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this inquiry is as follows. Fifty replies were received. Of ethe entire number of correspondents only 6 are either Ldoubtful of the desirability and practicability of after-care r4

associations for the dependent insane or are decidedly a

opposed to such a step. The reasons given by them are ythat the number of cases which are likely to be benefited 1by such aid is too small to be advisable, that while such a t

project might be desirable it is inexpedient, that while 4excellent in theory it would be impossible in practice, &0. t:On the other hand, the overwhelming majority of 44 in 50 t

(or 47 in 53 if the committee be included) express, and in dnot a few instances in the strongest terms, their decided tbelief in the great advantages likely to result from properly Iorganised and conducted aid societies of this kind for dis- t

charged insane patients who are recovered, convalescent, or f

improved. Regarding the number likely to be benefited in fthis way the experience of superintendents of hospitals for ithe insane, as indicated in these replies, is not of much iassistance, as the few who replied found it difficult to pro- ;:perly estimate the number of deserving patients. As to the auspices under which such associations should be conducted (

it is the general opinion of both the alienists and neurologists f

that they should by all means be begun as private organisa- E

tions and so continued until their utility be demonstrated. (

If successful, State aid could then probably be obtained. In t

reply to the question regarding the advisability of establish- (

ing State homes for convalescent patients as a part of the i

general policy of States toward their insane there is more diversity of opinion, but the same degree of interest and tcareful consideration of the subject. Scarcely a member of this association has written in opposition, and of 29 hospital (

superintendents and other alienists 19 were warmly in favour of such an accessory provision, 5 were doubtful of its:expediency, and 5 were decidedly opposed to the project. Of 4 members of lunacy and charity boards 1 is in doubt as to its utility and the rest think it would be an unnecessary and useless experiment. As a result of their inquiries the (

committee reports the following conclusion : It is the general and well-nigh unanimous sentiment of those who are the most conversant with the needs of the insane in this country that measures should speedily be inaugurated for the i

temporary relief of discharged, recovered, convalescent, and improved insane patients of the dependent class by organised outside assistance.

The New York Skin and Cancer Hospital. At the opening of the new building Dr. Bulkley, the

originator of the hospital and its present secretary, deliveredan address devoted to the history of the undertaking. Thefirst patient was admitted to the old building in Thirty-fourth-street on Feb. 26th, 1883 Daring these fifteen years the hos-pital has received about$375,000, of which$75,000 came fromthe board of patients and sale of drugs in the dispensary.The land and building are now practically free from debt.Since the opening of the hospital 25,031 cases have beentreated, 3010 of which were in the cancer department. The

greater number of patients were out-patients and the totalnumber of visits was 118,154. The number of prescriptionsfilled by hospital druggists was 132,263. In the wards ofthe hospital there had been 2872 patients and the totalnumber of hospital days was 165,077, of which 117,658 werefree.

Railroad Accidents.

It appears from the Inter-State Commerce Commission’sstatistics of the casualties to persons in railroad accidents inthe United States for the year ending June 30th, 1896, thatthe total of killed was 6448 ; of injured, 38,687. For nine

years the average deaths were 6444 a year ; the averageinjuries were 33, 000. Of actual passengers the killed in nineyears averaged 283 a year and the injured averaged 2600.The passengers killed were only one-twenty-third of all thedeaths and passengers contributed only about one-thirteenthof the injured. Of all the casualties to passengers less thanone-half are in train accidents. The other deaths and

injuries to passengers occur at highway crossings (going toand from stations), at stations, and from other causes.The last item includes those killed and injured whilegetting on and off moving trains, falling between cars,sticking their arms and heads out of the windows,and in other exhibitions of carelessness. In one Statethe passengers killed and injured from causes beyondtheir own control have, for at least ten years, beenless than half the total. Of the injuries much the greaterpart are very alight, a large percentage being so slight that

even the lawyers can find in them no basis for damage suits.It may be safely said, therefore, that the railroads are

responsible each year for the death of only 142 passengersand for the injury of only 1300. The passengers killed in a,

year are 283. But the passenger travel in 1896 was

13,049,000,000 miles, or it equalled one passenger travellingthat distance. It follows that a man can travel by rail.46,000,000 miles before he is killed. In other words, if hetravels night and day at 35 miles an hour he musttravel 150 years before he is killed. But if the averagedeaths are 6444 a year and the passengers killed are

