786 THE UNION OF QUEEN’S AND MASON COLLEGES.

M. GESSARD’s most remarkable facts as an indication

of the lines along which future work will have to be

carried on.

THE most important step in the history of the BirminghamSchool of Medicine since the conferring on it of the title ofQueen’s College by Royal Charter in 1845 was taken on the20th ult., when the amalgamation of Queen’s and MasonColleges was agreed to with only one dissentient-viz., SirJAMES SAWYER. Mason College has for the past ten yearssupplied the necessary scientific teaching for the medicalstudents of Birmingham which could not be so efficientlyrendered by the older college, and now the disadvantages ofa dual control and an attendance on two institutions for a

proper curriculum will be removed. There can be no doubtas to the wisdom of this decision, and, with characteristic

vigour and determination, the requisite steps for presentinga petition to the Chancery Division praying for the approvalof the new scheme have been already taken, whilst the plansfor a new building behind Mason College, which is to accom-modate the medical students with class-rooms for the medical

lectures &c., have also been prepared. The amalgamationwill remove from the authorities of Mason College alltemptation to become a complete school of medicine in

itself, and will secure for the students of Birmingham asecurity of scientific education which might at any timepreviously to this union have been taken from them if theprofessors at Mason College had wished to exclude Queen’sCollege students from their class-rooms. Sir JAMES

SAWYER opposes the destruction of an old foundation, butthe progress of the scientific element in recent medical

education, especially in the curricula of universities, makesit incumbent on all medical schools to form a thoroughlyscientific side among their professors, or to enter into analliance with a college of university standing for the pro-vision of this scientific instruction. The closer the

union the better for the student and the teacher. Such an

amalgamation, far from being a destruction, is really buta further development, especially if the union is to the

advantage of both Colleges. We look upon this fusion asthe first great step towards the formation, at no verydistant date, of a university in the Midlands, which willemulate in good work the Victoria University, if not someof the older foundations. Local universities are among the

most potent forces at work in the elevation of the highereducation throughout the country, and we have no doubtthat a fully equipped teaching university will soon be

desired by the citizens of the Midlands, and be secured fortheir children. Whether the department of Theology, which Iwill remain to Queen’s College after the removal of itsFaculty of Medicine, should be continued at Birminghamor removed to Worcester must be decided by the supportafforded to it by the Churchmen and inhabitants of Birming-ham. This is a local question. The future of the Bir-

mingham Medical School, of the Medical Department ofQueen’s College, and of Mason College is of importance toeveryone throughout the kingdom who is interested in thedue development of medical and scientific education,and in the adjustment of their proper relations to each

other.

Annotations." Ne quid nimis."

’

HER MAJESTY’S VISIT TO GRASSE.

THE eagerness of competition extends, it would seem, tolocalities and towns, and a knowledge of this fact will causesome hesitation before accepting absolutely all that hasbeen said about the town of Grasse, which is now beinghonoured by a visit from the Queen. The question whichhas been asked, with a purpose as it would seem, " Is Grassehealthy ?" admits of a ready answer. The situation ofthe hotel which the Queen occupies at Grasse is perfectIt is well protected from the north, is 1100ft. above sea,

level, and has a view of plain and sea and mountain suchas can scarcely be excelled in Europe. The air in such a,

place must be pure, and it goes without saying that HerMajesty’s advisers are satisfied as to the purity of thewater which the Queen will drink, and the soundness ofthe sanitation of the house which Her Majesty inhabits.That the old town of Grasse is not calculated to impressthe traveller as a place the construction and sanitaryarrangements of which are in any degree perfect is ofcourse true; but the Queen will incur as little riskfrom the old town as Her Majesty does from the slumsof Westminster when inhabiting Buckingham Palace.It must be admitted that the old towns along theRiviera are none of them inviting, and must be re>

garded as a menace to the health of visitors. Theold towns of Hyeres, Frejus, Cannes, Nice, Eza,Rocca Brunna, San Remo are all pretty much alike-crowded, ill-paved, malodorous ; but as the new townswhere the visitors congregate are more or less removed fromthe old ones, those who visit these spots for health or

pleasure take no harm. In one respect Grasse is betterthan its neighbours, inasmuch as the custom has long prervailed there of applying all organic refuse to agriculturalpurposes, instead of allowing it to foul the foreshore, as isdone at all the so-called " health resorts upon the coast.The argument has been used that inasmuch as Grasse isa place of great antiquity, the soil must have become

impure ; but such an argument shows a great want of

knowledge of elementary biological principles. The groundround Grasse is highly cultivated, so that the impurities ofGrasse become in due time violets, roses, jasmine, andorange blossoms ; and it is a well-known fact that the morehighly land is cultivated the more readily will it eat up, asit were, the impurities which are applied to it. With regardto the earth, the Shakesperian saying, that "appetite dothgrow by what it feeds on," is strictly true ; and it may behoped that those who visit Grasse may not be too prejudicedto bring away maybe a useful and thrifty lesson in sanita.-tion from this old city of Provence.

THE MEDICAL MORTALITY RATE.

IN our correspondence column to-day will be found aninteresting letter from Dr. Glover Lyon on this subject, inwhich the attempt is made anew to elucidate the questionof mortality in the medical profession. The results S

brought out conform much more nearly to what we conceiveto be the facts of the case than did Mr. Chatham’s figures,which we recently criticised. But Dr. Glover Lyon’smethod seems to us open to objection, and from two oppositepoints of view. The method is to take the claim register ofan insurance office and search through it until a medicalman’s claim is found, then to note the age at entry of thelife assured, and, as we understand, to continue the searchuntil a non-medical claim is discovered arising upon a life

787

which was entered in the company’s books in the

same quinquennium of age and approximately at the

same date as the medical case already discovered.The result is that the non-medical policies are found to

last slightly longer than the medical ones. Now it is

clear that the method of selection precluded the possi-bility of any great divergence between the two classesof policies because the date of death and date of entryare taken approximately the same, and the ages are

taken within the same quinquennial groups. It mighthappen that these precautions should prevent the true dis-parity from becoming apparent. Bat, on the other hand, if,as we understand, the medical case were first jound, andthen a non-medical companion case was looked for jurtheron in the register, it would follow that the non-medicalcases would have had a process of-perhaps unconscious-selection applied to them the tendency of which would beto give them an a priori advantage over the medical cases,since, other things being equal, the later entries must repre-sent policies of longer duration than the earlier. We shouldbe interested to know what would happen to Dr. GloverLyoh’a figures if instead of looking forward for his non-medical claims he looked back for them in his registers, andso gave to the medical policies the advantage which themethod as it stands appears to give against them.

PREHISTORIC TREPHINING IN PERU.

THE antiquity of trephining has formed a frequent topicfor the medical historian, and many skulls have been pro-duced from caves in France, the Canaries, Algeria, Mexico,&nd Peru, which bear evidences of having undergone theoperation during life. M. Broca has written a good dealon the subject,l also Dr. Prunieres of Toulouse who dis-covered some of the specimens. There does not seem tobe any doubt that the European specimens really representa rude surgical operation, for in many of the cases the

edges of the bone are rounded as if the individual hadlived for some considerable time af oer the operation. Less,however, would appear to be known about the Peru-vian trephining, as the accounts existing in medicalliterature are apparently limited to a description of a

single specimen by Broca and Nott. A very interestingpaper ha, however, now been published in La Cr6nicaMedica of Peru, by Dr. A. Lorena of Lima, with drawingsof four skulls, which, however, are only intended to

serve as specimens of several hundred similar ones inthe old tombs of Calca and Pomancanchi in Silque.Although Dr. Lorena does not seem to hold any strongviews on the origin of the trephine holes, he thinks it verydoubtful whether they were made by a surgical operation,though the beveling and notching may have been done bysome rude instruments-perhaps with some reference to thefitting of an obturator plate of lead, silver, gourd, or othersubstance, such as is not uncommon at the present day insome parts of South America. It is suggested that syphiliticdisease, which is known to have been very common in thetime of the Incas, notwithstanding their severe moral laws,may have caused the perforati ons, or some of them. It wouldappear that the venereal origin of some kinds of disease waspretty well known, for asmall statue has been preserved repre-senting a man covered with tumours and deformities, the sup-posed nature of which is sufficiently indicated by the figure ofthe phallus engraved on the surface. Another explanationpossible is that the skulls were injured by weapons. Athird may also occur to those who are acquainted with thediabolical cruelty of Indians-viz., that the holes in theskulls may have been chiselled or burnt out as a species

