904

became feebler and feebler till they ceased altogether abou1the eleventh dorsal vertebra. From these and other experiments he concludes that the splenic centripetal and centri.

fugal nerves enter the cord as low as the eleventh dorsalvertebra, and that they ascend in the cord to a sensori-motoicentre situated in the cord between the fourth and first

cervical vertebrae. It is probable also that the vaso-motoinerves of the spleen proceed from the same source. Some

observations made to determine the effects of nerve irritation

on the number of the white corpuscles issuing from thespleen showed that the number was greatest during theordinary non-contracted condition of the spleen, that it

diminished on contraction of the organ, and attained its

minimum during the period of return to the normal state.If, however, the spleen were made to contract after it hadbeen previously swollen by ligature of the veins, the numberof leucocytes contained in the splenic venous blood underwentgreat augmentation.

Annotations.

THE ELECTION OF EXAMINERS IN ANATOMY

AT THE COLLEGE OF SURGEONS.

"Ne quid nimis:’

NUMEROUS complaints have reached us respecting therecent appointment of Examiners in Anatomy and Physio-logy by the Council of the Royal College of Surgeons ofEngland. As we had previously announced, all the membersof the old board offered themselves for re-election with the

exception of Mr. Holden and Mr. Cooper Forster. The two

candidates who were recommended by the Committee onExaminations in Anatomy and Physiology to fill the vacan-cies caused by the resignation of these gentlemen wereMr. Arthur E. Durham, of Guy’s, and Mr. Sydney Jones,of St. Thomas’s. After the candidates were balloted for ata meeting of the Council, Mr. Durham and Mr. Pick, of St.George’s Hospital, were declared to be the new examiners.This action has naturally called forth a good deal of in-dignation from many teachers of anatomy both in Londonand in the country. Mr. Sydney Jones is a Fellow of the

College of 1856; whereas Mr. Pick is a Fellow of 1866 only.No one will, we feel sure, regret the anomalous circum-stance more than Mr. Pick himself, and we have no desireto add to his embarrassment. While those who selectedMr. Pick may be allowed to have acted under the fullbelief that he was best fitted by exceptional qualificationsfor the post, it seems necessary to remind them that amanifest injustice has been done to many esteemed Fel-lows of the College. Not only have the claims of manysenior candidates, well-known as successful teachers of

anatomy, been altogether ignored, but the schools to whichsome of them are attached have been left unrepresented.At present St. Thomas’s, the London, Charing-cross, St.Mary’s, and Westminster, to say nothing of the pro-vincial schools, have no representative on the Boardof Examiners, and to appoint a second examiner fromSt. George’s under such circumstances can have no justifi-cation. Mr. Mason, one of the lecturers on anatomy of St.Thomas’s, and Mr. Walter Rivington, of the London, whohas been known for many years as one of the best teachersof anatomy in London, have good grounds for complaint,both being Mr. Pick’s seniors in the profession and as Fellows.The last three Hunterian Professors of Surgery have beensurgeons connected with St. George’s Hospital; let us hope

that the operation of the same influences that accomplishedthose appointments will not be able to secure to the sameschool a monopoly of all the emoluments of the College.

MERCHANT SEAMEN.

THE Report of Her Majesty’s consul at Callao, recentlypublished, comments emphatically on the gradual butmarked deterioration as to physique of the British seamenfrequenting that port. Two ships recently arrived thereseverely smitten with scurvy, but the opinion of our consuls,both here and at other foreign ports, seems to be that themen sign articles when practically unfit for duty, and that,as a natural consequence, the vessel is virtually unsea-worthy from the commencement of the voyage, because aproportion of her crew are not physically competent to per.form their work. This, and clouds of other evidence thathave collected during the last six or eight years, ought toconvince the President of the Board of Trade of the

necessity of making Section 10 of the Merchant ShippingAct of 1867 compulsory, instead of, as now, permissive, andso utterly inoperative. We are informed that much oppo-sition to such a course is anticipated from shipowners, whonot only object to the possible expense of a medical exam-ination, but declare that, inasmuch as in some ports a suffi-ciency of sailors can with difficulty be found, this inspectionand probable rejection of a certain number of men on

physical grounds would stop ships, and so hinder commerceto a very serious extent. A perusal of the Shipping Gazettewill show, however, that this impression is not borne out byfacts, and that in the north-eastern, as well as the otherchief out-ports, there is usually a sufficient, and has latelybeen a superabundant, supply of seamen. We earnestlytrust that the promises of several prominent members ofthe Government last session on the subject of the Seamen’sas distinguished from the Shipping Bill, will result next

year in a practical measure, comprising sound legislationas to medical inspection of seamen, and also as to scalesof diet. A judicious change in, the antiquatei system onwhich the victualling of ships is still conducted wouldsave thousands of pounds annually to the shipowner, andrender the regular serving out of lime- and lemon-juice,unless under exceptional circumstances, a work of supere-rogation. -

VESICATION BEFORE AND AFTER DEATH.

AT the recent Wilts Assizes a woman named Ann Good-fellow was charged with the wilful murder of her child. Thecircumstances of the case, as detailed in evidence, were ofthe most revolting character. It appears that the prisonerwas delivered of a child on the 9th of July last, andaccording to her own statement it breathed once only. On

July llth an inspector of police went to the prisoner’s houseand inquired if she had the body of a child there. Aftersome conversation she removed the cover from a saucepanwhich was on the fire, and on looking into it the inspectorsaw the body of a child. The body had evidently beenboiled for a considerable time, for portions of the flesh

dropped off when it was removed from the vessel. On thesurface of the body were found some blisters containing,according to the medical evidence, some straw-colouredserum. The medical interest of the case consists in the

value of these blisters in determining whether the childwas alive or dead when it was put into the saucepan. The

contents of the blisters, it is stated in the report of thetrial, consisted of serum, but it is not reported what meanswere taken to determine the nature of the fluid.The effect of heat on serum is well known; it renders it

almost solid by coagulating the albumen. There can beno doubt that the body of the child found by the inspector

