797

Annotations." Ne quid nimis. ’

THE CERTIFICATION OF DEATHS FROMSMALL-POX.

IT appears that in 27 per cent. of the deaths from small-

pox registered in London since the beginning of the year,ihe medical certificates gave no information as to the vacci-nation or otherwise of the deceased patients. The failureto supply this information to a very considerable extentweakens the influence and detracts from the value of those

carefully compiled statistics bearing upon the efficacy ofvaccination which the Registrar-General publishes from timeto time in his weekly and quarterly returns. In Liverpooland Salford the certificates are in this respect even moreincomplete than are those in London. Anti-vaccinationistsdo not even take the pains to disguise their suspicions thatthere is some sinister motive in so large a proportion of thecases being "not stated " as to vaccination. It is, there-fore, desirable above all things that in every certificaterelating to a death from small-pox it should, when possible,be stated whether the deceased had or had not been vacci-nated. Beyond this, in order to furnish the means for com-piling perfectly satisfactory statistics, convincing even toanti-vaccinationists, other information is desirable in fatalcases "after vaccination." In all certificates relating to vac-cinated cases in adults it is important to know whether thedeceased were vaccinated in infancy, and whether they hadbeen revaccinated. In deaths of vaccinated children from

small-pox it is very desirable to know how long they hadbeen vaccinated before the small-pox eruption appeared.We have reason to believe it is not generally known thatsmall-pox has an incubation period of thirteen days beforethe eruption appears, and hence many children and otherswho during an epidemic are vaccinated because they areexposed to infection from small-pox cases, are thus oftenvaccinated after they have contracted the disease. Withinour own knowledge more than one death from small-poxhave been certified as vaccinated cases when the periodbetween vaccination and the appearance of the small-poxeruption has not exceeded six or eight days ; thus clearlyproving that the deceased must have caught the diseaseabout a week before vaccination. Even anti-vaccinationistswould scarcely maintain that these cases should be classedas deaths from small-pox after vaccination, and yet so longas they are so certified the Registrar-General is powerless tctreat them in any other way than as vaccinated cases. If

the certificates in these cases gave the date of vaccination,when known, as well as the true duration of the small-posdisease, sufficient data would in most cases be afforded fot

deciding whether the deceased was under the protectinginfluence of vaccination at the time small-pox was contracted.

____

LICENSED LODCING-HOUSES AT THEUNIVERSITIES.

LAST week we published a letter from Mr. G. S. Ward, oiHertford College, one of the delegates for licensing lodging !at Oxford, giving a denial, as far as Oxford is concerned, t<

the statements made by us as to the neglect of sanitaryarrangements by the lodging-house syndicates at bott

Universities of the houses under their supervision. Oustatement was made partly on the strength of personaobservation, and partly founded on complaints that havoreached us from parents having sons at the UniversityMr. Ward assures us that at the present time, in houseapplying for a licence, the drainage, water-supply, venti

lation, and cleanliness are all attended to, " inquiries madeas to the number of inmates, with a view to prevent over-crowding ; every sink and closet examined, and the soil-

pipes of in-door closets are required to be ventilated." Itwould have been more satisfactory had he been able tostate that all the sanitary deficiencies had been absolutelyand efficienr,ly remedied as well as attended to. Mr. Wardapparently makes a distinction between houses that havereceived a licence and those that now apply for one. In theformer instance we are told they have been " inspected andreported on" by a "highly qualified medical gentleman ";but no mention is made of the action taken in his report.In the latter case sanitary details are attended to, and cer-tain precautions required. The fact, however, that theOxford authorities have undertaken to grapple with thesedifficulties is highly creditable, and we hope to hear shortlythat the Cambridge Syndicate intends to recognise theirresponsibility in this matter. In giving prominence to Mr.Ward’s letter, The Times did us and the town of Oxford an

injustice in saying it was an answer to an attack by us onthe sanitary condition of Oxford. In our article the health

of Oxford was not alluded to, nor reference made to its

sanitary condition. Our remarks were limited solely to thequestion of lodging-house supervision; and, so far from

singling out Oxford for attack, our comments were equallyapplied to Cambridge, as the heading of our article clearlyindicated.

__

THE EARL OF MOUNT EDQCUMBE ON LECIS-

LATION FOR CONTACIOUS DISEASES.

THE Earl of Mount Edgcumbe presided at the late annualmeeting of the Royal Albert Hospital, Devonport, and inthe course of his address, moving the adoption of the reportof the Managing Committee, his lordship made some

remarks on the operation of the Contagious Diseases Acts,which were distinguished by an amount of vigorous soundsense and courage that is quite refreshing. Feeling thathe had never expressed an opinion publicly on the questionbefore, and considering that it was one on which it was hisduty to do so, his lordship declared it to be his firm con-viction that the arguments of those who were agitating fora repeal of the Acts could not bear the test of calm and

impartial judgment. In answer to those who, upon moral, and religious grounds, objected to the law, as representing

the sanction of vice, he declared that when vice had extended,as it had in this instance, throughout the land, and broughtwith it such fearful consequences, it was impossible to do

