616

lative interference is in great measure required, and, insteadof proving injurious, is likely to be of practical value to themanufacturer. There is little doubt that much of the pollu-tion proceeding from manufactories could be easily preventedwith little trouble and without imposing any great restric-tion. And we think also, as many manufacturers will admit,

that there are instances in which the reckless pollution ofthe stream has injuriously affected other manufacturers

lower down. We allude particularly to the casting of solidrefuse into the river, and the consequent blocking up of thestream, thus impeding navigation, and rendering floodsmore disastrous than they would otherwise be. Altogether,certainly, as far as legislation has hitherto gone, our manu-facturers have had little cause to complain of undue inter-ference, nor do we think they have much reason to fear inthat respect for the future. A question so intimately con-nected with the commercial prosperity of England will notbe entertained without "extreme caution," and an amplediscussion of the issues involved.

Annotations.

HOSPITAL ADMINISTRATION.

"Ne quid nimis."

Tnis subject was once and again discussed with consider-able spirit and some acrimony at the meeting of the Metro-politan Asylums Board held on Saturday last. It appearsthat a letter was addressed to this body in August from theLocal Government Board, the purport of which indicated

very clearly that in the administration of the Small-poxand Fever Hospitals at Homerton and Stockwell (and else-

where if opened) the authority of the medical superintendentshould be held to be supreme in lay as in professionalmatters connected with the working of the establishment.To this memorandum the General Purposes Committee ofthe Metropolitan Asylums Board very emphatically demur,holding the opinion that, in the interests of all concerned,it is better that the supervision of the medical officer shouldbe confined to his juniors, and the nurses, servants, andothers in immediate attendance on the sick ; but that thesteward should be uncontrolled in the exercise of duties

connected with his own department, and subject only to theorders of the Committee of Management. This is an unfor-tunate revival of a much-vexed question, which causedwhat was known as the Hampstead Hospital inquiry severalyears ago. We have also from time to time commented

upon discussions and dissensions of the same sort as theyhave arisen at other hospitals, and do not now see anyreason to depart from the principles that we have alwaysheld in dealing with the subject. They amount, in brief,to this-that, inasmuch as duality of government is fatalto the success of any administration, whether in a hos-

pital or elsewhere, it is necessary that one officer should

have in his own hands the final decision of all ques-tions. In most hospitals, whether general or special,the chief resident medical officer is undoubtedly the

proper referee. It is, however, equally essential to suc-cessful administration that the lay officers - that is, all

concerned with the structure of the building, the pro-

visioning, cleaning, and other arrangements-should havea responsible head. And, as all those who know anythingabout the practical working of a hospital are fully aware,the medico superintendent is only too glad to let thesteward and his staff go on their way rejoicing, and also to

co-operate with them in every possible way for the welfareof the inmates. But at intervals, sometimes rare, some-

times frequent, discussions arise among the officers that

require to be dealt with, not only firmly, but decisively,and with a decision that shall be final and absolute,until, at all events, the next meeting of the managingcommittee. We assume, for example, that the quality ofthe beef-tea provided is complained of by a sister or

a patient. The pride of the cook is wounded, a retortfollows, the steward backs up his own staff, and if he andthe lay element are absolute, the grievance, even if honest,remains unredressed, to the grave injury of the personsmost concerned. Again, a question may arise as to

honesty in the distribution of stimulants ordered. In sucha case, the affair must be settled at once and authorita-

tively. It is, indeed, from little circumstances such as

those above quoted that the intense mischief of a dualadministration is eminently apparent. And so, with a full

appreciation of the fact that medical men are not, as arule, good men of business, and also that they need not andshould not be charged with the financial work of the hos.pital in any way, it still appears to us that reference mustbe made to one officer in special cases, and that under suchcircumstances the proper man to be chosen as commandingofficer is the medical superintendent, who is of course

responsible to the managing committee, and would retirefrom office when he ceases to possess their confidence.

HEALTH OF KENSINCTON.

THE annual report of Dr. Orme Dudfield, medical officerof health for the parish of St. Abbott’s, Kensington, hasbeen recently published, and is specially noteworthy, ascompared with productions of the same kind that we arecontinually receiving, in that it evinces a very thoroughand painstaking appreciation of the responsible work

attached to such a post as that filled by the officer in ques-tion.The district under consideration, as is well known, has,

as to its population, increased more rapidly than any otherin the metropolis, which increase, as the author of the

report says. " is likely to persist so long as there is roomfor building operations." The number of new houses

brought into rating during the year 1875 was 777, repre-senting an increase in the population of about 5500 persons.The gross death-rate was 19’4 per 1000 persons living, or18’1 per 1000 if the deaths at the Brompton ConsumptionHospital, and those at St. Joseph’s House, Notting-hill, bededucted. Thus, as compared with all London, Kensingtonshows an advantage of 4’3 per cent. The statistics and

particulars of the zymotic diseases do not call for anyspecial remarks, as it is not our province in this place torenew a discussion about the "chronic prevalence of typhoidfever in South Kensington," raised some three months

ago by Sir Henry Cole. Dr. Dudfield comments emphati-cally upon the importance of utilising the 26th sec. of theSanitary Act, 1866 (now the 124th sec. of the Public HealthAct, 1875), which relates to the removal of persons sufferingfrom a contagious or infectious disease, and " without properlodging accommodation," and recites the advantages to begained by arrangement with the London Fever Hospital,as set forth in an annotation of last week. We must omitall reference to birth, marriage, and other statistics.