1 See THE LANCET, vol. ii. 1887, p. 213.2 See a letter from Mr. Blaker of Burgeys-hill, m THE LANCET, vol. ii.

1883, p. 881.

of torture. The objections to the theory of surgicaltrephining is that the Incas seem to have had no knowledgeof boring instruments, and that the operation, if suchit were, must have been an exceedingly common onejudging from the numerous skulls that are found withholes in them. Again, it is known that the Incas were tootimid and probably too superstitious to open the abdomenfor the purpose of taking the viscera from a dead body forembalming, practising instead the dragging of the intestines&c. through the anus, so that it hardly seems probable thatthey would have ventured to cut open the skull in the livingsubject. Of course, amongst these people, as amongstothers where it is more certain that holes have really beenchipped, scraped, or drilled into the cranium by barbaroussurgeons, the idea probably was to provide an outlet for theevil spirits which were supposed to cause headaches or otherdiseases. In one of the skulls with two apertures there isbetween these a kind of pit in shape something like the cellsof a wasp’s neat, which gives one the impression that theoperator after making a corcmencement there thought betterof it, and began again at a little distance. Two of the

specimens figured present two apertures, and two one only.Five of the holes are approximately circular, and are in theparietal bones ; the sixth, which is very irregular, probablyfrom pathological processes, is in the occipital bone. Mostof them are beveled at the expense of the outer table, andone is crenate, as if the edge had been filed with a cylindricalfile or cut with a boring instrument, there being sixteen arcsin the circumference. It is possible this may have beendone after death, with the intention of making an amulet.

PROPOSED DEMOLITION OF AN INSANITARYAREA AT BRIGHTON.

A PUBLIC inquiry has been held in Brighton with a viewto securing a provisional order confirming an improvementscheme which the Town Council propose to carry out underthe Housing of the Working Classes Act, 1890. Dr. News-holme, the medical officer of health, has made two repre-sentations to the Town Council with regard to the area inquestion, and before doing so he fully satisfied himself,from the high rate of mortality prevailing in it as com-

pared with the remainder of the borough, and from thenature of the diseases which occurred there, that it was

necessary that the area should be condemned in the interestsof public health. The houses, a number of which arebuilt back-to-back, are, as a group, damp, dirty, unpro-vided with sufficient air-space about them, ill-ventilated,and generally defective from a sanitary point of view.

They were also reported to be such that no mere altera-tions or repairs could make them healthy. In some

instances the upper storeys had been converted into

registered common lodging-houses, whilst the lower por-tions were let out as private apartments. The objec-tions to the scheme of the Town Council were hardlysuch as are likely to be allowed to stand in the wayof an improvement, which will be an obvious boon to the

town, and also, in so far as health is concerned, to those forwhom other dwelling accommodation will be provided thanthat afforded by this unhealthy area.

DANGERS OF SULPHONAL.

ALTHOUGH sulphonal is probably one of the safest, as it isone of the most efficacious, among the hypnotics recently in-troduced, the series of cases published byBresslauerof Viennashow clearly that it has certain dangers. Thedegree of perilis difficult to estimate, as the patients were lunatics, andwere also apparently feeble ; but the fact is significant thabout of seventy-seven patients who were treated with thedrug, no less than seven showed serious symptoms, and in.

788

five of those there was a fatal termination. It ought to 1be mentioned that the patients had been taking the drugfor a considerable time in good doses, and had borne it welluntil symptoms of disturbance set in, these being great con-stipation, dark-brown urine, slow, or in some cases rapid butfeeble pulse, discoloured patches resembling purpura on thelimbs, and great prostration. In the cases which ended

fatally the cause of death was heart failure, with oedema ofthe lungs. -

AN ISOLATION HOSPITAL SCHEMEABANDONED.

WE regret to learn that a scheme under which jointhospital provision was to have been provided for Enfield,Tottenham, Edmonton, Wood Green, and South Hornseyhas had to be abandoned. It appears that opposition beforeParliament was threatened by the Southgate Local Board,on the borders of whose district the hospital would probablyhave been erected ; and it was felt that, even if successattended the efforts of the combining authorities, the appealto Parliament would materially increase the cost. The site

appears to be close to the Winchmore Hill Infectious Hos-

pital of the Metropolitan Asylums Board ; and it is not

easy to conceive how a much less objectionable site, fromthe sentimental point of view, could have been secured.Indeed, Southgate would probably have been wise to havejoined in the scheme, which would, at all events, have giventhem the use of a hospital which was not within their owndistrict. The result of the opposition is the more seriousbecause there are few suburban areas which stand in greaterneed of means for the prompt isolation of infectious diseasesthan those which had to do with this scheme. In fact, theyrun considerable risk if they remain long as they now are inthis respect. ____

PUBLIC HEALTH AND PROFESSIONALCOURTESY.

A CASE of some difficulty is submitted to our judgment,but as the leading facts complained of have been publiclyissued in the form of a report appearing in the local press,we feel that the matter may properly be one for commentby us. The only medical practitioner in Brandon, Norfolk,draws our attention to the fact that the medical officer ofhealth for the Thetford rural sanitary district, having toinvestigate the circumstances of a diphtheria occurrence,

, has reported that the occurrence had its beginnings in fourcases which, he states, were certified by the Brandon practi-tioner to have died of "influenza and bronchitis "; that hetook this step without ever having seen the cases eitherbefore or after death; that in the absence, as he admits,"of any other information of a reliable nature" than amere localisation of the disease and a record of cases and

deaths, he has publicly reported that these attacks con-stituted the "starting-point of the outbreak"; and thatthe excessive fatality which attended the outbreak "wasmainly due to imperfect medical supervision." And theBrandon practitioner proceeds to ask us whether such actionis professional, and whether a medical oflicer of health hasany right to examine cases without the permission of themedical attendant. Dealing with the last point first,we would remark that so far as right is concerned no

duty of seeing patients is imposed on medical officers of

health, that this can only be done with the assentof the sick or of their relatives, and that it must be regardedas a breach of professional courtesy to take any such actionwithout some sort of communication with the medicalattendant of the sick. A medical officer of health should

not, without grave cause, undertake to go behind the certi-ficate of notification or of death of another practitioner,and he certainly has nothing to do with the results of treat- i

ment and medical care. There may be occasions when ao

imperative duty is cast upon a public officer to take thestep of questioning a diagnosis; and it is at such timeE>above all others that extra caution should be taken to-

comply with the common rules of professional courtesy.This is the first time we have found a public reportaccusing a fellow medical practitioner of faulty diagnosis,together with a suggestion of faulty medical supervision; yand we sincerely hope that there is, in the original reportor elsewhere, something which has been omitted from theprinted document, which will clear up a difficulty whichis obvious in view of such facts as are before us. Theduties imposed upon medical officers of health are at times

very delicate, and one of the first conditions necessary to>their proper fulfilment is the maintenance of an attitude ofstrict professional courtesy towards all the medical prac-titioners in the district which is concerned.

HYSTERICAL FACIAL PARALYSIS.

