127PARIS.-BERLIN.

PARIS.(FROM OUR OWN CORRESPONDENT.)

Presentation of Medals to Dr. Roux.

AT the end of last year the Municipal Council decided tooffer, on behalf of the City of Paris, a medal to Dr. Roux,"pour rendre un solennel hommage à ses beaux travaux scien-tifiques si utiles à l’hnmanité." The Conseil Général of thedepartment of the Seine adopted a similar resolution a fewdays later. Two gold medals were accordingly struck bearingon one side the effigy of the Republic designed by Chaplain,and on the other the words" À Docteur Emile Roux, le Dé-

partement de la Seine," and "Au Docteur Roux, la Ville deParis. " The ceremony of presentation took place on

Thursday last at the Hotel de Ville, where there awaitedour eminent confrere the members of the Bureauxof the two Councils, the Prefect of the Seine, andthe Prefect of Police. In the course of the com-

plimentary references made by the President of theMunicipal Council to Dr. Roux’s researches on diphtheria,he said : "Vous avez droit au plus précieux des remercie-anents, à celui des meres que vous avez rassurées et dont vousavez calm6 les angoisses." The following letter fromM. Pasteur was then read :-

"Monsieur le President,"Je regrette infiniment d’etre dans 1’impossibilite de me rendre a

’invitation que vous m’avez fait 1’homieur de m’adresser. Lorsqu’en1892 le president du Comeil municipal in’exprimait les vceux des elus4e Paris et me parlait de la reconnaissance populaire, il me causait unede ces emotions qui font qup toute une vie de travail se trouve reeom-pensee en une minute et par uu mot. Rien ne semblait pouverdepasserla joie que vous m’aviez donnée en ce jour de mes soixante-dixans. Bt cependant, ce que la municipalité de Paris veut faireaujourd’hui me touclie encore davantage. Vous fetez celui quifut mon élève, mon cher collaborateur, M. Roux. Ce que j’auraisvoulu dire devant lui et apres vous. Monsieur le President, c’est qu’endehors des services rendus a la population parisienne par le traitementde diphterie M. Roux contribue par ses r’ou.s s à l’Institut Pasteur a,repandre dans le monde entier une part, d’influence francaise. Ainsi secontinue, grace ii lui, aux chefs de service et aux preparateuis, 1’couvreque j’ai rêvée: laboratoires de recherches, laboratoires d’enseignement.,travaux de longue patience pour arriver &oit aux decouvertes, soit auddveloppement de certaines methodes et iecons professees pour faireconnaitre une science nouvelle. Je remercie encore le Conseilmunicipal de ce qu’il a fait pour moi, de 1’hommage qu’il offreaujourd’hui aux services rendus par M. Roux, et des bourses que leConseil municipal a fondees a 1’Institut Pasteur en faveur d’hommespleins de merite. Veuillez agrèer, Monsieur le President. 1’assurancede ma haute comidération. " PASTECR."

Ambulatory Delirium.In the Gazette des Hopitaux of July 2nd there appears a

communication from Professor Raymond, the late regrettedProfessor Charcot’s successor, on the above-named curiousmalady, to which he gives the supplementary denomination"fugue." He points out that the condition is not partand parcel of amnesia, or even a consequence of it. In

retrograde localised amnesia, due, for example, to an injury,the events of the forgotten period are ordinary occurrences,whereas the acts characterising the fugue are quitespecial. What imparts to ambulatory delirium a special"caehet" is the association of certain eardinal sym-ptoms, the most important of which are three innumber. They are: 1. An irresistible impulse to performcertain acts. In a case quoted it impelled the patient towalk, to undertake journeys ; but the impulse may take someother channel of expression. 2. The act, whatever form itmay take, is accomplishable in an intelligent manner ; inother words, the movements are regular, coordinated, and inharmony with surrounding circumstances. The patient doesnot fall nor does he stumble against obstacles. He evendoes tot omit to pay for his railway ticket. 3. The impulsiveact performed, there is complete forgetfulness of the totalperiod covered by the said act. The fugue may accordinglybe defined as an impulsive, complicated, and quite coordinatedact followed by amnesia. These impulsive acts, or fugues,may be met with in three difeerent disorders-viz.,epilepsy, hysteria, and in the dromomania of Régis. Maythey not also occur in senile dementia ? Only last Wednesdayafternoon an aged patient of mine inhabiting the VictoriaHome, Neuilly, wandered away, bonnetless, and, discoveredthe same night by a policeman on a bench at Batignolles,some miles away, was forthwith lodged at the Prefecture ofPolice, where she remained until discovered by us on theFriday afternoon. Questioned by me on Friday at the home,she Msured me that she had never left her room. Her memoryis a complete blank as to the events that occurred during hertwo days’ absence from home. This poor old Englishwoman