Among special subjects, attention is called to the tenacitywith which the inhabitants of a particular district cling tothe use of water from wells that have been proved to bepolluted from many obvious sources. Dr. Dudfield veryproperly says, "It may be broadly stated that London doesnot contain any safe shallow wells," and wo are glad toknow that he, in company with Dr. Sedg wick Saunders and

617

other health officers, is persistent in his efforts to close A process of recession of an ovum similar to the one sup-these active disseminators of epidemic mischief. Sewer posed is believed by some to have taken place in the humanventilation is referred to in a somewhat despairing tone; subject in a case where a corpus luteum was found in thefor if, as we believe, the ventilation of sewers into the road- right ovary and a foetus in the left Fallopian tube.way were abandoned, and the shaft system were more It appears certain that in some instances ovarian folliclesgenerally adopted, we should hear less of sewer-gas as contain two ova, and it is probable that this is one cause ofa nuisance, and know less also of its injurious effects. the formation of eggs having two yelks; at the same timeDr. Dudfield refers to the want of a complete drainage it is not impossible that such egg? may be formed in a dif-map of his district; and there is no doubt that one is ferent manner, and the inclusion accomplished in the

required for every sanitary area, particularly in the metro- specimen we have described gives a clue to such method.

polis. Slaughter-houses and cow-houses are a sort of Two ovarian follicles, each containing a well-formed ovum,hobby of Dr. Dudfield’s, and are copiously referred to, may rupture at the same time and their contents be re-but we must pass them by, as having been very recently ceived into the oviduct together. As they descend theyreferred to in THE LANCET. This very excellent report may become included in the same albuminous covering, andconcludes with the enunciation of sanitary desiderata in finally form a double-yelked egg. The experiments of Dr.the shape of a parochial disinfecting chamber and mor- Allen Thomson go far to prove that monstrosities are not

tuary, as well as baths and washhouses; all of which, in formed from double-yelked ova. It is, however, possibleso " well-to-do " a parish as Kensington, and with so liberal that when two well-developed yelks, each from a separatea local Board of Health, ought to be matters of fact follicle, are discharged at the same time into the oviduct,without much delay. ____

they may become more or less fused in consequence of the.

-

pressure exercised upon them by the oviduct during theirTHE DEVELOPMENT OF MONSTROSITIES. descent, and finally appear as one yelk. In whatever posi-

WE have received a pulle t’s egg w hich possesses rtain tion the egg is placed the cicatricula is uppermost. As thisWE have received a pullet’s egg which possesses certain tion the egg is placed the cicatricula is uppermost.

As this

depends, not upon the halazse, but upon the dinerenoe inpeculiarities that may give some clue towards the solution depends, not upon the chalazæ, but upon the difference inof a very obscure question in the pathology of development density between that part of the yelk where the cicatriculaof a very obscure question in the pathology of development, .

-ther formation of double monsters. In external appear- is placed and the part opposite, it may be conceived that in—the formation of double monsters. I n external appear- is pl aced and the part opposit e, it may be conceived that in

ance the egg in question presented no peculiarity. It was a compound yelk produced in the manner above suggested,of medium size; its shell was of white colour. On breaking the cicatriculæ of the two yelks entering into its formation,the shell, however, it was found that, besides the usual con-

would be ultimately placed close together, and when

tents—yelk and lbumen,—there was in the interior another examined present the appearance, not of two cicatncula butsmall egg similar to those usually known as wind-eggs. of one abnormally formed. Some of the observations of Dr.

The included egg measured rather more than three-fourths Allen Thomson seem to us to be in accordance with the

of an inch in the larger and nine-sixteenths in the shorter suggestion made here rather than with the view of excessdiameter; it weighed forty-seven grains. It had a calcified ot developmental power of a single ovum. Moreover, the

shell, which had a slightly brown colour. On examination view suggested appears to account to a certain extent for

by transmittsd light, it was evident that it contained no the regularity of attachment of similar parts observed in

yelk-thaf, in fact, its contents were similar to those of double monsters, as well as the production of some, thoughwind-eggs-namely, albumen and a bubble of air, due pro- not perhaps of all, supernumerary organs.

bably to evaporation of water from exposure. -

It was said that the included egg was found in the yelk of INFECTIOUS DISEASES ON EMICRANT SHIPS.

the containing egg, but, as it was discovered accidentally THE complications that have occurred in consequence ofwhen breaking the egg, it is possible that this observation an outbreak of scarlatina and diphtheria (so reported) onmay not be perfectly accurate. Still, the observation is sup- board the New Zealand emigrant ship Hurunui show veryported, to a certain extent, by the fact that the shell of the plainly a clashing and confusion of sanitary laws as re-little egg was not broken by the pouring out of the contents gards persons afloat. It appears that the Hurunui sailedof its including egg. for Gravesend at the end of last month, having on boardThe interest of the specimen consists not only in its about 250 emigrants bound for Wellington, New Zealand.

extreme rarity-for we have heard of one other of the kind Scarlatina appeared among them before the vessel was outonly, but in the bearing it has, or may have, on certain of the Channel, and the vessel put into Weymouth. But asobscure pathological conditions, and especially on the deve- no accommodation existed there for the sick, she was towed

lopment of monstrosities. round to Plymouth by direction of the Board of Trade

The included egg in this case, inasmuch as it contained authorities, who now control all Government emigrationno yelk, was probably not a product of the ovary, but of the work. The Emigration Act of 1855, which is, we believe, stilloviduct alone. It is not unlikely that its formation took in force, recites (45th Section) in effect that any personplace in the following manner:—A mass of albumen, secreted sick, and likely to endanger the health of others, shall bein the first or albumen-secreting portion of the oviduct, was landed, with his family if necessary ; and, indeed, if it bedriven downwards into the uterine portion ; it received its necessary, all the passengers may be landed, in order thatmembranous covering in the narrow portion of the tube the ship and her belongings may be fumigated and disin-where a well-formed egg receives a similar covering, and fected. But, inasmuch as the provisions of the Publicthis membrane became calcified in the uterine portion of Health Act, 1875 (Section 124), enact that all personsthe duct. Instead, however, of being expelled from the suffering from infectious diseases on board ship may bebody, it was made to recede into the oviduct, and there it removed by the port sanitary or riparian authority, Mr.came in contact with a normally developing egg in course Francis Fox, port medical officer of health, steps in when theof descent. Its backward progress was thus arrested, and ship arrives at Plymouth, and orders the sick people onit became involved in the soft, growing, and descending shore. It would appear, however, that Mr. Eccles, as

ovum. As additional layers of albumen were deposited on Board of Trade medical officer, acting upon the Passengersthe latter, the little egg became completely covered, and Acts, ordered the families of the sick on shore as well, thuswas finally expelled in an apparently normally-formed causing considerable confusion, and straining to the utmostovum. the hospital accommodation at Plymouth for infectious

618

diseases. Meanwhile the Admiralty lent their hulk Piqué years, and that, too, at an age when, as Dr. Lewis observes,to the New Zealand emigration agent, and the emi- the countenance sooner indicates threatening illness.