but 283, if the average injuries are 33,000 and thepassengers injured are but 2600, how shall we account forthe other 6161 killed and 30,400 wounded ? To save a con.fusion of figures I shall deal only with the killed hence-forward ; the lesson will be precisely the same as if itincluded the wounded also. The employes killed per yearin the last nine years were 2210 and the other persons were3951. Of the employés killed last year about 12 per cent.were killed while coupling and uncoupling trains, 25 percent. by falling from trains and engines, 19 per cent. in trainaccidents, nearly 10 per cent. from overhead obstructionsat highway crossings and at stations, and, finally, 34 percent. from other causes. A very large percentage ofthe deaths is classified so vaguely as to vitiate analyses ordeductions, but the small percentage due to train accidents.is striking and extremely interesting as suggesting the safetywith which trains are run. The total number of employés inthe year considered was 826,620. These men did an immenseamount of travelling, but those killed in train accidents wereonly 348, and, of course, most of these were in freight trainaccidents. There still remain 3951 deaths per year toaccount for, or 61 per cent. of the whole. These are neitherpassengers nor employ 6s. Of the 3951 persons other thanpassengers and employes killed every year (being 61 per cent.of all the deaths) 3566, or 55 per cent. of the total or 90 percent. of the others, are trespassers. Neatly 10 persons arekilled every day in the year because they are where theyhave no right to be. Of these trespassers 141 are killed athighway crossings, 323 at stations, and 2957 from othercauses. The trespassers are run down in small numbers atroad crossings, in greater numbers at stations and in yards,and in still greater numbers out in the open road, and thisshocking waste of life is going on, not through the fault ofrailroad officers, but because of an ignorant and apatheticpublic opinion.April 19th.

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AUSTRALIA.(FROM OUR OWN CORRESPONDENT.)

Dengue Fever in Queensland.Two interesting papers on Dengue Fever have been

published simultaneously-one, by Dr. Hirschfeld, in theInter-col,onial Medical Journal for March, deals with theepidemic in Southern Queensland ; the other, by Dr. F. C.Hare, in the Australasian Medical Gazette for the same>

month, describes the disease as observed in NorthernQueensland. Both writers agree as to the intense infectivity.of the disease. According to Dr. Hirschfeld the period of

I incubation is about two weeks. Dr. Hare says "thereis plenty of evidence to show that the incubationperiod does not extend beyond one week." Dr. Hirschfeldstates that "infection can take place despite unfavourableconditions of climate and soil and locality," but that"where climatic and local conditions are unfavourable a.

further spread of the disease is rendered unlikely." It isquite likely to invade the southern colonies. In the opinionof Dr. Hare the disease is essentially tropical and is greatlyinfluenced by temperature. The district of Herberton was,exempt from the disease owing probably to its -altitude andcomparatively cold climate. As to immunity Dr. Haremaintains that it does not extend beyond two years afteran attack, large numbers being attacked who had gonethrough the disease two years previously; a few cases hadan attack every year. Dr. Hirschfeld admits that it is notpossible to speak with final definiteness as to immunity, butso far it has been found that a patient who has once sufferedfrom the fever will not be attacked by it a second time.When patients make statements to the contrary a closeexamination will reveal that the supposed former attackwas not accompanied by a rash, without which the diagnosis

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of dengue is not complete, and was probably influenzaor a gastric attack. Both writers agree fairly as regardssymptomatology, sudden onset, pains, and raeh. Dr. Haresays that the pulse presents no striking peculiarities,but Dr. Hirschfeld maintains that the puln-rate does notrun parallel to the temperature and " it is characteristic ofdengue that a relative bradycardia may be observed duringthe continuance of the fever " and an absolute brady-cardia frequently appears during convalescence. Both agreethat the main element in treatment is rest. Dr. Hirschfeldthinks that the exhibition of quinine from the first diminishedthe tendency to relapse. For hyperpyrexia he advocateslactophenin. As bearing out Dr. Hirschfeld’s views as to.the probability of dengue spreading to the southern coloniesDr. Casement of Kempsey, New South Wales, has made areport to the Board of Health concerning an outbreak ofdengue in that town, where a great many cases haveoccurred, and he supposes that the disease was introducedfrom Queensland.

Appointment of Health Officres under the New HealthAct, New South Wales.

The Government of New South Wales, acting on therecommendation of the Board of Health, has appointed twomedical officers of health-one for Sydney and its neighbour-hood, constituting the metropolitan combined districts ; theother for Newcastle and the towns on the Hunter River, to’be known as the Hunter River combined districts. Theappointments are made under the new Public Health Actand though the salaries are paid by the Government the newofficers are really to be attached to the municipalities, to whomthey will send in regular reports. The duties attached to thepositions are practically to bring the provisions of the newAct into operation in the districts named, which includeabout 45 per cent. of the population of the colony, and

gradually to familiarise the public with the provisions of theAct. Dr. William George Armstrong has been appointed tothe metropolitan district at a salary of L750 a year andDr. Robert Dick to the Hunter River district at a salary of700 a year. Both gentlemen are graduates of SydneyUniversity and subsequently obtained the diploma of public.health at Cambridge.Death of a Medical Man through the Mistalze of a Druggist.On March 7th Mr. Samuel Prince Williams, L.R.C.P. and S.