A CASE, said to be of this nature, was recently communi-cated to the Socióté Médicale des Hôpitaux by M. GilbertBallet for 1B1. Ed. Boinet of Montpellier. The patient wasthirty-one years of age, and when she came under observa.tion was suffering from right facial paralysis of cerebral

type-i.e., affecting the lower part of the face, associatedwith anesthesia, with rhythmical tremor of the right arm.The tremor was recent, having come on after injury, butthe condition of the face dated back as far as seven years.The diagnosis of hysteria is made upon several grounds, thestrongest of these being the fact that the tremors dis-

appeared in a few days under suggestion, a sufficient proofapparently for French authorities that it was hysterical,But even if we grant that the tremor was a hystericalmanifestation, it by no means follows that the facial

paralysis is, and however difficult the explanation of thecondition may be there seems to be little, if any, justi6catiocfor the diagnosis of hysteria, a diagnosis as unsatisfactoryas it is meaningless.

-

THE HOUSING OF THE SALFORD POOR.

AN inquiry has been held at Salford into the accuracy ofthe representations of Mr. Charles Edward Paget as to fiveunhealthy areas under the Housing of the Working ClassesAct. These areas contain respectively 149, 84, 82, 42,.and 21 houses, the populations being 615, 240, 110, 90:,and 68 persons. The density of population in each re-

spectively is 360, 377, 468, 233, and 319 persons per acre.The average general rates of mortality in the five areasduring the five years 1884.88 ranged between 40 and 782,and during the same period the death-rates from the principalzymotic diseases, including diarrhoea, ranged between 5’8 and14’5, and from pulmonary diseases, including phthisis, be-tween 14 -4 and 2:i4. During the years 1889 and 1890 thesehigh death. rates were maintained. Apart, therefore, fromdefective condition of houses in the areas, there was a strongcase against them, but we gather from the report of theevidence given at the inquiry that the houses were of the back-to-back kind, and therefore nothing could be urged on theirbehalf. As a matter of fact, the schemes were not opposed,and we assume therefore that no obstacle will be put in theway of the Salford Corporation. The schemes proposedonly to rehouse 370 of the 1123 persons who would be dis.

placed, and Mr. Samuel Joseph Smith, the inspector of theLocal Government Board, who held the inquiry, pointed outthat there was no evidence as to how accommodation was tobe provided for the remainder. Mr. Paget, however, showedthat within a quarter of a mile of these areas there was alreadyvacant accommodation for 025 persons. The inhabitants willtherefore not be exposed to any serious inconvenience.Part II. of the Act gives special facilities to local autho.

789

rities on this point, and it may be hoped that eventuallyPart 1. will be modified in the same direction. It is notunreasonable to require that the land cleared shall bedevoted to houses for the working classes, but it is ini-prudent in the highest degree to require that an area whichhas been cleared at great expense shall be again over-crowded with buildings and population. We congratulatethe Salford Corporation and their medical oflicer on thestep which has been taken, and trust that nothing will leadthem to hesitate to continue to apply the Act until all theunwholesome spots in their borough have been improved.

THE STRUGGLE FOR LIFE AT THE WRECK OF

THE " UTOPIA."

IN The Times of March 25th there appears from an officeron board the Anson a most graphic account of the Utopiadisaster, evidently written while the terrible scene was freshin his memory and its horror still vivid before him. Whilethe officers of H.M.S. Anson were dressing for dinner the"officers’ call sounded, and all were speedily at their posts.The Utopia was sinking fast, and the waves, washing over her,were sweeping away people by dozens into the sea around.Every wave that passed over the ship lessened the numbersstruggling for life. There was one man hanging by one legto some rope aloft quite dead and nearly naked, and aroundwere others clinging and shrieking for help. Another man Ihad lashed himself to the sails for security, and was drowned I,standing up, while some of those free, and apparently Iia greater danger, were saved. One poor fellow, when theUtopia first sank, got so excited that, crying out " Oh ! ’’,,I can’t stand this," he jumped overboard. The cold waterbrought him to his senses, and lie was picked up and saved,but he had no recollection of what he did. Here is aninstance of the effect of shock on the senses suddenlydepriving the individual of the power of using them evento save his own life. We are apt sometimes to under-estimate the effect of shock in accidents less appalling, andit is only by such a circumstance as is here described thatwe can judge by comparison of those lesser instances ofshock to the nervous system which we are so often calledon to relieve or to estimate the bearing of with regard tothe future life of an individual ; especially is this so inrailway accidents, in which shock to the nervous systemoften forms the most serious part of the injury.

ST. BOTOLPH’S CHURCH, ALDGATE.IN THE LANCET of March 21st we pointed out that the

excavations in progress at St. Botolph’s Church, Aldgate, forthe purpose of widening the public roadway at the j junction ofHoundsditch with Aldgate High-street, had disclosed a

quantity of human remains. It appears that in the course ofthis work no less than 116 wooden cases, measuring inside4 ft. by 11 f b. by 1 ft., each containing the osseous remains oftwelve persons, in addition to forty coffins, each containingone body, or, approximately, in all, the remains of 1432persons, had been exhumed on Friday, the 20th ult. It is

likely that since then more of these boxes and coffins havebeen discovered. This enormous mass of human cor-

ruption, we were informed by a correspondent in last week’sissue, has been "reverently and decently" disposed of byplacing it in the vaults beneath the church itself, after

being smeared with lime and covered an inch thick withvegetable charcoal. A fortnight ago we protested againstthis as "a retrograde movement not admitting of any argu-ments in its defence," and suggested the removal of suchremains to some suburban cemetery. Dr. SedgwickSaunders, medical officer of health for the City of London,also feels " that an earnest protest against such a courseshould be entered in the interest of public health."

He writes: "The floor of these vaults consists of fine dryearth, intermixed with human bones in great quantities onand beneath the surface, besides which they contain sunkenbrick graves, in all probability containing human bodies inevery stage of decay." He adds: "We know that noamount of brickwork and cementing can ensure perfectsealing of noxious emanations with any certainty."Further, the heating apparatus of the church will actas an air pump, by which the foul gases will be attractedand conducted into the interior of the church. In addi-tion to this Inspector Hills reports, that "settlementshave taken place in the brickwork, occasioning cracksin the arches themselves, which are liable to increaseand add to the danger." Dr. Saunders recommends that-a representation of these facts be made to the Home

Secretary, with a view to amending the order of the

Consistory Court, and directing as an alternative theremoval of the whole of these human remains to the

City of London Cemetery at Ilford, a course, as we

pointed out previously, which should have been originallycarried out. Dr. Saunders has communicated with theHome Office, and is authorised to state that Dr. HoffmarpMedical Inspector, Burials Act Department, is in accordwith these views. It is a question whether the intermentof human remains within St. ’Botolph’s Church is not indirect contravention of an order in Council granted in 1853,which prohibited any further burials either in the vaults orchurchyard of St. Botolph’s Church, Aldgate. But if the

question of the legality of the proceeding is doubtful, it ismore than fifty years since its impropriety and its unwisdomwere settled. In these days of burial reform it is withoutdefence.

___

DURHAM DEGREES IN HYGIENE.

A SCHEME whereby registered medical practitioners overtwenty-two years of age can obtain the degree of Bacheloror Doctor of Hygiene in the University of Durham has beenapproved by the Senate of that University. The courseincludes attendance on lectures on public health, attendanceon the clinical practice and lectures, instruction in theCity Hospital for Infectious Diseases in Newcastle-on-Tyneþand instruction in sanitary medicine and practical hygiene.The examination will be conducted by written papers andpractical and viva-voce questions, and will be commencedon Sept. 14th, 1891, and again in April, 1892. Particularaof the syllabus for this examination will be given in ourStudents’ Number.

___

MORVAN’S DISEASE.