’ other than recognise it. And there were only two courses,

for the Legislature of the country to adopt-one to attempt’ by penal enactment the suppression of vice, which in this

case would be utterly impossible; and the other to attempt,in some indirect way, to lessen the evils consequent uponit. There was but one other course conceivable to his

mind, and that would be for the country to shut its eyes toit, and allow it to go on unchecked, disseminating disease,misery, and suffering, not only amongst those to whom itmight be considered that the evil courses brought their de-deserved punishment, not only amongst those whose laches

f might have excuses which even the most rigid moralists woulds pity, but often amongst the absolutely pure and innocent.) There was another argument also used, said his lordship, as7 reported in the Western Morning News, which appeared

to him to be very different-almost contradictory, in fact;r it was one which he should almost be inclined to style the1 immoral argument, and that was that the law was an in-3 fringement of individual liberty. If they only thought, for. one moment, what the individual liberty was to which thes argument referred, he thought it must be a surprise to some- of them that that argument came sometimes from the lips

798

of ladies. Pet’baps the argument might be an indication of J,Ln. 25th of the present year, a case of tracheotomy wasfeeling in their mind of an injustice which they thought recorded undor the care of Mr. Ccird, at the Exeter andthe law perpetrated in dealing only with one, and that the Devon II ospital, in which the metal tube could not be borne,weaker, sea. No one could feel more strongly than he that and no relief could be afforded until it was replaced by a longwhen two people were equally guilty, it; was a gross injustice india-rubber tube extemporised for the purpose. The chief

that all the degradation of punishment should rest with one, objection to the use of the flfxible tube is that pointed outand the other go free. That he felt would be a monstrous by Mr. Baker-viz., that it requires a guide for its intro-

injustice, but he did not think it applied to that case. God duction; and one of the cases he related met unfortunatelyforbid that he should speak without forbearance of the most with a fatal result, in consequence of the nurse being unablesinful or most degraded, but, at the same time, it was only to replace the tube, which the patient had herself draggedtrue to say that the lives of those to whom the provisions out. For the same reason&mdash;its flexibility, and therefore com.of the Acts were a,lone intended to apply had no parallel in pressibility&mdash;it, cannot be employed until a sufficient timethe lives of men. The arguments for the repeal of the law has elapsed for the trachea to have become fixed to. the sur.were not deserving attention, providing it could be shown, rounding tissues. ____

as he believed it could be, that the law had distinctly been -

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of use in reducing physical evil, and had not done anything THE ARCTIC EXPEDITION.

to encourage or increase the moral evil ; and, at the same ALTHOUGH: no further information as to the sanitarytime, that the law had not been abused. Attempts had aspects of this expedition have as yet emanated from thebeen made to prove abuses, and they had, he believed, Admiralty, there appears to be an abundant amount ofin every instance, and in that neighbourhood also, signally presumptive evidence, all tending to show that, from somefailed. The opponents of the Acts could not prove that by reason or other, the hygienic arrangements have beentheir existence the moral evil had been increased, and he lamentably mismanaged. Our first article on the subjecthoped as years went on that it would be still further shown hinted, naturally enough, that some neglect must havethat the execution of the law did go hand in hand with arisen. For it appears almost incredible that a pickedevery effort to bring religious and moral improvement to body of men, the cream of Her Majesty’s navy, provided withbear upon those who were subject to its operations. They all the varieties of clothing and all the prandial comfortswould see in the report that that was the case with regard that the skilled officers of the service could suggest, shouldto that hospital&mdash;that religious influence was attempted, and be unable to withstand the toil and privations of an Arcticwith success; and he hoped that the Legislature would be voyage that lasted altogether just eighteen months. Nofirm, and not allow ignorance or prejudice to undo the work less than twenty-six years ago, M’Clure, in the Investigator,which they had begun, and which he believed, if carried on spent more than two years in the same regions before aas at present, would do great good to the country. case of scurvy occurred among any of his men. The

present Medical Director-General of the Navy was his sur-TRACHEOTOMY TUBES. gon, and although it is ridiculous to compare the sanitary

IT is almost a truism to say that the practical efficiency equipment of the Investigator in 1850 with that of the Alertand value of instruments are in direct proportion to the in 1875, it is perfectly clear that the crew of the former were

simplicity of their construction. Certainly no better illus- kept in good health by the continued and skilled super-tration of this could be afforded than was given by two vision of their officers. Impressed with the (even then)papers read at the last meeting of the Royal Medical and well-known fact that lime- or lemon-juice was the most

Chirurgical Society. In one of them Mr. Morrant Baker efficient and most convenient antiscorbutic known to us,

introduced to notice a new form of tracheotomy tube, made the officers took very special care that every man drank hisout of india-rubber, and in the other Mr. Hulke related a ration every day under the eye of his own chief. Other

case in which the outer sheath of one of Mr. Durham’s sanitary precautions were, of course, also adopted, but theinstruments became detached, and, slipping down the value of the chief antiscorbutic was, in this case, tested

trachea into the right bronchus, remained impacted there very fully and practically. We need not, at this date,for three days, until it was cleverly extracted, but not ask whether similar precautions were carried out in thisbefore inflammatory symptoms had set in. To the causes last expedition, because all unofficial information as yetassigned for this accident, and the criticism passed by Mr. gleaned goes to show that, on the sledging expeditions, lime-Hulke upon the form of tube in question, we need not and lemon-juice were entirely ignored.further refer, except to remark that it is only fair to Mr. It is painful to cast any cloud of criticism on an expedi-Durham to admit with him that the instrument used was tion so nobly conceived; but we are bound, in all justicenot made strictly in accordance with his model. With re- and honesty, to point out that maladministration or lamen-gard to Mr. Baker’s invention, we may note that the first table want of judgment on the part of our naval authori-case in which his tube was used was recorded in these ties, has resulted in the death of several splendid men,columns about twelve months ago by Mr. Paley, of and has made most decidedly the Arctic Expedition of 187Sthe Evelina Hospital (THE LANCET, 1875, vol. ii., p. 834), a sanitary non-success. ____

and the inventor has acted wisely in not bring-ing the subject prominently forward until he has THE CAMPBELL DE MORGAN MEMORIAL.

