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summer, for the Nile was at an exceptionally high level.When the Nile is low the water becomes salt because it isthen below the sea level, and the inhabitants have to dependupon a large cistern which has lately been made water-tightand is regularly cleaned out. This is sufficiently large tosupply the town for two months. Moreover, Hince 1890 a newcircular canal has been dug, bringing Nile water from nearCairo, and this is now at its height. About the same datethe cloaca maxima of the town was filled in and convertedinto a road. During the latter half of September there wasa mysterious illness in the village of Ekhwa, and also in theeastern Delta, but many miles from Damietta; twelve sickpeople were treated and as many as nine died. The sickand the necropsies were seen by Dr. Kauffman, who failedto find any evidence of cholera, bacteriologically or

otherwise. They were also seen by Dr. Hamdy Bey,who, as sanitary inspector of Cairo in 1883, had a

large experience of cholera. Both declared officially thatthe disease was not cholera, and they believed that itwas due to some ptomaine poisoning. The inhabitantsof this village lived chiefly at this time upon dates, whichthey were gathering all day, and upon fisikh, a stinkingfish of which the natives are very fond. Since the reportsfrom Damietta I have interviewed both these medical men,and they are still quite firm in their belief that the Septem-ber illness was not cholera.

Cairo, Oct. 16th.

AUSTRALIA.(FROM OUR OWN CORRESPONDENT.)

Election of the Staff of the Melbourne Hospital. 0

ON Aug. 15th last the whole of the honorary medical staff S

of the Melbourne Hospital, eighteen in all, were elected bythe subscribers to the institution for a period of four years. aThe polling was conducted in a large hall in Collins-street, Pthe pavement in front of which, and for a considerable Pdistance beyond, was blocked all day by an eager crowd, and r’the public excitement was even greater than that seen at a apolitical contest. The partisans and touts of several of 7the candidates wore colours and distinguishing badges,and were most persistent in pushing the claims of their

prespective candidates. The proceedings, as a whole, hwere anything but calculated to raise the profession in t:the eyes of the public, and in individual instances were bmost offensive, and even ludicrous, as, for instance, when a esmall donkey-cart, holding a diminutive boy, was driven up tand down the street placarded with large posters asking for votes for two of the candidates, both of whom, however, hrepudiate the device. A remarkable feature was the number fof ladies who were present working for different candidates, awhile a most discreditable one was the fact that between atwenty and thirty cases of impersonation of voters occurred. nFor months past (as explained in a previous communica- dtion) candidates and their friends have been conducting ta most vigorous canvass, personally and otherwise, sand it is an open secret that money was spent freely in a

manufacturing votes. It was supposed that a by-law passed a few months ago would have prevented this; but some i:means of evading it must have been discovered, as the presi- Ident of the hospital stated, in a letter to the press,’that 130 cpeople in Adelaide voted by proxy and for one candidate, r

It must not be supposed that all the candidates resorted to r.

these undignified and discreditable electioneering dodges, and it is gratifying to know that those members of the old staff who refrained from making a personal canvass and aconducted their electioneering in a quiet and honourable tmanner were not only re-elected, but in most instances (occupied good positions at the poll. The results were as follows, all the members of the old staff seeking re-election (to their former positions being returned, their names being indicated in each case by an asterisk :-

PHYSICIANS. To IN-PATIENTS (4). 1

Votes.*Dr. J. Williams ...... 2674*Mr. J. W. Springthorpe ... 2481 *Dr. J. R. Maclnerney ... 2331

Votes. rE*Dr. P. "’oloney ...... 1962 Dr. D. Grant ...... 1761

.Dr. H. E. Astles...... 1427 .

TO OUT-PATIENTS (5). 1wVotes.

Dr. J. E. Nihill ...... 2658*Dr. W. R. Boyd ...... 2383*Dr. W. C. Daish ..... 1984"Dr. G. T. Howard ...... 1863Dr. H. F. Lawrence ... 1726

_

, ,-

Votes. LiDr. W. Andrews ...... 1713 diDr. G. Annaiid ...... 1201 evDr. E. J. Keogh ...... 1194 thDr. C. Bage......... 1166 th

j SURGEONS.I . To IN-PATIENTS (4).Votes.

