1551

Ulster being present. Dr. G. Gray, Newcastle (Ex-Presidentof the Branch), occupied the chair and the following motionswere carried unanimously :-

1. That in view of the interpretation placed upon Article 28 of theNew Dispensary Regulations in Ireland, given by the Court of Queen’sBench, this meeting of the North of Ireland Branch of the BritishMedical Association desire to express their opinion that the rule as itstands will inflict an injustice and a hardship on the dispensarymedical officers, will prove detrimental to the proper and efficient dis-charge of their responsible and practically unceasing duties to the sick

poor, and will tend to be a constant source of friction between theboards of guardians and their medical officers.2. That this meeting therefore urgently pray the Local Govern-

ment Board to take such immediate steps as may be necessary to makeArticle 28 so clear that there shall be no doubt in the future as to itsintention, as already avowed by the Local Government Board.

3. That a deputation consisting of the president, secretary, andtreasurer of the North of Ireland Branch of the British MedicalAssociation; the president and secretary of the Ulster Medical Societv ;Dr. Magennis, J.P. (Lurgan); and Dr. Robert Gray, J.P. (Armagh), beappointed to lay before the Local Government Board in Dublin theviews of this meeting.The following gentlemen spoke on the above resolutions.Mr. W. A. McKeown, Dr. F. P. MacLaughlin (Strangford),Professor Byers, Professor Whitla, Dr. H. L. Torrens, Alder-man J. Graham, M.D., Dr. J. W. Watson (Limavady), Dr.W. Thomson (Anahilt), and Dr. Samuel Agnew (Lurgan). Ahearty vote of thanks was passed to the chairman. It is hopedthat this large and representative meeting of the medicalprofession in Ulster (74 members were present and there wereapologies from 43 who were unable to attend) will have its dueweight in strengthening the Local Government Board, so

that instead of a rule worded in such a vague way as atpresent-that a dispensary medical officer is entitled to aholiday not exceeding four weeks "-they will make itclear and definite that the holiday is really meant to be fourweeks.

Outbreak of Typhoid Fever in Belfast.At the Public Health Committee meeting on May 17th the

medical superintendent officer of health reported that duringthe past week 49 cases of typhoid fever had been notified,which was a greater number than in the previous week.Every effort had been made to ascertain the cause of thisincrease, but without satisfactory result, as many of thecases had occurred in the better class of workers’ houses.The reports of the drain tests in these cases were ordered tobe submitted and steps were directed to be taken with aview to combating the disease. The death-rate for the week

ending May 12th had been from all causes 20’0 per 1000,and from the principal zymotic diseases 1’5, while in the

corresponding week of last year the death-rate from all causeswas 24’6 per 1000, and from zymotic diseases it was 2-2.May 22nd.

PARIS.

(FROM OUR OWN CORRESPONDENT.)

The Admission of Lunatics into Asylums.A CIRCULAR has recently been issued by the Director of

the Assistance Publique and addressed to the head of everyhospital calling their attention to the extreme facility withwhich hospital patients can be transferred to a lunatic

asylum simply at the request of the medical officer in chargeof the ward. Supposing such patients become noisy or restlessvery often they are simply transferred to get rid of them.The rigorous formalities which are demanded by the lawbefore an ordinary person can be placed in a lunaticasylum are reduced to practically nothing in the case

of a hospital patient. The medical officer in chargeof the ward has simply to sign a transfer order and thepatient is removed to the asylum without further ceremony.Owing to this custom the asylums which are alreadyovercrowded have become altogether insufficient. Therehave been instances of regular abuse on the part of certainsurgeons who wanted to get rid of sick persons or old patientswho were inconvenient in their wards. Not so very long agotwo patients in the midst of an attack of typhoid fever weremoved from two hospitals to the lunatic asylum of St. Annewhere they both died within 48 hours after admission. Athird patient who was comatose was also taken to the asylumand died on the same day. The certificate of the medicalman and of the police commissary set forth that he was quiteincapable of answering any questions on admission. Underthese circumstances the Prefect of the Seine has issued in-structions to the director of the lunatic asylum that he is to

send back to the hospital whence they come patients whoare sent to him in this way by physicians or surgeons.

The Exhibition.The various classes of exhibits connected with medicine

are gradually becoming organised. The exhibit of surgicalinstruments which is in the Champs de Mars and is beingbrought together by Professor Berger promises to be one ofthe most interesting, especially as regards the historical partwhich is much enriched by the generosity of many col-lectors. The sanitary organisation of the Exhibition is by nomeans above criticism. It is true that there is a plentifulsupply of spring water for alimentary purposes, but appa-rently the ambulance stations provided in case of accidentsare not numerous enough and are too far apart the one fromthe other. Then, too, owing to the crowds in the relativelysmall space allowed for the circulation of the sightseers anypanic would be the cause of injury to a number of peoplewhom it would be difficult to attend to immediately. It is

interesting to note that the space allotted for circulation ofsightseers as compared with that allotted to edifices hasdecreased with every exhibition. That of 1889 occupied960,000 square metres, of which 290,000 were occupied byedifices. That of 1900 occupies a space of 1,000,000square metres, of which 460,000 are occupied by edifices,and the number of exhibitors is this year 140,000 instead of95,000 as in 1889. Among the innumerable offers held outto foreigners by commercial bodies of every kind whichdesire to make their fortunes this year there is one, simplygrotesque, which is of interest to the medical profession. Itis a quack establishment, of which so many exist in Parisunder the deceptive name of "institute," which announcesin a lay journal that at its offices the visitor will find at anyhour of the day doctors of medicine speaking every language.Another, in return for a subscription which will last for oneweek, one month, or 10 months, the sums varying from10 francs to 75 francs, offers to provide any medical, surgical,or dental attendance that may be necessary.May 19th.