905

had been subject to great heat for a considerable time, and wipe out of memory, does not perceive the need of estab-there can be equally little doubt that, unless the body was lishing a School of Common Sense ! Simaia similibusboiled in an alkaline solution (which is not probable), the curantur would be a capital motto for an educational estab-albumen of the serum must have been entirely, or almost lishment wherein the too great cleverness of the uncommonlyentirely, coagulated, and the fluid in the blisters, though of wise might be cured by the administration of small anda straw colour, should not be regarded as serum. There is repeated doses of common sense. A contemporary not pronesufficient evidence, moreover, to show that blisters can be to faulty reporting made one of the speakers at a recentproduced by the action of heat on the surface of the body meeting say that 11 no less than 70 ’allopathic’ practi-after as well as before death. The experiments of Casper tioners had recently given in their adhesion to homoeo-and others place this beyond question. Besides, the boiling pathy." The returns from Colney Hatch did not supportof flesh is of frequent occurrence in our kitchens, and it is the assertion. It now turns out that, of 300 homoeopathicwell known to cooks that bladders containing fluid very practitioners, just 70 will support their schoolcommonly, though not always, form on fowls while under- ____

going the process of boiling. Blisters produced duringlife differ, however, from those produced after death in the CASES OF ANIMAL POISONING IN CLASOOW.

following points: the former are usually surrounded by a THE last meeting of the Glasgow Pathological and Clinicalred ring of congested skin, and the surface beneath them Society was completely taken up with the consideration ofis red and inflamed in character. These signs may, how- three cases of animal poisoning. Of the three fatal cases ofever, disappear after death, and they are absent in blisters hydrophobia lately in the hospitals, two were examined afterproduced post mortem. Again, the fluid of cutaneous death, and these two were brought up for consideration atbladders produced during life is far more albuminous this Society.than that of those produced after death. In the first case, Dr. Forrest gave some interesting infor-There is some difficulty, even in favourable conditions, in mation as to the retriever bitch which had inflicted the bite

deciding whether a blister found on a dead body was pro- on her master’s hand. She had just had six whelps, andduced during life or after death, but in the case before us, before inflicting the bite she had become peculiarly ill-the data upon which to form an opinion were entirely want- natured, had refused to let her pups suck, and had snappeding. If the vesicles were formed during life the long pro- at various persons; she had also bitten her pups, one ofcess of boiling to which the body had been subjected must which, at least, had died under some suspicion of hydro-have destroyed their distinguishing marks, and it had phobia. Dr. Dunlop gave a full account of the man’sbecome impossible to arrive at a correct conclusion with condition after admission to the Royal Infirmary, and de-respect to them. On the other hand, the blisters may have scribed minutely the excitement and the spasms from whichbeen produced after death. There is nothing in the he suffered. The other case (the last one occurring inevidence as reported opposed to this view ; indeed, the Glasgow) was that of a police sergeant who had been bittencharacter of the vesicles as described by the medical wit- on the hand by an unknown retriever, which met the officernesses appears perfectly compatible with it. while he was walking along the street. Symptoms ofWhich of the two views is correct it is not possible to hydrophobia became developed in a month; he had been

determine, because blisters caused during life may ultimately under observation all this time by Dr. McGill, the policeassume the characters of those caused after death. For-

surgeon, who at once removed him to the Western Infirmarytunately, however, the latter cannot assume the exact on the appearance of the symptoms. Dr. Alex. Pattersoncharacter of the former, and should consequently never be detailed the course of the illness while the patient was inmistaken for them.

____ his wards. The man died on the fourth day ; on the nightbefore his death the spasms had almost completely disap-

MEDICAL SYSTEMS. peared, and his general appearance of improvement wasALL "systems" are bad, and medical systems figure such as to mislead the nurses into supposing that he was

among the worst. There is nothing more ineffably weak much better. The wound in the first case had been cauterisedand witless than the system of " homoeopathy." We say immediately with nitrate of silver ; in the second case itthis without reference to the extra simplicity of infinitesimal was cleaned with a strong solution of carbolic acid im-doses. It is the folly of seizing on half of an idea and mediately after the injury. The post-mortem appearancescalling it a system that must strike sensible persons of every were negative except as regards the microscopic examina-way of thinking as ludicrous. Some unlucky wight has tion. Dr. Joseph Coates showed to the Society numerousbeen caught by one arm of a windmill and raised from the sections under the microscope, exhibiting in the pons

ground. You cannot get him down by pulling, so you push Varolii, in the medulla oblongata, and in the cord, a verythe mill round carefully, and he is carried over and comes to marked infiltration of the sheaths of the vessels with in-

ground safelythe other side. Straightway the yokels throw up flammatory cells, and in one instance the section made

their hats and cry "Similia similibus curantur." A frozen man revealed a small haemorrhage. He also found some suchis rubbed with snow until circulation returns, thus avoiding accumulation of cells around the vessels in the neighbour-the too sudden application of extreme heat; or a burn is hood of the bite, this being apparently out of proportion todressed with hot turpentine on the same principle, and the the other appearances of inflammation present. Thesecharlatan chants similia similibus curantur," and calls his lesions were found in both cases.method a system ! It is wondrously silly all this. Never- The other case of animal poisoning was one of malignanttheless there are people so grotesquely imbecile that pustule, contracted by a girl on her lip, and proving rapidlyalthough an individual with shaky views on religious sub- fatal. She was a worker in hair works, and was engagedjects having once recovered from some malady with the in spinning the hair, most of which was imported fromassistance of colocynth, an "absence of religious opinions" North America, and only some of which was submitted tois gravely put down among the indications for that useful previous boiling and disinfection. Dr. Cameron detailed

drug, devout believers in 11 the system" do not perceive the the patient’s state while under his care at the Royal In-absurdity of its pretensions. And now the poor people are firmary. The chief peculiarity was the appearance, afterabout to build and endow a 11 School of Homoeopathy." admission, of a considerable number of small vesicles andWhat a pity it is that some millionaire, with misdeeds to pustules on the skin, mainly on the trunk. Another pecu-