collected a sufficient number of cases to test the working THE general committee of subscribers to the fund

efficacy of his instrument. Ample testimony was afforded established to provide a memorial of the late Campbellat the meeting in favour of the new tube; but it is matter r D... Morgan met in the Middlesex Hospital on the 24thfor regret that want of time curtailed the discussion upon , ult. Mr. A. H. Ross, chairman of the weekly board of theits merits. The serious results that not unfrequently follow hospital, presided, and among those present were Lordthe employment of the ordinary metal tube, adding greatly Josceline Percy, Sir Thomas Watson, Bart., Captain Darley,,to the dangers of the operation, and always forming a source Drs. H. Thompson and Headlam Greenhow, and Messrs.of anxiety to the surgeon, are happily obviated by the use Flower, Sibley, Hyde Hills, Temple Frere, H. Morris, andof this flexible instrument. Theoretical objections to its others. It was announced that the amount already sub-use may be met by an appeal to the excellent results that scribed reached about J3596, and it was resolved thathave already attended its use. In our Mirror" for further steps should be taken to increase the fund, so as to

799

enable a fitting memorial to be established in the hospital claim for it the title of leucocythsemia. Dr. Gowera’s case

which was the scene of Campbell Do Morgan’s life labour, presented a marked parallelism to it, and the different desig-and with which his name will always be linked. It is nation depended on a difference of view as to the pathologyproposed for this purpose to open a new Cancer ward which of the disease. We do not suppose that it would be desirableshall bear his name. At present, with thirty-two beds to discuss fully the relations of lympbadenoma, lymphaticdevoted to female patients suffering from cancer, there are leueocytbaemia, and splenic leucocyth&aelig;mia; but it is cer-but six for male cases. The treasurers of the fund are tainly desirable that a clear understanding should exist asMessrs. Samuel Scott and Co. ; and the honorary secretaries, to whether all are equally amenable to the action of phos-Mr. George Lawson, Dr. Robert King, and Mr. C. M. S. phorus, by what symptoms the favourable cases may beChichester, the secretary to the hospital. We hope diagnosed, and whether the mere fact of the presence of anshortly to be able to announce a large increase in the fund, estimated excess of white blood-corpuscles is a, sufficient indi-which has for its object the double purpose of extending cation for its employment. Some valuable light will, we hope,the bounds of charity and of establishing a permanent be thrown on the subject, which will aid the ultimate deci-memorial of one whose name will long be cherished by all sion of these questions. those with whom he was personally associated.

DRUGGED TO DEATH.

PHOSPHORUS IN LEUCOCYTH&AElig;MIA. KNOWLEDGE of the danger of administering opiates to

I ’T will be seen from the report of the meeting of the infants is apparently very rare among the lower classes, or, if

Clinical Society which wa publish to.day, that a discuasion possessed, is habitually neglected for the sake of the relief to

of much interest may be anticipated at the next meeting. the mother which the drug secures. It is, therefore, very de-

that wide publicity should be given to the cases ill .Some difference of opinion seems to have existed as to the sirable that wide publicity should be given to the cases inwhich death has clearly resulted from such a course, and suchdesirability of discussing the questions raised by the cases publicity appears likely to be secured to a case which hasreported, and even some doubt as to what those questionswere. Undoubtedly a discussion on transcendental patho- lately occurred at Cardiff, in which both the parents and forlogy, such as seemed to be advocated by the proposer of manslaughter. Opiates seem to have been given to the childthe adjournment, would be entirely out of place at so prac- so constantly that some degree of tolerance was produced,tical a society as the Clinical, but there are practical points and the constitutional effects of chronic opium-poisoning,on which much valuable information may be gained if the true

and the constitutional effects of chronic opium-poisoning,rather than acute narcotism, was the real cause of death,

objects of the discussion are kept clearly in view. Firat of which occurred at seven months. The mother had been in

all, there is the question of the action of phosphorus in the habit of giving the hild soon mother had syrup ofthe habit of giving the child, soon after birti, syrup ofleucocytba)mia,. The startling results announced by Dr. poppies. But the syrup is not a strong narcotic, and so someBroadbent, and af terwards by Dr. IVilson Fus, as having been laudanum was habitually put into the syrup by the chemistgained by the administration of the drug in well-marked cases at the parents’ request to increase its narcotic effect ! Theof splenic leuoocythsemia, led to the belief that a specific chemist used at first to put three drops of laudanum in thefor the disease had been discovered. Other cases, such as medicine, but this having no effect upon the child, the fatherthose related by Sir W. Jenner, have shown that in some complained that it was not strong enough, on which theits

complained that it was not strong enough, on which theinstances little or no good has resulted from its prolonged chemist would always put in a larger quantity of laudanum;

action. But a sufficient time has now elapsed have been and the week before the child’s death fifty drops were put

