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Annotations." Ne quid nimie."

THE GENERAL MEDICAL COUNCIL.

APART from the questions connected with the proposednew Teaching University and with the educational schemeto which reference is made in other columns, the presentsession of the General Medical Council has dealt withseveral subjects of general interest. With his accession tothe presidential chair Sir Richard Quain has resigned theoffice of Chairman of the Pharmacopoeia Committee, andhas thus afforded the Committee a convenient opportunityof summarising the results of their labours. It ap-pears that altogether 100,000 copies of the British

Pharmacopoeia have been issued, and 25,125 copies of theAddenda. Owing to its having been found necessary todestroy the larger part of one edition, the financial resultshave not always been wholly satisfactory, even though theultimate result has been a pecuniary success. Sir RichardQuain’s labours on this Committee well deserve the cordialvote of thanks passed so enthusiastically by the members ofthe Council. It was in quite another mood that the adversecriticisms of Mr. Laffan and the communication from theWar Office were received. The first was an appeal to theLord President, "to compel a body which guards its owninterests, and its own interests alone, to do its duty by thepublic and by the profession." The two chief groundsof complaint are the non-recognition of "union hospitals" "and the alleged abandonment of the system of visitation ofexaminations. Naturally enough this letter was not re-ceived in a conciliatory spirit, though ultimately it wasdecided to transmit to the Lord President a copy of the Ireport of the Committee appointed to consider this commu- Inication. The Secretary of State for War called attentionto the manifest deficiency in orthography prevalent amongthe young medical officers of the Army, and the precisemethod of dealing with this deficiency afforded ample foodfor discussion. Whether the communication was a discreditto the War Department or to the Council, whether the defi-ciency applied to the spelling of technical terms or of commonEnglish words, and whether the source of failure was thenatural outcome of the action of the War authorities, or wasto be regarded as an " organic defect not at all associatedwith ignorance"-all these were discussed at length withdue regard to the dignity of the Council ; but in the end itwas decided to adopt measures for ascertaining the pre-liminary examinations in general education which hadbeen passed by candidates subsequently found guilty of

faulty spelling. The General Medical Council found someconsolation for these amenities by criticising the "confusedanswers" received from the various bodies who had repliedto the request for information in regard to the speciallaboratory work required of candidates for their sanitarydiplomas. The recommendations passed by the Council,speaking generally, certainly indicate the desire to renderboth instruction and examinations as thoroughly practicalas possible.

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THE ARMY MEDICAL SERVICE.

WE publish at p. 1283 a letter which has been addressedto Sir Andrew Clark by the War Minister, with refer-ence to the interview (in connexion with the grievancesof the Army Medical officers) which was held some fewweeks ago. This letter shows that the movement has metwith success as respects all material grievances, and wetrust that the concessions which the War Office has madewill be accepted by the department. It will be seen that

Mr. Stanhope has given directions for the preparation of anew Royal Warrant for the Medical Service; and he de-serves thanks for the resolution he has displayed in over-coming the prejudices and opposition of the combatant ranksof the army. We fail to notice any allusion to the subjectof foreign service, but we have reason to believe, from whathas been stated by Sir Andrew Clark, that the remedy hasbeen promised, and will follow in due course.

UNIFORM HOSPITAL ACCOUNTS.

WE publish in another page a letter from the HospitalCommissioner of THE LANCET, who on Monday last gaveevidence before the Committee of the House of Lords uponthe subject of hospital accounts. A part of that evidencewas directed, as will be seen from the full report which alsoappears in this impression, to the criticism of the state-ments annually published by the hospitals from a particularpoint of view-namely, that of the subscriber or of a memberof the general public interested in the question of hospitalfinance, and the witness was careful to point out thatthe effective exclusion of legacies from the accounts, whichhe chiefly criticised, was the natural result of the way inwhich the accounts were quite properly prepared for sub-mission to the Council of the Hospital Sunday Fund. The

explanation has not, however, obtained equal publicitywith the criticism, and, as an incorrect and probablyinjurious impression is liable to be occasioned by an im-perfect notice of the evidence which is going round thepress, our Commissioner seeks an opportunity in our columnsof applying the necessary correction and clearly statingthe position which he has taken up, and to which THELANCET also adheres-namely, this, that the accounts pub-lished annually by the hospitals of London for the informa-tion of the public should exhibit in a simple and easilyintelligible form the whole income received, from what-ever sources, within the year, and that book-keepingdevices, which may be proper enough in the prepara-tion of those statements for particular purposes-as,for example, for submission to the Council of the

Hospital Sunday Fund, by which authority they are

destined to be analysed in a particular way-should notbe allowed to cloud the perspicuity of a statement in-tended for ordinary readers. We believe that it is bytaking the public fully and frankly into their connienceboth as to their needs and their resources, that themedical charities will best secure, and in the long runmost effectively retain, public confidence.

ENTERIC FEVER IN INDIA.