906

liarity in the case was the occurrence of a high degree of Company. Why should the inhabitants of West and North-albuminuria. From the remarks made by those present, West London be supplied with water of second-rate quality ?’this formidable affection seems almost unknown in Glasgow. All the metropolitan water companies pay good dividends,The interest excited by these unusual cases attracted a and their sha,res stand at a high premium. It was never

large attendance of the profession to this meeting of the intended that the water companies should thus grow rich atSociety. ____

the expense of the public, and a Royal Commission is

urgently called for to consider how far the majority of theST. CEORCE’S HOSPITAL. metropolitan water companies have considered the public

THE contest for the vacant post of Assistant-Physician at interests. One thing is very certain, that common senseSt. George’s Hospital is likely to prove severe. Two candi- ought no longer to permit a company to pay enormousdates are in the field, and both are St. George’s men. The dividends by supplying water of a second-rate quality.senior is Dr. Robert Lee, formerly assistant Obstetric Phy- Either the charge on the public must be diminished or thesician, and now Curator in the museum of the hospital. company compelled to furnish water of a high degree ofDr. Lee is M A. and M D. Cantab., and Fellow of the Royal purity and also sufficiently abundant to afford a constantCollege of Physicians, where, in 1874, he delivered the supply. ____

Gulstonian Lectures. The other candidate is Dr. Herbert

Watney. This gentleman for some time has held the post OUTBREAK OF CHARBON AT NEWCASTLE-ON-of Demonstrator of Histology at St. George’s, and has TYNE.

already made some contributions to the science of WE have received from Mr. Henry E. Armstrong, medicalanatomy and physiology in papers read before the Royal officer of health at Newcastle-on-Tyne, a paper which heSociety. Dr. Watney graduated at Cambridge during the read before the Northumberland and Durham Medicalpresent year, and is a member of the Royal College of Phy- Society upon a recent outbreak of charbon among cattle insicians. It is not our province to deal with the respective that town. All the instances were examples of so-calledmerits of the two candidates, but we may express a hope splenic fever, which is included under the same class as thethat a contest which is likely to prove close will be carried better known malignant pustule. On the 27th of Octoberon with temper and good feeling. Already a false move has Mr. Armstrong was called by the meat inspector to pro-been made by one of the candidates, Dr. Watney, in pub- nounce as to the fitness for food of the flesh of a cow re-lishing his testimonials as an advertisement in the columns ported to have been slaughtered in consequence of over-of the daily papers. Such a course is contrary to professional feeling. The flesh appeared healthy, the only noticeableusage, and can only be designated as "most disastrous." feature being an unusual fulness of the bloodvessels, andHad the offence been committed by an older man, we should the meat was passed. On the 28th a second carcass in thehave felt bound to comment severely on his conduct; we possession of a market butcher was seized and declared un-are, however, unwilling to press hardly on a young man fit for food ; it was that of a cow from the same byre as thewho is just entering on professional life, and who perhaps first, and was stated to have accidentally banged itself inis not fully aware of the abhorrence with which any form the stall. On the 30th the writer was again summoned toof professional advertising is regarded amongst us, the a slaughter-house to inspect the carcass of another animalmore so as it is not improbable that, owing to the step on which, with two of its fellows, had been taken suddenly ill;his part, he may be disqualified for becoming a candidate. one had died, and this, with the third, had been slaughtered.We understand that at a meeting of the Governors last Messrs. Stephenson and Elphick, veterinary surgeons, sawWednesday a paper was received signed by Lord Chief the animal with Mr. Armstrong, and pronounced it to be aJustice Cockburn, Sir John Holker, Sir T. Erskine May, case of charbonous or splenic fever. The flesh was firm butViscount Hood, &c., asking whether the advertisement in dark, and the bloodvessels were loaded with dark blood.question was inserted without permission of the Weekly There were extravasations of blood beneath the serousBoard ; for the 69th Rule states that "no governor membranes, into the intermuscular tissue, and beneath theor governors shall circulate any notice or statement

gastric mucous membrane, and also a large number of sub-bearing date from the hospital relative to any elec-

pericardial and endocardial ecchymoses. The blood wastion, or tending in any way to influence the votes dark and fluid. The spleen had not been preserved. Atof governors at any election, unless such notice shall have the same time another animal in a different byre hadbeen previously sanctioned by the Weekly Board." THis been killed by its owner for sudden illness. In this caserule certainly makes the circulation as an advertisement of the spleen was obtained. It was three times the naturalthe testimonial of the medical staff a positive contravention size, and loaded with tarry blood. Other instances oc-of the laws of the hospital; and the governors of the insti- curred in rapid succession, both in the same byres as thetution are quite right in deciding not to nominate either of foregoing and in others in the town, and in allthe candidates until the technical question is definit.ively (up to November 8th) twelve cows and three horsessettled. had died from this disease; one of the latter with

THE LONDON WATER COMPANIES. the form of charbon known as "glosso-anthrax." Mr.

THE LONDON WATER COMPANIES. Armstrong sums up the morbid appearances as consist-PROFESSOR FRANKLAND, in the monthly report for No- ing in a marked fluidity of the blood, which was of purplish-

vember of his analyses of the waters supplied to the metro- chocolate tint, and in one case contained bacteria; in hsa-polis by the various companies, gives an instructive table morrhage from mucous surfaces, and into the tissues in allshowing the relative degree of impurity of each company’s parts, with marked engorgement and enlargement of thewater. Thus, taking unity to represent the amount of spleen; the viscera underwent rapid decomposition. The

organic impurity in a given volume of the Kent Company’s symptoms are given as commencing with refusal of food;water, we find the proportional amount in an equal quantity muscular weakness, so that the animals could not stand onof water supplied by each of the other metropolitan com- their legs nor hold up their heads; bristling coats, and dullpanies. From this table we learn that the Grand Junction eyes; in some there was great restlessness; others appearedCompany’s water contains nearly, and the West Middlesex to suffer much pain; some passed bloody fseoes and urine;more than double, the amount of organic impurity contained and in all there was rapid collapse, the fatal issue being, inin the excellent and abundant supply furnished by the Kent two instances, preceded by violent convulsions. Mr. Arm-

