963SIR LYON PLAYFAIR ON MEDICAL LEGISLATION.

sparse population there was as yet hardly any one to beaffected at Darenth. But as the case now stands, it is evidentthat in the opinion of Mr. Justice PEARSON, town small-poxhospitals, if resembling in their circumstances what the

London ones have heretofore been, can properly be closed asa danger to public health; whereas, on the other hand,the burden of proof that injury has already resulted willlie with the plaintiff in the case of hospitals in localitieshaving rural characteristics. As regards the MetropolitanAsylums Board, we are bound to acknowledge the unceasingenergy which they have displayed in their efforts to providefor the isolation of metropolitan small-pox cases, and we canonly hope that this mingling of acute cases-under the nameof mild cases-with convalescents, in the large numberswhich their Darenth camp is capable of containing, willnot eventually constitute a new element of danger.

Annotations.bTe Qaid nhnJø."

APOTHECARIES’ SOCIETY : EXAMINATION IN

SURGERY.

THE Court of Assistants of the Apothecaries’Society haveresolved to institute an examination in surgery for thosecandidates for the L. S. A. who have not already passed anexamination in Surgery at one of the Royal Colleges, or aone of the universities, or such other examining body as maybe deemed satisfactory to the Court of Examiners. Theexamination in Surgery will be held twice a week, and willconsist of written questions, clinical diagnosis and treatment,and the uses of instruments. It will be necessary for candi-dates holding no surgical qualification to pass this exami-nation before admission for the ordinary examination, whichmay be done immediately after passing the surgical exami-nation.

___

SIR LYON PLAYFAIR ON MEDICALLEGISLATION.

SIR LYON PLAYFAIR has been saying his usual list of

pleasant things to the universities and medical corporationsof Scotland, in the hope of securing his re-election for theuniversity. He speaks with the air of a man who can shapethe future Medical Bill, conscious no doubt of havingwrecked the Bill of last year. We can believe anything ofParliament and parties at present except a capacity for soundand honest work, and we see no improbability in the ideathat Sir Lyon Playfair’s wisdom will be accepted by thepresent Parliament in place of the wisdom of a Royal Com-mission and the immense majority of the medical profession.This infallible guide, who told the House of Commons thatour much over-stocked profession was disappearing at therate of 1600 a year, and that there was a risk of the publicnot being sufficiently supplied with medical men, told hisconstituents that a Bill of three clauses would meet all thenecessities of the case, and that he hoped to see such a Billnext session. The three points to be secured are : sufficientexamination in Medicine, Surgery, and Midwifery; a pro-perly representative Medical Council ; and, thirdly, thatthe Council should inquire and report upon, and if necessaryrender more efficient, the modes of teaching and examinationof the different bodies which give medical education andlicences. Our readers will observe that this programmecontains no guarantee of any reduction in the twenty com-peting bodies, throws on the profession the cost of maintaining

them, and on the Council the impossible duty of checkingand supervising them all. Verily, the exigencies of a can-didate for an election are terrible, and he has to bid high forthe favours of his constituents. To judge from Sir LyonPlayfair’s address one would fancy that the Scotch medicalauthorities, including the Corporations, had raised the pro-fession to its present eminence, and that no evidence wasforthcoming to show that the said corporations had soldfellowships, made thousands of pounds by the sale of

licences, and given diplomas with freedom to men rejectedby other boards. All we can say is that if Parliament canbe so misled by Sir Lyon Playfair, so much the worse forParliament. We shall certainly be no parties to treatingso slightly the deep wounds of an "agitated and mis-represented profession.

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" MORBID RELIGIOUS AFFECTION."WE have nothing to add to and nothing to withdraw

from our remarks on this subject, in spite of letters ap-proving and letters condemning the position we have takenup. It may be granted at once that it is to be regrettedthat there should be any need to refer to topics of such aclass and character; but evil must not be allowed to wokbecause it requires some courage to deal with it. We havenot spoken precipitately, or made rash statements. It is

necessary to be cruel to be kind, when those who are in adream of folly have to be awakened. We say again thatreligious affection is too ,often morbid. In the interests oftrue and sober-minded religion it is essential to expose thatwhich is simply emotional and has evil tendencies. It is

not, confessedly, our business to pose as critics of honestyin conviction. The medical standpoint is, however, onewhich not only enables but compels the practitioner of

physic to include in his field of vision much of the mentaland moral life of his patient. When we see morbid re-

ligious affection paving the way for disease it is our dutyto speak out plainly; and let us take leave to say thatwe are not to be deterred from the discharge of whatwe believe to be our duty by any imputation ot false-ness, wantonness, or wickedness. We believe, and can-not therefore hesitate to say, that the ecstatic reverieof worship or adoration into which women are wont to throwthemselves before the crucifix is "vicious" and demoralising.We do not say that they are conscious of the real nature ofthe emotional excitement stirred within them; but this doesnot affect the fact that it is an undesirable--most un-

desirable-state, and we must reiterate the expression of ahope that heads of families and ministers of religion, whothink more of the intellectual integrity and the mentaland physical health of their people than of forms and cere-monies and " ways and means of grace," will interpose to puta stop to practices in religion which tend to undermine thevery health and happiness they are designed to advance andimprove. Anything and everything that suspends the con-trol of the will, even for a moment, is injurious. Ecstasyand reverie are, physiologically considered, states of mentalunsoundness. It is idle to speak of sullying the mind andmoral purity by warning those who are forming the habit offalling into these states against that tendency, because thevery existence of a state of ecstasy or reverie implies andinvolves surrender of the mind to all contingencies. It is asdifficult for a woman abandoning herself to this ecstasyto prevent her thoughts from drifting into impure channelsas it would be for a man entering upon a drunkentirade to determine that he would be coherent and reason-able. The emotional nature " is as nearly allied to thepassions as these latter are to the organs of which they arethe function. The mischief that results from thinking andspeaking of the " mind" as something apart from the body,as more than brain-function, cannot be over-estimated.

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It is the cause of most of the troubles and difficulties wehave to encounter in striving to live natural and healthylives. There is peril, grave besetting peril, in the toleranceof mind-states which do not fall under the direct, active,and continuous control of the will. Waking dreamsare madness while they last, and the sort of day dreamwhich grows out of the contemplation of the crucifix is onethat may readily become morbid, and in so doing deprave themoral sense-first, because the state is mentally unsound,and, second, because the object of contemplation has specialelements which may readily suggest impure thoughts.

DISEASED MEAT.