IN the beginning of 1889 the Government of India

appointed a Committee to inquire into the alleged increaseof enteric fever in the army in India. The report was notvery satisfactory in that it left matters connected with theetiology and pathology of that disease very much wherethey were. Still, the Committee indicated that anew lightmight be thrown upon the subject by the application ofbacteriological research. We are glad to learn, on theauthority of the sanitary commissioner with the Govern-ment of India, that an important advance has been madein the investigation of the pathology of the enteric feverin this direction. At the date of the Committee’s reporbthe evidence of the existence of the so-called typhoidbacillus-the Eberth-Gaffky bacillus-was of a negativecharacter-so far, at any rate, as an examination of

specimens of tissues from some cases of enteric fever atLucknow were concerned. But Professor Bernhard Fischerof Kiel, to whom specimens of spleen and mesenteric

glands from two fatal cases of enteric fever in India havesince been forwarded, reports that he has discovered the

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bacillus of Eberth in them, thus establishing the identity occupied the energy of its members. Under its auspicesbetween some of the fatal fevers of India and the enteric substantial encouragement has been given to Healthyfever of Europe. Thus far a step in the right direction Homes Societies in adjacent districts. The value of thesehas no doubt been taken, and it only requires the further as means of promoting wholesome conditions among theprosecution of the inquiry by a more extended system of homes of the poor cannot be denied. The distribution ofbacteriological examination to show whether all the cases tracts on sanitation is another means towards the sameof fever attended with the symptoms and intestinal lesions end. This is a somewhat difficult matter to handle withof typhoid fever are, in reality, of one and the same nature. discretion. It appears to have been so used, however, as aPathologists and practitioners in India seem to be generally rule, by the Association. Health lectures have served theagreed that enteric fever has probably prevailed in our army same purpose in another way, the subjects treated of beingfrom the time we held that country to the present day; that chiefly such as lie within the sphere of personal andit is the disease of which the young and newly arrived domestic hygiene. The Ladies’ Branch does useful worksoldier dies there; that the symptoms during life and the by providing for house-to-house visitation, with a view toanatomical lesions found after death are very much the the detection and removal of unwholesome conditions, andsame as those which characterise it everywhere; and that its report, like that of the parent Society, wili at oncethere is abundant evidence to show that typhoid fever instruct and interest all readers who take pleasure in

is very frequently attributable to the same causes in undertakings which tend to promote a high standard ofIndia as in England and elsewhere. The only question public health. -

that arises is as to its etiology; whether this lies naturallyand exclusively along the lines of specific infection, so that THERAPEUTICS OF DIPHTHERIA.where an antecedent case cannot be found it may neverthe- -, , of Professor are soless be hypothetically assumed to 0 eX1S . "t T! /<’ writings

THE researches of Professor Loflier on diphtheria are soless be hypothetically assumed to exist, irndds writings well , , further ,. are, , " well known that any further communications from him arehad prepared the way for the acceptance of the bacillus of sure d any further areEberth as a connecting 1- i between and sure to command attention. To the Deutsche MedicinischeEberth as a connecting link between one case and another. March contributes

The problem that has to be settled is whether the scope of Wochenschrift for March 5th, 1891, he contributes a paper., on the therapeutics of dlphthena. lie commences bythe investigation into all outbreaks requires to be widened asserting that the bacilli first described by him are thornot, cases asserting that the bacilli first described by him are theor not, in order to include all cases in tropical countries, forexample. Eberth’s bacillus affords a definite scientific basis cause of the disease. To destroy the poisonous action of

to work upon. Its discovery in all the cases of so-called these germs two things are necessary: first, to guard againstthe inroad of the bacilli into the healthy mucous membrane;typhoid fever abroad would not only serve to distinguish the inroad of the bacilli into the healthy mucous membrane,their nature and stamp their identity, but might afford a secondly, to destroy the bacilli if they have already attackedclue to the cause of the prevalence and spread of this fever the auperficial layers of the mucous membrane of the

in India, and relegate the effects of climate, for example, larynx and parts generally invaded, to prevent an extensionto an entirely secondary and subordinate position. If of the process to unaffected parts, and to destroy the in-typhoid fever be found to be invariably accompanied fective material before it affects healthy individuals.

and caused by a bacillus, the next step in the inquiry Prof. Loffier has made most exhaustive researches as regards

will be into the genesis, development, reproduction, the effects on the bacilli of various drugs. These are toowill be into the genesis, . , ,

and morphological variations of these bacilli under the numerous to enumerate here, although the results of theand variations these bacilli under the , ,.., , . ,

various conditions of European and tropical countries. This action of these agents are given in detail in his paper.various conditions of European and tropical countries. Ihis -

would have followed by investigations to ascertain During an epidemic of diphtheria, or at any time whenwould have to be followed by investigations to ascertain -11.how and through what channels they enter the human body, healthy persons are necessarily brought into contact

and the circumstances essential to their further development with patients suffering from the disease, lie recommends

and to the display of their pathogenetic properties. The that as a prophylactic measure a gargle should be usedand to the of their properties. The

1 ’

. if&deg;i.-jj -T, a solation thegreat and increasing prevalence of typhoid fever in India,

of a solution of corrosive sublimate of the strength of

and the large amount of sickness and mortality it annually 1 in 10,000 or 1 in 15,000. . This should be employed for fiveand the large amount of sickness and mortalitycauses among our troops, call for serious consideration.