907

strong adds an account of a presumed case in the human sub- She is, according to Mr. Cave’s speech, delivered at theject. It was that of a butcher, who, after having dressed one annual meeting last week, practically bankrupt, and in theof the diseased carcasses, was seized with gastro-enteritis. presence of a second epidemic; but has no money to payThe patient was prescribed for by Mr. May, surgeon, on debts, or to deal properly and energetically with the out-October 31st, the day following the seizure, and he seemed break. It is possible that another X3000 will be spent, andto improve; but on Nov. 2nd was attacked with convulsions, much sickness and misery experienced. Meanwhile, theand died. Unfortunately an autopsy could not be obtained. Home Office contents itself with a perfunctory periodicalThe man does not appear to have wounded himself when inspection, and does nothing. It is manifestly the duty ofdressing the carcass; but confirmatory evidence of its beinl- this Department either to give substantial aid in such ana case of splenic fever was found in the fact that black emergency, or to close the establishment as speedily aspatches appeared on the skin of the extremities and in possible. ____

various parts of the body, and there was oozing of blood -

from the nostrils. ACCIDENTS TO RAILWAY PASSENCERS.

This outbreak of splenic fever appears, says Mr. Arm- THE constantly recurring form of accident in which astrong, to be closely connected with the use of some coarse passenger falls between the train and the platform shouldreedy-looking hay, grown on marshy ground, at a farm in induce the railway companies to seriously consider thethe country where the disease had been prevalent about the urgent need of providing a broad continuous footboard

beginning of the present year. In all the instances, with which would render it impossible for persons to bethe exception of two, the animals attacked appeared to precipitated in the manner described. There can behave been fed on this particular hay. This accords with the no insuperable difficulties against the adoption of suchstatements of Continental writers. a plan. It works well on many of the Continental

lines, and has been the means of greatly diminishing theSANITARY AUTHORITIES AND MEDICAL number of fatal accidents. A report issued this week

INFORMATION. states that in the three months, July, August, and Sep-As an excuse for their ill-success in limiting the extension tember, eighteen passengers were killed and thirty-eight

of epidemics, sanitary authorities are accustomed to say that at injured by failing between trains and platforms, and three

they do not get early information of cases of infectious sick- were killed and ninety-six injured by falling on to the

ness from medical men. A case has just occurred in Middles- platform while getting into or alicrhtino- from carriages.

borough, where a medical man, Mr. -rr- f. 1- was kind enough It is so evident that a large saving of life and limb-borough, where a medical man, Mr. Vietch, was kind enough to give information to the inspector, of a case of what he

would be effected by an improvement of the nature sug-to give information to the inspector, of a case of what he gested, that it is somewhat surprising the subject has notcalled "Variola simplex," requiringimmediateremoval to the gested, that it is somewhat aurprising the suhjeet has not

Fever Hospital. The inspector took advantage of the Latin been brought before the notice of the Legislature. An

name to do nothing. We certainly disapprove of latinity independent member of the House of Commons has here an

in regard to either small-pox. or scarlet fever. Itiseminently excellent question to work up for next session. It could

a caae for plain English, for calling a spade a spade. But not fail to command attention, nor could the ultimate suc-

the inspector is without excuse. An inspector ought to cessful iasue of so praiseworthy an undertaking be doubted.

know what variola means, and if he does not, and learns --

from a medical practitioner that it is something needing SANITARY WORK.

removal to a Fever Hospital, he should set about obtaining THE Board of Works for the Lewisham District is as to

information, and getting the patient removed as soon as many matters somewhat in advance of the district local

possible. Thereafter he should send a polite note of thanks authorities in and about London. They have recentlyto his medical informant. What made matters more dis- provided a hospital for the reception of the sick, especiallycreditable here was that the inspector, instead of being intended for persons suffering from contagious or infectiousrebuked, was supported by the Sanitary Authority. diseases, an ambulance suitable for the conveyance of such

persons, and an apparatus for disinfecting the clothing,SCHOOL-SHIPS. bedding, and other things likely to be contaminated in such

cases. It is notified that the use of the hospital may beAN epidemic of a scarlatinal character has broken out on had on payment of certain small fees fixed by the Board.

the Cornwall school-ship, off Purfleet, during the last three and that the ambulance may be borrowed on payment of theweeks. This ship suffered last year from a very protracted expense incurred for horse-hire only. All persons residentepidemic of enteric fever, which attacked about 40 per cent. in the district are entitled to make use of the disinfectingof the inhabitants of the ship. In this last case, as apparatus free of charge, and a fee of five shillings iasoon as the epidemic nature of the disease was dis charged to non-residents. In cases where persons are un-covered by the Port Sanitary Authority, the boys were able to defray the expense of removal or reception into theremoved to the Seamen’s Hospital at Greenwich. The hospital, such expense will be borne by the Board.Cornwall authorities, although the epidemic of last year We commend this practical mode of action to the noticecost them, according to the remarks of their chairman, of other metropolitan and urban sanitary authorities.£3000, do not appear to have profited much by ex-

____

perience; for no hospital accommodation has been pro-vided, nor any means of removing the sick. This par- DIVIDED AUTHORITY IN WORKHOUSES.

ticular ship is under the control of the Home Office, MR. EDWARD H. FULLER, of Wittington, Manchesterbeing established for the reception of boys who would other- one of the guardians of the Chorlton Union, has resignedwise be in prison. But the Home Office authorities seem his office in consequence of the refusal of the Local Govern-to be indifferent about the matter; for no assistance or even ment Board to inquire into the minagemi-nt of the pauperpractical advice has as yet emanated from Whitehall with infirmary attached to the Chorlton Union Workhouse. Mr.

reference to these disastrous outbreaks. The position of Fuller regards the workhouse as really a home for infirmthe Cornwall as a school-ship establishment is, as we take people requiring medical treatment and consideration.

it, most humiliating. She is partially supported by a This being so, he thinks it of prime importance that theGovernment grant, and partially by voluntary contributions.. sick, with their nurses, diet, clothing, exercise, and apart-

