and other maladies, we trust Mr Cunningham’s paper may receive the consideration it would seem to deserve.

THE BOARD OF TRADE JOURNAL.

Persons wishing to keep up their information on subjects connected with trade and changes in foreign tariffs may do so by consulting the _Board of Trade Journal_, the first numbers of which have just been issued. An attempt is also made in this journal to give the public information as to trade movements abroad, from the communications of the different consuls and colonial governors. Some of the periodical statistical returns of the Board of Trade will also be included from time to time. Such a journal deserves the support of all merchants and manufacturers at all interested in our foreign trade. Formerly, the commercial Reports from Her Majesty’s representatives abroad did not see the light for months, or perhaps a year, after they were received; now, these have some chance of being really useful to persons interested in foreign trade and to the community at large.

LOVE’S SEASONS.

Love came to my heart with the earliest swallow, The lark’s blithe matins and breath of Spring; With hyacinth-bell and with budding sallow, And all the promise the year could bring.

Love dwelt in my heart while the Summer roses Poured forth their incense on every hand; And from wood and meadow and garden-closes The sweet bird-voices made glad the land.

Love grew in my heart to its full fruition When Autumn lavished her gifts untold, And answered earth’s myriad-voiced petition With orchard-treasure and harvest-gold.

Love waned in my heart when the snows were shaken From Winter’s hand o’er the rose’s bed; And never again shall my soul awaken At Hope’s glad summons—for Love lies dead.

W. P. W.

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