grants were transferred thither pending the fumigation and To obtain good results, the inspection ought not to be of

cleansing of the Hurunui. It is pretty plain that the an intermittent kind. During ordinary periods, a weeklyMarine department of the Board of Trade, as responsible visitation would prove quite sufficient, but on the first

for the administration of the Passengers Acts, have, up threatenings of an epidemic a daily inspection should beto the present time, failed to perceive that what may rigidly enforced. By such a system not only would the ex-be called the port sanitary sections of the Public Health tension of zymotic disease be greatly checked, but also thoseAct, 1875, may, and really do in effect, override several pests of day-schools, ringworm and itch, would be greatlysanitary clauses of the Passengers Acts, so that, in fact, diminished, if not in time altogether stamped out. And

one or other should be amended. For, as things now are, the cost of such supervision would be small in comparisonit is perfectly competent for the port medical officer of with the burden now thrown on the rates whenever scarlethealth to remove any person from any vessel on the score fever or small-pox visits a town.of infectious disease, the emigration officer notwithstanding. __________

And it is equally necessary, when any Colonial Government HABITUAL DRUNKARDS.organises an extensive scheme of emigration from the ...United Kingdom, that proper accommodation should be pro- THE persistency evinced by Dr. Carpenter and others onvided by them at the port of departure, as well as at any this subject affords some prospect of attempted legislationports of call, for the reception of cases of infectious or next year. The question is manifestly difficult, but its im-

contagious disease. As the law now stands (indicated by portance is imperative, and the evils that now result, di-the terms of the Public Health Act) all such cases can be rectly and indirectly, in this country from the abuse of

thrust upon the port sanitary authority, which is a mani- alcohol are too patent to be disregarded. The exertions of

festly unjust and improper proceeding. the late Dr. Donald Dalrymple in this matter are still

____, fresh in our minds, although three years have now elapsed

MEDICAL SUPERVISION OF SCHOOLS. since the Bill that he had framed was, as it were, strangledTHE arguments advanced by Dr. Lewis, in a paper read

in its birth by the untimely decease of its promoter. WeTHE arguments advanced by Dr. Lewis, in a paper read in its birth 1 the untimely decease of its promoter. We .

in the Health Section of the Social Science Congress at shall do well, however, to remember the principles on which

In the Health Section of the Social Science Congress at , , .,

Liverpool, on the necessity of establishing a system of Dr. Dalrymple’s Bill was founded-viz., on the recommenda-

Select Committeerr f. Commons onmedical inspection for schools, have come at an opportune tions of the Seleet Committee of the House of Commons onmoment. A serious epidemic of small-pox threatens the

habitual drunkards, which sat in 1872, the pith of whichmoment. A serious epidemic of small-pox . threatens the was th a i in th e t reat ment of suc h persons the arrangemen t scountry, and already alarm and anxiety are expressed by

was that in the treatment of such persons the arrangementscountry, and already alarm and anxiety are expressed by ma d e s h a II no t, b e in any way connec ted d with th e 1 lunacylocal authorities at the rapidity of its advance, and exertions made sball not be in any way connected with the lunacy

’

, - system, or the lunacy law, as administered by the Commis-

are generally being made to check its progress by pro- sioners. This lunacy well are g enerally being made to check its progress by sioners. This was very well pointed out by Dr. Peddle someviding means for the prompt isolation of the infected. It two or This was very well pointed out d Dr. Peddie somebe effectual,

or three years ago in the British and Foreign Medico-ts evident, if this isolation is to be effectual, that rt should Chirurgical Review, and must not be lost sight of in the. , , , .. Chirurgical Review, and must not be lost sight of in thebe carried out at the initial stage of the disease. Yet it is

framing of any legislative measures. It is a work of su- -on this important point that the greatest difficulties are to pererogation again to point out how temporary elimina-be encountered. Several instances have been recently noticed tion from the streets of London of those persons who drinkin our columns of the perilous delays that often occur to to 0 excess systematically would diminish the work of magis-prevent the prompt isolation of the infected, owing to the trates, policemen, hospital house-surgeons, and railwayprevent the prompt isolation of the infected, owing to the t ra t es, policemen, hospital house-surgeons, and railwayamount of official circumlocution that is involved in what officials, a large proportion of whose time is now spent inought to be an extremely facile proceeding. Again, a

ministering to the resu lts of a terr ible ev il tha t righ t.ought to be an extremely facile proceeding. Again, a ministering to the results of a terrible evil that might, bychild suffering from actual disease or returning before con- legislative if by no other means, be made in a great mea-valescence is complete, may, by mingling with other sure preventable. Pending the introduction of legislative

children at school, spread the disease far and wide; yet measures, it is, however, pointed out by our contemporary,there is no supervision provided to prevent such a disastrous the World, that ptiblicans are responsible for a great deal ofthat publicans are responsible for a great deal of possibility. An investigation into the many fatal out- drunkenness, in that liquor, often of a filthy and adulteratedbreaks of scarlet fever and small-pox would show what kind, is served to the wretched frequenters of these gin-active centres large day-schools are in propagating infection palaces, who are turned into the streets only when bereftactive centres large day-schools ,

are in propagating , who are turned into the streets only when bereftthrough a town. And yet this source of danger could be of both money and sense. For it must be remembered that so readily removed. Dr. Lewis instanced the success that

adulteration (for which it is supposed we have now a legal(tor which supposed we have now a has attended the systematic medical inspection of emigrants remedy) has much to do with drunkenness, and that the before embarking for America, in checking the outbreaks police are as responsible for the maintenance of order inof in fec tious disease tha t former ly so frequen tly occure d police are as responsible for the maintenance of order inof infectious disease that formerly so frequently occurred licensed houses as in the streets.on board vessels during the voyage, as showing the ad-

vantages of the system, and that the difficulties supposed -

to lie in the way were readily surmountable. Dr. Lewis INFECTiON FROM THE DEAD.

states that during the last five years 189,455 emigrants AN important topic was the subject of a paper by Dr.have thus been examined per year, on an average, at Liver- Va,cher, medical officer of health for Birkenhead,’" The Deadpool alone, by the action of the Government and the vigi- Body a possible source of Infection." He discussed at somelance of the steamship companies, and that among this length the evidence in favour of the communication ofenormous mass the appearance of infectious disease on board disease from the dead to the living, and argued that it wasthe transatlantic steamers is very rare indeed. This is a reasonable to believe that dead bodies possess the power ofmarvellous success, and yet the work, though no doubt infection. The question was hardly susceptible of positiveextremely arduous as far as the medical inspectors are con- proof, but there was much evidence in favour of the occa-

cerned, is easy in application. Still more easy of applica- sional extension of disease by such means. He consideredtion would the work of super vision be in the case of schools; what legislative enactment would best effect the objectinstead of a fleeting mass of persons of all ages, the in- sought, and suggested a due provision for the removal ofspector would have to deal with the same persons for several the bodies of persons dead of infectious diseases to proper