908

ments, should be placed under the separate control of a tion of the subject, and quoted extracts from a report pre-resident medical officer, free from the interference of the sented by Surgeon-General G. Smith to the Chief Secretary,workhouse master. Mr. Fuller is right, and time will show in which the results obtained from the treatment of fever

that the Local Government Board is wrong in refusing to with the mixed alkaloids are given. Two pounds of theinquire into cases where the medical officer is thwarted in drug were sent to twelve hospitals for trial, and returnsthe discharge of his duties by an officer who, in the nature from ten of them are embodied in Dr. Smith’s report. The

of things, must be unfitted to control him. doses in which the preparation was exhibited ranged fromfive to twenty-five grains. In the larger doses it was found

HONORARY DECREES AND THE CENERAL to produce chinchonism and intestinal disturbance of anMEDICAL COUNCIL. aggravated form. One medical officer reports that he found

AT the annual meeting of the British Medical Association it caused so much sickness, giddiness, and prostration thatin Dublin, in August, 1867, as reported in THE LANCET of

he would not recommend it for general use. As an illustra-

the 10th of that month, p. 179, the honorary degree of M.D. tion of its insolubility, we may state that in one experiment

Univ. Dub. was conferred on the following registered practi- three drachms of dilute hydrochloric acid failed to make one

tioners-viz., Henry Wyldbore Rumsey, Francis Sibson, drachm of the powder dissolve in two ounces of water. MostJames Young Simpson, William Bowman, James Syme, of the patients submitted to treatment were suffering fromThomas Pridgin Teale, George Edward Paget, and Henry mild uncomplicated cases of intermittent fever. On the

Wentwoith Ac1and. On reference to the Medical Register it whole, Surgeon-General Smith concludes that the resultswill be seen that five of them-viz., Messrs. Rumsey, Syme, obtained in the trials of the preparation have not been suchand Teale, and Drs. Paget and Adand, were allowed to re- as to warrant a recommendation of its general use. There

gister such additional qualification. Why, therefore, the are supposed to be several tons of the mixed alkaloids now

honorary degree of M.D. of the Queen University in Ireland in store, which will very likely be shipped to Europe at acannot be registered, as the Branch Council for England cheap rate.

____

have decided, is not clear. If they are right now, they werehave decided, is not clear. explanation ought now, they were MODE OF ELECTINC HOUSE-SURCEONS.wrong before; and some eaplanation ought to be given ofthe matter.

____ IT is gratifying to notice the steady progress in opinion

as to the mode of electing the principal paid officers of hos-THEATRES AND FIRES. pitals. The last instance of this is reported in reference to

IT is pleasant to be informed that the Lord Chamberlain the Taunton and Somerset Hospital. At a special generalhas the need of enforcing special precautions against fire meeting of the governors, Mr. Rawlinson, in the absenceduring the pantomime season clearly in view. It would be of Prebendary Sandford, proposed that the General and- still more satisfactory to be acquainted with the precise in- Medical Committees shall form a united committee for the

structions his Lordship has issued. We believe a circular election of house-surgeon, matron, and head nurse, whenof some sort is addressed to the managers every season. vacancies occur. Mr. Rawlinson quoted THE LANCET inHas that now indited any peculiar features ? It is mani- favour of this change. We very strongly recommend it tofestly easier to administer consolation to the public than to every institution which has not already made it. To send

protect public interests effectually. There is an exceptional house-surgeons, in the impecuniosity of the period whichneed that something should be done; but if this need is to follows qualification and precedes practice, to canvass abe satisfied by simply entreating the lessees of houses con- large body of governors, extending often over a whole

structed like too many of those within the metropolitan county, is an injustice and an indiscretion not admittingdistrict to take 11 every precaution," we fail to see how the of defence. It must exclude many of the best men from the

performance of this paternal function can afford any solid candidature. Whereas election by the General and Medicalground for confidence. In a word, managers cannot alter Committees together is an admirable method for securingthe plan of their houses, and the opening of a few doors that the best judgment shall be brought to the selection ofwould do uncommonly little. It is idle to talk of protecting a candidate.

the public when the public has once got into the trap.Playgoers must protect themselves and their families; and A WORD IN SEASON.

the only way, under existing circumstances, that can be THE report of the death of the wife of a clergyman atdone, would seem to be by planning a safe retreat-in plain Chatham, from small-pox, contracted while visiting thetruth, keeping the contingency of a panic distinctly before sick in the parish-the unfortunate lady had been marriedthe mind, and thinking beforehand how to act. This is a only eighteen months-leads us to give a word or two ofsorry recommendation, it may be, but it is vain to put any advice to those similarly engaged. We should be sorry totrust in the well-meant but feeble efforts of the Lord say anything of a nature to damp the ardour of lady visitorsChamberlain, for whose intervention it is customary to to the homes of the sick poor. Those members of the pro-make an annual sensational appeal. The opportunity for fession whose duties take them into the most wretchedefficient precaution is practically at an end when a theatre and squalid quarters of our metropolis will testify to theis licensed.

____ courage and devotion with which ladies carry on the noblework of succouring the sick and distressed, and acknowledge

INDIAN QUININE. the assistance they often receive in this manner in the treat-WE lately announced the successful cultivation of the ment of disease. It may not, however, be out of place to

Chinchona bark in many fresh hill districts of India, and remind district visitors that, at a time when small-pox isventured to predict that the medical officers in the country so widely prevalent, the utmost care and precaution shouldwould ere long be able to rely entirely on the native produce be observed to secure their persons against infection. Wein the treatment of certain fevers. It would appear, how- assume that all whose self-imposed duties carry them intoever, from recent experiments that the mixed chinchona suspected quarters have already submitted themselves toalkaloids are of such sparing solubility, and have, moreover, revaccination. Two other preservative measures, disinfec-so strong a tendency to produce gastric irritation, that their tion and fumigation, should be practised as far as possible.administration in many cases is precluded. The Pharma- With regard to the disinfection of rooms lately occupiedceutical Journal devoted last week an article to the considera- by persons with infectious disease, no better agent could be

909

used than the bisulphide of carbon, which on ignition ruling, and the question will be argued in the Court ofevolves sulphurous acid in vapour. The substance is not Exchequer. The profession is under very great obligationcostly, and may be burnt either in an ordinary spirit lamp to the East London Medical Defence Association for takingor in an open dish. It should be used with caution, as it means to determine a question which the apathy of ouris extremely inflammable. ____ corporations and of the General Medical Council would leave

THE PATHOLOGICAL SOCIETY. undetermined indefinitely.