*Mr. R. A. Stirling...... 2632*Mr. T. N. Fitzgerald ... 23101 *Mr. F. D. Bird ...... 2278

Votes,.

*Mr.O.S.Byan ......22490. Ryan ::: Mr. H. Gardner ...... Dr. W. Gardner ... ... 1034,

To OUT-PATIENTS (5).Votes.

*Mr. A. W. F. Noyes ... 2364*Mr. G. A. Syme ...... 2247*Mr. G. C. Rennie ... ... 2177"Dr. W. Moore ...... 2143*Mr. F. H. Langlands ... 2093

Votes.

Mr. W. K. Hughes...... 1524Mr. James Amess ...... 1119Mr.R.H.Russell... ... ?6Mr. H. P. Godfrey ... ... 743Mr. J. A. Robertson ... 591

As has happened after previous elections, proposals are nowbeing made for altering the method of election. A Bill wasintroduced into the Legislative Council to appoint an electorallcollege for nll the hospitals in the colony, but the Bill wasnot even voted on, so evident was the opposition to it. The’Medical Society of Victoria at its last meeting decided to.hold a conference with the other medical societies for theobject of devising some better method of election. In the.past, however, the difficulty has not been in devising schemes,but in getting them carried into effect.

Fatal Case of Abortion by a Quack.Reference has already been made to the success and

effrontery with which quackery is practised in Sydney:One of the fraternity, however, would appear recently tohave gone a little too far, and in consequence is now lodgedin gaol on a charge of murder. The first discovery in thecase was rather sensational, a packing case being foundin a principal street in Sydney containing the mutilatedremains of a young woman. The inquiries of the police-soon enabled them to get the body identified as thatof a girl who had left her mother’s home and went to>Sydney with the object of getting abortion procured. It.would appear that she went to the quack in question, who is.alleged to have operated, with the result that she developedperitonitis and died. He then is said to have made a crude’post-mortem examination and attempted to dispose of theremains in the manner described, which led to his speedyarrest.

Hydatid Cysts : thei.r Treatment, Diagnosis, and PrevalenceHydatid disease continues to occupy the attention of the

profession in Australia. Mr. Charles Ryan of Melbournehas recently read two papers dealing with its surgicaltreatment. In the first paper two cases of multiple-hydatids of the abdomen were described. In one case

eighteen cysts were dealt with in four separate opera-tions. At the first operation thirteen cysts in the omentumwere removed, the portion of omentum containing them being-ligatured and removed en masae ; while another cyst growingfrom the pelvic peritoneum was evacuated, the cyst removed,and the adventitial sac sutured and dropped back into theabdominal cavity and the parietal wound closed (Bond’s.method). This cyst suppurated and had to be opened anddrained, and another cyst pressing on the rectum was openedthrough the cyst first treated. Two other cysts on the otherside of the abdomen were treated by Lindemann’s operationand drained. The patient was desperately ill for a time,but recovered perfectly. In the second case fifty cystsin all were treated in six successive operations.Eighteen omental cysts were completely removed at the firstoperation. At the second seven further omental cysts were-removed and two cysts in the liver treated by Lindemann’smethod. At the third operation two more hepatic cystswere treated in the same way. At the fourth operation fivecysts in the mesentery were removed and three were incisedand dropped back without suture of the adventitia. At the.fifth operation a cyst on the upper surface of the liver wasopened through the pleural cavity after excision of portion,of a rib ; the cyst was extracted and the wound closed with-out drainage or suture of the adventitia. Finally, at the-sixth operation a splenic cyst was opened from theabdomen arid treated in the same way. A good deal ofconstitutional disturbance followed the first four operations,but not the last two. In his second paper Mr. Ryanrelated four’ further cases of hepatic cyst treated by theintra-peritoneal method, without suture of the adventitia, andwith immediate closure of the abdominal incision. All didwell, and in three recovery was much more rapid than afterLindemann’s operation. In one case some constitutionaldisturbance occurred, and eight days afterwards bile wasevacuated through the wound and continued to discharge forthree weeks.’ As the result of his experience Mr. Ryan is a