THIS condition, first described about eight years ago bythe physician whose name it now bears, is one of those

apparently spinal diseases associated with changes in sensi-bility and nutrition manifesting themselves especially inthe hands. The three symptoms on which at first a.

diagnosis was made were pains in the limbs at the com-mencement of the illness, paresis and analgesia, especiallyof the hands, and the appearance in one finger after anotherof whitlows, painless but destructive. Several cases havebeen described, but the pathology of the disease is still,

uncertain, some physicians regarding it as merely a form ofsyringomyelia, while Morvan and his followers, relyingupon the somewhat unsatisfactory examination of one

specimen, regard it as due primarily to some change in the-cord associated with thickened arteries, and secondarychanges in the peripheral nerves. In the Journal of theAme’i’ican :lJfedical Association, Dr. Church of Chicagogives a clinical account of a case which seems to answerto the description of this disease. The patient is a Swede,aged thirty-five, the commencement of whose symptoms.date back to ten years ago, when he had a whitlow on the

790

right ring finger, which was painful, and has left the distalphalanx stunted, and nail much altered. About this time,also, his back was noticed to become bent, although pre-viously it had been quite straight. A few years ago, afterbathing in a cold lake and driving afberwards some distance,his left wrist, hand, and arm became swollen and painful.The swelling in the wrist has never quite subsided, and thecarpus is now to all appearance disorganised but quite pain-less. Three years ago he had a painless whitlow on theright index finger, in which now the distal phalanx is

completely wanting, as well as a part of the middle one.in the same year the middle finger of the right hand suffereda similar mutilation, also from a painless whitlow. Henow has these deformities in the fingers and the left wrist,has retention of ordinary tactile sensibility everywhere, butwith loss of the power of distinguishing tactile from painfulimpressions in the hands. Above the hands this disabilitygradually disappears. There is also present marked lateralcurvature of the spine ; his gait is shambling, but displaysno distinctive pecllliarity; his reflexes are normal, and hismind is unaffected. The case is a peculiarly interesting6ne, especially in reference to differential diagnosis fromsyringomyelia, but more will have to be known of bothconditions before a certain diagnosis is possible.

CHYLURIA IN HUNGARY.

A CASE of chyluria, the first recorded in Hungary, wasexhibited by Dr. Angyau before the Buda-Pesth MedicalSociety at its last sitting. The patient was a man of thirty-four, who had noticed his urine to be turbid for four or fivemonths, this being especially marked in the latter part ofthe day, that passed in the morning being less affected,and sometimes even quite clear. Occasionally he sufferedfrom pain in the region of the kidneys. The urine wasfound to pass turbid through a filter, but the addition ofether cleared it. With the microscope, molecular corpuscleswere seen, and also red and white blood-cells. The specificgravity varied from 1025 to 1036.

DEATH UNDER CHLOROFORM.

A CASE of death under chloroform is reported by Surgeon-Major Gordon Price, civil surgeon at Burdwan, India, in thecurrent issue of the Indian If’Iedical Gazette. The fatalityoccurred at the Burdwan Dispensary, and the patient, agedthirty, was about to have a plastic operation performed uponher face for the restoration of her nose. Physical examina-tion revealed no evidence of disease beyond a splenicenlargement ; the heart and lungs were healthy. Surgeon-Major Price himself administered the chloroform, and usedall precautions. Upon the patient becoming unconscious,he requested his assistant, Surgeon BJ.bu Guru Nath Sen,to undertake further chloroformisation while he proceededwith the operation. Assistant Surgeon Sen exclaimed,11 Wait, her pulse has stopped." "How can that be?" wasthe reply; "her respiration is all right," pointing to the,pttient’s abdomen, which was rising and falling regularly.Upon feeling for the radial pulse the statement of theassistant surgeon proved to be correct. "A few secondsafterwards her breathing, which had been perfectly normal,almost ceased." Artificial respiration was sedulously butvainly tried for an hour, and all efforts to stimulate theheart and respiration failed. Surgeon-Major Price con-

blades : " There was not at any time during the ad-ministration of the chloroform the slightest tendency toatertorous breathing, and the woman’s chest and abdo-men could be seen regularly rising and falling, as intaormal respiration, until some seconds after the exclama-tion of the assistant surgeon. The amount of chloroform<used was not measured, but was not excessive. I have

always believed, even before the time of the Hyderabad

Commission, that in death from chloroform the breathingwas primarily affected, and have, in administering the drug,paid continual attention to the patient’s respiration, andhave impressed this at all times upon my assistants. In thepresent case there cannot be any doubt that the heart wasprimarily affected." -

FRIEDLANDER’S PNEUMOCOCCUS AS AFERMENT.

IT has been known for some time that Friedlander’spneumococcus is capable of inducing fermentative changesin suitable solutions of glycose and cane sugar, this havingbeen first discovered by Brieger. His observations have

quite recently been confirmed by- Dr. Percy Frankland,Mr. Arthur Stanley, and Mr. William Frew, who have justcommunicated a paper on the subject to the Chemical Societyof London. They further found that the organism fermentsmaltose, milk sugar, raffinose, dextrin, and nunnitol, butthat, like the bacillus ethaceticus, i does not attack dulcitol.They made a special study of the fermentations of glucoseand mannitol, determining quantitatively the proportions inwhich the several products are formed. These products are ineach case ethyl, alcohol, acetic acid-generally accompaniedby a little formic acid and a trace of succinic acid-carbondioxide, and hydrogen. Both the glucose and mannitol werein all cases only partially fermented, and the decompositionof the glucose was especially incomplete, glucose beingapparently less readily attacked by the organism than man.nitol and cane sugar. The fermentation was not renderedmore complete by furnishing the organism with a more abun.dant supply of nitrogenous food. The products of the man-nitol fermentations were not only qualitatively similar tothose obtained in the fermentation of the same substance bythe bacillus ethaceticus, but the relative proportions in whichthey were formed were almost identical, the ratio corre.sponding closely to the molecular proportions 2 C2H5 ,OR:CH3.COOH. -

THE INFLUENZA IN AMERICA.

AN epidemic of this disease is said to be raging with morethan ordinary virulence in Pittsburgh and in Alleghany.At Chicago the death-rate has increased to 150 daily.Hospitals which were intended for the reception of accidentcases or paying patients only have been thrown open to thesufferers from influenza, and are crowded beyond theirresources. From Cleveland, Ohio, 2000 cases are reported,and in New York 160 policemen are on the sick list.

THE SECOND CONGRESS OF AMERICANPHYSICIANS AND SURGEONS.

Tais Triennial Congress is to meet at Washington, D.C.,in September, from Tuesday, Sept. 22nd, to Friday,Sept. 25 by, inclusive. Dr. S. Weir Mitchell will preside.Dr. John S. Billings is treasurer, Dr. William Pepper ischairman of the executive committee, and Dr. W. H.Carmalt, Newhaven, Conn., is the secretary. The Congressis a meeting of certain national medical societies, so arrangedthat, while each society meets separately, there are statedoccasions in which the members of all meet and constitutethe Congress. According to the preliminary programme thechief subjects of discussion will be: On the Tuesday, Con.ditions underlying the Infection of Wounds, including adiscussion on Disinfection; of the Relation of Bacteria toSuppuration; of the Resistance of Tissues to the Mtllti-

plication of Bacteria; and of the Effects of AntisepticAgents on Wounds, by Dr. Welch of Baltimore, Professorof Pathology in Johns Hopkins University, and Dr. Roswell,Professor of Surgery in the Buffalo Medical College. Onthe Wednesday : The Late Manifestation of Syphilis, by

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Dr. Phineas S. Conner of Cincinnati, Professor of Surgery inthe Medical College, Ohio, and Dr. Abner Post of Boston,Instructor in Venereal Disease and Syphilis in Harvard

University. On the Thursday: Fibroid Processes (ChronicInterstitial Inflammation, Scleroses), their Pathology andEtiology, with special reference to the Influence of Diathesisand Heredity, by Dr. Alfred L. Loomis of New York City,Professor of Pathology and Practice of Physic in the

University of the City of New York, and Dr. WilliamOsler of Baltimore, Professor of Medicine in Johns HopkinsUniversity. The programme is well conceived. The con.

stitution of the Congress warrants that the subjects will beviewed from many different points, and the executive is aguarantee of the representation of all that is best inAmerican medicine and surgery.

