1069MEDICAL SCHOOL DINNERS.-ASYLUM REPORTS.

in the least what the entry " was likely to be, he thought gthey might congratulate Dr. Shaw on what he had done for 7the school in the past.. They were all grateful to him for his

work, they would drink his health, and at the same time wthey would hope that his mantle had fallen successfully on c

Dr. Fawcett. Dr. Shaw responded, and the singing of a

."Auld Lang Syne brought to a close a very pleasant and successful evening, c

London Hospital.-The 117th session was opened on in

Oct. 1st with the usual old students’ dinner, which was Iheld in the library of the college, Dr. Frederick Daly n

being in the chair. 100 old students sat down to dinner. IDr. Daly, in congratulating the old students on the prosperity Iof the old hospital and college, called attention to the ienormous improvements which were now taking place, espe- Icially the addition of the new pathological block, out- t

patient department, isolation block, and operating-theatres. cHe said that a great deal of the work was now complete, c

and added that it was probably without precedent that r

such an enormous amount of work should have been i

carried on without a single bed being closed, so ithat the study of medicine and the students’ career (

had not been checked for a single hour. He also called i

attention to the large number of old students who had been (

out to the front, particularly alluding to the honours that <

had fallen to the College by Sir Frederick Treves receiving (

knighthood and Captain Neville R. Howse (from Australia) (

the Victoria Cross. Mr. M. Brownfield and Dr. J. Edmunds, old London students who qualified in 1854, said that they perhaps could speak with greater authority on the London ]Hospital Medical College than anyone else present. Through- ]out their lives they had felt thankful for the education they had received at their old hospital and for the enormousexperience in practical work that they had there gained.Mr. T. H. Openshaw, and others who had recently returnedfrom South Africa, spoke also of the practical work done byLondon Hospital men at the front. Mr. J. A. Hosker, latemayor of Bournemouth, and other speakers bore tribute tothe excellent opportunities afforded by their old hospital andcollege.

St. 1’homas’s Hospital.-The St. Thomas’s old students’dinner was held at the Whitehall Rooms of the Hotel

M&eacute;tropole on Oct. 2nd. Mr. H. H. Clutton was in the chairand was supported on either hand by General Sir IanHamilton and General Sir Reginald Wingate, the Sirdar.This year a new departure was made in order to give theold students an opportunity of talking with their formercompanions, for which purpose a conversazione was held inthe reception-room after dinner. After drinking the toastof "The King and the Royal Family," followed by that of" Success to St. Thomas’s Hospital," which latter was repliedto by Mr. T. G. Wainwright (the treasurer) and Dr. H. G.

Turney (the dean), Dr. S. J. Sharkey proposed the healthof the Chairman, who in his reply proposed that of the

secretaries, which was responded to by Mr. E. M. Corner.There were 150 people present and all adjourned to thereception-room after dinner and there ended one of the mostpleasant and successful meetings of the St. Thomas’s oldstudents. The great success of the conversazione will, itis hoped, lead to still further developments next year.

University College Hospital.-The past and presentstudents of University College Hospital held their annualdinner at the Hotel Cecil on Oct. lst. The chair was

occupied by Sir Richard Douglas Powell who proposed thetoast of the evening, " Success to University College MedicalSchool," to which the Dean of the medical school, ProfessorJohn Rose Bradford, replied. Amongst the other speakerswere Dr. F. Roberts and Sir John Williams. The dinner waswell attended, over 120 guests being present.

ASYLUM REPORTS.