A FEW days since the Tiverton magistrates had beforethem an important case for decision. It was one in whichthe question was raised as to the fitness of a carcase of beeffor human food. The facts, which were briefly as follows,were not disputed. A dairyman named Hellyer owned acow which had recently calved. As the animal was suffer-

ing from " milk fever" Mr. Chase, the veterinary surgeon tothe sanitary authority, was asked to give his advice in thematter ; this he did to the effect that the animal should beslaughtered, and inasmuch as the flesh presented a healthyappearance he saw no reason why it should be destroyed.The butcher, with commendable straightforwardness, in-formed the sanitary inspector that the carcase was in hispossession, and requested him to take what course he

thought fit. Dr. J. P. McNeil, medical officer of health,stated to the Court that he considered the flesh of a diseasedcow, especially after the birth of a calf, as unwholesome food,admitting at the same time that he was not in a position tocondemn it on the grounds of any morbid appearances.The magistrates, after inspecting the four quarters, heldthat they did not see their way to condemn the meat,especially as the veterinary surgeon " could not see how theflesh could be diseased." The question, What is diseasedmeat? is an exceedingly difficult one to answer satisfac-torily. It is needless to say that the flesh of animalsinfested with parasites should be discarded, seeing how un-certain are the methods of rendering the peccant bodiesinert. Nor do we hesitate to affirm that animal matterwhich has undergone rapid putrefaction should be un-

reservedly condemned. The unfortunate results of eatingrotten meat hitherto experienced are sufficient justificationsof this assertion; but there still remains a group of cases,amongst which are included those of animals dead of

specific or infective fevers, about which opinions differ asregards the propriety of allowing the carcases to be used ashuman food. That the latter must have deteriorated fromthe action of living organisms and the concomitant con-ditions of the febrile state is beyond dispute ; but this initself falls short of the proposition that such meat is abso-lutely dangerous as an article of diet. Nevertheless, wemaintain that since it has been proved that certain specificdiseases are communicable from animals to man, andthat the flesh of animals affected with the acute fevers is

very prone to decompose with the formation of what may bedeadly cadaveric principles (whether these consist of fattyderivatives, microbes, or alkaloidal ptomaines matters little),we hold that the balance of evidence is in favour ot

prohibiting the sale or consumption of meat which at anyrate contains the elements of danger, if not a certain causeof poisoning. This would undoubtedly entail a serious

pecuniary loss on those immediately concerned, and wouldbe felt in the aggregate by the community at large, thoughof course to a less degree; but the objection to such aprocedure falls to the ground in the face of the greater onethat health, and even life, may be sacrificed on terms whichno reasonable being would willingly accept. It seems alittle puzzling to reconcile the advice of Mr. Chase, that the

cow should be killed to save it from impending death bydisease, with his statement that the carcase might be eatenwith safety, and that he would not hesitate to partake of ithimself. However, if a person chooses to run a blockade hecannot complain if his ship is disabled or sunk, but it isquite another matter to recommend, or even sanction, theenterprise by one ignorant of the risks attending it. Possiblyon the whole the most practicable plan of dealing with thematter of meat "under a cloud" would be to judge eachcase on its merits, providing that the opinion of the medicalofficer of health be paramount.

THE BISHOP OF PETERBOROUGH AND SIR

ANDREW CLARK ON TEMPERANCE.

THE cause of true temperance is in the ascendant, andwill be greatly helped by such speeches as that of the Bishopof Peterborough and Sir Andrew Clark. It is greatly to thecredit of the Bishop that he has sided with the ChurchTemperance Society, and so far done what he could tocounteract the influence of that little smart epigram intowhich he fell a few years ago, and which, though in sensestrue, was in its main application highly questionable. Theteetotalers will put themselves entirely in the wrong if theydo not meet the Bishop half way, and endeavour to makecommon cause with all who try to increase the sobriety andabate’the drunkenness of the nation. Absolute abstention is amoral necessity for those who cannot observe moderation,and a medical necessity for a large number of cases ofalcoholism. What we want is "earnest advocates" of" temperance " in the sense of the great Apostle who" reasoned " about it, men who can admit, like Sir AndrewClark, that while " not necessary for health," there are

many persons to whom it has not yet been proved that cer-tain small quantities of alcohol, taken at stated times, at dinnerand supper, are injurious. Let us abolish casual drinking,tippling, public-house drinking, and careless social uses ofalcohol. This will cut off nine-tenths of the disease whichnow desolates families and disgraces British Christianity.

ACUTE RHEUMATIC ARTERITIS (?).

A CASE which possessed considerable interest and not alittle rarity was narrated by M. Legroux at a recent meetingof the Société Médicale des H6pitaux. The patient was ayoung lady, aged twenty-two, whose family history was onlycharacterised by the presence of the arthritic diathesis. In

July, 1884, she had a second attack of acute rheumatism; afirst having occurred at the age of twelve years, but had left notrace behind it. The rheumatism was of a subacute charac-ter ; some joints became painful, rose coloured, and a littleswollen, but during the moderate fever an eruption of nodoseerythema appeared on the front surface of both legs.After the lapse of three weeks the patient went to the seasideand seemed to improve considerably. At the beginning ofAugust there was quotidian fever, which could only be ex.plained on the assumption of a malarial origin. On the 15thof August there suddenly appeared numbness of the lefthand, forearm, and arm, soon followed by acute pains andinability to move the fingers or other parts of the limb.When seen by a doctor after these new symptoms, the radial,ulnar, and brachial pulse could not be felt on the left side;the limb was icy cold; the hand and forearm were a littleswollen, and presented on their dorsal aspect some spots ofa rose-brown colour. Gangrene was feared, but did notoccur. The fever, although somewhat abated by the ad.ministration of sulphate of quinine, still continued, and afterthe fresh incident increased once more; the pulse numbered110 to 120 a minute ; the temperature reached 38° to 39° C.,and soon prsecordial pain, dyspncea, palpitation, and amurmur of systolic time masked a pre-existing hemic bmit

965

The murmur was loudest at the apex beat, but extendedtowards the base and all over the aortic area. Thefirst diagnosismade by the patient’s ordinary attendant was ulcerativeendocarditis with embolic thrombosis of the left brachial

artery. There was a little tenderness about the left brachial

artery. Dr. Charles Hardy, who saw the patient later,suggested that acute rheumatic inflammation of the arteryexisted because of the nodosities to be felt along the vessel, ofthe sensitiveness of the vessel, and of the presence of a bruitall along the thoracic aorta. The obliteration would on this

opinion have been due to the acute arteritis, possibly startingfrom the endocardium and aorta. The limb was keptabsolutely at rest, the pains were calmed by hypodermicinjections of morphia, and small doses of iodide of potassiumwere administered. Some time after M. Legroux saw thepatient for the first time. The cardiac disturbance was thenmarked by loud bruits, and the action of the heart was sotumultuous that it was almost impossible to differentiate thevarious factors of this commotion. There was an intensebruit all down the vertebral column corresponding to thepath of the aorta; auscultation over the left subelavian

region yielded a loud bruit. There was a tender pulsatiledilatation of the axillary artery of the size of a large plum.Below the aneurysm the brachial artery was to be felt as ahard, fibrous, pulseless cord. The limb was pale, flabby,wasted, and motionless ; the hand was atrophied, and a deepfurrow in front of the lunule of the nails indicated the

period at which the circulation had been almost completelyarrested. A small degree of sensibility remained. A slighteffusion into the right pleural cavity was diagnosed. Theultimate issue of the case is not yet known.

INVALID HOTELS.