strong advocate of the method of treatment adopted in these

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cases, and says that "Lindemann’s’ operation may now berelegated to the past for simple and uncomplicated cases, andbe confined to suppurating and a few exceptional cases." He.also points out the advantage of dealing with multiple hydatidsin several successive operations when an attempt to removetoo many at once would prove fatal. With this opinionsurgeons who have had experience of these cases will agree,but the discussions on the two papers and on previousoccasions show that there is far from unanimity a,s to the

general applicability of the intra-peritoneal method, anddifference of opinion exists as to its dangers and as to whathappens when hepatic cysts are healed in this way. Somemaintain that the edges of the incision in the adventitiabecome apposed to the abdominal incision, and that if serumor bile be effused into the adventitial sac the effused fluidwill make its way out through the parietal incision and notinto the peritoneal cavity. Others maintain that the fluidwill escape into the peritoneal cavity, but will do no harm,being rapidly absorbed-i.e., if aseptic. Several cases havenow been reported which show that bile does escape, and sofar it has always, so far as is known, made its way out

through the parietal incision and without doing seriousharm. Since Mr. Ryan read his paper, however, he has him-self operated by the intra-peritoneal method on a large cystin the left lobe of the liver, with a fatal result from septicperitonitis. At the post-mortem examination the adventitial.cyst was not near the incision in the abdominal wall, andwas moderately distended with dirty grumous fluid similarto that which occupied the general peritoneal cavity.Dr. Fiaschi of Sydney contributes to the August number ofthe Anstralasian Medical Gazette a note on the value of" Santini’s hydatid resounding sound obtained by per-cussing a hydatid cyst while auscultating it. Dr. Fiaschi hasverified the fact that the sound exists, and regards it as

valuable, not only in helping to diagnose hydatid from othertumours, but in distinguishing single from multiple cysts.At the last meeting of the South Australian Branch ofthe British Medical Association Dr. E. C. Stirling ofAdelaide read a paper on the Relative Prevalenceof Hydatid Disease in the various Australasian Colonies,’compiled from figures supplied to him by the different

hospitals. It appears that hydatid disease is most

prevalent in South Australia, where practically 1 out of

every 100 patients admitted to hospital suffers from it."Victoria comes next with a percentage of 0’64, New SouthWales has a percentage of 0’57, Tasmania 0’52, WesternAustralia 0’23, New Zealand 0’19, and Queensland 0’07.The average for all the colonies is 1 hydatid for every 206’in-patients. There is a special concentration of the disease inthe south-eastern district of South Australia and the western,district of Victoria. From a comparison of these figureswith those compiled by the late Dr. Davies Thomas in 1884it appears that there is a substantial increase in the

prevalence of the disease, though the increased ratio is alsoprobably to be accounted for to some extent by the diseasebeing more frequently recognised.

Phthisis in Australia.Dr. G. L. Mullins of Sydney has contributed to the August

number of the Australasian Medical Gazette a paper bristlingwith statistics as to the prevalence and distribution of

phthisis in the Australian colonies. He controverts thestatement of Hirsch that " the reputation that Australiaused to enjoy for the rarity of consumption and for thefavourable influence of its climate upon the course of themalady has of late been shown to be a mistaken one."

Comparing the death-rate from phthisis both per 100deaths from all causes and per 1000 living in-habitants of Australia with other countries, Dr. Mullins.’shows that Australia has by far the lowest rate,and that the capital cities of that continent have a muchlower rate than European cities. Further, it appears thatphthisis is decreasing in prevalence in Australia. From thereturns of Queensland-the only colony from which suitablereturns can be procured-it appears that the Australian bornpopulation is not subject to phthisis. At the last meeting ofthe New South Wales Branch of the British Medical Associa-tion Dr. Sydney Jones advocated the establishment of a"farm hospital" for the treatment of cases of phthisis in itsearly stage. The buildings should be of an inexpensive kind,surrounded by a large area of land to be cultivated by thepatients, and in this way it might be partially self-supporting.He objected to the mixing of early and advanced cases ofphthisis in the same hospital. ’

.