or ten seconds every three or four hours. This gargle, how-Almost every other week, says the Pioneer, we hear of ever, has a disagreeable metallic taste, and a solution ofsome young officer-for it is from the new arrivals the cyanide of mercury of a strength of from 1 in 8000 to 1 insome young from the new arrivals thedisease selects most of its victims&mdash;struck down, often mor- 10,000 is equally effective, and less nauseous. Other solutions parts oftally. Every step which brings us nearer an accurate which he recommends are chloroform chlorine be 1100 parts ofknowledge of the disease brings us nearer also to a dis-

water, to which a little chloroform may be added, and a

covery of its cause and prevention, and we can only join solution of thymol, 1 part being dissolved in 500 parts ofwith our contemporary in echoing the hope that the 20 per cent. alcohol. As preventive measures also such

with our contemporary will hope that the remedies as oil of eucalyptus, oil of citron, oil of lavender,

beginning now made will be earnestly and patiently benzol, and toluol, given in the form of vapour, are

followed up. successful. Passing to the active treatment of the disease,

THE MANCHESTER AND SAL.FORD he recommends that the patient should gargle every hourTHE MANCHESTER AND SALFORD SANITARY or two with one of the weak solutions already mentioned,ASSOCIATION. and he should, in addition, use gargles containing drugs

IN a fall but concise report, the Manchester and Salford which have been shown to destroy artificial cultures of theSanitary Association have described the methods and bacilli. Of all the numerous agents which he has tried,developments of their work along with an account of their Prof. L&ouml;ffler recommends the following as being the most effi-proceedings during the year 1890. It is hardly-possible for cacious : Corrosive sublimate 1 in 1000, 3 per cent. of carbolicus to do more than briefly touch on the varieties of useful- acid dissolved in 30 per cent. of alcohol and also alcoholness with which the Association has been occupied during and oil of turpentine, to each of which is added 2 perthis period. In response to its representations efforts towards cent. carbolic acid. After a short time the throat may bethe improvement of artisans’ dwellings have been assisted painted every three or four hours with 5 per cent. carbolicby codification of the Acts relating to this subject. Inspec- acid, 2 per cent. bromine solution, or 1 per cent. chlorinetion of milk-supply, control of noxious vapours emitted by water. Concentrated watery solutions of creasote may bemanufactories, and the provision of recreation spaces are employed. Professor Lomer concludes by expressing thematters of almost equal importance which have likewiqe opinion that if his suggestions are fully carried out the

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mortality in diphtheria will be greatly diminished, for thebacilli only develop locally, and are not carried by theblood to other parts of the body ; consequently, if they aredestroyed at an early stage in the disease, only a smallamount of poison will have entered the body, and this it mayreasonably be hoped the organism will succeed in throwingoff. The importanb researches made in this direction by,Behring and Kitasato may help to throw light on thedifficult question whether the human body is capable ofdestroying poisons formed in the circulation by the develop.ment of bacteria.

HOSPITAL FUNCTIONS AND THE GUILDFORDPOOR.

THERE is a sharp division of opinion among the governorsof the Royal Surrey County Hospital as to the propriety ofcontinuing medical attendance to home patients in Guild-ford. A special committee has been appointed for the pur-pose, of which seven members voted for and six against thecontinuance of the system. The minority of six admitted thatin Guildford, as in other places, there may be a section ofthe people, not paupers, that require medical consideration,not to say charity. They proposed to meet this want bysomething of the nature of a provident dispensary. It is

undoubtedly wise in hospital authorities to restrict hospitalrelief as much as possible to in-patients who are at onceseriously ill and incapable of commanding suitable adviceand nursing at home. A hospital goes out of its way whenmembers of its medical staff go beyond its own walls toattend the sick. The argument of those who defend acontinuance of the present system is that it is a cheapercourse than the creation of a provident dispensary. Butthis is not a strong argument. The cheapest charity isnot necessarily the best; presumably it is the worst. For

ordinary complaints and diseases patients should not lookto hospitals, but to their own providence. Those whowish to help them should do so through their clubs or

provident dispensaries, which call for the exercise of thriftand forethought. -

MICROSCOPICAL RESEARCHES ON CARCINOMA.

IN a monograph upon some investigations of the intimatestructure of carcinoma (abstract in the Centralbl. f. Bakteriol.,ix., 21), J. Schtitz says that he found three different kinds ofmicro-organism in specimens from three cases of cancer ofthe lip-viz., a slender, rod-shaped organism resembling thetubercle bacillus, large cocci in groups, and spore-containingbacilli with pointed extremities. But he considers that

these, as well as the forms described by Scheurlen and others,have no special etiological relationship with the morbidchanges. He studied, further, the minuter histology of

cancer, and notes some interesting differences betweennormal epithelial cells and those of carcinoma. The latterin the recent state exhibit an exceptionally large proportionof "mitoses"&mdash;a fact he thinks to be associated with the

malignancy of a tumour. Next he declares that among thenuclei undergoing karyokinetic changes there are to befound in cancer cells some of exceptionally large size,such as are not to be. seen in normal tissues; andthis again, he thinks, implies some special degree ofvirulence. Again the "mitoses" are not of uniform size, asin physiological conditions, but present the greatest varietyin this respect in one and the same tumour. A furtherpoint is the peripheral disposition of the "mitoses" amongthe columns of cancer cells; and the frequency withwhich " wandering " corpuscles with divided nuclei are tobe detected within the cancer cells. Lastly, in all cases ofcarcinoma there is great vascularity and abundant forma-tion of round cells. To recognise these peculiarities, whichare deemed to be diagnostic of carcinoma, Schiitz advises

that the living tissue should be "fixed" in the fresh state byFlemmings’s process, and stained with carbolic fuchsin andmethyl blue. -

MALFORMATION OF THE HEART.A REMARKABLE CASE of congenital malformation of the,

heart has been recorded by C. Cipriani (abstr. in Centralbl.f&uuml;r Path. Anat., ii., 10). The subject, a male, lived to the,age of twenty, having been markedly cyanosed all his life.There was transposition of the lungs, and the heart lay on,the right side. This organ consisted of only two chambers-a lower conical one with a rudimentary septum at the apex,whence proceeded the pulmonary artery (with stenosed

orifice) and the aorta. The upper chamber was somewhatnarrowed where it was connected with the lower one, and atthis spot was a rudiment of a valve. Neither this valvenor those of the pulmonary artery and aorta were com-petent. The liver occupied both hypochondriac regions, andits left lobe was much more developed than the right. The

spleen was hypertrophied, and had a horizontal furrowacross its middle portion, whilst in the vicinity were threeother spleens, each the size of a fowl’s egg. The stomachwas very small and atrophied. The duration of life underthese circumstances is not the least singular feature of thecase.