THE project of establishing hotels for the reception ofinvalids in London is one which, if planned with due con-sideration and carefully carried out, ought to command thesupport of the class for whom it is intended. The idea isnot a new one; it is the extended, but also modified andtrained, development of that which has been known as the"home-hospital" system. We may say that it differs essen-

tially from the latter in the predominance of the homeelement over the hospital. Comfort is provided for as at thelarge general hotels, but with special regard for the neces-sities of disease, white at the same time exclusive centralisa-tion, that fruitful source of quack practice, would seem to bein a great measure obviated. The prospectus which liesbefore us disclaims any purpose of organising a hotel medi-cal staff, or portion of a staff. The invalid tenant is to beattended by auy practitioner whom he may choose; he hashis separate room, receives, subject to medical restriction, thevisits of his friends, and has access under all ordinary condi-tions to such society as his state allows. He is in fact a sickman in chambers, where he can be cared for. In one part ofthe plan, the employment of a trained nursing staff underthe control of matrons, the hospital principle is introducedunchanged. A compromise is thus designed between themethods of private medical practice on the one hand andthose of the nursing home on the other. The blend mightbe a happy one or it might not. The proposed measure, itseems to us, though better than others which have precededit, still has its weak point in this dissimilar association.Decentralisation goes hardly far enough, not so far as thetitle of the new establishment suggests that it will do,and not so far but that the hope of harmonious actionbetween medical men and their nursing assistants must

chiefly, if not wholly, depend upon the even balance of theirsocial qualities. This is committing too much to humannature. The experience of Guy’s Hospital a year or two agohas weakened our belief in nursing corporations. It would

probably be more satisfactory to all concerned if nurses and

doctors alike were available for hotel patients on some sys-tem approximately similar to that which now exists in familypractice. By maintaining a fixed moderate scale of remu-neration and a code of board regulations where necessary,this result, we think, might conveniently be achieved. Wehave spoken of the hotel principle as an extension of that ofthe pay hospital or home hospital. It is so inasmuch as itis intended to meet the requirements of no one class, but ofall save the poorest classes, which, as hitherto, we still con-sider to be the appropriate charge of those great and freecharities, the hospitals in the original and truest sense. Theinvalid hotel of whatever grade, and this no doubt mayvary, should be, in short, the resort of strangers, of sick

strangers, a place where they can feel at home and can betreated and healed as if they were at home. Its institution,if it be maintained as we have suggested, so that puff,quackery, and caucus over-pressure shall be equally con-demned in it, need not disturb the fair equilibrium of medi-cal work, while it will afford to many in their sickness arelief from avoidable anxiety. - -

DIPHTHERIA IN MICHIGAN.

THE recently published annual report of the State Boardof Health for Michigan contains a number of very interest-ing papers. Amongst the subjects dealt with a somewhatprominent position is given to diphtheria, a special com-mittee having been appointed for the purpose of investigat-ing it, and a list of questions having been prepared by Drs.Kellogg and Avery, and issued to a large number of medicalmen. Briefly stated, the conclusions at which the com-mittee arrive are as follows :-The disease is due to theinvasion of the system by a microscopic fungus, the growthof the bacteria resulting in fibrinous infiltration and inflam-mation, with invasion of the blood and the whole system,the patient by his breath, &c., throwing off great quantitiesof the infecting material. The contagiousness of the diseaseis regarded as unquestionable. The contagion is looked

upon as capable of attaching itself to articles of clothing,&c., and of being communicable to some of the loweranimals. The poison may be retained for months, andperhaps for years, but either drying or putrefaction rapidlydestroys its activity. Amongst the predisposing influences,the age of from one to five years is stated to be that duringwhich susceptibility is at its greatest, and acute catarrh of thethroat and bad sanitary surroundings are mentioned as favour-ing the reception of the infection. With regard to the relationof diphtheria to other diseases, all that can be said is thatthere appears to be some sort of relation between it and true

croup, scarlet fever, and some other septic diseases. Dr.

Baker, the secretary to the board, also contributes a paperon the distribution of deaths from diphtheria in the State.

MEDICAL STUDENTS AND ROWDYISM.

A SCENE ot disorder seldom occurs in London without

being attributed to medical students. This we think is veryanjust to a class of men who are as a rule certainly youngand, as befits the arduous profession they have adopted,robust and full of health and its concomitant high spirits. Weventure to assert that if Charles Dickens were writing nowhe would have some difficulty in finding in our hospitals BobSawyers and Allens to typify the medical student. Themedical student of the present day may be, as we have said,full of health and spirits, but he is not a rowdy or a rough;and it is unfair that he should have to bear the opprobriumand reproaches heaped on the head of such. On Mondayevening last a disgraceful disturbance occurred at CoventGarden Theatre, at the close of the Promenade Concerts, Itis stated to have arisen out of " an organised plan by a gangof so-called (the italics are our own) ‘medical students’ and

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others." " We are glad to note and emphasise the quali-fication in this instance. It is true that certain cries were

raised, such as " Guy’s to the front!" and " Medicals to therescue !" and it is probable that there was some medicalstudent element in the crowd. Nevertheless we do not be-lieve that this turbulent and discreditable scene was plannedin our hospitals, or carried out by their student?. Four

persons were subsequently accused at Bow-street Police-court of complicity in these disorders, three of them beingfined-not by any means too severely-and the fourth orderedto find a surety in j620 for his good behaviour for a month.It is significant to note that of these one was described as abuilder, another as a merchant, and a third as a gentleman, theoccupation of the last, who was identified as one of those whoshouted "Guy’s to the rescue!" not being given; he, how-ever, denied that he knew any medical students, and excusedhis conduct on the ground of over-indulgence in drink.

NEPHRECTOMY FOR CALCULOUS PYELITIS.

THE dependence of the issue of nephrectomy upon thehealthy state of functional activity of the remaining organis adverted to by Dr. E. Sonnenburg, who details a fatal casein which the non-extirpated kidney exhibited no definitestructural change. The case (Berliner Klinisc7w W ochen-schrift, Nov. 24th) was that of a woman fifty-two years ofage, who had suffered from pain in the right loin since lastEaster, accompanied by fever, wasting, and polyuria. Shecame under Dr. Sonnenburg’s care in August, when the’pre-sence of a large fluctuating tumour in the right half of theabdomen was ascertained, and on aspiration pus was drawn offfrom it. Nephrectomy by the abdominal incision was per-formed on August 25th. The operation was difficult andtedious, the thin wall of the cyst rupturing in the removal.The whole pedicle was secured to the wound, but it wasfound impossible to suture the peritoneum. The organ wasconverted into a chambered, pus-containing sac, withnumerous thin-walled outlying cysts, and a large branchingcalculus was lodged in the dilated pelvis. Hardly any renaltissue remained. Great collapse followed, terminating indeath on the second day, and during the whole interval no ’,urine at all was secreted. There was no peritonitis ; the left ’kidney weighed 190 grammes, and was anaemic, but histo- Iflogically almost normal, except for some localised htty de-generation of the renal cells and slight increase in places ofthe interstitial tissue. The fatal issue of the case could not,Df. Sonnenburg thinks, be attributed to the shock of theoperation and the collapse alone ; but that the condition ofanuria, the cause of which remains unexplained, was inthe main answerable for this result.

OPENING OF THE PARIS SCHOOLS.