Obituary.THOMAS GROOM, F.R.C.S. ENG.

By the death of Mr. Groom of Whitchurch, who passedquietly away on Oct. 7th, the county of Salop has lost itssenior medical practitioner, a highly respected veteran,whose talents had for more than sixty years been devoted tothe relief of suffering. He belonged to a very old Shropshirefamily, being the fourth son of the late Mr. John Groom,formerly of Hardwicke Grange, and lie was born at WolverleyHall in the same county. Hardwicke was the residence ofLord Hill, the famous general of the Peninsular War, whoalso fought at Waterloo, and was Commander-in-Chief to HisMajesty George III., and it was there that he died. Mr.Groom commenced the study of medicine by becoming anapprentice to the late Dr. Gwynne of Wem. He subsequentlystudied at Guy’s and St. Thomas’s Hospitals, and after pass-ing the usual examinations gained the diploma of the Societyof Apothecaries in 1833, and became a Member of the RoyalCollege of Surgeons of England in 1834. Having commencedpractice at Whitchurch in 1834, he for many years enjoyeda large and lucrative practice in the town and neighbour-hood, and in 1861 was admitted an Honorary Fellow ofthe Royal College of Surgeons of England, but of late yearshe retired from the more active duties of his profession.The deceased endeared himself to a large circle of friends,by whom he was much esteemed, and his cheerful dispositionand genial hospitality will long be remembered. He wouldhave been eighty-six years of age had he been spared a fewweeks longer to see Nov. 21st, and was a widower, havingbeen twice married, but has left no family. He was anardent sportsman, and as showing the abundance of gamein the neighbourhood of Whitchurch in the " good old days,"as compared with the present time, it may be noted that oneforenoon in September in the " forties," before the days ofbreechloaders, he killed with one barrel thirty brace of par-tridges. So greatly was the deceased respected that whenhis funeral took place, on Oct. 10th, along the entireroute from his late residence to the parish church there wasnot a house where the blinds were not drawn down or theshutters closed. Many beautiful wreaths and mosses weredeposited on the grave by relatives and personal friends.

FREDERICK BERNARD BETTS, M.R.C.S. ENG.,L.R.C.P. LOND.

ALL those members of the profession who came in contactwith Mr. F. B. Betts will be deeply grieved to hear of hisuntimely death at Antofagasta, Chili, on Sept. 4th. Mr. Bettsentered the medical school of the Westminster Hospital in1884, and worked with unremitting zeal until he became

qualified to practise in 1889, distinguishing himself by takingno small number of prizes. He held in the hospital allthe resident posts until failing health sent him for threevoyages to South America as surgeon to the R.M.S. Iberia.On his return with recovered strength he acted as resi-dent medical officer at Queen Charlotte’s Lying-in Hos-pital, after which he left England for the last time on

his acceptance of a post as surgeon to the HuanchacaSilver Mine and Railway Company at Antofagasta. Pos-

sessed, as he was, of an exceptionally cheerful dis-

position, he quickly won the hearts of those amongwhom he had elected to dwell, and his early death-Mr.Betts was but twenty-eight years of age-was received withiniversal dismay amongst European residents and Chiliansalike. The Chilian Times of Sept. llth paid a touching tributeo his memory in a long article, concluding : " Although butittle more than two years resident in Antofagasta, themiversal grief manifested at his death and at his grave,estified how much he was respected and beloved. Hisnemory will linger long in many a grateful heart."

JOHNSON MARTIN, L.F.P.S. GLASG., L.S.A. LOND.THE many friends and acquaintances of Mr. Johnson

Martin, of Great Lever, near Bolton, have been deeply moved)y his death, which took place on Sept. 22nd at his resi-lence, Carlisle-terrace, Moses Gate. He was the son of