Surrey County Asylum, Brookwood (Annual Report for1900).-The average number of patients resident during theyear was 1033, comprising 421 males and 612 females.During the year 285 patients were admitted, 133 being malesand 152 females. Of these 239 were first admissions. Alr.James E. Barton, the medical superintendent, states in hisreport that a female patient admitted from the RichmondHospital developed scarlet fever five days afterwards. Three.ether patients and a nurse were attacked and had to beremoved to the Cottage Hospital. The admissions were

generally found to be " of a bad class as regards recovery.71 had suffered from previous attacks, and in 53 the insanitywas of more than a year’s duration." A female patient whowas admitted pregnant was confined of a child. Of thecauses of insanity in the admissions, worry, overwork, andadverse circumstances accounted for nearly 28 per cent.Alcoholic intemperance and previous attacks were thecauses in 35 and 51 cases respectively. "In 18 instances themental disorder followed an attack of influenza. 14 generalparalytics were admitted, all of whom were males, and themajority of these came from the parishes situated on theLondon side of the county." "There is no doubt," adds Mr.Barton, "that general paralysis has been diminishingin frequency in the rural districts for some yearspast, and in the female sex it appears to be approachingthe vanishing point, only six cases having been admittedduring the last five years." The number of patients dis-charged as recovered during the year was 89-viz., 50males and 39 females, or 8’6 per cent. of the average numberresident. The deaths during the year amounted to 101,including 40 males and 61 females, or 9’77 per cent. as

calculated on the same basis. 11 patients died within onemonth of admission. Of the deaths one was due to myx-oedema, two were due to cancer of the liver, three to Bright’sdisease, seven each to epilepsy and cardiac disease, eight tocerebral hasmorrhage, nine to pneumonia, 10 to organic braindisease, 11 to senile decay, 13 to general paralysis, 16 to

phthisis and other forms of tuberculosis, and the rest toother causes. An inquest was held on the body of a malepatient who committed suicide by strangulation. "This

patient was the subject of melancholia....... He was foundsuffering with an ischio-rectal abscess which was opened....... On the following day he was found by the chargeattendant on the floor with one of the triangular bandageswhich had supported the surgical dressing tied tightly roundhis throat." Only four casualties to patients occurred duringthe year, three of these being fractures of bones and one a

, dislocation, all due to accidental falls. A complete fire anddomestic service has been laid on to the Cottage Hospitalfrom the water company’s main, and the outlet of the asylum

’

drain has been connected with the district council’s main. sewer so that any excess of sewage beyond what can be. beneficially utilised can be turned into the Woking sewer.The erection of additional wards at a cost of &pound;87,000 to

accommodate 350 patients was commenced in August, 1900.i An outbreak of swine fever occurred at the farm in April,necesaitating the destruction of the whole herd. The Com-

missioners in Lunacy state in their report that the day-roomswere bright and cheerful, the dormitories and bedding neatE and clean, and the case-books and post-mortem records1 carefully kept. They commend the recent addition of. another medical officer to the staff, and hope that patho-1 logical work will now be undertaken.

IJ2crhum County Asylum (Annual Report for 1900).-The. average number of patients resident during the year wass 1415, comprising 736 males and 679 females. During thet year 330 patients were admitted, of whom 165 were males1 and 165 females. Of these patients 253-viz., 135 males andt 118 females-were first admissions. Dr. W. St. John Skeen,

the medical superintendent, states in his report that "thet admissions were of the usual type and still show a large per-1 centage of aged people ; 26 patients were over 60 years ofs age, of whom four were over 75 years ; 72 were admitted ine a feeble state, and most of them died soon after admission."

Among the admissions were 27 cases of general paralysis.r The number of patients discharged as recovered during thes year amounted to 149, or 10-5 per cent. of the average,s number resident. Of 818 patients discharged as recovered

during the five years 1896 to 1900 inclusive, 124 have relapsedduring the same period. The deaths during the year amountedto 165-viz., 94 males and 71 females, or 11’6 per cent.of the average number resident. Of the deaths, one was dueto asphyxia by choking, five were due to cerebral h&aelig;mor-rhage, eight to epilepsy, 12 to influenza and its complica-

/1’ tions, 12 to congestion of the lungs, 15 to pneumonia, 29 togeneral paralysis, 30 to cardiac. disease, 34 to phthisis and

s. other forms of tuberculosis, and the rest to other causes.

s Four cases occurred during the year of serious injuries inr. the form of fractures sustained by patients accidentallyis or by being pushed down by other patients, and in

three of the cases satisfactory recoveries were obtained.During the year two female patients gave birth to children,