"ASTASIA-ABASIA."DR. GRAEME M. HAMMOND of New York reports a case ’’,

of this disorder. The patient was a young woman in whomthe symptoms came on after overwork. She had no neurotic

history, she had previously shown no sign of hysteria, andshe was active and energetic naturally. But at the com-mencement of her illness she had suffered from aphonia. Thecondition described as "astasia-abasia" is one of inabilityto stand or walk, but without paralysis-that is to say,that the patient is able to carry out all movements of thelimbs as she lies in bed, but is unable to walk. This patientin attempting to walk advanced the left foot, and thenslowly brought the right one up to it, alleging that if shetried to rest her weight on the right leg she would fall.An attempt to do so resulted in her turning round to theright and falling, and the same tendency to turn to theright was evident to anyone supporting her. There was no

anaesthesia, colour-blindness, or contraction of the visualfields. The knee jerks were active, and there was noankle-clonus. There appeared to be, however, slight lossof muscular sense in the right leg. The previously de-scribed cases of this disorder have been similar to Dr.

Hammond’s, although in many there have been variousdisturbances of sensibility, consisting in some of anaesthesia,in others of hypersesthesia. There seems to be little, if any-thing, to distinguish the case from one of so-called functionalparaplegia-a by no means uncommon condition,-and Dr.Hammond himself is of opinion that the condition is a

hysterical one. -

THE ACTION OF THE VAPOUR OF ETHEREALOILS ON BACTERIA.

NOTWITHSTANDING the researches of Schultz, Koch,Schill, Fischer, Riedlin, Chamberland, and Braddon, theaction of ethereal oils in a state of vapour upon bacteriais by no means well known. As this is a subject whichbids fair to have practical interest for the physician as

well as for the’bacteriologist, a somewhat elaborate re-

search by Dr. Omelchenko, which is published in theVrach,’ is a welcome addition to our information. Itsdetails must have been very carefully planned and carriedout, for it gained the Pirogoff gold medal of the Universityof Kieff. The observations were made upon cultures of thebacilli of typhoid fever, phthisis, and the Siberian sore(anthrax) by passing over them with the help of an aspiratora slow but continuous stream of air saturated with the

vapour of certain ethereal oils, and noting the time whicheach different vapour required to destroy the bacilli; thequantity of each oil used and the volume of air passed overeach tube, as well as the amount of each vapour which theair was capable of holding, were also noted. It was foundthat if the air was not quite saturated, the effect wasvery markedly diminished. The bactericidal properties of thedifferent oils were found to be greatest in oil of cinnamon,

after which the others may be arranged with reference to-their bactericidal power in the following descending order :-Oleum foeniculi, oleum lavendulse, oleum caryophyllorum,oleum thymi, oleum menthse piperite, oleum anisi, oleummentbse crispse, oleum eucalypti globuli, oleum camphorae’japonicee, oleum valerianae, eucalyptol, French oil of tur-

pentine. The oils of lemons and of roses had an exceedinglyslight action. Bacteria in a dry state were much less easyto destroy than those which were in their natural state; afresh condition of the sporules of the Siberian sore,

however, weakened the destructive effect of the vapour.It was found that the protoplasm of the various bacillrawas affected in its chemical constitution in a constantmanner for each kind of bacterium, losing its powerof taking the stain. This change seemed to affect aII4

parts of the organism equally. The death of the bacteria-was shown both by this loss of capacity for taking the:

stain, and also by the tendency to assume a granular con-dition. Tables are given of the experiments, from which’we see that oleum cinnamomi and oleum valerianae took the-same time to destroy the bacilli of typhoid fever-viz., forty-five hours; but, inasmuch as each litre of air took up only0’0005 grm. of the former, as against 0’0082 of the latter,the total quantity of cinnamon oil used being 00646grm.9while 1’0429 grm. of the oil of valerian was required, it is.evident that the former deserves the higher place in thescale of bactericidal substances. Experiments by previouswriters made with emulsions of ethereal oils placed in con-tact with bacterial cultures have not generally shown that,these possessed a high bactericidal capacity, and DrOmelchenko found that when he passed the air throughemulsions instead of through the oils themselves the amounttaken up was materially less than in the latter case, and soit would appear that the bactericidal capacity of any one othese substances depends largely upon its volatility.

THE PUBLICITY OF NOTIFICATION RETURNSa

THE London School Board have applied to the Metropolitan Asylums Board to be furnished with information-respecting the occurrence of cases of infectious diseases inthe metropolis, as shown by the notification returns, and in.making this demand they are supported by what passed at.a conference of metropolitan medical officers of health in.December last. We can quite understand the demand ofthe London School Board. Nothing is more evident than-that diseases such as diphtheria, measles, and scarlet feverowe their spread largely to the aggregation that takes place’in elementary schools, and if any information is available.enabling this spread to be prevented or diminished, it seems.absurd to withhold it. But it can apparently only be-properly utilised if the schoolmasters and schoolmistressesare, in turn, supplied weekly with the notification listwhich apply to the localities from which the children.

attending their schools are derived. And this means amabandonment of that avoidance of publicity which is be-lieved to have governed the drafting of the InfectiousDisease (Notification) Act, 1889, and especially of its thirdsection, by which it was enacted that the returns, insteadof being sent to the sanitary authority, were to be trans-mitted to the medical officer of health, who could be trustedto understand the desirability of maintaining, so far as it,was possible having regard to the interests of the public,an attitude of professional secrecy.

OCULAR TROUBLES IN TABES DORSALIS.

DR BERGER, in the Remte de Medicine, has drawn attentionto this subject. He has observed 109 cases of the disease,and from the results of those observations he draws certainconclusions. He finds that, in cases in which the conditionhas manifested itself in youth or in old age, serious ocular

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troubles are not met with, and that it is when symptoms ofthe disease appear between the ages of twenty-five and’forty that those complications for the most part occur. In’half the cases observed the Argyll-Robertson phenomenonwas present. In eleven cases it was accompanied by,mydriasis, in fifteen cases the pupils were of the usual size,and in two there was contraction of one with dilatation ofthe other pupil. He also found in a certain number of casessome irregularity in the shape of the pupil, and he remarksthat when myosis is present with the Argyll-Robertson,phenomenon the instillation of atropine causes a dilatation ofthe pupil, which may persist for four or five weeks. Atrophyof the optic nerve was found to be present in 33 per cent.of the cases, and it did not occur simultaneously in the twoserves. The interval between the commencement of atrophy,and the establishment of complete blindness was found by-this author to vary from two months to seventeen years,and he states that it usually begins in the pre-ataxic stage,- and that, this stage once passed, the danger of atrophynetting in is considerably diminished. Paralysis of the,external muscles of the eye was observed in 38 per cent.<of the cases. It was found to occur usually in the pre-ataxic stage, to be as a rule transitory, and to be more"frequent and more lasting in patients with a clearly specifichistory. In conclusion, the author formulates a theory of<the pathology of tabes. In his opinion it originates insome change in a centre in the medulla regulating the vaso-motor condition of the optic nerve and of the spinal cord.

WORKING WOMEN AND FACTORYLEGISLATION.