THE PATHOLOCICAL SOCIETY.

THE annual general meeting of this Society will take CLINICAL FEES AT UNIVERSITY COLLECEplace on the 2nd of January, when the officers and Council HOSPITAL.for the ensuing year will be elected. As already announced, WE congratulate the medical and surgical staff of thisthe meeting on Tuesday, Jan. 16th, will be set apart for hospital on the concession by the Council of the College ofthe exhibition of specimens illustrating the pathology of two-thirds of their clinical fees. Hitherto the whole of theVisceral Syphilis. We understand that the Council are de- fees have been given to the hospital, but the medical officerssirous that the specimens brought forward should illustrate have recently felt that they were not justified in giving upsomething new or unusual in the histology of the disease, the whole sum, and have at last decided to allow the Councilalthough specimens of interest in other respects will be to retain one-third to be given to the charity.welcome. Gentlemen intending to exhibit are requested to ,___.

send in their names, with the subject of their intended DR. 0 RME DUDFIELD, medical officer of health for gen-communication, at onae to the medical secretary. sington, in his last monthly report, states that since the

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issue of his previous return thirteen cases of small-pox hadSICK-PAY AND POOR-RATES. come under his observation, twelve of which occurred in the

IT is alleged that under the Poor-law Amendment Act north district. Nine cases occurred in two adjoining housesof last session guardians have a claim on the sick-pay in Lonsdale-road. In the same period two deaths fromallowed to members of friendly societies if they fall ill and enteric fever were recorded in the parish. In the case of a.must needs go to workhouse or asylum. This is scarcely a patient who was removed to the Fever Hospital and therewise arrangement, because, as asserted by a deputation of died, the disease was traced to an escape of sewer-gas fromForesters, who waited upon Mr. Salt, the parliamentary a soil-pipe constructed of glazed earthenware, placed in aSecretary of the Local Government Board, the other day, wall, and thinly covered with plaster. The smell was verythese societies saved the rates in the aggregate a great offensive, and on examiaation it was found that the jointsburden, and any measure which might deter men from of the pipe had never been closed. Dr. Orme Dudfield

paying their subscriptions regularly would be unfortunate, points out the evil of the practice of embedding soil-pipesand, in its remote effects, disastrous. Mr. Salt is of opinion in certain parts of walls, often to the common danger ofthat the provision in the Act applies only to the case of a two households.

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man in the habit of getting drunk and becoming charge- -

able to the parish, receiving his club money after recovery THE Pall-mall Gazette quotes some remarkable illustra-

and spending it in drink. However this may be, friendly tions of the way in which disease is spread, from a paper bysocieties appear to have the remedy in their own hands by Dr. Cornelius Fox, medical officer of health. In one case a

framing a rule that no member receiving relief from the publican’s wife attended to her children ill with scarlet

rates shall have any claim on the sick fund. Such a rule fever and to her husband’s customers with equal assiduitywould, no doubt, be sanctioned by authority, and it would, and impartiality. As a consequence, the disease soon ran riotof course, render any claim which the Act of last session throughout the neighbourhood. Another instance was the

may give boards of guardians entirely nugatory. refusal to close temporarily a village school where measles- was prevalent. In one case small-pox existed in a restaurant,

THE ARCTIC EXPEDITION. "the characteristic odour of the disease pervading the bar

WE are entirely in accord with a correspondent who where men stood drinking." Again, a tailor made clothesfor peop1e while enteric fever prevaledin his house, and

writes to The Times, suggesting that a select committee for people while enteric fever prevailed in his house, and

should be appointed to inquire, not only into the causes n thus distributed the infection. Several other instances areshould be appointed to inquire, not only into the causes of by Dr. Fox, all of which demonstrate the need ethe outbreak of scurvy on the last Arctic Expedition, but j... powers to sanitary bodies.the outbreak of scurvy on the last Arctic Expedition, but granting greater powers to sanitary bodies.into the subject generally. So much has been said and granting greater powers to sanitary bodies.written upon the subject that the main question at issue has DR. CAMERON, M.P., in an admirable address deliveredby many been entirely lost sight of, and the public have yet last Saturday before the Glagow Andersonian Medicalto know from official sources the exact text of instructions Society, strongly condemned the Act passed last sessionthat emanated from the office of the Medical Director- for regulating the practice of vivisection. He contrastedGeneral of the Navy previous to the departure of the ships the amount of cruelty attaching to a few experimentslast year. If a select committee be appointed to determine undertaken for the purposes of scientific inquiry with thatthe proximate and predisposing causes of scurvy it should, of involved in a battue of game, such as took place recentlycourse, include some membersof the mercantile marine. For, near Thetford. We should like to see our respected confrèreas we have before indicated, it seems now that the tables are more frequently explain his views publicly on matters havingturned, and that the Admiralty may profitably take a leaf especial interest to the profession.out of the book of the marine department of the Board of ____

Trade.._ OWING to the prevalence of scarlatina at Chilvers Coton,«

a thickly populated village in Warwickshire, the variousTHE CASE OF DR." HAMILTON. Church of England, Dissenting, and Roman-catholic schools

WE are glad to know that we shall soon learn whether the in the parish have been temporarily closed. This course

ruling of Mr. Knox as to the use of American titles for pur- has, we understand, been pursued on the recommendationposes of medical practice is to be regarded as valid or of Mr. Pitt, the medical officer of health, and is one whichotherwise in this country. The East London Medical may be recommended for adoption in other crowded locali-Defence Association has appealed against Mr. Knox’s ties where epidemic diseases prevail.