had lived in Paris for over thirty years, and was wellacquainted with the topography of the city.

A Deital School at Bordeaux.It is intended to create at no distant date at Bordeaux

a school of dentistry. The promoters of the scheme are afew local dentists and a group of Doctors of Medicine, mostof whom are members of the teaching staff at the BordeauxFaculty of Medicine.

Medicine and Politics.Our French confrères dabble in politics much more freely

than ourselves. There is a fair sprinkling of them in bothHouses of Parliament, and Corseils Généraux and munici-palities are full of them. Woe to the practitioner who,having imbibed during his university career anti-clericalideas, establishes himself in practice in a "reactionary"community, and ventilates his advanced and, according tohim, enlightened opinions. His existence soon becomes aburden, and unless he be endowed with a thick skin and along purse he may soon have to seek a more congenial fieldfor the exercise of his profession. Nor are the Republicansmore tolerant, as witness the enclosed advertisement culledfrom the current number of the Progrès Medical.On demandeun medecin republicain pourune commune importante

du departement de la Vendee. Tete de ligne de chemin de fer pourun port de pécbe et une station balnéaire. Gare a 2 h. 1-2 de Nanteset à une demi-heure de la mer. Pays de vignobles. Pas depbarmacien.S’adresser á la redaction du journal, le jeudi de 3 heures a 6 heures.July 9th.

________________

BERLIN.(FROM OUR OWN CORRESPONDENT.)

The Carcinoma Antitoxin.THE article communicated by Professor Emmerich and

Dr. Scholl to the Deutsche Medicinische Wochenschrift, whichwas mentioned in my letter inserted in THE LANCET ofMay 4th, was received here with general scepticism. Thatthis feeling was justified is now proved by the publishedobservations of Professor Bruns (Tubingen) and ProfessorAugerer (Munich). Professor Bruns was quoted by theauthors as vouching for the efficaoy of the treatment, buthe now states that in no instance was a curative effect re-marked, whilst in some cases the general state of the patientswas very unfavourably influenced. Cardiac trouble andraising of the temperature were very frequent, and musthave been due to a septic condition of the fluid. To thissuggestion Professor Emmerich answered that the antitoxinwas originally aseptic and must have been spoiled by Pro-fessor Bruns or his assistants. Professor Bruns replied thatthe fluid was examined immediately after its arrival in thebacteriological laboratory of the University, and numerousstreptococci were found in it. Professor Augerer stated thattwo of his cases were attacked with real erysipelas during theantitoxin treatment. The controversy between ProfessorEmmerich and his opponents sometimes assumed a verypersonal character and continues to fill the columns of themedical papers. The general impression is that the realcarcinoma antitoxin has not yet been discovered.The Annual Meeting of the German Practitioners’ Association.