THE Women’s Trade Union League recently held severalspecial meetings to discuss the Factory Bills now beforeParliament. The League, from its long and practicalexperience of the difficulties under which women labourwho seek to earn their living, was in a good position to.judge the merits of the proposed legislation. This legisla-tion, in the opinion of the League, is evidently incomplete.The discussions are summed up by a series of resolutionswhich, we are pleased to note, agree with many of thesuggestions we made during the course of our inquiries on ’,’the sweating system. For instance, the first resolution Iinsists that in factories and workshops each sex should beprovided with separate sanitary accommodation. Then the

League is so impressed with the necessity of a great increase’in the number of factory inspectors that it proposes the- creation of sub-inspectorships. These sub-inspectors would,we presume, stand in somewhat similar relationship to the’inspectors as sanitary inspectors do to the medical officersof health. With respect more particularly to the sweating-system, the League agrees with us that " the worst’economic and sanitary evils arise from the impossibility of-supervising and controlling home workers"; it there-fore urges that "home work should be discouraged by- every means available, and that all such places, in-

cluding even bedrooms, where goods are ma-1e up which thepublic will be invited to purchase should be put underthe control of the public, and consequently subjected to the’visits of factory and sanitary inspectors." This thoroughly- coincides with the principle we have always proclaimed-mamely, that the public has the right to protect itself.against the danger of infection by controlling the manu-facture of the articles it purchases. But in all this thereare two difficulties to be overcome-the supineness of localauthorities and the resistance of the working classes them-selves. The local authorities are, too often, slow to takeaction. The League therefore urges that some central

authority should have the power to stimulate and, if

necessary, to force the hand of the local authority. This,

we take it, is what is implied by the first clauses ofMr. Matthews’ Bill. There will still remain, however, theresistance of the working classes themselves, who dreadsuch sanitary inspection as may lead to interference withtheir work and consequently reduce their too slender

earnings. The Women’s Trade Union League, to obviatethis obstacle, recommends that power should be given bylaw to local authorities to make grants from the rates in

compensation for loss of work occasioned by the closing ofworkshops or factories ordered by such local authorities onsanitary grounds. This is an important suggestion. Wehave often urged that workers, especially home workers,like tailors, laundresses, &c, who usually earn barelyenough for subsistence, should, when their work is stoppedfor sanitary purposes, such as disinfection, be compensatedby the authorities. Otherwise the laws of self-preservationand the fear of hunger will tempt workers in this precariousposition to conceal the outbreak of any infectious disease.They must be made to feel that it is a public duty to giveimmediate notice of the presence of infection in their homesor their workshops, and that the neglect of this obvious dutywill entail severe punishment, but that its due observancewill result in no loss, for due compensation will be forth.coming. Altogether it will be seen that the Women’sTrades Union League has, in its study of the necessaryremedies to mitigate the evils of the sweating system, cometo about the same conclusions as those we were led to adoptafter the disclosures made by the special commissioners ofTHE LANCET, who visited the principal sweating dens ofEast London and the leading provincial towns.

LARYNGEAL COMPLICATIONS IN TYPHOIDFEVER.

Ix severe cases of enteric fever various throat complica-tions have been described, but their connexion with the

original disease has not been satisfactorily established. InL’Union M&eacute;dicale of March 10th, 1891, Professor Peterdescribes a case of a man who died of typhoid fever, and inwhom the throat complications were well marked. Incom.

menting on the case he remarks that hyperaamia of the

larynx is a common symptom of typhoid fever, being mostmarked on the aryteno-epiglottidean folds. Ulceration

following this condition was first noticed by Louisin 1828, who stated that if at a necropsy extensiveulceration of the larynx was found, and if tuberculosiscould be excluded, typhoid fever lesions should be soughtfor. Occasionally, when the laryngitis is intense, Eberth’sbacilli are found in the glands around the larynx. Anoedematous swelling often appears, and the inflammationmay lead to suppuration, extensive ulceration, and evendestruction of the cartilages. Laryngitis in connexionwith enteric fever assumes two chief forms : the acute andthe chronic. The first-mentioned develops from the fifteenthto the twentieth day, at the time when. the disease oughtto be subsiding. Its onset is marked by local pain, difficultyin swallowing, and dyspnoea chiefly affecting inspiration,expiration being perfectly easy. The difficulty of breathinggradually increases, generally requiring tracheotomy to beperformed in order to prevent death by suffocation. Postmortem there is found sero-fibrinous or purulent infiltrationwith commencing destruction of the epiglottis and the ary-tenoid and cricoid cartilages. The more chronic form does notcommence until convalescence has been well established,at least two months after the termination of the attack,and when the patient is apparently cured. The voicebecomes hoarse, there is evident difficulty in speaking, andfinally symptoms of oedema of the glottis appear. The

prognosis is then very grave; according to Sextier of tencases which required tracheotomy all proved fatal. SomeGerman statistics show that of nineteen cases which required

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operation seven only recovered. Even if a cure is effectedthe condition is a very unsatisfactory one, as the cannulahas to remain in position for an indefinite period, and thecicatrices which form in the larnyx often producing such con-striction as to cause almost total obstruction. In short, in allthe parts affected by enteric fever there is a tendency toulceration, and this is particularly liable to occur in the

larynx, and if such happens the submucous tissue becomesinfiltrated, and perichondritis follows in its turn. Finally,there is erosion of the cartilage ; and, if the patient survives,there are premature ossification of the cartilages and necrosisof the epiglottis and of the arytenoid and cricoid cartilages.Sometimes a small portion of cartilage may be detached-avery dangerous occurrence, as it is very apt to fall into thetrachea and cause alarming symptoms, and even death fromsuffocation. At other times the whole cricoid cartilagemay become detached, and be ejected in the form of a

sequestrum. The only treatment likely to be effectual is toapply counter-irritants, such as blisters, to the front of theneck.

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REGULATiON OF STREET MUSIC.

THE nuisance caused by street " musicians is a veryancient grievance, and it is greatly to be hoped that Mr.Jacoby will be more successful in his proposed measure for itsremoval than others have been before him. His proposal isthat every street "musician" shall, when requested by anyhouseholder to cease playing his "instrument," do so, andremove to a distance of not less than a quarter of a mile.There are, we believe, other provisions, but this is the onein which, as caring for the public health and the comfort ofmembers of our profession, we are most interested. A largeproportion of the inhabitants of these kingdoms must dwellin large towns or cities, and to all those who do not possessthe power of abstraction, the wear and tear of nerves, theworry and trial of temper caused by noises, tell very seriouslyon the health, and, it may be added, even on the durationof life. Street noises may be divided into those whichare inevitable and those which can be prevented. To theformer belong those caused by street traffic, to which peopleget so used that the quiet of the country is often irksome;while modern forms of pavements have in recent years donesomething to diminish them. The principal noises which canand ought to be prevented are those caused by street criesand street "music." Church bells, too, especially when tolledin the monotonous manner so familiar to all Londoners, causea noise which is very distressing to many invalids as well asto healthy but nervous people, and which is wholly un-necessary. Whether it would be possible to silence the bellsof the established churches by episcopal authority is an openquestion; but it may be observed that in churches and

chapels belonging to other denominations and in the Epis-copal churches of Scotland large congregations assemble forworship without any bell summons ; and if the bells in allthe London churches were silent save at the hours, halfhours, and quarters, the congregations would probably beas large, though there might at first be some late arrivals.We have frequently pointed out that the tolling of bellspreviously to any other service than morning and eveningprayers and funerals is not legal, and is certainly withoutany use. It is unfortunate that the subject of street"music" has never been treated either in or out ofthe House of Commons with the seriousness which itmerits. Those who complain of it are ridiculed, or a

plea is urged on behalf of the poor who but for theseitinerant "musicians" would never hear that "music" which"hath charms to soothe the sava,ge breast." It may be

very safely asserted that the music alluded to by the poetwas very different from the discordant sounds which issuefrom German bands and Italian barrel organs. Moreover,

Londoners have this so-called street music inflicted uponthem at any hour of the day, however unseasonable, fromearly morn to dewy eve, and even up to nearly midnight.The late Mr. Babbage, the late John Leech, and others,.who have earned fame in literature, had their lives harried,if not shortened, by this pest, and the marvel is that.it has been tolerated so long. The Bill proposed by Mr.Jacoby is, as regards this its most important clause, similarto a local Act in force in Liverpool and elsewhere. The-streets do not belong to any individual or class, but to all,and nothing can be more reasonable or moderate than thatany householder should have power to prevent any street" musician " from playing to his annoyance. Care mustbe taken to draft the clauses so that there shall be no loop-holes left for evasion, and it would be well to have copies ofthe Act (if passed) translated into German, Italian, andsuch other languages as may include the nationalities of allstreet "musicians." In conclusion, it may be observed that.street bands and organs have been the cause of many fatalstreet accidents. For all which reasons we trust that.Mr. Jacoby’s Bill will pass.