619

mortuaries, and that the exposure of a dead body in such a giving early warning of epidemic outbreaks, which are

way as to infect the living should be made as penal a pro- almost invariably of urban origin, but in allaying appre-cedure as the exposure of the infected living. hension. With regard to the general prevalence of small-

It is very desirable that well- ascertained facts relating to pox, it is eminently reassuring to find that among the eightinfection from the dead should be placed on record, for it is millions of persons living in our twenty largest town-almost certain that the contagion from the dead acts under centres only 34 fatal cases of small-pox were registered insomewhat different conditions from the contagion from the the week ending 21st instant, of which 22 occurred inliving, and that the likelihood of infection from different London, 7 in Liverpool, and 5 in Manchester and Salford.diseases is not the same after death as during life. A rural At present the epidemic is mainly confined to Lancashireburial club has lately been much exercised regarding the and London, and has only showed severely persistent fatalityspread of diphtheria by public funerals, and sent circulars in Salford. On the 1st proximo the Registrar-General willto a large number of neighbouring medical men, whose issue his usual Quarterly Return relating to the whole

replies were, in a large number of cases, so undecided that country; in the meantime, however, the information giventhe burial club thought it right to act on some evidence in the Weekly Returns affords tolerably conclusive evidencewhich was before them, and to recommend that the funerals that the prevalence of the disease is at present confined toof persons dying from diphtheria should be as private as but a very few centres of infection.possible. But diphtheria is far from being a very infectious ___________

disease during life, and there is at present no evidence to "VANITY FAIR" ON ARMY SURCEONS.show that death in any degree intensifies its infectiouscharacter. It is very difficult to believe that when a body Vanity Fair has degenerated since the time that it lost the

is enclosed in a coffin, and properly secured, it can still be a services of the artist whose brilliant caricatures of our

source of infection in such a disease. It is necessary, how- public men first brought that journal into notice. The

ever, to have other facts on which to order action than are earlier sketches were in every way so graphic, and admirable

at present available. The sources of fallacy in drawing a as likenesses, that they formed a most valuable addition to

conclusion are numerous; persons living or visiting in the contemporary history. Sorry caricatures, accompanied bysame house are often exposed to the same influences wbich a style of writing which aims at being terse and epigram-caused the malady in the individual first attacked, and such matic, but only succeeds in being vulgar, will not makean origin for subsequent cases, as well as all chance of con- up for departed force and truthfulness. That the letter-

tagion from the living, direct or indirect, must be carefully press accompanying some of the likenesses of the leadersexcluded before the evidence can have weight. in the medical profession was sometimes offensive and

____ impertinent, our readers need not be told ; but the

THE REGISTRAR-CENERAL’S WEEKLY journal has quite recently taken to fire off its petty insults

MORTALITY RETURNS. and offènslve reflections at a whole class at once. In the

.... number for Oct. 21st we read the following remarks :-

The Times, in a recent leader on the small-pox epidemic, " On the whole, perhaps, it would be unjust to say of theinformed its readers that - London stands alone in the majority of military medical officers who have entered theofficial issue of its weekly bills of mortality." It is hard to Service during the last few years that it is fortunate whenconceive how anyone presumably writing-with authority on they are not actively mischievous and positively objection-sanitary matters could have been so deceived as to the pre- able. It is not, however, far from the truth to say thatsent contents of the Registrar-General’s Weekly Returns of when they are gentlemen they are not doctors, and when theymortality. The statement, if it had been made twelve

are doctors they are not gentlemen" (The italics are ours.)years ago, would have been correct, but the first weekly This is the second time an article has appeared in thereturn in 1865 contained certain information relating to the same quarter reflecting most unjusUy on the army medicalbirths and deaths in six of our large provincial towns be- officer. If we were to hazard a guess at the authorship.sides London. In 1870 the number of provincial towns we should say that it was manufactured under irritation byfor which weekly returns were otficially published had some person who, from having failed to treat a doctor as aincreased to seventeen, and further details as to the

gentleman, has been snubbed accordingly. All we can sayages and the causes of the deaths were added. Since 1870 is, that if reflections of this kind are made, the army willother additions have been made, from time to time, and not only fail to get doctors who are gentlemen, but evenduring the present year the Registrar-General’s Weekly doctors who are no gentlemen. However, army medicalReturn has contained information relating to nineteen of officers may count it as a great compliment to be abused inthe largest English towns besides London and its outer paper that has descended to write in an offensive style ofsuburban ring, with an aggregate population of nearly such men as Sir James Paget and Sir William Fergusson.eight millions of persons. Through the co-operation of the ____

Registrars-General of Scotland and Ireland, mortalitystatistics also appear in this publication for Edinburgh, THE IRISH CONJOINT SCHEME.

Glasgow, and Dublin; and through the courtesy of THE Conjoint Examination question has had a revival invarious authorities abroad, information is published week by Ireland at the instigation of the University of Dublin. Itweek relating to the deaths, prevailing epidemic diseases, is creditable to the University of Dublin that it should haveand rates of mortaltity, in more than twenty great cities, invited the Irish bodies to a conference on this subject. Twosituated in the four quarters of the world, containing a of the bodies were conspicuous by their absence. They arepopulation of about ten millions. The further extension of said to have been absent for that best of reasons, that theythe area covered by these Weekly Returns is, however, only were not invited. But probably they were not invited be-a matter of public money. The Registrar-General could, cause of the known difficulties in the way of their joining,if the Treasury were to sanction an increase in his staff, or of their known reluctance. The three other bodies of

publish in his Weekly Returns mortality statistics relating Ireland were represented-viz., the University of Dublin,to 100 of our English and Welsh towns in addition to the the King and Qaeen’s College of Physicians, and the Irishtwenty now dealt with; and all will agree with The Times College of Surgeons. The proceedings of the Conferencethat at conjunctures like the present such an extension of were purely preliminary. It is certainly creditable to thethe Returns would have a practical utility, not only in three bodies, after all the delay and discouragement which

620

the promoters of this much-needed change have experienced, public who support medical charities. The nature of certainto be stirring in the matter again, and, though we are not statements which had been laid before the committee re-

sanguine, we wish them success. A little self-sacrifice on garding the abuse of the institution led them to arrive atthe part of these bodies, and others of a like kind in the the determination for the future to make a full and search-

country, would obviate legislation, which otherwise will ing inquiry into the circumstances of each case applyingcome, surely if slowly, and will compel the adhesion of for medical reliei, and where the income of the family wasother bodies.