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"THE LANCET" RELIEF FUND.SIR RICHARD QUAIN, the newly elected President of the

General Medical Council, has, with the sanction of theCouncil, accepted the office of an almoner of THE LANCETRelief Fund.

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THE NEED FOR AN ISOLATION HOSPITAL.

THE Sevenoaks Rural Sanitary Authority have taken a stepwhich they may before long have occasion to regret. Althougha site for an isolation hospital was actually offered to themas a gift, they have, by a majority of twenty-three tofourteen, practically decided to refuse it, and so to put offmaking arrangements for the isolation of infectious diseases.They have adopted this step in the face of sound advice to thecontrary emanating from those who understand the subject,and who have experience as to the conditions which arenecessary to success, and they appear to have been actuatedby the opposite sort of advice to adopt an alternative

step which is devoid of all promise of beneficial result.Thus a reverend gentleman brought before them a scheme-which he naively said he had not been able to elaborate-for the provision of a number of houses, each contain-

ing six beds, in different parts of the district. Somesuch scheme was originally suggested by the LocalGovernment Board themselves as an alternative to a

properly constructed hospital in somewhat scatteredrural districts; but it could never be acted on, and

although some four hundred authorities have provided them-selves with means of isolation, in no single instance has ascheme of this sort been matured or carried into effect. Butthere is a much greater objection to it. Legal proceedingsare at times taken against sanitary authorities for theerection of infectious hospitals, and hitherto the strongground held by the authorities has been that they havecomplied with conditions as to a surrounding zone andotherwise which the Local Government Board have shown

amply to suffice to prevent the diffusion of the infection ofthe current infectious fevers to the locality aroundthe hospital. If the Sevenoaks Rural Authority want tokeep free from legal proceedings, they will have to complywith these conditions also; and, above all, each of their in-fectious " houses " will have to be surrounded with an un-occupied zone nowhere less than 40 ft. wide, and each sitemust be properly enclosed. This runs into money, and most

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authorities who have viewed the matter sensibly have cometo the reasonable conclusion that one hospital, on one site,with one boundary fence, and one set of offices, is cheaper inthe end than multiple appliances, which are rarely complete,and which have constantly to be added to. Unfortunately,none of the alternative plans suggested are likely to becarried out, otherwise they might have served the purposeof proving by experience what are some of the conditionscalculated to ensure failure, financially and otherwise. The

only effect of the conclusion come to probably is that someextension of disease will now have to be awaited beforematters again reach the stage at which they broke downlast week.

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SERIOUS CHARGE AGAINST A MEDICAL MAN.

THE magistrates of the Houghton-le-Spring Police-courthad a few days ago the painful duty of investigating a casein which a practitioner, a medical graduate of Durham,was charged by Elizabeth Richardson with seducing herwhile she was partly under chloroform, and with takingliberties on other occasions. It was also alleged that hehad given medicine containing ergot. Dr. Coley, called tospeak to this point, said it was extremely problematicalwhether ergot would procure abortion.. It is alwaysvery difficult to refute such charges, and it is at least

suspicious that the girl never complained to anyone of thedefendant’s conduct, and that after his first alleged mis-conduct she again went to his surgery. It is ex-

ceedingly unlikely that a medical man of standing wouldbe guilty of the conduct attributed here to the defendant.The magistrates, however, were satisfied with the evidence,and made an order for 5s. a week.

THE PREPARATION OF MUSEUM SPECIMENS.

DR. RICHARD THOMA of Dorpat describes (Centralbl. fiirAllg. Path. 2cnd Path. Anat., ii, 10) a method he hasdevised for retaining the natural colour of organs inmuseum preparations. After slight washing in water theyare placed for some hours in strong saline solutions, ofwhich he gives two formul&aelig;:&mdash;

A R

The organ is suspended for eighteen to twenty-four hoursin one of these solutions, and then placed in pure spirit,which requires changing once or twice. It is better toimmerse only portions of the larger organs, such as theliver or spleen. The preparations retain their appearancefor month?, the only notable change being the conversion ofthe red colour of haemoglobin into the browner tint of

metbaemoglobin. Nor is their structure so affected as tobe unfit for subsequent microscopical examination.

THE EDUCATION OF GIRLS.