Broadbent’s paper for a large number of cases to have been into a pennyworth of the syrup, and half a teaspoonful wal!’ltreated in the same way, and tbe ultimate issue observed, . at a time. This, on the lowest computation, wouldand we trust that others will follow the example suggested contain three drops This, 1 au d anum, Th e c hild was wouldcontain three drops of laudanum. The child was muchby Dr. Greenhow, and bring before the Society a concise emaciated, suffered from constant vomiting, the lungs in-account of such cases, with sufficient details of the eym- flamed, the stomach small and contracted. Dr. D. E. Jones,ptoms, the stage of the disease, mode and length of who made the post-mortem examination, gave it as his opiniontime of employment of the drug, and of the results, that death was accelerated by the opium, and of this thereto form material for comparison. can be little doubt. The verdict of manslaughter of theAnother question of great importance, raised by the case coroner’s jury will be at least a much-needed warning to both

recorded by Dr. Gower!!, is whether phosphorus employed in parents and chemists, and it is to be hoped that it may lead toordinary medicinal doses is liable to give rise to degenerations some restriction on the too ready sale of infants’ narcotics.such as those described by him ; or if they were due to the ____

drug in his case, whether they depended on idiosyncrasy or THE WELD CASE.previous organic disease. It will never do to admit into our

ordinary armamentarium a medicine which will fulfil the old UNDER this heading the Indian press, more especially thetaunt of " curing the disease, but killing the patient." And Madras section of it, has been dealing with a subject thatif such a sequel to the use of phosphorus were anything but appears to have caused no little commotion in its way.

infinitesimally rare, it will be doubtful whether it should be The story is simple enough in itself, and is as follows. A

given at all until the disease has reached dangerous propor- Brahmin was buried near a tank or large pond which formstions, and is therefore less capable of cure. the principal source of the drinking-wd.ter of all classes of &pound;

But another question must arise with regard to the cases the people of N pgapatam. Mr. Weld, the assistant collector,reported. It is highly important that the class of cases on bearing of this, ordered the removal of the body onlikely to be benefited by the drug should be well understood. sanitary grounds, acting in accordance with the advice ofWith the exception of Sir W. Jenner’s cases, none of them Dr. Beach, the Zillah surgeon. The family of the deceasedwould come under the definition of leucocytbaemia as ordi- Brahmin petitioned the Duke of Buckingham, and his Gracenarily accepted. Dr. Goodhart’s case is, to say the least, an has most severely reprimanded Mr. Weld, and suspendedanomalous one. Dr. Broadbent’s case, shown at the pre- him for two months with the loss of his pay and emolumentsvious meeting, was atypical one of Hodgkin’s disease. Dr. during that time. Mr. Weld, it must be a.dded, appears toGreenfield regarded his case as one of Hodgkin’s disease, have had throughout the sanction and support of his im-

presenting some anomalous features, and, amongst others, mediate superior, Mr. Thomas, a collector of some thirtya decided increase of white blood-corpuscles ; but he did not years’ service, who is also censured by the Governor in

800

Council. The points of contention about the case are as to are being taken by the local authorities to reduce thiswhether the site at which the Brahmin was interred was a alarming proportion of material for increasing the fatalityburial-place or not, the necessity that existed for exhuming of small-pox in North London, due to the neglect of theirthe body, and the method and circumstances under which vaccination responsibilities by the local Poor-law guard-the law was put in operation. The Madras Government ians. Vaccination should be vested in local sanitaryhave decided against their subordinates on all these heads. authorities, instead of the guardians, and then, under theWe can only pretend to deal with the matter, however, advice and superintendence of medical officers of health,in its sanitary bearings. It is denied that the place there would be less chance of this dangerous neglect ofwas, or had been for some thirty years, a burial place at vaccination, which is in great measure due to the fact thatall, and asserted, on the other hand, that the body of the a certain proportion of guardians persist in "keeping theirdeceased Brahmin was surreptitiously interred there. It is minds open" as to the utility of vaccination,-in otheralleged in the order of Government that any danger from words, lean towards anti-vaccination.contamination of the water might have been entirely pre- vented without the removal of the corpse from the grave; THE ARTISANS’ DWELLINCS ACT INbut, however this might be, it is expressly asserted by those MANCHESTER.on the spot that, spite of the body having been buried atdistance of fifteen or twenty yards from the water, with a

DR. RANSOME, Professor of Hygiene at Owens College,thick wall and a large flight of steps intervening, there was recently delivered the first of a series of "health lectures

grave risk of such contamination, the sandy soil being for the people," organised by the Manchester and Salfordmost favourable to such an occurrence ; and as to this we Sanitary Association. The subject of the lecture was &deg;‘ Foulthink there cannot be any doubt. It appears to us that on Air and Lung Disease," in the course of which he alludedpurely sanitary grounds, and in the interest of the public to the fatal effects upon the purity of the air till recentlyhealth, Mr. Thomas and Mr. Weld were perfectly justified caused by the open ashpit system in Manchester. It was

in their conviction that the presence of the corpse in such a stated that twenty thousand of these abominations have

position was a grave source of danger. Negapatam is the lately been removed from the city, and that the remainder

town, we believe, from which, as a centre, the cholera were in the course of removal, at the rate of two hundred

epidemic of 1874-75 spread over the whole of the southern per week. After calling attention to the fact that pure airpeninsuls of India, preventing the Prince of Wales’s visit

was an impossibility in large towns without good local

I the t , The F stringent regulations e -*. government. Dr. Ransome urged that the Artisans Dwell.to the Anamalays. The most stringent regulations for its government, Dr. Ransome urged that the Artisans’ Dwell-improvement have been issued ,. in consequence, and Mr. ings Act was intended to aid local authorities in openingThomas, the collector, has earned great praise for the suc- up crowded portions of towns, and regretted that Man-

cessful efforts he has made in this direction. Mr. Weld was chester had not yet taken advantage of its powers, although