____ found to be adequate to remove them from the ranks ofthose who were unable to pay for medicine, to refer the

THE CONTACIOUS DISEASES ACTS. patient either to an ordinary medical practitioner or to a

A CHARGE was lately brought against Inspector Annis, in provident dispensary, care being taken that no hardshipconnexion with the administration of the Contagious Dis- was inflicted thereby. With this object in view, the com-eases Acts in the Plymouth district, which gave rise to a mittee had engaged the services of officials who made full

good deal of local excitement. The adjourned hearing of the and independent inquiry into the merits of each case, andcase before the Plymouth bench of magistrates took place on gave a written report accordingly. ° By these means it

Tuesday, the 10th inst., and at its termination the Mayor was expected that, on the one hand, the charity would nosaid the bench had unanimously decided to dismiss the case, longer be imposed upon ; and, on the other, that the medicaland were of opinion that Inspector Annis left the court profession would not be deprived of their fair means of

without a stain on his character. The alleged facts of the livelihood, arising from those who are able to pay their owncase for the complainant were simply these :-That at a doctor." The initiative taken at Salford is one that will

certain time and place a respectable female assistant in a claim a good deal of attention, and probably give rise to

draper’s shop, after parting with a young man to whom she some criticism. The evil it is sought to combat is not anwas engaged to be married, had been accosted, detained, imaginary one. That abuse of medical charity exists to athreatened, and improperly questioned by the inspector. The very large extent in London will scarcely be denied. There

evidence for the defence left not a shadow of doubt that the are few hospital physicians or surgeons who have not in

complainant had been mistaken, and that Inspector Annis their experience detected or observed instances of the mostcould not have been there on the occasion referred to. The mendacious frauds on benefits meant for the poor.

prosecution was undertaken at the expense of the Society for ________

the Repeal of the Contagious Diseases Acts. Of course if THE POLLUTION OF THE THAMES.there were any well-grounded reasons for supposing the THE proceedings of the Thames Conservators, who areadministration of the Acts to be tyrannically or badly carried charged with the prevention of pollution as well as with theout, the sooner any such abuse is brought to light the better, care of the navigation of the river, are becoming absolutelywhatever the agency employed. Everybody knows, how- farcical. As long ago as 1866 the Conservators were bound,ever, that charges innumerable have been made, from time by an Act passed in that year, to prevent the pollution of theto time, and motives imputed, against individuals concerned in river, the water companies agreeing to pay £1000 a yearadministering these Acts, but none of them have been sub- as au equivalent for benefits conferred. Under anotherstantiated. So much prejudice and passion have been im- Act, passed in the following year, the Conservators issued,ported into everything connected with this subject that the and have continued to issue, to the local authorities ofopponents of the Acts have themselves to blame for the Kingston, Surbiton, Richmond, Brentford, and other places,distrust they have awakened; and we congratulate our con- notices to divert sewage, the penalty for non-compliancetemporary, the Western Daily Mercury, for the very sensible being at the rate of £50 per day. This penalty has, in theand courageous comments it has made in connexion with case of Kingston and Surbiton, already amounted tothis subject. It is a pity that the repeal society did £100,000 in each case. But the subject appears, for atnot take the trouble to discover the individual who had least the twentieth time, to have been amicably discussedpersonated Inspector Annis. We contend that more real before the Kingston magistrates some few days, the resultgood-physical, moral, social, and religious-has arisen of which was an adjournment of the case for six monthsout of the operation of these Acts than from anything else " to give the Kingston corporation time (!) to prepare awith which we are acquainted. As Mr. Lewis, the late scheme which will satisfy the Bench." Meanwhile moremember for Devonport said, these Acts had, in his opinion, than two-thirds of the London water-supply is being fouled done more in bringing ° to bear a moral influence on the by riparian authorities on the banks of the Thames, whounfortunate women than all the voluntary efforts of all the have been permitted by the Conservators and the Local philanthropists who have ever existed." Government Board to discuss the question °° cloudily" at

-

uncertain intervals, and set at defiance for upwards of nineABUSE OF MEDICAL RELIEF. years an Act specially passed to remedy the evil. We have

IT is often urged by general practitioners, and with much no hesitation in classifying this Thames pollution businessshow of reason, that the authorities of hospitals and kindred as one of the most unsatisfactory episodes in the history ofmedical institutions are, as a rule, far too lax as regards the abortive sanitary legislation.admission of patients, and that no sort of test is exercised

-

that the applicant for medical relief is a really necessitous IMBECILE PAUPERS.

person, and not one in circumstances which should dictate SOME few days ago the members of the Metropolitanhis applying to a private surgeon. The grievance of those Asylums Board assembled at Darenth, near Dartford, towho think they are thus in a manner defrauded has been lay the first stone of an asylum intended for the use ofbefore now ventilated, but without resulting in the adoption imbecile children chargeable to the poor-rates of the metro-of any definitive course of action in the matter. The Com- polis. This asylum, designed by Messrs. A. and C. Harston,mittee of Subscribers to the Salford and Pendleton Royal will be arranged for the accommodation of 500 children-Hospital and Dispensary, at their annual meeting recently 300 boys and 200 girls. It is designed on the block system,held, announced that they had taken the subject into their each block having forty children, and all connected by aanxious consideration, and arrived at a conclusion, which is longitudinal and two transverse corridors. Special wardsof great interest to the profession, and to the benevolent are provided on both sides of the establishment for help-

621

less, paralytic, and epileptic children, and the arrangements pox amongst the crew, proceeded on board, and found a ladof the administrative block in the centre appear to be very in the desquamative stage of the disease, and nearly well.convenient. The laundries are so arranged that the dirty The patient was at once isolated in a hospital on shore toge-linen is received at one end, and, passing through the sue- ther with a person who had acted as his attendant duringcessive rooms, is issued clean at the other end without re- the voyage, and all the articles in the cabin likely to retainpassing. The warming of the day-rooms will be effected by infection were sunk in the river. The cabin in the meantimeopen fires in the side walls, with air-chambers for the was thoroughly fumigated, and the whole of the crew revacci-admission of fresh warmed air; and the dormitories, chapel, nated. On the completion of these necessary proceedingsdining, recreation- halls, corridors, &c., will be heated by the vessel was allowed to proceed to Glasgow. It behovesmeans of hot-water circulating pipes from the boiler-house. all port sanitary authorities to act with equal celerity andThe ventilation and closets must form the subject of com- vigour in circumstances of a like nature.ment at some future time, when the building is in progress, ____

as the description given in the report by the architect does TRANSFUSION AT THE ROYAL MEDICAL ANDnot very precisely indicate the arrangements proposed. CHIRURCICAL SOCIETY.