THE Medical Session in Paris begins in November, andour enterprising contemporary Le Progrcs Medical alwaysdevotes some space to a description of the introductorylectures of the various professors, which may be mentionedbriefly here. M. Falret commenced a course of lectures onMental Diseases at the Salpêtrière bydealingwith the subjectof classification and showing its imperfections, and proposingto treat in his course with what are termed the new forms of

insanity. M. Lannelongue, discoursing on Surgical Patho-logy, avowed himself a follower of Lister and a believer inthe germ theory. M. Blanchard treats of the subject of"Medical Natural History," and commenced his course oflectures by drawing attention to the close affinities, phy-siological and pathological, between man and the anthropoidapes. M. Trelat opened his course of Clinical Surgery atthe Charitc Hospital by some general remarks upon clinicalteaching, and the method he intended to pursue. At theMorgue Professor Brouardel was presented with an address II

from the students, testifying to the regard in which he isheld and their appreciation of his efforts to utilisefor instruction in legal medicine the rich material ofthat institution. M. S6e began his lectures on ClinicalMedicine at the Hotel Dieu by insisting on the

necessity of combining its study with physiology, his-

tology and pathological anatomy, and instanced the lightthrown upon clinical medicine by micro-biology-s.g, in

tuberculosis, pneumonia, and cholera. He then discussedsome of the symptoms of cardiac disease, and the value ofconvallaria as a diuretic and regulator of the heart’s action.At the Salpetriere M. Charcot’s clinic was, as usual, mostnumerously attended. He took for his subject the diseasewhich was first described by himself, amyotrophic lateralsclerosis, illustrated it by the exhibition of a well-markedcase, and pointed out that cases occur, as in tabes, of an in.complete or abortive kind. M. Charcot’s lectures are deli-vered on Fridays. M. Duplay lectured at the Faculty onOperative Medicine-in other words, surgical thera.

peutics ; he devoted his first lecture to a study of thegeneral conditions of the patient, external and internal,which govern operative procedure. M. Magnan beganhis course of Mental Pathology, discriminating between twogreat classes of mental diseases :-(1) Mixed states belongingto general pathology and psychiatry, as general paralyse,senile dementia (cerebral atheroma) ; circumscribed lesions(softenings, haemorrhages, tumours, &c.); hysteria, epi-lepsy ; intoxications (alcohol, absinthe, morphia, opium, &c.)(2) Insanity or psychosis, including chronic delirium, in-termittent insanity, insanity of the degenerate, mania, andmelancholia. M. Le Fort, in commencing his course of ClinicalSurgery at the Necker Hospital, spoke on the germ theory;M. Strauss dealt with cholera in beginning his lectures onPathological Anatomy. M. Cornil, who holds daily demon-strations at the Hotel Dieu, began his weekly lectures onthe 12th, with a description of the comma bacillus and itsculture. Lectures on Diseases of Children were commenced

by M. Legroux at the Faculty of Medicine, and by M, Joffroy,who has succeeded the late M. Parrot at the hospital.

THE DRAINAGE OF PRIVATE HOUSES.

THE near approach of cholera has once more awakenedpublic attention to the necessity of drainage improvements.The newspaper-reading community are called upon to "puttheir houses in order," and the assurance is given that thenthe cholera need not be feared. This advice, however, isfar easier to give than to carry out. A great number oftenants in London and in many other large towns hold theirhouses on merely a three years’ lease. It is not to be ex-

pected that they should incur any considerable expense forimprovements which at the end of the short lease wouldenable the landlord to augment his rent and oust histenants. On the other hand, the landlord almost invariablyrefuses to make the required improvements; nor do the

sanitary authorities move in the matter unless the nuisancebe of a very flagrant description. Most tenants, too, arevery chary of complaining to the sanitary authorities; not afew are in arrears with their rent, or at least irregular inthe payment, and under such circumstances are anxious toavoid anything that may lead to unpleasantness. Finally,there is no fixed official standard as to what constitutes a

well-drained house. In this respect the sanitary adminis.tration of Brussels is better organised than anything wepossess on this side of the Channel. At the Hotel de Villeof Brussels may be seen specifications given by the Serviced’Hygieae of what the law imposes. If any lodger, tenant,or other person have reason to suppose that in any particularhouse the principles laid down by these specifications arenot carried out, he has only to report the fact. An official

inspection is at once made. If the landlord inquires from

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what source the complaint emanated, he is politely informedthat that has nothing to do with the question. Either hishouse is in order, and if so there could be no objection to thefact being confirmed by the official inspector of the town ;or the drainage is not in a proper condition, and of course itwould be only right that he should conform to the generalregulations. Thus it is well known what should be done,who should do it, and how that person may be compelled toact, without the tenants or others being involved in anyunpleasantness. -

OXFORD GRADUATES’ MEDICAL CLUB.

THE second dinner of this Club was held at Limmer’sHotel on Thursday, November 20th, and, as members wereallowed to introduce guests belonging to their own or thesister university, a large assemblage took place, which waspresided over by Sir H. Acland. The objects of the Club arethe maintenance of associations with the University and thepromotion of good-fellowship among the members. In ful-

filment of this many came from the country to attend thismeeting, amongst others Professor Burdon Sanderson, Mr.Pridgin Teale, Dr. Griffin, &c., whilst London was re-

presented by a large number of well-known physiciansand surgeons. The health of the Club, which was proposedfrom the chair, was responded to by Dr. Fincham, thePresident, who paid a warm tribute to the secretaries, Dr.Samuel West and Mr. John H. Morgan, whose exertions hadbeen attended by such satisfactory results, as was shownby the numbers of the Club, which already amounted toupwards of ninety, and for which several fresh candidateshad sought admission since the inaugural dinner in Junelast. He in turn proposed the health of the CambridgeMedical Graduates’ Club, coupling with the toast the nameof Professor Humphry, which was most enthusiasticallyreceived. Dr. Humphry made a very eloquent speech, andalluded to the interests and sympathies which both uni-versities possessed in common, and, touching with muchtact and delicacy upon the various parts which each hadtaken in furthering medical education, pointed out thatwhile differing in their views on this subject each had muchto learn from the other. The health of the chairman was

proposed by Dr. Andrew, and after this had been respondedto the members spent the remainder of a very enjoyableevening in renewing acquaintanceships and in discussing themany medical topics in which Oxford men are now taking soprominent a part.

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AN ANALYSIS OF CASES OF DiPHTHERIA.

AT a recent meeting of the Berlin Medical Society Dr. IHenoch read a paper upon diphtheria, as observed in theCharité Hospital in the years 1882 and 1883, the full text ofwhich is to be published in the next 11 Charit6-Annalen.

"

Exclusive of doubtful cases of angina, so-called scarlatinaldiphtheria, and idiopathic croup, no fewer than 319 cases ofthe disease were observed ; 216 of these were between theages of two and six years. The mortality was very high-V)z., 208,-particularly in the first three years of life, for only17 out of 118 attacked in this period recovered. This highmortality was ascribed partly to the "genius epidemicus,"partly to the insanitary surroundings of the sick, and to thetact that many of them were tuberculous and of the lowestclass. In 145 cases the larynx was implicated, and 129 ofthe&bgr;e succumbed; of the remaining 174 cases, 79 died.