’Edin., of Nicholson - street, Fitzroy (a suburb of Mel-bourne) called at a druggist’s shop and asked for a solutionof sulphate of morphine for hypodermic injection. Thesolution was made up by the son of the proprietor of the.shop. Mr. Williams drove on to see a patient, whom he.injected with the solution. It appears that he was accus-tomed to use morphia himself and after injecting the

patient he gave himself an injection also. He then drovehome with his wife. Before they had gone very far he wasseized with violent convulsions and pain. Mr. Williamsrecognised that some mistake had occurred and drove to aneighbouring practitioner’s house, arriving in a collapsedcondition. He was found to be evidently suffering from theeffects of atropine. He rallied somewhat, but died the nextmorning. His patient was affected with similar symptoms,but not so severely, and fortunately recovered. The mistakearose through the druggist keeping morphine sulphate and’atropine sulphate in similar bottles with written labels andthe dispenser had taken up the wrong bottle, Mr. Williamsbeing in a hurry and telling him to be quick. The dispenserwas committed for trial for manslaughter by the coroner.Death of a Child from Swallowing a Bone : Alleged Neglect by

Hospital Authorities.On March 23rd the deputy coroner for Sydney held an

’inquiry concerning the death of a child at the Children’sHospital on March 19th. It appeared that while the father*was feeding him with a spoon with some Irish stew the childbegan to choke and cough. He took the child to a druggist,who examined him, said that he had a bone stuck in thethroat and advised the removal of the child to the SydneyHospital. There after some little delay, Dr. Bowker, residentmedical officer, examined him, but could feel no bone, andDr. Harris, senior resident, failed also to detect the bone. Thechild had no difficulty of breathing. The father was told totake the child back. Instead of doing so he took him to thePrince Alfred Hospital, where he was examined by theresident on duty, by the medical superintendent, andDr. McCormack, honorary surgeon. All failed to discoverThe bone. Dr. McCormack ordered the child to be kept in

the hospital and an x ray photograph to be taken. Theparents took the child out and had an x ray photographtaken themselves, but it did not reveal the position of thebone. The child got much worse and they took him to theChildren’s Hospital, where an operation was performed.While the trachea was being opened the child stoppedbreathing and in spite of artificial respiration and treat-ment died. Dr. Chisholm, honorary surgeon, said that thecause of death was septicaemia following an abscess round apiece of mutton bone which had perforated the gulleta good way down. The finding of the coroner was thatthe treatment adopted was proper and that the deceased diedfrom a bone being accidentally embedded in the throat,accelerated by a necessary surgical operation under chloro-form. The coroner said the case should have been reportedby the authorities at the Children’s Hospital and no

certificate should have been given. He thought that if theparents had taken the child back to the Sydney Hospital atonce his life might possibly have been saved, but that wasproblematical.

Thirlmere Home for Consumption.Some seventeen years ago the munificence and philan-

thropy of a private citizen, Mr. Goodlet, established theThirlmere Home for advanced cases of phthisis in destitutecircumstances. Mr. Goodlet not only established, but formany years maintained, this most excellent institution.When the financial crisis came he found himself unableto continue his work and he handed the home over to thepublic with an appeal to the charitable to maintain it. Fora time the public responded, but the subscriptions havegradually fallen off until the institution can no longer bemaintained. At the Jubilee time the public subscribed£12,OOO for the Queen Victoria Consumption Hospital andapparently thought it had then done enough for the phthisicalpatient. Now that attention has been drawn to the matterby the press the public will assuredly keep the ThirlmereInstitution going.

St. Vincent’s Hospital, Melbourne.A public meeting was recently held in Melbourne, his

Excellency the Acting Governor in the chair, to raise fundsfor the extension of St. Vincent’s Hospital. The projectwas approved by the meeting and .E2000 were subscribed forthe purpose.April lst,

Obituary.JAMES RHODES, M.R.C.S.ENG., L.S.A,

ON April 21st one of the best known inhabitants of

Glossop passed away in the person of Mr. James Rhodes. Hewas born at Tintwistle, near Glossop, in 1830 and was

apprenticed to the late Dr. Turton at Glossop in 1849. After

attending lectures at the Pine-street School of Medicine inManchester he took the Licence of the Society ofApothecaries of London in 1853 and the Membership of theRoyal College of Surgeons of England in 1854, when hebegan to practise at Glossop. He was thus associatedwith Glossop all his life. He was the first medicalofficer of health of the Glossop borough and district,honorary surgeon to Wood’s Hospital, Glossop, and heldvarious other local appointments. Mr. Rhodes had an

extensive private practice and worked hard at his profession,but found time to devote to scientific and philosophicsubjects. He was a member of the Manchester Literary andPhilosophical Society and a justice of the peace for theborough. The respect in which he was held was evidencedby the large number of borough officials, representatives ofsocieties, and personal friends who followed his remainsto the grave.

BoRIC ACID IN BUTTER.-At Pontypool police-court on April 23rd a grocer of Garndiffaith was fined £5,including costs, for selling butter adulterated with boricacid. The county analyst said that the sample contained91 grains of boric acid to the pound; he had examined over400 samples of articles for boric acid, but the highestpercentage he had observed prev. usly to this case was 63grains to the pound.