............... - ,, t. few large cities stood so much in need of them. In someno doubt acting in the spirit thus inculcated when he gave few large cities stood so much in need of them. In somethe orders which have resulted in what is, apparently, a very parts of the city, especially in Ancoats, he remarked thatsevere punishment.severe punishment. Dr. Ransome’s plea for the adoption of an improvement

SMALL-POX AND NECLECT OF VACCINATION scheme for Manchester, it may be urged that the average

IN HACKNEY. annual death-rate in that city during the five years 1871-5

.

was equal to 30 per 1000, and exceeded that which prevailedTHE present epidemic of small-pox in London has shown in any other of the eighteen largest English towns, not even

especial fatality in Hackney, no less than thirty-two deaths excepting Liverpool. Indeed, during 1875, the death-ratefrom small-pox being registered within this union and in Manchester exceeded that in Liverpool by 2-4 per 1000.registration district during the four weeks ending Novem- ____

ber 25th. Thus nearly 20 per cent. of the fatal cases of

small-pox in London occurred in Hackney, although the NOTES ON FIJI.

population of this district is less than 4 per cent. of the WE have been favoured by the Secretary of State for thepopulation of the metropolir. The last Vaccination Colonies with a printed Report on the Sanitary Condition ofReport of the Medical Officer of the Local Government Colo, Fiji, by Dr. Macgregor, who was attached to an expe-Board throws considerable light upon the cause of this ditionary force sent by the Government to Colo. The dis-

exceptional fatality of small.pox in Hackney. It appears trict is very mountainous, reaching occasionally an altitudethat of the children born in this district in 1873, of between 4000 and 5000 feet. Thermometrical readingsno less than 20-8 per cent. were returned as unac- of air and river were taken during twenty-six consecutivecounted for-in other words, remained unvaccinated. days in May. The river was found several degrees warmerNow the average proportion of unvaccinated children than the atmosphere; the average temperature of theamong those born in the whole of London in 1873 former being 6620, and of the latter 68 3&deg; F., while twowas 8’7 per cent., and ranged from 2’3 and 34 in Lewisham months later the river was 5’10 warmer than the air. Waterand Westminster, to 14’6 and 208 in St. Giles’s and is very abundant and of first-rate quality. Some interest-

Hackney. It is, of course, possible that the neglect of ing information is given of the diseases of the natives. Thevaccination in Hackney, so evident in the returns for 1873, most common malady of the inland district is coko, or

may have decreased during 1874 and 1875, and, therefore, " yaws," as it is termed in the West Indian islands.that a smaller proportion of children born in those years It chiefly attacks children, the attack lasting from nineremain unvaccinated. If, however, the result for the year months to three years, but the same individual seldom

1873 be accepted as evidence of the proportion of children sufftJrs a second time. Next to coko, the most prevalentvaccinated in Hackney in recent years, it may be estimated disease is leprosy, but of a mild type. We areglad to learnthat there are at the present time nearly four thousand un- that the old native treatment applied to the leper-viz.,vaccinated children under five years of age living in the burying him alive-is falling into desuetude. Ophthalmiadistrict, without taking into account the unvaccinated comes next in point of frequency; then scabies, Tokolauchildren aud adults over that age. With these facts be- ringworm, and vidikoso, the latter being characterised byfore us, surprise at the fatality of small-pox at Hackney extensive and obstinate ulcerations, persisting in certainvanishes, and it becomes important to inquire what steps cases for ten or even twenty years. It has been compared

801

to the Delhi boil and Aleppo boil. Not a single case of drinksbops in the town, enumerating the names of certainpulmonary consumption was met with among the people persons who have been convicted of drunkenness threeexamined. Vaccination has not yet been introduced into times within twelve months, and warning the publicans notthe diatrict&mdash;a circumstance that should cause the gravest to supply the same persons with intoxicating liquors for theanxiety to the authorities, if they are mindful of the lesson space of a year. It will be interesting to watch the workingof the late measles epidemic which devastated the island. of this Act. It, of course, can only be applied to a smallSmall-pox is known to be raging in California and Mada- town.

gascar, and it would be very easy to import the pest into -

Fiji. Two questions Dr. Macgregor particularly presses SENATOR MOLESCHOTT.on the consideration of the Board of Health: one, -the AMONG the numerous distinguished men who have justprevention of the interchange of diseasa between Fijians been raised to the Upper Chamber of Italy, Professor Mole-and foreign labour introduced by the Government"; the schott, of the University of Turin, must rank the foremost.other is, the desirability of vaccinating all natives and One of the greatest physiological chemists now living, heimmigrants as they arrive in the colony. An intelligent has shown in his "Licht und Leben " that he can combinenative would very probably be of opinion that the advent of with the severest inductive research the imagination of thecivilisation is not an unmixed good for his country. poet. This combination has endeared him to the young

minds over whom for more than fifteen years he has-atANATOMY AT THE FINAL EXAMINATIONS. Cavour’s instance, we believe-exercised professional sway;A " senior student" at the Medical School in Cork has and, accordingly, his recent elevation to the rank of senator

stated that a rule has recently been made by the Professor inspired his students for the coming year with the idea of

of Anatomy there, forbidding all fourth-year’s students to presenting to him a congratulatory address. On Tuesday.enter the dissecting room, unless on payment for the third the 21st, the ceremony took place, and the interchange of

time of the full fee for the course of Anatomy. It is mani- affectionate regard between pupil and master was spon-