It is estimated that the entire building will cost about THE ordinary routine of business at the Royal Medical£52,000. -

and Chirurgical Society was agreeably diversified last Tues-THE PHYSICIANSHIP TO THE QUEEN FOR day evening by Dr. Roussel’s practical demonstration of his

SCOTLAND. apparatus for direct transfusion. A brief sketch of the con-By the death of Professor Laycock a vacancy was created struction of the apparatus in question will be found in the

in the office of Physician to Her Majesty in Scotland. It is report of the meeting on a previous page. It combines in

not always easy to fill such a vacancy with satisfaction to itself the means of opening the vein of the person yieldingthe profession. In Scotland the difficulty is not less, at any the blood, and of injecting this in a continuous stream

rate, than elsewhere. The appointment has been given to directly into the patient’s arm. The admirable construc-

Dr. W. T. Gairdner, Professor of Practice of Physic in the tion of the instrument, the readiness with which it can be

University of Glasgow, and one of the candidates for the applied, and the rapidity with which the operation can bechair of Practice of Physic, also vacated by the death of performed, together with the great advantage of its not re-Professor Laycock. The appointment will be very favour- quiring the blood to be defibrinated previous to injection,ably regarded by the profession. It is satisfactory to see were features which were well appreciated by the spectators.Glasgow’s claim to such honours occasionally recognised. With reference to the experiment itself, it may be hopedAnd although we confess to hoping that before the week is that the willingness with which the subject of it submittedout Dr. Gairdner may be once more identified with Edin- to shed his blood for the sake of science and humanity mayburgh and her teaching, he receives this high and well- serve as a timely rebuke to those earnest enthusiasts whodeserved honour while yet Professor of Practice of Physic in have of late striven to arrest progress in this cause by theirGlasgow. The other physician to the Queen in Scotland is unmeaning outcry against experimentation on animals.

Sir Robert Christison, Bart. They will see that even human beings are not deterred from_______

submitting themselves to a vivisection, involving some riskMEDICAL PRACTITIONERS AND OFFICERS and certain inconvenience, when the object in view is an ad-

OF HEALTH. dition to our means of saving life.IT is to be hoped, for the sake of the public interest and _______

of the dignity of the profession, that medical officers of health CRITICISM AND THE LAW OF LIBEL INwill restrict themselves to their own duties, and not unneces- AMERICA.sarily interfere to dispute or disparage the opinions of prac- THE lay press of America generally is credited in this.. -, - - *

THE lay press of America generally is credited in thistitioners. A striking case is before us, in which Mr. Bennett,

country with having unbounded licence, and the privilegl-Chester-le-street, attended a case of illness which in thirty of saying what it likes of its opponents without the fear of days terminated fatally. Mr. Bennett certified the cause of an action for libel. The medical press, however, is as a

death to be typhoid, and took very proper precautions to rule action decorously conducted, and it is seldom that as aprevent it spreading. The history of the case accorded rule very decorously conducted, and it is .. that the prevent it spreading. The history of the case accorded bounds of fair, legitimate criticism are overstepped. A briefwith this view. The morning atter the death, and on the notice of

an action

brought against

the Boston Medical andstrength of a cursory look at the dead man, the notice of an action brought against the Boston Medical andstrength ot a cursory iook at the dead man, the medical

Surgical Journal for alleged libel may not be uninterestingofficer of health offered to give a certificate that the de- Surgical Journal for alleged libel may not be uninteresting- -.-.. ,.. . -, , , to many of our readers. Our contemporary last year pub-ceased died of consumption, in order to defer the funeral entitled " How Coroners are- -

,,, , hshed an editorial article entitled "How Coroners are

a day longer. Rather, this is Mr. Bennett s account .

-. ), and criticise d the appoi

ntmen of a cer taina day longer. Rather, this is Mr. Bennett’s account

appointed," and criticised the appointment of a certainof the action of the medical officer of health. If it be a

Mr. Newton to the office. The latter entered an actiontrue account, it seems almost incredible, and we hope the against the publishers of the journal, laying the damages- . ...... - .. ,

* against the publishers of the journal, laying the damagesmedical officer will be able to show its inaccuracy. at twenty thousand dollars. The plea was met by what was-

practically a justification of the alleged libel. It appearsINFECTIOUS DISEASE IN PORT. that by the statute laws of Massachusetts, either party to

AN illustration of the danger to which seaport towns are a suit may file questions to his adversary calculated toexposed in consequence of the arrival of vessels with infec- throw light on the issue to be tried, and if the party inter-tious disease on board, and the means necessary to obviate rogated unreasonably refuses or neglects to give thethe danger, is given in the last monthly report of the required information, the Court may order the nonsuit ofmedical officer of health for Greenock, Dr. J. Wallace. the" recusant party." The plaintiff failed to answer theGreenock is the post at which all ships bound to the Clyde questions submitted to him, and consented that judgmentare first boarded by the Customs officers, and the duty of should be entered for the defendants. " The plaintiff,"employing measures for the treatment of any sick and for says our Boston contemporary, "rather than answer underthe security of the town from an extension of disease falls oath certain inquiries into his antecedents, has chosen toupon the local authority. Dr. Wallace, on being informed abandon his suit, and seems to confess that our stricturesthat a ship had arrived on the 30th ult. with a case of small- were merited."