A REMEDY FOR ANTHRAX.

MR. E. H. HANKIN (Centralbl. f. Bakter., vol. ix.Nos. 10, 11) of Cambridge University has succeeded in

isolating from the spleen and blood-serum of the rat analbuminoid substance which destroys bacterial life. It is.a basic body, differing from any bases hitherto known in.being insoluble in alcohol and in water, and in not

dialysing. It is a globulin ; and to its presence is ascribedthe power possessed by the blood serum of the rat of

killing anthrax bacilli. Mr. Hankin thinks it probablethat the immunity which the rat enjoys to anthrax and’

diphtheria is, in part at least, to be ascribed to the-

capability of the rat organism of producing this material.Still further importance is to be assigned to this researchfrom the conclusion that the bactericidal property of this,substance can be exerted not only outside, but also withinthe body of animals susceptible to anthrax. Hence it is

possible, he thinks, for the " protective albuminoid bodyof rats" " to be utilised as a remedy for anthrax.

JUVENILE SMOKING.

EXCELLENT common sense on the whole directed the-

proceedings at a conference recently held in the Town Hall,Manchester, to consider the expediency of arresting the-

prevalence of juvenile smoking. According to the medicalofficer of health for the city this habit is practised by 80 percent. of the Lancashire boys, and his rough calculation maynot be very far from an accurate statement of facts. Any-one, or rather everyone, who daily meets with that pre.sumptuous atom of manhood, the boy cigarette-smoker,must have been astonished at the general distribution of the:prodigy. Equal, if not greater, is the surprise excited byhis diminutive size and exceedingly tender age. Some

years ago it was the boy of twelve, fourteen, or sixteenthat opened our eyes. Now it is the six or eight years old,the literal infant who prolongs his still recent privilege ofsuction in a fashion undoubtedly hurtful by perverting at acritical period the sensitive processes of nervous action andnutritive change. The Manchester conference discussedvarious possible correctives of this mischievous practice.Among these we may mention education of a homilecticcharacter, to be carried out in Board schools. Another andmore practical suggestion advised ministers and teachers toset the example of abstinence in their own persons. As a.last resource, it was proposed that the aid of the law-re-stricting, as in Germany, the right to use tobacco to personsover sixteen years of age-should be called in to strengthen

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the gentler measures already referred to. As regards thewisdom of this latter step there would seem to be somequestion. We are not of those who favour the unnecessarymultiplication of petty laws. There is, in cases of theKind in question, no power which in our opinion is eitherso natural, so safe, or so effectual as that of judicioushome training, and we are not hopeless of yet seeing its’influence applied far more widely than at present.

THE DEATH OF EARL GRANVILLE.

WE record most regretfully the close of the earthlycareer of the eminent statesman and politician Lord

Granville, at the age of seventy-six years. In his lastillness be was attended by Sir Andrew Clark, Sir JamesPaget, and Mr. Reginald Harrison. Some six weeks agohe canght a chill, from which he never completely rallied.Being of an extremely gouty disposition, his previousattacks of that disease had very much enfeebled his

recuperative powers. From time to time he seemed to

rally and regain strength; and during the illness he hadan attack of parotitis, which resulted in suppuration ofthe parotid gland and necessitated its being opened. Thiswas the only operation to which he was submitted, and itdid not seem to have very much to do with the fatal issue.

During the last week of his illness he manifested a greatdistaste for food, and although all kinds of endeavourswere made to administer nourishment they were unsuccess-ful. He gradually grew weaker, and finally succumbedon the evening of Tuesday, March 30th. While all menowe gratitude to him for the deep interest he took ineducational matters, medical men owe more from thepeculiar interest he took in that profession. Universities.and colleges, hospitals and medical schools, have alikederived inestimable assistance from the deceased nobleman.He occupied the position for the last thirty-five years of’Chancellor of the University of London, and was presidentof the Royal Medical Benevolent College at the time of hisdeath. A late president of the College of Surgeons has-.spoken of him as "an illustrious statesman, who, as

Chancellor of the London University, is foremost inthe promotion of general education, and President ofthe Medical Benevolent College, a president who hastaken a very active part in its welfare." But in days’long since gone by, between 1837 and 1846, the periodpar excellence of medical reform, when he was a mem-

’ber of the House of Commons, he invariably lent hisassistance to the promotion of those reforms, and has

frequently expressed his admiration of the founder ofTHE LANCET, and of the efforts made by the late Mr.

Wakley to effect legislation on behalf of the medical pro-fession, Those were the days of the Coroners Bill, theMedical Witnesses Bill, the Factory Bill, the VaccinationBill, and the Medical Reform Bill. In fall these legislativemeasures, and in many others, the late Earl took an activepart, and accorded his influential support to every measureof reform which was to benefit the medical professiongenerally. And since that period, during the forty years inwhich he had occupied a seat in the House of Lords, he con-tinued to be an earnest friend and benefactor to our profession.

THE RESPONSIBILITY FOR INFECTION.

IT is nothing new to learn that infection may be trans-mitted by post, yet we cannot doubt that this fact is oftenoverlooked and sometimes, as in an instance lately reported,by persons whose knowledge of the probable consequencesought to make them more careful. In the case referred toa hospital matron was censured and fined in costs for

sending to the neighbouring isolation hospital by parcel

post, and without using the needful sanitary precau.tions, a package of clothes which had been forwarded toher by a nurse for disinfection. One can easily under-stand the natural dread which prompted this actionas the readiest means of removing from the hospitalpremises material so dangerous to the health of its inmates.The primary fault it must be allowed was not on the side ofthe matron. The sender of the clothes and the occupantsof the house whence they were sent were the originalculprits, for, by the terms of the Infectious Diseases Act,disinfection, where not undertaken by the local authorities,must be carried out by the owner or occupier of the infecteddwelling. Possibly the clothes in this case were the nurse’sown, but if so this makes no real difference. They were forthe time being within the infected house, and their purifica-tion should have been there provided for. This circum.stance does not, of course, excuse the matron, who, havingreceived the parcel, was responsible for its disinfection; butit should serve, as it well may, to render any in her positionseverely careful that the dutie3 imposed by law in suchmatters shall be discharged by those who are in the firstplace accountable for their performance.

THE PIGMENT OF MELANOSIS.

DR. FELIX LAGRANGE, in a paper read before the Societed’Anatomie et de Physiologie de Bordeaux on Dec. 8th oflast year, described some investigations he had made asregards the distribution of the pigment in two melanotictumours. One case was that of a melanotic sarcoma

which had been removed from the orbit, and the other wasa tumour of the eyelid. Microscopic examination showedthe same structure in both cases, but the tumour whichhad developed in the orbit was more deeply pigmented thanthe other, though the distribution of the pigment was morpho-logically the same in each case. Sections of both tumoursexhibited fusiform cells and many embryonic elements. Afew vessels were seen, but there were no hemorrhagic foci.The pigment was intra-cellular. In some cells it was com-

pletely absent, whilst others were so fall as to lose theircharacteristics, and to appear as black round masses; othercells, again, contained in their protoplasm fine black granules.In order to study the nature of this pigment it was neces.

sary to isolate it from the cellular elements. By treating asection with sulphuric acid, the cellular elements were par.tially destroyed. Under the influence of this reagent thesarcomatous tissue became shrivelled, remaining as a

translucent structureless mass, in the centre of whichwas the pigment. Nitric acid was next tried; but,although the structure of the tumour was completelydestroyed, there still remained a whitish residue in whichthe pigment remained entangled. In order to obtaina pure preparation of melanine the following process wasadopted with success. Having treated a portion of thetumour in which the pigment was abundant with puresulphuric acid, it was placed, still saturated with the

reagent, for twenty-four hours in a moist chamber. In this

way the now plastic tissue was partially liquefied, someglycerine was then added, and the containing vessel closedfor forty-eight hours. At the end of that period thereremained nothing but the pure pigment. It presentedthree principal forms. 1. Some black masses, evidentlyformed by the union of a series of granules, separatedby unequal intervals, the spaces being filled by a trans.parent cement which had been unaffected by the acid.These masses were the remains of those cells which hadappeared to be entirely filled with the pigment. 2. Finedisseminated granules, which were rounded and verynumerous. 3. Small irregularly shaped particles, for themost part angular, but presenting considerable variationsin their form and size.