fest that this is an injustice which should at once be taneous, hearty, and fresh. In his reply, Professor Mole-

remedied. The regulations of the examining boards have schott spoke genially of his young ambition to visit Italy,of late insisted more and more on the necessity of an and of the joy he felt when that ambition was crowned byacquaintance with surgical anatomy at the final professional his being called to a chair in the University of Turin. "In

examinations, but if the teachers of anatomy do not allow this hall," he said, " and in your indulgent presence, Ithe senior students the opportunity to refresh their know- learned to make myself understood in your beautiful lan-

ledge by inspecting dissected subjects, the attempts to pro- guage by successive classes of pupils, and now that I havemote the study of surgical anatomy will be rendered more become, so to speak, a molecule in the legislative brain, myor less nugatory. Our correspondent appears to have paid efforts will be directed to making myself yet more useful to

the ordinary fee for a two-years’ course of anatomy, and you and to the science you cultivate."

asks merely to have the liberty of entering the dissecting- room to look at dissections. The request is a reasonable THE CULTIVATION OF DRUCS.one, and ought to be acceded to without delay. MOST Of the valuable drugs and plants of the physicians

-

are now successfully cultivated in some or other of ourTHE OBSTETRICAL SOCIETY OF LONDON. Eastern possessions. It is but a few weeks since we re-

WB would call attention to the next meeting of the corded the excellent progress made in chinchona cultivation

Obstetrical Society (to be held on Wednesday next, the 6th in entirely new districts. It appears that experiments in

instant), at which it is expected that a demonstration of growing ipecacuanha afford equally gratifying results. Atransfusion of blood from the living subject will be made quantity of the dried root grown in Bengal was pronounced,by Dr. Roussel of Geneva. It so rarely happens that mem- after extensive trial at the hospitals in the treatment ofbers of the profession have an opportunity of witnessing dysentery, to be as effectual as the best South Americanthis delicate operation, that we do not doubt that num- drug. Quantities of ipecacuanha have now been sent tobers of our readers will avail themselves of the occasion to the NeiJgherries, to Ceylon, and to British Burmah for

familiarise themselves as far as possible with the neces- trial, and those qualified to express an opinion are hopefulsary operative procedures, and also with Dr. Roussel’s ex- of success. A plant of less consequence, from a medicalcellent instrument. point of view&mdash;vanilla&mdash;does not take kindly to the CalcuttaAn important paper, "On the Obstetrical Aspects of Botanic Gardens, and Dr. King is of opinion that it will

Idiocy," will be read during the evening by Dr. Langdon never become a staple product of Bengal.Down, who is recognised as one of the first authorities on

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the subject of idiocy. Altogether the meeting promises to THE NEW MEDICAL SCHOOL OF CLASCOW.be one of unusual interest, and we congratulate the Society IT would have been a melancholy thing if the removal ofon its vigorous efforts to advance the science to which it the university and the erection of a new hospital in Glasgowis devoted.

____ had led to the entire disuse of the Glasgow Royal Infirmaryas a school of medicine. As our readers know, this is not to

THE SUPPRESSION OF INTEMPERANCE. be the case. The managers determined, acting under theirTHE ingenuity of the philanthropist and reformer is now- original charter of 1791, to institute such a school. It was

a-days taxed to the uttermost in devising schemes for the duly opened on the lst of November, and, if we may judgesuppression of intemperance, and it would be hard if none from the address of Dr. Fleming-well selected by theof the projects advocated should prove successful. The managers to express their views in inaugurating the newmost novel legislative enactment against what may be school-it will be conducted in a spirit of wisdom, and withtermed the national vice with which we are acquainted has feelings of respect to the other parts of the great Glas-just been put into operation in the Isle of Man. A few gow school, to which the world already owes much. Wedays since action was taken at Douglas under the Habitual do not forget that it is possible to have too many schools inDrunkards clause of the Isle of Man Licensing Bill, when a city. But it would be simply monstrous to have anBotices were served on each of the six hundred licensed infirmary of 600 beds without a school attached. The school

802

will have a serious rival in the university, but if its pro. THE trustees of the Manchester Royal Infirmary will meemoters try to secure teachers worthy of the position, and on the 4th December, to decide as to the removal of the

irrespective of all local considerations, the rivalry will be institution and the sale of the present site. Dr. Renaud

most beneficial, and Glasgow will become, according to pre- has addressed a long letter to the governing body, stronglysent appearances, a rival of Edinburgh, and worthy of the advocating the retention of the present building. He thinks

illustrious Cullen, wbofounded the school by giving his famous the advantage of site outweighs the structural defects of thelectures on the Theory and Practice of Physic in 1745. hospital, and that a way may be found to set it in a healthy

condition without resorting to the extreme measure of

PHYSIOLOCICAL ACTION OF MANCONA BARK. removal, and contends that it "stands on a rock of moral

FROM a careful extmination of the bark of Erythrophl&aelig;um and utilitarian usefulness from which all the blasts of the