622

ERYSIPELAS FOLLOWING VACCINATION. TgERE has just been issued a Report on Sanitary Mea-

sures in India in 1874-5, together with MiscellaneousTHE deaths of two children, seemingly from erysipelas Information up to June, 1876, full consideration of the con-

following upon vaccination, are reported in Liverpool. The tents of which we must postpone to another occasion. Itchildren were vaccinated by one of the public vaccinators is stated that the statistics of sickness and mortality in theat the same time and from the same source. Another European army during 1874 were most satisfactory, mainlychild was also vaccinated from this source, without evil owing to the almost complete absence of cholera. Malarial

consequences following. An inquest was held on the fatal fevers were the principal cause of sickness in Bengal andcases, and the medical evidence given was remarkable for Bombay, and were followed by venereal disease; in Madrasconfusing rather than for elucidating the circumstances of the latter slightly preponderated. With regard to thethe unfortunate occurrences. Not a particle of evidence serious prevalence of intemperate habits in the Bombaywas apparently given or sought as to the probable pre- army, it appears that the matter has been engaging thevalence of erysipelas in the locality in which the two serious attention of the Commander. in-Chief, and that hedeceased children had lived. The deaths will, no has received the sanction of Government to certain plansdoubt, form the subject of a more precise inquiry by the for rendering barrack-life more cheerful and attractive toVaccination authority than that which appears to have been the men. The Army Sanitary Commission observe withafforded by the Coroner’s Court. The jury returned a satisfaction that hill stations are being made more use ofverdict, in accordance with some of the medical evidence, than formerly. They think it is very desirable that newlyof 11 Death from the effects of pyæmia, consequent on arrived troops should be sent straight to the hills, and thisrecent vaccination, skilfully performed from a good source." is especially suggested by the effect that climate apparently

_______ has in predisposing to attacks of enteric fever.

INFECTIOUS DISEASES AND CORONERS’ ________

INQUESTS. AN effectual system by which the medical officer of health

AT a meeting of the Health Section of the recent Social of a district can be made cognisant of the removal of cases

-. of infectious disease has been adopted in Lam beth. When-Science Congress at Liverpool, Mr. F. T. Bond read a paper of infectious disease has been adopted in Lambeth. When-

on the legal enactments necessary in order to check the ever the ambulance is used in that paxish for the purposespread of infectious -. -. - the discussion t- i

of taking a patient to one of the hospitals in Stockwellspread of infectious diseases; and in the discussion which patient the hospitals in Stockwell-, T or Homerton, the guardians immediately acquaint thefollowed, Dr. Baylis, the medical officer of health for one of or Homerton, the guardians immediately acquaint the

., ,. medical omeer of health, Mr. A. Farr, with the fact. Inthe combined districts of Kent, strongly urged the necessity medical officer of health, Mr. A. Farr, with the fact. Infor the erection of hospitals for the treatment of these his last monthly report Mr. Farr drew attention to a matter

diseases, and for compulsory powers of isolation. Dr. deserving the consideration of the Metropolitan Asylumsdiseases, and for compulsory powers of isolation. Dr. d It appears that plaints have been ma de to hicoroner for Central Middlesex, is reported to Board. It appears that complaints have been made to himHardwicke, coroner for Central Middlesex, is reported to , appears complaints have beeu made to him

have said that he was 11 determined to bold inquests in that the nurses at the Stockwell Hospital "visit too

have said that he was " determined to hold inquests in much and that a f ew cases of small-pox which have re-every case of death from infectious disease, urging that much, and that a few cases of small-pox which have re-he was warranted in adopting this course in order to eg- cently occurred are attributable to this cause. Objection

pose the sanitary defects that egisted. Such a resolution, has also been made to the men tending the parochial ambu-pose the sanitary defects that existed. Such a resolution,

1 lance s stopping to talk e refresh ment at public- h ouses on th erf strictly carried out, would considerably more than double lance stopping to take retreshment at public-houses on the

if th strictly b carried out, would conside more than double road. The tormer evil is a grave one. At the present crisisthe number of inquests now held, and although much good , The former evil is a grave one. At the present crisisthe strictest supervision should be exercised over the hos-would doubtless result from the holding of inquests in cases the nurses. supervision should be exerClsed over the hos-where -...1 appears to b be direetly or indirectly due j pital nurses. The latter evil can bo remedied by appointingwhere a death appears to be directly or indirectly due to official to accompany the ambulance.

sanitary neglect, it would be simply impossible for Dr. a responsible official to accompany the ambulance.sanitary neglect, it would be simply impossible for Dr.

____

Hardwicke to hold inquests in all cases of deaths from in- .. ----:-iectious diseases within bis district. Indeed, in cases where ON Friday evening, the 20th inst., an attempt was made

a medical certificate of a cause of death from a registered by the London Hospital Medical Society to follow up thepractitioner is forthcoming, we should hold that inquests recent change in the College Board by a similar extension

are, as a rule, unnecessary. Much public good would, how- of its own constitution and the form of its annual soirde.

ever, result if inquests, or, at any rate, preliminary in- Some 400 to 500 visitors, including many members of the

quiries, were held in all cases where such a certificate was staff, of the lay committee, and of the profession in the East

not forthcoming. No death should be registered without of London, met by invitation at the Medical College. A

some trustworthy certificate of its cause. full and varied programme was provided, combining results

____ of recent research and inventions of scientific interest onthe one hand, with excellent music and art specimens on

THE STRAND TO BE PAVED WITH WOOD. the one hand, with excellent music and art specimens onthe other. In all respects the meeting was most successful,

IT is with great satisfaction we chronicle the success of and will, it is hoped, lead to good results. The ordinarythe movement to secure immunity from noise for the Strand meetings of the society are now thrown open, not only toby paving that thoroughfare with wood. We make no members of the staff and college, but also to neighbouringapology for having fought the local battle in these columns, medical men and members of similar societies elsewhere.because the principle asserted is one of universal applica- ______

tion. Wherever there is noise from a crowded and constant MR. JOHN ANGUS, M.R.C.S., L.S.A., the particulars oftraffic, wood-paving is not only a merciful precaution,.but whose untimely death we briefly described last week, prac-a necessity. The wear and waste of nerve-power, fretted tised for many years in the Soho district, though not withaway by ceaseless irritation during the day and sleepless- the success which his many excellent qualities merited-aness at night, is so serious, that a remedy at any price is result, perhaps, partly due to the fortuitous circumstancedemanded by common prudence, and a remedy which will that he entered the profession of medicine rather late inremove the cause must be priceless. life. He worked with unflagging industry and self-denial;

_____ while his gentle, unassuming manner, and sterling upright-DR. JoHN STORBAB has been re-elected a member of the ness of character, endeared him to a large circle of friends

General Medical Council, as representing the University of and patients. The deceased gentleman leaves a widow andLondon, for the period of one year. two children to mourn his loss.