IN an address delivered recently before the Medical

Society of the State of New York, Dr. William WarrenPotter touched upon an educational problem of increasinginterest, the training of girls between ten and fourteen yearsof age. The reason why this period has been selected is ofcourse obvious, and we would be the last to dispute Dr.Potter’s assertion that the appearance of the catamenia

ought in every case to engage the solicitude of a watchfulparent, and even that they may justify temporary changesin the school arrangements. At the same time we cannot

quite agree with all his recommendations in this connexion.When, for example, we are told that the young girl during her

first periods must not attend school at all, and that sub.sequent molimina should be marked by a day or two ofhygienic holiday, we are tempted to inquire how it comesabouli that so many healthy matrons of to-day survive inspite of schooling persistently carried out in utter disregardof the catamenial interruption. Surely there is a dangerthat so much care may result in careful error. Perhapsour mothers and grandmothers were too heedless tobe warned, or perhaps too healthy to need warningas regards this matter. Doubtless, too, the work ofeducation was carried on differently. At all events,the reasonable exercise of mind and body was found

compatible with the changes of puberty. Is it not

possible that the fault in our days lies rather in the systempursued in education than in its association with these

changes ? t We confess to some sympathy with this latterview. We note also that Dr. Potter has no great respectfor the school customs of our time. The sketch of astudious day which he introduces is not purely imaginary.Its leading characteristic is, of course, work ; but againstthis there is almost no play. We can hardly feel surprisedthat a system which is capable of such illustration is con.demned as inconsistent with the healthy employment of

.

nerve energy in other important functions. Its only prac.tical issue is overwork, and this at the menstrual periods

doubtless often does result in physical disablement. Some

rearrangement more compatible with natural processes isclearly needful, even though this may imply a longercurriculum of study or even a less finished social woman-hood. In this, rather than in periodic cessations of schoolwork, we would look for the remedy for present abuses.We cannot now deal with various matters of diet, dress,and the like discussed in this carefully studied paper, whichcomes as a timely and sensible protest against excessesdestructive of success alike in mental and physical develop-ment.

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THE ROYAL COLLEGE OF SURGEONS OFENGLAND.

THE two retiring members of the Council of the RoyalCollegeof Surgeons, Sir William MacCormac and Mr. Sibley,are eligible for re-election, and will again become candidatesfor seats on the Council. We learn that Mr. Sydney Joneshas decided not to seek re-election. The names of othercandidates have not yet been forwarded to the secretary of

the College. -

THE HEREDITY OF CRIME

IT is a truth asserted both in Scripture and in sciencethat the sins of the fathers are visited upon their children.Of late years, moreover, another doctrine has been heard

maintaining that in like manner the erring tendencies ofparents naturally find expression in the habits of their off-

spring. We will not deny that this, too, is a deductionfounded on faithful observation. More than this, however,we cannot say. We cannot allow that it possesses anyclaim to belief on account of its necessary accuracy. Onthe contrary, it is obvious that an assertion so broadlypositive is at all times open to fallacious interpretation. Aspropounded by some in our own day, notably by certainforeign ethnologists, it insists upon the recognition of areversionary type, a criminal race possessed of specialaffinities for ill-doing, and it thus almost ignores in themthe preservative power of conscience and of will. Asfor Deity and Religion, they are considered as virtuallymere terms current in a former unphilosophic era, butobsolete in this, and unworthy of serious treatment in con.nexion with the matter. This is indeed a dismal record onthe page of Nature’s evidences. In contrast with its

despairing uncharitableness, we turn with a sense of relief

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to the truer and bolder portrait of human character at itslowest level, which is presented in a paper by Dr. T. M.Dolan on "The Heredity of Crime." While admittingthe possible transmission in some degree of a morbid nature,the author justly attaches a great and real influence to

circumstance and to certain curative forces inherent incivilisation and in man himself. Chief among these latter arefree will, religion, and education. He shows how it is in

the power of the will to modify the conditions of the strugglefor existence and towage this battle successfully, but withoutselfishness or baseness. In it, when instructed by a religionof charity, patience, and continence, and by education con-ducted under happy and rational influences, he finds thetrue corrective of moral degeneracy. Whatever the allure-ments of an opposite and more fanciful philosophy, we mustall admit the practical soundness of this view. The con-nexion between badness and madness is sometimes clear

enough, but we agree with Dr. Dolan that it is not so clearby any means that the latter can, for a given class of

persons, excuse the former.

THE CROONIAN LECTURES. IDR. BURDON SANDERSON is recovering from an attack of

influenza. At the recommendation of Dr. Buzzard, whohas attended him with Dr. Andrews of Hampstead, thePresident of the College of Physicians has sanctioned thepostponement for the present of the Croonian Lectures.The lectures will be delivered as soon as possible, and duenotice will be given of the date fixed.

OXFORD GRADUATES’ MEDICAL CLUB.

THIS club, which was established in 1884, has just held itsannual summer dinner at Limmer’s Hotel, which was attendedby upwards of fifty members and guests. The meeting wasof more than ordinary interest, since it was presided over bythe new president, Dr. John W. Ogle, who was unanimouslyelected to succeed the late Dr. Fincham, who had beenpresident since the foundation of the club. The speecheswere, as usual, few and brief, but Dr. Ogle made a gracefultribute to the memory of the late president, and to that of Dr.Monro and Dr. Gulliver, who had also been removed by deathin the past twelvemonth. The financial condition of theclub was shown to be very satisfactory by the statement ofthe treasurer, Dr. Church; the numbers had increasedfrom 40, at which it started, to 140, which was thenumber at present on the list. It still maintained its

original purpose of being in no way political or polemical,’6ut fulfilled its intention of being a social gathering ofOxford men with a medical degree. He proposed the healthof Mr. John H. Morgan, who was resigning the post ofsecretary, and this was seconded by Dr. Champneys in afew kind and cordial words. Mr. Morgan, in reply, thankedthe members for their generous expression of approval ofwhat he had had great pleasure in doing for the promotionand success of the club, and congratulated his successor inhaving for a colleague Dr. S. West, who had by his laboursdone so much to bring about the satisfactory condition inwhich the club now found itself.