______________

BERLIN.(FROM OUR OWN CORRESPONDENT.)

Researches on Carcinoma and Syphilis.A HIGHLY interesting communication has been made

to the Centralblcctt fiir Bacteriologie by Professor Schüllerwho has discovered in malignant growths - sarcomaas well as carcinoma-corpuscles of a very characteristictype in different stages of development. According tohis description these corpuscles were of a round or ovalform, their size being three times that of the red corpusclesof the blood and their colour golden-yellow or brownish ; theyrefracted light strongly. They consisted of a solid, resistant,refracting, light-coloured capsule containing protoplasm ofa darker hue. Under certain circumstances the capsuleshowed not only different strata but also stripes. On thesurface of the capsule there were pores. The protoplasmwas of a granular texture in some cases. In cultures therewere also organisms, the capsules of which had burst andthe escape of the protoplasm had left the capsules empty andfolded. In living cultures ciliated protuberances were to beseen penetrating through the pores. Unstained specimenshardened in alcohol and cleared in oil of lavender were usedfor microscopical examination. The organisms were dis-

tinguished by their characteristic colour and brightness.They had been found by Professor Schuller in every specimenof carcinoma and sarcoma, both fresh and hardened, whichhad been taken from malignant growths of the tongue, thelips, the rectum, &c., and from melano-sarcoma. He hadalso made cultures of the organism, for which purpose onlyrecent growths, not yet degenerated, were used. He cut

pieces from the centre of the growth and kept them in glassvessels at the temperature of the human body, the tissueof the growth itself being used as the culture medium.When the culture was successful after a few daysgrey droplets were seen which, on microscopical exa-

mination, were found to consist of small bodies ofthe above-described species ; in some instances the

capsule contained protoplasmic substances, in othersthere were folded capsules without protoplasm. He hadendeavoured to infect animals with these organisms, but theexperiments were not yet finished. The organisms obviously

1552

belonged to the protozoa. He somewhat cautiously suggestedthat there might be a connexion between these organismsand the pathology of carcinoma. Another communicationby Professor Schiiller to the same journal was devoted tcorganisms discovered by him in every stage of syphilis, fromthe primary chancre to the tertiary form and in hereditarysyphilis also. In primary chancre he had found very smallorganisms with a double-lined capsule and brown proto.plasm, their shape being generally oval. They were best seenunder a magnifying power of 1000 diameters. In chancre,when the specimen had been stained in a solution of iodineand iodide of potassium, fine canals were seen going fromthe surface to the interior filled up by corpuscles of the formof conical bullets in which the above-described micro-

organisms were situated. They were present in fresh tissuesonly in every instance and were especially numerous in

hereditary syphilis. Cultures were less successful than inthe case of malignant growths, especially those from chancres,whilst cultures from the lymphatic glands gave a betterresult. The development of the cultures was very similar tothat of malignant growths. Professor Schuller believed thathis discovery was of great importance in connexion withthe etiology of syphilis. His observations, if verified byother pathologists, would certainly cause a great sensa-tion. It must, however, be remembered that in carcinomaand syphilis micro-organisms alleged to be the cause of thedisease had already been described by several authors, buthitherto all these discoveries had ended in disappointment,and the medical profession would therefore do well not to betoo sanguine when announcements were made relative to theetiology of cancer or syphilis.Researches on Vaccine Lymph and Toot-ahd-Ho?tt7t Disease.

Dr. Siegel, whose observations of foot-and-mouth diseasein the human subject have been already mentioned inTHE LANCET,I has written to the Deutsche MedicinescheWochenschrift, mentioning that he has discovered severalclasses of micro-organisms in the vaccine vesicles of vac-cinated calves and also in the vesicles of foot-and-mouthdisease in cattle. The first variety of these organisms isdescribed by him as consisting of spherical or oval bodiesresembling cysts, of a brownish colour, and from 10 to 18 µin diameter. The capsule has two layers, an externalone with radiating stripes and an internal smoothone. The capsule is sometimes torn. The organismsof the second group are smaller, being from 6 to 8 Ain diameter ; they are lighter in colour and are

covered with a visible membrane. Sometimes they aregranular and it is very likely that they are contained in thecapsules of the first-mentioned group. The third group con-sists of organisms belonging to the second group broken upinto a great number of very small round corpuscles which aredispersed somewhat uniformly throughout the specimen. Thediameter of the smallest organisms is hardly more than ¼ µ,their colour being yellow. There is no difference betweenthe organism detected in the vaccine vesicles and in foot-and-mouth disease. The above-mentioned large cyst-likebodies are rather rare, whilst the small corpuscles are verynumerous. It has not been possible to stain them and theyare very resistant against acids and alkalies.May 22nd.