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A GENERAL meeting of the members of the Sanitary In- MUCH interest continues to be shown at Manchester inatitute of Great Britain was held last week at their rooms the question of what is to be done with the Royal Infirmaryin Spring-gardens, when the report of the committee was of the town. Among the profession there would seem to bepresented. The committee recommend that for the present a balance of opinion in favour of a new site. Fifteen outthe examination of, and granting certificates of qualification of the sixteen physicians and surgeons attached to the in-to, subordinate officers of sanitary districts should be held stitution have reported to the trustees their decided con-in London, and for two classes only-viz., for local surveyors viction that the structural defects of the building are of soand inspectors of nuisances, whose examinations "should grave a character that no amount of alteration can render

comprise the elements of Sanitary Science, together with it efficient for the satisfactory treatment of patients, andengineering, the laws relating to the suppression of nuisances that they consider it absolutely necessary to pull down theinjurious to health, and for the prevention of disease." The present infirmary, and to construct one of larger dimensionscommittee also, inter alia, urge the desirability of the Insti- and on improved principles, " either on the present site ortute taking steps to procure a complete registration of sick- on any other which may be deemed more desirable."ness, especially zymotic disease.

- A SAD affair occurred at the South Staffordshire HospitalPUBLIC attention is again called to the defective sanitary at Wolverhampton on Saturday last. A man named Skitt,

condition of the public schools situated in Plumatead. We who had one of his fingers crushed, went to the hospital tofind it stated in a lately issued report that the closets in have it attended to, and it was decided to remove the firstthe Board schools at Church-terrace are very dirty and the joint. The house-surgeon administered chloroform, and theurinals unsatisfactory j at the Central schools the closets assistant-surgeon was about to operate, when it was disco-are very dirty and dilapidated, and the playgrounds are vered that breathing had ceased. Skitt was a man of moreunpaved and very offensive in wet weather, with stagnant than ordinary physical strength.pools about; and that the arrangements at the Slade schools are still more objectionable. The sanitary authority of the SMALL-POX has been prevalent in Chatham for some time,district should take the matter up, and insist that the and the disease shows no signs of abatement. Stringentmuch needed improvements, which can be easily specified, measures are taken by the military authorities to protectshould be carried out at once by those who are responsible the health of the troops. They are periodically inspected,for the state of the establishments. and those requiring it are revaceinated, together with their

wives and children, while the men are forbidden to enterA MEETING of commanding officers and surgeons of Volun- certain public-houses which are supposed to be infected.

teer corps was held a few days ago at the Royal United Service Institution, for the purpose of taking measures for ON Saturday last the Dundee Convalescent Home-theorganising the training of volunteers for the duties of sick- funds for building and endowing which had been left bybearers in the battle field on the system adopted in the Army Sir David Baxter, uncle of Mr. W. E. Baxter, M.P. for the

Hospital Corps. The meeting was addressed by Surgeon- Montrose burghs-was formally opened. It will providemajor Sandford Moore, and a discussion ensued, resulting accommodation for fifty patients. A sum of £ 10,000 wasin the adoption of two resolutions -one expressive of the expended on the building, and it has a maintenance fund ofreadiness of Volunteer surgeons to undergo the necessary £ 20,000.

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training if opportunities are given them, and the other of adesire to obtain the views of the Secretary of State on the a THE health authorities of Broadstairs are taking the wise

subject. We have more than once commended the present step of providing a complete system of drainage for the

movement, and are glad to see it in motion, even if slowly. town. Such a measure, although it involves a considerableoutlay at first, will be found economical in the end, as the

PROFESSOR HUXLEY, in an address upon Biology, delivered mortality will be diminished and the reputation of the

-at the South Kensington Museum on Saturday evening, place as a healthy seaside resort increased.drew attention to the possible use of the study in relation -.to ascertaining the true nature of the germs of infectious IT is announced that the parliamentary grant of £ 2000

disease. He pointed to the revolution in agriculture during a year scientific investigations into the "causes andprocesses " of disease is in future to be placed at the dis-the last forty years, and glanced at the precise definition of Passes " of disease is in future to be placed at the dis-certain processes which go on in plants, and which are part posal of the Royal Society. Heretofore ihis endowment of

of the subject of biology. Granting the use of studying research was controlled by Mr. Simon, as medical officer of

biology, Mr. Huxley argued that mere reading was of little the Privy Council. —

value without actual observation and experiment. He saw THE occurrence of a severe outbreak of small-pox in ano valid reason why it should not be part of an ordinary poorly inhabited part of Stepney has been reported, sevenschool training, and especially was it commended to those persons having been attacked in one house alone. Many ofwho followed the profession of medicine. the patients have been sent into hospita1, and the premisesCERTAIN courts and alleys in Westminster, which have

which they had occupied thoroughly disinfected and fumi-

long been recognised as hotbeds of crime and disease, gated. * —

are in course of being "improved" away by the ope- IT was determined at the meeting of the Metropolitancation of the Artisans’ Dwellings Act. In Whitechapel, Asylums Board on Saturday to erect six additional pavilionsapplication has been made to the Secretary of State for the at Fulham, and seven at Deptford, for the purpose of pro-Home Department to appoint an arbitrator between the viding accommodation for nearly 800 small-pox patients,Board of Works and the persons interested in the lands and the estimated cost being .841,705.hereditaments to be taken compulsorily for the purposes of —

the Metropolis (Whitechapel and Limehouse) Improvement DR. MACKINTOSH, medical officer of health for Chester-Scheme, 1876. We expect to find in the provision of cleanly, field, reports that the rate of infantile mortality in thatwholesome, and well-ventilated dwellings for the working town is as high as 55 per cent. A large amount of theclasses a beneficent influence from which the best moral as fatality recorded is attributed to a general use of dangerouswell as physical results will accrue. "soothing" medicaments.

911

DR. ANCHJS SMITH, F.R.S., and Mr. Robert Rawlinson,C.B., have been appointed by the Local Government Boardinspectors for the purpose of granting certificates under theRivers Pollution Prevention Act, 1876.

TYPHOID FEVER has broken out among the crew of the

guardship Valiant in Foynes Harbour. An application hasbeen made to the governor of a local hospital to accommo-date fifteen cases.

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FBESH cases of small-pox continue to be reported inLiverpool. Last week fifteen deaths from the disease wererecorded.

THE SMALL-POX EPIDEMIC.