MEDICAL AID FOR INDIAN WOMEN.

WE need not now do more than briefly direct attentionto that generous and highly useful effort originated by HerMajesty the Queen, but shaped and guided by the efficienthands of Lady Dufferin,-the work of affording medical aidthrough members of their own sex to the women of India.The movement, whic h has its headquarters at Calcutta,is, it must be remembered, an essentially Indian pro-ject. Its purpose, ot educating ladies, Indian as well aBritish, as medical practitioners, and despatching them

to the land of their future labours, has hitherto beencarried out with a gratifying measure of success. The

good fruit which has resulted from their exertions

may be judged from the facts related by Lord Reay-namely, that about 411,000 persons have been relieved

through their agency during 1890, that thirty-eight hos-pitals are connected with their Association, that some

forty lady practitioners of different degrees of qualificationare employed in the same service, and that 204 femalestudents, their intending followers, are engaged in studyat the Indian medical schools. Anyone acquainted withthe conditions of female life among the higher castes inIndia will at once understand the necessity for medical aidof the kind provided by this scheme. However we mayregret the fact, Oriental custom still adheres to the policyof exclusion which refuses all aid, even in sickness, from oneof the opposite sex. We would therefore heartily commendthis undertaking, so far successfully conducted by LadyDufferin and her helpers, to the still wider circle of those whorepresent public sympathy and liberality.

DEATH OF DR. FORDYCE BARKER.

WE regret to have to announce the death, from apoplexy,on May 2nd, of Dr. Fordyce Barker, of New York. Dr.Barker was born in 1819, and in 1856 occupied the pre-sidential chair of the New York Academy of Medicine.

BACTERIA IN URINE.

IN a recent number of the New York Medical RecordDr. Santvoord discourses on the presence of bacteria in theurine of patients who have never had an instrument passed.Sir William Roberts discussed the subject at considerablelength as long as ten years ago, but the mode in which theorganisms reached the bladder was not determined. Atten.tion was, however, called to the fact that, in women atleast, the condition may exist without giving rise to sym.ptoms, and that it is very amenable in its slighter forms totreatment by salicylate of soda. Dr. Santvoord recordsseveral cases which he has observed, some yielding easilyand readily to treatment, others resisting it, and from hisexperience he is led to suggest that a minor degree ofcystitis is more common than is generally supposed, espe-cially in female, but, as to its origin, all that is asserted isthat it is not in many of those cases the result of catheteri-sation.

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THE BIRTHDAY HONOURS.

WE heartily congratulate those members of the medicalprofession in the different public services upon whom honourshave been conferred on the occasion of the celebration ofHer Majesty’s birthday. We wish that in this distributionmedical officers had received a larger share of honours, forthe selection of only three officers out of the large numbercomposing those services certainly cannot be regarded aalavish, but might on the contrary be more appropriately styledvery meagre. We should like to have seen some recogni-tion of the heroism of Surgeon Parke, and fully endorse theremarks of our correspondent in his letter, which we publishon p. 1286. The Director-General of the Army MedicalDepartment-William Alexander Mackinnon-is made aKnight Commander of the Order of the Bath, and whilewe take the opportunity of congratulating him on his con-valescence from a sharp attack of influenza, we are glad thata titular distinction is the pleasant accompaniment of hisrecovery. Sir William Mackinnon has distinguished warservices, has long been a C. B , and has been awarded a good

, service pension. He served in the Crimea, was present at. the battles of Alma and Balaclava, in the expedition toI Kertch and Yenikale, the siege and fall of Sebastopol,

including the assaults on the Redan on June 18th and

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Sept. 8th, 1855. Sir William Mackinnon also served inthe Indian Mutiny and the New Zealand and Ashanti wars.Brigade-Surgeon Robert Waters, M.D., is made a Com-panion of the Order of the Bath. He served in Ashantiand in the Soudan-Nile expedition of 1884-5, and enjoyeda high reputation in the British Medical Service, from whichhe has retired. Surgeon-Major James Sutherland Wilkins,of the Indian Medical Service, has been appointed to theDistinguished Service’Order. He served in the AfghanWar of 1880 and the Burmese Expedition of 1886-7.

INSANITY IN TWINS.

INSANITY occurring in twin children is not a commoncondition. Dr. Worcester records an instance of it in theAmerican Journal of Insanity, and the account is the moreinteresting from the fact that both patients suffered fromphthisis. One brother had occasional attacks of excitementand destructiveness, which came on about the age of twenty-five. He had always been weak-minded. He died from

phthisis in 1883. The other brother developed symptomsof phthisis at the same time, but it ran a more rapid course,and terminated fatally in 1881. He had previously beenfeeble-minded, but good-natured and harmless, and had notsuffered from the violent fits to which his brother was

subject.

NEURITIS OR BERI-BERI (?).

IT is admitted that a disease which closely resemblesberi-beri is frequently present among sailors and fishermenin northern latitudes, but as yet its etiology remainsobscure. Dr. Petters records five cases which he has seen

among sailors who had been trading in different parts of theworld, and who all presented similar symptoms. The con-dition usually begins with pain or numbness in the legs,swelling in those limbs, with weakness, drop-foot, andabsence of knee-jerks. There is also usually present someweakness in the arms. All the cases reported here recovered,except one, which died suddenly. No account of the

microscopical appearances of the nerves is furnished, butthere seems to be little doubt that the condition underlyingthe symptoms is one of multiple neuritis; but the origin ofthis condition is still obscure. Diet in all probability hassomething to do with it, although in the cases to whichreference has been made the food was both good and

plentiful.