Tracheotomy was performed in 138 cases, with only 16

recoveries-i.e., 11:I per cent. ; but 17 of these deaths weredue to the supervention of scarlet fever. Of 66 cases tracheo-tomised in the first three years of life only 2 survived ;death being almost invariably due to croupous bronchitis orbroncho-pneumonia; but occasionally to erysipelas of thewound and diphtheritic collapse. On an average the greatest

danger to life was from the second to the fourth day afterthe operation. Speaking of the associated conditions andsymptoms, Dr. Henoch said that, scarlatinal cases ex-

cluded, cutaneous eruptions were rare. In three cases

a diffuse urticarial-like erythema was noted over thenates and extensor surfaces of the extremities. Swell-

ing of the submaxillary glands was constantly observed;but except in highly malignant cases it did not passon to suppuration. In no case-except one doubtfulscarlatinal one - was there swelling of joints; nor

endocarditis, which was never found post mortem. Albu-minuria was most common, and if it reached an amount ofabout one-third or more was regarded as of bad prognosticsignificance ; for in such a case it indicated either intense

blood-poisoning or nephritis, which per se was an elementof danger even after the diphtheria had passed away.Dropsy, however, rarely occurred, and nisemic symptomswere never observed. This nephritis, which could hardly beconsidered a true sequel, was frequently associated withcardiac debility, the occurrence of inflammations, and diph-therial paralyses. The use of corrosive sublimate as a gargle,of arsenic and iron, and of papayotin in serious cases, wasadvocated.

___

THE HEREDITY OF LONGEVITY.

IT would be interesting to study more closely, in the caseof centenarians and other aged people, the ages of their nearrelatives and immediate ancestors. It will probably be foundnot rarely that long-lived persons have not been stronger thanthose who have been short-lived. They have their " often-infirmities" like other people. It will also frequently be foundthat their brothers and sisters have been as short-lived, ormore so, than others. At the same time an element of

heredity may not seldom be traced, or may have to be reco-gnised, for we have not yet sufficient data for dogmaticconclusions. We are able to give to-day some few moreparticulars of the ages of the immediate family relativesof Sir Moses Montefiore, which we have reason to believeare correct, though in one particular at variance with a state-ment in a previous number. Thus one parent died at

seventy-nine, one at eighty-three, his grandfather at eighty-seven, his grandmother at ninety-three, a brother at seventy-five, another at sixty-nine, a sister at eighty-four, anotherat seventy-nine, another at eighty-two. These nine agesat death give an average longevity of eighty-one years.The first four-those of the parents and grandparents of SirMoses-give an average of eighty-five years.

THORBURN v. CRAWFORD.

THIS action, which, in our opinion, ought never tohave been brought, was tried last week by Mr. JusticeManisty and a special jury. The plaintiff, Dr. Thorburn,lately a Surgeon-Major in the Army, sued the presentDirector-General of the Medical Department for an allegedlibel contained in a letter written by him in 1882, when hewas Surgeon-General and Principal Medical Officer in

Bengal. The case, as stated by Dr. Thorburn’s counsel, wasthat in 1881 the stewards of the races at Delhi had suspendedDr. Thorburn from " riding, training, and running horses onthe course," in consequence of a charge brought against himof having ordered a pony of his to be "pulled" on purposeto lose the race. On an appeal to the stewards of theCalcutta Turf Club this decision was confirmed. The resultof this appeal was published in the Calcutta papers and thusbecame matter of public notoriety. Dr. Crawford felt it his

duty, in the interests of the discipline, good conduct, andrepute of the department of which he was the responsiblehead, to bring the circumstances to the notice of theCommander-in-Chief in India, who ordered a Court of Inquiry

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to be held. Dr. Thorburn had in the meantime sent in an

application to retire from the service, receiving a gratuity.He subsequently wished to withdraw this, but was refusedpermission by the military authorities. Dr. Thorburn

brought the present action against Dr. Crawford, allegingthat as a result of his letter "he had been injured inhis reputation and had been compelled to retire fromthe service," and claiming .610,000 as damages for the

injury thus done him. Dr. Crawford pleaded "privilege,denying that he wrote maliciously or that in consequence ofhis letter the plaintiff was injured or compelled to retire."Dr. Thorburn’s counsel, Mr. C. Russell, Q.C., stated thecase for the plaintiff, but admitted that Dr. Crawford had" only discharged his duty in sending the letter, and that hewould have failed in his duty if he had not sent it "; and healso admitted that an officer under such circumstances wasnot liable to any action. The learned counsel stated thatthe action was brought by Dr. Thorburn to vindicate hischaracter and to have an opportunity of denying the chargesagainst him. We think this hardly justifies the courseadopted of bringing an action against an officer who clearlyhad only discharged his duty. According even to hiscounsel’s statement, Dr. Thorburn appears to have beenremiss in taking steps to have the charges judicially investi-gated at the proper time. "In this, no doubt, he committeda mistake in not demanding a court-martial," we presumewhen they were first brought against him. On the applica-tion of Mr. Russell a juror was withdrawn, and the casethus dropped without any verdict. It has been from first tolast a most unpleasant affair, and while we cannot helpfeeling sorry for the plaiutiff, we also feel that Dr. Craw.ford has been exposed to an amount of unjustifiable an-noyance and worry for having simply done his duty. Surelysome less objectionable way might have been found toafford the plaintiff an opportunity of making public a denialof the charges which had been brought against him in India.

DR. BALTHAZAR FOSTER AS A CANDIDATEFOR PARLIAMENT.

see with great satisfaction that Dr. Balthazar Fosterof Birmingham is to be a candidate, in the Liberal interest,for Chester. We wish him every success. Of course wehave no politics in the vulgar sense of that word ; but wewish to advance the best interests of the people, and we seeno better way of doing this than by sending some of ourbest men to Parliament, where their large human experienceand enlightened]! professional knowledge will be likelyto tell. We should expect, too, that Dr. Foster, if hewere in Parliament, would mercilessly expose those refinedforms of obstruction to medical legislation which have dis-credited some would-be representatives of the profession, andbrought them into very questionable Parliamentary company.

CRUELTY TO ANIMALS.

IT is satisfactory to find that in these days, thanks to theexistence of a Royal Society for the Prevention of Crueltyto Animals and to the fact of our having sensible andhumane judges on the Bench, animals cannot always beill-treated with impunity. An appeal against a decision ofthe magistrates of Petworth, in Sussex, in a case in whicha man named Gilham was prosecuted by the above Societyfor having contravened the Wild Birds Protection Act of1880 under the following circumstances, was heard in theCourt of Queen’s Bench recently. He had trapped a largenumber of sparrows on March 15th, and sent them in bags,each containing six dozen, to the Swan Hotel, Pulborough,the manager of which bought them for Is. 6d. a dozen, forthe purpose of a starling and sparrow shooting match whichwas held in the grounds on the 17th. The birds were placed

under flower-pots, which were made to serve as traps, andmany of them were in so exhausted a state from being keptso long in the bags that they would not rise, on which theywere either pulled or kicked to death. The magistrates dis-missed the charge on the ground that proof had not beengiven by the prosecution that Gilham had not the licenceor authority of the occupier of the land on which the birdswere netted. This decision was reversed by Mr. JusticeHawkins and Mr. Justice Grove, the former adding: " Thiscase will be sent back to the magistrates to convict, and Ihope when they do convict they will pass an exemplary sen.tence on all who took part in the brutal sport of shooting atthese wretched birds." All trap-shooting is cruel, but inthis particular case cruelty seems to have followed crueltyin a very shocking way. We trust, therefore, that themagistrates, even if themselves supporters of pigeon-shootingfrom traps, may be deterred by no scruples from followingMr. Justice Hawkins’s advice. The same Society was alsosuccessful at Manchester the other day in a charge theybrought against a horse-slaughterer for disposing of a horsefor hard work that had been left at his yard for the purposeof slaughter, contrary to the provision of the Act 13 and 14Vict., sec. 9. We were glad, too, to see that a man describedas a porter has been deservedly sentenced to a month’s hardlabour for what the magistrate described as " most arrantbrutality " to a cat. We take this opportunity of remind.ing those who are responsible for the state of our streetsthat a free, and above all a prompt, use of sand when thewooden paving is slippsry from frost or greasy from slightrain may be the saving of much cruelty to horses.