FROM a careful examination of the bark of Erythrophl&aelig;um disaffected and the interest ought not to be suffered toguineense, MM. N. Gallois and E. Hardy have arrived at

disaffected and the interested ought not to be suffered to

the following conclusiona. The bark of the Erythrophl&aelig;um dislodge it unless the sanitary defects of construction can

guineense, employed by some of the natives of Western be proved faulty beyond reasonable or too costly redemp-Africa to poison their arrows, and which belongs to the tion. "LeguminoFse, contains a toxic substance of considerahie

mm Council of Sunderland have adopted a measureactivity. This substance-for which they propose the name proposed by their medical officer of health, Dr. Yeld, whichof " erythrophleine"&mdash;is a muscular poison, and especially a cannot fail to have a beneficial influence on the health of thecardiac muscular poison, paralysing the action of the heart inhabitants. The scheme deals with the cleansing of themore or less rapidly according to the dose administered town, and especially provides for the proper managementtown, and especially provides for the proper managementWarm-blooded animals die as soon as the heart is paralysed, of ashpits and the cleansing of the streets. Under the newwhilst in frogs life persists for a variable period. Inanimals

arrangement, the eleven thousand ashpits in the town will?poisoned with it the functions of the nervous system remain, be attended the every thousand the streets cleansed will atto all appearance, long intact after the heart has ceased to regular and frequent intervals. the addition t 0 th e goodbeat. In the dose of one. half to one artilligramme placed sanitary results anticipated, it is confidently expected thatdirectly on the heart, or of two milligrammes subcutaneously sanitary financial benefit will accrue to the Council by thatinjected, erythrophleine stops the heart of a frog in from reform.five to eight minutes ; four milligrammes injected beneath

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the skin of a guinea-pig proves fatal in the course of a few A REPORT of the health of Mile.end Old Town during thehours; and four centigrammes, in divided doses, killed a past year has been issued by the medical officer of health,curarised dog of moderate size in one hour and a half. In Dr. M. Corner. The population of the hamlet is now es-warm-blooded animals it produces convulsions and extreme timated at 100,000. There were registered in the period- dyspnoea, consecutive upon disorders of hsematosis. In cold- 2077 deaths, a mortality which gives a lower death rate for’blooded animals it produces progressive stupefaction, which the district than that for the whole of the metropolis.leads to complete resolution of the muscles. The heart is The Vestry may be congratulated on the fact that no

paralysed before either the smooth or striated muscles, con- death from small-pox was recorded in the year. Dr.sequent on the large volume of blood with which it comfs Corner’s report is ably arranged, and evinces a thoroughinto contact in a given time. In frogs the ventricle stops and practical acquaintance with the requirements of modernin systole, the auricles in diastole. In warm-blooded ani- sanitation.mals the heart is usually found soft and filled with blood,

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and the poison can be demonstrated by chemical tests in THE scheme for providing the volunteer forces with corpsthe blood. In the frog the heart beats slowly before stop- of sick bearers appears to meet with general approval. The

ing, but in the dog its action is considerably accplerated. promoters continue to receive much encouragement, andIn the three dogs operated on the arterial tension was found we have little doubt that they wilt carry the movement to ato be augmented. Atropine does not reanimate the heart ; successful issue. A meeting of commanding and medicalcurara retards its effects. It is difficult, the authors observe, officers of volunteers will be convened next month for theto say whether Man&ccedil;ona bark will ever be introduced into purpose of making a representation to the War Office, andpractice. If sternutatories were still employed, it would asking for facilities being given by the authorities for train-certainly take its place amongst them ; and it may be ob- ing volunteer surgeons in the system used in the army. Weserved that, like digitalis, it augments arterial tension. would suggest that a training school be established in the

SMALL-POX IN LONDON. tirst instance in the metropolis.

IT is gratifying to notice that the number of deaths from A DECISION affecting Poor-law guardians, with regard tosmall-pox registered in London last week was less (43, against the transport of patients with infectious diseases, was given52) than the week before. It would be a great error, how- last week. The Metropolitan Asylums Board, in reply toever, to regard this as a reason for in any way relaxing a letter from the Lewisbam Union, detailing the difficultiesvigilance and precautions. We are yet probably only at incurred in the conveyance of patients by the relievingthe beginning of the epidemic, and individuals and sanit-try officers to the hospitals, stated that it was no part of theauthorities should leave no stone unturned to reduce the duty of the managers to provide means for the removal ofnumber of persons capable of taking the disease. One of the patients to their hospitals. Thus the obligation of equip-cases specified in the return is that of a man of seventy- ping ambulances is thrown on the guardians.two, who had been inoculated in early life ; another proof that small-pox itself is not an absolute protection against the THE project to provide Clerkenwell with a much-neededdisease. mortuary does not mature rapidly. Estimates and tenders

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were received at a late meeting of the vestry, but after thePRINCE LEOPOLD. expression of a hope from one member that the vestry would

WE have authority for stating that H.R,.T-1. Prince accept the lowest tender, the matter was referred back toLeopold is suffering from a return of the swelling in the the Sanitary Committee for reconsideration. The obstinacyknee of a much more serious character than the previous displayed by the Clerkenwell authority in regard to thisattack. matter is truly phenomenal.

803

THE foundation-stone of a new hospital was laid at Wake-field last Saturday in the presence of a large aS8emblage ofpeople. It is intended that the institution shall providefifty-two beds, which number can be extended as occasionrequires to nearly 100. The total coat, including furniture,&c., is estimated to reach &pound;20,000, about &pound;14,000 of whichwill be expended on the building. The hospital is plannedon the pavilion system, and will have a length in the mainfrontage of 287 feet, with a central tower 70 feet in heightIt promises to be a commodious and handsome structure.

COMPLAINTS have been made to the Commissioners of

Sewers of the "offensive and dangerous effluvia arisingfrom the sewer ventilators in Mincing-lane," and the

authority is asked to remove the nuisance speedily. The

matter is now referred to a committee. The attention of

the Commissioners has also been called to a defective water-

supply in Paternoster-square, and a smoke nuisance in

Cannon-street. Legal proceedings will be taken, if neces-sary, to remedy these evils.