THE RECENT FATAL FIRE AND ITS WARNINGS.

WHATEVER its lessons respecting the necessity of culti-vating that inestimable faculty, presence of mind, and what-ever the satisfaction that assistance was so timely and soably rendered, the recent sad occurrence at Egerton-gardens conveys yet one other obvious injunction to thosewho will receive it. The fatal fire in which Lord Romillyperished was the result of an accident, and unfortunatelyof one which might easily have been prevented. This is

very far from being the first occasion on which the explosionof a lamp or the ignition of its contents has proved the sourceof a much wider conflagration. Accidents of this kind havebeen attributable usually to some defect in structure of thelamp, or to careless management in filling or extinguishing.The most fruitful cause of explosion, it should be remem-bered, is the accumulation in the oil chamber of inflammablefumes, mixed with air. This happens, of course, in pro.portion as during use the oil-supply becomes exhausted.Happen it must, therefore, in some degree; but in order toprovide against its possible effects, great care should be takenthat the reservoir is quite filled on each occasion of use. Thenecessity of accurate adjustment between the wick and itsholder, too, should not be overlooked. The method of ex-

tingn ishing the flame, where this is not provided for by a special

apparatus, deserves a word in passing. It may be easily andsafely accomplished by the simple device of screwing downthe wick to a point just below the upper level of its holder,and then directing the breath across the top, but not downthe chimney. One circumstance in particular in connexionwith the case above cited deserves comment. This is theabsence of any automatic extinguishing apparatus. Differentsimple contrivances designed for this purpose are now incommon use. An important point is the composition ofthe oil chamber. No one will deny the beauty of somechina reservoirs, but this unfortunately implies an increasedrisk-that of breakage. No reservoir can be regarded assafe unless composed of metal, though china or glass mayform the outer shell of one so constructed. As regardsprecautions to be taken in view of the actual occurrence offire, we need say but little. The action of Lord Romilly’sbutler in closing the door of the burning room showed com-mendable foresight, and the same is true of a correspondent’sproposal that heavy wraps, and if possible a supply ofwater, be conveniently placed wherever in a household thereis a possibility of accidental fire.

INFLUENZA.

WE are informed that there have been some cases ofinfluenza among the Royal servants at Balmoral andalso at Windsor. We are glad to be able to add authorita.tively that they are all of a comparatively mild nature.Amongst the sufferers from the prevailing epidemic maybe mentioned Sir Prescott Hewett and Sir J. RisdonBennett. It is stated that no fewer than eight medicalmen in Birmingham have died from the effects ofthe recent disease, the latest victim being Mr. Albert W.Gray of Edgbaston. We learn that during the pastfew weeks influenza has been extremely prevalent in

Hampshire and some of the other southern counties, whilstit seems slowly on the decline in the metropolis. Neverthe-

less, the death-rate in London for the week endingMay 30th was 28’9 per 1000, or an average for the fourweeks immediately preceding of 27’4, which is 8’4 per1000 above the mean rate in the corresponding periodsof the ten years 1881-90. The deaths primarily attributedto influenza amounted last week to 310, and in 64 othercases influenza was certified to have occurred in the courseof other diseases. The deaths from respiratory diseaseswere 591-more than double the corrected average,-353being due to bronchitis and 189 to pneumonia.

HALF-TIME CHILD LABOUR.

THE arguments by which the Home Secretary, in intro-ducing his Factory Bill, advocated the half-time system ineducation have not been allowed to pass unnoticed. The

right hon. gentleman has maintained in this discussion

very much the attitude of a special pleader. Whether the

question for the moment turns on health, on technicalskill, or on ordinary school training, he is alike at one withhimself as regards the conviction with which he enteredthe arena. Under any circumstances the child in school isat a disadvantage compared with his fellow whose industryfollows the divided course of learning and of productive work.We confess that we cannot see good cause for approvingthis confident position. It is only reasonable to supposethat a child under twelve years of age whose whole dayis devoted to school work possesses a distinct advantage inregard to prospective examinations as compared withanother who for half of this time follows a calling. Statisticson the subject, moreover, as explained by Sir W. HartDyke, prove that this is the case. There is something inMr. Matthews’ contention that the half-time scholar isreally undergoing a form of technical education. Of somecases no doubt this may be truly said. Of many more it can-

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not. Often the released pupil does not, at this stage even, enteron the real business of after life, but is merely on an insigni-ficant scale a means of profit by odd jobbing to his parents.It is dubious if, with time and work so divided and hurried,as it must be in many such cases, either the lessons of

school or of the workroom are well understood. The effecton health must largely depend of course on the characterof the occupation followed. The closeness of many school-rooms is notorious ; but what is to be said of the hygieneof business houses? The hurry and bustle, the irregu-larity in meals, and other discomforts of business havealso to be considered, and here, again, we are con-

fronted by the decision of the Education Committee,which has on inquiry condemned as inferior the phy-sique of these working school children. When we con-sider that but eight years fall within the school period,we must admit that six of these do not seem too manyto devote to the specific purpose of mental training.This would make the age of half-time work begin at twelveyears. What the special exigencies of child labour may befor different districts we have yet to learn, but it is difficultto see how the limit above stated should not accord with

any ordinary working conditions. Its adoption, in ouropinion, would certainly conduce to the physical and mentalwell-being of the children.