TESTIMONIAL TO DR. HANDFIELD JONES.

BBE understand that the retirement of Dr. HandfieldJones from the post of senior physician to St. Mary’sHospital, an institution with which he has been connectedfor over thirty years, will be made the occasion for present-ing him with a testimonial by his colleagues, pupils, andfriends. No man has done mc re to advance the cause ofscientific medicine than Dr. Handfield Jones, and we donot doubt that his valuable labours will meet with a fittingrecognition. The subscription to the fund is limited to

one guinea, which should be sent to either of the honorarysecretaries . Malcolm Morris, Esq., 63, Montagu-quare; orA. J. Pepper, Esq., 122, Gower.street, AV. C.

DISINFECTiNG STOVES.

A NUMBER of new contrivances for the disinfection of

infected bedding, clothing, and other articles by heat haverecently appeared, and sanitary authorities seem somewhatin difficulty as to their efficiency. Any stove or other appa-ratus professing effectually to disinfect by heat should becapable of securing a uniform temperature throughout allparts of the disinfecting chamber of not less than 250°

Fahrenheit, and this temperature should be capable of

thoroughly penetrating such articles as bedding/ &c. Inthis country there are not many appliances which can betrusted to produce this result, both uniformity of tempera.ture and power of penetration often failing. Dr. Ransom’s

stove, as manufactured by Messrs. Goddard and Massey ofNottingham, is one which after long experience may betrusted in these respects, and it has the immense advantageover others that, owing to the automatic contrivance whichcontrols the amount of gas which is consumed in producingthe heat, it needs but little supervision, and it ensures thegreatest procurable economy by the fact that no more gas isconsumed than is required to maintain the heat at whichthe regulator is set. Mr. Washington Lyon’s steam dis-infector stands foremost amongst disinfecting chamberswhere steam under pressure is relied on. It, too, has

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certain special advantages. In the first place, its power ofpenetration is much more rapid than in the case of stoves inwhich dry air is used, and hence it has largely come into usein towns where a large amount of disinfection has to becarried out ; it is, in short, certain and quick in its action,and can hardly be excelled. When compared with theRansom stove, it has the drawback that the use of steaminvolves constant skilled attendance ; but, on the other hand,steam can be used in places where gas is not available.These two disinfecting chambers are, in our opinion, by farthe best yet manufactured, and they may be fully trustedto secure the end desired. Amongst the others which havebeen manufactured, we may, however, mention a steamapparatus which has recently been made by Messrs. Benham.We have reason to believe that it also is efficient for all

ordinary purposes, but as yet it has hardly been put to thetest of experience to which the others have been subjected.Failing a really efficient apparatus which responds to theconditions we have laid down, sanitary authorities would dowell to rely on effectual fumigation of articles that can bespread out, and the destruction of others.

PARTIAL INQUESTS.WHETHER from respect for the feelings of common jury-

men or from a want of due appreciation of the duties attach-ing to their official position we know not, but this much iscertain, many of our coroners fail to carry out the pro-visions of the law, which enacts that an inquiry shall beheld as to "when, where, and by what means" So-and-socame by his or her death. We have repeatedly called atten-tion to the unsatisfactory way in which inquests are

too frequently conducted, or rather concluded, and quiterecently our attention has been directed to the same

point. On Monday, Nov. 17th, an inquiry was held at

Waingroves touching the death of Lydia Shawcroft, agedsixty-six. The deceased was seen alive and apparently wellat 8.45 A.M. on Saturday; at 4.30 in the afternoon she wasfound dead on the floor, the body being quite cold. The

jury, " at the suggestion of the coroner," returned a verdictof "Death from natural causes." It does not appear inthe report that a post-mortem examination was made,nor even that medical evidence was taken. We ask the

question, Was all reasonable care taken to show that deathwas not the result of accident or other mode of violence ?Unless the answer can be given in the affirmative, and wefail to see the grounds for it, it is clear the verdict wasnot wholly warranted by the evidence. In a secondcase investigated at Manchester on Nov. 29th, the causeof death of a woman, aged forty-one, was the subjectof inquiry. It appears that the deceased, who sufferedfrom bronchitis, took some "Balsam cough elixir." "

Shortly afterwards she felt sleepy ; this was followed bycoma and death. The coroner advised the jury that inas-much as persons poisoned by morphia or opium-it was notproved that the " elixir " contained either-usually fell intoa stupor some time before death, and that in the presentinstance the fatal issue quickly supervened, it did notseem probable that death was due to opium poisoning.He then left it to their discretion whether an analysisof the elixir should be made, and very naturally theywere content with the matter as it then stood, and forth-with brought in their verdict of "Death from natural

causes, probably bronchitis or heart disease." Now, whetherthe administration of the patent medicine had any part incausing the death-and this was the main point at issue-was left unsolved, and the object of the inquiry remained asproblematical as ever. If there be an instance in which it isimportant to decide the exact share that each of severalpossible factors has taken in bringing about the death of aperson, it is one like that under consideration, for there is

no other mishap from which the public stand in need ofwarning and protection more than that arising from igno-rance of the properties of drugs vaunted as specifics, andsold without the expressed or implied information that

danger is to be apprehended from small doses in diseasedstates, or large ones in healthy. We take exception to theview of the coroner respecting the action of a narcotic in apatient suffering from acute bronchitis.

ASIATIC CHOLERA IN NORTH AMERICA.