This meeting was held on June 28th and 29th in Eisenach,under the presidency of Dr. Aub (Munich). As probablyyour readers are not acquainted with the organisation of thePractitioners’ Association (Deutscher Aerztevereins-Bund) itis right to explain that it has no scientific objects, but wasfounded in order to improve the social condition of the

profession. The association. like the British MedicalAssociation, consists of district branches whose delegatesmeet every year and form the" Deutscher Aerztetag." Atthese meetings questions of general professional interest arediscussed, especially those concerning the relations betweenmedical men and the public. The delegates have as

many votes as they represent members, and the districtbranche, salthough independent, are required to observethe decisions of the meeting. There is also a councilelected annually, which meets from time to time to

prepare the business of the general meeting and todeal with urgent questions. The institution has no

official character, but depends entirely upon the voluntaryagreement of the individual urban and district branches.The meeting was opened by the chairman, Dr. Aub, who in hisintroductory address pointed out that the workmen’s in-surance laws, by which every workman was compelled tobecome a member of a sick-club, had materially affected

128 BERLIN.-ROME.

some departments of medical practice. Individual practi-tioners being powerless to struggle against the predominancyof the clubs, it becomes the duty of every medical man to joinhis district association, when he will be supported against anyunjustifiable pretensions of the sick-club committees. Anothermatter of importance, which requires the close attention of therepresentatives of the profession, is, in Dr. Aub’s opinion,the obvious deficiency of the qualifying examinations. Forinstance, a knowledge of mental diseases, which is not

required by the existing regulations, ought to be regarded asa necessity for every practitioner. Alluding to the Maria-berg Asylum trial, the chairman said that a lack of know-ledge of this branch of medicine had unfortunately causedmedical men to appear at a disadvantage in the courts oflaw. After this introductory speech the secretary reportedthat the association had now 249 district branches, with14,139 members, and that 117 delegates, representing13.407 medical practitioners, were present at the meeting.The first subject discussed was the so-called "free choice "system (freie Aerztewahl), which I explained in THE LANCETof Feb. 2nd, 1895. According to this system, a sick-clubdoes not appoint a fixed number of medical officers, but anypractitioner of the district who agrees to the club termsis allowed to attend the members. There are only a fewplaces where this system is still in operation, but the desireto have it adopted everywhere is very strong, not onlyin the profession, but also among the working men, thelatter, of course, wishing to exercise the right of selectingthe medical attendant in whom they have most confidence.The principal opponents of the new system are the speciallyappointed medical officers, who fear that they will lose muchof their income if the fees paid by the clubs are distributedamong all the practitioners of the place. The opinion ofthis meeting, where very numerous adherents of both the oldand the new system were present, was therefore anxiouslyawaited. After a very long and sometimes heateddebate the following motion was adopted : "That thismeeting is of opinion that the free choice system isthe most satisfactory both to the profession and to theclub members, and that it is therefore desirable to have thissystem accepted throughout the empire ; that, in order toavoid unjustifiable demands on the part of club com-mittees, the contracts with the clubs ought to be made,not by the individual practitioner, but by the district branches of the association." A contrary motion, pro- posed by Dr. Windels, to the effect that the free choicesystem, although theoretically preferable, would lead theclubs to ruin, was rejected by an immense majority. Onthe second day the meeting discussed the mutual relationsbetween medical practitioners and insurance companies.Several anomalies exist in these relations and ought to beabolished. In some companies, for instance, it is ufud forthe insurance agents to appoint the medical cfficers for thecompanies. At a joint conference of the council of thePractitioners’ Association and the managers of the insurancecompanies it was agreed : (1) That the medical officersshall be appointed by the managers only and not bythe individual local agents; (2) that the medical examina-tion shall take place in the consulting-room of the medicalman and not in the house of the proposer; (3) that the resultsof the examination shall be kept strictly secret ; (4) thata fee of at least ten marks shall be paid by the companyfor every examination ; and (5) that a permanent commis-sion, consisting of medical men and insurance officials, shallbe instituted in order to settle disputt d questions. In thediscussion it was stated that some medical men had beenmade liable to legal prosecution because they had giveninformation as to the health of a proposer’s relatives withouthaving previously obtained their permission. It was there-

upon decided that the companies should arrange thesematters with the families before applying to their medicalofficers for a certificate. All the other propositions of thecouncil were unanimously adopted. The next meeting willbe held at Nuremberg.June 9th.

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ROME.(FROM OUR OWN CORRESPONDENT.)