THE Policlinico at Rome will be so far exempted from theeconomising policy of the Government as to receive fromthe Ministry of Public Works 500,000 fr. (&pound;20,000) to putin working order so much of the building as has alreadybeen constructed. This subsidy it owes to the energy of itspromoter, Dr. Baccelli, who pointed out the scandal it wouldbe for Rome if, on the assembling there of the InternationalMedical Congress in 1893, the Polielinico had not somerecord of work to show.

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THE joint committees of the Councils of King’s andUniversity Colleges were summoned to meet at King’sCollege on Thursday at 4 P.M., and we understand counselhave been instructed to present their case to the PrivyCouncil. Delegates from the various medical schools alsoattended a meeting at the Middlesex Hospital at 5 P.M. ofthe same day to consider questions in connexion with theproposed Teaching University in London.

THE President of the Royal College of Physicians, SirAndrew Clark, Bart., F.R.S., has consented to deliver alecture at the City of London Hospital for Diseases of theChest, Victoria-park, on Monday, June 15th, at 4 P.M.The subject of the lecture will be " Observations on SomeRelations of the Human Soil to the Growth of TubercularBacilli and the Evolution and Treatment of PhthisicalLeaions."

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THE death, from the effect of influenza, is announced ofWilliam Edward Steavenson, M. D. Cantab., M.R.C.P.Lond.,physician in charge of the electrical department of St. Bar-tholomew’s Hospital, at the early age of forty-one years.One of Dr. Steavenson’s latest contributions, on the subjectof electric baths, appeared in THE LANCET so recently asMarch 28th.

Sm DYCE DUCKWORTH has been appointed Physicianto the Law Life Assurance Society, in the room of Dr.Robert Martin, lately deceased.

MR. E. C. STABB, M.B., F.R.C.S., surgical registrar, hasbeen appointed resident assistant surgeon at St. Thomas’sHospital.

THE

GENERAL COUNCIL OF MEDICALEDUCATION AND REGISTRATION.

THURSDAY, MAY 28TH.Practical Teaching in Midwifery.

THE following is supplementary to the report of Thnrs-day which appeared in our last issue on this subject.

Sir JOHN SiMON said the reason why he could not vote forDr. Glover’s motion was that he did not believe the Councilcould go beyond a statement of general principles, or verywell state principles applicable equally to all places and allcircumstances. It was better that the number of cases

should be left to the individual authorities. One of theseven wise men had said that the perfection of wisdom wasin the sense of proportion, but the proposal was dealingvery disproportionately with certain bodies, and he did notthink the Council should be continually nibbling at par.ticularities. He thought that such high numbers as wereproposed might bring about great difficulties in providingcases. He thought the Council should content itself withdrawing the attention of the authorities to the subject, andthat this obstetric war would then cease in the Council.

Sir WALTER FOSTER said his feeling was that the Councilhad nothing whatever to do with the regulations with re-ference to medical education, so long as the Council sawthat the examinations generally were good. The custom,however, had been to particularise with reference to howpeople should be educated, and how men were to spend theirtime in certain branches. He had no sympathy with refer-ence to the fallacy of numbers. The question should bediscussed from the wide standpoint of public interest, andnot in the interests of one or other of the schools. Thelegal position in this country was that a man should bequalified in medicine, surgery, and midwifery-a trinityof qualifying subjects; and therefore the Council shouldmake regulations on the subject of midwifery with somecare and accuracy. At present the regulations of theCouncil were the subject of ridicule. Those interested inthe passing of the Midwives Bill were continually met withthe statement, " You are asking those midwives to havereally a better training in midwifery than you require frommedical men." It had been referred to over and overagain in the public papers, and therefore the Council wasdetermined that the third branch of medical educationshould receive as much careful consideration as the othertwo. At present the numbers were much too small.

Dr. BRUCE said he did not mean to vote for Dr. Glover’sresolution. He quite agreed with Sir Walter Foster thatthis subject should be put in the same category as the othersubjects of medical examination, and studied clinically inthe hospitals. It was a great credit to Ireland that it hada hospital of world-wide fame, and had done so much forthe study of midwifery. He did not see that it was necessaryto have any definitely restricted number of cases.

Dr. GLOVER, replying to Sir John Simon, said he couldnot accept the easy doctrine that the Council had nothingto do with details. If there was any defect in medicaleducation, the Government did not address itself to themedical authorities, but to the Medical Council. It wastoo late for Sir John Simon to say that the Council shouldnot go into " particulars." It had already done so, and theparticulars were on the face of it inadequate and absurd.It was monstrous to say that the Council had the power toadd a year to the medical curriculum, and yet had no rightto say how this year was to be used. Sir John Simoncharged the supporters of the motion with "nibbling"-first with "fevers," and then with "midwifery." Theresult of the Council " nibbling with fevers had beenmost striking. They had sent a deputation to thePresident of the Local Government Board, as also hadthe College of Physicians, and the result was a clausein an Act of Parliament opening the metropolitan infectioushospitals, under conditions, for clinical teaching. Anotherreason for the interference of the Council in the questionof the practical teaching of midwifery was the great dis-crepancy in the requirements of the different bodies. It wasthe bodies that were to be charged with " a want of thesense of proportion "-one body requiring twelve cases only,another twenty, a third six months’ practice in a lying-inhospital. Where the bodies differed the Council must