AN important conference was held at St. Louis last monthon the threatened extension of Asiatic cholera to the NorthAmerican continent, and on the action necessary to preventor limit a cholera epidemic. Dr. Rauch, Secretary to theIllinois State Board of Health, contributed a paper dealingwith the practical recommendations necessary to secure thedesired end; this was followed by one by Surgeon Smart,U.S.A., on "Quarantine, and the Sanitary Methods formu-lated by the National Board of Health," which went toshow that the principles advocated by that Board very muchresemble those in practice in this country, and that cleanli-ness, medical inspection, and isolation are the essential

remedies ; and then Dr. Chancellor followed by asking " Canepidemic diseases be excluded by sanitary cordons ?" Dr.Chancellor is inclined to some views which we hardlyconcur in, but these in no way interfere with the valueof his conclusions that quarantine cannot be trusted to

prevent the importation of cholera, and that it is on an en-lightened sanitary control of towns and cities, and on suchmeasures as cleanliness &c., that people must in the main rely.Dr. Baker (Michigan) was the reporter of a special committeeappointed by the Conference, and he, with the concurrenceof his fellow-workers, reported that three factors were essen-tial to the prevalence of cholera on the American continent:first, the importation of the disease by means of ships,more or less directly from its only place of origin in India ;second, local insanitary conditions favourable to the recep-tion and development of the disease; and, third, personssick with the disease in some of its stages, or things infectedby such sick persons, to carry it from place to place. Therecommendations as to action, whether by the State, sanitarybodies, or individuals, were based on the acceptance of thesethree factors, and, with the exception of the represen-tatives from Minnesota, who refrained from voting becausethey thought the paper was too important to be dealt withwithout further consideration, the Conference was unanimousin accepting the conclusions formulated.

DENTAL AN/ESTHETICS.

THE two deaths that have lately occurred in dental prac.tice show but too clearly the necessity there is of some definiteopinion on the subject. Nitrous oxide gas has so long heldthe pride of place in dental anaesthesia that in London it isvery seldom any other ansesthetic is ever required, and whenthe request for such is made it is because the patient hashad some experience (generally of chloroform), or it is amatter of economy and convenience in which the operatingdentist acquiesces, if he has not already insisted upon it.The difficulties attending upon the exhibition of nitrousoxide in the provinces are, however, often so prohibitorythat we are constantly startled with the announcement of adeath from some other anaesthetic agent; and this is moreeasily understood when it is known that the simplest gasapparatus requires almost constant use for its efficiency, andthorough practice in its manipulation on the part of theadministrator, if nitrous oxide is to be exhibited deftly.Should there be any operation of sufficient magnitudeabout the mouth, that it cannot be performed under threeor four administrations of nitrous oxide gas, it ought

970

to be treated, as far as the anaesthetic is concerned, withjust as much dignity as any other surgical operation.The latest American dental chairs are least suitable of anyfor such work for many reasons. A high sofa or surgicaloperating table, with the patient duly prepared and placedin a horizonta.1 position, ought to be the preliminaries in ex-perienced hands; the choice of anaesthetic that in which theadministrator has a constant experience. The subsequentadministration of ether to a preliminary exhibition of nitrousoxide gas robs the latter of its good name and best qualities.

UNQUALIFIED ASSISTANTS AND THE

MEDICAL ACT.

UNQUALIFIED assistants and those who employ themshould take warning from a case at Hammersmith the otherday, in which an unqualified assistant was fined in themaximum penalty of JE20, and ordered to pay 23s. costs,recoverable by distress. The complainant was John Tomlin,and the defendant Henry Trist. The complainant allegedthat he was led to think the defendant a properly qualifiedpractitioner by seeing premises with " Surgery" written up, anotice that a medical man attended daily, and finding thedefendant in the consulting-room, who examined him and pre.scribed for him. The complainant was much dissatisfied withthe treatment, and called in Mr. Cooney, under whose care hegot well. It does not appear from the report before us thatthe defendant called himself a medical man or by a medicaltitle, but that he put himself falsely in the position of amedical practitioner. His solicitor tried to get him off onthe theory that he was the assistant of a medical man,Mr. Lintoff, and that it was the practice to employ un-qualified assistants, who, he said, were preferred to thosewho have diplomas ! We commend this defence to the

Licensing Bodies. We regret to notice that the report addsthat Mr. Cooney, on leaving the Court, was assaulted,though the complainant said in his evidence that he hadnot taken the proceedings on the recommendation of Mr.Cooney. The case is only one of many showing that thelaw will not shelter either unqualified assistants or those whoemploy them to act independent’y.

THE PONTIFICAL HOSPITAL.

IN view of the return of cholera to Italy, the Popeis, at his own expense, constructing a hospital on a con-siderable scale. It will stand near the little church ofSanta Marta on the Vatican Hill, almost within the shadowof St. Peter’s. Its drainage will be carried to the Tiber bya great conduit now half completed. Its area, quite isolated,will occupy 69,000 square metres, and it water-supply everytwenty-four hours will amount to 120 cubic metres for

drinking and 1000 cubic metres for other purposes. The

building will comprise seven blocks, with three spaciousgardens besides the courtyards. The hospital itself will standin the centre, and will consist of four storeys in addition tothe ground-floor, the latter containing the residence andbureau of the medical superintendent, the telephone office,the reception room for patients, the lift, the ruota or revolv-ing machine for receiving provisions frjm without, the dis-pensary and pharmacy, the kitchen and refectory, the

gasometer, the baths and the boiler for disinfecting the linenconveyed to it by an iron tube which opens on each floor.To the east of the grounds are the laundry and the apparatusfor the dry-air disinfection of wearing apparel; to the norththe corps de garde. There are, besides, ante-chambers forthe examination of the dead, with electric arrangements foreach bed, a mortuary and pathological room, with a furnacefor the combustion of refuse; there are, further, a steam-generator for the different services, magazines for funeral-cars, fire engines, ice machines, and such like apparatus.

The infirmary proper on the upper floors of the hospital willhave every means of maintaining cleanliness, disinfection,and the isolation (when necessary) of the sick. Ample ac-commodation is also being provided for the confes30rs, thesisters of charity or nurses, the resident physicians andpharmacists; while a separate house or tents will be orga.nised for convalescents. The entire arrangements have beenplanned under the direction of Dr. Ceccarelli, surgeon to hisHoliness, with the assistance of the architect, SignorMannucci, and of the engineer, Signor Gismondi, and, whenin full working order, the hospital with its adjacenttemple will form a nineteenth century reproduction of theold YE selepian system under which the care and cure of bodyand soul were made ancillary to each other.

KING HUMBERT.

KING HUMBERT of Italy is one of the most fortunateof sovereigns. He stands high in the esteem of his people,and deservedly so. The Roman citizens on his entry intothe capital thronged the streets, we are told, regardlessof the wintry weather, and filled the air with the soundof a welcome deeper and more cordial than that of mereState courtesy. They were giving voice to their feelingof respect for one who, being critically placed, knew how torally and lead them and their fellow-subjects in adversity,It cannot be said of them that they only praised the King,but rather that the free and dikinterested devotion shown byhim in his practical sympathy with a sister city has provedto their heart and judgment that a King is at his bestwhen he is most a man among men.

VACCINATION AGAINST YELLOW FEVER.

THE researches which have during the past two yearsbeen made by Dr. Dommgja Freire have now reached a newpoint of departure. This investigator has prepared an

attenuated virus with which he proposes to vaccinate indi-

viduals, with a view to rendering them proof against theoccurrence of yellow fever. The Emperor of Brazil, havingregard to the alleged innocuousness of the prepared virus,has authorised the practice of vaccination. Dr. Freire has

accordingly vaccinated five hundred individuals. Three

captains and all the crews of English vessels have beenvaccinated with a view of escaping the infection fiom yellowfever, which prevails at Rio Janeiro. Thus far none of thevaccinated people have been attacked by the disease, andnone of them suffered the least inconvenience from the

operation. M. Bouley, who gave the facts to the Académiede Medecine, whilst implicitly believing the above-narratedfacts’, does not yet implicitly accept the views of Dr. Freireon the micrococcus xanthogenicus.