)e in. one case a boy and in the other a girl, but in neither casere is the mother anticipated to make a satisfactory mental

1070 THE FIFTH INTERNATIONAL CONGRESS OF PHYSIOLOGISTS.

recovery. The asylum committee state in their report that’having regard to the requirements expressed from time to timeby the Commissioners in Lunacy of provision at the asylumfor the isolation of infectious diseases, the committee havedecided to erect a small detached isolation hospital for thepurpose. Electric lighting is now in operation throughoutthe building. The farm has continued to yield abundance of’milk, meat, and vegetables, and the whole of the live stock,with the exception of two cows which had to be destroyed,were in good health. The Commissioners in Lunacystate in their report that the wards and dormitories were,comfortable, fresh, and clean. They state that Dr. R. Smith,the late medical superintendent, after a long and faithfulservice of 44 years, has retired on a pension and has been’succeeded by Dr. Skeen, the senior assistant medical officer.They regret to find that it is proposed to reduce the medicalstaff by abolishing the post of pathologist. I I This we- consider a retrograde step and hope the committee can seetheir way to reconsidering the matter." They also state that" the insufficiency of the medical staff of late no doubt- accounts for the [medical] case-books being considerably inarrears." At a more recent visit (Feb. 15th, 1901) theCommissioners in Lunacy refer to Newton Hall, an annexe.of the asylum prepared for the accommodation of 52 malepatients from the county asylums, all of whom are of the- chronic ’quiet class, and who appear very healthy and con-tented in their new surroundings. Three assistant medical oilicers ’’ are now on duty, and the case-books duly entered’up to date."

"

Royal Edinburgh Asylum (Annual Report for 1900). -,f heaverage number of patients resident during the year was 940,comprising 482 males and 458 females. During the year 472patients were admitted, of whom 248 were males and 224were females. Of these 117-viz., 55 males and 62 females-were not first admissions. Dr. T. S. Clouston, the medicalsuperintendent, states in his report that the year 1900 has’been a record year for admissions, the number of admissionsbeing 38 over the average of the preceding five years. Thisincrease has been entirely in pauper cases, so that scarcelyenough room could be found for private cases. A number of’chronic insane pauper patients were boarded out during 1899in other asylums with the view of providing room in the WestHouse of the Edinburgh Asylum for recent and urgent private.-cases from Edinburgh. But this anticipation was not fulfilled.owing to the exceptional increase of pauper patients among-the admissions, chiefly from Edinburgh. As regards thecause of such an increase of pauper patients Dr. Cloustonthinks thac the excessive use of alcoholic liquors has to alarge extent been the main factor. " We had, as a matterof fact, 115 cases. or about a quarter of our whole number ofadmissions, in whom drink was assigned as either the sole oras a contributory cause of the disease. If the admissions of.men alone are looked at, 81, or about one-third of them, werealcoholic cases. I have never had experience of anythingapproaching this before, and I should fail in my duty if,seeing more of the terrible effect of excessive alcoholic

drinking in destroying honour and reason and self-controlthan almost anyone else in Scotland, I did not strongly.draw attention to a fact so disgraceful to us as a com-

munity....... It is certain that for every man in whom- excessive drinking causes absolute insanity there are 20 inwhom it injures the brain, blunts the moral sense, andlessens the capacity for work....... When in any com-

munity there is a large class to whom prosperity alwaysmeans excessive indulgence in drink in defiance of naturaland moral law it means that a higher sort of education isneeded or that degeneration has set in....... A true concep-tion of liberty does not necessarily imply liberty for a manto drink himself to death if he can afford to do so at his own