623

WE are glad to observe that the Pharmaceutical Society I AT St. Mary’s Hospital Medical School, Mr. W. A. Smith,are showing themselves diligent in detecting contraventions B.A. Oxon., has obtained the Scholarship in Natural Science,of the Pharmacy Act of 1868, and prompt in setting the and Mr. R. E. G. Cuffe, formerly of Epsom College, thelaw in motion where the provisions of that Act are proved Extra Scholarship in the same. Mr. A. Benson, M.A. Oxon.,to be infringed. Last week, at the Bloomsbury County and Mr. L. Roche were declared equal for the Classical andCourt, an action was brought by the Society against Mathematical Scholarship; the School Committee thereforeJ. Statham for the recovery of a penalty of £5 incurred increased its value and divided it equally between the two"in selling or keeping open a shop for the retailing, dis- competitors. ____

pensing, or compounding poison or poisons" contrary to -

the Act. It was shown in evidence that a person called at IT is announced by a contemporary that Mr. Henry Slade,

defendant’s shop near Blandford-square, and had a pre- fleet surgeon, H.M.S. Trincomalee, has received the thanks

scription of a mixture containing prussic acid made up by of the Director-General of the Medical Department of thethe defendant. The defence was not held to be satisfactory, Navy for 11 a paper of remarks on matters relating to hisand judgment was given for the Pharmaceutical Society for department made at the Exposition d’Hygiene et de Sauve-.85, with full costs.

____

tage lately closed at Brussels."

THE bountiful lady who does so much to ameliorate the CARLISLE is to be congratulated on the exhibition of acondition of the poor of our metropolis, and whose bene- very low death-rate. Dr. Elliott, the medical officer ofvolence is the more valuable that it is discriminating- health, in his last periodical report, shows that the mortalityLady Burdett Coutts-has intimated her intention of pro- of the town is only a fraction over 11 per 1000 annually.viding all the aged inmates of St. Pancras Workhouse whose It is to be hoped that this condition of salubrity will besight may be defective with spectacles. A list of the males maintained.

-

and females falling into this category has been drawn up by .

the master of the house, and their requirements will be at DR. AQUILLA SMITH has been re-elected representative ononce supplied by an optician. Any efforts to add to the the General Medical Council for the College of Physicianscomfort and solace of those whose sad lot it is to spend their in Ireland. ______.

declining years in a workhouse should be heartily en- MR. JAMES ALBERT BRIGHT, M.R.C.S.E., has been nomi-couraged. The example set by Lady Burdett Coutts will, nated to the office of Mayor of Glastonbury for the yearwe trust, be followed elsewhere. ensuing.LAST week we called attention to the perilous delay

frequently imposed on the removal of a patient suffering THE ROYAL COLLEGE OF PHYSICIANS ANDfrom infectious disease, in consequence of the regulation SIR W. GULL AND DR. JOHNSON.of the managers of the asylum hospitals that no person . . .

is to be admitted unless furnished with a certificate by a THE decision of the Censors’ Board of the College ofdistrict medical officer. In various quarters of London Physicians relative to the dispute between Sir Wm. Gulldifficulty continues to be experienced from this rule, and it and Dr. George Johnson, was read to the Fellows at theis urged that the certificate of any duly qualified prac- meeting of the College on Thursday afternoon, which wastitioner should be deemed sufficient. In view of the pro- unusually large in consequence of a special notice whichbable extension of small-pox, the managers of the Stock- had been given that the President would make a statement well and Homerton Hospitals should at once make the had been given After recounting the steps which had beenrequired alteration as regards the admission of patients. on the subject. After Board in the matter, and with the The danger over, they can revert to the original plan. result of apparently adjusting the the matter, between theIT has long been felt that an association of the medical disputants amicably and satisfactorily, the President stated

graduates of Glasgow and Aberdeen ’Universities would, for that it was thought right that the decision should not be

many reasons, be to the advantage of those universities published unless it were called for by Sir William Gull

and the interests of their medical graduates. On Monday, or Dr. Johnson ; but the appearance of garbled accounts23rd October, the Association of the Medical Graduates of

of the decision had altered the state of matters, and,

Glasgow and Aberdeen was most pleasantly and successfully if the College or either of the two Fellows specially in-inaugurated at the Pall-mall Restaurant, when between

terested desired it, he was of opinion that it should be read.

forty and fifty of the medical graduates sat down to dinner After some discussion, a motion, - that, assuming the

together. Professor Struthers was in the chair, and Dr. decision to be read, it should be regarded as a College

A. P. Stewart in the vice-chair. ’

secret,"’ was negatived, and, Dr. Johnson concurring,___ another resolution, that it should be read to the College

THE meeting of the Obstetrical Society on Wednesday was carried. The following is the decision:-next will probably be made particularly interesting by the [COPY.]relation by Mr. Jessop, of Leeds, of a case in which he suc- Royal College of Physicians, Pall-mall East,cessfully performed gastrotomy for extra-uterine fcetation, .

llth Oct., 1876.

both mother and child being saved. This gratifying result To Sir WILLIAM GULL, Bart., M.D.

will, it is to be hoped, help to place the operative treatment The Censors’ Board have given careful considerationof these grave cases on a clearer and sounder basis. Other to the statement of complaint brought by Sir William Gullcommunications of interest will be brought forward. against Dr. George Johnson and to Dr. Johnson’s reply.

_______ We exceedingly regret that any cause of complaint orON Tuesday night the Glasgow Pathological and Clinical misunderstanding should not have been removed by mutual

Society held a conversazione, which was largely attended by conference, so as to have rendered any reference to thethe profession in Glasgow. Numerous interesting demon- Censors’ Board unnecessary.trations were given by Mr. Dixon, Dr. M’Kendrick, and An ordinary perusal of Sir Wm. Gull’s evidence at theDr. Dudgeon, and Dr. Joseph Coats has succeeded Dr. Bravo inquest, as reported in the Daily Telegraph, must,Gairdner as president of the Soeiety. we believe, have led most readers to the conclusion which