THE fatality from small-pox in London has, with slightfluctuations, increased steadily since the beginning of

October, and the 75 deaths from the disease registeredduring the seven days ending 16th considerably exceededany weekly number since the decline of the epidemic in1870-1-2. These 75 deaths showed an increase of 25 uponthose returned in the preceding week, most of which

increase occurred in South London, to which 31 of the 75fatal cases belonged. After distributing the hospital cases,the Registrar- General’s last weekly returns showed that 11of the deceased small-pox patients had resided in Hackney,8 in Lambeth, 8 in Camberwell, 5 in Islington, 4 in Bow,4 in St. Pancras, 4 in Wandsworth, and 4 in St. Saviour’s,Southwark. The marked increase in the recorded fatalcases was not, however, the only unfavourable feature of thelast return. The number of small-pox patients under treat-ment in the Metropolitan Asylum Small-pox Hospitals atHomerton, Stockwetl, and Hampstead, which in the sevenpreceding weeks bad steadily increased from 185 to 586,further rose to 696 during the week ending the 16th.Accommodation for this additional number of patientshad in great measure been provided by the transfer-rence of the fever patients from the Homerton FeverHospital to the similar institution at Stockwell. Bearingin mind that during the first half of this year only 33 deathsfrom small-pox were registered in London, the increase inthe numbers has been far more rapid than it was at thecommencement of the last epidemic; during the threemonths ending September 110 fatal cases were recorded,and in the eleven weeks ending 16th, 420 further cases. Itis scarcely possible to believe that the present epidemiccan, in a more generally vaccinated population, assumethe same proportions as did the last; but*in the face of therecent ominous increase in the number of cases and ofdeaths, it is well to remember the fact that in 1871 no lessthan 7876 small-pox deaths were registered in London, andat the crisis of the epidemic, in the early part of May ofthat year, 288 occurred in one week. Notwithstanding the in-crease of hospital accommodation the proportion of fatalcases in private dwelling-houses continues between 40 and50 per cent. It is evident, therefore, that the MetropolitanAsylums Board is bound rapidly to increase their number ofbeds for small-pox patients, and it is to be hoped that theywill meet with cordial support both from the Governmentand the public in their thankless task. The assistance ofthe public may be rendered in two important directions-by practically recognising the importance of revaccination,and by not offering litigious local opposition to every siteproposed for temporary hospital accommodation. Local

sanitary authorities can render most valuable assistance byadopting all possible means for daily information to theirmedical officers of health of new cases of small-pox, in whicheffort the co-operation of all medical practitioners candoubtless be counted upon.Around London the most noticeable feature with refer-

ence to the prevalence of small-pox is the occurrence offour fatal cases in the infectious wards of the CroydonWorkhouse during the week ending the 16th inst. Twowere also recorded in the district of West Ham.Much exaggeration appears to have prevailed with regard

to reported outbreaks of small-pox in various parts of the

country, but judging from a few facts published by theRegistrar- General, the outbreak at Bromley is the only onethat has assumed serious proportions. In Bromley seven-teen deaths occurred between the end of September andthel6hh inst. ; three were registered in Swansea, two inKenda.1, and one each in Blackburn and Haslingden. Nodeath in Chatham was registered prior to the 16th inst.London, Liverpool, Manchester, S,dfol’d, and Bromley,appear to be the only towns in which the disease hasassumed an epidemic character, and it may yet be hopedthat the epidemic may not become general, as it did in1871-2.

Correspondence.

DIAGNOSIS OF INTRA-THORACIC TUMOURS.

"Andi alteram partem:’

To the Editor of THE LANCET.

SIR,—In THE LANCET of Nov. 18tb, 1876, are publishedsome °° Clinical Remarks on a Case of Mediastinal Cancerwith Aphonia from Laryngeal Paralysis," by Dr. BurneyYeo. In his comments on the case he lays considerablestress on the use of the laryngoscope in the diagnosis ofthese tumours, and, as a very similar instance was latelyunder my own care in St. George’s Hospital, I venture tosend you a brief extract from the notes in case you shouldthink them worthy of publication. At the same time, I donot know that I should have troubled you with a com-munication on this subject had it not, been for the concludingparagraph of Dr. Yeo’s lecture, wherein he says: 11 Thechief point of interest in this case, and that to which I wishto call attention in placing it on record, is the aid whichwas afforded us in our diagnosis by the use of the laryngo-scope, whereby we were enabled at once to discover that theloss of voice was not caused by intrinsic disease of thelarynx itself, but by disease within the thorax interferingwith the innervation of the laryngeal muscles." This facthas, I think, been long recognised by the profession, andno physician who had a case in which any alteration in theforce or character of the voice existed would, I imagine, failto have recourse to the laryngoscope in order that anydoubt which might exist as to intrinsic or extrinsic diseaseof the larynx might at once be set at rest. My own case soclosely resembles Dr. Yeo’s that it seems to be a fittingsupplement to his lecture.

Charlotte R-, a married woman aged thirty-seven,was transferred to my care by Dr. Cavafy on October 20th,1875. Her history was briefly as follows. She had enjoyedgood health until June, 1875, when she was attacked witha bad cough and spitting, which symptoms subsided in thecourse of a week, but from that time she suffered from con-stant pain in the upper part of the left chest, both in frontand behind. She had for a short period before her admis-sion into St. George’s Hospital wasted considerably-i. e.,she had lost in six weeks three pounds in weight.On her admission she was decidedly emaciated; had

slight sore-throat, but no cough or expectoration ; com-

plained of pain over the upper half of the left chest, ante-riorly and posteriorly ; her voice was reduced to a whisper;her tongue was clean, though she suffered from obstinateconstipation.On Oct. 22nd I examined her with the laryngoscope, and

found total paralysis of the left vocal cord, but no otherabnormal appearance in the larynx. The left chest waswanting in movement on inspiration, and was markedlydull on percussion in; front over the upper part of the lung.Similar dulness existed behind; while over the scapularregion percussion resonance was, if anything, greater thannatural. The bases of both lungs were dull on percussion,but on the right side breathing was distinctly audible;while over the left lung generally respiration was extremelyfeeble, and at the upper part quite inaudible. No tubularbreathing could be detected on the right side, nor werethere in the thorax any moist or dry sounds. Vocal fremituswas entirely absent on the left side. The heart’s apex beatabout one inch to the left of the sternum, and not below its