THE difficulties connected with the registration of diseaseexercise the profession abroad as well as at home. In Mon-

treal the City Corporation has proposed a new bye-law tothe effect that a fine of forty dollars and two months’

imprisonment be imposed on any medical practitioner whoshall neglect to report to the Health Committee a case ofinfectious disease within twelve hours after its occurrence.This extreme measure is, naturally enough, opposed by th(profession in the city. _

OWING to the difficulty experienced in obtaining nursesand officers for the Hampstead Small-pox Hospital underthe Local Government Board’s regulations, which requiresthat a week’s notice of a proposed appointment be given,the Central Board, at the request of the Hospital Committee,have suspended this rule. Arrangements have been madewith the sisterhood of East Grinstead for members of thatinstitution to take charge of the patients.

THE new committee for the Hampstead Small-pox Hos-pital has not commenced its work auspiciously. Under an

apprehension of danger to the workmen from the receptionof small-pox patients the committee stopped the works of thepermanent building. The Metropolitan Asylums Board havecondemned this action of the committee, and issued instruc-tions to resume the works and carry them out to completionwith the least possible delay.

THE overcrowded state of the Hanwell Schools must soonnecessitate the erection of additional buildings. There are

at present over 13,000 children from the City of London andSt. Saviour’s Unions in the establishment, a moiety of whomare under partial isolation on account of ophthalmia. The

Board of Guardians of the City of London Union have beenasked to take the matter into consideration.

WE learn that small-pox is very prevalent in Burnley,and that a hospital devoted to the reception of patients hasbeen opened. About forty cases are now under medicaltreatment. The occasion of a wedding party at a public-house, where there was a person ill with the disease, wasthe means of infecting no less than seventeen of the towns-people.

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IN Dublin, Bills are being prepared for presentation inthe next Parliamentary session, with the object of providingthe city with health spaces and recreation- grounds; for

opening St. Stephen’s-green as a public park, and for theextension of the main drainage.

WE observe that a well-deserved complimeot has been’ paid by the Corporation of London to the sanitary officers

of the City, for the manner in which they carried the lateproceedings in regard to impure tea to a successful issue.

MR. FRANCIS MASON has been unanimously elected Surgeonto St. Thomas’s Hospital in the place of Mr. Simon. Mr.Mason still retains his appointment of Lecturer on Anatomy

. at the hospital.

THE LONDON WATER-SUPPLY.

WE are glad to see the question of the supply of water tothe metropolis is again being brought under public noticeand discussion. Last week we called attention to the con-ference held by the delegates from the various parishes ofthe metropolis to consider and take steps with regard tothe extension of the charges of the water companies in theLondon district, and to prepare a memorial to be presentedto the Home Secretary praying for an alteration of the lawwith respect to the water-supply of the metropolis. The

monthly report of Mr. F. Bolton on the London water-supplycomes at an opportune moment for us to offer a few com-ments and suggestions on this important subject. It appearsthat a few of the companies are actively engaged in makingprovision for giving a constant supply in a portion of theirdistrict, under the provisions of the Metropolitan WaterAct, 1871. The companies thus honourably distinguishedare the Kent, the New River, and the East London. The

Act, however, provides power to compel all companies togive a constant supply, and any district may insist upon

; a constant supply when, and so soon as, four-fifths of the

3 district is provided with the proper fittitigs for such supply.We would urge that the responsibility of securing a con-

’ stant supply should not be thrown upon householders. We

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think it would be impossible to find any district so enlight-ened as to contain so large a proportion of householders

as would voluntarily incur the expense and trouble of

putting up fittings to secure a supply the advantages of;_

which they do not as yet fully understand and appreciate.n Householdera, equally with the companies, ought to be

compelled by Government to adopt the necessary measuresfor the immediate adoption of a constant supply. Thesweeping away the abominable leaden cisterns, with theirwaste-pipes so frequently in direct communication withthe sewers, would be attended by an improvement in thepublic health that it is impossible to estimate. Ourreaders,who no doubt see to the thorough cleansing of their cisternsat frequent intervals and the disconnexion of the waste-pipefrom the drain, would be surprised at the disgusting conditionan examination of at least seven-eighths of the neigt-ibourecisterns could reveal. We do not speak here of houses in thepoorer districts only, but of houses and mansions in therichest and most fashionable quarters ot the town. How manyfamilies will return in the spring to their London homes, andcummence drinking the water that has been stagnating forweeks in the capacious cisterns, and which the requirementsof the solitary servant, even a,ided by the demands of house-cleaning, have never been sufficient entirety to empty sincethe family took their departure in the autumn. If the cisternis covered, then the effluvia and gases from drains rising bythe prevailing waste-pipe have time thoroughly to saturateand poison the water ; if open, then it is exposed to the noless poisonous contamination of London dust. Nor is the

quality of the water generally supplied sufficiently pure toallow it to stand unchanged for lengthened periods even ifthe poisonous presence of sewer-gas and London dust beexcluded. Mr. F. Bolton tells us that the water in the riverThames at Hampton, Molesey, and Sunbury, whence a largequantity of London water is drawn, was good on seventeen

, days and turbid on fourteen days during October. The,

condition of the water in the river was good on nine

days, indifferent on twenty days, and bad on three days.What is the effect of three days’ bad water and of twenty