HaeMOGLOBINURIA AND SYPHILIS.

THE pathogeny of intermittent or paroxysmal hpemogb-binuria is shrouded in obscurity. The notion that it isrelated to malarial disease is now almost abandoned,at any rate as a universal proposition. Its dependence uponexposure to cold led to the hypothesis that it was due tovascular engorgement of the kidney, and that in that

organ the blood-cells were broken up and the haemoglobinexcreted. Such a theory may be called the vaso-motor

hypothesis, but it cannot be invoked in many cases. Othershave suggested that the corpuscular disintegration was dueto the absorption of bile acids into the blood, or to some lessmanifest changeinthenuid. That the syphilitic poison is some.times afactor, as some allege, is supported in afew casesmainlyby the effects of treatment. In the Berliner Klinisc7a. Wocheat.8chrift for the 10th inst. is recorded a case by Herr Gotze,from Professor Rossbach’s clinic, where a child of nine

years, the subject of inherited syphilis, became liable to the

971

affection on the slightest exposure to cold or even slightchanges in temperature. A resort to iodide of potassium,and to mercurial inunctions, was followed by a freedomfrom liability to the attacks which could but be regarded asa cure; for even immersion in ice-cold water of the ex-

tremities, and once of the whole body, failed to reproducethe baemoglobinuria after this course of treatment. !

IRISH UNIVERSITY REPRESENTATION.

MR. GLADSTONE never speaks of the medic d professionbut with respect and appirantly sincere desire to advanceit9 dignity and its unity. In a recent utterance he expressedhis wish to see it more largely represented in Parliament,though not seeiog how medical men could be admitted intoParliament save through the ordinary methods of popularelection. Dr. Augustus H. Bimpton, in The Times,expresses a hope that the claims of the graduates of theRoyal University of Ireland will not beoverlooked in thenew Bill. We quite shard this hop3. This University hasabsorbed the graduates of the late Queen’s University, alarge proportion of whom are medical graduate!’. A memberfor the new University would be an act of justice at once tothe University and to the profession.

PORRO’S OPERATION AND LAPAROTOMYFOR ILEUS.

La Gazzetta degli Ospitali of November 19th reports thatDr. Vincenzo Le8i performed P,)rro’,3 operation in the civilhospital of Imola on the 23rd ult. The patient was rachitic,and had been in labour many hours. Ten days after theoperation, absence of fever and other favourable conditionsjustified hope in complete recovery. Laparotomy for ileus,with fsecal vomiting of ten days’ duration, was performed atFlorence by Dr. Edgard Kurz on the 2nd inst. The stran-

gulated portion of intestine was readily found and liberated,the operation being completed in half an hour, under thespray and with iodoform dressing. Soon afterwards freeaction of the bowels commenced; the patient took liquidnourishment with appetite, and recovery proceeded rapidly,without febiile or other disturbance.

EXCISION OF TUMOUR FROM THE BRAIN.

ON Tuesday last, at the Hospital for Epilepsy and Para-lyais, Regent’s-park, a tumour was successfully removedfrom the substance of the brain. The case is under the careof Dr. Hughes Bennett, who, having diagnosed an encephalicmorbid growth of limited size, and localised it in the upperpart of the fissure of Rolando, requested a surgeon to trephinethe skull over the suspected region. This was carried out byMr. Rickman Godlee. A mass of glioma the size of a walnutwas extracted from under the grey matter of the upper partof the ascending frontal convolution. Up to the presenttime the patient has progressed favourably in every respect.We shall be glad to learn the future progress of the case.

SUCCESSFUL REMOVAL OF THE LARYNX.

MR. JORDAN LLOYD last Saturday removed the larynxfrom a man, aged fifty-one, who was progressing favourablyon Wednesday, with every prospect of a successful issue.We shall give a report of the operation and sequel in afuture number.

--

THE COMBINATION SCHEME.

WE publish at page 972 the series of regulations relatingto the professional education and examinations in connexionwith the Combined Scheme of the Royal College of Physiciansand the Royal College of Surgeons.

FROM the report on the composition and quality of dailysamples of the water supplied to London during the monthof October, recently issued by Messrs. Crookes, Odling, andTidy, it appears that of the 188 samples subjected to exami-nation 3 were found to be very slightly turbid; the remain-ing 185 being perfectly clear, bright, and well filtered. As

regards degree of freedom from organic matter, the watermore than maintained the character it has now exhibited

continuously for a long time past. Thus, while the meanproportion of organic carbon in the water supplied by theThames Companies during the previous three months was’128 part in 100,000 parts, the mean proportion in that

supplied during the past month was only ’118 part in 100,000parts, corresponding to about two-tenths of a grain of organicmatter per gallon; this excessively low proportion of organicmatter being quite unusual for the period of the year.

FROM the report of the examination made by ColonelSir Francis Bolton of the water supplied by the severalMetropolitan water companies during the month of October,it appears that the Thames water was of practically the samequality as in the previous month, the proportion of organicmatter being again small, as in all the samples collected sinceMarch last. The water drawn from the Lea also exhibitedno material change, the amount of organic matter in it beingless than in the samples of Thames water. All the waterswere clear and bright on delivery.

DR. MURRAY LINDSAY, superintendent physician of theDerbyshire Lunatic Asylum at Mickleover, was on the 25thinst. severely wounded while entering one of the wards of thatinstitution. One of the patients had been lying in waitfor him, and succeeded in inflicting three stabs upon himwith a chisel before being overpowered. Although thewounds are severe, one under the fifth rib, the second in thegroin, and the third on the hip, it is expected thatDr. Lindsay will recover. -

ON Wednesday, the 19th inst., the works for the ameliora-tion of the Roman Campagna were commenced. Twohundredlabourers have pitched their tents in the ravine of the Almo,a tiny ainuent of the Tiber, between the Via Appia Anticaand the Via Appia Nuova, and are employed on the desicca-tion of the soil. At night their encampm ent is picturesquelyilluminated with bonfires of dead leaves and brambles withwhich they seek to disinfect the air.

DRS. FINKLER and PRIOR have replied to Dr. Koch’sstrictures on their recent methods of research on bacilli in

simple cholera by a letter to the Kolnische Zeitung. Forthus appealing to the public in a lay journal rather thanto the profession through the medical press they have beenseverely blamed, especially as the Zeitung had not pre-viously published Dr. Koch’s criticism.

THE members of the medical profession in Paris stronglyoppose the admission of female medical students to the

hospital wards. It is stated that not one French ladystudent has applied for admission, all the candidates beingRussians, Roumanians, and Americans.

DR. T. W. MILLS has been appointed Professor of

Physiology and General Pathology in McGill MedicalCollege, in the room of Professor Osler, who has been electedto the chair of Clinical Medicine in the University of

Pennsylvania. -

THE epidemic of measles at Aberdeen seems to be spread-ing with alarming rapidity among the children in the city.The infant departments of the public schools and most ofthe Sunday schools have been closed.