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FOREIGN UNIVERSITY INTELLIGENCE.

Buda Pestli.-The medical faculty have drawn up a planfor altering the medical examinations for the degree ofM.D. According to the new scheme, which has yet to re-ceive the eanction of the Minister of Education, the piesentthree great Rigorosen, or " severe examinations," will bereplaced by five, as follows :-1. Physics and Chemistry.2. Anatomy and Physiology. 3. General Pathology, Patho-logical Anatomy, and Pharmacology. 4. Clinical Medicine,Surgery, Midwifery, and Ophthalmology, also Operations.5. Systematic Medicine and Surgery, Medical Juris.

prudence, Hygiene, and viva-voce examination in some

special department of Practical Medicine.Kiel.-Dr. F. Graf von Spee has been promoted to the

rank of Extraordinary Professor.Rostock.-Dr. F. Blochmann of Heidelberg has been

appointed to the chair of Zoology, in succession to ProfessorBraun, who has accepted an invitation to Konigsberg.

Tonlouse.&mdash;This school of medicine has been suppressedby decree, and replaced by a "faculty." The followingappointments have been made to professorships:-Anatomy,M. Charpy; Histology, M. Tourneux of Lille; PathologicalAnatomy, M. Tapie; Operations, M. Labeda; ForensicMedicine, M. Duponchel; Clinical Medicine, M. Caubetand M. Moss&eacute; of Montpelier ; Clinical Surgery, M. Chalotof Montpelier and M. Jeannel; Clinical Midwifery,M. Crouzat of Paris; Chemistry and Toxicology, M.

Fr&eacute;bault; Pharmacy, M. Dupuy.Vienna.-Dr. M. Kassowitz has been promoted to be

Extraordinary Professor of Children’s Diseases.

DEATHS OF EMINENT FOREIGN MEDICAL MEN.

THE deaths of the following distinguished members ofthe medical profession abroad have been announced:&mdash;Dr.Maly,* Professor of Chemistry in the University of Prague,at the age of fifty-nine.-Dr. Wilhelm Schlesinger, a well-known Vienna medical author, at the age of seventy-nine.-Dr. Karl Beyerlein, one of the most eminent of the Kissingenphysicians.-Prof. Karl Braun von Fernwald of Vienna, atthe age of sixty-nine.-Dr. N. P. Vasilieff, privat docentin the St. Petersburg Medical Academy, and editor ofBotkin’s Bolnichnaya Gazeta, of cardiac disease, at the ageof thirty-seven.

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THE Council of King’s College last week elected Dr.Joseph Priestley, B. A., M.D., D. P. H., as Demonstrator inState Medicine and Public Health at their new laboratories.

WE regret to announce the death, at the age of seventy-nine, on the 28th ult., of Deputy-Inspector-General of

Hospitals James Sanderson, F.R.S.Edin., of the MadrasArmy (retired). --

SECONDARY SEXUAL CHARACTERS.

THE study of biology is perhaps one of the most instruc-tive and humanising pursuits in the domain of science, andscientific medical men have by no means had the smallestshare in the development both of its botanical and zoolo-gical departments. Lectures on the subject are rarelycharacterised by the two qualities of impressive deliveryand artistic illustration. We have listened frequentlyto lectures on this subject, and in many cases havebeen fain to admit that, although they were " welldrawn," the amount of real instruction which has beenreceived and retained must have been to a large extent theresult of the inherent intelligence of the audience. Onthe other hand, flights of oratory dealing with portions ofsubjects in the shape of popular lectures have proved

through the scantiness of illustration but very insubstantialmental pabulum. The best lectures are those which,like the " object lesson," combine the qualities of apt-ness and facility of illustration with interesting andimpressive statement. A series of six lectures of thiskind has just been delivered in the Royal Collegeof Surgeons by Professor Charles Stewart, whose artisticskill and clearness of exposition made the coursea most instructive and enjoyable one. He chose forhis subject " Secondary Sexual Characters," a term whichhe defined as comprising those features by which we areenabled to distinguish the male trom the female quiteirrespective of the essential organs of reproduction, andwhich are not concerned either in the nourishment or in theprotection of the young. He brought together and ex-hibited a number of preparations illustrating this subjectand forming a series of types taken from the vegetable andanimal world. Illustrations were chosen from the algs&and mosses, the liverworts, and the common equisetum,Further illustrations of secondary sexual characters inplants were obtained from the catesetum, the valisneristspiralis, the fig plant, butcher’s broom, asparagus, many ofthe grasses, cannabis indica, and the common hop. Inlike manner types were chosen from the nematodesrotiferse, crustacea, arachnida, insecta, fish, amphibia,reptiles, birds, and mammals, from all of whichthe lecturer demonstrated that where a difference ofisize was found to exist between the male and thefemale it was noticed in all plants, in which there weresecondary sexual characters, that the female was the largerof the two. The same difference was found in the nema.todes, in the rotifers, and, with few exceptions, in thecrustaceans. Among the insecta very much the same thingexisted. In the mammals it was found that, without anyexception, where a difference exists, the male is the larger.In the reptiles also the male is the larger. In the amphibia,and nearly all fishes, the female is the larger. &laquo;herE:there is a difference of colour, the lecturer showedthat in almost every instance, both in plants andanimals, the more conspicuous and brilliant colour ispresented in the males. In plants the brilliant coloursattract the insects, which aid in their fertilisation. Thus,in the case of plants, by attracting the insect which isnecessary to convey the pollen to the female, colour operatesto some extent in bringing about that which is effectedin animals by sexual selection ; and it is a fact that inboth plants and animals it is the male as a rule which isfound to be most conspicuous in colour. As regards thesense organs, it is the male in almost every case thatshows excessive development of these. The antenna ofinsects, the eyes, the hairs, are almost invariably moredeveloped in the male. As regards glands which give offspecial odours (as in the case of bats &c.), it is found inalmost every instance they are possessed in the fullestextent in the male. This secretion acts very probably aaa sexual excitant. It may act like a drug, or it may act,conceivably, by mere association of ideas. In certain fish,and many other vertebrates, a marked difference in sizecharacterises the sexes. The more pronounced and out-standing characters are commonly found to be possessed bythe male, so that he is able to defend the female and theyoung, or to fight with his rivals for her favours. Thelecturer then considered the question whether the posses.sion of a certain structure by the male is to be lookedupon as having been acquired by him or lost by the female,It has been shown by Poulton that in the case of theantennae of insects there was evidence that in many instancesthe female had lost the large size and complex form of thatsense organ by a process of degradation, and from havingaltogether different habits of life from the male. In thecase of horns, Austin and others hold that originally bothmale and female possessed the organs, and that the femaleshave lost them. In the case of the reindeer both sexeshave them. For reasons such as this it is held that thefemale has lost the organs, from trusting to the protection ofthe male, in whom the horns are more developed. In ante-

lopes the horns of the male are longer, stronger, moreringed, and more ornamental than those of the female,showing a tendency to loss and diminution on her part. Asregards the origin of sex, the illustrations went to provethat so far as our observation at the present time goes,most forms in their primitive state were hermaphrodite tostart with. A large number of forms can be shown to beso, and all distinguishing characteristics of the two sexes