- expense or the right to render himself a burden on otherpeople and a source of degradation and danger to the com-munity....... Our recent Inebriates Act is almost a deadletter and Lord Peel’s report remains as yet an interest-ing subject of academic discussion....... Convictions for

being drunk and incapable steadily increase in Scot-land ; my alcoholic lunatics have risen from an averageof 152 per cent. in the years 1874-1888 to 2H percent. in 1889-1898, to 222 per cent. in 1899, and nowto 24-2L per cent. in 1900 ...... and yet the politician criesnon poss2cm2rs....... The national drink-bill steadily goes up.and the national degeneration progresses. I am convincedthat we shall have a big reckoning to pay some day....... Aconsumptive race might conceivably be cured in two genera-tions, or even in one by good conditions I do not believe a

drink-sodden race could be fully cured in a hundred years....... We can, I think, put down most of our 115 alcoholicsof the year as being preventable and we can, if the currentviews of its causation are true, pnt down almost all our 49general paralytics as in that list." Many of the patientsadmitted were suicidal and some were dangerous to others.During the year 165 patients were discharged as recovered,or 17’5 per cent. of the average number resident. Thedeaths during the year amounted to 99, or 10-5 per cent.as calculated on the same basis. Of the deaths two weredue to Bright’s disease, five to pneumonia, 10 to cardiacdisease, 14 to phthisis and other forms of tuberculosis, 17 togeneral paralysis, 19 to senile decay, and the rest to othercauses. Concerning the high mortality from phthisis Dr.Clouston observes that " many of the patients are veryweak indeed on admission....... They are liable there-fore in an undue degree to fall victims to the tuberclebacillus." The general health of the inmates has been

good with the exception of a slight outbreak of scarletfever in Craig House from infected milk, one sporadiccase of typhoid fever in the West House, and one

case of small-pox occurring in a patient who had comeon a South American steamer. The Commissioners in

Lunacy state in their report that the asylum throughout ismaintained in excellent order and that the medical case-books and registers are well kept, full accounts being writtenof the treatment and progress of the various patients undercare. The Board of Managers state in their report that thereis little prospect of the new asylum for the Edinburgh dis-trict being ready for occupation in February. 1902, as was atfirst calculated, and they "cannot without anxiety contem-plate the prospect of having to find accommodation for theever-increasing number of panpers."

THE FIFTH INTERNATIONAL CONGRESSOF PHYSIOLOGISTS.

HELD AT TURIN, SEPT. 17TH-21ST, 1901.

THE following are some further notes of communicationsmade to the above Congress :-The Results of Trephining the Cranium of Young Animals.M. JEAN DEMOOR (Brussels) contributed a paper on the

above subject. He said that Danilewsky had found that

trephining the cranium of young dogs was followed at alater stage by (1) arrest of development of the limb corre-sponding to the region trephined ; and (2) the supervention ofepileptiform convulsions followed by death, generally at theage of six months. M. Demon was able to corroborate thelatter result but not the former in its entirety. The

wasting was general. The animals developed normallyduring the months prior to the convulsions, but at thepost-mortem examination showed no emaciation or other

phenomena indicative of the region trephined. Experi-ments on rabbits gave similar results. Histologicalexamination of the brains revealed a very marked monili-form condition of the’ cortical nerve-cells. Stained bvthe method of Golgi the enlargements were darklycoloured and the intervening strands were pale. Thiscondition was the result of the strong cortical excitationwhich accompanied the epileptiform convulsions in whichthe animals died. If killed during the period of wasting thenerve-cell processes were smooth. A marked degree ofchromolysis was also seen in the nerve-cells accompaniedby a great poverty of chromatic substance which the authorregarded as characteristic of the nerve-cells of trephinedanimals. There was no neuro-phagocytosis present exceptin one animal when death came on very slowly preceded bya state of imbecility.Attempts to Educate a Pigeon devoid of Cerebral Hemispheres.

Dr. Z. TREVES and Dr. A. ACAZZOTTI (Turin) had found thatafter removal of the cerebral hemispheres the animal remainedmotionless for several days. Then slight spontaneous move-ments were made and later a few steps. If placed on asmall stage the bird dropped off on reaching the edge, butafterwards learned to advance with caution and remained

upon it. This indicated some power of perceiving andremembering impressions. The perch was a low platform afew inches square, placed within a fume chamber in thelaboratory : when thus far recovered the bird was droppednear its stage and encottrac e to return, aid being given at