Italy out of Torvn."Two voices are there, one is of the sea, One of the

mountains," sings Wordsworth in a magnificent sonnet, andall Italy, professional or lay, is divided as to which it shall

respond to. There is so much that is to be said for eitherthat many will declare for both-if Romans, alternatingbetween the Sabine or Alban Hills and Porto d’Aezio; ifNeapolitans, between Ca.po di Monte and Sorrento ; ifTuscans, between Vallombrosa and Viareggio. Italy, indeed,suffers from an embarras de richesses of summer haunts, andnothing but her backward hotel enterprise explains the factthat she does not detain on her uplands or on her seaboard thethousands of winter residents who would gladly avoid theSwiss tourist hive or the Tyrolese ant-hill. But she musttake not one, but many leaves out of the Helvetian hotel.book before she can keep the visitors she attracts, and par.ticularly on the less familiar lines of travel she must bringher cuisine and her accommodation, above all her drainageand her water-supply, out of the rut of mediæval tradition ifshe is to spare herself the mortification of witnessirg thepaying public deserting her picturesque, historic towns forSwiss hamlets which are neither and have not even theadvantage of more invigorating air. No British practitionerin her more frequented winter cities but has lamented thesad necessity he has been under of sending his convalescents,often at great risk and greater expense, "over the water.shed," when Nature was literally holding out her hands todetain them, and nothing but the rough, sometimes revolting,hotel appointments frustrated her kindly invitation. Improve-ment is, indeed, manifest in some of the provinces; but, inMr. John Morley’s phrase, the pace is "killingly slow, andwe shall be well into the twentieth century before Italyreturns to the social refinements and attractions even afBaias or Prseneste in the first.

A Mixed Blessing.This, as THE LANCET 1 has pointed out, is a proper

characterisation of the introduction of the new remedyfor diphtheria so successfully practised in many a Earo.pean city. It has had the effect of paralysing thathygienic or sanitary movement which, in these centres, wasjust beginning to combat the diphtheritic poison at its source.By the opportune injection of the " siero difteritico" a aRoman child well-nigh moribund from the disease was theother day rescued in the most striking manner, and thenames of the physicians in charge of the patient received anattention which these able practitioners would gladly seebestowed on the faulty health conditions to which thelittle patient owed his malady. But the old adage, "Pre-vention is better than cure," is a plant of tardy growthin a semi-superstitious society, where the prestige ofa sovereign remedy " will always countervail the humblercalls of sanitary observance. Happily "igiene locale" hasbeen vigorously taken up by the communal Giunta and a" regolamento " formulated for Rome and its provincewhich will shortly be extended, on express application, to150 other communes throughout the kingdom.

The Health of the Pope.After nearly ten months of in-door life, His Holiness has

resumed of late his saunter in the Vatican Gardens-thatspacious and beautifully disposed expanse of wild wood andflower bed which slopes gently uphill from behind thePalace to the ridge of the Janiculan. The frequent fountain," shaking its loosened silver in the sun," the winding water-courses " still murmuring, as they run, to the hushed ear ofnoon, " are not less grateful to sense than to respiration,from the delicious coolness they impart under the verticalheat. After threading his favourite walks in this "maze ofamenities," as it has been called, the Holy Father retires tothe tower of Leo IV., recently adapted as a summer retreatby the architect Vespignani, from whose able hands it

; passed into others not less able in the department of internaldecoration and appointments. There the supreme Pontiffcan, on occasion, give audience to the high functionaries ofhis court ; there he can spend the forenoon and afternoon

: in study and siESta with a degree of comfort that promptedthe suggestion that he might have sleeping apartments fittedup in the tower as well. But the project found no favourwith the medical advisers who keep watch over his person,the Mons Vaticanus still retaining through the hours of nightthat character for insalubrity it received from the Augustanpoets. So before sunset Leo XIII. is conveyed back to thePalace and up the successive flights of stairs in his sedia gestatoria to the traditional dormitory of his predecessors. Howwell the life he now leads is suiting him may be inferred fromthe fact that not for many months has the august octo.

genarian been more vigorous in mind or body. Indeed, no -

1 THE LANCET, Jan. 12th, 1895, "Sero-therapy and Sanitation."