___

EGYPT.(FROM OUR OWN CORRESPONDENT.)

The Assouan Reservotr.ASSOUAN has long been famous to tourists _for the first

cataract met with in going up the Nile and as the site of thePtolemaic temples of which the best known is Philæ. Here

may be deciphered no less than six languages cut on thetemple wall, hieroglyphic in abundance, some demotic(being a copy of the famous Rosetta stone), many Greek lines,Latin inscriptions in honour of the Roman Cæsars, Frenchnames of generals who pursued the Mamelukes thus far in1798, and lastly a memorial tablet in English to perpetuatethe fame of those of the Heavy Camel Brigade who fell in1884 while unsuccessfully struggling to relieve Gordon atKhartoum. Readers of a medical journal may perhaps bereminded that at Philm there was a celebrated templein honour of 2E4 sculapius, dating from the liberal times

1 THE LANCET, April 6th, 1895, p. 901.

when anatomy was a permitted study, when Herophilus andErasistratus became famous as dissectors, and whenAlexandria was the home of the museum and the centreof the world’s science, including medicine. Herophilus issaid to have described the best quality of a physician as" the power to distinguish the possible from the impossible."This is also true to-day of the world’s engineers, and onecannot but wonder what the immortal shades hovering aboutPhilæ think of the five years’ work which has for its objectthe damming of the great river which for countless ageshas leapt joyfully through the granite rocks. The work ofthe last two years has been so far a great success, andnow at lowest Nile all the eastern channels are stoppedand a huge granite wall is rising like a mightybreakwater. An army of 7000 Egyptians is workingat a high rate of pay and about 500 Italians are

cutting granite, because they do it so much more quicklyand better than the natives. All ar6 under the ordersof 150 British artizans, and practically all the engines andrailway plant and huge cranes have come out for the workfrom England. And the present motto is " Hurry ! " becausein three months the Nile flood will be down and then nomore can be done to strengthen foundations and to eat outthe grey granite which is not considered good enough totake part in a work which will some day rival the Pyramidsand the Suez Canal, and stand, whatever may happen, as apermanent monument of the English occupation of Egypt.The low Nile of this year is a nuisance to everyone but theengineers at Assouan, because it enables them to delvedown sometimes 100 feet to look for faults in the rocks andto blow up with dynamite any masses of doubtful consistency.At a quarter to 12 every morning a warning syren sings andeveryone scuttles away from the works to lunch and safety,with the exception of half a dozen firemen who remainbehind. At noon the syren is again heard and from avantage ground in the distance the men can be seen run-ning nimbly about the abysses to light the fuses to whichthe long dynamite cartridges are attached. And then isheard a sort of artillery feu dejoie, and for ten minutes atintervals masses of granite hurtle through the smoke andplunge into the pools of water yards away. And all thiswork must go on every day except Sunday and, exceptduring the three months of the Nile flood, until three moreyears are over, and the Europeans must be content to livewithout luxuries in mud-brick huts, the walls of which areoften made three feet thick. For this is the only way tokeep out the sun by day and to get comparatively coolnights in a tropical summer where the midnight temperatureis often as high as 100° F. But the men are healthy enoughand those who do not drink and who wear huge helmetsstand the hot sun very well.

The Aird Hospital.Messrs. Aird and Co. established a hospital soon after the

work began and they have been generous in carrying out allpractical suggestions made to them. Dr. Schmidt, an

American surgeon, organised the building of several isolatedhuts and prided himself on having a perfect operatingtheatre complete in every antiseptic detail. Now, after anattack of typhoid fever, he has resigned and his place hasbeen taken by Mr. Arthur White, late of the medical staffof the Uganda Protectorate. The assistant medicalofficer is a Syrian who was educated in London.The bulk of the patients, as might be supposed, are

suffering from injuries or from the effects of dynamiteexplosions, nearly all due to the carelessness of the workers.Familiarity with blocks of granite or with powerful cranesbreeds contempt, or the dynamiter tries to dig out an

unexploded fuse to save himself the trouble of boring a newhole for a second cartridge. The typhoid fever hut was emptywhen I visited the hospital, but in the isolation hutsthere were one case of erysipelas and two cases of small-pox. One of the latter was a mechanical engineer,responsible in his spare time for making ice and soda-waterfor the camp. Unfortunately he had declined to bevaccinated and he has now lost his life in consequence.During the last month more than 600 natives have willinglybeen revaccinated, and I now hear that the engineer’sdeath has converted the rest of the objecting Europeans.

Plague at Port Said.Just two years ago Egypt was startled by hearing of a

case of plague at Suez on a steamer in dock, but fortunatelyit was apparently the first sporadic case and thanks to thegreat care of Dr. J. E. Cresswell there were no further